The autonomic nervous system controls all the body's involuntary processes: respiratory rate, heart rate, blood pressure, gastric juice secretion, peristalsis, body temperature, and so on. When we feel stressed, our brain activates the sympathetic nervous system, which has come to be known as the fight-or-flight response. The heart pumps faster and harder, causing a spike in blood pressure; respiration increases in rate and moves primarily into the chest; airways dilate to bring more oxygen into the body; blood sugar rises to provide a ready supply of fuel; some blood vessels constrict to shunt blood away from the skin and the core of the body, while others dilate to bring more blood to the brain and limbs. The results? A body primed to fight or run, and a mind that is hyper alert.  So,  when the amygdala (deep  in the primitive brain ) does its ‘hyper vigilant’ scanning job…and when it detects something alarming…it pulls the fight or flight switch and signals the adrenals to mount a heightened response/attack…we can literally be off to the races…except when we shouldn’t be.  The amygdala also signals a lot of false alarms adhering to the ‘better safe than sorry’ principle of protection. Today we worry more about our jobs, our relationships or meeting a deadline at work than we do about fighting off the proverbial tiger.  But even when the perceived threat is mental or psychological or a false alarm, it still triggers the archaic survival response. Did you know that something as innocuous but continuous as noise in an open office setting is triggering the amygdala to signal fight or flight? Imagine all the multitude of stimuli in modern living which makes this primitive  yet complex signaling system fire at will…the end result being the fight-or-flight response rarely switches off, and stress hormones wash through the body almost continuously resulting in adrenal fatigue. This presentation will outline turn-key treatment strategies to re set the over-response to modern day stimuli and correct adrenal dysfunction and fatigue.

Pain is one of the most common reasons patients seek our help. Nutrition is often considered when counseling our patients, and it takes a high level of conviction to motivate people to change. Patients with chronic fatigue, fibromyalgia, and a myriad of pain conditions are much more dramatically affected by nutrition than most of us appreciate. A successful plan can be explained as a matter of three rules that need to be followed. Nutritional supplementation can also be helpful, and various nutrients will be discussed that can help improve healing.

The mouth is a barometer for our overall health since we can easily observe the mouth breaking down much faster than the rest of the body.  Quite often, a patient with Heart disease has a mouth full of dentistry to rebuild it from the years of infection and breakdown.  Research shows that almost 80% of patients with some form of cardiovascular disease have Obstructive Sleep Apnea that has not been diagnosed.  Additionally, nutritional deficiencies can devastate the overall health of the oral cavity without any sign of infection.

Session Description: Dr Richard Horowitz is board certified in internal medicine, and is medical director of the Hudson Valley Healing Arts Center, in Hyde Park, N.Y. The HVHAC is an integrative medical center that specializes in the treatment of Chronic Lyme Disease. The center has treated over 12,000 chronically ill Lyme patients over the last 27 years, combining Eastern and Western medical approaches in their treatment. Dr Horowitz is a practicing Buddhist with a daily meditation practice, and has studied with meditation masters from the Karma Kagyu Tibetan Buddhist lineage during the past 30 years. During that time, he has studied extensively with H.E. Tai Situ Rinpoche, Lama Norhla Rinpoche, the Venerable Kalu Rinpoche, and has studied Calm Abiding meditation, Vipassana/Insight meditation and Mahamudra meditation for over 10 years with the Venerable Thrangu Rinpoche. The most recent teachings he received were a direct transmission of the mind instructions of Khenpo Ganghar, who was a root teacher for both Thrangu Rinpoche, and the Venerable Chogyam Trungpa Rinpoche, considered to be one of the founding fathers of Buddhism in America. These teachings were credited with liberating countless Tibetans from suffering during extremely difficult times.

We too live in extremely challenging times. The external elements are out of balance, where floods, tornadoes, tsunamis, and earthquakes are a regular occurrence, and there are epidemics of cardiovascular diseases, cancer, and infectious diseases in our medical offices on a daily basis. Patients often do not cope well these challenges, as they struggle to deal with the consequences of their illness. In Chronic Lyme Disease, often have patients suffer for years going from doctor to doctor looking for answers. Apart from their striking physical symptoms, these patients often present with significant neuropsychiatric abnormalities, including severe depression, anxiety, a loss of hope, and a loss of meaning in their lives.  Despite pharmaceutical interventions, their psychiatric symptoms often cause ongoing suffering, and patients need new tools to cope with their challenging life situations.

This session will discuss several different meditation techniques that can effectively be integrated into our lives to help relieve both our own and our patients suffering. Simple techniques of Calm abiding meditation, mindfulness meditation, and Mahamudra meditation will be shared, in group practice settings. The scientific basis for meditation as well as the Buddhist understanding of the nature of mind and how to use meditation to discover its basic essence will be discussed, as well as ways to work with the difficult emotions that arise in everyday life and medical practice.

* AMA/PRA category 1 credit is not provided fro this session

In this session, participants will be introduced to tools and practices of wellbeing leadership and will learn strategies to incorporate wellbeing into their lives and organizations.

Current research indicates that development and maintenance of IBD requires the combined additive effects of at least three components:  genes regulating intestinal barrier function and repair, altered intestinal microflora, and impairment of innate immunity leading to excesses of adaptive immunity.  This model implies that diverse mechanisms underlie IBD in different patients and that each patient may have a distinctive illness with unique therapeutic requirements.  This session will review the substantial database of human clinical trial data utilizing diet, nutritional supplements, botanicals, probiotics, prebiotics and mind-body therapies for treatment of patients with IBD and provide a structured framework for individualizing therapeutic choices.

A major critique of integrative health care to date has been the limited attention the field has paid to the difficult questions of access to care for underserved populations. Although this may have been the case in the early days of the field, in recent years there are many groups working to make integrative care more accessible regardless of income. This session will have two areas of focus: information resources and practice models.

First, we will present the work of a national group called “Integrative Medicine for the Underserved,” which has worked over the past two years to develop an extensive web-based toolkit of resources for patients and practitioners in integrative approaches to health. This toolkit includes teaching materials and patient handouts describing evidence-based, affordable, and time-efficient integrative therapies for a range of common conditions, perfect for application in challenging settings such as the community health center or the neighborhood free clinic. We will demonstrate a number of these resources and share with participants the potential for how to use these in their practices. We will also discuss the potential use of these resources as teaching tools for practitioners in training, whether in primary care residencies, nursing, or CAM disciplines.

Second, we will present three stories of practice models that have found ways to overcome the constraints posed by under-insured and underserved patient populations, as illustrations of potential ideas for participants to try at home. One will be a community health center in NYC incorporating integrative approaches as part of a training model; the second will be a community acupuncture program; and the third will be a group-oriented patient empowerment model being used in Lawrence, Massachusetts.

2,500 years ago, Hippocrates, the father of modern medicine, was already reminding his students that they couldn’t heal others if they weren’t at the same time restoring their own equilibrium, clarity, and inner harmony. Like our patients, we must face life’s difficulties while celebrating the capacity for joy, peace, and inner wisdom we hold within ourselves. In this workshop, we’ll explore our own untapped gifts for self-healing as we discover the next steps in our own journey to greater personal health and professional contentment. We’ll practice several mind-body techniques—including two meditations and guided imagery—to mobilize our imaginations, reconnect with our bodies, and discover the next steps on our professional paths.

*AMA/PRA category 1 credit is not provided for this session

Anxiety disorders can manifest differently in women and can worse premenstrually, postpartum and in the perimenopausal transition.  Insomnia is pandemic in midlife women, although the cause remains unexplained within the scientific community.

This presentation will include an overview of these disorders and an integrative clinical approach to enhance clinical outcomes in women with particular attention to the influence of cortisol on sleep disturbance, and the influence of hormonal states on insomnia and anxiety. 

*AMA/PRA category 1 credit is not provided for this session

Taiji (t'ai chi) and qigong are often misunderstood as simply slow movement or breathing exercises. Taiji/qigong is a multidimensional mind/body/spirit integrative exercise that combines the benefit of meditation and mindful physical movement. In this interactive session, Dr. Yang Yang will explain the relation between taiji and qigong and methods and purpose of traditional training, and will share a summary of scientific evidence to date on the benefits of taiji/qigong exercise, and limitations of existing studies. Importantly, this will be an interactive presentation - Dr. Yang will lead attendees to experience taiji/qigong practice, and will share simple exercises that attendees can take home to reduce stress, increase vitality and promote quality sleep.

*AMA/PRA category 1 credit is not provided for this session

Connecting with meaning and spirituality leads to increased life balance, satisfaction and well-being. The process of integrative nurse coaching explores the clients’ meaning and spirituality through deep listening and reflective awareness practices. This creates an environment of trust and inner stillness that deepens and supports connection with inner healing potentials.

It has been known for centuries that what we eat has a profound effect on our immunity.  Deficiencies of macro and micronutrients can impair the immune system’s ability to fight off infection and heal wounds.  Overconsumption of certain foods and food additives can cause immune dysregulation, leading to obesity, cancer and chronic inflammatory disorders. In contrast, calorie restriction can downregulate inflammation and increase lifespan.  In addition, certain naturally occurring compounds can modulate immune function. More recently, gut microbes have been identified as active intermediaries between dietary intake and the immune response.  The emerging field of nutritional immunology encompasses all of these issues. This presentation will review the fundamental principles of innate and acquired immunity, discuss the pathways that disrupt normal function and explore the use of naturally occurring substances to modulate the immune response and improve health.

Dramatic improvement in clinical outcomes can be gained with the strategic identification of endogenous and exogenous disruptors of Neuroendocrine integrated pathways.  This presentation will  offer an integrated approach to quantifying and resolving individual imbalances in both Endocrine and Neurological systems, and by doing such allowing for resolution of co-morbid dysfunction.

Employing advanced testing and clinical interventions will be discussed thus allowing for a succinct and easy to employ approach that will address both improvement of each individual and combined performance factors of the neuroendocrine pathways.  Utilization of nutraceutical interventions as well and select prescription considerations will also be reviewed.

*AMA/PRA category 1 credit is not provided for this session

Participants will explore a new practice model for Integrative Medicine/Integrative Health (IM/IH) that addresses the present obstacles of working successfully in an interdisciplinary manner.  Based on findings from an ongoing, 10-year ethnographic study by integrative medicine doctors and a medical anthropologist at the Health Medicine Clinic in Northern California, this workshop presents practical steps for mediating among disciplines with widely disparate education, training philosophies, diagnostic and treatment methods, licensure, and scopes of practice.

In a lively, engaging way, participants will be able to use the findings from this study of Healing Circles, and role play to explore how various, novel treatment plans emerge when organizational geometry changes from hierarchy to democratized circles.

This presentation will review the current evidence-based approaches in the evaluation of autoimmune disease. Identification of the GI microbiota, food triggers, predictive auto-antibodies, and other predictive strategies, in the risk assessment, diagnosis and management of autoimmune diseases will be examined from an evidence-based perspective. These systemic disorders range from autoimmune inflammatory disorders, including rheumatoid arthritis, ankylosing spondylitis, to immunogenic thyroiditis (i.e., Graves and Hashimoto’s disease), and degenerative neurological conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS) and dementia. Within this framework the role of molecular mimicry in the genesis of autoimmune diseases will be fully explored. Novel diagnostic modalities and functional/metabolic objective laboratory assays, including emerging predictive antibody testing, in these applications will also be presented and critiqued. Finally, specific rational and efficacious integrative treatment interventions for these specific clinical situations will be offered.

The Human Microbiome Project which has sought to characterise the nature of the microbial community in healthy individuals is in many ways confirming concepts which had previously been gaining ground and needed supporting evidence. These include the understanding that individual variation in microfloral patterns appear to be dictated by diet, ethnic origin, and early colonisation patterns. Nevertheless, patterns of populations show many aspects of consistency across all individuals.

These findings are consistent with increasing awareness, that the microbiota has profound effects on both health as well as potential to directly cause, or increase risk of disease.

*AMA/PRA category 1 credit is not provided for this session

Polycystic ovarian syndrome (PCOS) is a disorder characterized by irregular menses, hyperandrogenism and enlarged and polycystic ovaries. Its etiology remains unknown and conventional treatment is usually symptom based. PCOS has the potential to cause metabolic syndrome and associated risk of diabetes and cardiovascular problems.  An effective integrative approach to diagnosis and treatment will be discussed.

This session will include slides introducing the UCLA Center for East-West Medicine and feature videos to show what we can learn from the life-changing experiences and wisdom shared by the pioneers of integrative medicine and leading figures in China. The goal is to demonstrate how blending the experience in China with the latest thinking in the western world can help develop successful clinical and educational programs. 

Beth Israel Medical Center (BIMC) in New York City, in collaboration with Donna Karan and Urban Zen Foundation, launched a unique pilot program in 2009 to enhance the care of patients in the hospital. The goal of this program is to create an optimal healing environment that is built around a menu of complementary healing therapies. 

The Pilot Program initially designed to help relieve symptoms of pain nausea and anxiety in cancer patients, evaluated the Optimal Healing Environment in an evidence-based research study.  It measured patient satisfaction and other outcomes (e.g., reduced symptoms, and decrease in use of pain and anti-nausea medications), family and staff satisfaction, and cost-benefit ratios*. 

This Pilot Program served as the model for development of the clinical rotations component for the Urban Zen Integrative Therapist (UZIT) program protocol.  Now in 2013, over 6,000 patients have received an Urban Zen therapist experience. Jillian Friedman, E-RYT, Program Supervisor of the Integrative Yoga therapies in the Department of Integrative medicine at BIMC will share recent research initiatives and poster presentations of this effort. In addition she will teach and experiential component of the UZIT training to illustrate how yoga can be delivered in a hospital environment.  Dr. Roberta Lee, Vice Chair of  the Department of Integrative Medicine at BIMC will discuss in broad terms how this holistic program contributes to the identity and meaning of IM in a clinical setting.

*Kligler B, Homel P,  Harrison  L et al. Cost Savings in Oncology thru an Integrative Medicine

Approach ,Am J Manag Care. 2011;17(12):779-784

*AMA/PRA category 1 credit is not provided for this session

This session will discuss the utilization of chiropractic for patients living with cancer as a chronic illness.  It will focus on pre-existing musculoskeletal conditions that become exacerbated during cancer treatment as well as common side effects from chemotherapy and radiation.  Several effective chiropractic techniques will be reviewed.  In addition to the indication for chiropractic intervention, the contra-indications for chiropractic treatment for cancer patients will be outlined.  Evidence based research with references will be provided during the presentation.  This presentation’s focus on  the quality of life for cancer patients will present new ideas for cooperation and collaboration between various health care professions, stressing the complexity of cancer.  The issue of quality of life is paramount with cancer patients.  The integrative approach allows for specialists to focus on their expertise and refer to colleagues for issues outside their scope of practice.

Chronic sinonasal disease is a significant part of any primary care practice.  Up to 40% of patients present initially to the primary care practitioner for evaluation and treatment of an array of nasal complaints, from post nasal drip, nasal obstruction, facial fullness and pain, to sneezing, itchy eyes and throat, chronic cough and sinus headaches.  Often patients leave with a “one-size fits all” treatment regimen, which may or may not be effective in alleviating the symptoms. Recent research even suggests that most sinusitis does not require antibiotics, yet most patients will leave the office with a prescription for the same. In children, some of OTC treatments for cough and cold are actually dangerous, and current recommendations to avoid such treatments do not offer patients alternatives for symptom relief. This is not satisfying or safe for either the patient or practitioner.