Category Archives: Integrative Medicine

Coriander seeds water can be beneficial for high blood pressure patients

Coriander seeds are versatile in nature. They can be used raw or they can be grinded to form a powder. Coriander seeds can be added to almost every Indian delicacy. They impart a deep flavour and texture to the food and also offer a variety of health benefits. The aromatic herb is full of fibre that can improve digest and regularise bowel movement. In a video shared recently on Instagram, lifestyle coach Luke Coutinho talks about the benefits of coriander seeds and how they be an effective home remedy for swelling, joint pain, arthritis pain and bloating to name a few.

Coriander seeds can effectively reduce pain and swelling in jointsPhoto Credit: iStock

Also read:The Many Health Benefits Of Coriander Seeds Will Amaze You

Also read:Jeera Water For Weight Loss: Top 5 Benefits You Must Know

(Luke Coutinho, Holistic Lifestyle Coach - Integrative Medicine)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Joint Pain, Arthritis Pain Giving You A Hard Time? This Coriander Seeds Concoction Is All You Need! - NDTV News

Cancer has an impact on every part of a patient's life. At GBMC Healthcare, the fight against cancer is about more than treating the disease. Delia Chiaramonte, M.D., Medical Director of Integrative and Palliative Medicine at GBMC, is leading the charge on integrative cancer care.

"It's not just about treating the cancer. It's also about how the person is coping, what side effects they may have from the disease itself or from the treatment, and how those symptoms make their life harder to manage," she says. "Treating the whole person is a really important part of cancer care."

These symptoms can be caused by a variety of internal and external sources, and Dr. Chiaramonte says it's important to get to the root of the cause of the symptom to better treat the patient.

"We hear the patient's symptoms then make an evidence-supported treatment plan that's different for every person, based on what their symptom is and why we think their symptom is happening," she explains.

For example, one person may not be sleeping well because of a physical reaction to chemotherapy. Another may not be getting good sleep because their mind is filled with anxious thoughts about their diagnosis.

Dr. Chiaramonte says there are three main causes of symptoms, and the Integrative Medicine Program makes it easier for patients to get an evidence-based, effective treatment plan and to receive those treatments at the Sandra & Malcolm Berman Cancer Institute at GBMC.

"We pull out all the causes and then address them with the treatment that is likely to work on that particular person, and often it's not just one cause," she explains.

The mind-body connection

The sympathetic nervous system directs our body's "fight or flight" response, which can be caused by both external factors and our own thoughts.

"Because the mind and body are connected, our anxious thinking can generate the 'fight-or-flight' response, and that can result in all kinds of physical symptoms, including increased pain, palpitations, changes in GI function, sleep, and nausea," Dr. Chiaramonte says.

According to Dr. Chiaramonte, there are a variety of ways to help decrease the sympathetic nervous response system, including craniosacral therapy (a light-touch manual therapy technique that works to balance and facilitate healing in the body) and massage. These methods reduce patients' anxiety.

Cancer treatment symptoms

It's no secret that chemotherapy and radiation can be taxing on the body. Nausea, fatigue, and neuropathy (nerve pain caused by damaged nerves) are just some of the side effects of cancer treatments that integrative modalities can help alleviate.

"Some energy medicine has been shown to help chemo-induced peripheral neuropathy," Dr. Chiaramonte says. "Many people come in with fatigue, usually from a combination of poor sleep and treatments. Acupuncture, meditation and guided imagery, reiki (a stress reduction and relaxation technique involving a trained practitioner), and yoga have all been shown to help fatigue."

Physical pain

Dr. Chiaramonte reiterates that the Integrative Palliative Medicine Program is just that: an integrative medicine program and not an alternative to standardized cancer care.

"I treat pain with medicines, with different kinds of opiates and complementary medications," she says. "But acupuncture has been shown to decrease pain. Meditation and guided imagery have been shown to decrease pain. Reiki has been shown to decrease pain. Depending on the person, we may use multiple modalities to help them manage their pain."

Massage is also an oft-used modality for physical pain.

"Often, when something hurts in our body, the muscles around it contract and tighten to try to protect it, and over time it can become the actual contraction of the muscle that hurts, not necessarily the underlying factor," Dr. Chiaramonte says.

She explains this can also tie into the mind-body connection because "if you're generating a lot of anxious thinking, you're more likely to continue to have this muscle tension, and massage can help."

Integrative treatment plans will vary by patient, which Dr. Chiaramonte says is the key to taking care of the mind, body, and spirit of every individual.

"We find out the 'why' behind each patient's symptoms, pull out the causes, and then come up with a plan for that particular patient, using all the tools that work."

For more information Integrative Medicine at GBMC HealthCare, click here.

Originally posted here:
How integrative medicine is changing the way cancer is treated - Fox Baltimore

People facing a cancer diagnosis, particularly a late-stage cancer diagnosis, may feel that their locus of control over life has been removed. They are now patients, relying on their oncologist, surgeon, radiation therapist and nursing staff.

But, consider an integrative cancer approach in which patients feel more empowered by an assortment of options they can choose, such as changing their diet, exercise, incorporating methods for reducing stress, seeing an acupuncturist and engaging in mind-body practices. Proponents of an integrative approach say these complements to conventional treatment (chemotherapy, radiation, surgery) make treatment more effective while reducing side effects.

Many cancer patients, like Jasmine Guha-Castle, are turning to integrative cancer care to enhance quality of life, improve outcomes and possibly beat the odds.

Guha-Castle, 50, of Austin, Texas, wont slow down for a minute in her fight to beat breast cancer, again. She made healthy living and volunteering at animal shelters her lifes mission since she overcame breast cancer 13 years ago.

But she received the unfortunate news that her breast cancer had returned while heading to England two summers ago. This time, it was metastatic, meaning the kind that spreads. And it was triple negative, a more aggressive kind of cancer that will not respond to hormonal therapy medicines. So, she flew right back to Austin.

This place gives me hope, which the other places havent so far.

Early in her treatment, regardless of a chemotherapy day, Guha-Castle could be found swimming in Austins Barton Springs pool, attending a meditation class, visiting a nutritional oncologist or acupuncturist, making carb-free foods, dancing and most often, reading science-based information about triple-negative breast cancer (TNBC).

Where you wouldnt find Guha-Castle was hanging out with other patients just because they share her condition. That isnt my cup of tea, says the expat Brit, who finds it hard to connect with members of the cancer community if they are depressed and not optimistic like she is.

You have to be positive and proactive to change the environment of your cells, notes Guha-Castle.

There are more options if you have the right doctor, she says. Initially, she was only treated with chemotherapy and radiation by oncologists who use conventional treatment methods. She says traditional oncologists did not show an interest in hearing about her anti-cancer literature related to medicinal mushrooms, turmeric pills and other approaches that might improve outcomes and help her feel better. She also wanted more guidance, more personalized care and more hope.

Integrative oncology is not alternative medicine, which usually refers to treatments used instead of traditional ones. It also isnt it only complementary, which refers to the use of single-intervention add-ons to support mainstream treatment. So, what exactly is integrative oncology?

Here is a comprehensive definition from JNCI (Journal of the National Cancer Institute) Monographs: Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products and/or lifestyle modifications alongside conventional cancer treatments. Integrative oncology aims to optimize health, quality of life and clinical outcomes across the cancer care continuum, and to empower people to prevent cancer and become active participants before, during and beyond cancer treatment.

After reading about cancer programs at different clinics, Guha-Castle decided to fly to the independent Block Center for Integrative Cancer Treatment in Skokie, Ill. She was reinvigorated by the clinic, with all of its physicians and specialists in the same building.

A growing number of leading U.S. cancer care centers claim to have integrative medicine programs.

Guha-Castle found it to be like no clinic she had seen, with a kitchen for nutrition classes, a yoga and exercise area and soothing lighting and music. Exercise equipment was only steps away from the chemotherapy areas.

This place gives me hope, which the other places havent so far, she says.

She was particularly motivated after reading the Block Centers preliminary study of stage IV breast cancer patients who were treated there. The treatment improved survival time for the patients, generally, compared to patients treated at conventional clinics.

Dr. Keith Block is the Block Centers medical and scientific director, and considered to be the father of integrative oncology. He developed a treatment program called Life Over Cancer, which uses a plant-based diet, exercise, nutritional supplements, nutritional infusions (administered intravenously) and mind-body therapies. He also uses innovative methods of chemotherapy and experimental and off-label medications.

No two patients are treated in the same way there. Treatment is based on individualized testing to determine a persons biochemical environment or internal biochemistry. This is the environment surrounding a persons cancer cells that can influence the growth and spread of cancers. It includes levels of inflammation, oxidation and the state of his or her immune system. Block uses blood tests for this assessment, which he calls this terrain testing or taking a blood terrain panel.

At the Block Center, all conventional cancer treatments, physician visits, blood draws and visits with counselors are covered by Medicare and most private insurance plans. Some extras, like dietitians, nutritional supplements and nutritional infusions are out-of-pocket.

Fortunately for Guha-Castle, she can afford to fly to the Block Center every two weeks for treatment. But many people dont have the means to do that, she acknowledges. She is still associated with an oncologist in Austin for blood transfusions and scans, but she says she would rather pay more to get the kind of care she wants at the Block Center.

A growing number of leading U.S. cancer care centers claim to have integrative medicine programs.

Dr. Lorenzo Cohen, professor and director of the Integrative Medicine Center at the University of Texas MD Anderson Cancer Center in Houston, says what distinguishes his clinic from the Block Center is being part of an academic medical system. He says blood testing and prescribing medications, particularly of herbs and supplements, becomes a little more challenging when you are in an academic medical center and must follow strict evidence-based guidelines, such as the National Comprehensive Cancer Network guidelines.

Treatments provided by integrated programs within large cancer centers are led by physicians, who also work with providers to guide patients in services like acupuncture, massage, music therapy, yoga, Tai chi and qi gong (methods of movement, breathing and meditation), physical therapy, nutrition and health psychology throughout treatment and whenever possible.

Like other treatment programs, they take commercial insurance and Medicare for standard procedures. The Centers for Medicare and Medicaid Services now covers acupuncture for Medicare patients with back pain. Cohen says this shows that insurers see that integrative approaches are not only cost effective, but a huge value gained in quality of life.

Dr. Dawn Mussallem specializes in breast care at Mayo Clinics Integrative Medicine and Health program in Jacksonville, Fla. She worked with Cohen on an expert integrative oncology panel that recently endorsed the Society for Integrated Oncology Breast Cancer Guidelines.

In the last couple of years, Mussallem developed and piloted a breast-specific integrative medical program within Mayos Jacoby Center for Breast Health that included acupuncture, massage therapy, cancer nutrition, mindfulness classes, yoga and superfood cooking classes.

Mussallem met with patients about whole-person well-being, discussing aspects like nutrition, exercise, purposeful living and avoidance of toxins like alcohol and tobacco. The programs results showed a favorable patient benefit on quality of life, and these integrative services are now offered to all cancer patients at Mayo Clinic in Jacksonville.

Given the high prevalence of patients using alternative modalities often driven by misinformation available to patients, there is a strong need to guide the use of appropriate integrative oncology care to achieve optimal outcomes for our patients, Mussallem says.

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More Than Chemo: A Different Way to Treat Cancer - Next Avenue

Dr Dani Gordon is a double board-certified medical doctor, working with integrative medicine, as well as wellness expert and leading expert in clinical cannabis/cannabinoid medicine after treating 2500+ patients in Canada in a referral complex chronic disease practice where she specialised in neurological disorders, chronic pain and mental health conditions.

She speaks internationally on cannabinoid medicine and in mid-2018 moved to London to train the UKs first cannabis medicine specialist physicians, developing a leading online cannabis medicine physician training programme, helping to set up the UKs first cannabis medicine clinics and become a founding member of the UK Medical Cannabis Clinicians Society (MCCS), delivering the MCCS guidelines to 10 Downing Street.

Gordon is an American Board Specialist in Integrative Medicine, the newest American sub-specialty of mainstream medicine, focussed on the intersection of conventional and natural evidence-based medicine and therapeutics and she has studied herbal medicine and meditation extensively throughout India and south east Asia with traditional teachers, mind-body medicine at Harvard, neurofeedback brain training and EEG brain imaging techniques with leaders in the field in North America.

Here, she speaks to Health Europa Quarterly about her extensive background in cannabis medicine, patient experience, and the representation of women in the rapidly evolving industry.

I am medical doctor and Im trained in both integrative medicine, which is natural evidence-based medicine and a recognised speciality. I am also trained in family medicine in Canada, and I specialise specifically in herbal medicine, cannabinoid medicine as part of my integrative medicine practice.

I have been practising integrative medicine for the last decade in Canada and that is mostly what I do in my clinical practice. Around four years ago, I started experimenting with medical cannabis and I have been running a complex chronic disease clinic with a focus on medical cannabis for the last four years in Canada; at this point I have treated thousands of patients using medical cannabis and CBD.

I have also trained medical students, physicians and allied health care providers on how to use cannabis medicine. I am a writer, and I speak worldwide on cannabis medicine and other natural evidence-based medicine topics and integrative medicine. Last year I relocated back to the UK where Im also a citizen to get involved on this side of the pond.

Since that time, Ive been involved in quite a few major projects here, I advise on some of the high profile child epilepsy cases, and Im the vice chair of the Medical Cannabis Clinicians Society. I advise companies and I have overseen training the first group of UK specialist doctors in cannabis medicine along with overseeing the curriculum for the Academy of Medical Cannabis, which is the main body established to educate physicians and researchers on medical cannabis.

Integrative medicine is a subspecialty which started out in the States. I already had my postdoctoral fellowship and you already need to be a doctor to take the fellowship programme. Its a two-year fellowship which I completed in 2012 in the US, and the reason I decided to do it is because I was practising as a holistic medical doctor in Canada. I was already a conventionally trained medical doctor with the qualifications I had, but I wanted to add to my practice natural things such as herbal medicine, mindfulness-based stress reduction techniques and mind- body techniques for the benefit of my chronic disease patients.

I went to the states and completed this training in 2012, because there was no postdoctoral level training in natural medicine and I really wanted to have the most bona fide qualification. Since 2012, it has now become a fully recognised speciality in medicine in the US. Initially I wasnt interested in integrative medicine when I started my practice in 2009 as a family doctor helping people with chronic disease was my main interest. I realised that just using pharmaceutical drugs alone for complex chronic diseases, were not really cutting the mustard so to speak. It just wasnt really working very well for a lot of my patients with anxiety, stress related disorders, mental health conditions, fibromyalgia, chronic fatigue syndrome, chronic pain and sleeping problems. Pharmaceutical drugs were just not helping enough on their own.

I became interested in cannabis specifically in 2015. At that time, I had been practising with herbal medicines and conventional drugs for almost half a decade. A lot of my patients started to tell me about their experiences with using cannabis therapeutically because I practised herbal medicine as well as the conventional kind.

I was really interested in the things they were doing, for example some of my patients were juicing cannabis in its raw form and saying that it didnt make them feel high. They explained that it was really a health supplement that their parents generation had been using it in West coast Canada where a lot of people grow cannabis on their land. That got me really interested in why they were juicing it and not getting high and what was what was happening with this plant; as a herbalist I became very intrigued.

I also had a few patients who were at the end of their life with terrible cancers and they told me how they were taking homemade cannabis tinctures to help reduce their morphine needs so that they could be more aware and alert. It allowed them to manage their pain, experience better quality of life and spend more time with their families in their final days.

I started to investigate it from there to find out how I could introduce it into my practice, so people wouldnt need to experiment with it alone and in isolation. I sought out additional training in cannabis medicine, and just found a few mentors but back in 2015, there really wasnt that much awareness. I started opening my door to cannabis medicine being included in my practice through the Health Canada legal system and I just started learning hand in hand with my patients. I was reading all the latest research and working with the plant just as I did with all my other herbal medicine practise. I started to see all these incredible changes in my patients so that really spurred me on to continue.

When I first started out in cannabis medicine, I was actually quite sceptical because I had a lot of ingrained training from medical school that cannabis was an addictive drug that it was going to make people lazy, hurt their brains and make them more tired.

What I found was the patients who were in orphan disease categories with conditions such as fibromyalgia, chronic fatigue syndrome, chronic anxiety and chronic depression, chronic pain were improving when nothing else we had tried previously was really effective. When I started to study the endocannabinoid system, which is the cannabis system we have in our own bodies It made sense because essentially the cannabis plant regulates our own cannabis system which is involved in processes such as regulating our mood and pain signals.

We [doctors and researchers specialising in cannabis medicine] think that a deficient endocannabinoid system also known as Endocannabinoid Deficiency Syndrome theory may play a role in all of these overlapping symptom clusters that are very, very difficult to treat. Conditions such as irritable bowel syndrome, fibromyalgia, chronic daily headaches, chronic migraine, chronic depression and anxiety all these issues sometimes improve using traditional drugs, but it usually doesnt provide a good solution with few side effects.

What I started to do with cannabis is adding in different forms of cannabis medicines primarily the low THC and high CBD strains of the plant and then selecting different strains of the plant more specifically. I found with my background as a herbalist I was able to really personalise the therapy.

With many of my patients who suffered from chronic mental health conditions, I really wanted to get them practising something called Mindfulness Based Stress Reduction (MBSR) which I went to Harvard to study alongside some of the top researchers in the world. I really believe in it; however, it is not a quick fix. Unfortunately, people with chronic pain and chronic mental health conditions are often so poorly that they cant summon the mental effort to keep the practise going long enough for it to start working.

Once I got them onto cannabis, even the low THC cannabis which did not make them feel high, I started to get them to use it before their mindfulness or meditation practise. I found that they started to do more mindfulness and from there they started to exercise more because they werent fatigued. Many patients started to lose weight and become more social; it was kind of a snowball effect that allowed them to do a lot of other things. It allowed them to engage with a lot of non-drug therapies such as CBT that they couldnt engage with before because they were too ill.

I think its been enormously important to the patient experience and I have to say that it has reinvigorated my love of medicine in many ways. It is the kind of medicine that is very well tolerated by most people and helps them with their quality of life so greatly, even though it doesnt cure their condition.

We dont know that cannabis cant cure things and maybe one day we can figure that out, but for now its about quality of life. It has changed my patients lives in ways I could never imagine. Nobody Ive ever prescribed an antidepressant to has ever said to me this has changed my life, but daily and weekly in my practice, I get letters from patients and verbal testimonials that starting them on cannabis has saved their marriage, or completely changed the relationship they have with their children because they can engage with their family life again.

I have seen patients who were so debilitated by very advanced arthritis that they couldnt work or play music anymore and they are able to go back to those things. I had one patient who surprised me with a concert; he hadnt played in 10 years and he was very depressed because his hands were so painful.

I have seen ranchers who live out in the middle of the countryside in Alberta who couldnt get on their horse anymore to round up their cattle and when I did a follow up consultation via a video app, they took me with them on a ranch ride for the first time in five years. It had been five years since theyd been on the horse.

Ive treated young adults with epilepsy who had been told that they would never be independent and that they were going to be in a care home for the rest of their lives, and seen them be able to go to a part time job and get an animal to keep them company these things were not possible before. It changes the whole familys lives not just the person with epilepsy. As far as a single thing I can give someone, although its not a cure it has been the single most powerful tool that I have found so far since going from a Western medicine doctor to a herbal medicine doctor.

One of the things that I get very excited about is changing the perception of cannabis because I think the old perception of cannabis was this kind of stoner culture. On the recreational side of cannabis, which is very different to the medical side. Its not a very wholesome image.

The images that were portrayed of women were often women in bikinis smoking cannabis which are not necessarily positive images of women in general and definitely not the image of cannabis the medicine as I practise it. I feel very lucky to be involved in kind of seeing the transformation of the image of the plant because a hundred years ago, it was a perfectly respectable botanical medicine and its coming full circle back to that.

I feel that women have played a large role in that to be honest, and really introducing a balanced movement into the modern era. It isnt just me, there is Hannahs Deacon, Alfies mother and Charlie Caldwell these are the women who have had kids with epilepsy and have had to fight for access to the treatment. Carly Barton is a good friend of mine and a patient advocate. I have needed and developed a network of women and through social media many of them have become my friends. I think it has been a powerful tool for connecting and empowering women.

One thing that you do find when you enter the business side of the cannabis world is a lot of the people may have come from a traditionally male dominated industry. Often, when I go to give a talk, I will be one of the only women there, but I do feel that is already changing. It is certainly the case that as with many male dominated, corporate professions, women are generally underrepresented which is something needs to be taken seriously; we might potentially have to work harder than men.

Dr Dani GordonIntegrative Medicine Specialistdrdanigordon.com

Please note, this article appeared in issue 11 ofHealth Europa Quarterly, which is available to read now.

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Cannabis and integrative medicine in Canada - Health Europa

I wont sugar coat it. Fighting breast cancer with chemo is a nightmare.

After three infusions, Ive grown accustomed to the weekend fatigue that will barely allow me to leave my couch. On infamous Chemo Day 3, after being up all night with aimless energy and a racing mind, I literally feel like Im going crazy, as if Im a stained-glass window thats been shattered and I cant quite figure out how to put the pieces back. The doctors refer to this symptom as steroid induced psychosis. Im trembling, dizzy and dropping things. My spirit and joy for life are almost non-existent as I generally feel flat-lined emotionally. Being nauseous and rapidly going bald round out the experience. You get the picture.

On a positive note, my pain remains in check after a fear-inducing first week. With my initial infusion came a CRPS-like symptom known as myalgia. For several days my legs would get unbearably achy before amping to up-all-night, think-Im-gonna-die pain. Terrified, I made an emergency appointment with my integrative doctor and Dr. Taws reassuring nature and acupuncture treatment calmed my mind and body. As always, integrative medicine is my best healer and my new chemo-induced pain symptom is gone.

Cynthia Toussaint

Im happy to report that despite the trauma of chemo, all is progressing well. That being said, Im certain that Im suffering far more than need be due to the over-care of western medicine. This has always been my complaint with pain care and now with cancer treatment, its the same damn thing. Truth be told, I think western medicines doing the cancer thing completely backassward. Theyre making us patients suffer far more than necessary. Its called over-care and its all about the blessed buck.

I got the first whiff of profit-motive after I had my port surgery (an implantable device that provides a direct line to the artery) a procedure that blew up my CRPS so badly I strongly considered not following through with the chemo. After somehow surviving six days of hell, my infusion nurse on intake asked me why on earth I had a port. For these drugs, Cynthia, we just go through the arm. Stunned, I asked my doctor if this was true as hed told me the port was non-negotiable. Chagrined, Dr. Lewis admitted to the deceit, but with the rationale the port is much easier for access. Sadly, my port isnt working well, needing multiple flushings to clear it. And it may stop working altogether.

Another big money maker for this healthcare system happened when I arrived for my first infusion. After doctor appointments, procedures and preps, a nurse casually mentioned theyd forgotten to do a kidney work up and wouldnt be able to start that day. I got the sense that this kind of screw up wasnt uncommon. All I could think about was how much money theyd just made off of me and absolutely nothing got done.

And then there are the many expensive, unnecessary drugs. Before each infusion I get zonked with enough meds to kill a small donkey. In fact its the steroid and Benadryl delivered by IV that make me most miserable through the week. These drugs are supposedly given to fend off an allergic reaction to the chemo. But when no reaction happens, Dr. Lewis keeps me at the same levels. Angry and suffering, I pushed him to lower both doses and allow me to take them orally. He finally acquiesced, and the crazies have tempered. Next round, Ill be pushing hard to go down all the way. Far fewer bucks in their pocket, but, thankfully, far less suffering for me.

Another suspicious money maker is the plethora of anti-nausea meds theyre plying me with. One, aprepitant, is doing the job, probably too well, at almost $3000 a pop. When I talked to Dr. Lewis about having so little nausea Hey, can we go down?- rather than decreasing the aprepitant, he pushed me to take preventative anti-nauseas through the week. Again, hes medicating a symptom thats not plaguing me. Oddly when I told him that I wasnt taking the additional Rxs, he refused to remove them from my records. Think about it. Data gleaned from my chart will help sell drugs that Im not taking, but are deemed successful.

On the integrative front, its just not happening with my infusion center, one known for this progressive care approach. Dr. Lewis is kind and smart, but to my disappointment, he basically dismissed my plan to exercise, work, eat a cancer fighting diet, meditate, get sleep, etc. to enhance chemo efficacy. He applauded my motivation, but has never followed up. When I asked about his experience using acupuncture for cancer patients, he mentioned knowing a doctor in med school once who had tried it. Frankly, I was stunned at his ignorance.

At the infusion center, its more of the same. I find it nonsensical that the nurses want fitness tips from me, the patient and, in fact, Im helping several of them with their exercise and diet. Then when I was offered a snack, an assortment of chips and soft drinks, they almost did a double-take when I politely declined their junk food, asking for fruits and nuts instead. Still, Im bonding with these super nice women who seem genuinely pleased that I question my doctors and have taken the leadership role of my care.

Due to my CRPS, I educated myself for six months before choosing which cancer treatments to take, with whom and where. At Dr. Taws strong suggestion, Im going low and slow with the chemo. Instead of getting a big blast every three weeks which is the traditional method, I do a third of a dose weekly. This regimen affords me fewer side effects with far more efficacy. And perhaps more importantly, it greatly lowers the chance of me getting more high-impact pain in the way of neuropathy and bone pain. I feel in control or, at least, Im getting there. I feel empowered.

I thought cancer care, because of its advanced standing as a measurable disease and mountain-high level of funding, would be light years ahead of pain treatment. But I couldnt have been more wrong. In fact Im more aware than ever, that out of necessity we women in pain have had to find our own outside-the-box pain remedies, and these inventive, integrative strategies lead to healing and well-being. My 37+ years of being a critically-thinking pain warrior are serving me beautifully with cancer. More to the point, they could be saving my life.

With every new diagnosis, we must avoid panic, follow our guts, get educated, ask questions, choose our health care practitioners with utmost care and trust and, most importantly, take responsibility for our own wellness.

Spoiler Alert: By finding chemo my way, a miracle has happened. Ill share the good news in my next post

See the rest here:
Finding Chemo - National Pain Report

The phones screen turns a serene blue, and Calm, the leading mindfulness application, opens. At the very center, without capitalization or punctuation, small and faint, are the words take a deep breath.

That gives way to a menu. What brings you to Calm?

The app offers options to reduce anxiety, develop gratitude, build self esteem, even increase happiness.

The next screen offers a seven-day free trial. Once the trial has ended, the annual rate is $69.99, a small price for happiness.

Somewhere around 2010, according to experts and Google search data, the practice of mindfulness began an upward swing. In less than a decade, it has become the fastest-growing health trend in the United States, according to the federal Centers for Disease Control and Prevention. Mindfulness rules the online app store. The San Francisco-based Calm is valued at $1 billion, and its competitor Headspace at $350 million. (The industry as a whole has been estimated to be worth as much as $4 billion.) Meditation retreats are en vogue. Corporations offer access to mindfulness in the same way they do for gyms. Even the military uses mindfulness breathing techniques to boost soldiers performance.

But as with any Next Big Thing, there are reasons to be cautious. Some say this rush into mindfulness has outpaced the science and stripped it of its cultural context. All of this threatens to turn a tool for well-being, for situating oneself in the current moment, into a tool for standard American commercialism.

Around the same time mindfulness began its upward trajectory, Ronald Purser, a management professor at San Francisco State University, started to feel the familiar weight of doubt. Hed been doing a fair amount of corporate management training and consulting redesigning the workplace to work better, at least in theory, for everybody. I became somewhat disillusioned and disenchanted, he says. Even when we were making progress, trying to redesign work so employees would have more autonomy and decision-making, the management sort of pulled the plug on some of those experiments.

It was around this time, too, that Chade-Meng Tan, a software engineer at Google, gained notoriety for integrating mindfulness into Googles corporate culture through a series of in-house mindfulness seminars. In 2012, Tan turned those courses into a blockbuster book, Search Inside Yourself: The Unexpected Path to Achieving Success, Happiness (and World Peace), and Purser found himself attending Tans very first public offering.

I became very disappointed by what I saw, just in terms of what the program was and how superficial it was, Purser says. I just saw this as part of the interest in behavioral science techniques as a way of yoking the interest or subjectivity of employees to corporate goals.

A year later, Purser published an essay with the Huffington Post. It was titled Beyond McMindfulness. Mindfulness meditation, he wrote, was making its way into schools, corporations, prisons, and government agencies including the U.S. military. Purser, a student of mindfulness for 40 years, wasnt knocking the practice but was wary of its growing reputation as a universal panacea for resolving almost every area of daily concern. Last year, Purser expanded on the essay and published a book titled McMindfulness: How Mindfulness Became the New Capitalist Spirituality.

Early on in his book, he writes this: I do not question the value of adapting mindfulness for therapeutic use, nor do I deny that it can help people. What bothers me is how its promoters want things both ways: one minute, mindfulness is science, since thats what sells; the next, it stands for everything in Buddhism, since thats what makes it sound deep.

The issues Purser called out eight years ago have only grown with time. Rhetoric, he says, still outpaces results. The practice becomes increasingly decontextualized, meme-ified and gamified. Mindfulness becomes a cure for more and more our happiness, our anxiety, our pain, even world peace.

Its worth pausing a moment to define or at least try to define mindfulness.

At its very core, its deepest and truest roots, mindfulness is a Buddhist meditation technique. There are hundreds, probably thousands of different meditative techniques. This is only one of them, says Mushim Ikeda, a Buddhist meditation teacher. Traditionally, in the Buddhist scriptures, it is said that what we call mindfulness meditation was one of 40 different techniques that the historical Buddha, the one we call the Buddha, talked about. So it wasnt even his one and only meditation technique according to those scriptures.

She knows those scriptures well. Ikeda, who primarily teaches at the East Bay Meditation Center, describes herself as a socially engaged teacher a social justice activist, author, and diversity and inclusion facilitator.

She describes mindfulness meditation as a secular term in Buddhism, one thats also called insight meditation. This is a sort of awareness, she says, that is different from the awareness that we might call everyday awareness the sort we need to drive a car, or maintain a conversation, or use an ATM. She and others describe mindful awareness as spacious and nonjudgmental. Ikeda says, Its been said mindfulness only sees. It does not judge.

The most common technique involves closing the eyes and focusing on the breath and only the breath, moving other thoughts, and the thoughts that come with those thoughts, away and out.

Mindfulness as a secular, western therapeutic intervention did not begin in Silicon Valley. Rather, youd have to go back to 1979 and a man named Jon Kabat-Zinn and the founding of the Stress Reduction Clinic at the University of Massachusetts Medical School. Kabat-Zinn has studied the effects of what he dubbed mindfulness-based stress reduction (MBSR for short), on everything from brain function to skin disease.

Still, its hard to ignore Silicon Valleys latest role in spreading and expanding mindfulness in the pursuit of a different tech culture value, peak performance. There is Search Inside Yourself, the book that coincided with the movements growth spurt. There are Twitter co-founder Jack Dorseys much-publicized meditation retreats. (Black Mirror, the dystopian science fiction show, seemed to parody both him and the now-ubiquitous apps.) Recently, there was the dopamine fast, a pseudo-scientific dopamine reset by way of doing nothing. (One originator said he drew directly from Buddhist Vipassana meditation when he crafted the fast.)

The voices are soothing and smooth soft, but not quite a whisper. The cadence and diction perfect, gently pulling you along. Birds chatter in the background. Waves move gently to meet a beach. Or maybe a brook babbles as it pushes over and under and between river rocks.

Breathing in ... I am calm.

Breathing out ... I am at peace.

A chime rings, a signal that this 90-second meditation to calm anger has ended. Calm offers its congratulations.

The danger in this rapid evolution is that it threatens to turn a very old practice into a fad that overpromises and underdelivers.

Helen Weng has practiced Buddhist meditation for more than two decades. I was reading a lot of books about psychology because I was unhappy because high school is horrible, she says. And her father, who, along with her mother, had immigrated to the United States from Taiwan, could offer her books about Buddhist philosophy. The two came together. The Dalai Lamas teachings offered her an opportunity to cultivate her own well-being. I dont like the word happiness anymore, but you can use mental exercises to become more aware of your feeling states and your thoughts.

Now Weng works as a clinical psychologist with the psychiatry department at UCSF and a neuroscientist with the Osher Center for Integrative Medicine and the Neuroscape Center, both at UCSF as well. Her scientific work uses magnetic resonance imaging to measure the amount of oxygen in the blood that flows to the brain as people meditate. Essentially, she can track whether the meditator is actually focused on their breath or if their attention has wandered. And in her clinical work, she offers meditation as one of many possible therapeutic interventions.

Still, she calls the recent spread of mindfulness very freaky.

Im very proud that practices from eastern cultures and religions generate so much interest, she says. At the same time, mindfulness and its results are super hard to study. So much so that I just thought I was a bad scientist for a long time. Whats more, she says, meditation isnt always the right sort of behavioral therapy.

Im very disturbed by these messages that meditation basically cures everything or its good for everyone or theres universally very good positive effects. The effects are really moderate and subtle. Its not any better than any other kind of psychotherapy, she says. Part of it is cultural appropriation where its this magical, mystical thing that then people can say does all these things, and I think were still in the height of that and its going to take some time for things to settle down.

Medical students, she says, inevitably ask her how much time they have to commit to mindfulness to make it work. There are studies that show clear benefits to mindfulness. Weng points to one that indicated 30 minutes a day of compassion meditation for two weeks increased altruistic giving to strangers and brain responses to pictures of people suffering.

But the key here is consistency. What happens if you work out for 30 minutes just once? she asks. It benefits you a little bit. Thats good. But if you just do it once, its not going to have a long-term effect.

After the chime and the congratulations, the waves keep moving in and out, and a quote appears onscreen. Insanity is doing the same thing over and over again expecting different results. (A quote sometimes attributed to Albert Einstein, but probably more correctly attributed to Narcotics Anonymous.) And in that moment, Calm reminds you that you really should turn on push notifications, in order to fully experience Calm. Decline and itll ask one more time about its mindfulness reminders.

Are you sure? Its hard to set aside time for yourself in our busy world without a little help.

Farrah Fawcett and Lee Majors are jogging. Theyre tan, of course. Their shorts are short. Her blond hair is fanned out, so are his brown curls. She has a broad, blindingly white smile and a red handkerchief tied around her neck. His jacket is zipped down almost to his navel; his chest is hairy. And right beside them, a headline: Farrah & Lee & Everybodys Doing It: Stars Join The Jogging Craze.

This is the cover of the July 4, 1977, issue of People magazine. Alex Will, the chief strategy officer for Calm, the industry-leading mindfulness meditation app, likes to reference this cover when he talks about mindfulness. (Theres even a copy of the issue at the office.) To understand the future of mindfulness, just look to the past.

Mindfulness is becoming mainstream, Will says. People are starting to understand that taking care of the mind is just as important as taking care of the body. Meditation and mindfulness is one way to do that.

In some respects, Calm isnt doing anything that hasnt already been done. Before smartphones, one could buy a meditation CD, slip it into a home stereo and start counting breaths. The app just makes it more portable and more accessible than ever before. I think one of the reasons Ive been so successful is that it is a very low bar for someone to try and get into, Will says. There are short, two-minute long meditations, narrations to help with sleep, even a beginners guide to mindfulness. Similarly, if you want to go deeper, we have a 30-minute master class where you can learn how to break bad habits.

All of the content, Will says, is vetted by mindfulness instructors, and, now that the app is available in more than 100 countries, the programming is also run by people to make sure translations work. This is very nuanced, he says. Language really matters. The Calm app has also been part of various clinical studies in an attempt to back up the applications rhetoric.

Mindfulness, by the way, has already had its magazine-cover moment. Not quite 37 years after the jogging craze, Time magazine featured the Mindfulness Revolution on its Feb. 3, 2014, issue. A blond, fair-skinned model stands straight, hands at her sides, eyes closed, face slightly upward. And the headline: The science of finding focus in a stressed-out multitasking culture.

Mindfulness began to trend in large part because corporations embraced the practice as a way to help employees relieve stress. This is one of the cruxes of Pursers concerns that mindfulness is just a way to wring more productivity from employees, a sleight of hand that shifts the onus from the company to the worker.

In 2012, the year Chade-Meng Tan published Search Inside Yourself, the idea of offering mindfulness courses to employees still felt novel. The New York Times featured Tan and the course hed developed for Google employees a course that involved meditation, Tibetan brass bowls, stream-of-consciousness journaling and lots of emotional openness. Even then the course was framed as a way to help employees deal with their intense workplace no mention of toning down the intensity.

Eight years later, mindfulness courses are the rule, not the exception. Apple, Nike, HBO and Target have all offered some form of mindfulness training to employees. Aetna, the insurance provider, decided to offer mindfulness and other stress-relief activities (including dog petting) after an internal study found that the most stressed-out employees spent $1,500 more a year on health care. And if a company cant bring a trained expert on board, well, they can always give employees memberships to Calm or Headspace.

The Buddha taught that almost everything comes and goes, says Muslim Ikeda, the East Bay Meditation Center instructor. Its called impermanence or change. And health trends famously come and go. Its a product of our capitalist system.

One year, its a certain kind of berry thats going to cure everything. Another year, its mindfulness meditation thats going to cure everything. Five years from now, heaven only knows, itll be something else. Burnt toast who knows?

Ikeda offers a path forward, a path separate from capitalism, a path that encourages students to cultivate a practice in which they care for themselves so that they may, in turn, care for their communities. Its an approach based in social justice and altruism. And yet, she isnt dogmatic.

Mindfulness, Ikeda says, does not judge.

A person might use mindfulness to lower their blood pressure or achieve peak performance. A corporation might use mindfulness to paper over an inherently unjust and healthy system. All this, she says, is like using a Swiss Army knife for just one thing. Its not what the tool was intended to do, and its not all it can do.

Mindfulness is always mindful awareness of something, Ikeda says. Who knows what a given individual is going to do with it? Or what it will do for them?

An individual might, for instance, become mindfully aware of a broken system.

Ryan Kost is a San Francisco Chronicle staff writer. Email: rkost@sfchronicle.com. Twitter: @RyanKost

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The (over) promise of the mindfulness revolution - San Francisco Chronicle

The diagnosis of cancer can turn your life upside down in a matter of minutes.

It is a life-altering experience that can be a cause for a lot of stress on the individual who received the diagnosis, as well as family members and caretakers. There are many things to think about when the diagnosis is made, including whether or not youll need to continue working throughout your treatment.

Holistic therapies can aid in the reduction of stress and ease the side effects of treatment if having to work while going through cancer.

Having cancer does not necessarily mean that you will have to stop working. Most likely you will need time off for appointments, treatments or extra rest. You might decide to work as much as possible or take a leave of absence and return when you feel up to it. Or you might have to continue to work for financial reasons and/or health insurance benefits.

One benefit of working while going through cancer is that going to work can help you feel more normal.

If you decide to continue working, it could take some adjusting. Your body might respond differently to normal activities when you have cancer or are going through treatment. You might feel tired, more stressed, have pain or difficulty thinking or remembering things.

Something to consider during this trying time are the benefits of integrative health. Integrative health is the unity of conventional and holistic medicine. It is a healing-oriented model that considers the whole person body, mind, spirit and lifestyle. It uses all appropriate therapies, both conventional and alternative, and focuses on the needs, values and well-being of the person.

Here are some holistic measures to help reduce stress and side effects of treatment:

Conserve energy. Take short breaks as needed throughout your workday to keep your energy up.

Be mindful of your innermost desires and acclimate optimism into your daily thoughts. Take time for yourself to reflect, soul search and nourish the soul. A positive mental attitude during this trying time can help heal the body and reduce stress.

Consider meditation practices. Meditation clears space in your head. Apps such as Insight Timer and Headspace are great places to start.

Use reminder lists and alarms to remember your meetings or tasks. Write a list of tasks that need to be completed for the day. A daily planner, Post-it Notes or use of a smartphone might be helpful tools. Set alarms to help remind you of the tasks that need to be accomplished.

Be open and honest about your situation. Talk with your manager about any concerns. Share your feelings and concerns with your family members and health care team.

Fuel your body with good nutrition. This will help to provide optimal energy throughout the day. A dietitian with experience in oncology nutrition can help you develop a plan.

Consider using essential oils. Aromatherapy can help ease anxiety, pain and nausea symptoms. A clinical aromatherapist can help guide you on which essential oils would be beneficial.

It is important to know your rights. Side effects of cancer treatment are considered disabilities under the American Disabilities Act. Your employer must provide reasonable accommodations according to the American Society of Clinical Oncology. These can include:

Giving you breaks to take medication, see a doctor or rest.

Having you do a job that fits your new hours or abilities better.

Giving you access to counseling through an employee assistance program.

Please remember, you are not in this alone. We live in a wonderful community where people care and want to help in any way they can. Seek out services offered by the community. There are many support groups and valuable resources available to help you and your loved ones through this healing journey.

Jessica Kennedy, BSN, RN, CHC, CMSRN, Jessica is a nurse at MercyOne Dubuque Medical Center.

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Continuing to work while going through cancer treatment? These tips can help - telegraphherald.com

Facebook/PoliceMelissa Smith is accused of murder in the fatal shooting of her husband, Red Bank Police Officer James "Chip" Smith, in Tennessee.

Melissa Smith is a 37-year-old Tennessee woman who has been charged with first-degree murder after police say she shot and killed her husband, Red Bank Police Officer James Smith, during an argument in a parking lot in the Kodak community of Sevierville, Tennessee. James Smith, 41, who went by Chip Smith, was shot in the abdomen about 7:20 p.m. on Saturday, February 2, 2020, and later died at a nearby hospital, the Sevierville Police Department said.

The Red Bank Police Department said in a statement, Our thoughts and prayers go out to Officer Smiths family during this difficult time. Officer Smith has many years of law enforcement service. He honorably and faithfully served this agency and community. We want to take this opportunity to ask for everyones support during this very difficult time. Please keep his family, friends and fellow law enforcement family in your thoughts and prayers.

The Sevierville Police Department said officers responded to a shooting at 3099 Winfield Dunn Parkway, a highway rest stop and visitors center, at 7:23 p.m. on Saturday. The officers found an adult male suffering from a gunshot wound to the abdomen. He was taken to University of Tennessee Medical Center by the Sevier County Ambulance Service and was pronounced dead, police said. Police said a handgun was recovered at the scene and Melissa Smith was taken into custody.

Heres what you need to know about Melissa Smith and the fatal shooting of Red Bank Police Officer James Chip Smith:

Melissa Smith and James Smith.

Melissa Smith told police she was with her husband at the Old Tennessee Distillery Company for about two hours before the argument and shooting occurred and they had been drinking, according to court documents obtained by the Chattanooga Times Free Press. The newspaper reports that officers found Melissa Smith kneeling next to her husband with her hand on his abdomen after the shooting.

Melissa Smith told police she and her husband began arguing in the car after they left the distillery, and James Smith pulled into a parking lot as it escalated, the Times Free Press reported.

The two exited the vehicle and continued to argue until Melissa Smith went back to the vehicle, grabbed a pistol and shot James Smith, the newspaper wrote, citing court documents. Melissa Smith admitted to shooting James Smith with the pistol, according to court records. A .380 semi-automatic pistol was found at the scene.

Melissa Smith and James Chip Smith had been married since August 17, 2002, according to Melissas Facebook page.

The couple has a 14-year-old son together, according to Melissa Smiths Facebook page. They live in Soddy-Daisy.

FacebookMelissa and James Smith.

Chip Smith was arrested on domestic violence charges in 2007 while he was a detective with the Soddy-Daisy Police Department, according to an article in The Chattanoogan from the time.

According to a complaint obtained by The Chattanoogan, James Smith and his wife got into an argument that led to a physical confrontation. Police said Melissa Smith confronted her husband on a marital issue and he grabbed her and threw her across a bed onto their child, the news site reported.

Mrs. Smith said her husband was on top of her and began strangling her with his hands around her neck. She said they began screaming and hitting each other, the news site wrote. Mrs. Smith said she ran into another room and called 911 on her cell phone. She said her husband grabbed the phone from her and hung it up. She said he pushed her down on a couch, but she was able to get away. Officers said they saw injuries to the right side of Mrs. Smiths neck as well as injuries on her left arm.

The case was dismissed in January 2008.

Melissa Marlow Smith works at CHI Memorial Integrative Medicine Associates, a family medical practice in Chattanooga, according to her Facebook profile. It is not clear what her job at the medical practice is.

According to her Facebook page, she was born and raised in Soddy-Daisy, Tennessee, and graduated from Soddy-Daisy High School in 2000, two years before she and Chip Smith married.

Chip Smith is also from Soddy-Daisy, Tennessee, and graduated from Chattanooga State Community College, according to his Facebook page.

The Red Bank Police Department said in a statement posted to Facebook about the death of James Smith that they, lost an outstanding officer and friend yesterday.

James Chip Smith and his son.

The department said, He also served several other law enforcement agencies and communities including the Soddy-Daisy Police Department and Chattanooga Police Department. As a law enforcement officer, he devoted himself to protecting the citizens of these communities. For those that ever met him or know him, they know that he was kind and always willing to do anything to help you. His loss will leave a void at our agency and the law enforcement community.

Chattanooga Police told the Times Free Press, they are ready to provide any patrol or special coverage needed by Red Bank Police Department as they grieve the loss of their officer and friend.

The Hamilton County Sheriffs Office said in a statement, We are saddened by the loss of a fellow officer in such tragic circumstances. Our hearts go out to Chief Seymour and our brothers in blue at the Red Bank Police Department during this very difficult time. Chip has served his community for many years as both a volunteer fireman and law enforcement officer. He will be greatly missed by all who knew him.

On Facebook, the Hamilton County Emergency Medical Service wrote, Chip was both an on duty and off duty friend to many of us here at HCEMS, and we are devastated by the news of his death. Chip was also a well known individual in the Soddy Daisy community, and he will be mourned by many. Godspeed Brother.

Melissa Smith is being held at the Sevier County Jail, according to police. Smith was booked into the jail at 1 a.m. on February 2. She was charged with first-degree murder and carrying a weapon while under the influence, according to online jail records.

She is being held in $1 million bail and has a March 2 court date scheduled on the weapon charge and a March 20 court date on the murder charge. It is not clear if she has appeared before a judge already.

Smith could not be reached for comment by Heavy and it is not known if she has hired an attorney who could speak on her behalf.

The Sevierville Police Department said in a statement, The investigation is ongoing and no additional information is available at this time.

READ NEXT: Recent College Grad Shot Dead While Driving with Boyfriend

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Melissa Smith: 5 Fast Facts You Need to Know - Heavy.com

Personalized medicine has taken a big step forward with the launch of non-profit n-Lorem Foundation, which will create patient-tailored antisense oligonucleotide (ASO) therapeutics for people with rare diseases at no cost to the patients. This comes at the same time as custom gene therapies for rare disease patients are being developed, including some combined with CRISPR. As a result, more peopleeven those with ultra-rare diseasescould finally have access to treatments.

The process of developing these treatments is still burdensome and expensive. Only a few patients will benefit at first. But this concept has only been a dream until now, with most of these patients being completely shut out of the typical drug development process. Whats more, the scientists and sponsors pioneering these approaches are hoping to create blueprints for the treatment of ultra-rare diseases in general.

One of the goals is to create a replicable protocol, said Simon Frost, the father of Annabel Frost, a child who suffers from the ultra-rare disease alternating hemiplegia of childhood (AHC). We want to do it for our disease, and then take that process and give it to more patients across many more diseases. Frost, who is CEO of Tiber Capital Group, has been in discussions with multiple labs and investigating several approaches, including ASOs, gene editing, and gene therapy.

The blueprint for the ASO-based approach was a made-to-order treatment for a child with Battens disease, a rare neurodegenerative disorder. In 2018, Timothy Yu, a doctor at Boston Childrens Hospital, sequenced the genome in then six-year-old Mila to diagnose the condition. It turned out Mila had a retrotransposon which had inserted into her CLN7 gene. That aberration was blocking normal protein production by that gene.

Yus team then created a tailor-made ASO, which they called milasen, to mask the mutation in Milas genome, as detailed last year in the New England Journal of Medicine. It took about one year from sequencing to delivery of the therapy. Then, nine months after her treatment began, Milas doctors reported being hopeful about her prognosis, although they noted that she may already have experienced substantial effects from the disease. Hundreds of people, including parents and researchers, have since reached out to Yu to try and have this process replicated. Yus lab is reportedly developing several more personalized oligos, including ones for a rare form of epilepsy and ataxia-telangiectasia, which is a neurological disease.

Addressing the challenges

The demand for more custom ASOs is intense. But there are many issues standing in the way of such therapies.

ASOs are at the point where the investment in the technology has paid off commercially, said Art Krieg, an expert in oligonucleotide therapeutics as well as founder and chief scientific officer of Checkmate Pharmaceuticals. And now Tim Yu has shown the process for making customized ASOs. The questions is whether you can standardize that and could companies find it profitable to develop those therapies. Further, ASOs only block mutations and need to be given for life.

n-Lorem is funded with $1.5 million from Ionis (formerly Isis) Pharmaceuticals, another $1.5 million from Ioniss founder and former CEO Stanley Crooke and his wife Rosanne Crooke (a researcher at Ionis), $1 million from Biogen, and additional funds from other donors. Crooke started Ionis in 1989, as a pioneer in RNA-targeted therapeutics. Today, the company has three drugs on the market and more than 30 in development for a wide range of conditions. Biogen is partnered with Ionis on several of these.

Biogen declined to comment for this article, but sent this statement: Antisense oligonucleotides have been a game changer in the treatment of spinal muscular atrophy (SMA) and we believe they could hold promise in tackling other diseases. So, we are pleased to help support the establishment of n-Lorem Foundation and their mission to provide advanced, experimental RNA-targeted medicines free of charge to patients with ultra-rare diseases.

I knew we could do this and I knew there was a need, said Crooke, who started working on n-Lorem two years ago. But he also realized it was going to be challenging. The patients need a full genomic workup, and you need an investigator who can submit the IND and oversee it, he said. One major development that convinced Crooke the concept was feasible was the 2014 establishment of the Undiagnosed Diseases Network (UDN), a research study funded by the National Institutes of Health Common Fund. The UDN comprises clinical and research experts from across the U.S. who work to solve medical mysteries. As of 2019, 12 UDN clinical sites were open.

While UDN will be a key source of qualified patients, Crooke says n-Lorem will not be restricted to those. We announced the launch last week, and we already have six proposals for patients to treat. But patients need a confirmed genetic diagnosis and treating physicians. Then they must submit a proposal to treat to n-Lorems Access to Treatment Committee.

Another critical issue is the FDAs response. Crooke said he has already approached regulators and they are supportive. But n-of-1 trials like these raise special issues. In an editorial that accompanied the Yu teams report in NEJM, FDA regulators point out the many challenges to evaluating n-of-1 drugs what are the differences between treating one, ten, or thousands of patients? they asked.

But they also acknowledge that the field is moving ahead rapidly. Academic clinicianinvestigators now have the capacity to rapidly uncover specific mutations and pinpoint the putative mechanisms leading to certain rare disease phenotypes. Various ASOs or other compounds can be produced by third parties, and investigators can evaluate them using in vitro assays or animal models, the regulators wrote. FDA is holding a workshop in March on individualized therapies to try and advance thinking around this topic.

Ioniss long experience with ASOs should help in this regard. There are several generations, or classes, of ASOs that the company has developed over the last 30 years. Many years ago I began putting together integrative safety databases about the different classes of ASOs we have developed, Crooke says. Each class has generally similar properties, but they also have important differences such has ligands that work in different organs. Ionis has published on these databases and the properties they reveal, as well as providing the FDA access to the databases. That doesnt mean, however, that researchers will be able to predict all the effects of any ASO in any patient.

Finally, there is the question of cost, which is a particular boondoggle for rare diseases. We know this is feasible but we want to reduce the costs as far as we can, Crooke says. n-Lorem and Biogen are both already working on processes to further cut costs, But we will need to raise even more money to help more patients, he added. Patients shouldnt have to be on the internet raising funds for this.

While hes aware of the challenges, Crooke said hes feeling optimistic. Ive been overwhelmingly impressed with the commitment and advice weve gotten from physicians, experts on antisense and clinical trials,and others. He also hopes more modalities, besides ASOs will be able to work with n-Lorem and start similar endeavors. Im hopeful a gene therapy company can join us or do the same thing, he noted.

Gene therapy too

While there is nothing equal to n-Lorem yet, other researchers are already pursuing customized gene therapies, even for patients who have mutations that are very rare or that are not correctable with standardized gene therapy.

Monkol Lek, for example, is a geneticist at Yale who has been working on a gene therapy for a single patient with an ultra-rare mutation in a muscular dystrophy gene. There are more than 30 types of muscular dystrophy, and some are caused by mutations that affect different genes or varying sections within those genes. Lek himself has limb-girdle muscular dystrophy (MD). When he was first diagnosed, he remembers hearing over and over again that there were no treatments for his condition.

That was enough to inspire Lek to leave a career in IT while in his 20s and obtain degrees in physiology, bioinformatics, and genetics. Soon after he arrived at Yale in 2018, Lek met Rich Horgan, founder of the non-profit Cure Rare Disease, and whose younger brother Terry has a type of MD. Lek analyzed Terrys genomic data, and found he is missing the dystrophin genes promoter region, which needs to be activated in order for that protein to be made. Terry is also missing part of exon 1, which is also necessary to generate the production of dystrophin.

While they originally considered using ASOs, Rich Horgan and Lek realized that wasnt feasible because rather than needing to turn off a gene, they needed to turn on a gene, or at least its promoter.

One twist in this particular case is that people have two alternative versions, or isoforms, of this promoter and exon 1one set in muscle cells and another in brain cells. With that in mind, Lek is using a modified version of CRISPR called no-cut CRISPR to introduce a transcription activator attached to the Cas9 enzyme to turn on the brain-specific set, and thus make up for the deficit in muscle. He uses an AAV and CRISPR activation construct as well as guide RNA to direct the CRISPR to the right spot in the DNA.

Lek has already tested his putative therapy on Terrys cells and successfully corrected the mutated gene in the lab. Next, the treatment will be tested in mice. However, Lek is also exploring the possibility of an n-of-1 clinical trial in which the therapy would only be tested in Terry or anyone with his specific mutation.

Rich Horgans Cure Rare Disease group is now leading new projects for two boys with different forms of Duchenne MD as well as a patient with the limb girdle form of the disease.

Frost, meanwhile, is still investigating the best options for treating his daughter Annabel. His family has spent $250,000 so far and he expects it will cost another $250,000 to $500,000 to reach proof of concept. Annabels mutation is in ATP1A3, a gene that is associated with at least 12 different rare diseases (See table). However, Annabels specific mutation is very rare. Were not sure yet how many of these other conditions would be treated by the same transgene, but it could be a large proportion, Frost said.

Krieg noted that we are not yet at the point where any for profit company will want to develop n-of-1 therapies. It doesnt cost that much to manufacture DNA, and its a fully automated process, he said. It has taken billions of dollars already to get the technology this far and develop applications for some more common diseases. But the overall cost of lifetime treatment is still prohibitive. Right now, I dont know why any company would want to do this, he added. But there will come a time when there are the right incentives and someone will try it.

For families such as Annabel Frosts, these developments are still encouraging, and give them hope that they can help shape the future of the new field of n-of-1 therapeutics. This also supports the idea that more children should undergo whole genome sequencing as soon after birth as possible. With many rare diseases, the damage is compounded the longer the child is untreated. Further, greater understanding of how the full range of possible mutations in any gene impact health, and how that can be treated, will press the field forward.

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Dawn of the Customized Cure - Clinical OMICs News

Your thoughts make up your feelings. So, the amount of time you spend on a thought, be it happy or unhappy, is going to affect your feeling and mood. Feeding unhappy thoughts can make you unhappy. Unhappiness causes discomfort, which in the long run leads to diseases.

Staying happy is important to stay stress-free and disease-free

Some of the most common diseases like obesity, diabetes, PCOD and thyroid are related to poor lifestyle. A poor lifestyle is a combination of poor eating habits, lack of exercise, smoking, drinking alcohol regularly and irresponsibly, chronic stress, anxiety and lack of sleep. According to lifestyle coach Luke Coutinho, one thing which is common in people with lifestyle is unhappiness. Unhappiness, he says, is the major cause of most lifestyle-related diseases. It is important to understand that happiness is something which you cannot seek from outside or from someone else and should come from within.

As part of a live session on Facebook, Luke says that unhappiness causes discomfort. Too much of discomfort ultimately leads to development of a disease. "Unhappiness comes from unhappy thoughts. Your thoughts are everything," says Luke.

Do not unnecessarily feed unhappy thoughts as they can make you feel stressed and uncomfortablePhoto Credit: iStock

The idea is to understand that even one happy unhappy or negative thought can make you feel uncomfortable and stressed, and ultimately affect your health negatively.

Also read:Can Stress And Anxiety Cause Hair Loss? Know Types And Ways To Hair Fall

Your thoughts make up your feelings. So, the amount of time you spend on a thought, be it happy or unhappy, is going to affect your feeling and mood.

"You are going to experience both happy and unhappy, jealous or angry, positive or negative thoughts. What matters is how much attention you pay to each of these thoughts," Luke explains.

Happiness exists independently of circumstances and conditions. As mentioned above, it comes from within and is not dependent on anything or anyone. So, a boss' feedback, an increment letter or a perfect life partner are not factors that are going to make you happy.

Happiness cannot have conditions. Conditioning it with a certain amount of money or any other kind of gain is going to make you miserable and prone to diseases.

Do not seek happiness from something or someone else. Happiness comes from withinPhoto Credit: iStock

Also read:5 Worst Inflammation Causing Foods: Avoid Them To Prevent Diseases

Thus, it is important to decide that you need to be happy by thinking of the things that are going well for you at the moment. It is important for both your physical and mental health.

Pay less attention to unhappy thoughts. Stop feeding them as unhappy thoughts lead to unhappy feelings. Do not expect your happiness from someone else. It is your responsibility and once you decide it, there is nothing that can stop you from being happy, stress-free and disease-free.

Also read:5 Lifestyle Habits That Can Help You Live Longer, Be Disease-Free

(Luke Coutinho, Holistic Lifestyle Coach - Integrative Medicine)

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

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Want To Be Disease-Free? This One Lifestyle Change Is All You Need! - Doctor NDTV