1. Integrative Healthcare Symposium 2015 Presented by: Jacob Hwang Doctor of Naturopathic Medicine Candidate 2016 February 19-21, 2015 New York Hilton Midtown, NY _____________________________________________________ Funded by Bastyr University Student Council

2. Integrating Emotional Freedom Techniques (EFT) into your Practice  Presented by Nick Ortner  Dr. Roger Callahan combined quantum theory, kinesiology, and acupressure to help patients with phobias and traumatic stress disorders  Gary Craig, a engineer at Stanford University worked with Dr. Callahan to develop a system of tapping points = EFT

3. Integrating Emotional Freedom Techniques (EFT) into your Practice  Theory or mechanism behind EFT: Tapping on the acupressure points along the meridian sends a calming signal to the amygdala  Tapping helps reset the hippocampus  Comparing past threats with present signals  When to use EFT?  Stress, anxiety, panic attacks, fears/phobias, trauma, anger, insomnia, grief/loss, enhancing self-esteem, pain management, addictive cravings.

4. Integrating Emotional Freedom Techniques (EFT) into your Practice  The tapping points:  Inferior to the eyebrow towards the midline  Lateral to the eyes  Inferior to the eyes  Inferior to the nose, but superior to the lips  Inferior to the lips, but superior to the chin  Infraclavicular fossa towards midline  4 inches below the arm, in the armpit

5. Principles of Integrative Cancer Medicine  Presented by Dwight McKee, MD  Integrative Oncology  Conventional: military style model of medicine  Destroy tumor cells  Traumatic, dietary concerns in calories only  Complementary/Alternative: support multiple systems during intervention  Increase host resistance to tumor cells and improve health  Tends to have nourishing treatments with dietary programs focused on enhancing the host and “starving” tumor cells.

6. Principles of Integrative Cancer Medicine  Old view – Somatic mutation theory  Cancer is a linear process: mutations occur and it grows into a tumor. The tumor needs to be removed  New view – Tissue organization field theory (TOFT) by Sonnenschein and Soto  Early cancers may spontaneously regress  Established cancers may stay dormant  The focus is on changing the terrain to prevent tumor progression and promote tumor regression  http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3882065/

7. Principles of Integrative Cancer Medicine  Effects to consider?  Nutrient availability  Changing the terrain/microenvironment  Epigenetic mechanisms  Utilizing the immune system  Reduce tumor burden  Immunotherapy

8. Functional Nutrition: Transforming Patients through the therapeutic use of food  Presented by Kristi Hughes, ND  Director of Medical Education at The Institute of Functional Medicine  “Functional nutrition emphasizes the importance of high quality foods and phytonutrient diversity to address clinical imbalances and move individuals towards the highest expression of health” – IFM  Phytonutrient spectrum foods, elimination diet, cardiometabolic, detox, and energy

9.  G for Gather:  Medical hx,  ABCD (anthropometrics, biomarkers, clinical indicators from physical examination, diet journals) evaluation  Nutrition status  O is for Organize:  PFC-MVP (Proteins, Fats/Oils, Carbohydrates, Minerals, Vitamins, and Phytonutrients)  Points of Connection  Pattern Recognition  I is for initiate  Further evaluation  Nutrition care plan  Patient education Functional Nutrition: Transforming Patients through the therapeutic use of food

10. Never only opioids: policy trends, patient experience, and practice models in treating people with pain  Moderated by John Weeks  Panelists:  Heather Tick, MA, MD  Martha Menard, PhD, LMT  University of Virginia School of Medicine study  150 in-depth qualitative interviews and content analysis of self-reported narratives with people living in chronic pain and physicians involved with medical errors  Many cultivated positive attitudes while demonstrating persistence

11.  Myofascial pain  Healing abilities  The benefits of opioids?  Acute use  Chronic use  History of opioid use in US  Long term opioid therapy (> 3 months) Never only opioids: policy trends, patient experience, and practice models in treating people with pain

12. Environmental Influences on Health: Research, Preventions, and Treatment Strategies  Moderated by: Susan Luck, RN, BS, MA, HNC, CCN, HWNC-BC  Panelists:  Robert Rountree, MD  Walter Crinnion, ND  Devra Davis, PhD, MPH

13. Environmental Influences on Health: Research, Preventions, and Treatment Strategies  Robert Rountree, MD  Save the bees: stop pesticides and use untreated seeds  Colony collapse disorder  Neonicotinoids: block nicotinic acetylcholine receptors of insects  Most widely used pesticide in the world  No data and studies  War in toxicology  Old school vs. new endocrinology research

14. Environmental Influences on Health: Research, Preventions, and Treatment Strategies  Walter Crinnion, ND  Air pollution  Possible correlation with CVD, DM, obesity, cognitive decline?  Low dose exposure of chemicals  We all have a toxic load  141 toxicants in everybody – CDC  Every single one is a mitochondrial toxicant  What to do? Avoid!

15. Environmental Influences on Health: Research, Preventions, and Treatment Strategies  Devra Davis, PhD, MPH  Cell phone use  Reduction in sperm count, potential carcinogen?  Experts are currently advising the WHO  RF exposure in phone: keep phone at least 5 mm away  Air pollutant  Smaller the particle, the deeper it goes  Increased CV incidence

16. Spotlight on Pain Management, Hands-on Experiential Education  Presented by Hal S. Blatman, MD, DAAPM, ABIHM  Pain is body’s communication of injury and damage  X-ray/MRI and other diagnostic imaging do not show most injuries of chronic pain – not helpful  Standard treatments generally not effective, the pain continues

17. Spotlight on Pain Management, Hands-on Experiential Education  The importance of fascia  Most underappreciated tissue in the body  Cleaned off in anatomy dissection  Injury to fascia provides key to understanding pain  Connective tissue  Hard to assess damage  Difficult to prove damage

18. Spotlight on Pain Management, Hands-on Experiential Education  Fascia is more innervated than muscle  Myofascial pain  Localized  Referred  Bodywork and fibroblastic activity  Stressed fibroblasts secrete inflammatory cytokines for repair  90 seconds of osteopathic stretch/compression can undo inflammatory changes from a 8 hr strain  Manual therapy may affect physiological responses

19. Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases  Presenters:  Lawrence D. Rosen, MD  Benjamin Kligler, MD, MPH  Aviva Romm, MD, CPM  Functional Medicine Model  Genomics, Proteomics, Metabolomics, Phenomics  Prevention > Treatment  Safest, most effective, and most cost-effective strategy

20.  Case 1: Asthma  Benjamin Kligler, MD  Increasing asthma cases? Hygiene hypothesis  Dietary manipulation  Milk, eggs, chocolate, soy, citrus, nuts, wheat, corn  Skin testing does not correlate with clinical symptoms  Elimination diet  Fish oil  Cochrane review shows no clear consensus regarding the efficacy of fish oil for asthma  Vitamin C and lycopene moderately effective  MBM for stress-related triggers for asthma  Evaluating atopic disorders Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases

21.  Case 2: Juvenile Rheumatoid Arthritis  Aviva Romm, MD  4 R program  Remove triggers and irritants  Repair the intestinal tract: L-glutamine, aloe vera gel, DGL, marshmallow root  Replace: digestive enzymes and HCl  Reinoculate: probiotics Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases

22.  Case 3: Inflammatory Bowel Disease  Larry Rosen, MD  IBD is a Gut-Brain-Immune syndrome  Immune dysregulation  Nutrition  Anti-inflammatory spices, antioxidants, omega-3 fatty acids, lean proteins, fermented/cultured foods  Vitamins D3, B12/folate  Iron, zinc  Do not use glutamine in children with IBD  Botanicals  Curcumin 1-4g/day in one study  Aloe vera  Boswellia Pediatric Mastermind: An Integrative/Functional Medicine Model for Complex Pediatric and Adolescent Cases

23. Mitochondrial Performance – Essential for Hormonal and Organ Function  Presented by Chris Meletis, ND  Epigenetics in mitochondria  Important mitochondrial nutrients: CoQ10, acetyl-L-carnitine, alpha-lipoic acid, carnosine, benfotiamine, riboflavin  A mitochondrial foundation…  Steroid hormone biosynthesis  Mitochondrial dysfunction involved in most diseases  Glucosamine as a new option in rejuvenating mitochondrial DNA?  Many medications can cause mitochondrial dysfunction  Directly or indirectly: inhibit mtDNA transcription/ETC or free radical production

24. Unraveling the mysteries of the Eye  Presented by Robert Abel, MD  Study from Harvard demonstrated that doctors tend to make a diagnosis in 18 seconds  Compare this to Sherlock who was always skeptical  Medicine is rational/linear thinking + artistic/non-linear thinking  80% of dx can be made from patient

25. Unraveling the mysteries of the Eye  Eyes can tell you clues  Relationship to different organs (brain, liver)  Vision is more than just an eye trait  Four stressors to the eye  UV light  Poor nutrition  Unhealthy lifestyles  Stress  Eye-brain connection  Connection to the world  Vision

26. Global Pain & Fatigue Syndromes Assessment and Treatment: When it is Fibromyalgia and When it is Not!  Presented by David Brady, ND, DC, CCN, DACBN  The different names of fibromyalgia  Fibrositis, Psychogenic rheumatism  Diagnostic criteria by ACR was created for research purposes  Central sensitivity syndrome  Perception of pain rather than a peripheral problem  CFS is not FM  Great FM masqueraders: sub-optimal thyroid function, myofascial pain syndrome, and sub-optimal mitochondrial/energy metabolism

27. Effective Treatment of CFS, Fatigue, & Fibromyalgia  Presented by Jacob Teitelbaum, MD, ABIHM, ABIM  SHINE = Sleep, Hormones, Infections, Nutrition, Exercise as able  Treatment recommendations:  D-Ribose 5 g TID for 3 wks, then BID  With B-complex vitamin  Good quality sleep (8-9 hrs)  Passionflower, wild lettuce, lemon balm, valerian, hops, L-theanine  Treat hormonal deficiencies (thyroid)  Promote weight loss  Adrenal support  Glandular extracts, Vitamin C, B5, licorice, DHEA (if low)  Treat chronic infections  MBM  Other CAM therapies  Medications for FM pain (do not use Tylenol or NSAID)

28. Thank you for listening! For more additional questions from any of these talks, please feel free to send me an e-mail.