Boomers won't bust us - Health care will

Boomers won't bust us - Health care will
Please click above link to read the CNN article.
Our economy appears to be suffering. The overall health of the future of american economy is described in CNBC article (http://www.cnbc.com/id/26001658) and the upcoming documentary, IOUSA.

Along with the trade deficits and the federal deficits are two culprits. A major portion of federal deficits, especially in the coming future, will be from Health Care. The U.S. government is the biggest payor of health care expenses including Medicaid and Medicare. http://www.cms.hhs.gov/nationalhealthexpenddata/ provides useful statitistics. In 2017, it is estimated that nearly 20% GDP will be dedicated to healthcare. That means nearly quarter of every dollar will be spent in health care.

What do we get from this very expensive health care system? The best in the world? No, not even close. http://healthcare-economist.com/2008/07/18/us-health-care-scores-poorly/ is an article that describes the health care system as sick. And this sick health care system is making our finances ill.

I believe that integrative medicine and preventive medicine can make a difference in the quality of care and quality of life. It is this firm belief that I chose to train beyond family medicine. I spent two years completing a preventive medicine residency and a master's in public health and another two years training with Dr. Andrew Weil at U of Arizona.

Integrative Medicine makes use of the Western diagnostic tools and also uses less invasive tools of healing for a problem before rushing to more invasive and more expensive modalities such as surgery. Preventive Medicine makes use of existing tools to prevent problems to become worse.

I hope that our politicians pay attention to the coming trends and attempt to correct the course before our financial future of the country will be threatened.

John Kim, MD MPH
Director
Georgia Integrative Medicine

UNM sets opening event for integrative medicine clinic

http://www.bizjournals.com/albuquerque/stories/2008/08/04/daily15.html

Above is the link for the news announcing yet another University Medical Center (U of New Mexico) creating an integrative medicine center. U of Arizona, UCSF, and Duke University have started integrative medicine centers recognizing the value of integrative medicine.

In my training with Dr. Andrew Weil at University of Arizona, probably the most important lesson was that Integrative Medicine's mission is to focus on patients' healing rather than to focus on tools and modalities.

Physicians and healers have a tendency to develop attachment to techniques that they have learned and invested their resources. For example, physicians tend to prescribe medications and chiropractors tend to perform adjustments and acupuncturists to acupuncture.

Rather than focusing on tools of healing, integrative medicine focuses on the needs of the patients and weaves a comprehensive healing plan setting priorities on methods that are less invasive to patients that have higher probability of success. The techniques where patient can enhance their own healing ability is also encouraged through nutrition, meditation, mind-body techniques, and physical activity such as Tai Chi.

This way, patients can be empowered for their own healing of the mind, body, and spirit.

John Kim, MD MPH
www.georgiaintegrative.com

Drugs to Build Bones May Weaken Them

Drugs to Build Bones May Weaken Them

Above link (click on it to read the original article) is NY Times News article on drugs that are used to treat osteoporosis may actually weaken them.

Osteoporosis is a serious health concern for American women. It is defined in women as bone mineral desnsity lower than 2.5 times the normal bone density. It is measured by DEXA. The main concern about osteoporosis is that it leads to increase risk of fracture. Hip fracture, especially, is traumatic to the patients, often requiring several months of rehab.

Osteoporosis is most common in post-menopausal women. It also is caused by the use of steroid medication. Osteoporosis can be prevented with lifestyle advice and sometimes medication, and in people with osteoporosis treatment may involve lifestyle advice, preventing falls and medication (calcium, vitamin D, bisphosphonates and several others).

There are a number of medications that are used to treat osteoporosis including fosamax. During my training at Dr. Andrew Weil's Program in Integrative Medicine, I was educated by my patients who researched about fosamax and was concerned about the possibility that fosamax actually may weaken the bone. The concern was a theoretical one at that time; it was thought that bone density increase was due to abnormal bone density growth that may not be as strong as normal bone. It seems that my patients may have been on to something.

Physicians at Weill Medical College of Cornell University are reporting that prolonged Fosamax—generically known as bisphosphonate alendronate—use may increase the risk of femur fractures, the large thigh bone that connects the leg to the hip. Continued evidence indicates that long-term alendronate use may overly suppress bone metabolism, which limits the repair of microdamage and increases fracture risk, Dr. Joseph M. Lane and colleagues report in the Journal of Orthopaedic Trauma. This report can be read by clicking following hyperlink http://www.newsinferno.com/archives/3443.

Meanwhile, earlier this year Canadian researchers issued a warning that bisphosphonates, sold under the names of Didrocal, Actonel, and Fosamax can lead to bone necrosis, a painful and disfiguring condition that results in bone death. The study found that such drugs almost tripled the risk of developing bone necrosis. The study was conducted by researchers at the University of British Columbia (UBC) and McGill University and is the largest study of its kind into the connection between bone necrosis and specific brands of bisphosphonates: Didrocal, Actonel, and Fosamax. Prior to that warning, the U.S. Food and Drug Administration (FDA) issued a warning about bisphosphonates and its link to a higher possibility of severe and sometimes incapacitating bone, joint, and muscle pain. “I think the study’s important just basically to let the public know if they do experience any severe, unusual pain they could tell their health professional,” said Dr. Mahyar Etminan, the principle investigator from the University of British Columbia. This report can be read by clicking following hyperlink http://www.newsinferno.com/archives/3443.

This puts many patients who are on Fosamax and related medicine at a catch 22. There are integrative approaches to slowing the bone loss using nutrition - calcium, magnesium, boron, and strontium. In addition, green tea extract, and ipraflavone can be useful. However, there is no documented study of strengthening the bone. From preventive point of view, the maximal protection comes from having had maximal bone density achieved in the teen years - which is affected by genetics, nutrition, and physical activity.

John Kim MD MPH
www.georgiaintegrative.com

Popular Fish, Tilapia, Contains Potentially Dangerous Fatty Acid Combination

Popular Fish, Tilapia, Contains Potentially Dangerous Fatty Acid Combination

Last week, I posted an article about Tilapia containing potentially dangerous omega 6 fatty acids resulting in increased inflammation. Above article from Science Daily detail the account of the risk.

"The researchers say the combination could be a potentially dangerous food source for some patients with heart disease, arthritis, asthma and other allergic and auto-immune diseases that are particularly vulnerable to an "exaggerated inflammatory response." Inflammation is known to cause damage to blood vessels, the heart, lung and joint tissues, skin, and the digestive tract." (from http://www.sciencedaily.com/releases/2008/07/080708092228.htm)

During my study with Dr. Andrew Weil, I found above statement to be absolutely a true statement. Inflammation has become a rampant epidemic resulting in causing so much health problems in the developed countries. This has been made worse by the use of the industrial farming practices combined with our business modeling focused on the lowest price doctrine.

As a result, we pay heavily on the treatment side as a society and as members of the society. The solution is not simple; it involves consumer consciousness which must educate the industry. Organic is a good start, but not good enough; we need to be mindful of nutritional contents of the food. Salmon not enough - you need to know that it is either Organic fed with high omega 3 fatty acids feed or from the nature without heavy metal toxins.

John Kim, MD MPH
Director
www.georgiaintegrative.com

Why integrative medicine is the way of the future

Why integrative medicine is the way of the future
Above is an article from an Austrian news discussing the application of integrative medicine for the treatment of cancer.

The 2008 Summer Wellness Brief is dedicated (click here to open Summer 2008 Cancer & Healing) on integrative oncology. When I worked with Dr. Andrew Weil at University Medical Center in Tucson, I was fortunate to witness a number of remissions that could not be attributed to medications alone.

There is a tendency in the medical field to give credit to the illness or to the disease and not to give enough credit to the individual's healing ability.

Integrative medicine explores the boundary of the healing ability of the person by providing a therapeutic healing partnership and by creating a synergy of healing techniques leveraged at helping the whole person, Mind, Body, and Spirit.

The therapeutic regimens that one can use using the mind, body, and spirit is almost limitless in its application. The goal is to empower our patients to feel comfortable about being an active participant in their healing.

This combination of empowerment, nutritional support, emotional support (we require our cancer patients to go to a support group and/or see a counsellor once a week), and conventional medicine and surgery can make a powerful impact. We saw two people achieve remission from Stage 4 cancer last year who followed above advise. We do not understand the exact mechanism of their healing at this point, but we are happy to see our patients enjoy a higher quality of life.

John Kim
Director
www.georgiaintegrative.com

Low-carb diet beats other diets in study

Low-carb diet beats other diets in study

Above link describes the outcome of a study demonstrating that Low-carb diets show superior results compared to other diets. The article states, perhaps tongue-in cheek, that Atkins diet may have a point. Atkins diet's weakness is that it underestimates the danger of cholesterol and the types of fat coming from meat sources in the form of omega 6 fatty acids which result in increasing overall inflammation in the body.

Inflammation is a common pathway where multiple illnesses come together. As a result of increasing inflammation, you put yourself at risk for increasing degenerative illnesses including Alzheimer's disease, osteoarthritis, as well as coronary artery diseases.

I prefer a nutrition plan based largely on vegetable, 1 - 2 servings of whole grain per day, and a high quality protein either from grass fed meat or safe fish (list is available from Monterey Bay Aquarium). My favorite is wild Alaskan salmon providing omega 3 fatty acids as well as excellent source of protein.

Extinguishing the Fear at the Roots of Anxiety

Extinguishing the Fear at the Roots of Anxiety

Above is the hyperlink to the New York Times article on anxiety. We live is a face paced world full of stress. The effect of stress can play havoc with both physical and mental health.

Perhaps the most well understood of effect of acute stress include production of cortisol, a stress hormone produced in our body, resulting in a number of problems including immune suppression, anxiety, blood sugar dysregulation, and weight gain. This understanding has helped to create a field of science referred as neuro-psycho-immunology.

Anxiety in Chinese medicine represents a Yang aspect of Shen (psych-emotional-spiritual) disturbance often leading to depletion of Shen energy resulting in symptoms of depression based on anxiety which is different from Yin aspec of Shen disturbance which results in depression based on fear, hopelessness, and helplessness.

There are many mind-body medicine combined with therapy that can result in significant transformative changes for mental health. An integrative approach focuses on understanding of the present mindfulness of the anxiety at a functional level. As to extinguishing the fear at the roots of anxiety, I am not sure any modality without transformative therapy work can be successful. Perhaps that is the reason, despite the explosion of mental illness medications, we still have an epidemic of mental illness negatively impacting quality of life...