Monday, May 23, 2022

OVERVIEW: IDENTIFYING THE TYPES OF PAIN

BATTLING THE OPIOID CRISIS WITH INNOVATION

Introduction:
The Integrative Pain Healers Alliance was originally inspired by every chiropractor or PT  visit where patients often get a more comprehensive explanation of how their personal injuries relate to their physiology.  We are blessed to have doctors who take the time to educate us on our issues and as educators themselves, pain therapists possess the talent to bring additional healing through the calming power of direct knowledge.

Statistics show that the United States continues to struggle with a significant drug crisis with more than 1,500 deaths per week from opioid-related overdoses, a toll that has spiked across the country amid the COVID-19 pandemic. Meanwhile, millions more Americans suffer from opioid addiction.  Analysts say the problem started with the overprescription of legal pain medications, but note that it has intensified in recent years with an influx of cheap heroin and synthetic opioids, particularly fentanyl, supplied by foreign-based drug cartels. The crisis has reached such a scale that it has become a drag on the economy and a threat to national security: opioid misuse is costing the country tens of billions of dollars annually, not only in health-care expenses but also in the form of a weakened workforce. [1]


PAIN 101: THE MIND-BODY CONNECTION
Written by: Josh T. Schueller

Pain is everywhere.  Billions of dollars are spent each year in the United States alone on pain treatments and remedies. Per the National Center for Health Statistics almost 60% are living with pain.  While most sufferers of pain want relief and answers, many medical professionals may be providing inefficient or incorrect pain reliefs counters.  The “cookie cutter” approach for pain over the last several decades has left the world in a pain crisis.  One of the main reasons why- the current treatment model does not do an adequate job in categorizing pain.  


Pain falls under different categories.  Most people do not understand that the type of pain you have directly correlates the type of treatment given.  Personalized medicine in the treatment of pain holds the key to understanding the types of pain and developing the correct course of action to treat the pain.  

Even though no one wants to be in pain, pain is the body’s early warning system that something is wrong.  If not for pain, we wouldn’t know to move our hand off a hot stove before doing serious damage.  When pain becomes an interference to our normal activities is when we have a problem.  Most people will group all pain into one big category but there are actually many different types of pain.  By recognizing and knowing the different types of pain clinicians can formulate an appropriate treatment plan that is pain specific to the person’s needs.


Here is a brief description of the types of pain:

ACUTE PAIN is sudden onset (within 3 months) that is normally caused by an injury such as a burn, strain, sprain, fracture, laceration, and surgery.  Typically, an abnormal trauma to the body causes the body to respond with pain.  Acute pain is described as throbbing, burning, stabbing, tingling, weakness, and numbness.  The pain will normally go away after healing has occurred with no lasting restrictions.

CHRONIC PAIN occurs during an event that lasts over 3 months in duration.  The original injury may have healed or resolved itself, but the pain persists for months into years.  Pain signals remain on high activity levels in the nervous system, despite no acute injury.  In instances of chronic pain corresponding emotional effects may occur such as depression, anger, anxiety, and fear.  

NOCICEPTIVE PAIN is sensation caused by tissue damage. This pain is described as sharp, aching, and throbbing. This can be caused by an external injury such as a athletic event injury or stubbing your toe that typically results in bruises, sprain, swelling and redness.  The brain responds to the information received from the nociceptors to initiate healing process

NEUROPATHIC PAIN occurs when there is damage to the neurological system.  Pain messages are sent to brain via the Central Nervous System from many times an infection or injury.  People have described this pain as burning, shooting, or numbness.  Pain associated with diabetic neuropathy and multiple sclerosis are neuropathic in origin.

PSYCHOGENIC PAIN is caused by psychological factors.  This can occur from a non-physical origin.  Psychogenic pain can be caused by embarrassment, shame, bereavement or in response to emotional or mental trauma.  Treatment for this type of pain can be challenging for many clinicians.

CENTRAL PAIN SYNDROME occurs when damage is to the brain, spinal cord, and/or brainstem. Possible causes of this pain can occur with stroke, MS, tumors, seizures SCI or Parkinson’s. disease.  Pain is moderate to severe, burning aching with sharp stabbing.      

COMPLEX REGIONAL PAIN SYNDROME is a rare and not much research has been performed.  This tpe of pain usually affects the arm or leg and occurs after injury, stroke, or heart attack.  Common symptoms is hypersensitivity, swelling, pain, skin changes, spasms and atrophy.  Many times, reflex sympathetic dystrophy (RSD) occurs.

VISCERAL PAIN is caused by injury or damage to your internal organs.  Pain is in your trunk or back or abdominal or chest and is referred pain from the organ.  Can be described as pressure, aching, cramping, nausea, and vomiting.  Examples can be IBS, gall stones, kidney stones, appendicitis, and bowel obstruction.  In many instances proper care is delayed because of inability to recognize the origin of pain and can lead to life threatening emergency.

When someone says “I am in pain” the first line of defense is medications.  Pharmacological interventions have become as American as apple pie and fireworks on July 4th.  Many times, the same medication is given for all types of pain.  Pain suffers often experience ineffectiveness of the desired results (no pain), but also develop debilitating side effects.  Knowing what type of pain, the suffer has can go along way in developing a personalized treatment approach that can alleviate or abolish the pain and allow a return to normal activates without a financial burden.


RELATED ARTICLES

WHAT IS PLANTAR FASCIITIS?
Approximately 3 million people per year.  PF is the inflammation of a thick band of tissue that connects the heels bone (calcaneus) to the toes on the underside of your foot.  The most common symptoms is sharp, stabbing pain in the bottom of your foot that is worse in the morning and after long periods of inactivity.  When getting out of bed in the morning, the bottom of your foot can feel like someone had pounded a spike through the bottom of your foot. The increase tension and stress of repetitive pounding (such as in running) can cause microtears in the plantar fascia causing inflammation and pain.


WHAT IS KREBS CYCLE? - Otherwise known as citric acid cycle, Krebs Cycle can be synonymous to the process of converting your paycheck into cash and going shopping with it. When you receive a paycheck (glucose) through direct deposit that paycheck is deposited into the bank (mitochondria).  Throughout this process there are fees (byproducts) that must be paid in order to receive the money.  These fees (NADH, GTP, CO2 etc.) are an essential part of the process.  The result is currency. In order to receive the money (ATP) it must go through to the ATM (electron transport System).  When you withdraw the money (ATP) you can spend on goods or services (energy production). As money is essential to the survival of the economy the Krebs Cycle is essential to the survival of the organism."



ABOUT THE AUTHOR

JOSH T. SCHUELLER has dedicated his life's work to the support and treatment chronic pain and disorders with non-invasive, safe, effective treatment solutions. He is the current VP of Clinical Operations and Business Development at AxioBionics LLC. and the Clinical Director for Orthopedic Physical Therapy Clinics (Rockford, MI).  As an active member of APTA, he holds advanced certification in Physical Therapy treatment techniques including the McKenzie method of patient empowerment.  He has over 20+ years experience in the treatment of neurological conditions such as Spinal Cord Injury, Traumatic Brain Injury, CVA, Cerebral Palsy etc.  In 2021, Josh is elected a clinical advisory role and educational advocacy for IPHA (Integrated Pain Healers Alliance) and has published research articles in pain management while co-launching the MedTech Reviews program of therapeutic devices.   Today, Josh continues to support patient suffering from disabilities and has expanded his focus to contribute his expertise in treatment programs for Veterans and first responders. 


References:

1) The U.S. Opioid Epidemic- Council on Foreign Relations: https://www.cfr.org/backgrounder/us-opioid-epidemic


Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.





Friday, May 13, 2022

Mental Health 101: Treating Incontinence Starts With Overcoming The Stigma

By:  Jessica Connell-Glynn, LCSW
Edited by: Roberta Kline, MD

Health issues are often linked to a range of emotional distress, but a major contributor to the progression of chronic issues such as urinary incontinence starts with the sufferer's instinct to conceal the problem.  This reactive response from embarrassment and shame drives many women (both men and women) to hide their condition from their closest supporters as well as their physicians, making incontinence go unchecked and unaddressed.   Over time, it is this level of clinical neglect that brings bladder health issues and urinary incontinence to grow into a more challenging health condition.[1]

Internalizing reactive shame plays a critical role in the effects of STIGMA and its self-propelling negative cycle, further driven by self-esteem issues, depression and hopelessness.  From a 2002 World of Psychiatry report, both public and self-stigma may carry three components: stereotypes, prejudice, and discrimination.  These elements are observed to be quite powerful in driving human activity and decision-making as they align with our sense of social acceptance, personal safety and survival.[2]

Treatment experts identify the critical progression of incontinence to start from the sufferer isolating themselves in secrecy.  According to Daphna Ross, PT, owner of Women's Health and Healing Physical Therapy, Inc., "it is extremely embarrassing and uncomfortable for women to talk about this topic. They often hide it from friends or family but also from their doctors.  This often contributes to worsening of their condition.  At first it starts as a small leak and an annoyance but then it gets worse when left untreated; they require the use of pads, start limiting their social activities their exercise, or how long they're willing to be outside the home. The leakage will affect their quality of life.  They often limit their fluid intake as well, which actually worsens their condition and causes other issues.   It's really important to see the sufferers when it's just a small issue- women should know that there are tools to manage their condition and  ensure that they don't go down this trajectory".

There have been many studies evaluating groups of sufferers of urinary incontinence directly reflecting emotional distress.  Under varying conditions of functional loss, the investigative teams in these studies tend to conclude similar association between this physical impairment and levels of anguish and anxiety where the embarrassment of incontinence would often lead to self isolation- where seeking direct care or proper counsel is often compromised.[3]

References:

1) The impact of stigma on emotional distress and recovery from psychosis: The mediatory role of internalised shame and self-esteem  https://pubmed.ncbi.nlm.nih.gov/28531822/ 
 2) Understanding the impact of stigma on people with mental illness  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489832/ 
 3) Urinary Incontinence and Psychological Distress in Community-Dwelling Older Adults  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827934/ 


MedReview: FEMALE INCONTINENCE EXPLAINED

Written by: Dr. Bobbi Kline


INTRODUCTION:
In my experience as an ObGyn, urinary incontinence is the unspoken secret among women. It affects up to 1 in 4 women, and this increases with age so that by age 65 up to 75% of women are affected [1]. And yet, most women never seek help. In a study published in 2013, 95% of women reported a negative impact on their quality of life, and yet 64% of the women had never received any medical help [2].  So often hidden out of shame, many women suffer in silence despite many efforts to raise awareness. Even those that are aware there is help may not seek it. What’s the point of speaking up when you fear it will only lead you down a path full of embarrassing conversations, invasive testing or procedures– and often does not produce effective or long-lasting results?

THE 'UNSPOKEN FEMALE DISORDER'
While urinary incontinence is most common in women over age 50, it can happen to women of all ages. More recent research is also showing that ethnicity plays a role. Sometimes the cause is temporary, as can happen with a urinary tract infection. Pressure on the bladder, as we see in pregnancy or from fibroids or other pelvic masses, can also lead to incontinence. Addressing the underlying issue typically leads to resolution of the urinary leakage.

But most commonly, the involuntary loss of urine is not so easily fixable. The causes of urinary incontinence are grouped into four different categories: urgency, stress, functional and overflow incontinence. Functional and overflow incontinence are typically due to non-bladder related causes, while urgency and stress incontinence are closely linked with dysfunction of the bladder or other structures in the pelvic floor.

The bladder is a sac made up of smooth muscle, and when it fills up with urine there is a reflex that results in release of that urine. Early in life we learn to control when those muscles contract, and thus control when we urinate.

URGENCY INCONTINENCE occurs when there is some loss of that control (3). This is often called “overactive bladder”, or OAB. Certain substances, such as caffeine or wine, or changes in hormones related to menopause, are known to aggravate this. But most often, we don’t know why this occurs. As a result, lifestyle or medication treatments are often less effective because we aren’t addressing the root cause.

STRESS URINARY INCONTINENCE is most often caused by trauma to the pelvic floor during childbirth, when the muscles that are designed to support the bladder are weakened (3). As a result, women leak urine when the bladder is put under pressure such as with coughing, sneezing, laughing or jumping. This is fairly common immediately after vaginal delivery, and many women will notice their symptoms improve with Kegel exercises designed to strengthen these pelvic floor muscles, along with the natural healing process. In my experience, many women are not sufficiently educated and supported in this. Or, as is especially the case with new moms, they are so busy taking care of everyone else that they neglect their own health needs.

Some women never fully recover, and even those that do often see the stress incontinence symptoms return later in life. And to make things even more challenging, often women have both urgency and stress incontinence. So women hide, often arranging their whole lives around avoiding leaking urine because they are ashamed to seek help. They change their exercise routine. They forego activities that bring them joy and pleasure, including sex. They buy pads and hope no one notices. They are always worried about a leak that reveals their shameful secret.

In my opinion, it’s part of a larger problem in how we view and treat women’s bodies. But fortunately, things are starting to shift thanks to technological advances in both our understanding and treatment. Even Personalized Medicine is yielding breakthrough insights into underlying causes. We are learning how each woman’s DNA related to pelvic floor muscles and collagen, and the DNA of her urinary microbiome, can impact her risk as well as the effectiveness of current treatments. 

I am optimistic we may someday soon be able to truly tailor both prevention and treatment in a way that is much more accessible and effective in addressing urinary incontinence in women.


Why I wear Pull-Ups… By: Jesi Stracham 

When Depends became too baggy after my weight loss causing leaks and the pads would slide to the side, I switched to GoodNites brand children’s diapers. Immediately, my confidence was boosted with the cute designs and panty like fit. Even though I have my bladder well managed, I still wear them daily. With my active lifestyle I like the piece of mind that if I have an accident my wheelchair cushion and clothes will still be dry. I simply rip the diaper off, clean my downstairs “area” with a baby wipe, put a new diaper on and wheel on my way. 

Often times SCI survivors suggest Botox Injections and pharmaceuticals to help with my incontinence. I used both up until April 2017 when they quit working. I searched high and low for natural alternatives after realizing how well my body felt after getting off of the pharmaceuticals. The uncomfortable constipation and dry mouth ceased within days!

Early summer 2018 I had a bladder study done. The nurse who perform the study shamed me for refusing to take the prescribed medicines. She put me in tears saying due to the amount of spasms my bladder has shrunk significantly.  She continued on with a shame train because I refused pharmaceuticals after explaining they didn’t work and made me feel funny. She placed fear deep within my soul threatening that I would need a permanent catheter in my stomach with a bag or bladder augmentation (surgery where they take a piece of your bowel to make you bladder bigger) before I knew it.  (see complete Blog entry)


About the Author

JESI STRACHAM
 is a trauma survivor on a mission to help individuals see the opportunity in their obstacles. She is the founder of Wheel With Me Foundation, the owner of Wheel With Me Consulting, and a fitness and growth coach. Through her struggles, she works for teaching individuals the power of our mindset. Jesi is an honest, authentic, America-loving athlete. Over the past several years, she has generated a significant following among both the spinal cord injury and able-bodied community. Her goal is simple: show the world there is an opportunity in their obstacles, restoring hope during life’s difficult moments. She helps people achieve their dreams through the importance of goal setting, taking control of what we have control over, and showing YOU what’s possible with consistent hard-work.








Using Ultrasound for Evaluation of Incontinence
Written by: Dr. Robert L. Bard

Prolapse of the pelvic floor contents (the uterus, bladder or the anus) is also associated with incontinence. 3-D pelvic floor ultrasound is performed in two ways: 

1) transvaginal probe which goes inside the vagina 
2) transperineal scan which is a more common way for evaluating stress urinary incontinence since the trans perineal probe is applied at the outside of the pelvic floor in the area between the vagina and the anus which is called the perineum.

MRI has been used for years to image the prolapse of the pelvic organs but is being replaced by the 4D real time transperineal sonogram as it is quicker and instantaneously shows the tear in the muscular ring (levator sling) that is associated with the trauma of birth. This exam is done in the privacy of an office instead of an MRI center or hospital setting and may be completed in a few minutes by the physician or specially trained technician. The muscle bundle that supports the bladder is white on the sonogram while the tear is black and readily distinguished.   During the examination the patient participates actively by bearing down or straining (Valsalva maneuver) to provide an exact measurement of the degree of the descent of the uterus, urethra, bladder or rectum.

THERAPY
Stress urinary incontinence (SUI) is distinct from overactive bladder (OAB) while both may be problematic in older patients with weaker muscle tone. The KEGEL maneuver is a common therapeutic approach to improve muscle strength and diminish the loss of urine when coughing, sneezing or laughing. While the technique is simple, the learning curve is often difficult for women who are accustomed to bearing down rather than “sucking up” the anus or vagina. While 4D ultrasound is optimal for diagnosing the cause, it is sophisticated equipment and requires advanced medical skills.  It can go beyond diagnosis and aid in treatment: the demonstration of the bladder change in the proper Kegel contraction is visible to the patients as a dynamic training guide by the physical therapist.  

The bladder descends during the Valsava while the bladder and urethra move upward in the correct maneuver.  This equipment is portable so it may be brought to the patient rather than a clinic visit or a treatment facility.  The technology is also wireless and point of care (POC) images may be transmitted to a reading site for interpretation as is done in ambulances where the EKG is read remotely by the Emergency Department physician while the patient is in route.


FIG-1: Postpartum delivery and difficult childbirth are a major cause of pelvic floor trauma, muscle tears and of course, urinary and fecal incontinence.  The ovoid white muscular ring in this case on the right shows a star, which indicates that the white muscular lining, which is smooth on the right hand side of the picture is bulging and actually torn and disappeared by a black area, indicating the exact location at the extent of the tear.  This is important preoperatively for reconstructive pelvic floor surgery.  While the 3d probe takes 15 seconds to scan the entire pelvic floor surface, it takes training and of course the specialized ultrasound technology, which shows the location and the depth of the disease. More importantly, the patient dynamically assists that is active patient participation to bear down or Valsalva or hold the urine for a varied period of time is important for measuring the descent of the bladder and the uterus in the pelvic floor. Thank you very much for your attention.

For the reasons of accurate diagnosis and ease of use, pelvic floor ultrasound is widely used in Europe and becoming popular in the US. The technology is safe and a “black and white” visual aid for learning the Kegel maneuver.  Additionally, during the diagnostic evaluation, the physician will look for other etiology of the voiding dysfunction such as bladder stone, bladder cancer and cystitis as well as inflammatory urethritis which is seen with treatments such as transvaginal tape (TVT) or surgical devices that are implanted.  Complications of endometriosis and cervical, ovarian or uterine tumors may be detected and definitive treatment may be timely instituted. 

Reference:
Dietz, H.P.,  Pelvic Floor Ultrasound Ultrasound, Atlas and Textbook , 2016 Obstetrics and Gynaeoclogy- Springwood NSW Australia



Pelvic Floor and Physical Therapists
Written by: Joshua T. Schueller, PT
Edited by: Bobbi Kline, MD

There has been a recent surge in interest in physical therapists who specialize in Pelvic Floor Rehabilitation, and more therapists are choosing to specialize to address this need. These highly trained professionals are giving people their lives back. The days of labeling Pelvic Floor treatments under one umbrella are long gone.  The physical therapist is an integral aspect of the profession that has been misunderstood and underutilized in the past.  Standard Physical Therapy programs currently are not doing an adequate job of educating on the pelvic floor.  This has forced the therapists to pursue post-graduate certification through continuing education courses.


The pelvic floor plays a vital role in the whole-body function in both men and women, and Pelvic Floor Rehabilitation needs to treat the whole person.  Due to the variety of conditions that begin in the pelvic floor a thorough evaluation of history, exam, and intervention that is individualized from a therapist that specializes in Pelvic Floor Rehabilitation is a vital aspect to success. By treating only the symptoms, you may miss the underlying cause. 

While Pelvic Floor Rehabilitation is the generalized term, there are many layers and conditions that could be causing your problem. In the past, physicians recommended treatments for pelvic floor dysfunction that concentrated on pelvic floor exercises (kegels), medications, internal medical devices, injections, and complicated surgeries. Aside from the kegel exercises, these treatments are costly and invasive despite having varying degrees of success.

In speaking with many experts in the field of Pelvic Floor Rehabilitation, there is not one cookie-cutter approach to diagnosis or treatment.  A comprehensive evaluation by a highly trained experienced therapist is essential in providing success.  A thorough examination, both externally and internally, determines Interventions. A holistic approach is the most successful way to determine the appropriate course of action. Lifestyle, nutrition, activity levels, and past medical history can all play a role in what is causing the problems. Education to the client is also essential.  Knowing what is going on and why helps the person understand causes, and rationale for treatments.

Common Physical Therapy treatments focus on muscle imbalances.  Weakness, spasm, misalignment, or poor recruitment of muscles are common in Pelvic Floor conditions.  This can lead to incontinence or pain among other dysfunctions.  Educating the person on strengthening exercises or relaxation techniques can be very beneficial.  Demonstrating the proper way to engage different muscle groups can be done through biofeedback.  Therapists use manual therapy techniques to reduce pain, improve stability, decrease inflammation, improve movement, and improve function.  

Currently, many non-invasive treatment techniques are gaining in popularity and have shown significant promise in the treatment of many pelvic floor dysfunction conditions including incontinence.  Electrical stimulation, biofeedback and pulsed electromagnetic field therapy have shown the most promise.  Utilizing these products for home use has allowed the individual users to achieve success outside of the clinics, often saving them time and resources in addition to having the benefit of privacy that these effective treatment options offer.




Groundbreaking New Solution for Incontinence: Meet ELITONE
2/22/2022- Health and Healing 101 reviews the latest innovation in addressing female incontinence. A wearable medical device called ELITONE (by Elidah, inc.) hit the market in 2019, offering a non-intrusive incontinence treatment as an alternative to pads.  Team Kolb shares their valuable insights on the creation of this remarkable device, while also discussing the road to achieving regulatory approval for product launch.  (See complete article)



References
(1) https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/is-urine-incontinence-normal-for-women

(2) Sensoy N, Dogan N, Ozek B, Karaaslan L.  Urinary incontinence in women: prevalence rates, risk  factors  and  impact on quality of life. Pak J Med Sci 2013;29(3):818-822

(3) Aoki, et al. Urinary Incontinence in Women. Nat Rev Dis Primers. ; 3: 17042



CONTRIBUTORS

BOBBI KLINE, MD
(Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://bobbiklinemd.com 

 
ROBERT L. BARD, MD  (Diagnostic Imaging Specialist)
Having paved the way for the study of various cancers both clinically and academically, Dr. Robert Bard co-founded the 9/11 CancerScan program to bring additional diagnostic support to all first responders from Ground Zero. His main practice in midtown, NYC (Bard Diagnostic Imaging- www.CancerScan.com) uses the latest in digital Imaging technology has been also used to help guide biopsies and in many cases, even replicate much of the same reports of a clinical invasive biopsy. His most recent program is dedicated to the reporting of mental health diagnostic and innovative solutions including the use of modern neuromagnetic technologies and protocols in his MEDTECH REVIEWS program. 

 
JESSICA CONNELL-GLYNN, LCSW, CPC, CEC
- (Mental Health Dir.)
As a therapist and mental health coach for the Women's Diagnostic Network, Jessica's expertise is highly in-demand in many areas of pre/post procedural care. She provides direct support in managing personal anxiety, panic, targeting TRAUMA and residually related fear.  This is specialized work honed by her extensive experience and research with the general public and within the Women's Wellness community. Jessica is also currently leading an interdisciplinary research project with a team of mental health and professionals in neurology, assessing psychological disorders. (Visit her website- www.jagtheracoach.com 

  
JOSH SCHUELLER, PT 
(Assoc. Editor)
Josh supports the treatment chronic pain and disorders with non-invasive, effective treatment solutions. He is the VP of Clinical Operations and Business Development at AxioBionics LLC. and the Clinical Director for Orthopedic Physical Therapy Clinics (Rockford, MI).  He is an active member of APTA with advanced certification in Physical Therapy treatment techniques including the McKenzie method of patient empowerment.  He has over 20+ years experience in the treatment of neurological conditions such as Spinal Cord Injury, Traumatic Brain Injury, CVA, Cerebral Palsy etc.   


 DAPHNA ROSS, PT, PRPC, WCS (Guest contributor / technical advisor)
Daphna is the owner or Women's Health and Healing Physical Therapy, Inc with 20 years as a practicing physical therapist, specializing in Women's Health for the past 10 years. She is a board certified specialist in the field of Pelvic and Women's Health Physical Therapy, served on faculty at the Rehabilitation Institute and now proud owner of Women's Health and Healing. Daphna's focus is on treatment of women of all ages including pregnancy and postpartum, incontinence, urinary urgency and frequency, prolapse, and pelvic pain. She utilizes evidence-based treatment in a warm and nurturing environment. www.womenshealthhealingpt.com 

Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.






Thursday, May 12, 2022

MedTech Review: The Science of Energy Healing (part 1)

Energetic healing has been practiced by many cultures and in many ways over the centuries. While mainstream medicine has embraced some forms of energetic modalities, by and large it has viewed most as “alternative” and “non-science based”. This is slowly changing as the science is catching up to be able to explain this ancient practice.  


Samples of energy therapies include:

• Biofield energy healing
• Contact healing
• Distant healing
• Therapeutic touch
• Reiki
• Magnetic resonance therapy

• Colorpuncture
• Light therapy
• Polarity therapy
• Bioresonance therapy
• MORA therapy
• Zero Balancing


ENERGY IS EVERYWHERE
Everything is energy. Quantum physics has demonstrated that everything exists as a vibrational energy. Some forms of energy have a frequency low enough to make the object solid and therefore visible and physically tangible, such as concrete, trees, mountains, and the human body. Others, such as sound, light, heat and gravity are invisible – but they are no less real. 

Every living thing requires energy to exist and function, and this comes in different forms. For example, in the human body are “energy generators” called the mitochondria. These tiny powerhouses in our cells convert fat, protein and glucose into ATP – the energy that fuels everything that is needed for us to be alive. (see review on the mitochondria)

While the science behind how energy exists and is utilized for health and well-being is quite complex, efforts have been underway for more than 30 years to create a more approachable understanding.


THE SCIENCE OF ENERGETICS: THE BIOFIELD
The Biofield is a relatively new term developed in 1992 to describe the concept of energy in a more unified way, integrating knowledge gained from traditional practices with that of modern science. [1] Three of the main scientific principles underlying our current understanding of the Biofield energy are thermodynamics, physics and quantum physics.

The First Law of Thermodynamics is a conservation law, meaning that the total amount of energy in the universe is constant, therefore it cannot be created or destroyed but only transformed. 

Physics operates on the principle that energy is the ability to do work, and there are 4 types of energetic forces found in nature: gravity, electromagnetism, and two related to atoms. 

Quantum physics demonstrates that all matter is energy, composed of atoms and subatomic particles that are always in motion. This energy is never static in its natural state, rather it is vibrating at a specific frequency. Sometimes that frequency is readily measured, as in the electrical signals from various parts of the body. The ECG (electrocardiogram) measures the electrical activity of the heart, the EEG (electroencephalogram) for the brain, and EMG (electromyogram) measures electrical activity in response to a nerve’s stimulation of muscle. These are all standard in Western Medicine.

In addition to the physical body, our food, thoughts, beliefs, emotions, and consciousness are also composed of energy. The end result is a complex interaction of multiple vibrational frequencies that either work in harmony or are creating dissonance. 

“The concept of biofield regulation offers a shift from a mechanical, chemistry-based view of biology to an information-based view.” [1]

This, then, is the biofield: a complex energy field responsible for the generation, maintenance, and regulation of biological homeodynamics. Cell biology and biophysics research has validated that our own electromagnetic and other types of energetic fields play active roles in many biological processes including embryonic development, tissue repair, inflammation, pain, cell-membrane potential, cell signaling and other communication, and even as information encoded in our DNA. [1, 2, 3] 

The ongoing exchange of information that is required for living systems to maintain their integrity could be considered to be the true “language of life”. While much of this language has been described to date as electromagnetic, there is growing evidence for the role of quantum energy as well. [1]

ENERGY IS HEALTH
When that vibrational frequency or information flow is disrupted or altered, cellular health suffers and the end result can range from minor aches and pains to major illness. But now our knowledge of the Energy of the Biofield also provides the opportunity for healing in a much more effective way that can complement or even replace the need for more invasive conventional therapies. 


ACUPUNCTURE AND ACUPRESSURE
The ancient modalities of acupuncture and acupressure are now thought to operate within the connective tissue biofield that runs along the meridian lines, creating a rapid and effective communication channel [1] that may result in epigenetic changes. (see DNA methylation)

ULTRASOUND
With a wide range of frequencies available, clinical uses for ultrasound have expanded from limited diagnostic and treatment (such as lithotripsy for kidney stones) to advanced assessment and treatment of a wide range of tissues – even including surgical procedures. [4]


ELECTROMAGNETICS
PEMF (pulsed electromagnetic fields) devices have a wide range of frequencies available, and can influence cell membrane potentials of many different tissues to enhance communication and increase blood flow, decrease inflammation and activate a number of genes [3] possibly through epigenetics. 

Pharmacology is also leveraging electromagnetics to explore more effective ways of getting medications into cells. Drug delivery systems are being developed using nanoparticles designed to manipulate cell membrane electromagnetic fields to improve absorption.

No longer relegated to a few small corners of the healing world, energetic medicine has come into its own as an advanced way to view health and to promote healing.



ABOUT THE AUTHOR

BOBBI KLINE, MD 
(Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://bobbiklinemd.com 



REFERENCES

[1] Rubik B et al. Biofield Science and Healing: History, Terminology, and Concepts. Global Adv Health Med. 2015;4(suppl):8-14.

[2] Seema Bhattessa Pharmaceutical Drugs and the Human Energy System (Biofield) Global Journal of Medical Research: B Pharma, Drug Discovery, Toxicology & Medicine  Volume 20 Issue 6 Version 1.0 Year 2020

[3] Wu, Ziying et al. Efficacy and safety of the pulsed electromagnetic field in osteoarthritis: a meta-analysis. 2018 BMJ Vol 8 Issue 12

[4] Miller, Douglas et al. Overview of Therapeutic Ultrasound Applications and Safety Considerations. J Ultrasound Med. 2012 April ; 31(4): 623–634.

Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.



JANUARY HOWARD: "MED-PRENEUR" & LEADERSHIP MENTOR

IPHA NEWS is proud to kick off our spring 2022 feature spotlight series on female role models in our community.  Welcome January Howard, owner of MedSpa 101.  Her business is coaching medical professionals who are new to aesthetics- looking for financial freedom.  January found her passion with coaching professionals find their next interest in the world of aesthetics.  She is among a set of remarkable women chosen as part of the EMPOWERMENT SERIES by our panel of public advocates for their leadership in their respective careers or fields of study, while others have been chosen for social or technical achievements that can inspire us all.   


A VENTURE IN PERSONAL ENHANCEMENT

By: January Howard

If process of elimination is a direction finder, I learned at a very early age where I didn't belong.  I started out with a degree in exercise science and went the gym route as a personal trainer.  The hours were exhausting, the pay was defeating and it didn't lend itself to a truly fulfilling existence.  I hate to admit that my mother may have been correct about choosing the wrong degree, but lets face it, many of us never end up in the first field we start out.

We are at a great age when we can access inspirations to explore and evolve in a better direction. You can learn just about anything on YouTube.  Nowadays, you can become an expert at just about anything. Finding those kinds of resources and just being inspired to question life and find better ways in life-- and when you surround yourself with those innovators, I took note and chose to look for the positive.  A mentor taught me that 'you don't sell your product, you sell the solution... your product solves". So it's whether it's pain, whether it's anti-aging, whether it's just straight vanity and/or it's the newer cooler best thing.  I enjoy being healthy and happy, so I choose to inspire others to find their own healthier, happier ways as well!  

I just kept evolving- but I've always loved helping people. I had a successful marketing company for a while and it crashed when the economy crashed.  I became an event planner for a booming network marketing company where we launched a game-chainging 90 Day Fitness Challenge and set a world record for the largest simultaneous flash dance to date!  Alas the rockstar life was awesome because when the economy was down, we were growing but I totally burned out on that and went back into aesthetics and evolved into the person I am now. My evolution in aesthetics started when I took on a microneedling device. Microneedling found it’s self on the FDA's radar, a competing pen got the FDA clearance first and I temporarily got swept into a nasty battle with a less than ethical local rep.  In reflecting, I simply decided to be better. 

I formed a new business model focused on edutainment as we call it, thorough yet entertaining skill and marketing training.  Most clinical trainings, are mundane and boring, educational, but far from inspiring.  Simply put my courses are more fun, more condensed and just better all around.  This program was more focused around the client and their growth- and took off beautifully. My retention rate is literally at 99.5%. After a while, we created an elevated culture where our students left fulfilled and ready to not only preform a skill but to thrive  

I won't take all the credit for a successful business. There's Tony Robbins, which was my catalyst, and then there is Jeff Henderson, which is a direct mentor of mine. He was actually the CMO of Chick-fil-A. He teaches very similarly to likes of  John C. Maxwell and Napoleon Hill, A major lesson I learned from Jeff is that "you must become a raving fan of your clients, in order for then to become a raving fan of you... and that's the goal is our clients be our raving fans!". I choose to surround myself with like-minded, grounded individuals who strive to evolve into the best versions of themselves!  When I am not teaching Drs aesthetics over the weekend.  I serve at my non-denominational church by teaching 4 year olds in Sunday School, I get by giving and am grateful for the teachings and support I get for free every Sunday I attend.  


I love what we do. Even though our line of work can be the more on the vane side, we do help people look and feel better about them selves. We help people with scars, hyperpigmentation and hair loss, we help soften fine line and wrinkles, which improves overall texture. This truly helps people build their self-esteem. It's not just for the socialites that want to look amazing-- aesthetics is also for someone scarred from a fall, or that's had a bad bicycle accident and her lip has been scarred and we help bring their face a back to symmetry.  And for that child that was acne ridden or a beautiful woman that's full of acne scars - we can smooth her face out. I did it. We worked on an accountant that works with us and we had done six treatments--  acne takes a while (some take several couple years). I had not physically seen a difference and I asked her thoughts, after a while, she tears up and she said, "oh my God, I can smile without it hurting... I can move my face now, like a normal person.".  We literally worked on her to address a major piece of scar tissue. So this part of her face used to hurt when she smiled.  Stories like this make it a beautiful space to work in.  Also, there's a lot in PRP for wound care including diabetics, treatments that actually save limbs, and restore burns to the natural color and texture!  

We provide accredited classes and that's my specialty. This can be ongoing and speaking of evolution, I've had to evolve again because of COVID. My primary focus is working with clients who are medical providers who are new to aesthetics.  I help everyone from ophthalmologists, orthopedic surgeons, nurse practitioners, physician's assistants- anyone that that hunger and wants to grow into aesthetics because we're the fun part! And I use the word 'FUN' a lot but I truly believe that once you get into aesthetics, you don't really want to go back.  In addition to FUN, aesthetics is a cash based business which is an immediate retun on investment for the practice!


WHAT IS MICRONEEDLING?

So in very layman terms, micro-needling Is the exact same thing as aerating the lawn or the golf course. So aerating for some ladies that don't know, you put little pivots into the grass and it makes the grass come back thicker and greener. In creating perfect micro injuries to the skin in which the skin comes back firmer, tighter, more polished, more radiant. It works on skin, scars and hair. It's just a moderately aggressive treatment. It is literally is like a tattoo needle with 12 to 16 needles in the little cartridge and you use a topical numbing cream then you put the little holes in the skin. The best treatment I believe is with PRP -that's called the vampire facial coined trademarked by Dr. Charles Runels.  For best results a series of 4 sessions spaced 4 weeks apart is needed.  


MEDSPA 101

I'm great at branding everyone else but a little slow to brand myself.  It's been up and running but formally launching the website was a little challenging. This is how you can open a med spa with as little as 5,000, as much as 20,000. And I can teach you to easily make a hundred thousand dollars in a year with that. So it's very simple. I am focusing on the beginning stages of med spas. That's where I would rather work and building a library of resources for my clients and those clients mainly general practitioners that want to just start offering Neurotoxins,  Fillers,  micro-needling and PRP.


To me, microneedling and PRP should be your first investment in launching aesthetics in both new and or existing practices!  Simply because with those two, you train and immediately start earning income.  Botox takes time and practice. You need to practice on your friends a lot before you really start charging for it. With PRP, if someone's a confidant injector, they can immediately start making money.  PRP is actually platelet rich plasma. You would take a vial (or six). Some, some treatments require around 60 Ml's of blood (it's not even equivalent to a cup of coffee) and it's way less than you give if you donate blood.   The provider will spin the blood in a medical grade centrifuge. In which the machine separates the red blood cells from the white blood cells.  Red blood cells have absolutely no value. And then you will extract the platelet rich. So typically if you did that 60 ML draw, you would typically have anywhere from five to 10 Ml's of platelet, rich plasma, after you can dilute it depending on the procedures that you're doing.  PRP for are the platelet rich plasma facials, which we call the vampire facial. The VAMPIRE FACELIFT, which would be injecting the PRP with a synthetic filler can be used for joints, The O-SHOT and P-SHOT for sexual function, (and yes they really work) for hair loss and just about anything.  It's great for acne. PRP just brings the body back to a state of homeostasis- correcting, scars, softening the skin, thickening hair.  However if a man's been bald for 10 years, his hair is not going to come back.  If someone is thinning we can thicken the hair up, wake it up quicken up the hair cycle.   Hair loss has been on the rise due to elevated stress levels, a rise in hormone, issues, as well as a lingering side affect of the Covid virus.  Women with these root causes have great results with PRP therapies!  In addition BioFiller requests are on the rise this is where the provider uses heated plasma mixed with PRP instead of synthetic filler.  This is perfect for those more on the  homeopathic side, as well as those looking for a softer more natural look.  


ON PARTNERSHIPS

I've been very lucky. I think maintaining my ethical values and my core beliefs throughout running a business has really paid off. I remember working with a med spa and Dr. Reynolds came to town and we hired him to speak at our event. I loved what he was doing. I love the Cellular Medical Association teaches medical professionals, life changing therapies that also create financial freedom for the provider at the same time!  I joined his affiliate system and working with him motivates me because I'm continuing to learn about the benefits.  For example, in a weekly training, there was a situation about people getting synthetic filler in their temple and a provider injected PRP to reverse necrosis. The patient could have been scarred for life yet PRP to fixed that!  I am also a product of the product!  I micro-needle myself every 4 to 6 weeks, have thickened my own hair, and navigated a gnarly injury to my face without scaring; do to my access to PRP and micro-needling!  In addition to working with Dr Runels I also have the privilege of working with Dr Arun Garg, one of the original inventors of the very first centrifuge!   It’s truly a privilege to work with these innovators, and living legends!  


Conclusion There is truly a plug and playbook to aesthetics, and or I/ she call it a spa in a box!  Navigating aesthetics is a fun and fruitful journey when you partner with the right team!   



Saturday, May 7, 2022

HEALTHSPAN: Living Longer with Quality of Life (feat. TELOMERES EXPLAINED)

By Dr. Roberta Kline

Thanks to the many advanced health solutions and wellness resources available, our concept of aging and lifespan continues to evolve.  Our new generations who boast about "50 is the new 30" is no longer content with hoping to add a few years to their existence- instead seek true QUALITY OF LIFE even in the advanced years.  This means feeling healthy and vibrant and running at optimum performance as long as possible. 

RE-DEFINING TIME
A person’s chronological age describes how long a person has been alive. The biological age describes how well they are aging at the cell level.  HEALTHSPAN (years of good health) is now replacing LIFESPAN as the ultimate goal. This has spawned a huge global industry with people spending hundreds of billions of dollars on services ranging from aesthetic products and procedures to complementary and alternative therapies to optimize mental and cellular health, and that is only expected to grow with an aging population. [1] Grandview research

Knowing how to objectively measure the impact of these strategies to increase a person’s healthspan is a key driver behind development of technologies from lab tests that evaluate biochemical pathways to ones that look at biological aging. Two tests that evaluate biological aging are telomeres and DNA methylation.

TELOMERES EXPLAINED
DNA exists in our cells as tightly coiled sequences called chromosomes. Each cell has 23 pairs. Every time our cells divide to create new cells, our DNA also has to get divided and replicated. In order to do this, the chromosomes have to unwind and become vulnerable. 

Telomeres are specific sequences of DNA on the ends of our chromosomes that are designed to protect them from getting tangled or damaged during this process. This minimizes the risk of large-scale errors in the DNA when the chromosomes get transferred to the newly created cells.

But telomeres also have another function: they are a cell’s biological clock. Telomeres shorten over time, and one of the main ways this happens is when cells divide. Eventually the telomere becomes too short to protect the chromosomes reliably, and so the cell dies. In this way, the length of the telomeres can provide a good estimation of how many times the chromosomes have been replicated to form new cells. [3] 

It is also possible increase telomere length, thus resulting in the interaction of multiple factors such as female sex and genetics. Estrogen tends to be associated with longer telomere length. Errors in a person’s genes, whether due to rare inherited genetic mutations or more common smaller changes called SNPs (single nucleotide polymorphisms) can lead to shorter telomere. [4] 

To review the telomere length, shorter telomeres are associated with an increase in the risk for many diseases associated with aging, including cancer, heart disease, diabetes, osteoporosis, and Alzheimer’s Disease.[5]  Though studies have shown that telomere length is typically longer in cancer cells, because they have hijacked the normal internal clock. This is one reason why cancer cells can continue to multiply much faster and longer than normal cells.  But cancer is not the only way to lengthen telomeres. Dietary and lifestyle factors have also been shown to affect the length of telomeres. Chronic stress, poor diet, environmental toxins (including smoking), and lack of adequate exercise have all been linked to shorter telomeres, primarily by increasing the levels of oxidative stress. [4] 

Not everyone who experiences these stressors ends up with the same length telomeres, however. All of these interactions are under the control of genes, and having multiple errors in these genes called SNPs (single nucleotide polymorphisms) can make a big difference in how much these factors affect telomere length. 

The good news is that a person’s short telomere length is not irreversible. Recent studies have shown that providing the right dietary, lifestyle and nutritional supplements to reduce oxidative stress can reverse this process of telomere shortening over time. [5] 

DNA METHYLATION
Diet, lifestyle, stress and environment also affect our DNA in another way called EPIGENETICS. More broadly termed as epigenomics, this literally means “above the genome”. Epigenetics provides a way for genes to quickly adapt to changing environments, without changing the actual DNA. Epigenetic changes can turn genes on and off, modifying a person’s biochemistry without changing the DNA code itself. Because of this, these changes can be easily reversible if the situation calls for something different. [3] While there are several mechanisms to accomplish this, one of the best-studied is called DNA methylation.

DNA methylation works by utilizing a specific chemical your body produces to run your biochemistry: a methyl group, composed of carbon and hydrogen molecules. These methyl groups are used in thousands of biochemical processes throughout multiple biological systems every day. When a methyl group is added to a specific place on the DNA, it turns the gene “off”. This same methyl group can also be removed through a process called demethylation, and that turns the gene on. This is a normal process that controls everything from fetal development to how various cells can function differently even though they have the same DNA and the same genes. [7]

Researchers have discovered that over time, the natural course of aging results in fewer genes having these methyl groups attached to the DNA. [8] But, like the telomeres, this is a dynamic process that is also influenced by a number of different factors, including genes, diet, lifestyle, environment, and exercise. 

As with every biochemical process in the body, genes themselves control the whole process of methylation and demethylation. SNPs in these genes can impact a person’s ability to efficiently regulate DNA methylation. One of the best known genes is involved in producing the methyl groups necessary for DNA methylation, and is called methylenetetrahydrofolate reductase – or MTHFR for short. People with this SNP are predisposed to producing fewer methyl groups, and this is even more significantly impacted by diet and lifestyle factors. 

Aging is a natural process, and yet we are learning that the diseases commonly associated with aging may not be inevitable. As science continues to progress, it is providing clues as to how we can stay healthier longer. Telomeres and DNA methylation are two technologies to help people know how they are doing in the quest for a longer healthspan, so they can enjoy their later years to the fullest.


1)  https://www.grandviewresearch.com/industry-analysis/medical-aesthetics-market 
2) https://www.grandviewresearch.com/press-release/global-alternative-complementary-medicine-therapies-market 
3) Genome.gov
4) Tsoukalas, D et al Association of nutraceutical supplements with longer telomere length. Int J Mol Med. 2019 Jul; 44(1): 218–226
5) Gruber HJ et al. Telomeres and Age-Related Diseases. Biomedicines 2021, 9, 1335.
6) Masood A. Shammas Telomeres, lifestyle, cancer, and aging. Curr Opin Clin Nutr Metab Care. 2011 Jan; 14(1): 28–34.
7) https://www.cdc.gov/genomics/disease/epigenetics
8) Heyn H et al. Distinct DNA methylomes of newborns and centenarians. PNAS June 26, 2012 vol 109 no 26




ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group)
Dr. Kline is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/


Disclaimer: The information (including, but not limited to text, graphics, images and other material) contained in this article is for informational purposes only. No material on this site is intended to be a substitute for professional medical advice or scientific claims. Furthermore, any/all contributors (both medical and non-medical) featured in this article are presenting only ANECDOTAL findings pertaining to the effects and performance of the products/technologies being reviewed - and are not offering clinical data or medical recommendations in any way. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, never disregard professional medical advice or delay in seeking it because of something you read on this page, article, blog or website.


THE GLOBAL VIDEO ENCYCLOPEDIA & THE SOCIAL VOICE

Dr. Bard interviewed by CH11 PIX News: 10/8/2021 To gain an understanding of today's digital video messaging is to accept the very basis...