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Heart Health


            Enrique Saguil, MD
          First Health Associates

We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
Release:
• This lecture is not meant to substitute for
  medical care
• Please see your doctor for questions
• There are no financial connections between
  Bodhi Prem Yoga-Enrique Saguil, MD
• A copy of this ppt is available by calling
                (847) 593-3330


 Or friend                  DrRic Saguil
My Doctor:
                    Listens to my concerns
                    Cares what I have to say
                    Doesn’t Keep Me Waiting
                    Gives Me Options




We didn’t invent the practice of medicine….
                we’re just changing the way it’s provided.
The First Health Approach




 We didn’t invent the practice of medicine….
                 we’re just changing the way it’s provided.
Your Community
     of Care

      Ric Saguil, MD
    Jason Gruss, MD
     Tom Jordan, RD
 Katrina Christie, LCPC
  Jennifer Green, ND
   Joe Musolino, DC
  Emery Paredes, PT
   Courtney Day, EP
   Aimee Weber, EP
   Yu Zhu, MD China




      You
What is this thing in our chest?
Sir Isaac Newton followers:


• It’s made of muscle
• It moves blood like a pump
• It beats/contracts every second
Albert Einstein followers:
• An area of radiating energy
• True seat of control for daily function
• A way into consciousness
Yogic practitioners:
• A vortex of energy (Anahata)
• Allows us to give and receive love without fear
  or attachment
What we learned in school
        –it gives life!
What we learned at the “physical”
           –its going to attack us
                           The heart will die if
                           cholesterol or blood pressure
                           is too high

                           250,000 women die annually

                           25% Americans fit Metabolic S

                           2.5% m (1.9%f) increase in
                           cardiovascular events in
                           Prehypertension

                           AHA heart attack risk calc –
                           americanheart.org
What we learn in some yoga classes
Three guys are hunting duck:
• Family Medicine Doc     DUCK !!!

• Internal Medicine Doc   R/O Mallar, R/O Quail!!!

• Surgeon                 I Dunno, but I got it!!!
The Saguil Approach

•   Rescue
•   Stabilize
•   Grounding
•   Nutrition/Behavioral/Movement
•   Flare up/maintenance planning
Rescue
• Coronary artery disease
Western medicine
• Bypass
• Angioplasty
• Medicines to increase heart function
                contractility
                preload lowering
                after load lowering
Whats this sign!?!
•   Chest discomfort
•   Discomfort in other areas of the upper body
•   Shortness of breath
•   Other-cold sweat, lightheadedness, nausea
Soft Rescue=Risk Screening
•   History and Physical/ekg
•   Exercise stress echo/thallium
•   Ultrafast CT scanning of the heart
•   Homocysteine/cardiac CRP
•   Fasting lipid
•   Fractionated lipid
•   BMI/BP/waist to hip ratio
WHR
                             Rib and Iliac
                          1 in above navel




                            Widest butt or
                                hip




 WHO            NIDiabetesDigestiveKidneyds
 0.9 males      1.0 males
 0.85 females   0.8 females
Mega Hospitals vs Healing Centers




Having one/creates the other


                               Healing Center
The Saguil Approach

•   Rescue
•   Stabilize
•   Grounding
•   Nutrition/Behavioral/Movement
•   Flare up/maintenance planning
Stabilize and plan the wean

• Return to ADL’s
• Plan sustainable changes.
• Plan to get off rescue meds with diet,
  grounding and movement
• Or lower side effect stabilizing med/s
Meds:
•   Asa - daily
•   HCTZ – 50 daily
•   Beta blocker – bid
•   Ace inhibitor 1-2xday
•   Calcium channel blocker – 1-2xday
•   Nitroglycerin – 2xday
•   Coumadin – daily
Meds work on the “Newton Heart”
The Saguil Approach

•   Rescue
•   Stabilize
•   Grounding
•   Nutrition/Behavioral/Movement
•   Flare up/maintenance planning
Dr Saguil’s Special Forces
• The concept of “Grounding”
• Nutrition/Behavior/Movement
        Registered Dietician
        Behavioral Health
        Exercise Physiologist
        Yoga Therapeutics
Special Forces in Action              - Dean Ornish, MD pilot study



•   Nutrition
•   Managing stress
•   Fitness/Yoga
•   Love, Intimacy, Support
                                           Now
                                        covered by
•   28 patients for 1 year              Medicare!!
•   Low fat vegetarian
•   Stop smoking
•   Stress management
•   Moderate exercise
• 82% experimental group had change toward regression 1yr
                                     …more regression 5yr
Flare Up/Maintenance planning

• Re-conceptualize flare up pain
• Plan Reassessment and Reset goals
• Accountability is key
Western medicine maintenance goals

•   Control blood pressure   medicines
•   Control cholesterol      medicines
•   Control diabetes         medicines
•   Prolong life?            medicines


• Nutrition and exercise     on your own
“Alternative” medicine goals

• Eat properly                 FFFF
• Poop properly                “
• Move                        Yoga/Qi Gong
• Sleep                         “
• Commune/contribute          Service to others
• Love                          “



• “Lack of disease does not equate health”
Fat’s where it’s at
• Monounsaturated

• No vegetable oils
• Olive oil/macadamia nut oil/toasted sesame
  seed oil/walnut oil
Fiber
•   Changes satiety
•   Slows absorption
•   Pulls cholesterol
•   Adds bulk to stool/massages gi tract
Flat-curve carbs
• Low glycemic index/load




• ANDI/MANDI
Refined nutrition that “dumps insulin”


                       GoGo Juice from
                       Toddlers and Tiara’s star
                       Anna Holler
Friendly herbs
•   Ashwaganda – anxiety 500 bid
•   Boswellia – inflammation 300 2-3xday
•   Guggul – cholesterol 500 tid for 3 months
•   Triphala – bowel regulation 1000 qhs
•   Gymnema – chew 3-4 xday
Dr Ric’s beginner supp’s…
•   Multivitamin (watch vit A, calcium)
•   Omega 3 fish oil
•   Vit D
•   Disease/medicine specific repleation



• Sshhh……until you maximize your nutrition!
Colorado Blizzard Feb 2012




“There’s no more meat or lettuce!!!”
Learn three dishes
Learn three spices
Dr Ric Fav’s

• Roasted Asparagus Spears – OO, Fresh Garlic,
  Crushed Red Pepper, Salt - 350x12 min
• Spinach/Garlic Stir Fry – OO, Spinach, Fresh
  Garlic, Grated Ginger, Oyster Sauce –
  Medx15min
• Sockeye Salmon – OO, Salt, Pepper, Fresh
  Garlic, Tumeric P – 400x20min
Movement (exercise)
•   150 m/week moderate exercise
•   75 m/week of vigorous (vig/mod)
•   30 m/day/5days/week
•   10 m/3xd/5days/week
•   2500 steps/day (ACSM high success than 10,000/d)

• http://www.startwalkingnow.org/
Calories per hour
Activity                        100 lb   150 lb   200 lb
Bicycling, 6 mph                160      240      312
Bicycling, 12 mph               270      410      534
Jogging, 7 mph                  610      920      1,230
Jumping rope                    500      750      1,000
Running 5.5 mph                 440      660      962
Running, 10 mph                 850      1,280    1,664
Swimming, 25 yds/min            185      275      358
Swimming, 50 yds/min            325      500      650
Tennis, singles                 265      400      535
Walking, 2 mph                  160      240      312
Walking, 3 mph                  210      320      416
Walking, 4.5 mph                295      440      572
Energy work!!!!!
•   Einstein and quantum physics
•   Traditional Chinese medicine
•   Ayurveda/yoga
•   Reiki
•   Healing touch
•   Prayer/intention
•   Food/Plants/oils/aromatherapy
Ayurveda Whole System Approach to Energy
• Chakras
• Nadi’s
• Marma point
Moving energy
Lets move together!!
Synchronicity-Love and Service to others
•   Takotsubo Cardiomyopathy (temp LV dys 4-6 wk)
•   Harmonic coherence
•   Menstrual synchrony
•   Unified field theory (theory of relativity with electromagnetism)
Breathing as exercise?

         Inspiratory
           Reserve




                                                         Olympians
                       Normal in/out
Navy SEAL’s
                                        Expiratory
                                         Reserve
Contestants ready….deep breath in
            …..and…..
A neti pot reminder:




                       Neti kriya
                       Nasya Karma
Pranayama (BAM!)
                                     Breath Awareness Meditation




• Ujjayi       Victory or Ocean

• Nadi Shodana Nadi cleansing/ Alternate nostril
• 4-7-8        Andy Weil



             5-10 minutes beginning and ending your day
Meditation
•   Moving
•   Supported           Tim Olmsted
                        -Pres. Pema Chodron
•   Group               Foundation
                        -Spiritual Director Buddist Center
•   Open                Steamboat Springs CO
                        -Teaches with Yongey Rinpoche
Supported meditation to
              maintain change
•   Sight -candle, mandala, image
•   Sound -singing bowl, nature, breath, om
•   Smell -aromatherapy, nature
•   Taste -mindful eating
•   Touch -healing touch, comfort, sit bones
•   Breath, mantra, yoga, tai chi, Qi Gong


• Keep the concept of “monkey mind”
Meditation timers



               Start:
               5-10 minutes twice a day
               Maintain:
               30 minutes twice a day to
Proving “hokupokus” with RCT’s!
Control the internal milieu
 that determines your future



weak



       strong
The Saguil Approach

•   Rescue
•   Stabilize
•   Grounding
•   Nutrition/Behavioral/Movement
•   Flare up/maintenance planning
DrRic take home points

1.   Patient heal thy self,
2.   Find your own “center for healing”
3.   Keep western medicine “on a leash”
4.   If you find a doc that listens and is an
     example of health…never let go and share
     with others.
How to choose what is right for you?
                    http://integrativemedicine.arizona.edu/alumni.html




National Center for Complementary and Alternative Medicine - National Institutes of Health,
Integrative medicine …."combines mainstream medical therapies and CAM therapies
for which there is some high-quality scientific evidence of safety and effectiveness."
Q & A?
  Future Lecture: Hypertension
 Pioneer Park Arlington Heights
    February 25th 11-12noon
         (847) 593-3330

DrRic               on
Saguil
   We didn’t invent the practice of medicine….
                   we’re just changing the way it’s provided.

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DrRic Heart Health (slide share edition)

  • 1. Heart Health Enrique Saguil, MD First Health Associates We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 2. Release: • This lecture is not meant to substitute for medical care • Please see your doctor for questions • There are no financial connections between Bodhi Prem Yoga-Enrique Saguil, MD • A copy of this ppt is available by calling (847) 593-3330 Or friend DrRic Saguil
  • 3. My Doctor:  Listens to my concerns  Cares what I have to say  Doesn’t Keep Me Waiting  Gives Me Options We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 4. The First Health Approach We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.
  • 5. Your Community of Care Ric Saguil, MD Jason Gruss, MD Tom Jordan, RD Katrina Christie, LCPC Jennifer Green, ND Joe Musolino, DC Emery Paredes, PT Courtney Day, EP Aimee Weber, EP Yu Zhu, MD China You
  • 6. What is this thing in our chest?
  • 7. Sir Isaac Newton followers: • It’s made of muscle • It moves blood like a pump • It beats/contracts every second
  • 8. Albert Einstein followers: • An area of radiating energy • True seat of control for daily function • A way into consciousness
  • 9. Yogic practitioners: • A vortex of energy (Anahata) • Allows us to give and receive love without fear or attachment
  • 10. What we learned in school –it gives life!
  • 11. What we learned at the “physical” –its going to attack us The heart will die if cholesterol or blood pressure is too high 250,000 women die annually 25% Americans fit Metabolic S 2.5% m (1.9%f) increase in cardiovascular events in Prehypertension AHA heart attack risk calc – americanheart.org
  • 12. What we learn in some yoga classes
  • 13. Three guys are hunting duck: • Family Medicine Doc DUCK !!! • Internal Medicine Doc R/O Mallar, R/O Quail!!! • Surgeon I Dunno, but I got it!!!
  • 14. The Saguil Approach • Rescue • Stabilize • Grounding • Nutrition/Behavioral/Movement • Flare up/maintenance planning
  • 16. Western medicine • Bypass • Angioplasty • Medicines to increase heart function contractility preload lowering after load lowering
  • 18. Chest discomfort • Discomfort in other areas of the upper body • Shortness of breath • Other-cold sweat, lightheadedness, nausea
  • 19. Soft Rescue=Risk Screening • History and Physical/ekg • Exercise stress echo/thallium • Ultrafast CT scanning of the heart • Homocysteine/cardiac CRP • Fasting lipid • Fractionated lipid • BMI/BP/waist to hip ratio
  • 20. WHR Rib and Iliac 1 in above navel Widest butt or hip WHO NIDiabetesDigestiveKidneyds 0.9 males 1.0 males 0.85 females 0.8 females
  • 21. Mega Hospitals vs Healing Centers Having one/creates the other Healing Center
  • 22. The Saguil Approach • Rescue • Stabilize • Grounding • Nutrition/Behavioral/Movement • Flare up/maintenance planning
  • 23. Stabilize and plan the wean • Return to ADL’s • Plan sustainable changes. • Plan to get off rescue meds with diet, grounding and movement • Or lower side effect stabilizing med/s
  • 24. Meds: • Asa - daily • HCTZ – 50 daily • Beta blocker – bid • Ace inhibitor 1-2xday • Calcium channel blocker – 1-2xday • Nitroglycerin – 2xday • Coumadin – daily
  • 25. Meds work on the “Newton Heart”
  • 26. The Saguil Approach • Rescue • Stabilize • Grounding • Nutrition/Behavioral/Movement • Flare up/maintenance planning
  • 27. Dr Saguil’s Special Forces • The concept of “Grounding” • Nutrition/Behavior/Movement Registered Dietician Behavioral Health Exercise Physiologist Yoga Therapeutics
  • 28. Special Forces in Action - Dean Ornish, MD pilot study • Nutrition • Managing stress • Fitness/Yoga • Love, Intimacy, Support Now covered by • 28 patients for 1 year Medicare!! • Low fat vegetarian • Stop smoking • Stress management • Moderate exercise • 82% experimental group had change toward regression 1yr …more regression 5yr
  • 29. Flare Up/Maintenance planning • Re-conceptualize flare up pain • Plan Reassessment and Reset goals • Accountability is key
  • 30. Western medicine maintenance goals • Control blood pressure medicines • Control cholesterol medicines • Control diabetes medicines • Prolong life? medicines • Nutrition and exercise on your own
  • 31. “Alternative” medicine goals • Eat properly FFFF • Poop properly “ • Move Yoga/Qi Gong • Sleep “ • Commune/contribute Service to others • Love “ • “Lack of disease does not equate health”
  • 32. Fat’s where it’s at • Monounsaturated • No vegetable oils • Olive oil/macadamia nut oil/toasted sesame seed oil/walnut oil
  • 33. Fiber • Changes satiety • Slows absorption • Pulls cholesterol • Adds bulk to stool/massages gi tract
  • 34. Flat-curve carbs • Low glycemic index/load • ANDI/MANDI
  • 35. Refined nutrition that “dumps insulin” GoGo Juice from Toddlers and Tiara’s star Anna Holler
  • 36. Friendly herbs • Ashwaganda – anxiety 500 bid • Boswellia – inflammation 300 2-3xday • Guggul – cholesterol 500 tid for 3 months • Triphala – bowel regulation 1000 qhs • Gymnema – chew 3-4 xday
  • 37. Dr Ric’s beginner supp’s… • Multivitamin (watch vit A, calcium) • Omega 3 fish oil • Vit D • Disease/medicine specific repleation • Sshhh……until you maximize your nutrition!
  • 38. Colorado Blizzard Feb 2012 “There’s no more meat or lettuce!!!”
  • 39. Learn three dishes Learn three spices
  • 40. Dr Ric Fav’s • Roasted Asparagus Spears – OO, Fresh Garlic, Crushed Red Pepper, Salt - 350x12 min • Spinach/Garlic Stir Fry – OO, Spinach, Fresh Garlic, Grated Ginger, Oyster Sauce – Medx15min • Sockeye Salmon – OO, Salt, Pepper, Fresh Garlic, Tumeric P – 400x20min
  • 41. Movement (exercise) • 150 m/week moderate exercise • 75 m/week of vigorous (vig/mod) • 30 m/day/5days/week • 10 m/3xd/5days/week • 2500 steps/day (ACSM high success than 10,000/d) • http://www.startwalkingnow.org/
  • 42. Calories per hour Activity 100 lb 150 lb 200 lb Bicycling, 6 mph 160 240 312 Bicycling, 12 mph 270 410 534 Jogging, 7 mph 610 920 1,230 Jumping rope 500 750 1,000 Running 5.5 mph 440 660 962 Running, 10 mph 850 1,280 1,664 Swimming, 25 yds/min 185 275 358 Swimming, 50 yds/min 325 500 650 Tennis, singles 265 400 535 Walking, 2 mph 160 240 312 Walking, 3 mph 210 320 416 Walking, 4.5 mph 295 440 572
  • 43. Energy work!!!!! • Einstein and quantum physics • Traditional Chinese medicine • Ayurveda/yoga • Reiki • Healing touch • Prayer/intention • Food/Plants/oils/aromatherapy
  • 44. Ayurveda Whole System Approach to Energy • Chakras • Nadi’s • Marma point
  • 47. Synchronicity-Love and Service to others • Takotsubo Cardiomyopathy (temp LV dys 4-6 wk) • Harmonic coherence • Menstrual synchrony • Unified field theory (theory of relativity with electromagnetism)
  • 48. Breathing as exercise? Inspiratory Reserve Olympians Normal in/out Navy SEAL’s Expiratory Reserve
  • 50. A neti pot reminder: Neti kriya Nasya Karma
  • 51. Pranayama (BAM!) Breath Awareness Meditation • Ujjayi Victory or Ocean • Nadi Shodana Nadi cleansing/ Alternate nostril • 4-7-8 Andy Weil 5-10 minutes beginning and ending your day
  • 52. Meditation • Moving • Supported Tim Olmsted -Pres. Pema Chodron • Group Foundation -Spiritual Director Buddist Center • Open Steamboat Springs CO -Teaches with Yongey Rinpoche
  • 53. Supported meditation to maintain change • Sight -candle, mandala, image • Sound -singing bowl, nature, breath, om • Smell -aromatherapy, nature • Taste -mindful eating • Touch -healing touch, comfort, sit bones • Breath, mantra, yoga, tai chi, Qi Gong • Keep the concept of “monkey mind”
  • 54. Meditation timers Start: 5-10 minutes twice a day Maintain: 30 minutes twice a day to
  • 56. Control the internal milieu that determines your future weak strong
  • 57. The Saguil Approach • Rescue • Stabilize • Grounding • Nutrition/Behavioral/Movement • Flare up/maintenance planning
  • 58. DrRic take home points 1. Patient heal thy self, 2. Find your own “center for healing” 3. Keep western medicine “on a leash” 4. If you find a doc that listens and is an example of health…never let go and share with others.
  • 59. How to choose what is right for you? http://integrativemedicine.arizona.edu/alumni.html National Center for Complementary and Alternative Medicine - National Institutes of Health, Integrative medicine …."combines mainstream medical therapies and CAM therapies for which there is some high-quality scientific evidence of safety and effectiveness."
  • 60. Q & A? Future Lecture: Hypertension Pioneer Park Arlington Heights February 25th 11-12noon (847) 593-3330 DrRic on Saguil We didn’t invent the practice of medicine…. we’re just changing the way it’s provided.

Notas do Editor

  1. Based on a survey of our patients, we found a consistent theme of what frustrates them about conventional medicine practices and why they felt First Health was different. Since identifying these 4 key areas, we have made a consistent effort to offer our absolute best to:Listen attentively to Patients concernsMake the patient the driving force as the center of careMinimize wait timesExplain all the options for treatment, and give the patient choices (medications, alternative medicine, nutritional medicine/supplementation, psychological medicine)
  2. Design notes: list of providersWe want this to look much more inviting—these chairs are way too cold.Had thoughts about putting the actual providers in the chairs. Could be an actual live picture with a sample patient in the red chair or could be a group of providers sitting around the table.