Integrative Medicine: The Best of Both Worlds (podcast)

Integrative medicine is basically incorporating all therapeutic approaches to help a patient reach optimal health and healing. It’s a combination of both traditional Western allopathic medicine — which is what I’ve been trained to do in medical school — but bringing more Eastern philosophies, more Eastern therapeutic options. And that could be supplements, herbs, and also different healing modalities, as well as a real profound focus on lifestyle and intervention. Really looking at how lifestyle plays a role in a person’s health.

We treat pretty much anything related to chronic disease. Myself specifically I’m a cardiologist that has been integrative trained. Also within the field of integrative medicine, we treat hypertension, cholesterol issues, cancer, fatigue, various issues related to women’s health, sleep issues, pain, GI issues, diabetes.

My father’s health is really what got me into integrative medicine. When he was a young man, and I was just a baby, he got diagnosed with terminal lung cancer. Given six months to live, he ended up beating that 10 years later. Then I go into medicine. I’m a resident in medicine, and he died from adult onset diabetes at age 61. What didn’t make sense to me at that point was he beat a disease that he was told he was going to die from. And then, there was a disease that he developed, diabetes, that I believe is manageable at least, if not beatable, and he died from that.

He was taking 19 different medicines at the time when he died. All the physicians that he worked with tended to do was just add another pill to treat this ailment or this side effect. I was left very empty. I was left lost in the field of medicine. Here I was a budding resident in medicine, learning all these great techniques and therapies and I felt like medicine had let them down. So, I searched for a different approach, an approach that I felt really looked at a patient from kind of a more holistic approach.

The emotional and mental aspect of healing cannot be separated from the body. The mind, body, spirit is understanding that the stresses in life, your emotions, they play a huge role in illness. But they also play a huge role in wellness and healing.

Lifestyle intervention is the crux of what we do. That’s my biggest passion.

Every disease that a person can get, or just keeping a person healthy, it comes down to what you’re putting in your mouth. What you’re doing or not doing for exercise and the way you’re managing your stress, and whether the techniques you learn keep that stress from either hurting you or harming you.

At the Scripps Center for Integrative Medicine, we have 65 employees, which encompasses a lot of different therapeutic options. We have four cardiologists. We have two integrated pain doctors. One is a family medicine doctor who does integrative approaches to headache and various pain issues. We also have a physical medicine and rehab physician who does all integrative approaches to pain. The two of them do a lot to really impact and reduce pain, eliminate pain, all through non-narcotic approaches.

We have a family medicine doctor who specializes in integrative approaches to women’s health. Beyond that, we have nutritionists, healing touch therapists, biofeedback therapists and acupuncturists. We have a fully staffed gym. We have a whole team of nurses and staff that have been trained in integrative approaches. We have our Early Detection Center, which is a state-of-the art imaging techniques from eco and ultrasound to nuclear cardiology imaging, to PET rubidium stress testing to CT scanning. It’s a whole armament of tools that can really approach patients from a truly integrative approach.

Yes, we get referrals from primary care physicians and from specialists. A lot of patients call up and schedule appointments.

First, we would try to find the source of the pain and address that source. From a more integrative approach, we would bring in different therapeutic modalities, such as acupuncture, biofeedback, massage therapy, cold laser — different modalities that can really help mitigate pain without the use of narcotics.

Again, we would try to find the source of their problem, whether it is pain or stress or emotional issues. We would try to address those issues. Then, we’d focus a lot on sleep hygiene. Are they burning the candle at both ends? Are they going to bed early enough? Are they drinking too much fluids in the evening, making them wake up in the middle of night to go to the bathroom too often? Are they drinking alcohol? Alcohol is a huge source for disrupted sleep. Are they meditating?

Could teach them how to meditate or breathe or use mindfulness techniques, journally to help them calm themselves, free their mind, so they could sleep better at night? Maybe turn off the news and not watch the news in the evenings, maybe not look at email or screen time right before bed. Those are techniques that really make a huge impact on sleep.

Inflammation is a natural process in the body. It is a process that’s necessary and important to heal. Inflammation occurs when there is an injury or a threat to the body. It’s the body's way to try to heal that issue.

There are foods that cause inflammation. Your diet plays an integral part in inflammation. If you’re eating the wrong foods, it is interpreted as a threat to the body and you still get that same inflammatory process. Some of those foods are things like red meats, things saturated in trans fats, fried foods, processed foods and refined sugars. Those are the types of foods that tend to cause an inflammatory response in the body.

From an integrative perspective, we try to find the source for their inflammation and see if we could help mitigate that source. From a lifestyle intervention, dietary perspective, we take a deep dive into their nutrition. We look at the foods that are harming them, and then really try to switch and incorporate foods that are really considered anti-inflammatory.

When somebody gives up exercise or does not have time for exercise, or is just really not focused on it, their resiliency goes down.Their ability to heal goes down, and their ability to recover from inflammation goes down. Stress is a threat to the human body and that gets interpreted as inflammation. There is a ton of different healing modalities that a person can either learn or participate in that really helps to mitigate that inflammatory response.

We first look at the sources. We have an open discussion. I’m not a psychologist or a psychiatrist, but it’s really important to me as an integrated cardiologist to bring up what is going on in a person’s life from an emotional perspective, and then really try to be open to hearing a person out and giving suggestions on how can we get to the source of trying to resolve that stress. What if they can’t resolve that stress? What if it’s something in their life that’s not going away? Then, it’s all about teaching the patient how to reduce that impact of stress in their body internally. Can we teach them how to meditate, be more mindful? Can we teach them how to breathe? Can we put them in therapy, such as healing touch, or acupuncture, that can help the coping mechanisms for those stresses?

We do a mindfulness. We have a mindfulness-based stress reduction program that is one of the best around. We have tai chi classes. We do yoga classes. We have nutrition classes. We have a vegan cooking course that teaches people how to cook and eat better. We do sound therapy. We have healing touch, biofeedback and acupuncture.

It’s incorporating sounds, instruments, crystal bowls. It’s a meditative technique that uses not only sound but the vibration from sound to really help people heal.

Swim therapy is great for all kinds of different ailments. It is great for people who have trouble walking or using their cardio equipment in a gym. We get them in a pool and take the weight off of them. It could be something as simple as water walking, where they just go back and forth in shallow water and against the resistance of the water. We use different instruments or tools in the pool to help with mobility and resistance. We do swimming just for exercise, including water aerobics, to get heart rates up. If you’ve got pain in your knee from arthritis, or you’re coming back from maybe a knee replacement, you can maybe not use as many pain meds and you can use these water therapies to deal with the pain. Water therapy is a great way to deal with pain. Being in a heated pool further helps that.

It basically opens the toolbox. It gives me so many different options for a patient. The worst thing I can do is take a patient’s hope away. In integrative medicine, we often get patients that are at the end of their rope. They’re desperate. They’ve been told there’s nothing else that can be done for them. We don’t accept that. We use these different healing modalities, these different therapeutic approaches that are not considered mainstream, but we consider them very effective and very impactful for a person.

It gives me more therapeutic options. It brings in the holistic approach. All too often in medicine we are siloed. As a cardiologist, I take care of the heart. The gastroenterologist just deals with the stomach. You can’t do that. You can’t separate illness. These systems all work together. What the primary care doctors are doing, or what the various specialists are doing greatly impact what I’m trying to accomplish for a person’s heart health. The holistic approach is really bringing that all together, and understanding it’s not just one silo, but it’s really all of them that really will help our patients get better.

Research is paramount to what we do in medicine. Medicine can’t move forward without good clinical research. The Scripps Center for Integrative Medicine embraces that. We believe, especially in a field where we’re doing more, non-traditional approaches, in evidence-based research. We’ve done research on our lifestyle intervention programs. We had a great research project where we had heart failure patients and were successful incorporating them in a lifestyle intervention program that really showed improvement in them recovering and feeling better with their heart failure diagnosis.

We have ongoing research currently with POTS syndrome, called POTS disease.We do research on advanced cholesterol management on obesity management and on pain management.

If somebody wants to get involved in one of those clinical trials, they can call our center. We have a research coordinator that they would be referred to.

That is actually often a goal for patients. They tell us a really big reason that they come to an integrative consultant is they are tired of taking medicines. I hear that. I work with that. My goal is to optimize their health. There are plenty of prescription medications that I find a lot of use in and I am totally open. Integrative medicine is the best of both worlds. So I’m not necessarily out to reduce and stop every pill if I think there’s truly a benefit for them. But I love stopping medicine. I love not starting medicine. I really like to do things as naturally as possible.