Visit 4: Outside In Integrative Medicine Practices for Fibromyalgia

Transcript

1. Integrative Medicine & Mind – Body Practices for the Management of Fibromyalgia Group Visit “Outside In” Group Medical Visit presented by Integrative Medicine Specialist Marc Fierro, PA-C, L.Ac., Frank Russell MFT, Lauren McDaniel CNC, FMHC and Kimberly Defazio LVN, FMHC, at the Sutter Institute for Health and Healing
2. Welcome back! • Today’s class is the 5th in the series. • In today’s group visit, the participants will have the opportunity to share how much they were able to implement the therapeutic recommendations from the initial group visit and assess how it is affecting their quality of life. • Today’s topics will include teaching how to implement the approaches from the categories of: • Outside In – Neurostim, laser, red light, IR sauna, acupuncture, TMS, massage, somatic therapy, craniosacral, osteopathy, chiropractic, injections, surgeries. • Additional Tai Chi – Qi Gong exercises - will be taught today. • Bundled Activities – Listen to music while dancing, walking outside, Tai Chi, Yoga, Qi Gong and more exercises that use all the therapeutic directions by design. Exercise with friends and pets. Participating in support groups and volunteering.
3. Quick summary review of last group visits Tri flex approach to the management of Fibromyalgia. • 4 therapeutic directions organizes the 5’ R’s and 7 Seeds into a workable action plan, especially if you do ONE SMALL item from each group. • Top Down – Sleep, stress, and emotional regulation management techniques, MBCBT, journaling, counseling, cognitive training programs, biofeedback, meditation, observing nature, socializing, engaging in joyful activities. • Bottom Up – We all have 2 hearts, 1 in the chest and the 2nd is the entire body! Move daily any way you can. PACED, short interval graduated exercise, aquatic therapy, recumbent biking or pedal device, especially if dysautonomia w/ low BP, modified Yoga, Tai Chi, Qi Gong . It is okay to take a short nap before you exercise and afterwards if needed. • Inside Out – Diet, nutritional supplements, prebiotics, probiotics, herbs, essential oils, cannabinoids, low dose Naltrexone, Psilocybin and medications Lyrica, Gabapentin, Amitriptyline, Cymbalta, Savella and Ketamine. New research on Mestinon for post exertional fatigue at Brigham Young University and Harvard. • Outside In – Neurostim, laser, red light, IR sauna, acupuncture, TMS, massage, somatic therapy, craniosacral, osteopathy, chiropractic, injections, surgeries. • Bundled Activities – Listen to music while dancing, walking outside, Tai Chi, Yoga, Qi Gong and more exercises that use all the directions by design. Exercise with friends and pets. Participating in support groups and volunteering.
4. Patient check in: Patient check-in time! How have you been doing since last class? Please feel free to tell us what you have tried to incorporate from the Tri-Flex Lifestyle Changes into your self-care program since we met last. Please limit your comments to 2 minutes or less so everyone has a chance to share if they would like. Please raise your hand to speak or leave comments in chat. Thank you!
5. Sharing group wisdom and progress, 3rd group visit check in topics • TRI-FLEX CHECK IN: Which activities from the 4 therapeutic Directions, 7 S. E. E. D. S. and 5 R’s did you choose since the initial group visit? • Did you start or plan on seeing the health coach? • Did you start the Happiness Trap and practice with the Mindfulness Coaching program app? • Did you start reading the TIGER protocol book? • What has been the impact on your health and well-being since doing those activities?
6. Outside In - Neurostim • Neurostim - using TENS/NMES [Trans electro neuro stimulation] at low frequencies has been shown in many studies to decrease neuropathic pain and migraine headaches especially when coupled with acupuncture. • Consider using the inexpensive TENS 7000 device which can be set at 2 hertz and placed at the acupuncture points ST 36 and GB 34. Also, I like to use vagus nerve stimulation in the ear with special electrodes that fit just behind the ear canal and tragus. Apply treatment for 30 minutes a day. This increases vagal parasympathetic nervous system tone which decreases pain and improves sleep and symptoms of anxiety. • For large treatment areas, there are conduction garments that fit the neck and back, shoulder and knee that can be attached to the device.
7. Outside In – Transcranial Magnetic Stimulation • Transcranial magnetic stimulation [TMS] is an FDA approved and insurance covered noninvasive form of brain stimulation in which utilizes a magnetic field to induce an electric current at a specific area of the brain. • An electric pulse generator, or stimulator, is connected to a magnetic coil connected to the outside of the scalp to induce the magnetic field. • It is approved for: • Major depressive disorder (MDD) (including treatment- resistant depression) • Obsessive-compulsive disorder (OCD) • Migraines • Smoking cessation • There is ongoing research studies for: • Fibromyalgia • Chronic Pain • PTSD • Tremors • Alzheimer’s
8. Outside In - Infrared Sauna • INFRARED SAUNA: Can be a helpful form of very mild exercise like activity and detoxification. Start at 3 minutes and try to work your way up to about 20 minutes. • Here are some available high-quality models. Serene Life AZSLISAU10BK Infrared Home Spa One Person Sauna with Heating Foot Pad and Portable Chair, Black And TaTalife Infrared Sauna| Portable Personal Sauna| Home Spa Sauna| Separate Heating Foot Pad and Portable Upgrade Reinforced Chair, Relaxation at Home (L 27.6"x W 31.5"x H 37.8") There are also sauna blankets available as well. • New study shows hot water immersion for 45 minutes at 104° is extremely helpful for fibro pain management.
9. Osteopathy and Chiropractic care • Reduced Pain and Discomfort: Chiropractic adjustments can help alleviate pain associated with fibromyalgia. • Increased Range of Motion: Manipulations improve joint mobility and flexibility. • Decreased Inflammation: Chiropractic care may help reduce inflammation in affected areas. • Improved Muscle Tone and Strength: Regular adjustments can enhance muscle function.
10. How does it work and what to expect? • The treatment experience for Osteopathy and Chiropractic care can vary, but here’s what you might expect from both of them: • Assessment: The osteopath and chiropractor will evaluate your overall health, including posture, movement, and any specific issues. • Hands-On Techniques: Osteopaths and chiropractor use gentle manual techniques to improve joint mobility, reduce muscle tension, and enhance blood flow. • Individualized Approach: Treatment plans are tailored to your unique needs. • Possible Discomfort: Some techniques may cause mild discomfort during or after the session. • Follow-Up: Multiple sessions may be necessary for lasting effects.
11. Is Physical Therapy helpful for fibromyalgia? • Physical therapy offers several benefits for fibromyalgia patients, and research supports its effectiveness. Here’s what you can expect: • Pain Reduction: Physical therapy helps manage pain associated with fibromyalgia. • Improved Function: Exercises like walking, strength training, and stretching enhance physical, emotional, and social function. • Quality of Life: Regular physical therapy can positively impact overall quality of life. • Symptom Management: It effectively addresses key symptoms, even when combined with medication
12. How about good old massage! • Massage therapy can provide several benefits for people with fibromyalgia: • Pain Relief: Massage helps reduce pain. • Improved Sleep: It can enhance sleep quality. • Stress Reduction: Massage therapy reduces anxiety and stress. • Increased Range of Motion: It promotes flexibility. • Enhanced Mood: Overall well-being improves with regular massages
13. Tai Qi Gong Stretch Break • Tai Chi Wrap Pat • Small Lohan • Knee Taps • Cloud Hands • 5-4-3-2-1
14. Tai Chi - Qi Gong Therapy Form • Clouds Hands
15. Tai Chi - Qi Gong Therapy Form • Serve Tea (Grasping Sparrow’s Tail)
16. Acupuncture and Chinese Medicine • Developed in China around 200 B.C. Its oldest known major text is Nei Jing (Han Dynasty). • Incorporates many empirically and evidenced based diagnostic and treatment modalities. • Cost effective. • Efficacious for certain types of disease.
17. What conditions will OM and Acupuncture commonly improve or resolve? • Neurological: • Fibromyalgia • Headaches [all types] • Bells Palsy • Bulging and herniated disc disease • Moderate stroke residuals < 2 yrs • Restless leg • Sleep disturbances • Neurogenic bladder • Metabolic • Fatigue • Weight management • Psychiatric: • Depression • Anxiety • Gastrointestinal • Dysmotility • Gastritis • Irritable bowel • Musculoskeletal: • TMJ • Neck pain, • Low back pain • Shoulder pain • Knee pain, • OA and tendonitis
18. How does it work and what systems does it influence the most? ▪ ANS: Sympathetic / Parasympathic Rebalancing ▪ Neurophysiologic [Pain Inhibition Pathway I & II] ▪ Neurochemical [Hormones and Neurotransmitters] ▪ Neuroimmunologic [Neuropeptide Pathway]
19. The Chinese Energetic Model This is based on the theory of maintaining the balance of the: • Energy of the Yin & Yang • Biological Clock • Five-Element / 8 Trigram Networks • 12 Meridians system. • Treatment is based detecting imbalances and then correcting them with acupuncture.
20. Acupuncture Is As Simple As 1-2-3 Patients complain of global functional problems versus local focal problems. 1. The acupuncturist then identifies and targets either a single imbalanced meridian for local problem or a group of imbalanced meridians for global problems. 2. The treatment is focused on re balancing either a single meridian or a group of meridians with healthy meridians. 3. Hair thin [30 to 40 gauge] acupuncture needles are placed in the points that control the imbalanced meridians and reflex zones to restore the flow of energy equally throughout the meridian system. 4. Patients usually feel relief within a few seconds to a few minutes if the acupuncturist diagnosed the problem correctly! Note long term management may take 6—12 visits to resolve condition completely.
21. Acu Maps Body & Ear
23. 5th Group Class Recommendations: • Start or continue with very small experiments. • Choose 1 or 2 things from each of the previously listed 4 Therapeutic Directions from matching the 7 Seeds of Resiliency and Recovery. • Apply it in a realistic way that is modified just for you, by you. • Use our health coaches. They are experts in getting you started, educated in self care and staying on track! • Remember you now have all 5 group class slide presentations as reference and to support your healing path along with recommended books and device applications. • If possible, try to stay connected to your social network or a group that is supportive.
24. Program support literature, and software apps are highly recommended for long- term success. Aim to read 3 chapters a week of the books and 3 minutes a day on the apps.
25. For best results get support and get started with your Health Coaches right away!
26. Questions and Answers …