Treatment Plan Victoria Brunet, Jacqueline Caruana, Natalie Ethier, Jessica Madrid, Amira Zaidan

7 Guiding Principles- First, Do No Harm- Healing Power of Nature- Address the Fundamental Causes of Disease - Heal the Whole Person- Doctor as Teacher- Principles of Healthy Living & Preventive

Medicine- Constitutional Health of the Individual (balance)

Disease Issues- Previously medically diagnosed with :

- Fibromyalgia- Asthma and environmental allergies- Osteoporosis- Chronic fatigue depression and anxiety- Crohn's disease- Incontinence with exercise- Chronic headaches- Gallbladder attacks

Disease Issues- Primarily environmental allergies (ex: pollen, mold, scents trees)

that worsen her asthma and cause headaches and sinusitis.● Red pinpoint rash on her upper body 3-4x/year at any time of the year

(non-specific allergic reaction)● Exposed to many chemicals (topical and inhalants) in the operating room

with poor ventilation system

- Fibromyalgia:● Has never been without pain since her late 20’s

Disease Issues

- Chronic constipation:● Severe pain in right upper quadrant of the abdomen blood and mucous in

the stool almost every week.● Persistent bloating primarily in transverse colon + right upper quadrant of

abdomen.

- Medication: ● Ativan 4-5x/week depending on the situation (anxiety)● Tylenol 3 approx 4x/week and Advil approx 2x/week

- Recovering from serotonin syndrome

Disease Issues- Fatigue ● Recurrent nightmares and restless leg syndrome, exhausted all the- Pneumonia 6 times in the past 5 years and gets bronchitis at least 2x/year

that lasts for 3-4 weeks body is freezing cold any time of the year

- Diet:● Gallbladder attacks lasting approx. 8 hours when fatty, greasy foods are

eaten

Hereditary Susceptibility

Depression: siblings, both parents, maternal grandmother Fibromyalgia: sister, brother and mother Glaucoma: father Myocardial infarctions: paternal and maternal grandparents and

mother Bipolar disorder: sister Rheumatoid arthritis: brother Alcoholism: brother Alzheimer’s: maternal grandparentsAlready presenting with depression, fibromyalgia, early signs of

Alzheimer’s

Susceptibility to Other Conditions

Bone Breakage

Immunity Problems

Slipping of TMJ disk

Suicide

Root Cause of Health IssuesFibromyalgia: is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues.

People with fibromyalgia also are more susceptible to tension headaches, temporomandibular (TMJ) joint disorders, irritable bowel syndrome, anxiety and depression

http://www.mayoclinic.org/diseases-conditions/fibromyalgia/basics/definition/con-20019243

Fibromyalgia Due to Severe Emotional TraumaTraumatic childhood events:1) When she was six years old, she witnessed a classmate

get hit by a car and killed2) Both her parents contemplated suicide frequently during

her childhood and she found her father’s suicide note when she was 13 years of age

3) Her brother was physically abusive and she was afraid of him until she was 17

Acupuncture Therapy for Pain Stival and colleagues (2014) conducted a double-blind study

to evaluate the effectiveness of acupuncture as pain treatment

In this study some patients were administered acupuncture adhering to traditional Chinese Medicine while others were given sham acupuncture

The study concluded that acupuncture done by traditional Chinese Medicine can result in the immediate reduction of pain in fibromyalgia patients.

Acupuncture interferes with the neurotransmitters related to pain and depression making it an effective therapy for chronic pain patients.

Alternative IdeasMind-body work: Qigong, yoga, massages

Qigong: is said to help with insomnia, restless leg syndrome and fibromyalgia

Yoga: focuses on stretching, relaxation and low impact movements that will ease joint and muscle pain

Massage Therapy: help reduce inflammation and ease muscle tension/stiffness

Detoxification: steam baths, saunas, mineral baths and low-intensity exercise to induce sweat

Exercise as Fibromyalgia Treatment

Bote et al., (2013) conducted a study to determine if single sessions of moderate cycling would relieve the inflammatory response experienced by fibromyalgia patients.

Following the completion of the study, it wasfound that cycling caused a decrease in the release of inflammatory cytokines by the patients monocytes

“Modified habitual exercise” is considered an effective non-pharmacological therapeutic aid in the treatment of fibromyalgia inflammation

Alternative ExerciseAqua fitness and aerobics: water buoyancy will reduce strain on bones and muscles making it easier to exercise

Whole body vibration: Can help reduce pain and fatigue of

fibromyalgia

Increasing bone density

Reduce the stress hormone cortisol and elevate serotonin

Mindfulness Training for Fibromyalgia Patients

Study to determined whether the implementation of a mindfulness-based training program is effective in reshaping anger, anxiety, and depression levels in a group of women diagnosed with fibromyalgia.

7 week mindfulness training program consisting of acceptance and commitment therapy, explanations and discussions, tales from Zen philosophy and Vipassana

Teach participants to let their thoughts flow without any judgement and without trying to change them. Learning to think and not react to situations. Learning to not let emotions control them (not dwelling or holding onto negativity)

Significant reduction of anger levels, internal expression of anger, state anxiety and depression was revealed in statistical analysis.

(Amutio et al., 2015)

Other Treatment Options- Gallbladder attacks: cut out

greasy and fatty foods out of diet- Restless Leg Syndrome: leg

massages, heat/ice packs, Relaxis pad

- Appetite: not consuming enough water, (7-8 glasses)

- TMJ: heat/ice packs, massages, soft foods, dentist

http://www.webmd.com/oral-health/guide/temporomandibular-disorders-tmd?page=3#1

Patients Goals & How Treatment Plan Works With Them

- Wants to slow down the progression of illness and diseases and wants to prevent other illnesses from occurring

- Health Promotion: want to strive towards healthier living

- Wants a better quality of life.

Possible Problems With Treatment Ideas- Fatigue and Muscle Pain- Sedentary Lifestyle- Urinary incontinence- Lack of self-efficacy- Depression- Anxiety

Integration With Existing Practitioners➮ Psychiatrist

➮ MD and Chiropractictor

➮ Gynecologist

➮ Naturopathic doctor

➮ Massage Therapist

Concluding Statement

References Amutio, A., Franco, C., Pérez-Fuentes, M. de C., Gázquez, J. J., & Mercader, I. (2014). Mindfulness training for reducing anger, anxiety, and depression in fibromyalgia patients. Frontiers in Psychology, 5, 1572. doi:10.3389/fpsyg.2014.01572

Bote M. E., Garcia J. J., Hinchado M. D. & Ortega E. (2013). Fibromyalgia: anti-inflammatory and stress responses after acute moderate exercise. Public Library of Science 8 (9). 1-6.

http://diet.lovetoknow.com/wiki/Detox_Diet_to_Cure_Fibromyalgia

http://www.drweil.com/drw/u/WBL02312/Qigong-Eases-Fibromyalgia-Pain.html

http://www.massagetherapy.com/articles/index.php/article_id/644/Treating-Fibromyalgia

http://www.mayoclinic.org/healthy-living/womens-health/in-depth/kegel-exercises/art-20045283

http://www.medicaldaily.com/fibromyalgia-symptoms-may-be-reduced-whole-body-vibration-exercise-285446

Stival R. S. M., Cavalheiro P. R., Stasiak C., Galdino D. T., Hoekstra B. E. & Schafranski M. D. (2014). Acupuncture in fibromyalgia: a randomized, controlled study addressing the immediate pain response. Revista Brasileira de Reumatologia. 54 (6). 431-436

http://www.yogajournal.com/article/health/pain-reliever/

http://www.webmd.com/fibromyalgia/features/water-exercise-for-fibromyalgia-easing-deep-muscle-pain