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The Evolutionary Perspective
Category Archives: Alternative Medicine
Posted: January 18, 2020 at 10:28 am
Over the years the wellness industry has evolved and grown. And while there are some trends well be steering clear of (sorry Gwyneth - we wont be buying a candle that smells like your vagina), theres a smorgasbord of therapies housed under the complementary and alternative therapy umbrella were happy to explore.
Because heres the thing were all different. Whats helpful for one person, wont be helpful for another. We all have our own preferences, beliefs and approaches that resonate. So, it can be helpful to know that if one approach doesnt work, we have other options.
Anything that doesnt fit under conventional or standard medical care can be called a complementary or alternative therapy (or complementary and alternative medicine, CAM). These practices, products and therapies include approaches that have been used throughout history such as aromatherapy, yoga and ayurveda. Some have roots in ancient Eastern philosophies of health such as Traditional Chinese Medicine, like acupuncture and herbalism.
The aim of these approaches is to be holistic and treat the whole person, not just the symptoms. This means they can help with both mental and physical health, and your overall wellbeing will be taken into account.
Complementary therapies are intended to be used alongside conventional approaches. For example, if youre receiving treatment for cancer you may benefit from exploring complementary therapy to help cope with the side-effects.
Alternative therapies are generally used in place of a conventional approach. Often this is the case when someone has tried a number of conventional approaches but they havent found them helpful. For example, if you find conventional approaches to anxiety dont help, you may decide to try aromatherapy or yoga.
Of course, many therapies here overlap and can be used as either a complementary therapy or an alternative. Whichever way you choose to use a therapy, you are advised to speak to a medical doctor before trying a new therapy, especially if youre receiving treatment for a condition.
Most therapies that fall under the CAM umbrella are not currently regulated in the UK (with the exception of physiotherapists, chiropractors, osteopaths and chiropodists). This means there are no laws that say what level of training someone needs in order to practice.
There are, however, several professional bodies which self-regulate certain therapies. Therapists can choose to join a professional body and then the body will ensure they meet their training requirements. Professional bodies have a complaints procedure, so if youre unhappy with your treatment, you will be able to make a complaint.
When you come to search for a complementary or alternative therapist, we recommend you ask about their qualifications, ensure they have insurance and see if they have a membership with a professional body. They dont need to be a member of a professional body in order to practice, but if youre worried, this may help put your mind at ease.
While there are some complementary and alternative therapies options through the NHS, sadly, theyre not widely available. Speak to your doctor to find out the availability in your area; if you cant get what you need on the NHS, you may need to look for a private therapist.
The National Institute for Health and Care Excellence (NICE) offers guidance to the NHS on which treatments are effective. Currently they recommend the use of CAMs in certain circumstances, including:
The great thing about these therapies is that there are lots to choose from. So, take your time if youre new to the world of CAM and see what resonates with you. Here we explore five common therapies and how they could support you.
Using very fine needles, acupuncture aims to bring balance to the bodys energy flow (known as qi pronounced chee). Traditional Chinese Medicine works on the premise that we have energy within our bodies, carried by meridian channels. You can imagine this like a network of rivers.
Its believed that when these energy channels become blocked or stagnant, our physical and mental health are affected. Stimulating the meridian channels with needles is thought to remove blockages to restore flow.
Despite what it sounds like, this therapy is not supposed to hurt and many report feeling very calm throughout. Acupuncture is particularly helpful for pain-related conditions including migraines, tension headaches and back pain. Many practitioners say this treatment can support overall wellbeing, mental health and work as a preventative to future ill health.
In reflexology its believed that certain areas on the feet, hands and ears (called reflexes) relate to other areas of the body through the nervous system. The aim is to apply pressure and massage certain reflexes to encourage energy flow and natural healing.
This approach is wonderful at reducing stress as the experience itself is very calming. As well as helping with stress, reflexology is thought to help ease pain, help with insomnia, improve circulation and support overall wellbeing.
Digital Marketing Executive at Happiful Katie has reflexology to help cope with the after-effects of glandular fever.
During the treatment, Im so relaxed. I have actually fallen asleep many times and I almost feel Im floating or in a trance-like state, completely at ease with myself and my surroundings. It allows me to accept the symptoms I struggle with, acknowledge why they are there but also trust that my body will eventually heal itself.
Reiki is considered an energy healing therapy, and again the aim here is to maintain balance within this energy. Reiki practitioners attune themselves to Reiki energy and then use their hands to help balance energy. This doesnt often involve touching, and may be used with hands above the body.
You will be lying or sitting, fully clothed in a calm and relaxing room. Encouraging relaxation, Reiki is ideal for those feeling overwhelmed, disconnected or isolated. The process can help you feel more centred and able to cope with lifes ups and downs.
Because this approach is non-invasive, its suitable for all ages. However, as with all of these approaches, if you have a medical condition or injury, be sure to tell your practitioner so they can take the necessary precautions.
Using essential oils from plants and flowers, aromatherapy can be used in a number of ways. The most common are through inhaling the scents (usually by burning essential oils) or by applying the oils (usually by massage). Aromatherapy massages are a popular way of enjoying essential oils, combining the healing power of essential oils with the physical benefits of massage.
Aromatherapy can be used for several conditions but is thought to be particularly helpful for people struggling with stress, anxiety and insomnia. Its also been suggested by NICE that aromatherapy can help ease feelings of agitation in those with dementia.
Targeting certain parts of the body with gentle rolling movements, the Bowen Technique is a physical therapy that looks to help the body balance, repair and reset itself. The approach was developed in the 1950s by Tom Bowen and it is holistic by nature, looking at the whole person, not just the condition presented.
Believed to be helpful for a wide range of conditions, Bowen therapy can be especially helpful for back, neck and shoulder pain.
This really is just the tip of the iceberg when it comes to complementary and alternative therapies. If its an area youre interested in, we recommend doing your research and having fun exploring different approaches. Some will require you to work with a professional, others you might be able to try at home yourself.
Try some different therapies out, see what helps and remember to keep your doctor in the loop at all times.
The rest is here:
Global Complementary and Alternative Medicine Market 2019 Valuable Growth Prospects and Upcoming Trends till 2024 Dagoretti News – Dagoretti News
Posted: at 10:28 am
Research study on GlobalComplementary and Alternative MedicineMarket Examination of Market Segmentation Including Product Type, Application, And Regions
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Some of the existing and emerging players being profiled are specified in this report including:Columbia Nutritional, Iyengar Yoga Institute, Helio USA, Herb Pharm, Pure encapsulations, Herbal Hills, Yoga Tree, Nordic Naturals, Deepure Plus, John Schumachers Unity Woods Yoga Center, The Healing Company, Quantum Touch,
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The report reveals comprehensive details regarding the supply and demand analysis, participation by major industry players and market share growth statistics of the business sphere. The report contains an exhaustive analysis of this business space, along with a succinct overview of its various market segments. A basic overview of theComplementary and Alternative Medicinemarket has been offered with respect to its present position and the industry size, based on revenue and volume. The forecast is based on data from 2014 to the current date and forecasts until 2024, easy to study other graphs and tables people watching for major industry data in easily available documents.
Then the next part of the report includes detailed information about the market in different regions. Each region offers a different scope to theComplementary and Alternative Medicinemarket. The regions included in the report are
North America (United States, Canada and Mexico)
Europe (Germany, France, UK, Russia and Italy)
Asia-Pacific (China, Japan, Korea, India and Southeast Asia)
South America (Brazil, Argentina, Colombia)
Middle East and Africa (Saudi Arabia, UAE, Egypt, Nigeria and South Africa)
Information about different regions helps the reader to understand the global market better.
The GlobalComplementary and Alternative MedicineMarket is segmented on the basis of product type, applications, and its end users. Moreover, other trends covered in this report include globalization, growth progress boost fragmentation regulation & ecological concerns as well as factors like in relation to products like the products prototype, manufacturing method, and R&D development stage are included in the report.
Key Takeaways From The Report:
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Here is the original post:
Posted: at 10:28 am
Alternative system of medicine is the future of health care, say experts
Experts at an international conference on alternative medicine said on Wednesday academic and industry linkage should be encouraged to develop evidence-based alternative medicine, scientific gatherings should be held more frequently, and institutional linkages regarding student and faculty exchange programmes should also be established between different countries.
They further called for launching combined research projects to have a strong scientific validation of alternate medicine, inviting more international speakers to the conference and organising more technical courses in the area of alternative medicine.
They said Mattab Hamdard Aram Bagh should be declared a national heritage, and added that the National Coucil for Tibb should define the extent of clinical practices for Tabbibs/Hakims.
They made these recommendations while speaking at the concluding session of a three-day 5th Hamdard International Conference on Alternative Medicine, Responsibilities and Challenges at Bait al Hikmah Auditorium (Library) at Hamdard University, Madinat al Hikmah, Karachi.
Other recommendations of the conference included behavioural changes in the community through mutual cooperation, counselling of patients by Hakims, doctors, homeopaths and community leaders for better and early healing through alternative medicine, need for an integrated approach for education, research and practice in the alternative system of medicine. It was further recommended that pre-clinical trials and studies should be conducted before proceeding towards human clinical research.
Experts believed that the alternative system of medicine is the medicine of future; however, compliance with standardisation of drugs and therapy should be ensured.
Speaking at the concluding session, Dr Farhana Memon, director, Sindh Healthcare Commission, said collective efforts were needed to resolve healthcare issues and experts of Tibb along with modern medical practitioners should work together to resolve much pressing concerns and issues healthcare faced today.
She congratulated Hamdard Pakistan and management for holding the conference successfully. She also highlighted the importance of these conferences for the promotion of Eastern Medicine. She especially lauded the efforts of Hamdard to create awareness about the effectiveness of Eastern medicines.
Farhana Memon urged the National Council for Tibb to initiate dialogue with all stakeholders and bring forth recommendations to resolve healthcare issues in the country.
She said breastfeeding was a healthy practice which was unfortunately given up by most population of urban areas even though it had been a practice followed by our elders for centuries.
We have to adopt these old practices and women understand the importance of breastfeeding. Besides that, ancient treatment methods of remedies of Eastern medicines are also very effective, she added, and called on others to spread the work of Hakim Said, his accomplishments in the fields of Tibb, his research and discoveries so that more and more people could gain benefit from his work.
Prof Dr Ejaz Moihuddin, dean, Faculty of Eastern Medicine, Hamdard University, and Hakim Abdul Bari, Dy. Director Production, Hamdard Laboratories, presented their papers.
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Posted: at 10:28 am
JEFFERSON COUNTY, Ohio (WTRF)- Today marks the one year anniversary of medical marijuana sale in Ohio. 4 dispensaries opened on the first day of the program just one year ago, and only one of them was small and locally owned, and it is right here in the Ohio Valley!
Ohio Valley Natural Relief (OVNR) in Wintersville provides alternative medicine to countless patients. A lot of preparation went into its opening, and despite many obstacles at first, business is good for this pioneering industry. The owner tells me education is key to making a decision- whether for or against- and that the stigma of medical marijuana is fading away.
In 2016, Mike Petrellas father was diagnosed with Stage 4 cancer, passing away 2 months after diagnosis. Petrella was overcome by the suffering his father had to endure and wanted a better way to alleviate pain. This is when his journey began.
Petrella, the Owner and CEO of Ohio Valley Natural Relief, LLC, told 7News I started to dig a little deeper, went to Colorado, spent 5 days out there, learned the industry from cultivation, processing, dispensaries, visited dozens of dispensaries to try to learn the business from the ground up.
OVNR has helped thousands of patients, averaging 20-30 per day.
Petrella said on day one we had people from all over the state of Ohio again there was only 4 of us open we had people hours away and even to this day some of those relationships that we built with those patients they feel the most comfortable coming here with our staff so they still drive at least 3 hours away to come and see us.
Yes, patients are often skeptical and afraid at first. But, an exemplary staff covers all of the bases, making their patients completely comfortable with their products.
Petrella added for 2020 we see our sales probably doubling and as a state we see the patient count where its at 80,000 patients registered we see that number as a statewide hopefully jumping to 200,000 patients by the end of 2020 so it will only benefit owners and obviously patients because it will drive the price down as well.
At 28 years old, Mike Petrella is one of the youngest owners and one of the only single-sole proprietors of a dispensary in the entire nation. Featured in Marijuana Venture Magazines 40 under 40, Petrella was humbled by the honor, but more importantly, the community is highlighted on a national stage. Petrella said anytime you can shine a positive light on your local community on a national level, on state level, on a local level, its been great for everyone involved especially for the community of Wintersville.
Everything is based on qualifying health conditions. Safety and compliance come first. And nobody walks into the actual dispensary without their official medical cards. Even our 7News reporter had to give a drivers license to enter the lobby.
Lastly, Petrella added, we just really look forward to keep helping as many people as we can, educating people trying to get them to understand what were doing, why were doing it, how much its going to actually help. And at least come talk to us before you make a judgement on medical marijuana.
Heres how Ohio is doing compared to other states:
Read more here:
NutriDrip, ahead of funding round, sets up aging and hangover treatments at Wynn Hotels, Equinox – CNBC
Posted: at 10:27 am
At Clean Market in Midtown, New Yorkers have a wide menu of healthy offerings to choose from, such as "superfood smoothies" and bowls with a side of a "moon dust of choice."
But if clean food isn't enough, customers can also get a boost from vitamins delivered intravenously at the NutriDrip bar. The service is growing in popularity and attracting customers from fitness and lifestyle companies like Equinox to some major hotel chains.
NutriDrip sells 15 vitamin infusions administered by medical professionals via an IV drip that takes about 30 minutes. The Nutribody drip aims to support fat loss with a combination of l-carnitine, taurine, vitamin C, B complex, among others. There are also the popular hangover remedies Basic Recover, Super Recovery and Mega Recovery which range in price from $119 to $199 depending on how much you're hurting from the night before. The Nutriyouth drip claims the ability to "help stop cellular aging in its tracks" with a mixture of anti-aging enzymes, molecules and vitamins for $599.
Founded five years ago, NutriDrip is looking to expand in 2020 with a Series A funding round in the first half of this year. Executives declined to say how much money they're looking to raise.
"Over the last three years, IV nutrient therapy, specifically NutriDrip, has grown, at like a 60 to 80% year-over-year growth rate, even while opening new stores," said co-founder Asa Kitfield. "So we're really excited to see what sort of saturation the market can see on like a local and national basis."
One of its new corporate clients is Wynn Hotel will be offering NutriDrip IV drips to its guests in Las Vegas in early 2020.
A woman receives a vitamin infusion via intravenous drip.
Carlos Allegri | Reuters
"As many of our guests now expect a more holistic set of wellness options, we have evolved to include broader wellness themes related to functional wellness, physical fitness, and healthy cuisine," said a Wynn spokeswoman, adding "providing IV therapy is one more way to help our guests maintain personal wellness routines while they are traveling."
The Equinox Hotel in Hudson Yards also has been offering the service to guests when it opened last summer. Kitfield also told CNBC, NutriDrip is slowly rolling out the service to other Equinox gym locations in early 2020 as well.
Equinox executives Jeffrey Weinhaus and Harvey Spevak were early investors in NutriDrip parent company Clean Market, along with real estate investor Jack Terzi, Seritage Growth Properties CEO Ben Schall, fashion designer Andrew Rosen and venture capital firm Able Partners.
Celebrities, including Madonna, Rihanna and Simon Cowell, are reportedly fans of IV vitamin treatments, but it's drawn some controversy.
"Anytime you poke a hole in somebody's vein, there is some risk that they'll bleed excessively. There's also some risk that they will clot excessively," said Dr. David Katz, founding director of Yale University's Prevention Research Center. "So the risks are not great. And the risks are not very common, but there are risks, and the only way to justify any risk in medicine is by a greater likely benefit."
He said there is "minimal evidence that there is any meaningful benefit for most people."
Kitfield said NutriDrip doesn't make grand promises about its treatments but said the company and customers clearly believe in its benefits.
"When you look at our business where 50 to 60% of our revenue comes from regulars, and that's why we continue to grow, the proof is kind of in the pudding, Kitfield said.
According to the Global Wellness Institute, a nonprofit that tracks the industry, the global wellness market is a $4.5 trillion industry. While IV therapy and alternative medicine is a small portion of the overall spending, GWI says it's among the fastest-growing sectors.
Posted: at 10:27 am
In early June of 2018 elite middle-distance runner Robby Andrews was on fire. Was, unquestionably, at the top of his running game. The then-27-year-old had just run one of his fastest races ever: 3:36 in the 1500 meters at the Oslo Diamond League Meet in Norway, beating out 18-year-old phenom Jakob Ingebrigtsen. Which is why, for Andrewswinner of the 800-meter national outdoor title in high school, holder of a national indoor record in the 800 meters as well as the 1000 meterswhat happened two weeks later was such a shock.
June 21. The USATF Championships in Des Moines, Iowa. Andrews felt confident going into the 1500 meters, but mid-race he completely ran out of steam. He placed a disappointing fifth in his heat, not even qualifying for the finals. I dont know what happened, a confused Andrews told reporters after the race.
A few days later he came down with flu-like symptoms. For the next month he battled nasty upper respiratory and sinus infections and 102-degree fevers. Training just sucked, says the Olympian. My paces were nearly 40 seconds slower than theyd been just a few weeks before. Andrews went to his doctor, who ran tests for everything from Lupus to Lyme, but they all came back negative. I was told, There is literally nothing wrong with you, recalls Andrews. But there had to be, he knew. This could not possibly be all in his head.
Still, he had a contract with Adidas to fulfill, so Andrews traveled to Europe, where he clocked disappointing times: 3:44 in the 1500 meters at the Lignano Meeting International in Italy; 1:52 in the 800 meters in Flanders Cup Kortrijk in Belgium. For the remainder of the summer, Andrews felt constantly wiped out. Normally he would be up at 7:30 to train; now, he couldnt pry himself out of bed until 10. The few days a week he forced himself to run, hed get so dizzy and breathless hed have to quit after 20 minutes. Every afternoon, he napped for up to four hours.
He kept thinking how closely his symptoms resembled those of people he knew whod had Lyme, including his older sister Kristin (also a runner who is a 2020 Olympic hopeful) and his former roommate, Donn Cabral (a 2012 and 2016 Olympian in the 3,000-meter steeplechase), so Andrews asked to have his Lyme test re-run in September. It came back positive. The doctor wanted to prescribe antibioticsthe standard treatment for Lymeimmediately, but Andrews was worried about the side effects. Instead, he decided to take the advice of a holistic doctor who had helped his sister during her bout with Lyme in 2016.
Once a week Andrews swallowed eight drops, an hour aparta concentration of herbs such as ashwagandha, rhodiola, turmeric, licorice root, and cordycep mushroomsthat the holistic doctor said would help strengthen his immune system. He soaked his feet in a proprietary blend of herbs that he was told would draw toxins out of his body. He spent more than $1,000 on treatment. He didnt care if anyone thought he was nuts. He just wanted to feel better.
And he did, for a few months. My energy went way up. I could run three miles without having to stop, says Andrews. Then, in February, it all fell apartan almost overnight, dramatic decline in his physical and emotional health. Fatigue weighed down his body. Headaches crackled through his brain. He was sweating so much at night that he had to change the sheets. And perhaps the worst? Really depressive thoughts. It was a dark couple of months, Andrews says. If it wasnt for my girlfriend and family, I would have gone days without talking to anyone or leaving the house. He raced at the U.S. Championships at the end of February on Staten Island, in the 1000 meters. I felt bad from the first step. Something was wrong. He clocked in at 2:26dead last.
Patrick SmithGetty Images
Disillusioned with the holistic protocol, Andrews finally accepted a prescription for antibiotics in March. His doctor told him to take them until his symptoms were relieved for a full month. Andrewss concerns about side effects were valid; the antibiotic gave him severe fatigue and headaches, brain fog and GI issues.
Desperate to make the 2019 world championship team, he ran the 800 meters at the Adrian Martinez Classic in April, only to come in last, again. In June he set his sights on the Princeton Qualifier. I missed my college roommates wedding for it, that is how important this race was for me, he says. Midway through the 1500-meter race, he dropped out, wheezing and depleted.
Andrews felt like he was out of options. And although he didnt know it at the time, he had entered the Lyme Wars, a fiercely contested fight about why some Lyme patients develop chronic, relapsing symptoms even after treatmentand what to do about them.
A stealth pathogen. Thats what some researchers call the corkscrew-shaped bacteriaBorrelia burgdorferithat causes Lyme disease, now one of the fastest growing infectious diseases in America. More than 300,000 new cases are diagnosed every year, according to estimates from the Centers for Disease Control and Prevention (CDC).
Black-legged ticks pick up Borrelia from the birds and small mammals they feed on, then they pass the bacteria into our blood when they feed on us, usually from May to Septemberprime months for logging miles on wooded trails and grassy park paths.
Removing a tick quickly lowers your risk for infectionit takes an estimated 36 to 48 hours for the arthropod to transmit Borrelia. But once the bacteria enters your body, it is a master of evasion. The Borrelia can spread from the skin to other tissues, which can make it more challenging to treat. Your immune system takes days to a few weeks to recognize any infection, including Lyme. Thats why the standard Lyme testwhich checks for antibodies (not the bacteria itself)can more easily give a false negative test early on, like Andrewss did.
When your body finally detects Borrelias presence, it launches an immune response to fight it, which is what can bring on flu-like symptoms such as sluggishness, fatigue, muscle aches, and joint pain. Runnersespecially those who spend hours outside during the summer training for fall marathonscan attribute symptoms to overtraining.
The majority of Lyme cases are easy to treat and cure with a 10- to 28-day course of antibiotics, says Paul Auwaerter, M.D., the president of the Infectious Diseases Society of America (IDSA). Ying Zhang, MD, Ph.D., a leading expert on the Lyme bacteria and a professor of molecular microbiology and immunology at the Johns Hopkins Bloomberg School of Public Health, disagrees. Lyme can be a really terrible disease and a very complex one. Different patients have different responses, and the disease can manifest in different ways, says Zhang, who believes Lyme can indeed develop into a chronic form that resists the current antibiotic treatment.
Indeed, for around 20 percent of Lyme patients, a dose of antibiotics isnt the end of the story. Not by a long shot. They continue to suffer from a variety of symptoms that can last for months, even years: fatigue, headaches, muscle and joint pain, difficulty concentrating, and sleep disruptions. The frequently used medical term for these persistent problems is Post-Treatment Lyme Disease Syndrome (PTLDS). PTLDS means that we know that a patient has had Lyme, has gotten a course of antibiotics, and doesnt feel like theyve bounced back, says Auwaerter.
PTLDS is often referred to as chronic Lyme, a term Auwaerter disparages as a catchphrase for otherwise unexplained fatigue, pain, and neurologic symptoms in people who dont meet the diagnostic criteria for Lymeusually obtained by medical history, a positive blood test, and physical exam. But diagnosing Lyme can be tricky. In the first three weeks after infection, the test detects Lyme only 29 to 40 percent of the time and some 30 percent of all Lyme patients, like Andrews, dont get the telltale bullseye rash.
What really keeps the controversy alive is this: There isnt yet a sensitive and reliable test that can determine if ongoing symptoms after Lyme treatment are due to an ongoing active infection, says Brian Fallon, MD, director of the Lyme and Tick-Borne Diseases Research Center at Columbia University. Without one, some medical organizations, like the International Lyme and Associated Diseases Society (ILADS), believe chronic symptoms may be due to the persistence of the Lyme bacteria. They suggest that for some patients, the potential risks of treating with antibiotics for longer periods of time outweighs the consequences of an untreated persistent infection. Giving credence to this argument are several recent studies that found Lyme bacteria remained in animals even after they were treated with antibiotics. And in March, Zhang and his colleagues found that a slow-growing form of persister Lyme bacteria not only resisted standard single antibiotic treatment, but also caused more severe arthritis-like symptoms in mice. They found that a cocktail of three antibioticsdaptomycin, doxycycline, and ceftriaxonecompletely killed the bacteria, and they are now planning clinical trials to see if the result is the same in humans.
On the other hand, groups including the IDSA maintain that symptoms that linger after antibiotic therapy are not due to an ongoing active infection of the Lyme bacteria and therefore should not be treated with additional rounds of antibiotics because theyre unlikely to help. Six clinical trials have shown that long-term antibioticsbeyond the recommended 28 dayare not effective, says Auwaerter. Plus, long-term use of antibiotics can lead to serious side effects, such as blood clots and, even, in rare cases, death.
If chronic symptoms are not caused by an active infection, then what? It could be due to an autoimmune reaction, where a prior infection has triggered an immune reaction that is now acting independently, or it could be that the prior infection changed the brain activation patterns, Fallon says. Theres some evidence to support both of these processes.
While researchers debate, patients are left sick, with lots of questions, and no good answers. Its devastating for peoples lives and some are willing to try anything to get better, Fallon says. After his dismal race in Princeton, Andrews was one of them.
This June, after battling symptoms for nearly a year, Andrews visited Mark Sivieri, M.D., a board-certified family practice doctor in Maryland who is also board certified in integrative medicine (which pairs traditional medicine with complementary therapies). Andrewss cousin had been seeing him for her own ongoing Lyme symptoms. There was an instant connection: Sivieri had also been a professional runner; he and Andrews even shared a coach at one point. During the three-and-a-half-hour appointment, Sivieri studied Andrewss previous blood tests. He noticed that, in addition to Lyme, Andrews had tested positive for two other tick-borne infections (Andrews says the doctor who had ordered the test never mentioned them).
Ticks carry and transmit loads of other bacteria, parasites, and viruses beyond Borrelia burgdorferi. A single tick can make a person sick with several diseases at the same time, including Anaplasmosis (a bacterial infection that causes fever, aches, chills, and muscle aches), Babesiosis (a parasitic infection that attacks red blood cells), and Powassan virus (which can cause an infection in the brain and can even be deadly). And not all doctors check for these when they are focused on Lyme; those who do test for them may believe the antibiotics prescribed for Lyme will be enough to wipe out the co-infections. The estimates for co-infection rates with Lyme disease can widely range anywhere from about two to 40 percent. And not only are some, such as Powassan, more dangerous than Lyme, but simultaneous infection, some research suggests, may make Lyme harder to treat or recognize, and might affect how the immune system responds to Burgdorferi.
Sivieri put Andrews on a 60-day course of the two antibiotics hed previously been taking to kill the bacteria for Lyme; he also prescribed a medication to wipe out the co-infections. He said the night sweats and the shortness of breath, thats what the Babesia parasite does, it eats your red blood cells and prevents the oxygen from moving around your body. Thats obviously a big concern for runners. I couldnt breathe well when running, right from the start, says Andrews. And Im a trained athlete.
Sivieris tests showed that Andrews was also sensitive to gluten and dairy; he recommended avoiding them to help take pressure off his immune system. My stereotypical Italian grandma was aghast when I told her no more pasta and chicken parmesan, Andrews says. That was a big transition for me. But if thats whats was going to get me better, I didnt care at all.
Sivieri then turned to natural remedies to help strengthen Andrewss immune system, putting him on adaptogenic herbssaid to help with all types of stresssuch as curcumin which can reduce the inflammatory response caused by Lyme.
Using alternative medicine to nuke hard-to-kill bugs might sound like folklore, but science is starting to back the theory: Zhang recently found that, in laboratory dish tests, 10 oilsincluding from garlic cloves, myrrh trees, thyme leaves, allspice berries, and cumin seedsshowed strong killing activity against the non-growing and slow-growing persister forms of the Lyme bacteria, even better than standard antibiotics. We need to do proper clinical trials, to see how to use them more effectively without being toxic but [in the future, I believe that] the more effective treatment is going to come from a combined approach of antibiotics with essential oils or natural products.
The combination of traditional and alternative medicine helped Andrews. The past year has been brutal, but he finally feels like his old self again. I wake up in the morning and I have energy all day, he says. Im not sweating at night, [there are] no headaches. The depressive thoughts are gone. Im training at full capacity. He plans to run the indoor season in 2020, still in hopes of achieving the Olympic qualifying time.
He stopped taking antibiotics in mid-August, now its complementary treatmentsincluding vitamin C for his adrenals and immune system and curcumin for inflammation. He still avoids gluten and dairy and is content to continue the regimen for the near future. The supplements could be pointless, but hes not going to chance it. It seriously feels like I have my life back, he says. This is me. Im back to me.
Posted: at 10:27 am
Smart Group is inviting Integrative and Preventive Medicine stakeholders to rally together for a two day event that has been jointly organised with the American Academy of Anti-Aging Medicine; this conference event is a corollary of the annual A4M World Congress which is attended by over 5000 physicians in America.
From January 18-19, 2020 doctors, specialists, general practitioners, nutritionists, alternative medicine practitioners and other stakeholders in healthcare who are looking to expand their horizons will be gathered at the Hyatt Regency in Delhi to attend the event which will be loaded with the latest in cutting edge innovations and practices for healthcare with the key focus being on preventive and integrative health.
Aside from over 600 leading health practitioners, representatives of Government and bureaucracy and Partnership with Premium Medical Associations from across India attending the conference there will also be a series of lectures which will be conducted by some of the most accomplished and renowned clinical expert leaders in the field travelling to join the informative and educational presentation of information from Canada and America to share the most cutting edge research which will feature topics such as Intermittent Fasting, Gut Metabolism, Inflammation, Memory and Focus, Stem Cells, as well as Genomics and Regenerative Medicine among many others.
I envision a world where people can live Happy & Healthy, beyond 100. This event and the doctors & exhibitors associated with it are the people who will be able to crack the code to create this world and I feel happy that I can lead this new healthcare revolution in India, says Dr. BK Modi, founder-chairman of Smart Group.
Globally, there is a positive shift towards integrative and functional medicine to complement and optimise traditional medicine methods. It doesnt matter if you are an MD or GP, any kind of additional knowledge about how a human body interacts with itself in the face of stress or any lifestyle the disorder is worthy. The medical industry is on the cusp of a revolution and practitioners will have to keep up to continue to stay relevant, says Preeti Malhotra, president of Modi Mediciti and GMHRC. Our vision behind bringing this concept to India was to disrupt the healthcare model in the country. Healthcare services currently offered across the country are essentially based on reactive care and not preventive care. We want to completely transform this dynamic.
A4M announced the new partnership with India as part of the continued commitment to international expansion, this will be the first two day event in New Delhi, India that will serve as a foundational course in the fundamental tenets of Anti-Aging Medicine. The conference was planned by world renowned experts, clinicians, and researchers in the field of Integrative Medicine and it will highlight the most recently emerging therapeutic practices and protocols in personalized and preventive care; with a focus on how to customize as well as individualize medicine, and address the root causes in order to better enhance patient care.
A4M and the Centres mutually aligned goals will redefine todays practice of healthcare through a holistic and comprehensive approach. A4M expansion into India marks an important step towards facilitating the goals of preventive medicine on disease prevention before symptoms occur. A4M is positioned to advance the landscape of modern medicine in partnership with healthcare practitioners and professionals around the globe, for the benefit of all.
To find out more or join us in redefining medicine click here: A4M India Conference
Posted: at 10:27 am
Shes called Gemma. Shes three years old. She fell into a canal, said a senior nurse. By the time her parents managed to get her out, apparently shed already stopped breathing. Paramedics three minutes away, called another nurse, holding the scarlet phone on which emergencies were called through. With a grace and efficiency akin to choreography, a team of professionals who moments beforehand had been as disparate as atoms, dispersed across the hospital, were poised around an empty resuscitation bed, waiting as one to swing into action.
The consultant quietly confirmed each team members role. The anaesthetist, responsible for airway. The scribe, who would note down, in meticulous detail, the timings, the drugs, the doses, every iota of care which, if we were lucky, might snatch life back from lifelessness. Doctor one, doctor two the roles and responsibilities went on. Then, a moment of silence before the paramedics brute force pushed a trolley through the swing doors and there, tiny, limp and pale, lay a toddler, unmoving beneath the harsh fluorescent lights.
It was impossible to hear the paramedics handover above the screams of Gemmas mother. Save her! she pleaded, over and over. Please, please, save her! Gently, a nurse discussed with her whether she wished to stay or leave the bay for a moment. The crash team worked on, its focus absolute. In moments, the child had been intubated. Tubes and electrodes sprouted everywhere. Tiny, toddler-sized chest compressions continued, interrupted every two minutes to check for the resumption of a heartbeat.
Too inexperienced to help, I hovered on the periphery, trying not to wear my shock visibly. I had never before seen a child this unwell. Unless the crash team managed to restart the heart, I was watching, in effect, a dead little girl. I thought of my own toddler, safe at nursery, and of the magnitude of the horror with which Gemmas mother, sequestered in a relatives room, must now be seized.
On and on the crash team worked. Compressions, adrenalin, electric shocks, compressions. A miniature mannequin, manhandled with conviction. The collective will in the bay for this child to live, to survive, was so strong as to be almost palpable. A forcefield of longing around the bed. Its silent incantation: come on, come on, come on, come on.
Fifteen, 20 minutes must have passed. The resuscitation attempt was going nowhere. In an adult, the risk of brain damage is high, but Gemmas youth gave her body resilience. I bit my lip to keep tears at bay. And then, impossibly, before our disbelieving eyes, the chaotic scrawl of the ECG trace was jolted by the latest shock into something that coalesced into a normal rhythm. Gemmas stunned, battered, fibrillating heart had somehow started to beat again. This bodys submersion in brackish water, these lungs fully flooded with rank green canal despite it all, this little heart had maintained its capacity for life. A resurrection had occurred. Right there, on crumpled NHS cotton, a girl had been brought back from the dead. I wanted to cheer from the rooftops.
Not for one second did the teams concentration dip. The luxury of jubilation was forbidden while her life, her brain, still hung in the balance. ROSC return of spontaneous circulation is only the first step from an arrest back to health, and Gemma was whisked straight to the paediatric intensive care unit.
The smiles after she departed could not have been any broader. Consultant hugged staff nurse hugged student, in a rare moment of shared elation. But what stayed with me, as I walked out of A&E that night, was not this eruption of joy but the preceding ruthless dispassion. That total focus while I, on the sidelines, had fought not to quiver and cry. The crash team, simultaneously human and robotic, crunching through the protocols that maximised a childs chances of life. I wanted to eradicate my human weakness and become, like these doctors, part machine.
The man widely regarded as the father of modern medicine, the Canadian professor William Osler (18491919), famously recognised the unique importance of stories in medicine. Osler insisted that medical students should learn from seeing and, crucially, from talking to their patients. Memorably, he said: Just listen to your patient, he is telling you the diagnosis.
Those words are as true today as they were back then. Storytelling is the bedrock of good medical practice.
The author Philip Pullman goes one step further, stating that: After nourishment, shelter and companionship, stories are the thing we need most in the world. In boldly insisting on stories as imperative for human survival he imbues them with a transformative force in medicine. It is undeniable that the meanings we construct around our afflictions and diseases, the stories we tell ourselves about what is wrong, and where we are heading, can overturn our experience of illness.
You might imagine that storytelling is the last thing on a doctors mind. We are all far too busy doing our jobs, often with time running out. But Pullmans words are nowhere more apt than in a hospital, where what heals is not confined to a doctors drugs or scalpel blades. It is the quieter, smaller things too being held, heard and shown you matter that make patients feel cherished, and hospitals humane.
The NHS hospice where I work today is strikingly beautiful. Natural light streams in from skylights and floor-to-ceiling French windows, allowing patients to look out on gardens, trees and the birds just outside. There are whirlpool baths, massage, art and music therapy, ice-cream and homemade smoothies on tap. We hold weddings here, set up date nights, sneak in pets, break the rules. There is even a drinks trolley, wheeled from room to room twice a day, amply stocked with fine wines and cans. Because what better way, for those who fancy a drink, of remembering normal life back home?
Bird food and beer might not seem revolutionary, but when I arrived here, seven years after starting life as a doctor, they signalled something thrillingly radical. For all the care contained within hospital walls, it would be hard to design a more dehumanising space than your typical busy teaching hospital.
Even after resolving to specialise in palliative medicine, the decision was less a conviction than a leap of faith. Indeed, during my early days in the hospice I felt like a brand-new doctor all over again, learning an alternative medical paradigm, one with people, not diseases, at its heart.
Simon was a man in extremis. He had a cancer of his thyroid that was threatening to suffocate him. Already requiring oxygen, this morning his breathing had taken a turn for the worse and now, we had been told, he was fighting for air.
A former policeman in his 60s, Simon had retired a few months earlier. He was looking forward to having time to while away in the fresh air, walking and jogging. Shortly afterwards, he had noticed a lump in his neck, painless, innocuous and perhaps, he had assumed, related to a recent head cold. But the lump, unlike the cold, persisted and, more unnervingly, continued to grow. Still more curious than concerned, he visited his GP.
The speed of his referral to hospital impressed him, innocent of the fact that he was on a two-week cancer pathway, its celerity commensurate with his doctors worst fears. There was to be no well-earned peace in the countryside for Simon. The scan became a biopsy, and the biopsy a consultant, murmuring cryptically about inoperability, as Simon sat stricken, pinned to his seat, hearing nothing of substance after cancer.
I heard him before I set eyes on him. Specifically, I heard the sound of air being sucked into his lungs through an airway severely compressed by tumour. Stridor the harsh rasp of air with each intake of breath, audible only when the trachea is critically narrowed. Once heard, never forgotten.
When I entered his room, Simon was sitting bolt upright, eyes darting frantically, his shirt ripped off and both hands gripping the bed like his life depended on it. From deep inside his body, from the depths of his spinal cord, he trembled with fear. Beside him stood a woman in her 30s, distraught and dishevelled, saying: Its OK, Dad. Look. Look, the doctors here. Everythings going to be OK now.
Simon stared up at me, beads of sweat on his brow, gulping for air. There was no way he could sustain this work of breathing. At the same time, I observed, the oxygen required was sufficiently low to be delivered not through a mask, but through small tubes in the nose. Although petrified, and with good reason, he was not yet in respiratory failure.
In an A&E department, Simon would have been gowned, cannulated and hooked up to lines and monitoring. I chose instead, you might argue, to gamble. If Simon was about to die, I reasoned, none of this paraphernalia was going to prevent that. But if, as I suspected, panic had exacerbated his airway obstruction, then I knew how to help.
I ascertained from Sophie, Simons daughter, that he had completed radiotherapy to his thyroid a few days earlier. His oncologists hope had been to shrink the tumour, eking out a little more time, perhaps even enabling him to reach his grandsons sixth birthday.
Simon, I am confident we can help you feel better, I began, but Id like to sort out some treatment straight away. Then we can talk. Is that OK? He nodded, mute.
I worked fast. The nurses brought the large dose of steroids that would, I hoped, begin to shrink the swelling in Simons neck. Next, a tiny dose of a fast-acting sedative, just enough to take the edge off his panic.
Would you like me to explain what I think is happening? I asked him, keen to allow the sedative more time to calm his fears. Yes, he said clearly the first word he had been capable of speaking out loud. I spoke evenly, unhurriedly, hoping to instil trust and confidence. I think there are two problems, Simon. First, there is your tumour, pressing on your windpipe, but there is also the radiotherapy, which has damaged the tissues in your throat and caused them to swell. We see this very commonly. The breathing often becomes worse for a few days after radiotherapy, maybe a week or so, before it gets better. Steroids can really help bring down the swelling.
There are moments in medicine when what you say next feels as pregnant with risk as the surgeons first incision
As I talked, Simons eyes never left me. His gasps, I noticed, were beginning to decelerate. How does it feel now? Is the injection we just gave you helping at all? Well, I dont feel quite as bad, he said doubtfully. Out of the corner of my eye I saw that Sophie was crying.
Simon began to describe living alone with his cancer, having been widowed a few years previously. Its all been so quick. Too much to take in. Sophie, if Im honest, is my rock, but she has Timmy, her boy, to look after as well.
Dont be ridiculous, Dad, Sophie interjected, almost angrily. You know looking after you is no problem. We all love being with you, especially Timmy.
Simon could not meet his daughters eye. His chest, damp with sweat, still undulated with muscle, a torso sculpted from lifelong activity, not yet effaced by cancer. I wondered how much it cost him to appear this vulnerable in his daughters eyes, and whether shame was inflaming his distress.
Gently, I kept tweaking the oxygen downwards. Simon, you know this is really encouraging? Youre managing to talk in full sentences. I dropped the oxygen down as low as it will go a good 10 minutes ago. May I try taking it off you?
Youre a sly one, he exclaimed, with the faintest trace of a smile.
The hint of a relationship forged, I broached the topic of the future. He cut me off instantly. Look, Im not stupid, he exclaimed. I dont have one, do I? This is it. I know whats going on. Dad, pleaded Sophie, tears flowing. Shes trying to help. Dont shout at her.
There are moments in medicine when what you say next feels as pregnant with risk as a surgeons first incision. The right words, used wisely, can bridge the airiest expanse between you and your patient but, if misjudged, may blow trust to pieces. In scarcely a month, cancer had snatched from this man of action and authority his health, his future, his strength and his fearlessness. And today, perhaps worse than all of that, his daughter had witnessed him writhing in fear.
Few sensations are more terrifying than that of fighting to breathe. In that moment, every mental sinew you have ever possessed lifelong habits of logic, love, faith and reason are wiped out by a frenzied craving for air. Simon had been fighting for his life, the most powerful and desperate of all human instincts. I needed to give him control, if only over our conversation.
Simon, are you the kind of person who likes to discuss everything frankly, I began, or do you prefer to take things one day at a time, without speculating about the future? I already know Im dying, he responded. What else could you possibly tell me?
Well, people often assume that once you arrive here, you will never leave. But around half of our patients dont die here. They go home again once weve managed to sort out their symptoms. Its not always a one-way ticket.
He blinked. No one said anything for a while, as we listened uncomfortably to the scrape of his stridor. Finally, it was his daughter who spoke: I didnt realise that, Dad. Did you?
Silence. My intuition was that Simon not only feared never leaving the hospice, but was also convinced he was imminently dying. Perhaps the only way to reach him was to confront this head-on. One of the things Ive noticed working here, Simon, is how often patients feel unable to ask about the thing theyre most preoccupied with, which is what its actually going to be like when they die and I wonder whether this is something youd like to talk about?
I saw a flash of horror distort Sophies face; but her father, if anything, looked relieved. Go on, he said cautiously, giving nothing away.
OK. But please stop me at any point if you dont want me to continue. I glanced at Sophie. Simon confirmed that he wanted her to stay. So ... we tend to see the same patterns over and over in people with cancer, or another terminal illness, who are approaching the end of life. One of the first things many patients notice is losing their strength, their energy. Things they used to take in their stride become a real physical and mental effort. Im guessing youre already aware of that?
A dying man had faced his end and found the strength to look towards what mattered more than anything: those he loved
A rueful roll of the eyes. No kidding. I used to run marathons. Cant even get up the stairs now.
That loss of energy gradually worsens. You might find you need a nap most days, more than one, probably. Then, one day, you realise youre sleeping more than youre awake. Its not painful or horrible, its just immensely frustrating. Patients can find it helps to try and plan in advance a bit, saving up their energy for the things that really matter.
Like Timmy, Simon interrupted. I like to know when hes visiting so I can have a sleep beforehand. I didnt realise that, Dad, said Sophie. Well, I want to give him my best, dont I? And I dont want to lose a second with him.
Sophie now turned to me. Timmys dads not around any more, you see. Left when he was two. Dads more like his real father.
I see, I said slowly, computing the layers of loss, more intricate and heftier than I ever imagined.
By now, I noted, Simon had been breathing calmly for half an hour without requiring any additional oxygen. Encouraged, I went on. Often, at the end, there arent any dramatic changes. That sleepiness continues. A patient finds they are sleeping nearly all of the time. You stop feeling hungry and you dont want to eat. You may stop feeling thirsty, too. Then, one day, rather than sleeping, you slip into unconsciousness. Its not a distinction you are even aware of. Your brain is just more deeply unresponsive. Sometimes, I wonder if this is the bodys way of protecting the mind you stop being afraid, youre oblivious to it all.
I paused, trying to gauge Simons reaction. Shall I go on? I asked. The most perfunctory of nods, so I continued. You might be thinking that what youve experienced today is nothing like what Ive just described. Youve felt as though youre suffocating to death and I cant imagine how awful that must be. But what I can promise you is that, if you feel like that again, we will still be able to help you. We can take away that feeling of panic with drugs that work almost instantly. You dont need to feel like that again. We will be right here for you, whatever happens.
Both Simon and Sophie were quietly crying. The sky was darkening outside. We were sitting, I realised, in a small pool of light from the adjustable lamp just above Simons bed. A father, a daughter and a doctor, surrounded by shadow, staring together at the death to come. Weighing it, considering its shape and form, perhaps for the very first time. The hostility with which Simon had been bristling was gone.
How long do you think I have left? he asked me directly.
I have no reason to think you are going to die today, Simon. Im not even certain the blockage in your airway is what will kill you. I do think your time is short weeks, not months, perhaps only very short weeks but I would love to believe we can get you home for a bit, if thats what you would like.
For a while, Simon said nothing. The silence, though thick with emotion, was not strained. Finally, he raised his eyes to mine and smiled. OK. Maybe Ill get to my boys birthday too. Thank you, Rachel I mean it.
So often, soreliably, Iwitness peoplerising totheir best onfacing theworst
My heart, for a beat, threatened to knock me off balance but only later, that night, did I allow myself to feel. A dying man had looked his end in the eye all of it, the worst of it, potential suffocation and yet, in that moment of profound mortal reckoning, with every single thing he loved slipping from his grasp, had found within himself the strength to look outwards, towards what mattered more than anything: the human beings he loved. How, I wondered, could someone be so aghast at their weakness while behaving with such unseen strength?
I cried that night. But not for what we lose. It is who we are that moves me, time and again, in the hospice. When people ask me if my job is depressing, I reply that nothing could be further from the truth. All that is good in human nature courage, compassion, our capacity to love is here in its most distilled form. So often, so reliably, I witness people rising to their best, on facing the worst. I am surrounded by human beings at their finest.
In 2017, my dearest Dad was himself a dying man. He had spent half a year on the chemotherapy carousel. Infusions, blood tests, nausea, fatigue, infusions, damaged nerves, infusions, bleeding skin. Hope, more than anything, kept him coming back for more. Even when the scans showed terminal spread, still he yearned, burned, for more life. He took these monthly batterings of the cytotoxic drugs because they allowed him to imagine a future.
Even as new symptoms revealed themselves, Dad managed to maintain his poise. He was a doctor and, I suppose, his training was useful. None of it came as a surprise to him. Theres something you need to know, he told me later. Over the weeks he had sat down in private and, through the fog of cancer fatigue, written letters to his wife, children and grandchildren. Theyre in a sports bag in my wardrobe, Rachel. Youll find them under my shirts. This was love, painstakingly scrawled and sealed inside envelopes, a legacy of words for his family.
After the funeral, I returned to work a different doctor. I have known the taste and weight of grief. Now, when I enter a patients room, I recognise the sunken eyes and tired frowns of those who cling to the one who would be lost to them. I understand that from the inside out, grief, like love, is non-negotiable, and that the only way to avoid the pain is to opt out of ever loving.
Above all, I have learned from my conversations with my father that being given a terminal diagnosis changes both everything and nothing. Prior to this news, a man of 74, he knew he would die one day, just not when exactly. And after this news, he knew he would die one day, just not when exactly. Everything he had always loved about life was still there to be loved, only more attentively now, more fiercely. All that had changed was the new sense of urgency, the need to savour each day and its sweetness.
Dear Life: A Doctors Story of Love and Loss, by Rachel Clarke, is published by Little, Brown on 30 January. To order a copy go to guardianbookshop.com. Free UK p&p on all online orders over 15.
Smart Group Announces India’s First Anti-Aging & Preventive Healthcare Conference – India Education Diary
Posted: at 10:27 am
New Delhi: Dr. BK Modi led Smart Group is inviting Integrative and Preventive Medicine stakeholders to gather for a 2-day conference, jointly organised with the American Academy of Anti-Aging Medicine (A4M). The conference is a corollary of the A4M World Congress, held annually in Los Angeles and attended by over 5000 doctors.
From 18th to 19th January 2020, Doctors, Specialists, General Practitioners, Nutritionists, Alternative Medicine Practitioners and other stakeholders in healthcare who are looking to expand their horizons shall be gathered in Hyatt Regency, Delhi to for an extravaganza of the latest cutting edge innovations and practices in healthcare with a key focus on preventive and integrative health. A series of lectures, conducted by some of the leaders in Preventive and Integrative Medicine, from USA, Canada, India, the conference will feature new age topics like Intermittent Fasting, Gut Metabolism, How to control inflammation, how to improve memory & focus regardless of age, Genomics and Regenerative Medicine amongst others, all of which have taken urban India by storm and are being increasingly endorsed by celebrities from Bollywood, sports and even politics.
Globally renowned speakers from the A4M like Dr Andrew Heyman (MD, MHSA); Dr Daniyar Jumaniyazov (MD, PhD); Dr Brian Delaney (PhD) and Indian health leaders like Dr Naresh Trehan; functional medicine experts like celebrity nutritionist, Dr Anjali Hooda, President of the Stem Cell Society, Dr Alok Sharma et al will lead the discussions at the event.
Commenting on the event, Dr BK Modi, Founder-Chairman, Smart Group, mentioned, I envision a world where people can live Happy & Healthy, beyond 100. This event and the doctors & exhibitors associated with it are the people who will be able to crack the code to create this world and I feel happy that I can lead this new healthcare revolution in India.
Preeti Malhotra, Chairman, Smart Bharat, shared her wisdom on why aspiring medical practitioners should attend this conference, Globally, there is a positive shift towards integrative and functional medicine to complement and optimise traditional medicine methods. It doesnt matter if you are an MD or GP, any kind of additional knowledge about how a human body interacts with itself in the face of stress or any lifestyle the disorder is worthy. The medical industry is on the cusp of a revolution and practitioners will have to keep up to continue to stay relevant.
Posted: at 10:27 am
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Just after 10pm on a still Sunday night in March 2016, Jeremy Barr, having cleaned up the dinner dishes in his San Diego apartment, was thinking about bed when his mobile phone buzzed into life with a FaceTime call. Barr instantly recognised the mane of striking salt-and-pepper hair and trimmed beard on the screen. It was his laboratory supervisor at San Diego State University, Professor Forest Rohwer, one of the worlds leading microbial ecologists, and his tone was urgent.
Rohwer, a 47-year-old with a thoughtful demeanour, began quizzing the young scientist from Brisbane about his research into bacteriophage therapy phage therapy, for short which turns viruses into chemical weapons against antibiotic-resistant bacterial infections. Rohwer was curious about how Barr removed toxins from phages, so they were safe to use in humans.
Whats this about Forest? interrupted Barr, whod been working at Forests San Diego lab for four years on a postdoctoral fellowship. Rohwer explained that a local man had contracted a superbug while on holiday in Egypt and the most powerful antibiotics had failed to work. Now on the brink of multi-organ failure, the man would almost certainly die within days unless the infection could be stopped in its tracks. Could bacteria-eating phages be put to work to kill the deadly disease?
Phages, unlike antibiotics, are not drugs. Rather, they are hunt-and-kill viruses.
Both men were aware of the perilous risks of such a procedure. Phages, unlike antibiotics, are not drugs. Rather, they are hunt-and-kill viruses that inject their DNA into bacteria cells, causing the bacteria to burst and die.
The downside is that when the bacteria burst, they also release poisonous impurities and endotoxins, which can kill a person quickly with septic shock. Thats why its vital the phages be scrubbed clean of these endotoxins, without damaging or deactivating the bacteria-zapping viruses.
Could Barr perform this critical task of purifying the phages, sourced from laboratories across the US, within a couple of days, Rohwer enquired. Barr did a quick mental calculation. Yes, he said. I reckon its doable.
But Barr, a tall, slim, fair-haired 30-year-old, was terrified the moment he hung up. Hed never prepared anything for human trial before; his was still an experimental treatment. And this would be the first case in the US of a person receiving intravenous phage therapy for a systemic superbug infection that antibiotics couldnt treat.
About 20 minutes drive away, at Thornton Hospital at UC San Diego Health, the patient in question, a 69-year-old man, a lifelong surfer whod always been super fit, was hooked up to a maze of tubes, including a respirator, in an induced coma.
A. baumannii now shares top billing with two other superbugs listed by the WHO as being the most dangerous to human health.
Tom Pattersons swollen stomach contained a pseudocyst (a pocket of fluid) the size of a football and his body was swimming with a deadly, multi-drug-resistant superbug, the bacterium Acinetobacter baumannii, sometimes dubbed Iraqibacter for its signal talent for striking wounded soldiers during the last Iraq War. (A. baumannii now shares top billing with two other superbugs listed by the World Health Organisation (WHO) as being the most dangerous to human health.)
Patterson had been in a coma for weeks and had lost 45 kilograms from his formerly athletic, strapping 6 feet 5, 100-kilogram-plus frame. Only months earlier, in late November 2015, Patterson and his wife, Steffanie Strathdee, had been holidaying in Egypt.
Just hours after enjoying a romantic moonlit dinner on the top deck of a cruise boat on the Nile, Patterson developed nausea and vomiting, which hed initially dismissed as food poisoning (the intrepid couple had had their share of stomach bugs during their many trips, and routinely packed the antibiotic Cipro). But when he developed severe diarrhoea and a fever, Patterson was rushed by ambulance to a local medical clinic. Within hours the pain was so excruciating the hairs on his head burned.
Pattersons condition worsened over the next few days, to the extent he could no longer even get up to go to the bathroom. Overcome with a growing sense of panic, Strathdee pressured the doctors, who diagnosed pancreatitis.
After two weeks of not responding to treatment, looking deathly pale and losing weight, Patterson was medivaced to Frankfurt Hospital in Germany. Here, doctors discovered a pancreatic cyst teeming with A. baumannii. The only antibiotics that had any braking effect on the microbes lethal spread were the powerful meropenem and tigecycline, and the big gun colistin, a drug of last resort because it can lead to kidney damage.
By the time Patterson was airlifted home to San Diego to the intensive care unit at Thornton Hospital he was delirious, imagining (among other things) that there were hieroglyphics on the walls. He had become resistant to the big three antibiotics administered to him intravenously. Even worse, A. baumannii had migrated through his whole body. He was placed in a medically induced coma.
So much for the dark part of the story; now for the moment of serendipity. Pattersons wife Steffanie Strathdee was an infectious disease epidemiologist at UC San Diego (UCSD), where Patterson was a professor of psychiatry. Refusing to give up on her husband, Strathdee had been researching A. baumannii and treatments to fight it via PubMed, the search engine of the National Library of Medicine, for some weeks.
One night in February, 2016, she researched phage therapy in more detail, compiling a list of US phage researchers. Her mind drifted back to studying phages in virology classes as an undergraduate. Derived from the Greek term phagein, meaning to devour, phages were once medicines great hope, after these bacteria-eating viruses were discovered in England and France during World War I, and later employed with mixed success.
An artists illustration of a phage virus attacking bacteria.Credit:Getty Images
But after the mass production of the more reliable, easier-to-use antibiotic, penicillin, in the mid-1940s, phage research was left behind and eventually forgotten in the West, although it remained popular in the Soviet Union (Stalin was a fan of phage therapy). Its still possible to buy generic phages over the counter in Russia, Poland and Georgia, but they are only effective if they match the specific bacterium causing the infection, so can be unreliable.
The difference between the phage therapy of the past and today is DNA technology, which allows phages to be matched for their specific bacteria-killing properties. Now, with time running out, Strathdee appealed to Dr Robert Chip Schooley, professor of medicine in the division of infectious diseases at UCSD, who, although sceptical at first, helped her locate a selection of phages specifically designed to fight the malevolent invader killing her husband, which sequencing showed was an Egyptian strain of A. baumannii.
Researchers from three US laboratories forwarded the phages and they were granted emergency approval for use from the US Food and Drug Administration.
The tiny bacteriophages, housed in sealed plastic tubes, arrived at Barrs lab in the late afternoon after Rohwers phone call the night before. Dressed in his regulation white lab coat, plastic goggles and rubber gloves, Barr set about stripping the phages of their toxins, a long and painstaking process involving successive washes, cooling and spinning treatments in a centrifuge. What he had to avoid at all costs was damaging or destroying the phages: these were the only batches available.
A phage resembles an alien spacecraft with spindly legs that lock on to the surface of the much bigger bacterial cell.
In the early hours of the following morning, a weary Barr placed the cleaned phages in a speed vacuum to boil away the residual alcohol, a process that would take five hours. Then he went home to grab some sleep.
Since his days studying microbiology at the University of Queensland in his 20s, Barr had been fascinated with phages. Under an electron microscope, a phage resembles an alien spacecraft with spindly legs that lock on to the surface of the much bigger bacterial cell. Here it penetrates the bacteriums protective shell and takes over its cellular machinery to produce more phages.
Overwhelmed by the invader, the bacterium dies, releasing a flood of new bacteria-gobbling phages.
When Barr returned to the lab the next morning, everything appeared to have gone smoothly. But the phage testing kit, which compared the results before and after endotoxin removal, repeatedly failed and his heart sank. Another had to be despatched from Germany, which set him back another day.
After 24 hours of intense frustration, Barr faced the moment of truth with the new testing kits colourimetric read-out: bright yellow marked a high and dangerous endotoxin level, clear indicated a low safe level. When it came up clear, Barr almost jumped for joy and immediately buzzed Forest Rohwer, who got in his car and drove the phages, packed in a freezer box with ice packs on the passenger seat, straight over to the hospital.
Dr Schooley pumped the first of five phages directly into Pattersons pseudocyst via catheters, and followed this up with an intravenous injection of the remaining phages.
On the evening of March 19, 2016, Patterson awoke from his coma for the first time in more than two months, turned to his eldest daughter and kissed her on the hand. Even though the bacteria developed resistance to the initial phages, and Patterson slipped into septic shock the following week, Schooleys team fought back the infection with more phages, while Barr kept adjusting the cleaning protocol to keep them safe. After three months and another setback, Pattersons infection was completely under control and, in August, he was discharged.
Illustration of Bacteriophage anatomy.Credit:Getty Images
The case grabbed international headlines when it was announced to the press in early 2017, and since then there have been a number of remarkable victories with phage therapy, including the recovery of a 16-year-old girl with cystic fibrosis in Kent, England, whose life was threatened by a strain of mycobacterium,and a 17-year-old Sydney boy critically ill with a golden staph infection, who suffered a stroke and went into a coma.
Trials in the US, Belgium, the UK and Australia suggest that phage therapy could become an important part of the arsenal against the growing crisis of antibiotic resistance across the globe.
Its a common myth that only those who use antibiotics regularly, or the sick, elderly and infirm, are at risk of developing antibiotic resistance. The unhappy fact is that anyone can get an infection thats resistant to the drugs, no matter how healthy and fit they are.
I should know. When it comes to antibiotic resistance, Im an interested party.
Ding Dong. Its 8pm on a steamy night in mid-January 2019, and Luna, our highly excitable Staffordshire cross, skids across the polished floorboards trying to beat my partner to the front door when the doorbell rings. Im in the kitchen drinking my umpteenth glass of water. I dont feel well.
I ask whether I might eat a bite of dinner first. He hands me the results of the tests and a referral for hospital staff. No, he says.
Its my doctor, a compact man in his 30s with a kind, round face, floppy, jet-black hair, and a taste in bright chinos. Ive been trying to ring you, he says, standing in our living room, to which I splutter something about my phone sitting upstairs being recharged. Youve got to go straight to hospital. Youre very seriously ill. You have highly elevated inflammatory markers.
I ask whether I might eat a bite of dinner first. He hands me the results of the tests and a referral for hospital staff. No, he says gently. You should go now.
I take a deep breath. Since returning from a short work trip to South Africa some weeks earlier, Id been feeling strangely under par, with an overpowering lethargy and body aches classic flu symptoms but with no sore throat or cough. The leeching of my energy levels was disconcertingly out of character, my partners standard simile for me being that Im like a human Eveready battery.
Before departing, Id had a complete physical (passing with flying colours), and all the requisite jabs, including for hepatitis A, malaria and tetanus. On the day before I flew back to Australia, I, along with a small posse of other journalists, was given a tour of a crowded medical clinic in a remote, northern part of the country. Within a day or so of my return, I fell ill. I asked my doc: could I have picked up some unpleasant microbial hitchhiker while I was away, or was this just an unlucky coincidence?
I dont believe in coincidences, he replied, writing me a script for oral antibiotics. Lets see if this knocks it out.
After a few days on them, I felt better, but within a week or two of finishing the script the symptoms returned, only with far, far greater force. These peaked one night in a fitful, feverish sleep in which my eyes were jolted open every couple of hours by unusually vivid dreams. Of my teeth falling out. Of cutting my way through a steamy jungle as thorns and sharp branches ripped the hell out my skin. Each time I awoke I was saturated in a sweat so thick my hands were drenched wiping it off despite a standing fan blasting air on me less than a metre away.
Fevers always seem worse at night, of course, with sensitivities heightened and distractions lowered. The next morning, I went straight back to my doctor, who after taking my temperature (raised) and blood pressure (significantly up) immediately ordered a full battery of blood and urine tests.
Ill mark them urgent, he said, scrolling back through my medical records. The results should be back by late this afternoon. Ill call you.
When I check my medical report I notice more than half the antibiotics administered to me resisted the killing powers of the bug.
So after my doctors visit to my house, here I am sitting in the waiting area of Accident and Emergency at my local hospital, mind in neutral, mystified as to why Ive become enveloped by this mysterious illness, but concerned about the man next to me, who is bent over, wracked in far greater pain than I.
After a couple of hours of waiting, and another series of tests, including blood cultures, Im taken into triage, where the doctor and nurse trade glances and talk about IV antibiotics. He also needs IV fluids, the doc adds.
What you reckon this is? I ask tentatively. Im sure you havent got cancer, the doctor says reassuringly. But you do have a serious infection.
Within a couple of hours of receiving IV antibiotics, my heart rate and blood pressure have settled down, Im feeling a hell of a lot better, and Im discharged the following morning. But when I later check my medical report I notice more than half the antibiotics administered to me resisted the killing powers of the particular bug, from the enterobacteriaceae family, Id been infected with.
Fortunately, the bug was sensitive to three of the drugs so I was soon on the mend. The earlier round of oral antibiotics just hadnt been strong enough to vanquish the bacterium, my doctor later tells me.
Peter Collignon, professor of microbiology at the Australian National University, has been warning about the overuse of antibiotics for more than 30 years.
Weve known about the increasing threat of drug-defying strains of bacteria for decades. In 2014, the World Health Organisation called antibiotic resistance a major global threat and early last year warned that a slew of serious and common complaints, from sexually transmitted diseases such as gonorrhoea and syphilis to respiratory and urinary tract infections, are becoming untreatable, posing a major public-health menace, especially among the very young, the elderly and the seriously ill.
We have reached the point where we should be very worried. An increasing number of infections are becoming harder or almost impossible to treat. Thats Peter Collignon, professor of microbiology at the Australian National University, and director of the infectious diseases unit at Canberra Hospital, whos been warning about the overuse of antibiotics for more than 30 years.
Although Australia has much lower antibiotic-resistance levels than most countries, were facing a tsunami of resistance among our neighbours to our north, in Indonesia, India and China, where levels are two or three times those of 30 years ago, says Collignon. Fifty per cent of common infections in India are untreatable now, he warns. Were virtually back to the 1920s.
We have reached the point where we should be very worried. An increasing number of infections are becoming harder or almost impossible to treat.
Since that day in September 1928 when Alexander Fleming realised the spores growing in his lab were what hed call penicillin, to antibiotics coming into general use in the late 1940s, countless millions of lives have been saved.
But humanity swiftly began to overuse the drugs, especially after it was found in the early 1950s that they helped accelerate growth and weight in chickens, pigs and cattle. By volume, 80 per cent of antibiotics in the world are given as food to animals, although its much lower in Australia, around 50 per cent, says Collignon. Whatever you do with animals comes back to people.
The overuse of antibiotics in livestock produces dangerous drug resistant bacteria that can spread throughout the environment. This prompted the WHO in 2017 to call for a global ban on the use of antibiotics to promote growth in healthy livestock.
China, which produces and consumes the most antibiotics in the world, uses more than 160,000 tonnes of the drugs a year, according to a 2013 study by the Chinese Academy of Sciences. Antibiotic-resistant genes are turning up in river systems, soil and even the air around farming areas in China and the US, say a wave of reports coming out of those countries.
In an eye-opening study early last year, a team of scientists at Perths Murdoch University found that one in five Australian silver gulls were carrying superbugs such as E. coli, resistant to antibiotics. Worryingly, the latest research also shows mutated strains of common bugs are becoming more potent in infecting hosts.
Antibiotic resistance not only makes it more challenging to treat infections, but it may make bacteria more robust, more able to cause infection, notes Collignon. Which means not just more antibiotic-resistant deaths but many more people with urinary tract, sinus and respiratory infections that will become chronic because theyll never be completely cleared up.
Theres no doubt the number of people dying from antibiotic resistance is climbing each year, from about 700,000 currently to an estimated (and conservative) 10 million deaths annually by 2050, according to the WHO. Although no global system for tracking antibiotic use exists, a survey of 76 countries published in the journal Proceedings of the National Academy of Sciences in 2018 found the use of antibiotics in humans increased nearly 40 per cent between 2000 and 2015.
One distinct advantage of phages over antibiotics is that theyre a natural part of the environment, found in air, soil and water in countless trillions upon trillions. Thats because wherever a bacterium set up home, theres a bacteriophage ready to break in.
Even a drop of raw sewage, taken from deep within the bowels of a hospital, could contain the chemical elixir that might fight an antibiotic-resistant infection in a patient languishing in a bed four floors above, as I find to my astonishment when I visit a research facility in western Sydney.
Sydney phage researcher Dr Aleksandra Petrovic Fabijan has worn a hazmat suit to collect samples of raw sewage at the citys Westmead Hospital.Credit:Dominic Lorrimer
Its mid-morning at Sydneys Centre for Infectious Diseases and Microbiology at Westmead Institute for Medical Research, the largest phage research facility in Australia, and Dr Aleksandra Petrovic Fabijan is telling me how she always keeps an eye out for a good spot to take a sample of bacteriophages, whether at placid, bucolic landscapes such as lakes and parks, while out for a picnic with her family, or at less pleasant, germ-filled places such as water treatment facilities.
Petrovic Fabijan and other members of her team have even donned impermeable yellow hazmat suits to venture into the deepest bowels of Westmead Hospital to extract samples of raw sewage to drop into specimen jars (for less hazardous sites of phage collecting, they dont have to swaddle themselves in a hazmat suit). The amount of protection depends on where youre sourcing the phages, she explains.
Dr Carola Venturini, a postdoctoral scientist at the institute, tells me shes even collected stool samples from her 12-year-old cattle dog, Cathy. You have to go where the bacteria are, which is also where youre likely to find a phage against it. From humans, weve taken sputum, faeces and skin scrapings and baby poo.
Dr Carola Venturini, phage researcher at Sydneys Centre for Infectious Diseases and Microbiology. "You have to go where the bacteria are, which is also where youre likely to find a phage against it," she says.Credit:Dominic Lorrimer
For phage therapy to advance, phage biobanks will have to be built into research facilities, explains Venturini, and the institute was recently awarded a research grant for this very purpose. You need to have a wide variety of high-quality phage samples already on hand to deal with any number of antibiotic resistant infections that arise.
The team at Westmead has treated 14 patients with phage therapy since 2017, including people seriously immunocompromised from kidney transplants and infected heart valves. If success is judged by the elimination of superbugs (so-called 28-day mortality, or survival one month after the infection has cleared), then its been a success, with eight patients beating the infection.
Long-term survival is very challenging because of these serious pre-existing and underlying diseases, explains Associate Professor Ruby Lin, project manager of the bacteriophage therapy team. Treatment typically takes about 14 days, with the phages intravenously injected twice a day, in parallel to prescribed antibiotics for the patient.
So far, research at Westmead has shown that phage therapy is safe and tolerable in patients, and only kills bacteria, with no harm to human cells. However, we need more evidence, particularly from randomised controlled trials, before we can offer it in a regular health case setting, says Lin, who as a teenager was driven to study genetics to find a treatment or cure for her older blind brother, who would go on to become the respected New Zealand wine consultant, C.P. Lin.
Phage researcher at Sydneys Centre for Infectious Diseases and Microbiology, Associate Professor Ruby Lin.Credit:Dominic Lorrimer
Lin, Venturini and Petrovic Fabijan are part of the Critical Infection/BARRD Group, a team of microbiologists led by Professor Jon Iredell at the front line of phage therapy in Australia.
Iredell, a youthful-looking 59-year-old who has been working in infectious diseases for more than 30 years, sums up the advantage of phages over antibiotics in three bullet points. First, because phages can be found everywhere on Earth, there are untold trillions available, unlike antibiotics. Second, phages only target bacteria, not the so-called good bugs in the host. Third, once biobanks are established, phages can be administered fairly quickly within 24 hours of a superbug diagnosis, in some cases.
But Iredell concedes phages cant beat the convenience of antibiotics. With antibiotics we know what their structure is and we can administer them to multiple people. With phage therapy, we have to develop phage cocktails for each patient tailored to the infecting bacterium.
Were now able to link the DNA signatures of viruses to the signatures of the bacteria, which accelerates the matching process.
But what Iredell calls the ultimate personalised medicine is also perfectly placed to take advantage of the leaps in todays medical technology, such as DNA testing, mapping the human genome, robotics and artificial intelligence.
These technologies, which werent possible 15 years or so ago, are advancing phage therapy, he says. Were now able to link the DNA signatures of viruses to the signatures of the bacteria, which accelerates the matching process.
Money for phage research worldwide has been slow to pour in, notes Iredell. How do you develop intellectual property around a product that naturally occurs in the environment? he asks. No one knows how to make a dollar out of it. Its not like you need to take a pill every day for the rest of your life, which is how pharmaceutical companies make money. (A similar lack of financial incentive is the reason why research into new antibiotics, also a class of drugs you only take occasionally, has been progressing at a snails pace for decades: most new drugs in the pipeline are only enhancements of existing drugs.)
Phage researcher at Sydneys Centre for Infectious Diseases and Microbiology, Professor JonIredell: "How do you develop intellectual property around a product that naturally occurs in the environment?"Credit:Dominic Lorrimer
Dr Karen Weynberg, of the school of chemistry and molecular biosciences at the University of Queensland, is researching synthetic phages, which in theory would be free of the toxins and risks associated with the natural ones. My goal is to engineer superphages to fight superbugs, she tells me.
Because phage therapy to date has been largely administered on compassionate grounds to elderly people gravely ill with other long-term illnesses that may sooner or later kill them, its success in eliminating a life-threatening infection isnt easy to herald to the media, or even the medical community. Its the miracle recovery stories of the young that grab the headlines.
But sometimes a couple of extra weeks or months of survival can mean the world of difference, not just to sufferers but loved ones, too. Penelope Jackson, a semi-retired resident of the Blue Mountains outside Sydney, had a serious heart condition dating back to a bout of rheumatic fever she suffered as a child growing up in Britain in the 1960s.
Until about 12 years ago, nothing seemed to stop Penny, recalls her husband Russell Jackson, who migrated to Australia with her in 1999, when the couple were in their 40s. Even after Penny had her second heart valve replaced in 2007, she was working hard and keeping busy around the house. Almost until the final months of her life, she was running her dog grooming business from home, he adds, in a thick Mancunian accent.
Russell Jackson is grateful for how phage therapy helped his wife.Credit:Wolter Peeters
One Saturday night in June last year, after suffering breathlessness and chest pain, Penny was taken to the hospitals in Katoomba and later in Nepean, where her condition rapidly deteriorated.
She arrested three times, was intubated, and went into a coma, says Russell, 62. After Penny was transferred to Westmead Hospital, doctors told him that a superbug infection (methicillin-resistant staphylococcus or MRSA) had colonised the tissue around her mechanical heart valves, and antibiotics had failed to quell the infection.
Here it was decided that Penny would be a good candidate for phage therapy, and after two weeks of treatment, the infection cleared up. The antibiotics on their own werent working, but a combination of the phages and the antibiotics saw her recover, says Russell. Another major operation to replace her faulty valves appeared to have been a success.
Even the most fervent advocates for phage therapy concede its unlikely to supplant antibiotics.
Penny returned home and the couple had a blissful two weeks together. So much better did Penny feel that on a Sunday afternoon the pair trudged through car sales yards to check out options for a new car for her. She was due to see her cardiologist on Monday morning.
When Russell went to wake her at about 7am, she had passed from a heart attack. It was of course a terrible shockbut Im so grateful she died at home peacefully, he says.
If phage therapy is a new script for an old plot the one titled humanitys millennia-old battle against infectious disease the obvious question is, will it ever replace antibiotics? Does it represent a stand-alone cure-all?
No, and no. Even the most fervent advocates for phage therapy concede its unlikely to supplant antibiotics because of the latters long-standing success and ease of use. At most, it will be a powerful ally in the battle against infectious disease. For this to happen, phage therapy needs to be shown to be safe, effective and practical on a large scale.
Since her husbands ordeal made medical history, Steffanie Strathdie has written a book about her story, The Perfect Predator, published last year, and set up IPath, a non-profit phage facility at UCSD aimed at ensuring patients suffering from life-threatening superbug infections have a place to turn.
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