JULY 2011
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

Highlights of Annual Cardiology Summit 2011 – Part II


A joint session of the Cardiovascular Society of India and the American College of Cardiology (ACC) brought together several experts to address the important issue of Heart Failure (HF) management in patients of Indian origin both living in India and in other countries. Hamang H. Patel, a cardiologist from Ocshner Heart and Vascular Institute, New Orleans, said that non-resident Indians are more likely to have heart failure at a younger age group and with more severe symptoms and worse survival than Indians residing in India. This is possibly related to the high incidence of diabetes and insulin resistance among NRIs. Risk factors for acute heart failure among Indians include older age, coronary heart disease, hypertension and diabetes. So, beware, all of us need to focus on preventive care. Professor Pravin Goyal from Lucknow felt that yoga and pranayama could be used to calm the mind, lower central sympathetic activity and prevent the progression of heart failure.

Hospital to Home (H2H) program

As the population is getting older, chronic diseases, especially cardiovascular diseases, become a major challenge to contend with and HF again dominates the list. Admissions and readmissions are common and mortality rate remains high. As soon as patients get discharged from the hospital to home, they are back in the emergency room. One study noted 12 percent of patients discharged with HF die within 30 days! The major question is “why can’t we take care of our patients at home” properly after they are discharged in stable condition.

The ACC’s H2H (Home to Hospital) program, a national quality improvement initiative, helps to change this by improving the practices and strategies when patients are discharged home. A multidisciplinary team involving the home health care nurses, physicians, physical therapists and technologists along with remote monitoring, patient education, observing for drug discrepancies and drug side effects, etc., will go a long way in keeping these patients at home in stable condition and cut down the costs of medical care as well. This is also applicable for many other chronic ailments such as recurrent pneumonia, chronic bronchitis, abdominal problems, etc. No doubt, it would be welcome news to the patients.

A new frontier in HF therapy involves administration of stem cells that can aid the failing heart in regeneration of its muscle. Andreas Zaher, M.D., from Germany said: “We are just in the beginning and this is a rapidly growing field.” Many centers in the United States, including Tampa, are already involved in stem cell research and it holds a lot of promise in the years to come. However, the main treatment still involves proper medical management to decrease excessive fluid retention and improve the cardiac pump function. If all else fails, one will have to consider a Left ventricular Assist Device, a mechanical stimulator of heart pump, which is essentially a bridge to cardiac transplantation.

Two spotlight discussions focused on Information Technology (IT) in Cardiology. Yes, IT is here to stay in all medical fields and expected to promote connectivity between all medical personnel, hospitals and other institutions. President Obama has authorized $20 billion to assist in the development of a robust health information technology. By 2014, this will be implemented and all physicians must be ready with meaningful electronic medical records. I am sure it will facilitate health care information exchange better among all the providers.

The ACC convention provided a lot of new information and unique opportunities to practicing physicians, hospital administrators, fellows and residents and all members of the cardiac care team. The ACC 11 Expo was one of the best with lots of vendor booths and learning areas. It provided hands-on sessions for many new instruments, a great learning experience. An Industry Expert Theatre, set up in the middle of the Expo room, it attracted quite a lot of attendees. Here, you received first-hand information on many current topics, cutting- edge research and even short clips of movies on some of the complex interventions. All in all, this was a great experience. I was indeed quite excited at the tremendous strides we have made in the diagnosis and management of cardiac patients.

Last of two parts

Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.


Integrative and Functional Medicine embody the medicine of the future


By definition, medicine is the science of diagnosing, treating, or preventing disease and damage to the body or mind. When we dissect this sentence, there are parts that modern day doctors are doing quite well by ‘definition.’ America’s medical education system churns out thousands of physicians dedicated to the tireless search of ‘the diagnosis.’ Why such an emphasis on finding it? Because all treatment is almost purely based on finding the diagnosis. Once the symptom or disease is named, physicians and patients have something to ‘blame’ as the cause of the ill condition. Then, it’s just a matter of picking the best medicine from the approved list of pharmaceuticals that have been ‘proven by research’ to fix the issue. Evidence shows the current practice of medicine is dangerously off track misguided by two factors – society‘s ‘quick fix fever’ and a disease-focused health insurance paradigm.

So, it’s not surprising that there is a growing movement of patients standing up to the shortcomings of this approach. What’s their mantra? Treat the patient; don’t just treat the disease. Ancient traditional modalities such as Traditional Chinese Medicine (TCM) and Ayurveda prioritize a thoughtful immersion in the aspects of the body that are not functioning optimally and a priority placed on returning it to the natural healing balance that it evolutionarily, spiritually, and/or genetically is programmed to attain. By removing factors that get in the way of disease and providing the factors that support health, these practitioners are able to heal body, mind and spirit.

In this country, TCM, naturopathy, homeopathy, Ayurveda and other ‘unconventional’ modalities are designated as Complementary and Alternative Medicine (CAM). Complementary Medicine defines therapies used in addition to conventional therapies for treatment (e.g. acupuncture for pain management used in addition to surgery or pain medications). Alternative Medicine, on the other hand, is a substitution for the conventional approach to a disease (e.g. taking Chinese herbs for infertility instead of taking prescription medications or getting in-vitro fertilization). Patients are seeking CAM options as a low-risk, low-cost option for their health concerns. But people still want to retain the security of access to the high-tech benefits of modern medicine if an emergency situation were to occur. Wouldn’t it be nice if there was a doctor who could do both based on what was necessary?

Enter Integrative Medicine. Combining mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness, it is creating a movement. Some of its strongest advocates include Dr. Andrew Weil and Dr. Mehmet Oz. My personal practice philosophy ‘integrates’ further with Functional Medicine, led by the pioneering work of nutritional biochemist Dr. Jeffrey Bland. Functional medicine practitioners work to treat disease by seeking out the ‘dysfunction’ in the underlying systems of the body and bringing them back to ‘function.’ Integrative and Functional Medicine physicians rely on the fact that the human body has a considerable power to heal itself under the right circumstances (without the use of drugs and surgeries many times).

If there is any better proof that Integrative and Functional Medicine embody the medicine of the future, it can be seen through the accelerated introduction of these philosophies in the most well-respected medical education systems of this country. Progressive powerhouses such as MD Anderson, Duke, Harvard, Yale and Mayo Clinic offer programs to teach medical professionals the benefits of this new way of thinking. All to the credit of patients demanding more from their medical community, the mantra still resonates …

Treat me. Don’t just treat my disease.

Dr. Shilpa P. Saxena is the founder and Medical Director of SevaMed Institute in Lutz. She seeks to educate patients and physicians in the expanding fields of Integrative and Functional Medicine. She leads Living Wellness University, an online Integrative Medical Education Community, which provides beneficial lifestyle tools for all. Visit www.livingwellnessuniversity.com for more information.

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