Thursday, September 16, 2010

Genetically Modified Salmon?!!

What can I say, inspiration has hit again for the second time in the same year.

Coming in from morning run, and as I turned on my James Taylor music and turned off the TV, the announcement was that the FDA is contemplating approval of genetically modified salmon. According to the developer of the GMO salmon, the fish that have been grown thus far are not any different from wild caught salmon. The salmon's DNA has been spliced with the Growth Hormone gene from the Chinook salmon and the 'antifreeze" gene from the Ocean Pout to allow rapid growth. The Ocean Pout gene allows it to grow in cold temperatures, where Atlantic Salmon usually stop growing when season changes. The genetically modified fish will grow to full size in 18 months instead of 3 years due to the all year round eating behavior of the Ocean Pout when the Altlanic Salmon usually feeds aggressively in spring and summer. (Sounds like some major league baseball players) Supposedly the fish behaves and tastes like wild Atlantic Salmon, and scientists for the company state the only difference is the extra gene. They claim due to the dwindling salmon population and the increasing human population numbers, lab created fish will provide economic windfall to the fish industry in addition to providing more omega 3 fish oil sources and thus cut back on heart disease. (A biotech company that is actually thinking about world health sounds like an oxymoron to me). It brings up the problem with Monsanto the pesticide company patenting genetically modified corn and soybean seed. This biotech company created a seed that would live through application of pesticide. Only problem like the Gentically Modified salmon, to get the gene from one species into another, you have to fool the living beings immune system. Plants, fish and humans share the same built in mechanism for the living being to protect itself from bad gene replication. The human DNA replication system will seek out unusual genes and destroy them, those mutant gene lines that evade destruction usually mutate to form tumors or cancer. So when foreign dna is introduced by simple cutans splice and the cell doesn't recognize, immune killer cells seek and destroy the mutated cell. The way Monsanto scientists were able to get the pesticide resistant gene portion into normal seed was by piggy backing the short gene on a virus. Virus' are great at infiltrating the cell and taking over the replication in the DNA center-the nucleus of the cell. The job of a virus is to infiltrate a host cell, take over DNA control and produce mass amounts of more virus to be shed in the host until usually the host dies-(ie, swine flu, influenza). Once the virus/piggyback gene gets transcribed within the normal DNA sequence, it becomes invisible to the killer cells and the mutation begins. Good for the seed and fish industry but the concept the environmentalists are worried about, what happens to the virus that helped the "gene" get past the "bouncers"? Well, the virus also gets passed along in the Geneticall Modified Organism. The virus gets passed to all the offspring of the seed/fish as well as all those other wild seed or fish that cross breed with the mutant seed/fish. More importantly all those that eat the GMO or its offspring/crossbreeds will also be digesting and absorbing the virus. No one has been able to prove that piggybacking a virus, then absorbing/implanting any altered DNA will have implications to the human. But do your own research and listen to "your gut" regarding the idea of eating anything made from a biotechnology company. If there was no concern of money and you had two fish to choose from for the family dinner, would you pick organic or genetically modified and why?

One would think that creating a lab food source to bypass nature would save alot of "steps". Problem comes in side stepping nature. Nature has told the Atlantic salmon to decrease its appetite during certain seasons to balance the eco system and allow ebb and flow to occur. It could be likened to restocking the feeder fish in a pond, allow those small fish to repopulate so the next season, the next new batch of big fish have food to eat. The genetically modified fish are to be kept in locked in ponds and tanks but as a Purdue computer program calculated, if 60 lab fish were allowed to mix with 60,000 wild fish, the wild fish would be extinct in 40 generations. That would mean an entire planet of genetically modified fish, remember if they eat all year round, they have to eat something. Do your own research and listen to "your gut".

Finally, talk to the families with MS, Lymphatic Cancer, Lupus, Celiac disease or any other autoimmune diseases that are "on the rise". Read on GMO's, Monsanto, what exactly it means to be certified organic, why support local farmers, what transfats are, what grass fed means, why choose free range chickens. (Watch the film Dying to have Known) The Saguil Approach; a patient has to be his or her own advocate because there will be no one else to blame for poor decisions made in haste or ignorance. When I talk to my families about buying organic, I understand the price differences and feel it personally as well. I would love to buy all organic but it's too expensive. I used to lecture at Whole Foods and loved going there in the 90's when one opened up next to my Central Dupage Office. Problem is that although the arrangement of the veggies was very market-like, and the meat/fish/poultry sections had the best looking products raised grass fed or wild caught; I couldn't afford all "fancy food". The flip side is I felt low in my energy, emotion, sleep and concentration if I binged on 6-10 cheap, take out meals a week. So I would take a deep breath, plan on getting some food groups here some food groups there, but most importantly, I would keep it as my choice. I still "own" the decision of what I pick, I can take responsibility for what I prepare for my family. I let my patient families know at this point, they too can still make a choice on what is healthy (just have to do a little reading). As I mentioned in my last posting, choosing the easy way out, the cheapest way out may be necessary for the time being but usually at the sacrifice of something else later. Do what you think will be healthy in the long run, listen to "your gut" follow "your heart".

Wednesday, September 15, 2010

Lack of disease doesn't equal good health.

Had a "gut feeling" this morning to post to you (my patients, friends, family) about a concept I learned from a teacher of mine, David Simon at the Chopra Center. I usually don't like to start my day listening to death, rape, beheaded bodies found, billion dollar other words the morning news. But as I got back home the TV was on and as I went to turn it off, the last words I heard were, "in the case of Toyota and a class action law suit, judgement is being considered to dismiss the case since investigators [regarding vehicles with run away acceleration] have failed to demonstrate a defect". As I shut off the TV, the words reverberated in my mind then my soul. I feel for those individuals that were behind the wheel when the car would accelerate uncontrolled and those that were the involved in accidents. The message being sent out to the universe is, a group of mechanics have determined the ABS system, Engine Check light, Computer diagnostics and factory craftsmanship are all normal so it is either your fault or not in the control of human engineering that the accident occurred. Lack of a defect in the mechanics of your car means it appears normal and the car is safe for future driving, no intervention necessary at this time.

With guilt I admit I have said this to patients in the past. Your cholesterol is normal, no need to start and exercise program this year. Your chest xray is normal, no need to stop smoking this year. Your sugar level is normal, no need to lose weight this year. Your blood pressure is normal, no need to work on stress reduction this year. Your mammogram is normal, no need to worry about breast cancer yet. Your knee xray and medicines are keeping your pain controlled, no need to start yoga or tai chi yet. Your back mri and neurological evaluation are normal, no need to continue physical therapy exercises or work on flexibility until the next flare up. Conventional insurance based medicine is very "newtonian". Newton was a physicist who came up with formulas to explain motion (inertia and gravity). Much of the current model of medicine is based on reasoning from scientists during Newton's time. Physicians are very "linear" in their thinking. A liver makes bile and detoxifies the blood, if the tests are normal it will function forever. If you have stage 4 cancer, you will die quickly. If you take this pill to turn off acid, you should not get ulcers. In the last 15 years, I believed I was helping people by using the basic information from training and more importantly, the continued outpouring of information from drug studies and research. I now question all this new information (that is ultimately backed by some organization with money. In my mind, the text books that we have been using for the last 5 decades have established legitimacy. In my heart, I think we are only now opening to true human healing. I feel humans are very prone to entropy (disorder), take the easy way out, path of least resistance. It is usually a faster and easier decision to complete a task with the least amount of effort. Saving time and effort is not a problem, the problem comes if the consequences to saving time result in a disasterous chain reaction that ends in compromised health that is "fixed" with surgery or pharmaceuticals.

My first step away from Newtonian medicine was in studying Medical Acupuncture at UCLA. My medical indoctrination said it wasn't well understood, research came out stating it doesnt work, text books of Neurology state there are no energy channels in the body that correspond to meridias of traditional chinese medicine. I took the course anyway. I remember how I felt having it done to me, then I remember applying it to Sheryl a lady with chronic headaches on multiple medicines with multiple consults and my single 30 minute treatment gave her a few hours of a headache free life-for the first time in decades. But due to the fact that I worked for a hospital and it wasn't in the norm of practicing family medicine using acupuncture, I couldn't bill for it without lying to insurance, or I had to bill outrageous prices to make the difference of time spent away from insurance paying patients. So I was discouraged and stopped doing it. I am now learning about nutrition with Andy Weil and spirituality with Deepak Chopra but the same issues are arising, dietary evaluation is difficult to get reimbursement for from insurance even if the patient has elevated cholesterol, diabetes or obesity. If I teach this I either have to bill "creatively" or see the patient as cash only if I can't bill above and beyond the contracted medical insurance company. I am now on the path to become a yoga instructor with The Chopra Center and Total Body Yoga and I know I will be able to provide anxiety, hypertensives, chronic pain, cancer sufferers a successful addition to medicines and surgery not to mention a total alternative. Problem: insurance doesn't have ICD-9 codes for meditation, breathing or yoga. No code equals no payment or at least the need to resubmit a bill 2nd and 3rd time back to insurance company and arbitrate payment with a person on the other line who probably doesnt practice meditation or has to follow rules in a book written by a non-healthcare technician.

This "other side" of medicine is sometimes referred to as the Einsteinean approach. Relativity, energy, cosmology....all involve a concept that life is composed of an energy not well understood but that ancient traditions/civilizations have relied on for centuries. White light, gut feelings, love, bad karma, dreams, bliss, spirituality, healing hands, aromatherapy are all modern day categories where we group things for lack of any better way of definition. Andrew Weil has popularized the term Integrative Medicine with his own credentials and a decade of tolerating criticism with research from the NIH. He has worked on true preventive medicine. Family Medicine used to be a specialty training where the primary care doctor who is essentially the gate keeper of health would help the patient with preventing disease. Go into any primary care docs office now and 80% of the visits are for acute care-(colds, coughs, scrapes or ER visit followups) and maintanance care-(testing blood to refill prescriptions). Unfortunately, it is up to the patient to be his or her own advocate for health. Lack of abnormality on testing doesn't mean you are healthy. Eating right, sleeping well, keeping healthy relationships, exercise and spirituality won't keep death and disease away but it will make for a healthier and happier environment for your cells in doing their best to function at optimum levels. I believe their is an inherent energy that comes with any life, being, cell, dna molecule or atom. "Bathing" it in a healthy environment will allow for unleashing it's maximum potential. I witness this occuring and unfortunately it is very seldom but when it occurs the label of "miracle" is given. What is worse is when an event of unleashing one's maximum potential is experienced in a disease state and the body is allowed to fix itself, the excuse that "you were misdiagnosed" is given.

Bottom line, here is the Saguil Approach: if a car accelerates when it shouldn't, if a pain is happening and someone says "we can't find anything", listen to and trust the message your "gut", your inner being, your heart is telling you and act on it. A "qualified professional" saying you're fine when you know you something is wrong is never a reason to relax. I tell patients this, "thank God I can't find anything wrong, now go and start the diet you've postponed, begin the yoga class you've missed, get the sleep you deserve, cut back on work and stop spending money you don't have to buy things you don't need to please people you don't like" (last one is from Deepak). The potential energy, from that atom that makes up that dna that makes up that cell that makes up that organ that makes up your body is probably asking for permission to show itself and an environment to do what it does best; live, create and serve others. Listen to your body/mind/spirit and trust in what you feel.