A Path To Wellness:Avoid Crimes Against Wisdom

Ores tes Gutierrez, D.O., ABFM, ABIHM.Regional As s is tant Dean PNWU

OPSO Pres ident

Disclosures

None

Learning Objectives

Phys ician Burn-out problem and s olutions

STEP 1 Stres s management and treatment

STEP 2 Nutrition for chronic dis eas e

STEP 3 Exercis e pres cription

Burnout: Definition, Symptoms, Causes

“phys ical or mental collaps e caus ed by s tres s ”

Sx: fatigue, ins omnia, depres s ion, anxiety, etc.

Caus es : Many... work-life imbalancewww.Mayoclinic.org

Case Study

62 yo retired admiral with metabolic s yndrome, carotid artery s tenos is 100%, nicotine dependence, alcohol abus e, who refus es medication…

What is your treatment plan for 62 yo retired admiral?

A) Nutritionis t cons ult (dietary modification)B) Daily exercis es pres cription C) Convince him to s tart medicationsD) Dis mis s al for noncomplianceE) Send him to a Yoga clas s

Avoid Crimes Against Wisdom

“Willful indulgence in unhealthy practices that leads to disease”

Prajnaparadha = crime against wisdom

Reducing Stress through Mindfulnes s and

Meditation

Step One

Three Stressors

Cataclysmic: Ts unami...

Objective: Sprained ankle...

Subjective: Perceived mental s tres s ...

*58 healthy premenopausal mothers

*Caregivers to health child or chronically ill child

*Perceived s tres s (s ubjective) accelerates aging

*Telomere s hortening approx. 9-17 years aging

Three Brain Centers

1. Stres s Center2. P leas ure Center3. Compas s ion Center

Three Stressors & TreatmentCataclysmic: LKM.

Objective: Sprained ankle, RICE therapy, etc.

Subjective: Concentration/Mindfulnes s /LKM.

*2000 genes assoc. with stress reduction in practitioners vers us non-practitioners

*With 8 weeks of RR training 1,500 genes as s oc. with s tres s reduction activated from bas eline

L.O.V.E.S. is the 5 Uni ty Principles

“A Wandering Mind is an Unhappy Mind”

2250 adults with iPhone app as ked three Q:

1) How are you feeling right now?

2) What are you doing right now?

3) What are you thinking about?

*fMRI brain activity in experienced meditators vers us meditation-naive controls

*Concentration, Loving-Kindnes s , and Mindfulnes s deactivate mind-wandering

Three Types of Meditation

Focus ed attention/concentration

Mindfulnes s /choiceles s awarenes s

Loving-Kindnes s practice

*3T MRI Brain of 25 men

*Compared novice vers us LKM practitioners

*More gray matter volume in LKM practitioners

Stimulus

Stimulus SPACE TO CHOOSE

NO SPACE

Reaction

Response

Freedom To Choose

“Everything can be taken from a man but one thing: the last of human freedoms - to choose one's attitude in any given set of circumstances, to choose one's own way.”

V. Frankl

Loving-k indnes s practiceMay you be happy, may you be healthy, may you be peaceful.

May I be happy, may I be healthy, may I be peaceful.

May all be happy, may all be healthy, may all be peaceful.

Nutrition For Disease Prevention and Revers al

Step Two

Precautionary Principle

“The precept that an action s hould not be taken if the cons equences are uncertain or potentially dangerous ”

Which diet has been shown to reverse CAD in randomized trial?

A) Mediterranean diet-Lyon dietB) DASH DietC) Paleo DietD) Vegan DietE) Keto DietF) Ornis h Diet

Whole-Food, P lant-Bas ed Diet

American Cancer Society Recommendations

Feb 2015-2020 U.S . Dietary Guideline Advis ory

Oct 2015 WHO proces s ed meat is Carcinogenic

Okinawa Study, Kita Study, China Study, Seventh Day Adventis t, Uganda, Blue Zones , Ts imane

Movement In Moderation is Your Fountain of Youth

Step Three

The Fountain of Youth: Exercise

https ://www.cdc.gov/phys icalactivity/bas ics /pa-health/index.htm

The Fountain of Youth: Exercise*Strengthens mus culos keletal s ys tem: bones , mus cles , heart, brain and s pinal cord.

https ://www.cdc.gov/phys icalactivity/bas ics /pa-health/index.htm

The Fountain of Youth: Exercise*Strengthens mus culos keletal s ys tem: bones , mus cles , heart, brain and s pinal cord.

*Lowers ris k of premature death, CAD, CVA, HTN, DM2, CAs .

https ://www.cdc.gov/phys icalactivity/bas ics /pa-health/index.htm

The Fountain of Youth: Exercise*Strengthens mus culos keletal s ys tem: bones , mus cles , heart, brain and s pinal cord.

*Lowers ris k of premature death, CAD, CVA, HTN, DM2, CAs .

*Improves s leep, well being, s erotonin, & hormones , HDL, LDL, TG, TC, wt los s .https ://www.cdc.gov/phys icalactivity/bas ics /pa-health/index.htm

SummarySTEP 1: Formal and informal meditation practice for s ubjective mental s tres s .

STEP 2: Nutritional intervention for chronic dis eas e: Predominately WFPD

STEP 3: Exercis e Rx is 30-60 min of aerobic exercis e daily, res is tance 2x/wk, avoid s itting.

Resources

Resources

Well Being Index https ://www.mededwebs .com/well-being-index

Provider Wellnes s Program 24-Hour Confidential Support Line 541-345-2800

National Suicide Prevention Lifeline 1-800-273-8255● https ://oregonwellnes s program.org● Lane County Medical Society Phys ician Wellnes s Program● Oregon Attorney As s is tance Program (available for physicians)● The Foundation for Medical Excellence