Integrative Medicine Conference Report |
| Posted by Administrator (vitalis) on Dec 07 2007 at 2:45 PM |
Australasian Integrative Medicine Association Inc International Holistic Heath Conference
Queenstown 3-6 August 2006
Report by Meredith Youngson
These are my notes from the various keynote speakers and workshops that I attended at this conference. I have most of the original papers submitted by the speakers if anyone would like more information on any of these.
Thursday 3rd August
Conference opened at 6.00pm by the Minister of Health, the Honourable Peter Hodgson
He talked about how holistic health can be approached in terms of individuals – attention to the whole person - or as a population, which is the perspective he takes in his position as Minister of Health. He acknowledged that the Maori approach to health is a very holistic one.
He stated that the NZ health system is open to more integrated healthcare. Some things are already happening and he particularly mentioned Green Prescription as something we should be proud of.
He spoke about the regulation of complementary and alternatives as something that needs to happen as soon as possible and cited the example of topical steroids being found in some Chinese medicine preparations posing a potential hazard. The vehicle for regulation will be the NZ/Australian collaboration.
Professor Marc Cohen AIMA President, spoke on Integrative Medicine in Practice.
He proposed the view that western medicine aims to restore people from ill health to average health, while complementary medicine aims for enhanced health.
There are many complementary medicines and practices available – how do people choose?
P ersonal preferences
E vidence
A lternatives
C osts and benefits
E xpedience (availability, accessibility etc..)
Best thing health care practitioners can do is get to know their patients as people first and patients second – develop a therapeutic relationship. Hard to do in a 10 minute consultation!! Good medicine takes time – spending more time with patients produces much better outcomes.
In the current health system it is considered conservative to :
* Strip a vein from a leg
* Open the chest
* Place the vein across a blocked artery
* Repeat the procedure every 10 years
And it is considered radical to:
* Relax
* Exercise
* Eat good food
* Share your feelings
Activities that complement health:
Stress management
Exercise
Nutrition
Social/spiritual interaction
Education
The psychosocial aspects are probably the most neglected by medical practitioners.
Future of health care –
* Integrative medicine is accepted as standard care
* Supported by govt and industry funding models
* Accepted in all healthcare settings
* Wellness activities dominate over illness
* Integrative holistic care is part of social fabric.
Professor Gerard Bodeker – globalisation of traditional and complementary medicine
Dr Bodeker picked up on Pete Hodgson’s comment about individual vs population healthcare by stating an Ayurvedic principle – translated as “as is the microcosm, so is the macrocosm”. In other words there is no difference.
He presented a large number of extremely interesting maps showing which complementary medicines were used and accepted in various parts of the world. Apparently most people tend to use complementary medicines in additional to conventional health care (where that is available). On a global basis modern medicine actually has to be considered as alternative!!!
There has been a significant rise in recent years of spiritual healers. Another interesting observation is that CAM users tend to be more environmentally aware.
Regulatory and policy guidelines are required to ensure the safety and quality of CAMS. The ultimate ideal is that nothing is considered alternative or complementary, conventional or orthodox. Rather all possible contributions to health would be evaluated for their value, and used for the good of health and wellbeing.
Friday 4th August
Associate Professor Mel Sydney-Smith – Nutritional medicine – genes, nutrition and health.
Genetic inheritance affects metabolic nutrient requirements AND diet and nutrients affect gene expression and tissue metabolism. Common dietary chemicals affect individual propensity towards health or disease.
Nutritional requirements and disease susceptibility vary between populations and individuals. Genotype is not an immutable prescription for a disease. Multiple factors – diet, nutrition and lifestyle can influence. Modification can counter a disease-promoting hormone.
Gene’s of modern man are not too different from prehistoric man (0.05%) but diet and lifestyle changes are huge.
Professor Tony Smith – Rational Regulation of Complementary medicine
Primary principle of any therapy must be to do no harm.
4 principle potential problems with CAMs
* Composition – natural variation, quality etc..
* Direct toxicity – e.g colloidal silver, kombucha tea (hepatoxicity)
* Predisposed individuals – e.g. royal jelly. Need to identify “at risk” individuals and have warning on product.
* Potential for interaction – people often don’t tell Drs about CAMs they are taking, Drs need to ask.
Regulation must be accompanied by education of both healthcare professionals and consumers.
Dr Tessa Jones – Achieving real success with hormone supplementation
Hormone supplementation can be used for inflammation (important to use natural hormones). Transdermal tends to be better than oral.
* Acute inflammation keeps us alive, chronic inflammation kills us.
* Inflammation associated cancers respond well to inhibition of inflammation.
* C reactive protein used as marker or predictor of many conditions including heart disease and dementia.
* Pro-inflammatory cytokines are directly stimulated by stress and negative emotions.
Chronic inflammation and disease are associated. Low levels of hormones and chronic inflammation are associated. Ensuring an optimum level of hormones reduces chronic inflammation.
Petrea King – Health and Happiness: what’s the connection?
Petrea talked openly and frankly about her life journey and what has brought her to this point, including drugs, rape, the suicide of her brother and then her diagnosis with leukemia.
When you’re meant to die (as she was) and then you don’t, it does make you stop and think “well, now what!” She talked about the difference between reaction and response. Reaction is the re – activation of a biological state that has happened before.
We can make of every moment a heaven or a hell. We tend to postpone a sense of contentment or happiness – “I’ll be happy when......, I’ll feel better when......”
We are not our body – we HAVE a body and with it comes a responsibility to look after and nourish it appropriately. Same with our mind. – we are not our mind, we HAVE a mind and have a responsibility to witness what goes on in our mind and at times calm the ceaseless chatter. We need to keep our mind in good company – our environment, books, movies, music, people all affect us so we need to ensure these are positive effects. We are not our feelings – we HAVE feelings.
Trauma is often a major catalyst for change. We should ask ourselves – who am I? Am I living the life I came here to live?
Peace is a dynamic state of being. Embrace every moment - regardless of its challenge – with an open heart free of judgement and a clear mind.
KEEP YOUR BULLSHIT DETECTOR ON AT ALL TIMES!
Don’t give power away to other people who just sound like they know what they’re talking about.
Once you get to the point of thinking, “I want peace more than anything else” the universe will conspire to bring it about.
Peace is a quality of being, not doing
Peace – individual, family, community or global – depends on the 4 C’s:
1. Regain CONTROL over our response to life
2. COMMITMENT to living – deep reverence for life, not just wanting not to be dead. This shows up in our priorities. Important aspects are communications with ourselves (what is it that I am feeling) and forgiveness which one of Petrea’s patients defined as giving up all hope for a better past. Whatever happened in the past is not an excuse for what is happening now.
3. Sense of CHALLENGE – opportunity to question our beliefs. Things that give us the most pain in life may give us the most understanding of ourselves. Need to be careful who you share yourself with – don’t let others use it against you.
4. CONNECTEDNESS - to our own spirit and the spirit of the world around us.
Difference between curing (body) and healing (whole person)
“Don’t heal yourself so you don’t die, heal yourself so you live better”
Dr Robin Youngson – Humanity and compassion in the practice of medicine.
Didn’t take any notes from this session, as I have heard it all before . It was a very moving and inspiring keynote to a very appreciative audience. I felt very proud! I have the full script if anyone wants it.
Ms Sally Anderson – Legacy Leadership
Sally is another very strong woman who has suffered great personal trauma as she was abducted and raped by the mongrel Mob (aged 15) over a period of 3 days. After hitting rock bottom she has turned her life around and is now a trainer and coach for the future with her business Legacy Leadership. www.sallyanderson.co.nz
Sally believes that our legacy is not something we leave behind us but something we begin here and now. She talked about transforming the illness industry to the wellness industry through her 9 steps to transformation process that she calls The Hero’s Journey.
These steps are:
1. Call to Adventure – can come about through personal trauma or a growing awareness.
2. Refusal to Call – often we refuse to heed the call through fear, insecurity or just not wanting to face the responsibility.
3. The Guide – once we do accept the call, guides and/or helpers will appear.
4. Crossing the Threshold – a commitment to change and separation from old ways.
5. The Road of Trials – initiation and transformation
6. Helpers – although the journey is our own, helpers and guides continue to appear at opportune times.
7. Supreme Ordeal – facing our greatest fear(s) to a divine knowledge
8. Return (to the known world) – essence of the return is contribution to society/humanity with a new level of awareness and experience.
9. The Gift or Legacy to the known world – achievement of our goals.
It is all about ‘being’ leadership other than ‘doing’ leadership. This depends on being truly ‘present’ to other people. Legacy Leaders become students of Leadership who build other leaders who build other leaders who build other leaders.
Through personal growth a business leader can better facilitate higher performance with wisdom and compassion.
Saturday 5th August
Dr Ian Gawler – Is palliative treatment terminal?
Chemotherapy is often oversold and overused. Quality of life often not considered in the desire to not die.
Evidence based medicine = evidence from literature PLUS clinician’s own experience.
Chemotherapy is very effective for some cancers, can improve the survival times in others, and can palliate in others (such as prostate cancer)
In a recent study it was shown that if you take out the cancers that are cured by chemotherapy, the overall benefit of chemotherapy to the 5 year survival rate was 2.3% in Australia, 2.1% in America.
In other words the majority of chemotherapy is palliative, not curative.
So is chemotherapy the best palliative option?
There are numerous side effects that have a negative effect on quality of life.
Often people are pressured into chemotherapy by professionals or their family or by the personal need to try anything that might effect a cure.
Lifestyle is a basic issue that is always considered for CVD and diabetes. It should be considered for cancer as well.
Physical lifestyle aspects that make a difference –
* Nutrition
* Exercise
* Sunlight
* Sexuality
* Hobbies and interests
Mind body interventions
* Group therapy
* Meditation
* Tai chi and Yoga
* Spiritual beliefs and practices
Best cancer prevention is a healthy lifestyle.
Adverse effects – minor and rare
Positive side effects – people enjoy life more
Cost - small
Associate Professor Joanna Barnes – Challenges and Strategies in pharmacovigilance of herbal medicinal products.
Currently there is no requirement for manufacturers of CAMs to prove quality of product.
Herbal medicines are defined as those medicines that contain as active ingredients only crude and/or processed plants and/or plant parts. A chemical derived from a plant is not a herbal medicine.
Challenges –
* Herbal medicines are chemically rich complex mixtures
* Profile of constituents varies quantitatively and qualitatively
* Herbal products manufactured by different people are not the same.
* Large number of people are using them but few are tested for efficacy or safety
* People assume they’re safe and don’t tell practitioner
Professor Stephen Myers – the legitimacy of traditional medicine
Life/Science doesn’t occur in a vacuum. All knowledge is contextualised.
Evidence Based Medicine – an idea whose time has come but is often misapplied and poorly understood.
Should be a balance between best external evidence and clinical expertise. Patient choice is also an important consideration.
Herbal medicine is the current primary medication in 80% of the world.
Herbal medicine is an empirical science based on thousands of years of practice and observation.
3 Short Presentations
Mr Stephen Penman – The use of yoga for mental health
Results of a survey of 4754 yoga teachers and students were presented that demonstrated that most of the benefits of yoga were to the Muscular-skeletal system and Mental Health including Stress)
Ms Lesley Braun – Use of CAMS by surgical patients
CAMS often used as adjuncts to conventional medicines, not alternatives. People tend to self medicate and 58% don’t tell their Drs or other health practitioners – usually because they are not asked. This is of concern as some do pose a risk, Predictors of use tended to be:
* Higher education
* Female
* Non smoker
* Higher income bracket
Ms Lesley Braun – CAMS within hospitals – patient safety
The question is whether the use of CAMs in hospitals poses a patient safety risk. Patients are not usually asked about their CAMs as the Dr forgets, think it’s not relevant, and/or have insufficient knowledge about the safety and action of popular OTC remedies.
Pharmacists are usually better than Drs in their awareness of CAMs and have greater tendency to seek out knowledge.
Pharmacists and Anaesthetists showed the greatest interest in future learning about CAMs.
Recommendations – need standardised guidelines for Drs and better information and education for both healthcare professionals and consumers.
Professor Ian Brighthope – Beyond evidence based medicine
We can manipulate genes with nutrients – make them behave better
Often multiple nutritional deficiencies seen in mentally ill patients
Mental illness is currently treated on a hospital food diet plus coffee plus cigarettes and then given drugs and ECT.
Individuality is a crucial factor in nutrition.
Inflammation can be lowered through diet.
Ian gave a number of example case studies of patients presenting with a range of symptoms who improved dramatically with very specific nutrient therapy.
Professor Avni Sali – Nutrition for healing and wellness
Avni gave a dynamic and amusing review of nutrition for healing and wellness. He defined nutrigenomics as the effect of nutrition on genes and gene expression. Nutrigenetics is the effect of genes on nutrition and the development of nutrition related diseases.
He talked about the health properties of a range of common foods including the fantastic news that chocolate is indeed good for you (dark chocolate 70% cocoa solids) and women can eat, oops I mean SHOULD eat, 35 grams a day. Men can have 50!
The major components of wellbeing are
Reduction of stress
Relaxation/meditation techniques
Healthy food
Adequate exercise
It is essential for health professionals to understand nutrition and to ensure a dietary history is taken as a healthy diet is paramount to good health.
Professor Vivian Lin – Chinese medicine, naturopathy and western herbal medicine: issues in health workforce regulation.
Policy and regulation is a blunt tool but has important implications for practitioners and health service users.
With the Chinese Medicine registration most cases prosecuted are people claiming false qualifications. It is too easy in an unregulated environment for people to set up as complementary health practitioners. A number of doctors who have been struck off for negligence have done just this and there is nothing to stop them.
A significant challenge of regulation is minimal practice vs best practice – developing best standards with other health professions.
Why do consumers use complementary medicines?
* More effective treatment
* Support for chronic conditions
* Maintenance of wellness
* Holistic care
* Longer consultations
* Mitigation of the effects of pharmaceuticals
Other findings
* Adverse events exist
* Consumers navigate parallel primary care system
* Lack of hospital protocol
* Drug-herb interactions
* Limited research funding support
* Difficult to define standards
* Insufficient regulatory protection for consumers
Women don’t tell Dr that they are using CAMs as they don’t want to be ridiculed
Men don’t tell because they don’t think it’s necessary
Generally people want regulation to raise standards and stop un-ethical practices. Back