July 2014 MEDELLA CURE, HEALING POWER, HEALTH Vol. 1, Issue 6 A PUBLICATION OF GW CIM GW Center for Integrative Medicine 908 New Hampshire Ave NW, Suite 200, Washington D.C. Metro: Foggy Bottom Website: www.gwcim.com Phone: 202-833-5055 Hours: 9 am to 5 pm

INSIDE THIS ISSUE Demand coverage Use your voice for medical choice for naturopathic Patients can demand insurance coverage for naturopathic services health care Reiki as a path to a better health very year, Turmeric for E depression approximately one New health radio million Americans show choose to visit one of FEATURED the 4,500 licensed ARTICLE naturopathic doctors (NDs) in the country Reiki as a Path to a instead of seeing a Better Health conventionally trained doctor. In so doing, they express a personal preference for the WANT A BETTER holistic, natural, patient-centered, prevention-oriented approach LOOK? to health care that naturopathic medicine offers. Presumably, they are expressing a strong preference given the significant The PDF version financial impact that comes with this choice. Although NDs of this issue will receive education and training comparable in duration and rigor be published on GWCIM's to that of medical doctors (MDs) and doctors of osteopathy (DOs), website in and are highly qualified as primary care providers (see Medella September. March 2014 issue), health care services provided by NDs are often Medella is taking not covered by government-sponsored or private insurance. More a break for than 60% of naturopathic physicians do not accept health August. insurance. However, recent lobbying activity indicates that Have a great operating on a cash-only basis is not necessarily a practice model summer! NDs desire.

Section 2706(a) of the Affordable Care Act (ACA) was designed to Subscribe to Our prevent discrimination against naturopathic physicians (and other Newsletter licensed non-MD/DO providers) on the part of insurance companies (see Medella February 2014 issue). Although the provision went into effect in January 2014, there is a shared belief within the ND community that section 2706(a) is not being honored by insurers. So widely known is this perception that earlier this year the U.S. Department of Health and Human Services (HHS) - one of the government agencies charged with overseeing implementation of the ACA - issued a Request for Information asking concerned patients and clinicians to submit their comments about the issue as a matter of public record. These comments will be used to inform the Department's decision making around future enforcement measures.

In its comment submitted last month to the HHS, the American Association of Naturopathic Physicians (AANP) described a multitude of ways in which discriminatory practices persist.

Routine physician visits and preventive services are being denied reimbursement when performed by NDs, and in most states NDs are not included in insurance companies' provider networks. This limits the freedom of medical choice for patients. The AANP is now in the process of preparing materials to help state associations approach insurers who are not complying with Section 2706.

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FEATURE STORY

Reiki as a path to a better health

Reiki is a non-invasive, complementary health approach that promotes relaxation, enhances the body's natural healing abilities, and improves mental, emotional and spiritual well-being. Reiki is based on the idea that an energy field permeates the human body, and on the Eastern belief that energy supports the body's innate or natural healing abilities. Reiki originated in Japan in the 1920s through the vision of Mikao Usui (Usui Sensei). Reiki seeks to restore the energy balance of the body. Rei means higher power, Ki is a Japanese word for life energy, similar to Chinese qi or chi.

People use Reiki to reduce pain, anxiety, and fatigue, help manage symptoms, reduce side effects of medications, and support recovery after injuries or surgery. Reiki generally helps patients start feeling better very quickly, often as a result of lessened anxiety.

The person receiving Reiki remains fully clothed and lies on a comfortable table while the Reiki practitioner lightly places hands in various positions on or near the body, with the goal of facilitating the person's own healing response. It is not a massage. Usually a practitioner allocates time before and after the actual Reiki session for discussion and questions about the experience. Each patient describes Reiki differently. To some, the sensation might feel like heat, cold, tingling, or a feeling that energy is moving through the body. The most common result is deep relaxation and peacefulness during the session.

Reiki can be received from someone else - a friend, healthcare provider, or Reiki professional -- or it can be learned by all who want to practice Reiki on themselves.

Reiki does not replace conventional care, but rather is integrated with other medical treatments and therapies. According to the 2007 National Health Interview Survey, which included a comprehensive survey on the use of complementary health approaches by Americans, more than 1.2 million adults had used an energy healing therapy, such as Reiki, in the previous year. As the use of integrative therapy grew within the past years, this number has grown significantly. Reiki is now being used in a growing number of hospitals and clinics throughout the United States and throughout the world, with the Mayo Clinic and the George Washington University hospital.

Continued here RESEARCH

Turmeric shows promising results in treatment of depression A new study published last month added to the long list of possible health benefits of turmeric, demonstrating it works to relieve symptoms of a major depression.

Turmeric (Curcuma longa) is a plant, also called Indian saffron, used as a spice in curries, mustards, butters, and cheeses. The root of turmeric has been used in medicine for arthritis, many gastrointestinal conditions, jaundice, liver problems, gallbladder disorders, headaches, bronchitis and many other conditions.Turmeric has been an important spice in India since ancient times due to its coloring properties by its key pigment curcumin, and perceived medicinal efficacy as anantiatherosclerotic, antidiabetic, antimutagenic and anticancer remedy.

Turmeric's finger-like underground stems (rhizomes) are dried and taken by mouth as a powder or in capsules, teas, or liquid extracts. Turmeric can also be made into a paste and used on the skin.

Depression has been associated with not only mood disturbances, but also with several chemical imbalances in the body, including inflammation and increased free radicals within the body. For these reasons -- to address the biological disturbances -- recent treatments for depression have begun to include supplemental therapies, such as antioxidant and anti-inflammatory therapies.

The study by researchers from Australia examined the effects of curcumin, the active ingredient in turmeric, on depression. Participants included 56 male and female participants from the ages of 18 to 65 who had met the psychiatric criteria for major depressive disorder and had not suffered from chronic medical illnesses such as diabetes, autoimmune diseases, and hypertension. Half of the participants took a 500 mg capsule containing curcumin twice a day, and the other half of the participants took a placebo, a simple cellulose capsule without active drug ingredients. Participants completed two self-reported surveys before the study and after the 8-week study was completed. The first survey contained 30 questions pertaining to the severity of depressive symptoms experienced within the past week. The second survey contained 40 questions that examined anxiety symptoms.

The results showed that from the start to week 4 of the study both groups in the study experienced positive changes in the depression scale. However, from week 4 to week 8, the group that took curcumin had greater improvements. Similar results were found in the anxiety measure: both groups had improvements in the first four weeks, but the study group continued to have improvement after the four weeks.

Another study, that included patients visiting a psychiatric outpatient facility in India, demonstrated similar effects of curcumin. It compared the efficacy and safety of curcumin with fluoxetine, a medication used to treat symptoms of major depressive disorder. The participants were randomly assigned to one of three groups: a group that received fluoxetine, a group that received curcumin, or a group that received both fluoxetine and curcumin. The study was masked, meaning that the investigators did not know which treatment the participants were receiving. Participants were observed and graded according to a scale for depression based on the observations of the study investigators. Results of the 51 patients showed that curcumin, when combined with fluoxetine, showed effectiveness and had a good safety profile.

NIH's National Center for Complementary and Alternative Medicine considers turmeric safe for most adults and is funding basic research studies on the potential role of turmeric in preventing acute respiratory distress syndrome, liver cancer, and post-menopausal osteoporosis.

Last month, the Journal of American Medical Association published a touching poem by Dawn McGuire titled Turmeric in its Poetry and Medicine column. The poem describes a patient with glioblastoma, a brain tumor, believing that turmeric keeps it in check. [This article is not intended to diagnose or treat any condition or provide medical advice. Please consult your doctor.]

Sources:

 Sanmukhani, J., Satodia, V., Trivedi, J., Patel, T., Tiwari, D., Panchal, B., Goel, A., & Tipathi, C. (2013). Efficacy and safety of curcumin in major depressive disorder: A randomized controlled trial. Phytotherapy Research, 28, pp. 579-585  Lopresti, A., Maes, M., Maker, G., Hood, S., & Drummond, P. (2014). Curcumin for the treatment of major depression: A randomized, double-blind, placebo controlled study. Journal of Affective Disorders, 167, pp.368-375  Roghella, V., Patel, V. Antioxidant profile of organically grown and conventionally grown fresh turmeric (Curcuma Longa L.): A comparative study. Journal of Cell & Tissue Research. 2013, Vol. 13 Issue 2, p3749-3754.  McGuire, Dawn. Turmeric. JAMA. 2014;311(24):2547.

Back Continued: Naturopathy...

Although the official comment period ended on June 10th, there is still time to have your say in the matter. Over the next year, it is predicted that HHS will be formulating its plan for whether and how to enforce section 2706(a), with official regulations likely to be issued sometime in 2015. In the meantime, you have a chance to express your message loud and clear, demanding insurance coverage of naturopathic doctors. Fair and equal reimbursement is what the law requires. If you've ever been denied coverage for a visit to your naturopathic physician and want to share your discontent with your State Insurance Commissioner, there is an easy way to do it: please go to www.covermynd.org and submit an online letter reporting your case and asking for change. (Please send GWCIM a copy of your letter electronically or as a hard copy - we will keep it on file for reporting the statistics to the D.C. Association of Naturopathic Physicians.)

You deserve to choose your health care provider without financial penalty. The ACA protects that right. This year patients have a chance to make sure insurance companies respect their choices. Your voice can make a difference.

Sources:

 Barnes, PM, Bloom B, Nahin R. CDC National Health Statistics Report #12. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. December 2008.  American Association of Naturopathic Physicians website: www.naturopathic.org/medicine  Department of Health and Human Services, Request for Information Regarding Provider Non-Discrimination. Docket ID: CMS-2014-0033. Available at www.regulations.gov/#!docketBrowser;rpp=25;po=0;D=CMS-2014-0033  American Association of Naturopathic Physicians, Comment in response to HHS RFI. Docket ID: CMS-2014-0033-0635. Available at www.regulations.gov/#!documentDetail;D=CMS-2014-0033-0635.

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Continued: Reiki...

GWCIM's Reiki Master Teacher, Luann Jacobs (pictured below), started the Reiki Volunteer Program and brought Reiki to George Washington University Hospital as one of the first in the U.S. pilot programs for cardiac catheterization patients. Now she directs Reiki volunteers for the GWU Hospital palliative care, surgical, cardiac, and medical services, and has been providing Reiki to women diagnosed with breast cancer at the GW Breast Care Center since 2011. Last September, Luann and her volunteers marked the 5,000th visit to GWU hospital to provide Reiki to patients, their families, and staff. At GWCIM, Luann and her colleague Yael Flusberg see patients and teach classes to the public and medical students.

There are three main groups of people who use Reiki today: individuals who have learned it, practice it, enjoy it, and give it to family and friends; Reiki professionals who offer Reiki in healthcare wellness settings; and nurses, physicians, and other healthcare professionals who integrate Reiki into patient care during office visits or inpatient care in hospitals, nursing homes, and other healthcare facilities.

Research has examined the use of Reiki for conditions such as fibromyalgia, pain, cancer, and depression, and for overall well- being. Interestingly, many positive effects of Reiki are reported in medical articles covering the nursing profession. As one article points out, Reiki "has ancient roots, but is uniquely suited to modern nursing practice." It states, "Reiki is easily adaptable to nursing practice in a variety of settings, and can provide support for the practitioners of Reiki themselves, as well as benefiting those they treat with Reiki." Another study explains: "Self-care practices such as Reiki studied in hospital settings with nurses have been reported to serve as a way for nurses to avoid stress and burnout, cope with increasingly busy and hectic acute-care settings, nurture themselves, and provide a caring, supportive environment for patients."

A literature review of the effect of Reiki therapy on pain and anxiety in adults examined seven studies: four articles studied cancer patients, one examined post-surgical patients, and two analyzed community dwelling older adults. The authors reported decreased anxiety in women undergoing breast biopsy and decreased pain in adults.

Finally, a study examining patients who were undergoing cancer infusions during a six-month period at a university hospital and also receiving Reiki through volunteer services evaluated changes in pain, mood, distress, sleep, and appetite. Forty seven participants were seen in the cancer infusion center and 98 in other areas of the hospital. Reiki was rated as a positive experience by 94% at the cancer center and 93% of others, with 92% of cancer center patients and 86% of other patients interested in receiving additional Reiki sessions. Patients from the cancer center and other hospital areas reported similar improvement in symptoms: 89% of cancer patients and 86% of other patients reported "much to great improvement" in relaxation; and 75% of patients in both groups reported improvements in anxiety/worry.

Although Reiki can be learned by anyone, to become a Reiki Master takes years. The ability to use Reiki is not taught in the usual sense, but is transferred to the student during an "attunement" given by a Reiki master. This allows the student to tap into an unlimited supply of "life force energy," to improve one's health, and enhance the quality of life.

The next Level 1 class offered by GWCIM starts August 2, 2014.

Sources:

 Thrane S, Cohen SM. Effect of Reiki Therapy on Pain and Anxiety in Adults: An In-Depth Literature Review of Randomized Trials with Effect Size Calculations. Pain Manag Nurs. 2014 Feb 27. pii: S1524-9042(13)00080-5.  Gallob R. Reiki: a supportive therapy in nursing practice and self-care for nurses. J N Y State Nurses Assoc. 2003 Spring-Summer;34(1):9-13.  Lewis Mehl-Madrona, MD, PhD, MPhil, Nita M Renfrew, and Barbara Mainguy, MA. Qualitative Assessment of the Impact of Implementing Reiki Training in a Supported Residence for People Older Than 50 Years with HIV/AIDS. Perm J. 2011 Summer; 15(3): 43-50.  Marcus DA, Blazek-O'Neill B, Kopar JL. Symptomatic improvement reported after receiving Reiki at a cancer infusion center. Am J Hosp Palliat Care. 2013 Mar;30(2):216-7.  University of Minnesota, Center for Spirituality and Healing. http://www.takingcharge.csh.umn.edu/explore-healing-practices/reiki/how-can-reiki- help-me.

Back NEWS

New weekly radio show will cover integrative medicine topics

A new VoiceAmerica internet talk radio program addressing the best of standard and natural health options to reclaim and maintain optimal health will air every Friday at 5 PM Eastern Standard Time (2 PM Pacific Standard Time). The show, named "The Cutting Edge of Health and Wellness Today", will be hosted by two leading experts in both conventional and holistic and integrative medicine, Dr. Neil Nathan and Dr. Jacob Teitelbaum.

The first show will air August 1st (www.voiceamerica.com). The show will discuss highly effective treatments for fibromyalgia and chronic fatigue. In its future shows the radio program plans to cover topics that include effective treatment for Lyme disease, mold toxicity, chronic pain, thyroid and adrenal problems, environmental toxicity, dementia and Alzheimer's disease, sleep problems, autism, and intestinal health.

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GWCIM warmly thanks contributors to this issue of Medella: Morgan Adessa, J.D, and Shivani Shah, M.D. candidate at GWU.

Next issue of Medella will be published in September. Happy summer!

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