Integrative Approach to Pain

Last Friday, January 29, 2010 -  I gave a lecture on the Integrative Approach to Pain during the UP Grand Scientific Symposium.  I was happy to see old friends, classmates, dorm mates.  I was extra happy to discover that there are doctors who are interested to collaborate and truly be integrative in our approach to pain. Integrative meaning bringing together the safest and most effective modalities whether conventional and alternative or a combination.

The lecture presented our experiences in our clinic following the integrative approach to pain. What has worked for our patients, and which situations needed co-management with conventional pain specialists. We have almost 15 years of experience and this has made it possible for us to speak with conviction, and with so much freedom. I know this is what the doctors wanted to hear.

I included the 18 studies on pain using Anthroposophic Medicine evaluated for the HealthTechnology Assessment Report submitted to the Swiss Federal Government. These were well researched studies that showed statistically significant improvement in pain when using Anthroposophic Medicines. Conventional medicines were not necessary. The anthroposophic remedies were well tolerated with very minimal side effects.

The integrative appraoch allows us to develop a program for our patients following the 4-fold approach of Anthroposophic Medicine. Thus our pain management includes: Physical Body Nutrient Therapies and other remedies; Etheric Body Massages and other Energy Body Treatments; Artistic Therapies for the Emotional Forces and Biographical Counselling to address the Human Spirit which provides the inner strength to conquer the pain.

From our experience, acute and severe pain may need co management with conventional pain specialists. For example, we had to refer our patient with breast cancer in severe pain to an anesthesiologist for a nerve block.

But what i have observed is that the 4fold programs we develop for the patient broadens the possibilities for them and more important gives them the venue to take part in their own pain management. They discover what has brought about the pain, and how they can address it using their self-regulatory mechanisms.

The message i left was: if you or your loved one is in pain , unrelieved by any of the conventional modalities we have today— wouldnt you want to start thinking outside the box? and think integrative?

Eventually, the will to go on a healthy diet kicks in

For those of us who do not believe in New Year resolutions, but decided to start living a healthier life years ago,  this is what i found out:  eventually, the WILL to go on a healthy diet kicks in!

Just persevering on a regular exercise at a minimum of 40 minutes 3x a week according to research —- can prepare the body to submit to a healthier eating pattern.  Eventually, you no longer crave for  that which will just add to your liver roll or liver rolls — thats the one that rolls out when you sit down.

then slowly, it will just be fine to reduce the carbs and have more of the protein and lots of the low carb vegetables.  The low carb vegetables are usually the leaves – just make sure you have many nice dressings (that are also not too fatty).

The will to be healthy is something you think about, decide to do — and then let go of the thought.  Slowly, the will to do what one needs to do — just kicks in  and you stick to it because it feels much better.  Less anger with tighter clothes, less breathlessness going up the Guadalupe MRT steps and less not-very-nice- remarks from friends and family.

Where did this WILL to do Healthy come from after all?

Conversations with Dr. C Tautz 3

During the visit of Dr. Tautz to Clinica Blumea – he saw several children diagnosed to have asthma who needed steroids.

Is this really asthma or a normal response of a hyperactive mucosa responding to allergens or toxins?  The former may need steroids but the latter may be managed conservatively through supportive measures.  Eventually, the child can outgrow the hypersensitivity.

But this can be a difficult situation to manage both for parents and doctor and one must find the best treatment , for every child, for every given time.

The question to ask is : What actually happens to the mucosa that is chronically given steroids?

Conversations with Dr. Tautz 2

The Clinica Blumea Medical Team and Dr. Christoph Tautz had another soul searching theme for conversation.  As responsible medical and nurse practitioners,  shouldnt we be also aware of what actually happens to the prescribed antibiotics, chemotherapeutic agents, hormones and even nutrients especially those synthetically produced, or dyes we used in our diagnostic tests  when they exit the body ?  Perhaps we have not really explored this angle of our practice but just being aware that these could actually have an environmental impact will help us prescribe with caution.  Thus, the medical dictum we all follow –First, do no harm — means do no harm to the person and also the environment.  This does not mean that we should not prescribe therapeutic agents that are definitely necessary and life saving. The question is a reminder for us to study the matter and take the necessary precautions inour actions.  The question also brings us to work towards safer modalities and substances for diagnosis and treatment.  Many are now aware of the need for nutritional supplements which can be cheaper if synthetically produced.  WE are also aware of the food based nutritional supplements which may in the long run be more effective, safer for both the person and the environment, although at the onset — more costly.  In the end, we all are free to make an informed choice.

Conversations with Dr. Christoph Tautz

From November 7 to 14, 2009 -  Dr. Christoph Tautz our mentor visited our clinic .  Dr. Tautz is a Pediatric Oncologist from Herdecke, Germany where he was the former Chair of the Pediatrics Department of a 500-bed Integrative (Anthroposophic) Hospital.   In addition, he has been a mentor for the anthroposophic doctors in Georgia for 15 years and thus has also gained experience in the care of adult patients.

For a week, we had precious conversations about our medical practice as Integrative (Anthroposophic ) Doctors.  And i decided to write about a few of the questions we discussed.

As an oncologist, Dr. Tautz has used Mistletoe injections (one brand is known as Iscador by Weleda)  for cancer patients.  We have used these injections too in our clinic  since 1998.     Mistletoe is one of the most well researched treatments for cancer  and thus anyone interested can surf the net to learn more about this.  It was important that we were able to talk about the immune modulating effect of mistletoe.  Mistletoe as an immune modulator thus gives the body the capacityto recognize a cancer cell and destroy it.  It is often used in conjunction with chemotherapy or radiotherapy with much success.  Often patients who are afraid of injections refuse to undergo mistletoe treatment.  It is therefore important to know what it can do for you and what the extensive research is saying.

We are singing  the Christmas carol —”kissing under a mistletoe”  —- which can actually be a “kiss for a better life”.  Eventually one actually gets used to the minute gauge 27 subcutaneous needle for a 1 cc injection of mistletoe.  Not bad after all.  And worth all the courage.

To be continued:  next conversation- “What actually happens to all the antibiotics, chemotherapy, and all the medicines that exit our body and go to the environment?”  do we know?

Anthroposophic Art Therapy – A Potential Left Untapped

Each time I prescribe an Anthroposophic Art Therapy to our patients – the response is classic —”I am not an artist” , ” I cannot sit for long” , ” I have never done art in my whole life”.

It must have been our art lessons in earlier school days that has left most of us Filipinos with a trauma about water colors, crayons, clay sculpting and the like.  I also felt the same way on my very first day in my Art therapy training course.  But I made up my mind that I will have to persevere.

I am happy I did.  I have found one of the more powerful “medicines” that we have left untapped.

Art therapy brings the “invisible to the visible”.  What is important is the listening.  It is not a time to analyze a painting and to judge whether one is nice or not.

Art therapy creates for us a space only for ourselves, a time to take care of ME.  The water colors, pastels, clay, bees wax only become a medium.  Through them , an inner transformation slowly unfolds which is actually what medicine and healing is all about.  As you go through the process, you discover something and a lot of precious insights.  For this reason, analyzing the painting is not the key.  It is you in process, discovering how beautiful and loveable you are.

After a series of art therapy sessions, it will be time to go to our laboratories to see if our blood chemistries and other parameters have also improved.

Our integrative medicine outlook makes this possible for us.

The Biochemistry Behind a Sharp and Balanced Mind

After  passing biochemistry in medical school, most of us doctors may have forgotten all about the basic processes going on in our minds.   It seems it is now time to bring back our biochemistry into our heads.

Lately , we have had the powerful experience of seeing people come back with inner joy and strength by providing nutrients that the body needs to produce serotonin, GABA, and dopamine.  We all know that these are vital neurotransmitters behind a sharp and balanced MIND.  What we have forgotten is that the body needs her nutrients so that these neurotransmitters can be produced.  Without these, we become anxious, depressed, fearful, and worried about everything.

And all these we learned in biochemistry!  If we look into our notes again – we will understand why providing methionine  and other supplements can help our depressed loved ones come back to their real selves once again.

Isnt it worth revisiting our biochemistry?

Sleeping But Not Really Asleep

For the past months, in our clinic we have had the opportunity to help people sleep better.   Sleep is becoming one of the most precious treasures of our time.  For indeed, as soon as we are able to help people sleep on their own again — they now start  looking forward to a new day.  Medically, we know we have also brought them back to the road to better health without having to take anything.

Through the chronomedicine device we use in our clinic, we have documented that some people claim to be asleep but they are not really asleep.  Their autochronic image does not show any distinct sleep structures.  And the relaxation responses through the parasympathetic nervous system is not active during the night.

What could be creating this pattern?

Through the autochronic images of several persons we have been able to come up with a few helpful hints.  Those who are watching television 1-2 hours before sleeping , do not have good sleep structures.  Thus , it may help if television watching is done earlier.   Even those taking a sleeping pill for sleep are not really asleep.  Thus, it will be worthwhile to look for other more effective ways to be truly asleep.  Some are not busy enough during the day. Thus spending time on activities that are engaging and stimulating in the morning  and the early afternoon can make the evenings quiet and restful.

Are you really asleep ?  Why not check out your nights?

Rethinking the Management of Metal Toxicity

As integrative medicine practitioners, we often do a hair analysis on most of our patients who have a chronic problem. The hair analysis as we all know determines the level of metal toxicity in the body.  I have noticed that most patients have toxic levels of at least one metal usually lead, mercury, aluminum.  Recently, i had one analysis that showed very high levels of nickel. This person had been exposed to second hand smoke at a young age.  As soon as we find toxic metals in a patient with chronic and serious problems, we start the detoxification process usuallyusing EDTA and or DMSA depending on the metal involved.  Now that most if not all of us in this toxic world are battling against these metals — shouldnt we rethink our therapeutic approach to these metals?  Is there a simpler way to handle these toxins that can be applicable to most people?  This becomes essential if we start to consider the majority who do not yet have a serious problem but have a toxic system based on hair analysis.  HOw can we start a simpler detox for them?Or since metals are homeopathically one of our strongest medications like Plumbum for instance (Lead) — shouldnt we rethink our attitude about these toxic metals and best to manage them in our bodies?

And How Should We Take Care of Ourselves as Doctors? A glimpse into integrative medicine

Since 1994, I have been handling the exposure program of medical students on Integrative Medicine.  Sometimes, the elective subject is called Alternative Medicine or Traditional and Alternative Health Care.But I tell the students, I prefer they remember the elective as Integrative Medicine —meaning there is a place for everyone. There is no one approach in medicine that is better than the other.

I invented an introductory course for the students which I entitled : And How am I Going to Take Care of Myself, As A Doctor?  Because I believe the doctors will only realize how valueable the Integrative Medicine thinking is — if they are able to see how well it can help them take care of themselves.

So often, I have encountered during the elective that students realize how well they have mastered disease , and yet they are unable to know what they should do to prevent illness and stay healthy.  Or to even take care of their simple, ordinary aches which we all go through like pimples at an older age! or backaches which is so common or weight gain.

As soon as I get my dream teaching hospital going, the first thing ill do is let the students learn prevention and wellness during first year.  While teaching anatomy, I can teach them how to use acupuncture points to massage or treat their back.  When they get to biochemistry, it is the opportune time to talk about food and their biochemical nature so they can easily understand why the statins are not really the best way to manage the lipids.  When they study physiology, it just might be the best time to teach muscle physiology and kinesthetics and learn the best physical exercise.

So if doctors at a young age start applying the simple wellness lifestyle starting with the 3 basics- food, exercise and sleep and practice these knowing the scientific basis   — then patients will meeet more and more doctors who teach what they live and not just doctors who prescribe medications.  Doctors cannot teach what they do not practise themselves.  And if these wellness habits were not scientifically explained and given proper importance during training — doctors will not know what to do , and therefore what to teach.

No wonder, it is now the general public that is mastering health and wellness.  And doctors , are just there for the disease.  Thus, it is disease that will keep the doctors secure because it is what they mastered, and what they are paid for.  Are we surprised then that we all continue to be sick and stay sick because the system is made to promote illness not health?

If we want the medical system to be healthier, let the doctors enjoy real health.  AT least those doctors who choose to be bearers of health, vitality and rejuvenation and not just of disease.  Medical students should start learning how to take care of themselves.  What they should be eating.  What exercise they can be doing. And how they can improve their sleep quality. Then they will know how and what to teach their patients.

Medical students and young doctors, do take a glimpse into Integrative Medicine, by learning how to take care of yourself before you become a Doctor Only-for -Disease.