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Integrative Medicine. Enrique Saguil, MD. AKA. Alternative Herbal Chinese Natural Homeopathic Osteopathic Chiropractic Complementary. Hospitals with a CAM Department. Childrens Memorial Hospital Chicago Mayo Clinic Duke University Medical Center
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Integrative Medicine Enrique Saguil, MD
AKA • Alternative • Herbal • Chinese • Natural • Homeopathic • Osteopathic • Chiropractic • Complementary
Hospitals with a CAM Department • Childrens Memorial Hospital Chicago • Mayo Clinic • Duke University Medical Center • University of California San Francisco • All 18 Hospitals on US New’s America’s Best Hospitals
Americans are involved • 1997 harvard study- 629 to 386 mill • 1997 21.2 billion • 2002 62.1% americans used in 12 mnths • Women, higher socio level, hospitalized and former smokers (publ 2004 CDC) • NCCAM funding FY 07 121.6 million
The “practice” of medicine in the US • Alipathic--------MD • Osteopathic---DO • Chiropractic---DC • Podiatric-------DPM • Naturopathic--ND What is traditional?
Forms of “primitive” medicine • Chinese (acupuncturist) • Ayurvedic (yogi) • African (witch doctor) • Native american (medicine man) • Barber and blacksmith (?)
Hippocrates 460 BC • held the belief that the body must be treated as a whole and not just a series of parts • believed in the natural healing process of rest, a good diet, fresh air and cleanliness.
Maimonides 1135-1204 • He indicates that the physical well-being of a person is dependent on his mental well-being, and vice versa • Ruled that fear and anxiety needed to be assessed before invasive medical procedures are considered
Sir William Osler, MD 1849-1919 • “One of the first duties of the physician is to educate the masses not to take medicine.”
1st professor of medicine at Hopkins • It is much more important to know what sort of person has a disease, than to know what sort of disease a person has… (he combined physiological and psychological treatment of patients)
Dean Ornish, MD • showed that a lifestyle regimen featuring meditation, a low-fat vegetarian diet, smoking cessation, and regular exercise could not only stop the progression of CAD, but could actually reverse it. Lifestyle Heart Trial, Lancet 1990
Andrew Weil, MD …emphasizing prevention over treatment and focusing on nutrition, botanical medicines and mind-body interventions to complement conventional synthetic drug and surgery protocols
Turning Points • Frustration with traditional medicine • Lack of appropriate insurance • Lack of appropriate medical care • Intractable disease state • Previous experience with alternative care • Curiosity during healthy times • Performance enhancing
My turning point • Sports injuries • Time spent in the Philippines (herbolarios) • Exposure to Medical Acupuncture (UCLA) • Patient requests • Time spent in Florida (medicine of the south) • Dr Andrew Weil
Basic idea • Integrate traditional and nontraditional aspects of medicine • Medicines • Diets • Supplements • Exercise prescription • Stress reduction • Spirituality • Preventive medicine (misnomer)
Common examples • Traditional medical practice • Dietary evaluations (dm, lipid, gout, hbp, heart) • Physical therapy (aqua, core, endurance, manual, hand, biofeedback) • Herbalist • Instructor (sifu, yogi) • Fung shui specialist • Therapist (http://www.emofree.com)
Americans have no choice • Obesity= 15% 1980, 27% 2002 • Food industry 1 trillion • Medical industry 1.4 trillion • Physicians becoming technology dispensers pressed for time • Insurance doesn’t pay for wellness (diet and exercise)
Complementary and Alternative improving choices • NIH branch (NCCAM) • Insurance pays some (+FSA and HAS) usually chiro • 2005 IRS allowed CAM deductions (acu and chiro) • Representative from Texas…"truthful health information about supplements and natural remedies”…as a platform.
Typical office visit • History! History! History! • “Bandaid” medicine review • Dietary evaluation • Review of exercise/ exercise prescription • Stress reduction • Supplement use
Testing • Traditional physical exam • Standard blood testing • Specialized blood testing (spectracell) • Baseline radiology • Specific testing (stress tests, biopsy) • Alternative exams (tongue, pulse, muscle)
My Standard tests • For your eyes only
“Biophysical250” biomarkers • Autoimmune ds • Cancer • Cardiovascular • Cell signaling • Diabetes/metabolic • Hematology • Hormonal • Immune/inflamm • Infectious disease • Nutritional • Organ system • Osteoarthritis $3500.00
The Antiinflammatory Diet • Loading up on junk foods, high-fat meats, sugar and fast foods will increase inflammation in your body. • …unhealthy fats used in preparing and processing these foods, especially trans fats and saturated fats • -chemicals such as nitrites that are associated with increased inflammation and chronic disease. • Diets high in sugar have also been associated with inflammation
Antiinflammatory Foods • Breakfast could be oatmeal served with fresh berries and walnuts, with a cup of soy milk. • Snack on whole fruits, nuts, seeds, and fresh vegetables throughout the day instead of cookies and candy. • Eat more fish and less fatty red meat. • Stay away from deep fried foods and bake or stir fry your meals instead. • Choose green, orange, and yellow vegetables for your side dishes. • Drink plenty of water, fresh 100% fruit and vegetable juices, herbal teas and green tea.
Dr Weil’s Approach • Appendix in “Healthy Aging” • http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet
Dean Ornish’s Approach • Reverse plaque formation • Reverse high psa
The Spectrum • Less sat fat • Fewer trans fat • Fewer simple carbs • More unrefined complex carbs • Lose weight • 3 gms fish oil daily • Add soluble fiber • Curcumin • Red yeast rice • Niacin
The Spectrum (controversial) • Garlic • Guggul • Beta-sitosterol • Policosanol • Pantethine • Chocolate • Don’t forget: • Exercise • Stress reduction
Rush Copley Opportunities • Education with your primary care doctor • Education with a registered dietician ……(630) 978-4851 clinical nutrition svc, but remember to inquire with insurance 1st • www.eatright.org
Activity • Burn excess calories • Condition the heart • Massage the brain • Assist the gi tract • Stretch muscle
Flexibility and exercise combo • Tai Chi • Yoga Classes at the Rush Copley Healthplex include several different forms of Yoga
Nutritional Supplements • Non FDA regulated • US factory • Pharmaceutical grade • Cleared by banned substances control group
Exercise, diet and supplements • Every patient is different • Get help from trainer, therapist • RD, MD and nutritionist • MD, ND or Herbalist • Read! Research! Call! Redo!
Standard supplements for all • Omega 3 fish oil • Acidophyllus • Antioxidants • Multivitamin • Antiinflammatory (unless very good with diet) Whole foods, Second opinion, Village Herbalist, The Herb Shoppe