precision medicine

What is precision medicine?

Precision medicine (previously called personalized medicine) is when the focus is on identifying, which medical approach will be most effective for each patient dependent upon genetics, environmental and lifestyle factors.

Pharmacogenomics is a part of precision medicine. In Pharmacogenomics an individual’s genes are tested to see what kind of response they will have to a particular drug. By combining pharmacology (the science of drugs) and genomics (the study of genes and their functions) certain labs are able to develop and identify effective, safe medications and doses that are tailored specifically to a person’s gene make up.

 

Understanding Pharmacogenomics

Understanding pharmacogenomics

 

Could a Simple Mouth Swab Protect You from Adverse Drug Reactions & Help Your Physician Find the Medication That’s Right for You?

Why would a company promote their drug for a specific medical condition in an advertisement when they are required to list ALL the possible side effects that a patient might experience? They are telling their patient market for example, if you take our drug you might experience a seizure, excessive bleeding or even suicidal thoughts!  So why do patients still agree to take these medications despite these warnings? The answer is simple- 1) we accept the risk of side effects when we believe that the benefit of taking the drug is worth the risk 2) we have come to believe that side effects are just part of being treated with some medications 3) we trust our doctors to have the knowledge to minimize the risk when prescribing us medication.

The truth is however, unfavorable drug reactions are a major concern for all clinicians who prescribe drugs, and most patients have experienced everything from small insignificant side effects to life threatening reactions.  According to Harvard University, Edmond J. Safra Center for Ethics, a total of 840,000 people in hospital are given drugs that cause serious adverse reactions. Newly approved drugs cause an adverse reaction in 1 out of 5 people. About 128,000 people in the US die each year from the drugs prescribed for them, and there are about 200,000 deaths in Europe from prescribed prescription medications.

For those who suffer with health conditions, even with a 1 in 5 risk of a negative drug reaction, they are willing to take the chance. But wouldn’t it be fantastic if physicians could better separate individuals by who may react negatively to certain drugs and those who might greatly benefit from them? In other words, the clinician could use genetic testing to make sure they are giving the right dose, to the right patient, at the right time! Think of the lives saved and the suffering that could be prevented!

The good news is that we aren’t talking about the future…we are talking about what is possible NOW! Although genetic testing is a new option for clinicians and patients, it is available now through a new field called pharmacogenomics.  This field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) which allows for the development of safe medications and doses tailored to a specific person’s genes.  Although pharmacogenomics is not available everywhere, there are hospitals, clinics and doctor’s offices right now swabbing patients mouths and sending the samples to pharmacogenomic companies that ensure the samples go to labs who specialize in the specific type of genetic testing, depending on the patient’s needs.

The test results are provided to the clinician in an easy to review Patient Medical Record, which then allows for safer prescribing and better outcomes for patients.  If you are interested in learning more about genetic testing, click here and complete the form. Protect your patient’s, reduce your liability and become a part of Community Health Focus, Inc’s efforts to improve health care now.

 

My Painful Stumble from Furious to Fit

By Leah Tyler

One fateful day in 2011, I stood before my bathroom mirror and watched myself descend into a full-fledged rage attack. My mere 34 years of existence had hit me pretty hard.

I was 100 pounds overweight, riddled
with pain, ravaged by illness, and utterly
incapable of participating in my own life.

Although I had narrowly escaped death and was technically lucky to be alive, it sure didn’t feel that way. I had absolutely no idea how to pick up the shattered pieces of my reality and move forward, but knew I had to do something to curtail the uncontrollable fury gobbling up my sanity. My at-home yoga practice clearly wasn’t doing the trick, so I decided to start running.

But that’s the most misleading way to phrase it. Because I was so out of shape and in so much pain, all I could do was shuffle at a fast trot for 5 out of every 90 steps. Literally. So that’s what I did, every other day when I walked my dogs. After a few weeks, I was trotting ten steps and walking eighty. Over time I kept whittling away the ratio, until the day finally came when I was running a block at a time. It took many months, and my efforts were rewarded with ungodly amounts of pain. I’d hobble up the stairs, gulp down extra pain meds, and lay around moaning about how bad I hurt. But my rage was tempered, and I even lost a little weight, so my progress kept me going.

Years before, in the early days of my journey with chronic illness, I started researching nutrition. This inspired me to try pretty much every diet, cleanse, potion, philosophy, and ideology imaginable claiming to offer the true key to health. While none of them fixed me, the more I shunned preservatives, chemicals, refined, and processed, the better I felt. Marginally. I delved deeper into my quest to understand the human body’s relationship with food and uncovered the startling truth about the dangers of yo-yo
dieting.

For the first time in my life it became
urgently clear whatever modifications
I decided to implement had to be forever.

Read More My Painful Stumble from Furious to Fit

 

Exercise: How a Little Goes a Long Way

By David L. Katz, MD; Chief Medical Officer of the Community Pain Center

 

Mechanistically, exercise is entirely dependent on action potentials, while its incredible benefits may be characterized as the potential of action to enhance our lives. Ironically, perhaps, the luminous potential of action to promote our health is in a very fundamental way the exact opposite of the action potentials from which it derives.

I imagine that may be about as clear as the way through a Tough Mudder. No worries; I’ve got Windex.

An action potential refers to the mechanism that underlies the firing of our nerve cells, or neurons.

Famously, action potentials are “all or nothing.”
Active nerve cells
At rest, there is a slight electrical gradient maintained across the cell membrane of a neuron. That slight charge is energy dependent, requiring the constant work of ion channels that traverse the cell membrane, shuttling positively and negatively charged ions in opposite directions. When we talk about “resting energy expenditure,” or “basal metabolism,” these are the kinds of functions represented; our cells are always working even when we are not.

That electrical gradient is, quite literally, an “action potential,” because it primes the cell to take the one action it owns: depolarizing. When a stimulus reaches a neuron, if it is strong enough, it reverses the electrical charge at the site of contact. That reversal of charge, or depolarization, then courses along the length of that nerve cell, rather like a fast moving wave.

If the nerve cell in question is a sensory neuron, the result of that wave is that we feel or perceive something—a caress, a color, a shiver, or a symphony.

If it is a motor neuron, it ends at a muscle cell, which in turn is stimulated to contract. When a whole lot of muscle cells contract in unison, we have the familiar command over our moving body parts; such as my fingers, currently dancing over this keyboard.

We could, of course, go much deeper into the weeds, but that’s the relevant gist. What matters for today’s story is that the depolarization of every neuron, or muscle cell (myocyte) for that matter, is all or nothing. The stimulus reaching it is either enough to excite full depolarization, or it is not. There are no partial responses; there is no dose response curve.

Read More Exercise: How a Little Goes a Long Way

 

Holistic Medicine: How to Define It

By David L. Katz, MD; Chief Medical Officer of the Community Pain Center

 

We are probably all familiar with things that are tough to define, but that we recognize when we see them. No, I’m not planning on talking about that one

The term I have in mind is: holistic.

Healthy concept, Spirit, Body and Mind

I practice holistic medicine. Specifically, for the past decade, I have directed a rather unique clinic that provides what we call ‘evidence-based integrative care.’ We have published and presented details of the model.

People tend to have a strong sense of what holistic means, whether or not they can actually define it. Detractors see it as an indication of quackery–without looking past the label. Proponents embrace it as an emblem of virtuous humanism. Holistic is good, and all else … less so.

But if that is really true — if holistic care is better (I’m among those who believes it is) — then a workable definition is important. First, so that people who want to sign up for holistic care — to give it, or receive it — know what they are signing up for, exactly. And second, and more importantly, because you can’t practice what you can’t define. Unless we can say just what holistic care is, it can’t be taught, tested, replicated, or improved.

The medical version of TheFreeDictionary tells us that

Holistic care is: “a system of comprehensive or total patient care that considers the
physical, emotional, social, economic, and
spiritual needs of the person; his or her
response to illness; and the effect of the illness on the ability to meet self-care needs.”

I am comfortable with this in theory, but not in practice. In practice, it begs the question: how, exactly, do you do that? What does considering ‘physical, emotional, social, economic, and spiritual needs’ look like in a doctor/patient encounter? What is a clinician actually supposed to do in a room with a patient so that the care that transpires between them is holistically concordant with this definition?

Let’s acknowledge that platitudes don’t really help. Of course, a holistic practitioner looks beyond a battered body part to the whole body; looks beyond the body to the mind and spirit; looks beyond the individual to the body politic of which they are an intimate part; and, if responsible, looks at the body of pertinent scientific evidence as well.
Read More Holistic Medicine: How to Define It

 

Animal-Assisted Therapy for People with Chronic Pain

By Kristen Counts, MOT, OT/L

 

This notion of animals as having a healing
effect on humans is almost intuitive,
considering our history in seeking
their companionship.

Background Information

Humans have been in close partnership with animals throughout most of recorded history. We have depended on their working with us for our survival as they have tended livestock, guarded our homes, and hunted for game, among other types of work. Evidence of animals as companions has also been traced to the very beginnings of human history. The symbiotic relationship continues today and is gaining recognition as a therapeutic modality. This notion of animals as having a healing effect on humans is almost intuitive, considering our history in seeking their companionship. When looking at the therapeutic value of the human-animal bond in alleviating pain and associated symptoms, research is in its initial stages.

Man with pets

Animal-assisted therapy (AAT) is the term most often used when animals are utilized as a therapeutic modality. AAT is used in a variety of settings by nurses, occupational therapists, physical therapists, speech and language pathologists, and psychologists, along with additional health professionals. It is utilized for a variety of conditions in children, adults, and older adults.

Read More Animal-Assisted Therapy for People with Chronic Pain

 

Environmental Therapy:
An Important Step in Pain Reduction

By Teresa Emerick, D.M.

 

Environmental therapy is important for most chronic pain patients, especially those suffering with fibromyalgia, migraines, lupus, severe allergies, and most autoimmune illnesses. These patients develop a heightened sensitivity that demands they become aware of their surroundings at all times in order to minimize symptoms. Most Western physicians are not familiar with environmental therapy and what an essential tool it can be for their chronic pain patients. However, many alternative therapists that specialize in energy therapies such as Reiki, massage, EFT, acupuncture, music therapy, and reflexology understand the importance of energy flow in a patient’s surrounding environment to promote healing.

The very minute that we are born,
we start to die.

Every cell in the body goes through a process of birth, transformation, and death. These cells are all connected and react to their surrounding environment. What we see, hear, feel, smell, and even think, all create a ripple effect that causes a cellular reaction within our body. A bigger issue can be the things we do not see, hear, feel, or smell, but are still there causing problems, such as energy.

Energy is what makes everything happen. There are two types: potential energy, which is stored energy, and kinetic energy, which is moving energy. Energy can be emitted in many forms, such as chemical energy within molecules, the radiant energy of light, thermal energy transferred as heat, or energy transferred between electrical fields. One form of energy can be transferred to another form. The laws of thermodynamics determine why and how energy is transferred.
Read More Environmental Therapy: An Important Step in Pain Reduction