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Reconnecting With Self

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Reconnecting With Self Reconnecting With Self Presentation Transcript

  • How to treat a woman: A Broader View
    Jo Robins, RN, PhD, ANP-BC, AHN-C, CHTP
    VCU School of Nursing
  • Outline: What am I offering you today
    A holistic and balanced exploration of illness and health
    Both personal and professional
  • COMPLEMENTARY THERAPIES AND HOLISTIC CARE
    The Placebo Response
    Innate healing ability
    Holism- Mind, Body, Spirit
    Self-care
    Personal/Professional
    Treating/Curing/Healing Partnership
    Integrative Practice
  • nccam.nih.gov
    1-888-644-6226
    Outstanding resource
    Currently sponsored clinical trials include the areas of acupuncture, herbs, dietary supplements, and massage in the areas of arthritis, neurological disorders, cardiovascular disease, and cancer
  • Categories of Use- NIH NCCAM
    Alternative Systems: TCM, Ayurvedic,Homeopathy
    Biological:Diet, vitamins, supplements, herbs
    Manipulative/Body based:Chiropractic, massage, Trager…
    Energy:Healing Touch, Therapeutic Touch…
    Mind-Body:Psychoneuroimmunology,Breath work, Guided imagery, meditation, tai chi, yoga, humor, .…
  • Ayurvedic Medicine
    Focus is on person as energetic entity, balance, breath, diet, exercise, mind-body techniques, yoga
    Wisdom of Healing; Return to Wholeness by David Simon, MD
  • Mind-Body Constitution or Dosha
    http://doshaquiz.chopra.com/
    http://www.whatsyourdosha.com/
    Vata = Air
    Pitta = Fire
    Kapha = Water
  • Traditional Chinese Medicine
    Ancient eastern system of medicine focusing on balance, energy flow
    Meridians
    Ying/Yang
    5 elements: fire, water, air, wood, earth
    Acupuncture, Massage (Tui Na) , Herbs, Nutrition, Qi Gong (vital energy)
  • Balancing Yin and Yang
    Yang is the “daylight”, the “active”, the “doing”, the “producing”.
    Yin is the “nighttime”, the “stillness”, the “contemplative”, the “refilling”.
  • Balancing Yin and Yang
    The flame is the yang; the wax is the yin.
    The battlefield is the yang; the fort is the yin.
    Doing is the yang; being is the yin.
  • Biological-Based
    Diet: Primary focus for maintaining, rebuilding health. Food is Information.
    Some truths about Vitamins, Supplements, and Herbal therapies
  • Resources for Vitamins, Supplements, Herbal Products
    Herbal PDR
    Commission E Monograph
    Herb Contraindications and Drug Interactions by Brinker
    Natural Medicines Database
    South River Compounding Pharmacy
  • Resources for Vitamins, Supplements, Herbal Products
    Metagenics
    Perque
    Phytopharmica
    Xymogen
    New Chapter
    Numerous others
  • Manipulative/Body Based
    Massage: Effective for stress management, reducing and eliminating a variety of pain syndromes.
    Trager-Effective in helping manage Parkinson’s disease.
  • Energy
    Fully developed framework
    Era I, II, III Medicine
    Healing Touch and Therapeutic Touch help decrease pain and anxiety; improve sleep quality, and well-being
  • Functional Medicine
    Functional Medicine Institute www.functionalmedicineinstitute.org
    Biochemical individuality describes the importance of individual variations in metabolic function that derive from genetic and environmental differences among individuals.
  • Functional Medicine
    Patient-centered medicine emphasizes "patient care" rather than "disease care.”
    Follows Sir William Osler’s admonition that “it is more important to know what patient has the disease than to know what disease the patient has."
  • Web-like interconnections of physiological factors
    An abundance of research now supports the view that the human body functions as an orchestrated network of interconnected systems, rather than individual systems functioning autonomously and without effect on each other.
  • Evaluating CAM Therapies
    1. Evaluate the therapy itself- can you assess whether the therapy is probably harmless, possibly dangerous, or potentially helpful in some significant way (ie, does it operate in a plausible way, is there scientific literature?).
  • Evaluating CAM Therapies
    2. Evaluate the practitioner offering the therapy-training, reputation within professional networks (patients/colleagues), Do they have expertise treating your condition? Do they make any claims regarding outcomes? Can they integrate with your conventional therapy? Is the practitioner worthy of your trust?
  • Evaluating CAM Therapies
    3. Evaluate the quality of the service including delivery, cost, and quality of service being rendered.
  • Many Professional Organizations
    American Holistic Nurses Association (www.ahna.org)
    American Holistic Medical Association (www.ahma.org)
    American Association of Integrative Medicine (www.aaimedicine.com)
  • Peer Reviewed Journals-Nursing and Medicine
    Journal of Holistic Nursing
    Holistic Nursing Practice
    Journal of Complementary and Integrative Medicine
  • Peer Reviewed Journals
    Evidence Based Complementary and Alternative Medicine
    Alternative Therapies in Health and Medicine
    Journal of Alternative and Complementary Medicine
  • What is “Stress” ?
    Overused, non-specific
    Typically viewed as negative
    Promotes adaptation, growth, learning
  • Stress Response
    Brain integrates and coordinates behavioral and neuroendocrine responses to “stress” and normal diurnal rhythms.
    Remarkable individual differences in coping related to genetics, early development, behaviors, experience….
    Neuroendocrine and behavioral responses programmed to adapt for homeostasis, allostasis. Must efficiently turn on and off.
  • Short-Term Adaptive Responses
    CV-catecholamines (CAT) increase HR, BP, Vasoconstriction to be upright, active
    Brain-Adrenal hormones (AH), CAT increase awareness, memory retention
    Immune- AH & CAT promote cell trafficking; modulate cyto-,chemokines
  • Stressor
    Factors
    Person
    Factors
    STRESSOR
    T
    Social-
    Environmental
    Factors
    STRESSOR
    Norepinephrine
    NKC
    Epinephrine
    B
    Cortisol
    Mn/MN
    DHEA
    Spleen
    Cerebral
    Cortex
    IL-2
    IL-6
    TNFa
    Limbic System
    IL-1
    IL-3
    Hypothalamus
    CRF
    PVN
    CRF
    CRF
    Locus Ceruleus
    Pituitary
    Proopiomelanocortin:
    b-endorphin, ACTH,
    ANS
    a-melanocyte
    stimulating hormone
    Lymphoid Tissue
    ACTH
    Adrenal
    Cortex
    Adrenal
    Medulla
    IL-2
    Thymus
    Enkephalins
    TNFa , IL-1, IL-6
    Met-enkephalin
    b-Endorphin
    Interferons
    IMMUNE SYSTEM
  • Potentially Damaging Long-Term Effects
    CV- prolonged BP elevations accelerate atherosclerosis and with metabolic hormones lead to Type II DM
    Brain- HPA overactivity, excitatory neurotransmitters reduce neuronal excitability and atrophy, hippocampal brain cell death
    Immune-Immunosuppression and immune overactivity (autoimmune, inflammation)
  • Allostatic Load: McEwen & Stellar, 1993
    “Hidden cost of chronic stress to the body over long time periods, which act as a predisposing factor for the effects of acute, stressful life events.” “Wear and Tear”
    “Presents a model showing how individual differences in the susceptibility to stress are tied to individual behavioral responses to environmental challenges that are coupled to physiologic and pathophysiologic responses.”
    (p. 2093)
    Cumulative result of allostasis, allostatic state
  • 4 Types of Allostatic Load
    1. Repeated events over a long period of time (sustained economic hardship)
    2. Failure to adapt to a repeated stressor (never adapting to flying or public speaking)
    3. Failure to shut off hormonal stress response or return to normal trough (sleep deprivation)
    4. Inadequate hormonal stress response allowing other systems to be overactive (autoimmune)
  • Contributors-Allostasis, Allostatic State, Allostatic Load
    Daily diurnal patterns (sleep-wake, cardiovascular changes to stand)
    Genetic predisposition
    LBW
    Early development- bonding, abuse
    Perceived loss of control
    Learned helplessness
    Learned behaviors/ lifestyle choices- exercise, diet, smoking, alcohol consumption, mind-body fitness, spirituality
    Health Disparities
  • Mediators of Allostasis
    Adrenal steroids
    Catechoamines
    DHEA
    Prolactin
    Pitocin
    Growth hormone
    Sex hormones
    Cytokines
    Once hormones are released there are immediate and long term effects on cellular function.
  • PERCEPTION
    Negative Affect or Loss of Personal Control.
  • PERCEPTION
    Positive Affect; Sense of Personal Control
  • BREATHING- The Basis of Health and Healing
    Learning to be, be with without doing is the path of the feminine
    Breath=Spirit
    Begin by observing breathing patterns
    Three deep breath upon arising and before sleep
    Promotes relaxation-de-activates SNS (impacts neuroendocrine, cardiovascular, and immune systems
    Dr. Andrew Weil audiobook “Breathing”
  • Creating Change
    From a feminine perspective, it is about process instead of outcome
    It is a process-the beauty and glory are in the process of growing and evolving, not necessarily the “getting there”
  • What Have I Learned
    Own and honor therapeutic presence