Alternative to Alternative to Integrative Integrative MedicineMedicine

Ron Mosiello D.O.Ron Mosiello D.O.Osteopathic Manipulative Osteopathic Manipulative

Medicine Medicine Neuromuscular MedicineNeuromuscular MedicineSouthern Maine Medical Southern Maine Medical

Center/Prime CareCenter/Prime CareAssistant Professor UNECOMAssistant Professor UNECOM

Alternative Medicine: Alternative Medicine: ObjectivesObjectives

• Grown out of “grass roots” or popular Grown out of “grass roots” or popular desire for a different approach to healingdesire for a different approach to healing

• Has many forms, (Plant/Herb, Energy, Has many forms, (Plant/Herb, Energy, Structural Manipulation, Structural Manipulation, Subconscious/Mind)Subconscious/Mind)

• Traditional Allopathic Medicine does not Traditional Allopathic Medicine does not have a monopoly on healing have a monopoly on healing

• Difference between SERVING and Difference between SERVING and FIXING a patient FIXING a patient

Incidence of Adverse Drug Incidence of Adverse Drug Reactions in Hospitalized Reactions in Hospitalized

PatientsPatients. JAMA . JAMA 1998;279(15):1200-1205.1998;279(15):1200-1205.

• 106,000 hospitalized 106,000 hospitalized patients die from patients die from properly prescribed properly prescribed drugsdrugs

• Greater than two million Greater than two million suffer “serious” side suffer “serious” side effectseffects

Geriatric Challenges and Geriatric Challenges and Pharmaceuticals Pharmaceuticals

• PolypharmacyPolypharmacy*Decrease in GFR and liver metabolism *Decrease in GFR and liver metabolism with age with age

*Increase in medication with age*Increase in medication with age *Acute changes in mental status *Acute changes in mental status

New med vs. infection, CVA, New med vs. infection, CVA, *Pain medication: Dizziness/Falls/Mental *Pain medication: Dizziness/Falls/Mental

Status Status changes/Liver-Kidney changes/Liver-Kidney toxicity/GI upset toxicity/GI upset

NSAIDs, Muscle relaxants, NSAIDs, Muscle relaxants, NarcoticsNarcotics

Acetaminophen (Liver)Acetaminophen (Liver)*Financial stress (fixed income)*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

History of Medicine History of Medicine Medicine and the Ancient WorldMedicine and the Ancient World

China, Egypt, Rome, Greece, Medieval China, Egypt, Rome, Greece, Medieval Europe,Europe,

Africa, South and North American Indians, Africa, South and North American Indians, India, Middle East India, Middle East

• ““Bone Setting” in early colonial and early Bone Setting” in early colonial and early America: folk tradition dating from 1500’s America: folk tradition dating from 1500’s

• Pasture (germ theory) vs. Beauchapms (host Pasture (germ theory) vs. Beauchapms (host theory of disease) theory of disease)

• 1900 Medical philosophies1900 Medical philosophies Allopathic, Homeopathic, Osteopathic, Allopathic, Homeopathic, Osteopathic,

Chiropractic, Naturopathic, Sylvester Chiropractic, Naturopathic, Sylvester Graham Graham

History of MedicineHistory of Medicine• Allopathic Medicine in 1900: MedicationsAllopathic Medicine in 1900: Medications Calomel (contained mercury) rapid cathartic Calomel (contained mercury) rapid cathartic Lead, Arsenic, Opium, BelladonnaLead, Arsenic, Opium, Belladonna *Source: Merk Manual 1899 *Source: Merk Manual 1899 • Rockefeller, Carnegie, Vanderbilt invest in Rockefeller, Carnegie, Vanderbilt invest in

allopathic medicine in late 1800’s early 1900’sallopathic medicine in late 1800’s early 1900’s• Abraham Flexner’s report to US congress 1907 Abraham Flexner’s report to US congress 1907 Financed by the Carnegie foundationFinanced by the Carnegie foundation Standardized medical education and practiceStandardized medical education and practice 1904 160 medical schools in US, 1935 only 661904 160 medical schools in US, 1935 only 66

Louis Pasteur 1822-1895 Louis Pasteur 1822-1895 French French

Chemist/Microbiologist Chemist/Microbiologist (GERM THEORY)(GERM THEORY)• Host lives in hostile Host lives in hostile

environmentenvironment• Disease invades body Disease invades body

through harmful Germthrough harmful Germ• GERMS primary GERMS primary

invasive/destructive invasive/destructive cause of diseasecause of disease

• Adopted contemporary Adopted contemporary medical model medical model

• Created first Created first vaccinations for Rabies vaccinations for Rabies and Anthrax and Anthrax

Pierre Jacques Antoine Pierre Jacques Antoine Beauchamp (1816-1908) Beauchamp (1816-1908)

Chemist Biologist Physician Chemist Biologist Physician • Healthy tissue immune Healthy tissue immune

to germ infection to germ infection • ““Biological Terrain”Biological Terrain”• Germs are Germs are

Opportunists Opportunists • Support tissue health Support tissue health

and wellbeing and wellbeing • Nutrition/Rest/Hygiene Nutrition/Rest/Hygiene

Exercise/Emotional Exercise/Emotional wellbeingwellbeing

• ““The primary cause The primary cause of disease is in us, of disease is in us, always in us.”always in us.”Antoine Beauchamp, Antoine Beauchamp, 1883 1883

• Theory ignored and Theory ignored and feel into obscurity feel into obscurity

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

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

HEALTH

History of Medicine: History of Medicine: 1960’s1960’s

• Question/Distrust Question/Distrust authorityauthority

• Take responsibility Take responsibility for ones own healthfor ones own health

• Influx of Eastern Influx of Eastern Philosophy/Culture Philosophy/Culture

• Looked to Native Looked to Native Americans guidanceAmericans guidance

*plant based *plant based medicinemedicine

*organic farming *organic farming

History of Medicine History of Medicine (Ancient Cultures) (Ancient Cultures)

• Ayurveda (INDIA)Ayurveda (INDIA)• Chinese MedicineChinese Medicine• Egyptian MedicineEgyptian Medicine• African MedicineAfrican Medicine• American Indian American Indian • Aborigines Aborigines

COMMON COMMON APROACHESAPROACHES

*Herbal Medicine*Herbal Medicine

*Manual Medicine *Manual Medicine

*Energy Medicine *Energy Medicine

Manual MedicineManual Medicine

• Osteopathy/Osteopathy/Cranial-Sacral Cranial-Sacral (fascia/spine/organ(fascia/spine/organs)s)

• Massage Massage (muscles/fascia)(muscles/fascia)

• Chiropractic Chiropractic (Spinal (Spinal articulations)articulations)

• Rolfing (Fascia)Rolfing (Fascia)

Manual MedicineManual Medicine

• ““The rule of the artery must be absolute, The rule of the artery must be absolute, universal, and unobstructed or disease universal, and unobstructed or disease will be the result” – A.T. Stillwill be the result” – A.T. Still

• Lymphatic return Lymphatic return • Immune functionImmune function• Neuroendocrine System/Homeostasis Neuroendocrine System/Homeostasis • Sympathetic and Parasympathetic (ANS)Sympathetic and Parasympathetic (ANS)

Manual Medicine: Manual Medicine: Structure and FunctionStructure and Function

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

• Macroscopic vs. Microscopic Macroscopic vs. Microscopic *sickle cell, Atherosclerosis*sickle cell, Atherosclerosis*cytoskeleton *cytoskeleton *Somatic Dysfunction *Somatic Dysfunction

(musculoskeletal or visceral (musculoskeletal or visceral restriction) restriction)

Somatic DysfunctionSomatic Dysfunction

• ““Impaired or altered Impaired or altered functionfunction of of related components of the somatic related components of the somatic (body framework) system: skeletal, (body framework) system: skeletal, authorial, and myofascial structures authorial, and myofascial structures and related vascular, lymphatic, and related vascular, lymphatic, visceral and neural elements” visceral and neural elements” Foundations for Osteopathic Medicine, Foundations for Osteopathic Medicine, glossaryglossary..

Osteopathic Treatment and Osteopathic Treatment and other Manual Medicinesother Manual Medicines

• Remove fascial restrictions Remove fascial restrictions • Fascia is connective tissue Fascia is connective tissue ligaments, tendons, durra, omentum, ligaments, tendons, durra, omentum,

mesentery, all body membranes mesentery, all body membranes • ALL nerves, blood vessels, lymphatic ALL nerves, blood vessels, lymphatic

vessels, are carried throughout the body in vessels, are carried throughout the body in fasciafascia

• ALL organs (Brain, lungs, hart, intestines, ALL organs (Brain, lungs, hart, intestines, stomach, liver, ect…) are incased in fasciastomach, liver, ect…) are incased in fascia

• FASCIA attaches to BONEFASCIA attaches to BONE

Osteopathic Treatment: Osteopathic Treatment: REMOVE RESTICTIONS TO REMOVE RESTICTIONS TO

MOTIONMOTION• Improve Improve RANGE OF MOTIONRANGE OF MOTION of all joints of all joints normalize muscle tension around a jointnormalize muscle tension around a joint normalize nervous input/output from a jointnormalize nervous input/output from a joint• Remove restrictions to proper Remove restrictions to proper blood flowblood flow venous/arterial mechanical restrictionsvenous/arterial mechanical restrictions Autonomic nervous system imbalanceAutonomic nervous system imbalance• Remove restrictions to Remove restrictions to Lymphatic FlowLymphatic Flow extra-cellular fluid drainage extra-cellular fluid drainage immune system reaches and removes immune system reaches and removes

unwanted materials (infectious, damaged, unwanted materials (infectious, damaged, toxic)toxic)

Types of OMTTypes of OMT• Balanced Ligamentous Tension (BLT)Balanced Ligamentous Tension (BLT)• Soft Tissue Manipulation: Myofascial Soft Tissue Manipulation: Myofascial

Release Release Facilitated Positional Release (FPR)Facilitated Positional Release (FPR) Counterstrain Counterstrain • Articulatory: High Velocity Low Amplitude Articulatory: High Velocity Low Amplitude

(HVLA) (HVLA)• Cranial Manipulation Cranial Manipulation • Visceral ManipulationVisceral Manipulation• Muscle Strain: Muscle Energy, Trigger Muscle Strain: Muscle Energy, Trigger

Point TreatmentPoint Treatment• Biodynamic: Fluid fields, Membranes, Biodynamic: Fluid fields, Membranes,

fascia and fluid as one hole componentfascia and fluid as one hole component

Energy Energy MedicineMedicine• AcupunctureAcupuncture

• ReikiReiki• QigongQigong• Therapeutic TouchTherapeutic Touch• Osteopathy Osteopathy

(Biodynamic)(Biodynamic)• Homeopathy Homeopathy

Energy MedicineEnergy Medicine• Channels conducting Channels conducting

energy (Qi or Ki) life energy (Qi or Ki) life force energy occur force energy occur through out the bodythrough out the body

• Blocking energy Blocking energy channels limits channels limits energy and enhances energy and enhances entropy and DIS-entropy and DIS-EASEEASE

• Re-establishing Re-establishing energy channel flow energy channel flow will promote proper will promote proper functionfunction

Energy MedicineEnergy Medicine

• Scientific/Specific placement of Scientific/Specific placement of Acupuncture needlesAcupuncture needles

• Direction of Energy through trained Direction of Energy through trained touch and intentiontouch and intention

• Touch is light/softTouch is light/soft• May be augmented by specific May be augmented by specific

breathing and posture by the recipient breathing and posture by the recipient

Energy MedicineEnergy Medicine• American Cancer Society promotes American Cancer Society promotes

Therapeutic Touch for cancer patientsTherapeutic Touch for cancer patients• Therapeutic touch abstracts for Therapeutic touch abstracts for

anxiety/tension headaches/painanxiety/tension headaches/pain• Western scientific research confirms that Western scientific research confirms that

Qigong reduces hypertension and the Qigong reduces hypertension and the incidence of falling in the aged population. incidence of falling in the aged population.

• The Effect of Reiki on Pain and Anxiety The Effect of Reiki on Pain and Anxiety in Women With Abdominal in Women With Abdominal Hysterectomies: A Quasi-experimental Hysterectomies: A Quasi-experimental Pilot Study:- Holistic Nursing Practice, Pilot Study:- Holistic Nursing Practice, 2006 - journals.lww.com2006 - journals.lww.com

• Acupuncture isAcupuncture is the most widely researched the most widely researched of all of the energy medicine modalitiesof all of the energy medicine modalities

Herbal Medicine/Plant Herbal Medicine/Plant MedicineMedicine

• Common in all Common in all Cultures Cultures

• Developed from a Developed from a different different view/understandinview/understanding of Reality/Natureg of Reality/Nature

Modern Science Modern Science MedicineMedicine

• Objective fact OnlyObjective fact Only• Scientific TrialsScientific Trials• Consensus OpinionConsensus Opinion

Native Natural Medicine Native Natural Medicine

• Dialogue of the Dialogue of the INNER and OUTER INNER and OUTER worldsworlds

• Subjective FacultiesSubjective Faculties

*Intuition*Intuition

*Imagination *Imagination • Humans are apart of Humans are apart of

Nature and the Nature and the Natural Environment Natural Environment

Doctrine of Signatures Doctrine of Signatures (Intuition and Imagination)(Intuition and Imagination)• Nicolas CulpepperNicolas Culpepper 1616-1654 (Botanist, 1616-1654 (Botanist,

Herbalist, Physician, Astrologer) English Herbalist, Physician, Astrologer) English • ParacelsusParacelsus 1493-1541(Physician, 1493-1541(Physician,

Botanist, Astrologer, Alchemist) German-Botanist, Astrologer, Alchemist) German-SwissSwiss

• Emanuel SwedenborgEmanuel Swedenborg 1688-1772 1688-1772 (Philosopher, Theologian, Scientist) (Philosopher, Theologian, Scientist) Swedish Swedish

• Samuel HahnemannSamuel Hahnemann 1755-1848 1755-1848 (Homeopathy, Physician) German(Homeopathy, Physician) German

Doctrine of Signatures Doctrine of Signatures (Intuition and Imagination) (Intuition and Imagination) • INTUITIONINTUITION (helps (helps

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

• IMAGINATIONIMAGINATION *Images generated with *Images generated with

oneself (Fantasies) vs. oneself (Fantasies) vs. images that come images that come from beyond us from beyond us (Visions)(Visions)

AngelicaAngelica

• Found in damp Found in damp shady soil shady soil

• Effect is warming Effect is warming and drying and drying

• Removes damp and Removes damp and cold from the cold from the systemsystem

• Notable for long Notable for long hollow tube of stalkhollow tube of stalk

• Resembles Tubes of Resembles Tubes of the bodythe body

Angelica (Treatment Angelica (Treatment Use)Use)

• Remedy for bronchial Remedy for bronchial tubes and blood tubes and blood vessels (red/purple vessels (red/purple stalks)stalks)

• Removes stagnant Removes stagnant blood and warms and blood and warms and stimulates the stimulates the circulationcirculation

• Delayed Delayed menstruation/crampinmenstruation/crampingg

• UTI/urinary antiseptic UTI/urinary antiseptic • Intestine peristalsis Intestine peristalsis

Albert EinsteinAlbert Einstein• ““Imagination is Imagination is

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

Quantum Physics Quantum Physics

• Entanglement Entanglement TheoryTheory

*All matter was *All matter was “Entangled” or “Entangled” or connected at the connected at the moment of the “Big moment of the “Big Bang”Bang”

*Space is just a *Space is just a construct that gives construct that gives the illusion that the illusion that there are separate there are separate objectsobjects

0102030

40506070

8090

1stQtr

2ndQtr

3rdQtr

4thQtr

East

West

North

Quantum Physics Quantum Physics

• Heisenberg Heisenberg Uncertainty Uncertainty PrinciplePrinciple

*by observing *by observing something you something you change itchange it

*What is *What is Consciousness?Consciousness?

*Is all Consciousness *Is all Consciousness interconnected?interconnected?

The MindThe Mind

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

The Subconscious MindThe Subconscious Mind

• Capable of running multiple tasks Capable of running multiple tasks simultaneously simultaneously

• IT DOES NOT JUDGE, CRITICIZE, IT DOES NOT JUDGE, CRITICIZE, ANALYZE OR REJECT!ANALYZE OR REJECT!

• It excepts all thoughts the conscious It excepts all thoughts the conscious mind thinks into it AND ACTS ON mind thinks into it AND ACTS ON THEMTHEM

• Repetition reinforces the suggestionRepetition reinforces the suggestion• It is a super computer It is a super computer

Have you ever been Have you ever been Hypnotized?Hypnotized?

• We are constantly given suggestions byWe are constantly given suggestions byParents, teachers, peer pressure from Parents, teachers, peer pressure from friendsfriendspoliticians, religion, politicians, religion,

*Newspaper and TV: advertising tries to *Newspaper and TV: advertising tries to persuade us to do things…vote for persuade us to do things…vote for someone, buy somethingsomeone, buy something

*If you bought something from a salesman or *If you bought something from a salesman or an ad that you never thought of buying an ad that you never thought of buying before or don’t really need – then you before or don’t really need – then you where hypnotizedwhere hypnotized

What is Hypnosis What is Hypnosis • Being open to suggestionsBeing open to suggestions• A intense state of relaxation and A intense state of relaxation and

concentration, in which the mind concentration, in which the mind becomes detached from everyday becomes detached from everyday cares and concernscares and concerns

• In this relaxed state the subconscious In this relaxed state the subconscious mind is best able to respond creatively mind is best able to respond creatively to suggestion and imagery.to suggestion and imagery.

• A state of deep relaxation and A state of deep relaxation and heightened responsiveness to heightened responsiveness to suggestion suggestion

So What is Hypnosis So What is Hypnosis Good For?Good For?

• Reprogramming negative Reprogramming negative conditioningconditioning

irrational fearsirrational fears

smoking/addictionssmoking/addictions

anxietyanxiety

recalling forgotten memoriesrecalling forgotten memories

Problems with “Alternative” Problems with “Alternative” TreatmentsTreatments

• Lack of Research and Research fundingLack of Research and Research funding• What works for one person may not What works for one person may not

work for everyonework for everyone• Out of pocket expense Out of pocket expense • Have an idea about the Have an idea about the

treatment/therapy that you refer a treatment/therapy that you refer a patient topatient to

• Lack of “Alternative” practitioners in a Lack of “Alternative” practitioners in a communitycommunity

Serving vs. Fixing Serving vs. Fixing

• Maximize homeostasis Maximize homeostasis and function and function

• Support Mental/ Support Mental/ Emotional wellbeing Emotional wellbeing

• Teach and Nurture Teach and Nurture • Encourage independence Encourage independence

as much as possibleas much as possible• LISTEN LISTEN

Alternative MedicineAlternative Medicine

• Grown out of “grass roots” or popular Grown out of “grass roots” or popular desire for a different approach to healingdesire for a different approach to healing

• Has many forms, (Plant/Herb, Energy, Has many forms, (Plant/Herb, Energy, Structural Manipulation, Structural Manipulation, Subconscious/Mind)Subconscious/Mind)

• Traditional Allopathic Medicine does not Traditional Allopathic Medicine does not have a monopoly on healing have a monopoly on healing

• Difference between SERVING and Difference between SERVING and FIXING a patient FIXING a patient

THANK YOUTHANK YOU