Alternative to Integrative Medicine

Ron Mosiello D.O.

Osteopathic Manipulative Medicine Neuromuscular Medicine Southern Maine Medical Center/Prime Care Assistant Professor UNECOM

Alternative Medicine: Objectives

• • • • Grown out of “grass roots” or popular desire for a different approach to healing Has many forms, (Plant/Herb, Energy, Structural Manipulation, Subconscious/Mind) Traditional Allopathic Medicine does not have a monopoly on healing Difference between SERVING and FIXING a patient

Incidence of Adverse Drug Reactions in Hospitalized Patients. JAMA

1998;279(15):1200-1205.

• 106,000 hospitalized patients die from properly prescribed drugs • Greater than two million suffer “serious” side effects

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Geriatric Challenges and Pharmaceuticals Polypharmacy

*Decrease in GFR and liver metabolism with age *Increase in medication with age *Acute changes in mental status New med vs. infection, CVA, *Pain medication: Dizziness/Falls/Mental Status changes/Liver-Kidney toxicity/GI upset NSAIDs, Muscle relaxants, Narcotics Acetaminophen (Liver) *Financial stress (fixed income)

National Health Statistics Report, number 12, Dec 10, 2008

Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007

• In 2007, the CAM therapies most commonly used by U.S. adults in the past 12 months were nonvitamin, nonmineral, natural products (17.7%), deep breathing exercises (12.7%), meditation (9.4%), chiropractic or osteopathic manipulation (8.6%), massage (8.3%), and yoga (6.1%).

History of Medicine

History of Medicine

• • • Medicine and the Ancient World China, Egypt, Rome, Greece, Medieval Europe, Africa, South and North American Indians, India, Middle East “Bone Setting” in early colonial and early America: folk tradition dating from 1500’s Pasture (germ theory) vs. Beauchapms (host theory of disease) 1900 Medical philosophies Allopathic, Homeopathic, Osteopathic, Chiropractic, Naturopathic, Sylvester Graham

History of Medicine

• • • Allopathic Medicine in 1900: Medications Calomel (contained mercury) rapid cathartic Lead, Arsenic, Opium, Belladonna *Source: Merk Manual 1899 Rockefeller, Carnegie, Vanderbilt invest in allopathic medicine in late 1800’s early 1900’s Abraham Flexner’s report to US congress 1907 Financed by the Carnegie foundation Standardized medical education and practice 1904 160 medical schools in US, 1935 only 66

Louis Pasteur 1822-1895 French Chemist/Microbiologist (GERM THEORY)

• Host lives in hostile environment • • • • Disease invades body through harmful Germ GERMS primary invasive/destructive cause of disease Adopted contemporary medical model Created first vaccinations for Rabies and Anthrax

Pierre Jacques Antoine Beauchamp (1816-1908) Chemist Biologist Physician

• Healthy tissue immune to germ infection • • “Biological Terrain” Germs are Opportunists • • • • Support tissue health and wellbeing Nutrition/Rest/Hygiene Exercise/Emotional wellbeing

“The primary cause of disease is in us, always in us.”

Antoine Beauchamp, 1883 Theory ignored and feel into obscurity

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Have you ever wondered why only a few people get a cold after coming in contact with someone that already has one?

If Pasteur’s theory was right surely we would all ‘catch’ a cold with no exception?

HEALTH

History of Medicine: 1960’s

• • • • Question/Distrust authority Take responsibility for ones own health Influx of Eastern Philosophy/Culture Looked to Native Americans guidance *plant based medicine *organic farming

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History of Medicine (Ancient Cultures)

Ayurveda (INDIA) Chinese Medicine Egyptian Medicine African Medicine • • American Indian Aborigines COMMON APROACHES *Herbal Medicine *Manual Medicine *Energy Medicine

Manual Medicine

• • • • Osteopathy/Cranial Sacral (fascia/spine/organs) Massage (muscles/fascia) Chiropractic (Spinal articulations) Rolfing (Fascia)

Manual Medicine

• • • • • “The rule of the artery must be absolute, universal, and unobstructed or disease will be the result” – A.T. Still Lymphatic return Immune function Neuroendocrine System/Homeostasis Sympathetic and Parasympathetic (ANS)

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Manual Medicine: Structure and Function

“Disease is the result of anatomical abnormalities followed by physiologic discord” – A.T. Still M.D.

Macroscopic vs. Microscopic *sickle cell, Atherosclerosis *cytoskeleton *Somatic Dysfunction (musculoskeletal or visceral restriction)

Somatic Dysfunction

• “Impaired or altered function of related components of the somatic (body framework) system: skeletal, authorial, and myofascial structures and related vascular, lymphatic, visceral and neural elements”

Foundations for Osteopathic Medicine, glossary

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Osteopathic Treatment and other Manual Medicines

Remove fascial restrictions Fascia is connective tissue ligaments, tendons, durra, omentum, mesentery, all body membranes ALL nerves, blood vessels, lymphatic vessels, are carried throughout the body in fascia ALL organs (Brain, lungs, hart, intestines, stomach, liver, ect…) are incased in fascia FASCIA attaches to BONE

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Osteopathic Treatment: REMOVE RESTICTIONS TO MOTION

Improve RANGE OF MOTION of all joints normalize muscle tension around a joint normalize nervous input/output from a joint Remove restrictions to proper blood flow venous/arterial mechanical restrictions Autonomic nervous system imbalance Remove restrictions to Lymphatic Flow extra-cellular fluid drainage immune system reaches and removes unwanted materials (infectious, damaged, toxic)

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Types of OMT

Balanced Ligamentous Tension (BLT) Soft Tissue Manipulation: Myofascial Release Facilitated Positional Release (FPR) Counterstrain Articulatory: High Velocity Low Amplitude (HVLA) Cranial Manipulation Visceral Manipulation Muscle Strain: Muscle Energy, Trigger Point Treatment Biodynamic: Fluid fields, Membranes, fascia and fluid as one hole component

Energy Medicine

• Acupuncture • Reiki • • • • Qigong Therapeutic Touch Osteopathy (Biodynamic) Homeopathy

Energy Medicine

• • • Channels conducting energy (Qi or Ki) life force energy occur through out the body Blocking energy channels limits energy and enhances entropy and DIS-EASE Re-establishing energy channel flow will promote proper function

Energy Medicine

• • • • Scientific/Specific placement of Acupuncture needles Direction of Energy through trained touch and intention Touch is light/soft May be augmented by specific breathing and posture by the recipient

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Energy Medicine

American Cancer Society promotes Therapeutic Touch for cancer patients Therapeutic touch abstracts for anxiety/tension headaches/pain Western scientific research confirms that Qigong reduces hypertension and the incidence of falling in the aged population.

The Effect of Reiki on Pain and Anxiety in Women With Abdominal Hysterectomies: A Quasi-experimental Pilot Study:- Holistic Nursing Practice, 2006 - journals.lww.com

Acupuncture is the most widely researched of all of the energy medicine modalities

Herbal Medicine/Plant Medicine

• • Common in all Cultures Developed from a different view/understanding of Reality/Nature

Modern Science Medicine

• • • Objective fact Only Scientific Trials Consensus Opinion

Native Natural Medicine

• • • Dialogue of the INNER and OUTER worlds Subjective Faculties *Intuition *Imagination Humans are apart of Nature and the Natural Environment

Doctrine of Signatures (Intuition and Imagination)

• • • • Nicolas Culpepper 1616-1654 (Botanist, Herbalist, Physician, Astrologer) English Paracelsus 1493-1541(Physician, Botanist, Astrologer, Alchemist) German-Swiss Emanuel Swedenborg 1688-1772 (Philosopher, Theologian, Scientist) Swedish Samuel Hahnemann 1755-1848 (Homeopathy, Physician) German

Doctrine of Signatures (Intuition and Imagination)

• INTUITION (helps us see patterns in the world) *Connect Herbs from environment to a disordered condition

IMAGINATION

• *Images generated with oneself (Fantasies) vs. images that come from beyond us (Visions)

Angelica

• • • • • Found in damp shady soil Effect is warming and drying Removes damp and cold from the system Notable for long hollow tube of stalk Resembles Tubes of the body

Angelica (Treatment Use)

• • • • • Remedy for bronchial tubes and blood vessels (red/purple stalks) Removes stagnant blood and warms and stimulates the circulation Delayed menstruation/cramping UTI/urinary antiseptic Intestine peristalsis

Albert Einstein

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“Imagination is more important than knowledge. For knowledge is limited to all we now know and understand, while imagination embraces the entire world, and all there ever will be to know and understand.”

Quantum Physics

• Entanglement Theory *All matter was “Entangled” or connected at the moment of the “Big Bang” *Space is just a construct that gives the illusion that there are separate objects

1st Qtr 2nd Qtr 3rd Qtr 4th Qtr East West North

Quantum Physics

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Heisenberg Uncertainty Principle

*by observing something you change it *What is Consciousness?

*Is all Consciousness interconnected?

The Mind

• The Subconscious Mind emotions, imagination, memories, and autonomic nervous system (all are very closely interlinked) *very powerful at dealing with many complex instructions at one time but is not “intelligent” *has the reasoning of a four year old *has a strong desire to help and facilitate change but is very naïve a to the proper way to do so.

The Subconscious Mind

• • • • • Capable of running multiple tasks simultaneously IT DOES NOT JUDGE, CRITICIZE, ANALYZE OR REJECT!

It excepts all thoughts the conscious mind thinks into it AND ACTS ON THEM Repetition reinforces the suggestion It is a super computer

Have you ever been Hypnotized?

• We are constantly given suggestions by Parents, teachers, peer pressure from friends politicians, religion, *Newspaper and TV: advertising tries to persuade us to do things…vote for someone, buy something *If you bought something from a salesman or an ad that you never thought of buying before or don’t really need – then you where hypnotized

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What is Hypnosis

Being open to suggestions A intense state of relaxation and concentration, in which the mind becomes detached from everyday cares and concerns In this relaxed state the subconscious mind is best able to respond creatively to suggestion and imagery.

A state of deep relaxation and heightened responsiveness to suggestion

So What is Hypnosis Good For?

• Reprogramming negative conditioning irrational fears smoking/addictions anxiety recalling forgotten memories

Problems with “Alternative” Treatments

• • • • • Lack of Research and Research funding What works for one person may not work for everyone Out of pocket expense Have an idea about the treatment/therapy that you refer a patient to Lack of “Alternative” practitioners in a community

Serving vs. Fixing

• • • • • Maximize homeostasis and function Support Mental/ Emotional wellbeing Teach and Nurture Encourage independence as much as possible LISTEN

Alternative Medicine

• • • • Grown out of “grass roots” or popular desire for a different approach to healing Has many forms, (Plant/Herb, Energy, Structural Manipulation, Subconscious/Mind) Traditional Allopathic Medicine does not have a monopoly on healing Difference between SERVING and FIXING a patient

THANK YOU