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Salmon Green Chili Omelet

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Wednesday, September 27, 2017

2 eggs per person

Add whatever liquid you prefer; skim milk, almond or other milk (I add water) and whisk thoroughly

2 or 3 large peeled and minced chilies

2 or 3 inch square of cooked salmon, crushed with fork

Add chilies and salmon and stir well

Pour ingredients into a frying pan heated with a tablespoon or so of grapeseed oil

Sprinkle with preferred cheese, cheddar is really good with this dish

Cook over low to medium heat until the edges have congealed and omelet has cooked through.

Carefully loosen one side and gently flip over to make omelet.

Finish cooking to degree of preference: soft, medium or well cooked!

Sprinkle with pepper and turmeric and decorate with a sprig of fresh basil.

Enjoy!

My grandmother made an omelet envied by all. She also made the best scrambled eggs. Her secret? Leave the eggs alone while they’re cooking. She would say, “People keep stirring them while they’re cooking and ruin them!” 

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A Fall Ritual in the Land of Enchantment

Posted By Carol L. Hunter PhD, PMHCNS, CNP,, Wednesday, September 27, 2017

On a crisp Saturday morning in September, lines are forming outside the wooden barrier that keeps the chili lovers safely separated from the flames of the chili roasters. From the moment you step outside your vehicle, the scintillating aroma of roasting chili captures your attention, conjuring up memories associated with this unique odor and time of the year. It is just another one of the many annual traditions in New Mexico and it brings out the diehards in droves.  My favorite stand is Wagner’s Farm in Corrales, a small agricultural community outside Albuquerque, owned by four generations of the Wagner family since 1910. Besides the fresh produce, they have hay rides, a pumpkin patch, a corn maze and a petting zoo which makes for a busy day for the children. www.wagnerfarmscorrales.com

Ristras are red chilies hung from twine, which serve a dual purpose: to keep a ready supply nearby that one can simply pick off the rope and also to offer a bright visual that is a work of art. They are strung across the face of the farm stand in different sizes, casting a welcoming banner. Inside the “stand,” which is really a full sized building, there is bin after bin of fresh produce, from corn, squash, peaches, pumpkins, okra, green beans, cucumbers and jalapenos to melons, varieties of apples and of course a whole wall of chili options from the mildest to the extra hot, in either bushel or standard burlap bag size. If you have the freezer space and want your chili to last all winter, most folks grab the large burlap bag, throw it into the cart, pay for it with cash or a check, (no credit card accepted), and take it outside to the roasting area to await their turn. Today the line is long and the customers take this opportunity to catch up with each other on the local news.

These farm stands are all over New Mexico during the chili harvest season, well known throughout the world as simply the best chili there is. Even next door in Arizona, the taste cannot be compared to the crop that is harvested in the Land of Enchantment. Fortunately today, those who live far away need not be deprived as many varieties can be bought on the internet. However, the experience of getting your chili freshly roasted is truly a treat. The aroma will stay in the vehicle for several days and it smells just wonderful. Once home, the chili must cool down so the sack is opened and allowed to cool to room temperature. Some like to peel their chilies before freezing, which makes it easier when you want to use them later. Others freeze it with the skins on as the chilies are easily peeled as they are defrosting at a later time. I use both quart and gallon bags to allow for a more appropriate amount for any given dish. A gallon bag would definitely go into a large green chili stew; several from a small bag would go into a batch of scrambled eggs.

One of my favorite breakfasts is a salmon and green chili omelet. My favorite chili is the Sandia hot variety, which has a nice warming effect on the tummy without an actual burning sensation. If I have a grilled salmon steak for dinner, I put some aside to put in an omelet later. Along with two or three chilies and some melted cheese on top, it is a wonderful meal to start off the day.

Buen Provecho!

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Tags:  Carol Hunter  recipe 

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CardioRetinometry Solves Many Deficiencies

Posted By Dr. Sydney J. Bush [paid advertisement], Monday, September 25, 2017
 PAID INFORMATIONAL ADVERTISEMENT 

 

In 2002 Prof Steve Hickey declared with Dr Hilary Roberts in their book "Ridiculous Dietary Allowance" that...CardioRetinometry represents a new and quantifiable method for derivation of vitamin C requirements. The following papers reveal the evidence for the need of an urgent and total revision of vitamin C needs now exposing the origins of a vast variety of fatal diseases associated with different degrees of deficiency and never suspected of holding the key to almost all non-violent premature deaths.

The recent SUN paper produced in Spain shows over 50% of cardiovascular deaths to be so linked.

Published less than a month ago, Nutrients 2017, 9(9), 954; doi:10.3390/nu9090954  Article "Vitamin C Intake is Inversely Associated with Cardiovascular Mortality in a Cohort of Spanish Graduates:" The SUN Project [Nerea Martín-Calvo, Miguel Ángel Martínez-González] proves over 50 Direct correlation reduction of heart events with small supplements of vitamin C in 13,421 participants in their 40s.

This wealth of data supports Sydney Bush´s finding that over more than a decade in his contact lens clinic, dispensing 200 gram pots of sodium ascorbate powder, that there were no deaths at all from CHD and the only myocardial infarcts and deaths were amongst those who rejected the advice to supplement with it.

 The evidence for reduction of CHD by ascorbate is now overwhelming and the new science iof CardioRetinometry enables its precise derivation of individual biological need by direct quantification effects on the retinal vasculature.

 If vitamin C had been killing people like Vioxx, the debate would have long been over. It is now appropriate for me to inform everyone of the original statements made in the Hull University thesis on  CardioRetinometry that was published by Paul Francis BSc.

 He talks of a paradigm shift in medicine that is fully supported by the thesis of Dr. Sam Wallace DO, that I sent you yesterday that will be published in an `open access´ journal before the end of the month. I think you will agree that the language of both researchers leads to the conclusion that we are indeed observing a paradigm shift in health  care. It is worth mentioning, before I quote his words from his thesis, that Francis himself was astonished at the degree of atherogenesis caused by his stress with the task of researching CardioRetinometry, and the happy outcome when, under direction, he accepted the nutritional supplementation that he was able to record showing the recovery of his own arteries"

The quoted section below is precisely as he wrote it and members should now be in  no doubt whatever that with this supporting evidence, they are obliged to take note and offer the new prevention which represents the greatest advance in medicine as they suggest since Helmhotlz enabled fundus inspection and removes guesswork from treatment by observation of precisely measurable cardiovascular pathology.

"Accurate measurement of vessel structures in retinal images plays an important role in diagnosing cardiovascular diseases. (CVD). This paper presents a method for the direct quantification of vessel geometry and texture in retinal images associated with increased oral intake of vitamin C.

Using models of vessel intensity profile presented and applied across a series of time lapse images, results are presented for their variation.  The developed methods were used to analyse retinal vessel variation across images taken over a 6 month period of a healthy white male taking oral supplementation of vitamin C.

This study found that direct quantification of variation across images was achieved using the models of vessel intensity profile, and that variation across images was affected by machine accuracy, image capture and vessel segmentation techniques.More accurate quantification of the changes witnessed requires the enhancement of existing instrumentation and diagnostic techniques to facilitate the increase in accuracy in the measurement of arterial deposits via retinal image analysis.

A limitation however may be the natural resolution of the human eye which deteriorates with age. Automated analysis of sequential images is envisaged with the evolution of the system to produce graphed predictions of life expectancy corresponding with degrees of regression of atherosclerosis achieved coupled with rates of change, quantification, possibly using ocular coherence tomography in absolute terms of the volume of plaque removed, with brief periods of reversion to the earlier diet and supplementation (or the lack of it ) in order to assess rate of regression.

These elements factored in from data gathered during the phase of retolysis are expected with suitable refinement to produce three graphs

 (1)The previously expected ‘normal’ life expectancy at each age.

(2) A graph superimposed on the first, showing the actual gain of CV life expectancy achieved by arrestation of atherogenesis.

(3) A graph above the others predicting total life expectancy factoring in the rate of regression which is anticipated to increase with age.

 

METHOD. Sequential fundus imaging ideally not less than biannually; Manual scanning by rapid alternation of images that would otherwise superimpose, allowing quick judgment of increase or decrease of retinal and atherosclerosis, retinal and papillary perfusion changes, curvilinear, blood - flow and lumen changes.

RESULTS: Informal study of images captured in 1998 were noted in 1999 to have started showing consistent atherolysis claimed by patients to have resulted from either extra vitamin C, dietary or lifestyle improvements. A hundred claimed in writing that they attributed the improvements to one or the other, a high proportion insisting that their sodium L - ascorbate or vitamin C tablets had effected the transformations.

CONCLUSION: After 150 years,a new system of healthcare has been revealed which may finally bring to mankind the full benefits of Helmholtz’ 1851 invention of the ophthalmoscope.

A multitude of nutritional and medical challenges to the retinal vasculature might now be evaluated for improving health, e.g.individual assessment the ideal duration of treatment with statins, Because of the dramatic effects seen and the removal of guesswork from the controversial correlation of blood fats and cholesterol to actual atherogenesis, urgent evaluation of this discovery is recommended for the establishment of better healthcare and real cardiovascular life extension in what might be the first paradigm shift in medicine since Pasteur"

 

The next course for the Diploma in  CardioRetinometry starts in October. To learn more contact Professor Sydney J. Bush at info@instituteofcardioretinometry.ac or visit www.LifeExtensionOptometry.com.  

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Chilled Cucumber Soup

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Friday, September 15, 2017

Ingredients:

4 large cucumbers

½ cup chopped parsley

1/3 cup fresh dill

2 tablespoons dried tarragon

1 avocado (optional)

6 scallions, chopped

2 cloves garlic

1 cup vegetable broth

1/8 cup virgin olive oil

1/8 cup lemon juice

1 cup Greek yogurt

Sea salt and pepper to taste



Preparations:

1). Peel, split lengthwise and remove seeds. Then chop into small pieces.

2). Chop the parsley, garlic cloves, dill and scallions.

3) Add to blender: olive oil, lemon juice, and broth. Then add the cucumbers, parsley, garlic, dill and scallions. Then add the Greek yogurt and the avocado. ( Save a bit of dill for top dressing)

4) Blend well on medium speed until veges are pureed, then run on high until mixture is well blended and creamy.

5) Chill either overnight or make it first thing in the morning so it has a good 8 hours or so of chilling time before dinner.

6) Decorate each bowl with a few slices of cucumber, topped by a handful of small chopped purple onion and a sprinkling of extra dill.

7) Voila! Your fresh garden soup is ready. Don’t be afraid to experiment with proportions. Some people like more Greek yogurt, some less like me! Don’t expect to taste the avocado as it gets lost in this recipe, but it contributes to creaminess and nutrition!

Bon appetite!

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A Digital Blackout Day

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Friday, September 15, 2017

One of the things I love about blogging is featuring people and their businesses that I believe are making a contribution to the betterment of the human race in one way or another. A note of caution is that there are many who are doing just that outside my frame of reference or understanding, so to those physicists out there, I apologize. Over a year ago I came across Darren Hardy, a psychologist. I would call him a motivational speaker with a genuine ability to connect with others.  On one particular day he talked about taking a break from the digital world. I stopped and thought about how important this was. After all, I was just like everyone else, waiting in the grocery checkout line, checking my email messages on my phone. And checking them again in the doctor’s waiting room, and oh yea, the vet’s waiting room, as my dogs paced around me. Yes, feeling connected to everyone on the rest of the planet is good but like everything in life, it can be overdone to the point where you have trouble relaxing, where you now have a chain around your neck, and it’s heavy.

My designated day was Friday because I have it off, so I gave some thought as to how I would proceed. Hmmm, sometimes Friday is the only day I get a chance to talk to my daughters, when they are busy with their weekend plans. Some work related topic invariably comes up on a Friday. Medication refill requests and other telephone and paperwork requests keep cropping up, reminding me of scooping out a shovelful of sand on the beach, only to have it immediately fill up with water. As fast as I can address the issues, more take their place. I pondered how I would accomplish such a feat. Here is what Darren Hardy said and I really love his words:

Disconnect Day
A day for undisturbed creative production or rest and recovery
A day when my grand intentions will not be squandered in the vortex of reacting to the solicitations of other people’s agendas

I will declare a Disconnect Day to avoid the siren call of the Matrix
I will have a day unencumbered by the demands of the digital world
I will be free for 24 hours - DarrenHardy.com

His words are worth thinking about. How would you go about setting aside such a day? I haven’t found it to be easy, but I have found it to be a very worthwhile goal. It definitely helps to plan ahead. First, how are you going to spend this precious, unencumbered time? Face to face time with family and friends are most likely number one on the list, but a little alone time never hurts. Have you ever wondered what it would be like to paint? To play an instrument? To take your dog on a full day’s hike to that picture of the quiet lake in your brain?  What about the opportunity to take on that project around the house you’ve been putting off? Mine is painting the patio furniture. Don’t forget about some pampering like a massage or bath in essential oils. Any time spent outside the digital grid is good and nourishing to the soul. I believe that this sacred time helps to shore up our defenses against the inevitable stress of daily life. Life will always be throwing curveballs at us and yesterday was a good example. My automatic gate did not close all the way and despite the small gap, all three of my dogs squeezed through and decided to go on an adventure. Thankfully, they hadn’t wandered very far and were busy sniffing bushes, but I hate to think how that would have played out had I not been home. So, grab a bowl of fresh, delicious cucumber soup and get started on your digital checkout day. You’ll be glad you did.

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Happy Summer 2017!

Posted By Carol Hunter , Wednesday, August 2, 2017
Updated: Tuesday, August 1, 2017

This month I am just couldn’t resist a recipe for a summer desert. But first the history! When I was 21, I baked my first soufflé. You see, my parents in law were European and they served meals with artistry and finesse and expected the same from their young daughter in law. When they visited from Austria, I was at full attention, doing my utmost best to impress them. Sometimes that worked, as it did with the “chicken in aspic” which, much to my surprise, turned out to look just like the pictures and tasted good. Other times it was a complete disaster and the disaster was a soufflé. I had decided to bake a cheese soufflé and had the recipe, the soufflé dish and the determination. I remembered once during my growing up years, we had a chocolate soufflé for dessert and it was heaven. But I had no idea what I was getting myself into when I made that fateful decision.

The day of the dinner for my parents in law, I had everything assembled and was ready for the task. I started the preparation and then I came to whipping the egg whites. I whipped and I whipped and I whipped again, but the glossy peaks never formed. Not having any idea what was wrong, I put the batch aside and began with a fresh bunch of eggs. That didn’t work either and I started fretting about the cause because dinner was right around the corner. Believe it or not, I gave up after a dozen eggs had been vigorously whirled without forming stiff peaks. I was forced to ditch the beautiful result in my mind and accept reality. OK, so what can we have for dinner for your lovely parents without them knowing my distraught state? I can’t even remember what we ended up having for dinner because my mind was nestled in that failure.

Fast forward to the game of life where things still don’t always go as planned. Much later I realized the problem had been the egg whites. They don’t like to be whipped when they are cold. Many recipes fail to provide the advice to set the eggs out so they can go to room temperature. What a difference that makes! Take the eggs out hours ahead if you can. One hour will not be long enough. Then you will get that beautiful result in which the glossy peaks form. Souffles are a spectacular dish to be cherished and eaten quickly.

A couple more tips. Your soufflé dish will not be tall enough so put a collar of foil around the sides so that it can rise up as high as it can. While cooking, place it in another pan with water to have a water bath; it needs the moisture. Another thing is that you can make a soufflé out of just about anything, from cheese, to chocolate to fruits. It can be a main course with a salad or a dessert.

Since it is summer and peach season, my recipe calls for fresh peaches. The  better quality peach, the better the results.

I wish all of you a wonderful summer: drinking slushies under a summer sun, strolling on a boardwalk along the coast, lying in a field of clover and watching the moon just for the fun of it; waterskiing on the lake; relaxing in a hammock reading another great book; barbecues with family and friends; and my favorite, seeing my vegetables blossom into an edible, luscious crop!

                                                Georgia Peach Souffle

http://www.marthastewart.com/354141/georgia-peach-souffle by Chef Virgina Willis. I used this recipe as a base, but substituted some of the ingredients.

Ingredients: 

3 tablespoons unsalted Earth Balance buttery spread, olive oil

3 large fresh peaches

Juice of one lemon

1 teaspoon pure vanilla extract

7 large egg whites, at room temperature

¼ teaspoon fine sea salt

¾ organic coconut palm sugar (replaces sugar in 1:1 ratio)

Confectioner’s sugar, for sprinkling

Directions:

Preheat oven to 400 degrees F. Generously butter six 8 ounce ramekins or a one quart soufflé dish. Set aside in a small pan filled with water.

In a food processor, add the peeled and chopped peaches, the lemon juice, vanilla extract, and a pinch of salt and puree until very smooth.

In a heavy duty mixer, use the whisk attachment to beat the egg whites with a pinch of salt on medium speed for several minutes until foamy. Add one tablespoon of sugar and beat on high speed until the whites hold soft peaks, one to two minutes. Slowly add the remaining sugar and beat on high speed until the whites are glossy and hold stiff peaks when the whisk is lifted.

Add about a quarter of the beaten egg whites to the peach puree and gently fold it in until well mixed. . Pour this mixture over the remaining egg whites and fold them together as gently as possible.

Spoon the mixture into the dish(es) and surround the dish(es) with a piece of foil that extends the height of the dish. Set it in a dish of water and put in the oven.

The directions said 8 to 10 minutes but that was not nearly enough cooking time. I kept cooking in five minute increments until the top was golden brown and the top of the soufflé was above the top of the dish. I cooked mine about 30 minutes.

Sprinkle with the confectioner’s sugar and serve immediately.

Bon appetite!

Tags:  dessert  healthy living  summer 

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Remembering Dr. Warren M. Levin, MD

Posted By Administration, Thursday, July 27, 2017

The staff and leadership at ACAM are remembering and honoring a pioneer in Integrative Medicine, Dr. Warren M. Levin, MD, in light of his recent passing last Friday at the age of 79. 

Not only did Dr. Levin open the first alternative medical center in NYC in 1974, but his landmark defense of his medical license in NY culminated in a 1994 decision in his favor, which paved the way for the continuation and advancement in the field throughout the country. He touched countless lives with his vision for health and well being long before it was commonplace to think in those terms. He is survived by his loving wife, Susan; children Beth Galan, Julie Levin (Marc) and Erika Needleman (Matt); brother Joel Levin; grandchildren Dave & Chris Galan, Karina Rahardja & Emi Daigle; Binah, Mindy & Chaim Needleman.
 
We are so grateful for his groundbreaking work in Functional Medicine and would not be where we are today without his invaluable contributions to the field. He was a revered doctor to his patients and a pillar of the integrative health community at large.
 
ANH-USA has established a memorial fund in his name to honor and continue his work in Integrative Medicine. All money raised through this fund will go directly to the advancement of Integrative/Functional Medicine. Please donate today and help ANH-USA honor his legacy.
http://www.anh-usa.org/dr-levin-legacy-fund/ 

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What is Assisted Outpatient Treatment?

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Saturday, July 1, 2017
Updated: Monday, June 26, 2017

There are many family members who struggle with trying to manage a love one with mental illness. I have watched this heartbreaking problem over the last four decades and finally we have a solution that applies some teeth to the issue. It is called Assisted Out Patient treatment and it is a court monitored program of the severely mentally ill who meet certain criteria. One such criterion is that the person must have been hospitalized at least several times over a certain span of time. This program has become law in almost all states but there are a few holdouts. My own state of New Mexico has been slow getting on the bandwagon and to date, we only have one city participating in AOT.  AOT is a result of Kendra’s Law in which a young woman was pushed in front of a train in 1999 by an untreated schizophrenic in New York.

First, it is important to address the issue of medication nonadherence, sometimes called noncompliance. It is due to a psychiatric phenomenon called “anosognosia” whereby an afflicted person lacks the insight to realize that they have serious mental disorder. Due to this process, it is common for people with schizophrenia and bipolar disorder to stop taking their medication. While the act itself of stopping the medication is willful, the insight to make a logical decision is absent; therefore, there is no blame assigned to these disordered individuals. They simply don’t see the need for it and often blame their resistance on side effects. While side effects are certainly a valid issue, we prescribers use every available strategy to minimize such events. Stopping the medication results in a decompensation into psychosis, characterized by hallucinations, delusions or mental disorganization, such that the afflicted person often becomes a danger to self or others in the community.

I am clearly a proponent of this new federal program simply because I have witnessed the desperation of family members far too often. Family members often are in fear for their lives in the middle of the night and commonly have to put away all sharp and potentially dangerous objects in the household. They struggle to help their loved one as best as they can, locking up medication and administering it, volunteering to be a court appointed treatment guardian and learning all they can about the illness from organizations like NAMI (National Association for the Mentally Ill.) However they can’t do this alone and need as much community support as they can get from prescribers, therapists, community support workers and psychosocial rehabilitation staff. They also need the court system and I can verify that patients often listen more closely to judges than their doctors.

 I have served as an expert witness in many competency hearings for both adults and children and when I was teaching, I would regularly take my students to the courtroom to observe the proceedings. I have personally witnessed patients with schizophrenia on an inpatient unit mumble to themselves in the morning, responding to the voices in their heads, and several hours later, answer questions appropriately by a judge. The patient is represented by an attorney usually with a degree of expertise in the mental health field and the physician/provider is there to represent the state. While most physicians/providers put forth a logical and convincing argument for treatment, the judge is paying close attention to the behavior of the defendant. If he or she is able to convince the judge that they are of sound mind and judgment, he or she will be discharged and free to discontinue their medication without further monitoring. Down the road, the cycle begins again when the person decompensates and is either hospitalized or incarcerated.  Sometimes they are deemed competent because they are responding well to the current treatment; sometimes they are able to put forth their own convincing argument because they have learned what buzz words to use in front of the judge. 

I have recently experienced this phenomenon myself. After having worked very hard to persuade three of my schizophrenic patients to take the long acting antipsychotic injectable medication that eliminates oral medications, all three decided to discontinue after having shown noticeable improvements in mood, behavior and functioning. Since there is no AOT program in this community, the family and I stood helplessly by and watched the inevitable process of decompensation begin. This is a tragic and unnecessary cycle that should be stopped.

While opponents to this program cite violation of civil liberties, statistics have shown that due to the effectiveness of AOT, the capacity of the mentally ill to exercise civil liberties is restored and there is a reduction of incarceration, hospitalization, suicide, homelessness and victimization. (www.treatmentadvocacycenter.org/component/content/article/1336).

If you are facing this devastating challenge in your own family, find out if AOT has been instituted in your state. If not, write to your representatives and ask why not. The internet address above is a great source of information on the topic. Inform yourself, then get involved and make your voice heard. No one can speak to this issue as well as a family member. 

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Cooking ahead for the week.

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Saturday, July 1, 2017
Updated: Monday, June 26, 2017

One of the challenges we all face with our diet is having the time to prepare a nutritious meal. If we wait until the last minute at the end of the day to think about what we will have for dinner, chances are we are tired and want to avoid standing, chopping, stirring, etc. One solution to this problem is cooking something for the week ahead that provides a foundational source of nutrition that can then be varied.

I like to promote products that I think will be useful to my readership and one that I have tried for the past year has proven to be tried and true. It is the VERSA 8-in-1 Multi-Cooker and it is a combination pressure cooker and slow cooker. It also allows you to saute, brown, simmer and steam. It comes with a recipe book that his handy. I absolutely love this cooker which comes in different sizes.

My typical preparation on Sunday is to combine two whole grains of my choice, adding in different vegetables and often legumes. You can prepare a delicious meal in minutes with the pressure cooker feature which includes a button for brown rice, white rice, yogurt and risotto.

So here’s an idea of a dish you could prepare in advance and then vary it by combining different greens:

Place 3 to 4 tablespoons of grapeseed oil in bottom of liner and push saute button, then start button. You have 30 minutes of saute time while chopping and adding your vegetables and grains.

Add ½ cup chopped carrots

Add ½ cup chopped celery

Add one medium chopped onion

Add a cup of chopped mushrooms

Add ½ cup chopped bell peppers

Add 1/8 tsp ground cardamom

1/8 tsp fennel seed

1/8 tsp whole cumin seed

1/8 tsp celery seed

½ tsp tumeric

Saute all vegetables until translucent, then stir in:

 1 cup brown rice and 1 cup of millet for approximately 5 minutes

Add in 5 cups of vegetable broth( 3 for rice, 1 each for veges and millet)

Then hit stop button. Secure pressure cooker lid and follow safety directions. Hit the “brown rice” button, then hit Start. The timer will not start counting until the proper pressure has been reached. Cook time is quick, 20 minutes. Once the pressure has been released and the lid opened, do not be alarmed if you still see water. It will absorb if you keep the lid closed for another 10 minutes or so. You need to experiment a bit with the amount of water to add. If I am adding in a cup of beans, I will add in one cup of water for the beans.

You can put some chopped kale or other green on top of the grain dish and it will steam by the time you sit down to eat. Add sea salt and pepper to taste. The grain dish can be used for breakfast with an egg on top or tofu crumble. Experiment with other healthy grains like quinoa and lentils. This Sunday preparation has been a life saver throughout the following busy week. But the time Thursday arrives, I am a bit tired of it and ready to think about the next dish!! Next on my slow cooker agenda is homemade chicken soup- good all year round!! Bon Appetit!

 

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The Foundation of Health

Posted By Carol Hunter , Friday, May 26, 2017

I have written about vitamin and mineral supplementation before in The Link, but for those of us who provide healthcare services, we are very aware of its importance as a foundational step towards excellent health.  In our practices, we confront the consequences of subclinical malnutrition, the inadequacy of our current mainstream diet, the ongoing riptide of pesticide sequelae, and the established medical resistance towards supplementation on a daily basis. Most importantly, we are challenged by the lack of financial support for preventive services and that includes supplementation. We have made a bit of progress as now many multivitamins, vitamin D and sometimes melatonin are covered by Medicaid. That is more important than I can say because although many of my patients are willing to follow through on supplementation, they cannot afford to do so unless their insurer cooperates. The lower socioeconomic groups need these supplements the most. I know because I follow them from one hospitalization to the next. 

My job is to keep them out of the hospital, at least in terms of their mental health.  But who is to say that the 35 year old young woman who was hospitalized with serious suicidal ideation wasn’t deficient in iron, vitamin B6 or vitamin C or D? Since we do not normally test for vitamin deficiencies, we may not discover the underlying culprit for those life threatening thoughts. Iron deficiency can result in poor concentration and lack of energy, symptoms that are complained about frequently in mental health. B6 deficiency can also lead to depression and anxiety, causing decreased amounts of serotonin, the feel good hormone, dopamine, and melatonin. Decreased melatonin can produce all types of sleep disorders from trouble falling asleep, to middle insomnia, to early morning awakening. Of all the complaints I hear every day from patients, the number one complaint is inability to cope with stress. Aside from the psychologic component that reflects inadequate coping skills, there is a physiologic basis for this as well. Vitamin C is stored in the adrenal glands and how often have we heard that term “adrenal exhaustion?” Some blame poor adrenal response on consuming too much coffee, but vitamin C deficiency would be a better guess. Vitamin C is crucial in producing many important hormones and neurotransmitters in the body and when norepinephrine, thyroxin and dopamine are depleted, it takes its toll on a person’s ability to fight daily stress.

Our lifestyle today is largely unhealthy. Picture this: after a poor night’s sleep and awakening in an irritable mood, a person fights the stress of congested traffic to arrive at work to put in 8 hours or more under fluorescent lights in an artificial environment with too much noise, not enough time to eat, relax, and oftentimes even use the restroom. The pace of the work world does not wait for those who can’t keep up with its demands and these demands can become overwhelming. When the usual coping mechanisms no long seem to work, a host of unhealthy responses can set in, from shutting down and falling into a serious depression in which a person struggles to even get out of bed to becoming irate and flying into a rage that puts others at potential risk. Another response is to consume excessive alcohol or any of the many illicit substances that are so easy to come by today but which wreak complete havoc on a person’s life.

I recently listened to Dr. Tieraona Low Dog’s webinar on “Silent epidemic: the Hidden Dangers of Nutrient Deficiencies” sponsored by Emerson Ecologics. By the end of the presentation, I was in tears confronting the possibility that in my efforts to help patients by prescribing potent medications, I could have actually worsened their condition. The medications we utilize in mental health are like all prescription medications, they are extremely potent. Dr. Low Dog talked about the effect of the anticonvulsant drugs depleting vitamin B12 and folate. The anticonvulsants are one of two classes of drugs that we use as mood stabilizers. Along with the SSRIs and SNRIs, there are many medications that contribute to osteoporosis. The only thing that made me feel a little better is the fact that for as long as I can remember, I have recommended a multi vitamin/mineral supplement for ALL my patients and over the years, vitamin D3, fish oils and melatonin are also on the list. For those who feel that they can’t cope, a high stress vitamin B complex with 100% of the recommended amount of each B vitamin, is suggested. I am happy to say most follow through and I like to think that overall, my patients get better.

Dr. Low Dog also addressed the true origins of our deficiency syndromes, the lack of soil quality in which our food is grown along with the extensive use of pesticides today. I would add that another factor is well meaning but incorrect dietary advice from the medical community, pushing us to eat egg whites and throw out the perfect yolk, containing all nutrients to sustain life except vitamin C. Poor dietary habits along with small daily exposure to those nasty “endocrine disrupters” have most likely contributed to a burgeoning number of children with attention deficit disorder. Instead of examining the true cause, we throw more potent medications at these children and although I am licensed to do just that, I have my serious reservations about it. I have lived long enough to know that when I was growing up, there was no such thing as ADHD. Why has the inability to concentrate in so many children reached epidemic proportions today? I think we need to take a closer look at the physiologic origins of the problem.

With the deleterious consequences of poor nutrition in mind, it is inspiring to come across an agricultural business that is “safe for people, plants and pets!” I get a lot of catalogues and one that definitely caught my attention is “Spray-N-Grow,” a trio of organic plant foods developed by a chemist and father, Bill Muskopf, from Rockport, TX. There are three different products that when combined in a spray delivers the “Perfect Blend.” Rather than targeting the root system, these nutrients are sprayed right on the leaves where they make their way down the stems to the roots. The catalogue states that “foliar feeding is up to 10X more efficient than root feeding.” The first product is the fertilizer in “a perfect ratio of nitrogen, phosphorus, and potassium.” Next comes the second product, the Spray-N-Grow Micronutrients that are “like vitamins for your plants” and contain calcium, zinc, copper, iron, sodium, magnesium and other compounds. The third part of the trio is the Coco-Wet, which is a nonionic wetting agent that assists the other products to stick better to the leaves for better absorption and is made from all natural coconut oil. I think I have discovered my new approach to developing a beautiful, nutritious garden and look forward to trying out these unique products this summer. There are other products as well for natural pest control and animal repellents. Order a catalogue by phone: 800-323-2363 or go online to spray-n-grow.com.

If you haven’t done it thus far, get started on your vitamin supplements and a good quality multi is a good place to start. The information out there is overwhelming and can be confusing, so seek out a trusted professional to guide you through the process. 

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Strawberry Rhubarb Quinoa Pudding

Posted By Carol Hunter, Friday, May 26, 2017

As summer approaches, we look forward to more fresh fruit selections put together in interesting and nutritious ways. While I love presenting my own recipes, I also love to give credit to those who have offered a unique recipe and this one by “eating well.com” filled the bill. Including a healthy grain in a dessert is a great way to boost nutrition and please the palate at the same time. I always avoid using sugar if I can and substitute with maple syrup; otherwise I stayed with the original ingredients. This fruit combination of strawberry and rhubarb is one of my very favorites and always reminds me of the great pies at our New Mexico State Fair. Bon Appetit!

Ingredients:

1/3 cup quinoa

½ teaspoon ground cinnamon

Pinch of sea salt

¼ cup organic maple syrup plus tablespoon

1 tablespoon corn starch

1 cup nonfat plain Greek yogurt

1 teaspoon vanilla extract

Preparation time: 20 minutes active; 1hour 45 minutes until ready

1). Combine 2 cups water in a medium saucepan with rhubarb, strawberries, quinoa, cinnamon and salt. Bring to a boil over high heat, then reduce to maintain a simmer. Cover and cook until the quinoa is tender, about 25 minutes. Stir in the maple syrup and lemon zest. Whisk cornstarch with the remaining ¼ cup water in a small bowl. Stir into quinoa mixture, return to a simmer and cook, stirring constantly for one minute.

2) Remove from heat. Divide the pudding among 6 bowls and refrigerate until cool, about one hour.

3) Just before serving, combine yogurt, vanilla and the remaining 1 tablespoon maple syrup in a small bowl. Top each serving with a generous dollop of vanilla yogurt and fresh strawberries, if desired.

Nutrition information: calories per serving: 151; serving size: about 2/3 cup; nutrition bonus: 33% daily value of vitamin C.

Credit: http://www.eatingwell.com/recipe/250696/strawberry-rhubarb-quinoa-pudding/

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Cannabis Drug Reduces Seizures in Severe Epilepsy Cases

Posted By Maggie Fox & Lauren Dunn - NBC News, Thursday, May 25, 2017

A compound taken from marijuana greatly helped some children with a severe and often deadly form of epilepsy and completely stopped seizures in a very few, researchers reported Wednesday.

It's a rare success in a field suffused with more hope than facts — in which advocates clamor to have marijuana and compounds taken from the herb legalized for free use, while government rules limit use and researchers struggle to prove what works and what doesn't.

In this study, the researchers enrolled kids with Dravet syndrome, a very rare and often deadly form of epilepsy caused by a genetic mutation. These kids have multiple, prolonged seizures that cause brain damage.

There's no treatment.

"It's hard to portray how serious and devastating this is," Dr. Orrin Devinsky, director of the New York University Comprehensive Epilepsy Center, told NBC News.

Devinsky and colleagues around the country tested a cannabis derivative called cannabidiol — CBD for short — on 120 Dravet syndrome patients.

Half took it for 14 weeks and half got a placebo.

 

"Seizure frequency dropped in the cannabidiol-treated group by 39 percent from nearly 12 convulsive seizures per month before the study to about six; three patients' seizures stopped entirely," the team wrote in the New England Journal of Medicine.

"In the placebo group, there was a 13 percent reduction in seizures from about 15 monthly seizures to 14," they added.

"Quite remarkably, 5 percent of the children in the active treatment group with CBD were completely seizure free during the 14 weeks of the trial," Devinsky said.

"And these were kids who were often having dozens of seizures, if not many more than that per week."

The kids who got CBD were more likely to stop the trial because of side-effects. "Side-effects were generally mild or moderate in severity, with the most common being vomiting, fatigue and fever," Devinsky wrote.

But those who have been helped have been transformed, he added.

"There's no doubt for some children this is just been an incredibly effective and game changing medication for them," Devinsky said.

"These are some of the children I care for [who] were in wheelchairs, were barely able to open their eyes in an office visit and really showed no emotion and … now they come in, they're walking, they're smiling, they're interactive. It's like a different human being in front of you."

He said it's not quite accurate to called CBD "medical marijuana."

"Cannabidiol is the major non-psychoactive compound present in cannabis or marijuana," Devinsky said.

"In this study, we were giving a compound CBD which has no high-producing or psychoactive properties."

It's highly processed to strict standards. A British company, GW Pharmaceuticals, is seeking Food and Drug Administration approval for the product under the brand name Epidiolex.

"The drug we gave was derived from cannabis or marijuana but it really should not be confused with the medical marijuana that would be obtained from dispensaries in the 44 U.S. states that have approved it. Those typically contain combinations of THC with CBD and many other compounds," Devinsky said.

 

It's not clear precisely how CBD works. It appears to attach to brain cells, he said.

"The CBD binds with a novel receptor in the brain and thereby dampens down too much electrical activity," he said. "It seems to be a relatively unique mechanism of action that's not shared by any of the existing seizure medications."

Doctors are interested in trying CBD on autism, anxiety, inflammatory and autoimmune disorders, Devinsky said.

It may help people with other types of seizures, as well. Jack Ziokowski, now 13, has been taking CBD for more than two years.

His seizures started with a viral infection, said his mother Jenny Ziolkowski, who lives in Stamford, Connecticut.

 

"We got a phone call from the school saying that Jack had had a massive seizure on his first day of first grade," Ziolkowski told NBC News.

"He was having seizure after seizure and they couldn't stop the seizures, and they couldn't figure out what was causing them so he was just hooked up to all these machines and wires," she added.

"He couldn't walk, he couldn't talk, he couldn't feed himself and he couldn't do any of those things."

Jack recovered somewhat but could never be left alone. "The post-illness Jack is not much like the pre-illness Jack," his mother said.

But once Jack started taking CBD, he went six full months without having a seizure and now rarely has one, his parents said.

"That was like a miracle. I mean ... we were actually able to see him grow and make progress," Ziolkowski said.

"He got a skateboard for his 13th birthday three weeks ago."

Australian epilepsy expert Dr. Samuel Berkovic said much more testing is needed. "This trial represents the beginning of solid evidence for the use of cannabinoids in epilepsy," Berkovic, who works at the University of Melbourne, wrote in a commentary.

Devinsky is hopeful.

"For 3,800 years, healers and physicians have been prescribing cannabis and documented that use to treat epilepsy," he said.

"After nearly 4,000 years we for the first time have vigorous scientific data that a compound from cannabis works to treat epilepsy."

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ANH Founder: Food IS Medicine

Posted By Alliance for Natural Health, Wednesday, May 24, 2017

The founder of the Alliance for Natural Health, Dr. Robert Verkerk, spoke this past weekend at the Natural and Organic Products Europe conference in London during what is clearly an important time for big ideas, given the changes occurring there.

The potential impact of “Brexit” (the United Kingdom’s “divorce” from the European Union passed by referendum in June 2016) was a focus of the panel discussion. Dr. Verkerk made this all-important point :

One of the biggest problems we have is the intersection of food and medicine law. The reason we have a roadblock, with products being taken off the market, is because medicinal law imposes itself far too often on food law….We’ve now got a very different scientific environment to the one that this regulation grew up in. We now know that food is medicine, we know that exercise is medicine, and therefore we need to re-frame the way that foods can be used for therapeutic benefit, and I think that will yield a fundamental change. I believe we need to review the whole of medicinal law in relation to the use of therapeutic foods. And that could create a possibility of a third route.

Of course, Dr. Verkerk is alluding to the fact that, by law, only government-approved drugs (in the US, only FDA-approved drugs) can claim to diagnose, cure, mitigate, treat, or prevent diseases, even if there are mountains of evidence to show that a natural vitamin or mineral can help with a disease. And because such approval commonly costs billions, only patentable, new-to-nature molecules fit the system. Food, food supplements, and exercise are totally excluded, even though we now know that they are often the most powerful medicine we have.

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VIDEO: Why Other Countries Don't Want American Food

Posted By Alliance for Natural Health, Wednesday, May 24, 2017

 

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How AMHA Can Meet the Needs of You and Your Patients

Posted By Alexander Lopera, American Health Alliance (AMHA), Monday, May 22, 2017

Far too many people face a debilitating illness such as cancer, Lyme disease, or other conditions that require more energy than normal to fight and endure treatments. But unfortunately, they also face a need to maneuver through the complexities associated with a very complicated insurance and health system. Long-term or grave illnesses often involve recommended treatments that are not covered by insurance or seeing providers that are out-of-network. Or, perhaps conventional treatments and medications are not working. As a result, some patients are seeking alternative, holistic, or naturopathic treatments. However many of these treatments, both overseas and within the U.S., require payment upfront.

As the need for medical help continues and the complexities of dealing with insurance companies becomes an epidemic, more and more patients need someone to help them evaluate every aspect of their hospital stay, possible treatments, and appointments. Not just any help, but someone who will evaluate and assist in the preparation of those billable medical expenses for reimbursement.

Alexander Lopera realized the need for this service. With years of experience working within the insurance and health fields, he founded AMHA - a company that helps remove the stresses of dealing with insurance companies from those who need to save their energy to fight their illness.

 

The Alternative Myth
Patients are under the assumption that treatments received at alternative clinics are all non-approved; however, that is not the case.  Ancillary services such as lab tests, radiology, diagnostic imaging, consultations, and more, are billable services. AMHA has a team of billing experts who will thoroughly review a patient’s medical bill to identify which aspects of their treatment and medical care are billable. However, each item needs to be properly coded in accordance to rules set forth by the American Medical Association.

In addition, some facilities will give patients a basic bill with a few codes. Thinking that this is enough, the bills are submitted to the insurance company, hoping for a reimbursement. But, when it’s insufficient, as it often is, it will either be delayed or denied. AMHA has worked with providers to help them create a billing template that itemizes the various treatments a patient receives so a claim is submitted with all the necessary information to properly process it.

 

How the Process Works
Prior to treatment, perspective clients can complete an AMHA patient information form, and then return it to AMHA’s office so it can be evaluated by the trained staff, free of cost. Even though they cannot make any guarantee of coverage, they will have a much better understanding on what coverage the patient may or may not have after evaluation. With this valuable information, they can then instruct you in the best manner to proceed.

After the treatment, the patient will submit a completed AMHA patient information form, along with the medical bill and proof of payment to AMHA’s office. Upon receiving the completed paperwork, the billing staff will determine which treatments and services provided are FDA approved. They will then note them with the appropriate codes and submit the claim for processing. The claim will be followed by AMHA throughout the entire processing stage, until a final decision is made.

 

 How AMHA Benefits Patients
With the help and expertise of AMHA, many patients can now afford to receive more medical care, due to successful reimbursements by the insurance company. Working on a contingent basis, AMHA will only get paid if they can obtain a reimbursement for a patient. So, there is absolutely no risk in utilizing their professional services.

 Here are some of the services AMHA provide:

  •  Free verification of patient insurance benefits
  •  Professionally and accurately prepared coded claims
  • Certified CPT/ICD10 coders
  • Electronically submitted claims
  • Secondary insurance billing
  • Insurance follow up in a timely manner
  • Level 1 appeals

Alexander Lopera has over 20 years of experience, and has an experienced and dedicated team to help you in your needs. If you feel as though you could benefit from AMHA’s team, or want more information, give them a call at (281) 580-1423 or visit www.amhabilling.com

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Kentucky Derby Pie

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Wednesday, May 3, 2017
Updated: Tuesday, April 18, 2017

Ingredients:

2 eggs

2 TBSP oil (grapeseed)

1 TBSP Kentucky straight bourbon

1 tsp vanilla extract

¾ cup flour (garbanzo bean, gluten free)

4 TBSP pure maple syrup

1 tsp organic blackstrap molasses

½ cup dark brown sugar

8 oz organic buttery spread

1 and a half cups pecan pieces

12 oz package of semisweet chocolate chips

One bottom dough crust (Pillsbury, premade)


Directions:

Preheat oven to 325 degrees F

Beat eggs in an electric mixer until fluffy

Add oil, vanilla extract, the maple syrup, the molasses and the bourbon until blended.

Beat flour and dark brown sugar into mixture until smooth

Beat in butter until creamy and smooth

Hand stir in the pecan pieces and the chocolate chips

Mould the dough into the bottom and sides of a deep pie dish

Gently stir-fold in the ingredients

Place on a cookie sheet in the 2nd rack of the oven and bake for 55 to 60 minutes until golden brown on top.

Decorate with a dollop of whipped cream or vanilla ice cream.

Basic recipe courtesy of 1000toprecipes.com/recipes/Kentucky-derby. Thank you 1000 top recipes for this wonderful recipe BUT I just had to make it a bit healthier!!

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“Oh, the sun shines bright…”

Posted By Carol L. Hunter PhD, PMHCNS, CNP, Tuesday, May 2, 2017
Updated: Tuesday, April 18, 2017

On the first Saturday in May, the “longest two minutes in sports” takes place at Churchill Downs. This May 6th will be the 143rd running of the Kentucky Derby. Truly, there is nothing quite like it in the racing world, as it has evolved into the premier race of the year. Whether you love the beauty and power of the magnificent horses in the field, the splendor and vibrancy of Southern charm, the signature feature of colorful hats and mint juleps or the prospect of choosing the winner, there is something for everyone. In addition, the Barnstable Brown Gala is a charity event that in the last 10 years has donated $13 million to the University of Kentucky's Barnstable Brown Diabetes and Obesity Center.

For a horse to get to the top 20 contenders, it’s a long and strenuous road. Most all have won a derby somewhere along the way or other prominent race. Some have been undefeated and never lost a race; others have done poorly, suddenly rising like a phoenix out of the pyre. As the race looms closer and closer, the leadership board is constantly changing and horses create their odds. Experts and racing pundits spout their words of wisdom based on formulas, angles, odds and statistics. Some of the experts really do seem to possess the algorithm for success and have a proven track record for calling the winners. Some are talented at identifying the pretenders, the ones who are destined to struggle to keep up. Regardless of all the strategic commotion, there is one basic truth and that is that the race is always unpredictable. The leaders in the field with the most points have the odds in their favor of course, but it’s the dark horse that keeps everyone on their toes. The horse who overcomes such great odds that it brings the house down in buckets of cash. One such nondescript bay pulled off this monumental upset in 2009 when Mine that Bird overcame odds of 50 to 1 to win the Kentucky Derby. Not only did he win the first race at Churchill Downs, but he nearly became a Triple Crown winner, coming in second place at Preakness Stakes and third at Belmont Stakes. The unusual circumstances of his life, from his early failures to the long journey in the trailer from New Mexico to Kentucky, to his incredible win after having been last in the field became worthy of a movie, 50 to1, released in 2014.


Are there lessons to be learned for humans in all of this risky but lucrative business? We humans struggle to control as much as we possibly can in our lives. To do otherwise and drift along in a sea of nonchalance and passivity is anxiety provoking. But sometimes it is the things we know we cannot control that offer the biggest attractions. The thrill of competition and victory, whether in sports, the stock market, in careers or relationships, propels us forward and gives us the perseverance, the stamina and the resolve to put forth our best, much like a field of racing horses.  In the starting gate, the competing horse is a culmination of thoughtful breeding, inherent talents, excellent training and above all, the spirit to win. The unpredictability of it all lays down a perfectly equal playing field. The same is true for us and we’ve all heard the stories of how some have overcome the most drastic odds for achievement or success or even survival.  So when that monster anxiety grabs you and you start to fret over your lack of control, take a deep breath and learn to relish the unpredictable moments, developments and outcomes in life. They might just bring a smile to your face. 

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Alzheimer's Association Creates Care-Plan Toolkit for Clinicians

Posted By Administration, Wednesday, April 26, 2017

After Medicare began covering care-planning visits for patients with cognitive impairment, the Alzheimer’s Association developed a toolkit to help clinicians provide better care.

In January, Medicare began covering care-planning sessions for patients with cognitive impairment, including Alzheimer’s disease and other dementias. In response, the Alzheimer’s Association has created the Cognitive Impairment Care Planning Toolkit to help physicians, nurse practitioners, and physician assistants provide the best care under the new Medicare code.

A change to the G0505 Medicare code means healthcare providers can get reimbursed for a clinical visit to develop a comprehensive care plan for a patient. It also helps providers identify community support services that are appropriate for the patient.

The Alzheimer’s Association, along with its sister organization, the Alzheimer’s Impact Movement, had pushed for this change. They had advocated for the Centers for Medicare & Medicaid Services to cover cognitive and functional assessments and care planning for patients with cognitive impairments.

“Diagnosing patients and linking them to services is a challenge,” said Beth Kallmyer, the association’s vice president of constituent services. This toolkit is “an opportunity to make a big difference in how people are diagnosed and how they’re linked to services.”

Most people with dementia are treated by primary care physicians, even if they are diagnosed by specialists, Kallmyer noted. The association had heard from doctors that putting together a care plan is time-consuming and difficult, so it assembled a group of specialists to decide what the association could offer to help clinicians conduct the care-planning session and implement the new Medicare code.

The toolkit helps clinicians understand what the code covers and provides resources to use in these sessions. It includes best practices and materials such as an overview of the code, validated tools to assist with diagnosis (including the Dementia Severity Rating Scale), a safety assessment guide, a caregiver profile checklist, and an end-of-life checklist.

Part of the association’s mission is to provide and enhance care and support for everyone affected by Alzheimer’s. Care planning helps improve outcomes and maintain quality of life. “It’s huge for people living with the disease,” Kallmyer said, explaining that some patients get diagnosed with dementia but then don’t receive much follow-up care or any comprehensive care planning.

Having a plan in place helps people living with the disease as well as their caregivers. A comprehensive plan can empower patients by giving them a better understanding of their future and allowing them to plan better for it, Kallmyer said. “They can say to their family, ‘This is how I want things to go.’”

“Alzheimer’s is one of the costliest diseases out there,” she said. A care plan helps families plan for when the patient might need to turn to residential care, for example. “Having a plan in place makes a big difference for families every single day with this disease.”

Now, the association is working on raising awareness and getting the word out to all the association’s 80 chapters about the toolkit and the resources it offers. “They are our boots on the ground,” Kallmyer said.

Tags:  alzheimer's  Toolkit 

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Dr. Warren M. Levin- Mentor, Innovator, and Friend of ACAM

Posted By Administration, Wednesday, April 19, 2017

Dear Friends, Colleagues, Former Patients:

As many of you know, Warren (Dr. Warren M. Levin, MD) aka Saba for Grandpa, Dad, Brother, and so much more to so many, relocated to Atlanta, GA in August 2015.  For him it has been a wonderful retirement filled with reading endlessly, doing level 5+ Sudoku, crossword puzzles and jig saw puzzles. It has also been a time for him to sleep as much as he wants and only waking up when he wants. He tells everyone that he is in retirement, and he is not to be disturbed until he is ready. He eats what he wants and when he wants and totally enjoying it. After 50+ years of serving others, he is now being served.

With his legacy website (www.warrenmlevinmd.org) continues to hear from former patients as well as new patients wanting to just have a few minutes of his time to consult with them. He has received and continues to receive letters from patients from as long ago as perhaps 40 years ago. Remarkable, wouldn’t you agree? 

It is not often that a Physician touches so many people and supports them in helping them to recover and achieve optimal wellness. What a gift. 

In my recent travels, I have had the privilege of seeing Dr. Levin’s colleagues that we have not connected with for years. Hearing their stories of how Warren Levin touched them, mentored them, inspired them and helped transform their lives and the lives of their patients. Most recently I was so touched by the kind words from Jeffrey Bland, PhD.,  Dr. Boyd Haley, PhD., and Dr. Michael Gerber all describing how Dr. Levin influenced their lives. I have been moved to tears and feel an overwhelming sense of gratitude.  They come at a very special time.

Dr. Warren Levin was closely acquainted with Dr. Linus Pauling, Dr. Jonas Salk, MD PhD. and Dr. Hans Selye, the Father of Stress. He was also privileged to meet 5 other Nobel Prize winners. Other luminaries closely related in Dr. Levin’s life are Dr. Abram Hoffer, Dr. William Rea, Dr. Theron Randolph, Dr. Virginia Livingston Jackson, MD, Dr. Bruce Halstead, Dr. Elmer Cranton, MD Dr. Richard Casdorf, MD, and Dr. James Carter, MD. PhD. Dr. James Frackelton, MD Dr. Michael Schachter, MD, Dr.  Murray Susser, MD, Dr. Ross Gordon and Dr. Garry Gordon, Dr. Bob Atkins, Dr. David Steenblock, MD. Dr. Johnathan Wright, Dr. Alan Gaby, MD, Dr. Julian Whitaker, MD, Dr. Richard Horowitz, MD, Dr. Daniel Amen, MD, Dr. Martin Waugh, DO, and Dr. Carlton Fredricks, PhD, Dr. Sidney Baker, MD, Dr. John Trowbridge,MD, Dr. David Perlmutter, MD and  Dr. Terry Chappell, MD  just to name a few.  

 Along with this exciting and stimulating time, it was certainly intermingled with times of great stress, angst and struggle. However, there have been angels in our life that helped support the complementary medicine movement and believed in Dr. Warren Levin, his alternative medical mission and his integrity.  

Today, Dr. Levin is facing the next steps in life’s transition. He has now entered into kidney failure. Having only one kidney, dialysis not being an option for him in terms of his quality of life, we have now been given the gift of whatever precious time there is available to us. Because of all the incredible sharing of thoughts and memories most recently, I am reaching out to each and every one of you to put your pen to paper and share your memories and experiences -- the special gifts he has given to all of you freely, with love and integrity. 

I have been privileged to be beside him. He has been a mentor and I have soaked in as much as possible. For me now, I have chosen that my work is to carry on his work and make a difference in people’s lives. Please be so kind as to share how Dr. Levin has impacted your life and work.

I ask that you forward your letters to Dr. Sue Vogan, Peerobmagazine@aol.com, who has offered to help organize this tribute to Dr. Warren Levin. We will put a book together that he will be given so that he will be comforted in these final days. The book will also serve as a treasure for his friends and family so that may be consoled and encouraged for years to come by the sentiments. 

Susan Levin

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Lead Poisoning Afflicts Neighborhoods Across California

Posted By Reuters: Joshua Schneyer and M.B. Pell | NEW YORK, Friday, March 31, 2017


Dozens of California communities have experienced recent rates of childhood lead poisoning that surpass those of Flint, Michigan, with one Fresno locale showing rates nearly three times higher, blood testing data obtained by Reuters shows.

The data shows how lead poisoning affects even a state known for its environmental advocacy, with high rates of childhood exposure found in a swath of the Bay Area and downtown Los Angeles. And the figures show that, despite national strides in eliminating lead-based products, hazards remain in areas far from the Rust Belt or East Coast regions filled with old housing and legacy industry.

In one central Fresno zip code, 13.6 percent of blood tests on children under six years old came back high for lead. That compares to 5 percent across the city of Flint during its recent water contamination crisis. In all, Reuters found at least 29 Golden State neighborhoods where children had elevated lead tests at rates at least as high as in Flint.

“It’s a widespread problem and we have to get a better idea of where the sources of exposure are,” said California Assembly member Bill Quirk, who chairs the state legislature’s Committee on Environmental Safety and Toxic Materials.

(To see the Reuters interactive map of U.S. lead hotspots, click here reut.rs/2h55POf)

Last week, prompted in part by a December Reuters investigation pinpointing thousands of lead hotspots across the country, Quirk introduced a bill that would require blood lead screening for all California children. Now, just a fraction of the state’s children are tested.

 

READ COMPLETE ARTICLE

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European Parliament votes to ban amalgam for children

Posted By Charles G. Brown, President - World Alliance for Mercury-Free Dentistry, Tuesday, March 28, 2017

By an overwhelming 663 to 8, the European Parliament voted last week for a comprehensive package to reduce mercury use, as required by the Minamata Convention on Mercury. Under this new European Union regulation:

  • Amalgam use in children under age 15 will be banned on 1 July 2018.
  • Amalgam use in pregnant women will be banned on 1 July 2018.
  • Amalgam use in breastfeeding mothers will be banned on 1 July 2018.
  • Each country in the European Union will be required to develop a national plan by 1 July 2019, laying out how it will reduce its amalgam use.
  • The European Commission must decide by mid-2020 whether to move forward with plans to phase out dental amalgam completely in the European Union.

This progress is the result of our team’s seven years of toil: building a united European coalition...meeting after meeting with government officials...submitting comments to one scientific committee after another...presenting testimony at a half dozen public hearings...organizing the grassroots... finding the right experts...and collecting signatures for petitions.

When we started, the European Union was the largest user of amalgam in the world – but that will change dramatically when this new regulation goes into effect in 2018. As the European Parliament explains in its press release, this new regulation “aims to phase out the use of mercury in dental amalgam by 2030.”

But we’re aiming to finish off this primitive, polluting mercury product even sooner – including in the United States. (After all, if we can win in the complicated European Union system, we can win anywhere!)

Today, Consumers for Dental Choice filed a petition that calls on the U.S. Food and Drug Administration (FDA) to act. It points out that while the European Parliament is taking steps to protect European children from amalgam, FDA’s 2009 amalgam rule fails to protect American children. To solve this problem, our petition urges FDA to follow the European Union’s example: ban amalgam use in children under age 15, pregnant women, and breastfeeding mothers....and then take the lead in championing a mercury-free future!

Now FDA needs to hear from you too! Please sign this online petition* telling FDA to catch up with the European Union. Then share it with your friends, colleagues, patients, and family.

Banning amalgam use in children and pregnant women was the step that led to the ultimate phase out of all amalgam use in Sweden. Now that the European Parliament has taken that first step, there’s no going back in Europe….and if we pull together, we can take this most crucial step in the United States too!

 

Charles G. Brown
National Counsel, Consumers for Dental Choice
President, World Alliance for Mercury-Free Dentistry
316 F St. NE, Suite 210 Washington, DC 20002 USA
Phone: 202-544-6333   Fax: 202-544-6331
www.ToxicTeeth.org 

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Urban Air Pollution is a Causative Factor in the Development of Insulin Resistance, T2DM, and Obesity

Posted By Walter Crinnion, ND, Monday, March 27, 2017
Lifestyle approaches for the prevention and treatment of insulin resistance, metabolic syndrome and T2DM are typically focused on diet and exercise. The goal being to reduce the number of calories going in and increase the number of calories being burned. Yet, a number of environmental pollutants have been clearly linked to increased risk for T2DM including persistent organic pollutants and arsenic.

Over the last decade articles have begun to associate vehicular exhaust – ambient air pollution commonly elevated in all urban areas across the globe. In the last seven years several studies have demonstrated that adults and youth who are exposed to higher levels of nitric oxides, NO2 and PM2.5 had higher rates of T2DM. Three studies have demonstrated that children and adults with increased exposure to vehicular exhaust had higher calculated insulin resistance (using the homeostatic model assessment of insulin-resistance – HOMA IR). Since HOMA-IR results are not always confirmed with glucose tolerance testing, this longitudinal study was done. A new study provides more proof that urban air pollution plays a role in the development of T2DM and weight gain.

This study followed 314 obese or overweight Latino youth, between 8 and 15 years of age, in the Los Angeles area who participated in the Childhood Obesity Research Center Air Study. These children were recruited between 2001 and 2012 and were followed for an average of 3.4 years. None of those included in the study were diabetic (assessed by an oral glucose tolerance test) or were on any medication that would affect insulin or glucose tolerance.

Levels of ambient vehicular exhaust air pollutants, including nitric oxide, nitrogen dioxide and particulate matter less than 2.5 microns (PM2.5), were estimated by utilizing data collected from monitoring stations in the Los Angeles area. Monthly average exposure levels were calculated from daily values and based on the distance from the measuring stations (using a distance-squared weighting algorithm).

Insulin sensitivity was assessed with a 13-sample insulin-modified frequently sampled intravenous glucose tolerance test. Data from this test provided a rating for whole body insulin sensitivity (Si), acute insulin response to glucose (AIRg), and a assessment of beta-cell function (disposition index [DI]). BMI was also measured throughout the study.

When the exposure data and the BMI status, insulin and glucose response were correlated clear associations were found. Both PM2.5 and NO2 were independently associated with statistically significant reduction in insulin sensitivity. NO2 was associated with a statistically significant decline in beta-cell function. Both PM2.5 and NO2 were associated with a statistically significant increase in BMI.

This new study demonstrates the causal link between urban air pollution, insulin resistance, beta-cell function and adiposity. Clinicians need to start paying attention to the myriad adverse health effects from simply breathing air in any metropolitan area. Air purification units for the home that force air through a series of filters to remove particles down to 1 micron should be on the list of “must haves” for all patients, right next to water filters, organic varieties of “the dirty dozen” (most toxic) fruits and vegetables, and exercise.

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Tags:  causative factor  insulin resistance  obesity  T2DM  Urban Air Pollution  Walter Crinnion 

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Teta’s Hungarian Goulash

Posted By Administration, Friday, March 24, 2017

Many years ago I knew a lovely Czech woman we called Teta who had been exceedingly kind to me and my children. She was an excellent cook and I especially loved her Hungarian goulash. Back in the 70s, we weren’t so cognizant of our cholesterol intake and with the addition of the sour cream, the calories and cholesterol could mount up. I hadn’t made this dish in years but wondered if I could change a few things to make it a bit healthier. I think it turned out well and I substituted low fat plain Greek yogurt for the sour cream. I did not add the potatoes because I wanted to use noodles as an accompaniment. Teta used to serve the dish with spaetzli and cucumbers with dill in yes, more sour cream! So don’t give up on your favorite recipes from the “old country,” just change a few things to make it more healthful. Bon appetite!

Ingredients

½ to 3/4 pound lean, grass fed beef, cut up into small bite size pieces

4 large carrots

4 celery stalks

1 small container of organic mushrooms

1 large purple onion

½ bulb fennel root (optional)

4 cloves chopped garlic

Sprinkle caraway seeds

Sprinkle dill

1 to 2 TBSPs paprika

One 28 oz can of Muir Glen organic diced tomatoes

2 cups vegetable or beef broth

4 large potatoes, peeled and diced, optional

Directions

Heat up a heavy cast iron pan with several tablespoons of grapeseed oil on medium to high heat and saute the carrots, celery, mushrooms, onions, fennel and garlic for 10 minutes or until browned and softened.

Push them to the side and add the beef, sautéing until browned, about another five minutes.

Add the broth, dill, caraway seed and paprika and stir well.

Add the tomatoes and stir again.

Turn down the heat to low and simmer on top of the stove for an hour or until the meat is tender. You can also bake it in the oven if you prefer at 350 degrees until the meat is tender.

If you are adding potatoes, add them in after about a half hour of cooking time so they don’t fall apart.

You can cook this dish on low heat and keep it simmering until everything else is ready.  I served the goulash over” No Yolks,” cholesterol free egg white pasta, Kluski European style.

The cucumber, peeled and sliced, is chilled in no/low fat yogurt in the refrigerator. Teta traditionally sweetened hers with a dash of sugar but stevia or maple syrup would do even better. Add in a couple teaspoons of dill and mix well. Serve the goulash with a large tablespoon of yogurt on top over the noodles.

Enjoy!

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To Replace or Regenerate, that is the question!

Posted By Carol L. Hunter PhD, PMHCNS, CNP,, Friday, March 24, 2017

Last fall after having enough pain in my left hip to take my breath away when making normal movements, I saw an orthopedic physician who informed me that the x-rays showed bone on bone. That made me a great candidate for hip replacement surgery. The young physician was quick to tell me that “cartilage does not regenerate.” The hip, unlike the knee, is not easily accessible and is buried deep within the pelvis, classifying it as major surgery. I’ve known many people who proclaim they have breezed through this surgery and never looked back. There are also the horror stories. At any rate, I decided to do more research on options and was surprised to find many resources that challenged the doc’s thinking and insisted that yes, joint cartilage can regenerate. After mentioning my dilemma to a friend, she told me about two sisters who went to a physician in California to have stem cell transplants in their knees. I doubted if this relatively new procedure extended to the hip, but in fact, it did, and there were several testimonials in this regard on the doctor’s website. I talked to one of the sisters who was gracious enough to walk me through the whole process from beginning to end. She is in the early stages of recovery so the end result is not quite in yet, but it looks promising for her. Stem cells are extracted from the posterior side of the pelvic bone and also from abdominal fat cells beneath the umbilicus. After being processed they are injected back into the joint space along with dextrose, an irritant that serves to catalyze the inflammatory response. It is this response from the body that brings in nutrients to the young cells and allows them to differentiate into cartilaginous cells. The procedure is done under conscious sedation and can be completed in a morning’s time. There are two more injections needed of plasma rich platelets approximately six weeks apart that are reported to promote collagen synthesis, cell proliferation and cartilage repair. My informant called it “Miracle Gro!” There is a second center located in Florida and between the two clinics, costs range from $6500 to $8000 per joint or $8000 to $13,000 for two joints. To the best of my knowledge this procedure is not covered under commercial or federal health plans because it is still considered to be under investigation and experimental. Jennifer Elisseeff, Ph.D., an associate professor of biomedical engineering and her team of researchers, affiliated with the Whitaker Biomedical Engineering Institute at Johns Hopkins, have used a liquid transporter for the stem cells that when subjected to a ultraviolet light, becomes a gel like substance that provides a matrix known as a hydrogel, for the immature cells to attach to and grow. The advantage of using adult stem cells is that patients can use their own stem cells decreasing the risk of infection and tissue rejection. It also eliminates the controversy over use of embryonic stem cells. Unfortunately, this technique is not yet available in humans but research produced impressive results using adult goat stem cells that indeed developed into cartilage. All in all, it looks very promising for cartilage regeneration (Sneiderman, Phil; John Hopkins Medicine, no date.)

Short of surgery, is there any other approach that can help the condition of osteoarthritis? Here is my anecdotal evidence to date. I decided to start using systemic enzymes, which are similar to a cleanup crew in the body. Taken upon an empty stomach, the little enzymes find their way to areas that are “troubled” and go to work to remove debris. The catch is remembering to take them so my solution was to take them in the middle of the night when I invariably wake up. This has worked well and I have not missed more than a few nights since starting last November. In addition, I started a pair of supplements manufactured by Zycal Bioceuticals Healthcare Co. The first is Ostinol Advanced, 5X. which contains a complex of collagen and bone morphogenetic proteins and boswelia. The second is Chondrinol, containing glucosamine, chondroitin and the same complex as in the Ostinol. These are expensive supplements but far less than the costs of surgery and if they can help, it is worth the cost. More recently I have also started quercetin, PPQ and UC-II, a patented form of bio collagen, all of which have shown efficacy in promoting joint comfort and mobility. In Life Extension Magazine of September, 2014, Michael Enders references several studies by Kanzaki et al (2012) and Matsuno et al (2009) stating that “quercetin has demonstrated superior anti-inflammatory properties. When a group of flavonoids was studied, quercetin showed the strongest specific inhibitory effects on the pro-inflammatory enzymes. Added to a standard glucosamine/chondroitin supplement, 45mg/day for 12 to 16 weeks showed significantly improved joint pain and function scores compared with placebo.”  Both pyrroloquinoline quinone (PPQ) and UC-II are also potent anti-inflammatory compounds. UC-II is the cartilage from chicken breast and its collagen has a unique way of teaching killer T-cells in the gut to ignore exposed joint cartilage, thus reducing damage and destruction (Preston, W., 2/2012, Life Extension Magazine.)

For pain, I use boswelia, an additional dose from the one mentioned above and CBD, an extract of cannabidiol, from the hemp plant that does not have any psychoactive effect and is legal in all 50 states. From the natural remedies as cited above, I can say my condition has significantly improved. I no longer have the sudden, sharp pains that took away my breath. I have no pain or achiness at night when it is most noticeable. As if that was not enough, I was able to get back on my incline trainer and spinner and start back on my exercise regimen. I still have stiffness and decreased range of motion and occasional aches but it is nothing like it was and I am greatly encouraged. Perhaps that young doctor was wrong after all. I would prefer to believe that our wondrous human bodies have the capacity for regeneration if given the tools that are required.

For more information, the websites on stem cell transplants are: drfields.com and smartchoicestemcell.com. (These are only two examples and are not intended to be a complete listing.)

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Can CAM Docs Legally Prescribe and Sell Herbals and Nutritional Supplements as Therapy Without Bad Things Happening? Prescribe, Yes. Sell? We'll See

Posted By Richard Jaffe, Esq., Thursday, March 23, 2017
Many CAM and integrative doctors recommend and/or sell all kinds of nutritional and herbal products to their patients. There is a supplement manufacturer sub-industry which only sells to physicians and other health care professionals, for resale to patients. And most of the top tier, high profile docs have their own private label supplement brands. That’s a fact. But is it legal and ethical to do so?

Legal is a matter of state law. But for better, (but mostly) for worse, ethical is largely determined by those noble, public-spirited and never ethically-challenged folks at the AMA (American Medical Association for those living under a rock). They’re not completely controlled by Pharma; just ask them and they will tell you. And they’re not trying to stop cheaper non-patentable interventions like nutritional supplements and herbs, all at Pharma’s behest. Their thought leaders do not receive tens, hundreds of thousands, or millions of dollars from Pharma for research, public relations and advocacy. Just ask them and they will tell you.

And their “ethical guidelines” reflect an open-minded attitude serving the best interests of the patients. Ok, you get the point.

So is it AMA “ethical” for physicians to sell nutritional and herbal products? Technically yes, but practically, not so much:

Here’s the latest iteration of the AMA “ethical” rule on the sale of health related products. (Sorry, it’s longish)

9.6.4 Sale of Health-Related Products The sale of health-related products by physicians can offer convenience for patients, but can also pose ethical challenges. “Health-related products” are any products other than prescription items that, according to the manufacturer or distributor, benefit health. “Selling” refers to dispensing items from the physician’s office or website in exchange for money or endorsing a product that the patient may order or purchase elsewhere that results in remuneration for the physician. Physician sale of health-related products raises ethical concerns about financial conflict of interest, risks placing undue pressure on the patient, threatens to erode patient trust, undermine the primary obligation of physicians to serve the interests of their patients before their own, and demean the profession of medicine. Physicians who choose to sell health-related products from their offices or through their office website or other online venues have ethical obligations to:
(a) Offer only products whose claims of benefit are based on peer-reviewed literature or other sources of scientific review of efficacy that are unbiased, sound, systematic, and reliable. Physicians should not offer products whose claims to benefit lack scientific validity.
(b) Address conflict of interest and possible exploitation of patients by: (i) fully disclosing the nature of their financial interest in the sale of the product(s), either in person or through written notification, and informing patients of the availability of the product or other equivalent products elsewhere; (ii) limiting sales to products that serve immediate and pressing needs of their patients (e.g., to avoid requiring a patient on crutches to travel to a local pharmacy to purchase the product). Distributing products free of charge or at cost makes products readily available and helps to eliminate the elements of personal gain and financial conflict of interest that may interfere, or appear to interfere with the physician’s independent medical judgment.
(c) Provide information about the risks, benefits, and limits of scientific knowledge regarding the products in language that is understandable to patients.
(d) Avoid exclusive distributorship arrangements that make the products available only through physician offices. Physicians should encourage manufacturers to make products widely accessible to patients.

So what does this gobbledygook mean? Well, it means that you CAM docs have a problem.

First, virtually no supplements or herbal remedies have the kind of scientific support set out in subparagraph (a). There are only a few supplements for which the FDA have approved health claims, like folic acid for pregnant mothers, and such. I also suspect that the peer-reviewed literature the rule refers to means mainstream journals to the AMA. My guess is that this AMA subsection could be used to render “unethical” the recommendation of the products routinely recommended and sold by physicians.

But there are bigger problems.

Subsection (b) seems to suggest you have to either give away the products, or sell them at cost in order to avoid the conflict of interest or appearance of the conflict. Moreover, you’re only supposed to give away or sell at cost enough product to meet the patient’s immediate needs, or until they can get the product from a less conflict-ridden source.

This is idiotic. By the logic of this provision, if you go to a surgeon for a surgical consult, it would be unethical for the surgeon to actually perform the surgery rather than just recommend it, because he has a financial interest in performing the operation.

But not to worry, under the rule, the surgeon can lessen the conflict by either 1. Operating for free, or 2. Charging his actual cost, rather than the high fees the surgeon normally charges. To further lessen the conflict, he should only do a temporary surgery, just fix the problem enough to allow the patient to go to another surgeon who has no financial conflict of interest arising from the first surgeon’s surgery recommendation. The same would apply to an interventional cardiologist recommending a stent, angiogram/angioplasty or to any other physician who both makes recommendations and provides a procedure or therapy to effectuate or implement the recommendation.

To generalize, there is the same conflict of interest for any professional who both consults and does something. By the logic of the AMA rule, a lawyer cannot both recommend suing and actually suing (unless he sues for free or at cost). Nor could a lawyer prepare a trust, or do anything the lawyer recommends, because implementing the recommendation means that the lawyer makes extra money for the doing, which under the logic of the AMA rule irreparably taints the lawyer’s judgement (unless the service is done for free or at cost, and is only a temporary fix until a conflict-free professional is retained).

The AMA world view embodied in this rule reminds me of the commercial for a personal identity protection company. You know these commercials: There’s a patient with his mouth open in a dentist’s chair, and a guy with a white coat looking in the patient’s mouth who says “you have one of the worst cavities I’ve ever seen.” The patient says. “OK doc, fix it.” And the guy in the white coat says “Oh, I’m not a dentist; I don’t fix teeth, I’m just a dental monitor.”

In the AMA la-la ethical world, the guy tells the patient “Yes I am a dentist and I’d like to fix your tooth, but I have a conflict because I’m going to make extra money doing what I said should be done. So, we’re done here and you have to see another dentist who will actually fix your cavity”

Is this really how we want physicians who have a service or product to act? Have them become health care monitors, and have another class who are health care problem fixers?

Let’s not leave AMA ethical la la land yet: At the new dentist’s office, the dentist looks over the films, examines the patient, and concurs with the recommendation, thereby creating a chargeable evaluation and management fee. Doesn’t the new dentist also have a conflict? He’s got his examination fee, and he’ll get extra money for fixing the cavity. This can get ridiculous!

Let’s face it, we rely on professional to give their opinions and implement a solution within the professional’s expertise. This happens zillions of times a day, all over the world. To single out physicians who use and sell the kind of products used by millions of people is just nuts.

This rule obviously hasn’t been used to stop surgeons, cardiologists or dentists from doing the thing they were trained to do. But what about a CAM physician who uses herbals or nutraceuticals as primary therapy? Can they do that, or are they caught in the same AMA ethical net?

But before we get to that, here is another question:

Does this AMA ethical rule matter?

Short answer: yes

Alittle longer answer: it matters because some state medical board laws have specifically incorporated the AMA ethical rules into their standards of professional conduct, such that a violation of an AMA ethical rule is a violation of the state’s medical board law. Even in the absence of express incorporation, states can and do go after physicians for ethical violations of all sorts (just ask docs like Burzynski about that).

Why is any of this relevant or important to CAM docs?

There’s a new case against a doc (it’s my case, and not in California or Texas where I maintain offices, but I don’t want to give the details just yet) which raises the very issue of whether it is unethical and a state board law violation to use and sell herbal and nutritional interventions as primary therapy. What makes the case more interesting is that the therapy is only available from physicians, and only physicians who have gone through the company’s training about how to use the products. (Many of you CAM docs probably know the product line I’m referring to.)
How can the AMA possibly view this kind of thing as the “sale of health a related product?” Well maybe it doesn’t, but initially at least, the state medical board seems to think it is the sale of a “health related product” and is going after the doctor for do so.

Here’s where it gets interesting with the AMA ethical rules: The second opinion after the sale of health related products is the following ethical precept:

9.6.6 Prescribing & Dispensing Drugs & Devices In keeping with physicians’ ethical responsibility to hold the patient’s interests as paramount, in their role as prescribers and dispensers of drugs and devices, physicians should:
(a) Prescribe drugs, devices, and other treatments based solely on medical considerations, patient need, and reasonable expectations of effectiveness for the particular patient.
(b) Dispense drugs in their office practices only if such dispensing primarily benefits the patient. (c) Avoid direct or indirect influence of financial interests on prescribing decisions by: (i) declining any kind of payment or compensation from a drug company or device manufacturer for prescribing its products, including offers of indemnification; (ii) respecting the patient’s freedom to choose where to fill prescriptions. In general, physicians should not refer patients to a pharmacy the physician owns or operates. AMA Principles of Medical Ethics: II,III,IV,V.

Does this section apply to a doctor prescribing and selling a product used as primary therapy if the product is only available from the health care provider and only from one who is trained by the manufacturer? It seems to.

Although the heading only refers to “drugs” and “devices”, the actual rule specifically mentions “drugs, devices, and other treatments.”

A prescription is just a written order issued by a healthcare provider containing the provider’s recommendation for a product, such as a drug, device, or other treatment, or in some cases a recommendation of behavior (like bedrest). So a written order by a physician to take an herb or nutritional supplement in order to cure or mitigate a disease is a prescription and such products are prescribed. (And in case you are concerned, the fact that a physician prescribes an herb or supplement for the treatment of a disease doesn’t turn the product into a drug, because it’s the manufacturer’s intent that governs not the prescribing practices of healthcare providers, under FDA law.)

Admittedly, the language in (b) mentions a pharmacy, but not all prescribed things are found in pharmacies. Take the aforementioned bedrest for example. And we’re stipulating that the prescribed products can only be obtained through the doctor, and is not available directly to the consumer.

So does this AMA rule 9.6.6 sanction a physician prescribing an herbal remedy or supplement for the treatment or mitigation of the disease or medical condition?

I looked at the literature and haven’t seen any cases on this yet. I think it does, and the case I’m working on will provide what may be the first legal ruling on the issue.

As a backup, it seems to me that even if both AMA ethical rules could apply, I don’t see how a medical board can sanction a physician for a violation of an ethical rule where the physician’s actions are ethical under another ethical rule, or arguably so. It seems to me that a board must first make this determination, publish it and put the licensees on notice, which my research indicates has not yet been done in this state at least.

So although I think I am right, as of right now, there doesn’t appear to be a definitive answer to the question as to whether a CAM physician can prescribe and sell an herbal remedy or nutritional supplement or supplement regime as primary therapy for the treatment or mitigation of a disease, at least in a state which has specifically incorporated the AMA ethical rules.

But give me six months or so and I’ll give you the answer; hopefully the one you’re looking for.

In the meantime, and to make that happen, any academics out there with some ethics background care to opine and help make it happen? I’ll be waiting to hear from you.

Rick Jaffe, Esq.
rickjaffeesquire@gmail.com

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