Team hits road to promote holistic medicine
FORT MEADE, Md. (Army News Service, May 5, 2015) -- Tai Chi, breathing techniques and mindful eating are among exercises that medical professionals will take part in during a 2.5-day class scheduled for Army clinics across the country.
A team, from Army Medical Command, is going on the road to show doctors, nurses and other medical practitioners the value of holistic medicine and alternative treatment plans.
Dubbed "Move to Health," the pilot program began last month on Joint Base Myer-Henderson Hall, Virginia, and recently moved up to Fort Meade, Maryland. Next week it is scheduled for Fort Bliss, Texas. The first week of June, the program will be taught at Joint Base Lewis-McChord, Washington. Then it is on to Fort Hood, Texas, and over to Hawaii.
Classes ideally include entire care teams from military health clinics, said Lt. Col. Robert C. Oh, the physician lead for the class and also the physician lead for MEDCOM's System for Health and Performance Triad.
Empathy with patients is one of the themes he stresses. He wants doctors to take the time to hear the patients' stories and to get Soldiers involved in drafting their own treatment plans that will set them on a path to wellness.
"Let's change the conversation," Dr. Oh said. "Instead of finding and fixing disease ... let's prevent disease. It's a subtle change, but a seismic one."
When a patient comes into a military clinic with back pain, Oh said perhaps the treatment team should not just focus on the back, but the whole body instead.
Chronic back pain can come from many sources and many conventional treatments do not pan out so well in the long term, he said. Opioids only bring temporary relief. Epidural steroid injections, back fusion and other surgeries do not always work, he said. Statistically, he said, better long-term results often can be achieved with movement that strengthens the body's core.
This is grounded in science, he said. "You can move more mindfully and improve your health."
Mindfulness can also bring relief to pain in the short term, he said. Patients who expect pain will usually feel it. On the flipside, those who expect pain to subside will often report reduced levels of suffering, he said.
Heart-rate variability biofeedback and breathing techniques can reduce chronic pain, he said. Mindfulness interventions can reduce pain intensity.
Despite the many uses of mindfulness, some of the health-care professionals, who attend the classes had never even heard of it before, Oh said.
Just before lunch, Lt. Col. Tamara Funari, a nurse, demonstrated mindful eating.
This means not only being mindful of what is eaten, but how it is eaten, she said.
"It's about slowing down and enjoying the flavor," Funari said. It is about using all of the senses, she explained.
Mindful eating is about becoming aware, deliberately paying attention without judgment and being thankful for the moment and the food, she said.
She held a strawberry in her hand, looked at it, and slowly lifted it to smell the aroma. Then she took a small bite to appreciate the taste, texture and "what nature has provided."
Funari also discussed how to survive mindless eating. Studies have shown that subjects with smaller bags of chip - even though they have multiple bags - will eat fewer chips than those who have one large bag.
Those with a huge bag of chips will often keep eating mindlessly until the bag is empty. On the other hand, those who had to stop and think about opening a second bag, often decided to stop eating.
Surviving mindless eating is about creating a safe environment at home or work so one is more likely to choose wisely, Funari said. It is about making the unhealthy choices more difficult. This will help during stressful times, such as long work days, when exhaustion tempts judgment.
It is about keeping the kitchen counter clear of junk foods, Funari said. Instead, she recommended keeping a bowl of fruit on the counter.
Dining facilities that have placed a fruit and salad bar in the front of the facility, and moved the dessert bar to the rear, have reported a drop in dessert consumption and an increase in salad consumption.
"Willpower will only get you so far," Funari said, hinting at the power of convenience.
Obesity is not just a health problem, it is a national security issue, said Col. Deydre Teyhen, division chief for the System for Health and Performance Triad, G-3/5/7, Office of the Surgeon General. The rate of non-deployable Soldiers makes it a readiness issue, she said.
Fewer than 40 percent of Soldiers get good sleep, she said. Fewer than 5 percent eat enough fruit and vegetables.
"Health is the consequence of our daily choices," said Lt. Col. Rob Goodman, who taught at Fort Meade about the power of the mind and resilience.
"I really think that a big piece of this course is ... as providers, how do we communicate choice, how do we empower patients to make choices," he said.
Meagan Rikas, a medical support assistant for internal medicine at Fort Meade's Kimbrough Clinic, said the program was beneficial and inspirational.
"It changes your way of thinking," she said.
The physician on her internal medicine team, Dr. Russ Davis, also attended the class. He said much of the material was "intuitive" and reinforces what many in the medical profession have known for some time, but have not always fully applied.
"We're sort of building the plane as we fly a little bit," Oh said about the pilot program, meaning that the instructors are wedded to the concept, but willing to change the course curriculum to some degree.
It is a process that will be continually developed, he said, as the class travels around the Army striving to "change the conversation" toward health and wellness and bring mindfulness to care plans.
The "Move to Health" instructional team comes from the Health and Wellness Directorate, G-3/5/7, Office of the Surgeon General, in Falls Church, Virginia.