DrRic Asthma Attacking the Cause not just the Effects (slide share edition)

Asthma-attacking the cause,not the effects

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Enrique Saguil, M.D.

My Doctor: Listens to my concerns Cares what I have to say Doesn’t Keep Me Waiting Gives Me Options

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

First Health Associates

2010 S. Arlington Heights RdLL Suites

Arlington Heights, IL

The First Health Approach

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Your Community of Care

Ric Saguil, MDJason Gruss, MDTom Jordan, RD

Katrina Christie, LCPCJennifer Green, NDJoe Musolino, DCAmy Iaquinta, DCNick Nowicki, DC

Emery Paredes, PTCourtney Day, EPYu Zhu, MD China

Mike Blumberg, LCPC

You

Basic anatomy

Upper airway

Lower airway

• Upper respiratory tract

• Lower Bronchospasm

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Asthma anatomy

Post Bronchospasm

Hyperinflation

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Allergy mediated

Bronchial smooth muscle

Bronchodilators and Anti-inflammatories

• Bronchodilators• Inhaled steroids• Singulair • Nedocromil• Ipatropium bromide

• Allergy control antihistamines• Oral steroids

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Standard prescription treatment

Pharmacologic control of bronchospasm and inflammationworks for treating the effects!

…back to inflammation again!

Airway obstruction PFT’s

Pre and post albuterol PFT’s

Education Always Wins

The perfect balance

• Short term rescue- fast acting albuterol, oral steroids• Long term control- long acting albuterol, inhaled steroids• Lifetime control- environmental modification, nutrition, exercise, behavioral modification, herbal supplementation, posture/ alignment

Many allergic responses are cumulative!!

Why so many allergies?

How Integrative Medicine can help:

• Naturopathic medicine!!!• TCM (“lung meridia”)• Yoga/posture/alignment• Behavioral stress response control• Nutritional education (anti-inflammatory diet)• Alternative testing (allergies, toxin, deficiency)

• Hx-Px A comes in with persistent cough for last 12 hours since going to bed. No sick contacts but usually gets sick this time of year. Low grade fever and usual medicines are not helping (nebulizer every 2 hours last one 1 hour ago).

• Nasal turbinates swollen, PND, chest clear no accessory muscle use, no other sign of infection.

• Tx=Continue with bronchodilator, add steroids, consider antibiotics and follow up in 1-2 days.

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Scenario patient A

• Hx-Px B comes in for check up and has used an inhaler few times a week for the last year. No big flare ups but hesitant on stopping for fear of attack. Obese with occasional cigarette with going out and has a cat.

• Tx-Suggested group therapy for tabacco cessation and diet changes/exercise. Also restrict cat to rooms and vacuum dust 2-3x week in addition to hard wood flooring. Reeval in few weeks after changes but refill meds until then and add steroid inhaler.

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Scenario patient B

• Hx-Px C comes in for check up and has used inhaler a few times a week for the last year. Avid exercise with weight training (pretraining inhaler) BMI 23, diet is mostly fast food or fast restaurant, works 60 hours a week and high stress position. No supplements

• Tx-counseling and meditation, dietary evaluation, naturopath evaluation, herbal treatment and cut back on weekly inhaler, keep preexercise puffs. Exercise phys for interval running program/farlek.

We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Scenario patient C

• History for cues on if symtoms are truly reactive airway, stress level, environmental triggers, genetics, diet, use of inhaler, asthma action plan, supplements

• MD/DO, naturopath, homeopath, dietary, behavioral, acupuncture TCM, exercise phys, physical therapy, yoga (careful articulation between disciplines)

• Tests for allergies, deficiencies, methacoline challenge, chest xraysWe didn’t invent the practice of medicine….

we’re just changing the way it’s provided.

At First Health Associates:

QUESTIONS?

COMMENTS?CONCERNS?

Asthma:Attacking the cause, not just the effects.

2010 South Arlington Heights RoadArlington Heights, IL

Phone: 847-593-3330www.FirstHealthAssociates.com