Academic Journey

2. Academic Journey • University of Pittsburgh Medical School, Class of 1981 • University of Pittsburgh Radiology Residency • Pittsburgh NMR Institute MRI Staff Instructor • University of Pennsylvania Musculoskeletal Fellowship • Thomas Jefferson University Assistant Professor • Duke University Associate Professor, 1993 - 2004 • Musculoskeletal Radiology Section Head • Co-Founder Duke Center for Integrative Medicine • Director of Integrative Medicine Education • President, Healing Imager, Inc., 2004 - present

3. Burk DL Jr, et al. MR Imaging of Shoulder Injuries in Professional Baseball PlayersJMRI 1991;1:385-389.

4. SMRI Safety Committee • Society for Magnetic Resonance Imaging • Committee member from 1985 - 1994 • Manny Kanal, MD, Frank Shellock, PhD • Claustrophobic patients • Electromagnetic fields and radiofrequencies • Attraction of ferromagnetic objects

5. Wrench Trick - Pittsburgh NMR Institute - 1985

7. Duke University Medical Center • Series of three Anodyne Imagery trainings in 1995 and 1996 for hospital staff. • Trained 50 staff members, including physicians, nurses and technologists from a variety of departments. • Trainings positively affected more than 1000 patient interactions per week. • A senior urologist was asked how valuable the training was compared to a new surgical technique that he had learned at an expensive CME conference. He responded that he used that technique just once a month, and he used Anodyne Imagery on every patient every day.

8. Cost Analysis of Adjunct Hypnosis with Sedation during Outpatient Interventional Radiologic Procedures • Elvira V. Lang, MD, Max P. Rosen, MD, MPH • Radiology 2002; 222:375–382, Harvard University • Patients undergoing vascular and renal interventional procedures underwent either standard sedation (n 79) or sedation with adjunct hypnosis (n 82). • The cost associated with standard sedation during a procedure was $638, compared with $300 for sedation with adjunct hypnosis, which resulted in a savings of $338 per case with hypnosis. • Hypnosis reduced room time (61 vs 78 minutes).

11. 62 year old wallpaper hanger with rotator cuff tear Shoulder pain and difficulty sleeping for past 6 months. Wants to return to work without surgery. Carries 60# buckets and does overhead work.

13. Unwrapping sterile needle bubble pack

14. Acupuncture needle insertion in Liver 3

16. NIH Consensus Conference. Acupuncture.JAMA 1998 Nov 4;280(17):1518-1524 • Proven efficacy: adult postoperative and chemotherapy nausea and vomiting and in postoperative dental pain. • Promising, but further research needed: addiction, stroke rehabilitation, headache, menstrual cramps, tennis elbow, fibromyalgia, myofascial pain, osteoarthritis, low back pain, carpal tunnel syndrome, and asthma.

17. Duke: T J Gan, MD • A Randomized Controlled Comparison of Electro-Acupoint Stimulation or Ondansetron Versus Placebo for the Prevention of Postoperative Nausea and Vomiting • Anesth Analg 2004;99:1070-1075 • 75 patients undergoing major breast surgery under general anesthesia. • Electro-acupoint stimulation seems to be more effective in controlling nausea, compared with ondansetron. Stimulation at P6 also has analgesic effects.

18. Acupuncture for Chronic Pain Individual Patient Data Meta-analysis • Arch Intern Med. 2012; online Sept 2012. • Andrew J. Vickers et al. • 29 RCTs, with a total of 17,922 patients. • Back/neck pain, osteoarthritis & headache • Acupuncture is effective for the treatment of chronic pain and is therefore a reasonable referral option. Significant differences between true and sham acupuncture indicate that acupuncture is more than a placebo.

19. Is Acupuncture Safe? A Systematic Review of Case Reports. Lao L, et al. Altern Ther Health Med 2003;9(1):72-83 • 35 years, 1965-1999, 98 papers, 22 countries • 202 serious adverse events, 7 deaths • 94 cases of hepatitis prior to 1988, none since • Improvement due to clean needle procedure • Pneumothorax, 2nd most common complication • Spinal cord injury rare from okibari technique • Cardiac tamponade rare, but cause of 2 deaths

20. Incidence of Adverse Drug Reactions in Hospitalized Patients: A Meta-analysis of Prospective Studies.Lazarou J, et al. JAMA 1998;279:1200-1205. • 30 years, 1966-1996, 39 prospective studies • Excluded errors in drug administration, noncompliance, overdose, drug abuse, therapeutic failures, possible adverse drug reactions (ADRs). • Serious ADRs, 6.7% incidence, 1994 estimate of 2,216,000 ADRs/year • Fatal ADRs, 0.32% incidence, 1994 estimate of 106,000 deaths, 4th to 6th leading cause of death

22. CDC – ACE Study • Survey 17,000 Kaiser Permanente patients • Abuse, Neglect and Household Dysfunction • Number of Adverse Childhood Experiences (ACE Score) • 0 = 36%, 1 = 26%, 2 = 16%, 3 = 10% • > 4 = 12 % • the risk for the following health problems increases in a strong and graded fashion:

23. High ACE score at risk for: • Alcoholism and alcohol abuse • Chronic obstructive pulmonary disease • Depression • Fetal death • Health-related quality of life • Illicit drug use • Ischemic heart disease • Liver disease

24. High ACE score at risk for: • Intimate partner violence • Multiple sexual partners • Sexually transmitted diseases • Smoking • Suicide attempts • Unintended pregnancies • Early initiation of smoking • Early initiation of sexual activity • Adolescent pregnancy

25. Energy Therapies like Emotional Freedom Techniques (EFT) are often called acupressure for emotions. The end points of Meridians are used to help balance the body’s energy system.

26. EDANVIR Tapping (EFT)

27. EFT Discovery Statement • The cause of all negative emotions is a disruption in the body’s energy system. • EFT works through tapping on the meridians and deleting the body memory of a trauma and the charge that goes with it. • The cognitive memory in the brain will remain although it may fade in intensity.

28. EFT Case Report: Hives • College student with hives after MVA • Resolved on meds, but too drowsy to study • Hives came back immediately off meds • EFT: “Even though I had a scary, thought-I-was-going-to-die car accident, I deeply and completely accept myself.” • Hives gone, never to return, able to study

29. The Body Keeps Score: Memory and the Evolving Psychobiology of Posttraumatic Stress • Bessel A. van der Kolk, MD • Massachusetts General Hospital, Trauma Clinic, Harvard Medical School • Harvard Review of Psychiatry • 1994, Vol. 1, No. 5, Pages 253-265 • Ever since people's responses to overwhelming experiences have been systematically explored, researchers have noted that a trauma is stored in somatic memory and expressed as changes in the biological stress response.

30. Energy Psychology Mechanism • Acupoint stimulation during episodes of hyperarousal can send deactivation signals to brain structures that regulate affect. • When a memory or thought that triggers limbic hyperarousal is evoked, and acupoints that decrease activation signals in the amygdala and related brain areas are simultaneously stimulated, hyperarousal is reduced. • When the memory or thought is then reconsolidated, the strength of its ability to trigger hyperarousal remains diminished, leading (after a number of exposures to the procedure) to the extinction of the elevated limbic response.

31. The Treatment of Combat Trauma in Veterans using EFT • Traumatology, March 2009, Volume 15, number 1 • Dawson Church, PhD • 9 veterans and 2 family members • 5 days with 2 to 3 hours of treatment per day • 6 psychotherapists or life coaches • SA-45 (Symptom Assessment 45) • PCL-M (Posttraumatic Stress Disorder Checklist – Military)

32. PCL-M > 50 = PTSD • 9 of the 11 participants scored higher than 50 prior to treatment. • The average score was 62. • After treatment, the average score was 23. • After 30 days, the average score was 32. • After 90 days, the average score was 33. • www.operation-emotionalfreedom.com

33. www.letmagichappen.com • Let Magic Happen: Adventures in Healing with a Holistic Radiologist • Amazon.com paperback & ebook • EFT newsletters & video blogs • Chapters 7, 11 & 14 • 300 links for chapter references