Download Healthy 850 - Brigham and Women`s Hospital

Healthy 850
A Courtesy of
The Osher Clinical Center for Complementary and Integrative Medical Therapies
FREE Resources for BWH Employees
at the Osher Clinical Center
Acupuncture Assisted Smoking
Cessation
November
Tuesday / Thursday: 12:-1:00
November 2012
….Caring for your Immune System….
Immunology 101: A Quick Course in Understanding
Our Immune System
-Megan Tabor, DC and Donald B. Levy, MD
Hatha Yoga for Medical Symptom
Reduction
Tuesdays, 1:15 – 2:30
To register call (617) 732-9700.
_____________________________________
Featured Healthy Links
BWH Cardiovascular Wellness Service
Welcome to this month’s Healthy 850 newsletter, which is devoted to the Immune
System. We thought it a good idea to start off with a “Readers Digest” explanation
of some of the components of the immune system and what it does, so you can
really appreciate this issue’s content.
What is the Immune System?
_____________________________________
Additional Services at 850 Boylston
Street
__________________________
The immune system is a network of cells, tissues, and organs that work together to
defend the body against attacks by harmful invaders—such as bacteria or viruses-that can cause infections or disease.
Yoga – with Andrea Soler
Kripalu / Vinyasa based yoga
Mondays 6:30-7:45 at the Fish Bowl
$10.00 class or $85.00 for 10
It’s a complicated system that we’ve broken down here into its two primary lines of
defense; (1) innate immunity and (2) acquired immunity. Each have their own set
of tools and work together to protect us from harm--whether it’s fighting a cold,
preventing the flu, responding to an allergic reaction, destroying cancer cells or
giving us life-long protection from some diseases.
Your Body’s First Defense: Innate Immunity
Important Date
st
World AIDS Day is December 1 . The
2012 theme is “Working together for
an AIDS-Free Generation”. Click here
for more information.
The Innate immune system delivers the first line immune responses when we are
exposed to invading microorganisms. These responses are present when we are
born and do not need to be adapted or changed over time. This early response
mechanism is essential since invading bacteria or viruses can begin reproducing in
minutes. There are many components to the innate immune system, including:


physical barriers, such as the skin and mucous membranes
many types of specialized white blood cells called neutrophils, monocytes,
macrophages, mast cells and platelets that secrete thousands of enzymes
and other biologically active molecules that activate, modulate and
maintain the inflammatory response to invading microbes or damaged cells.
The signs of inflammation that we all recognize—redness, heat, swelling and pain—are all generated by the innate
immune system.
For the most part, we are not aware that this system, with its billions of cells and thousands of chemical mediators, is
constantly at work defending our health. When we ingest, breathe in, or are otherwise exposed to viruses or bacteria, the
innate immune system goes to work quietly and efficiently and often the infection never blossoms into a perceivable
inflammation; we do not even know that we have been “attacked”.
When this first line innate immunity needs help, the second defense line, called adapted or acquired immunity, is triggered.
Read on for more details.
Your Body’s Long-Term Defense: Acquired or Adaptive Immunity
The Adaptive (or Acquired) Immune System consists of other white blood cells—mostly “T”
and “B” lymphocytes and a huge array of helper cells and secreted chemical mediators.
T-lymphocytes perform a variety of tasks. For example, when viruses and some bacteria get
inside a cell and reproduce, T-lymphocytes are important in the elimination of infected cells. T
cells also attack cells that exhibit odd or unrecognized behavior, such as cancer cells.
Unfortunately, they may also destroy therapeutically transplanted cells, causing graft
rejections.
B-Lymphocytes produce specific antibodies to specific invaders or antigens that they encounter. These cells produce various
types of immunoglobulins which can be classified as IgG, IgA, IgM and IgE. Contact with a recognized invader causes the B cells
to activate, proliferate and differentiate. Memory B cells may live for many years, circulating inside the body in search of
foreign invaders. Upon encountering one they begin their work, but it can take many days to produce enough antibodies to
completely ward off an attack. We can take advantage of this process through vaccination. Vaccinations expose the immune
system to all, or specific parts, of a common invader such as influenza, measles, polio, or hepatitis virus, etc. to stimulate a
primary immune response to the invader. The memory B cells are now ready. They can respond faster and more effectively
when exposed to the natural microorganism.
Mounting the Immune Response: It Takes a Village
In summary, there is a lot to understand about our complex immune system and its many moving parts—billions of white blood
cells and thousands of types of chemical mediators and molecules. Each part requires its own building blocks, nutrients and
maintenance to operate at peak performance and keep you healthy. The Innate and the Adaptive (acquired) immune systems
function very differently but they work closely together and interact to support each other. Knowing some important basics will
help you better enjoy the helpful information in this issue as the winter season approaches.
Avoid Getting an Upper Respiratory Infection this Winter
“I need something to boost my immune system”
- Donald B Levy, MD
There are many claims about the ability of certain herbs, dietary supplements and lifestyle measures to “boost the immune
system” and/or prevent infectious diseases. If you study the immune system, or just read “Immunology 101” above, you quickly
realize how broad that statement sounds. Boost the whole thing? One part? Which of the several thousands of moving parts?
Here are a few suggestions to help you stay healthy this cold and flu season: two protective behaviors, and two nutritional
supplements whose benefit is backed by reasonable scientific evidence.
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
2
Two Protective Behaviors
1.
Wash your hands with soap and water (or use a qualified purifier, such
as Purell®) as frequently as you can when sharing touched objects in a
public space.
Travel Hint: Consider giving an extra wipe of the surface of the parts of
the hotel room that have the most germs. Studies show that these are:
the TV remote, telephone, alarm clock, bathroom faucet, thermostat,
ice bucket, door handles, and yes, the Bible in the drawer!
2.
Moderate daily exercise may help prevent upper respiratory
infections—so stay active in the cold weather months [but you do not
need to train for a marathon].
If you tend to get sick a lot, get a
check-up with your PCP and then
consider an integrative medicine
consultation at the Osher Center.
Doctor Levy will be happy to discuss
which popular interventions [such
as: Airborne™, astragalus,
Echinacea, vitamin C , vitamin D,
fish oils, Oscillococcinum™,
probiotics, zinc, etc.] have some
evidence for efficacy and safety,
which do not, and the proper doses
and formulations to use.
Two Useful Nutritional Supplements
1.
For Prevention you can try this supplement for 2-3 months:
Green Tea Extract—Components of green tea appear to stimulate certain T-lympocytes to produce a powerful
antimicrobial molecule called a cytokine. In a randomized, controlled trial of a proprietary formulation of green tea
extract - ImmuneGuard®- two capsules daily [equivalent to drinking about 10 cups daily] was taken for 3 months, there
was a significant decrease in the incidence of cold and flu illnesses. For those who became ill, there was a significant
decrease in the number of days that subjects had symptoms. ImmuneGuard® can be ordered on-line. It is difficult to
tell if all similar products would have the same effect.
2.
Getting sick? Starting to get that familiar viral feeling? Try this Immediately:
Elderberry (Sambucus nigra) Extract
Nutrients known as flavanoids contained in elderberry are thought to be responsible for its anti-viral and immune
priming effects by stimulating white blood cells called monocytes to produce particular cytokines (not unlike the
process for green tea). Certain flavanoids in elderberry inhibit H1N1 to about the same degree as prescription
medications such as Tamiflu and amantadine, and reduce symptoms when given to patients with influenza A or B. Take
extracts as instructed on the label as some are crude extracts (whole plant) and some are standardized concentrates.
Dosing is usually every 6 hours for 3-4 days.

Gaia Herbs makes a high quality liquid tincture –30-40 drops in any liquid may be taken 4x daily

Sambucol™ is sugar sweetened and found in regular pharmacies. Buy “The Original Formula”. It contains 3.8 g
Black Elderberry Extract per 10 ml--Take 2 tsp. four times daily— which finishes the bottle in 3 days. It may be
repeated if needed
Enhancing Immunity with Dietary Choices and Habits
- Caitlin Hosmer Kirby, RD
A Google search of "immune enhancing foods" will provide a long list of healthful options (e.g., garlic, fatty fish, spinach,
blueberries, yogurt, kale, lentils....and the list goes on). Instead of pinning optimal health on individual foods, here are a couple
higher level suggestions for getting you on the right track. Pick one that is new to you and start preparing for winter!
Limit sugar and eat a low glycemic diet--that is, one that includes complex carbohydrates and other foods that the body takes
longer to break down and turn into simple sugars. Excessive sugar intake not only contributes to the development of obesity
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
3
and diabetes, but also taxes our immune system’s ability to respond and function properly. High, or rapid rises in, blood sugar
promotes inflammation. So, consume quality foods that have a low glycemic index –For more information on low glycemic
index foods, go to http://www.glycemicindex.com/index.php
Eat more fruits and vegetables! Eat a rainbow of colors. Each and every one packs
micronutrients noted below that may provide a boost to one or more of the many aspects
of the immune system.
Make an effort to choose a fruit or vegetable in a category/color you don't usually eat.
Click on the hyperlinks below to learn more about the various benefits of each color
category of fruits and vegetables.
Green – [Contains EGCG, isothiocyanates, lutein/zeaxanthin, and isoflavones] – green tea, broccoli, Brussels sprouts, spinach,
kale, green peppers, green beans
Red/pink - [Contains lycopene and ellagic acid] - red bell pepper, tomatoes, strawberries, pink grapefruit, guava
White - [Contains allicin and quercitin] - garlic, onions
Purple/blue – [Contains anthocyanidins and resveratrol] - blueberry, beets, pomegranate
Yellow/orange – [Contains alpha-carotene, beta-carotene, hesperitin, and beta-cryptoxanthin] - carrots, cantaloupe, winter
squash
How to protect yourself and our patients from the flu!
- Louise Schneider, MD
Medical Director, Internal Medicine
Gretchen and Edward Fish Center
for Women’s Health
One of the very best ways to prevent the flu is to get vaccinated. Even healthy
people can get very sick from influenza and spread it to others. Everyone over
six months of age should receive the flu vaccine especially if you live or work
with people who are at risk for developing flu-related complications.
There are also strategies to reduce the spread of influenza which include:





Stay home from work or school when you are sick
Cover your mouth and nose with a tissue when you cough or sneeze – If
you don’t have a tissue available, cough into your sleeve instead of your
hand
Wash your hands often with soap and water or Purell
Avoid touching your eyes, nose or mouth
Practice good health habits like eating well, exercise, stress
management, drink plenty of fluids
BWH Note:
As in past years, all employees are
required by the Massachusetts
Department of Public Health (DPH) to
document in PeopleSoft that they either
received a flu vaccination or declined to
be vaccinated by Dec. 15, 2012. Those
who decline will need to enter a reason
for their declination.
Flu symptoms may include fever, cough, sore throat, runny or stuffy nose, body aches, headache, fatigue or diarrhea and
vomiting. It is important for you to seek medical attention if you experience shortness of breath, pain or pressure in your chest
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
4
or abdomen, dizziness or confusion, severe of persistent vomiting or if your flu like symptoms improves but then return with
fever and worse cough.
Once again, obtaining that flu shot is your best defense to ensure you and your family have a healthy fall and winter.
Warm Autumn Recipes
- Lynda Danzig, Lic. M. T., Lic. Ac.
The autumn season is brings lots of transition in the air, the colors, clothes and especially in our menus. In the 5 Element Theory,
commonly used in acupuncture and oriental medicine, autumn is represented by the element metal. The corresponding internal
organs are the lung and large intestine. It is a good time to support these internal organs by addressing the dry quality of this
season and preparing for the cold. The following two simple recipes are used to tonify the lungs, have a warming thermal nature
and aid in food digestion (and are delicious!).
NOT Y OUR AVERAGE APPLE SAUCE
4 baking apples (Macintosh, Courtland, etc.)
4 very ripe Bosc pears
Tablespoon of lemon juice
I inch diameter of fresh, grated ginger
1-2 tablespoons of dried Lycii berries (Gou qi-zi) FYI - "Goji berry" and Lycii berry are virtually the same.
Quarter the apples/pears and remove the seeds. I use a melon ball scooper for an easy, efficient extraction of seeds, after they
are quartered. Place in a large sauce pan, add remaining ingredients, toss to coat fruit with juice and cook until very soft. When
it is at your desired consistency, gently mash with a slotted spoon for a satisfying dish. It is suggested to serve warm at this time
of year.
GINGER SYRUP
2 cups sugar
2 cups of fresh peeled ginger, cut in 1/8 slices
2 cups of water
In a medium sauce pan combine ingredients and cook over a high heat until it boils. Reduce the heat
to a simmer. Cook until the liquid is syrupy and reduced down to half. Strain out the ginger root and
cool the syrup. Store the syrup in a glass jar with a lid. It keeps best in the refrigerator.
This syrup is a gentle and delicious way to calm an upset stomach. Ginger is used traditionally for nausea. Use it on toast as part
of the BRAT diet (Banana, Rice, Apples, Toast, these are all foods suggested for someone who is suffering with gastrointestinal
distress.) A terrific way to start the day may be with oatmeal, ginger syrup and a dash of cinnamon. This is very warming,
energetically sustaining and a great way to tonify the energetics of the Earth element represented by the spleen and stomach.
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
5
Would you like some help quitting? - One more Free trial…..
Would you like help with smoking cessation through acupuncture? November is the host month for
“The Great American Smokeout”, “Lung Cancer Awareness Month” and “COPD Awareness Month”.
We will, again, be offering FREE acupuncture assisted smoking cessation on Tuesday and Thursday
from 12:00-1:00 during the month of November. For more information, or to reserve an
appointment, please call 617-732-9700.
Featured Monthly Acupuncture Point – To Boost the Immune System
- Brendan Carney. Lic. Ac.
The LI-10 - LI-11 area is known for it's usefulness in stimulating
our immune system. You may find that while your arm is at a 90
degree angle it has a crease at the elbow. Towards the end of
the crease of the elbow on the outer arm is where the Large
Intestine meridian - or "LI" is located. Search in an area with
light palpation about one inch away from your elbow crease in
a direction towards your wrist and look for little bumps. These
bumps are where the active immune points are located. You
can massage them of use light pressure on the arm to help
stimulate your immune system.
Stress and the Immune System
- Randall Paulsen. MD
Stress is a dualistic term. There is good/bad, acute/chronic, and adaptive/maladaptive stress.
One can have too much stress – frantic multitasking, etc. There can be too little stress –
retirement with nothing to do. There must be a balance between the two extremes.
Unbalanced stress can drive us out of our minds, and, moreover, it can drive our minds out of
our bodies.
Take a minute right now. Stop reading, close your eyes and observe and count your next 3
natural breaths. …. Welcome home.
Now, for a brief example that demonstrates a link between stress or stress-reduction, and the
immune system. Richard Davidson, MD director of the Center for Investigating Healthy
Minds at the University of Wisconsin conducted a very interesting study involving a simple flu
vaccination.
Most of us get shots, particularly at this time of year. The flu shot introduces a small amount of killed flu virus into your blood
stream in order to alert your immune system to what this year’s flu might look like – sort of a specific preview that allows your
system to prepare certain proteins, called antibodies to recognize this year’s enemy (your adaptive immune system). These
proteins are prepared by the B lymphocytes in the immune system are called immunoglobulins, and they are ready when we are
exposed to the flu virus itself.
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
6
Dr. Richardson conducted an experiment with 2 groups of patients during July and August prior to flu season. The
experimental group was given a full Mindfulness-Based Stress Reduction Course or MBSR (taught by Jon Kabat-Zinn actually)
and the control group was given a course in health issues. Both groups had a class with a skilled instructor on a weekly basis.
The difference was that the MBSR group was taught meditation, yoga, mindful eating, in short some of the basic skills to bring
focused awareness, or “mind”, back into the experience of being in the body. The control group was given good health
information, but no practice, no daily meditation homework. At the end of the 8 week programs, both groups were given their
annual flu shot. Six weeks later blood samples were drawn from all the members of both groups. The MBSR group showed a
much higher level of anti-influenza immunoglobulins in their bloodstream. It seemed that the practice of bringing focused
awareness to their bodies on a daily basis had enabled their immune systems to be more efficient in making antibodies as a
response to the flu vaccine.
The take-home message is that if we can work earnestly at the practice of being more present in our bodies, taking some time
daily to focus on something as simple as the breath, or sensations in the skin, we may actually improve the way our immune
system functions. The next time you drive home from work, try turning off the radio, driving in the right hand lane, and just
enjoy the quiet, maybe pay attention to your natural breath, let your mind muse over the events of the day. When you arrive
home, your family may enjoy seeing a more relaxed you, your car will have burned a little less gas, and your immune system
may be a little more supple in its ability to respond to the germs your kids have brought home from school.
I encourage you to find your way to being more aware and more present inside the home that is your body.
* D av i d s o n , R . J. , Ka b at - Z i n n , J . , S c h u m a c h e r, J . , Ro s e n k ra n z , M . , M u l l e r, D. , Sa n to r e l l i , S. F. , e t a l . ( 2 0 0 3 ) .
A lte rat i o n s i n b ra i n a n d i m m u n e f u n c t i o n p r o d u c e d b y m in d f u l n es s m e d it at i o n . P sy c h os o m a t i c m ed i c i n e , 6 5 ( 4 ) ,
5 6 4 - 57 0 . )
Tai Chi for Parkinson’s Disease
Tai Chi integrates gentle movements, rhythmic breathing and imagery to improve
strength, balance, flexibility, mental focus and emotional tranquility. Recent research
suggests that Tai Chi can significantly improve balance, mobility, and quality of life for
individuals with Parkinson’s Disease (PD).
Growing out of a unique collaboration between researchers, clinicians and Tai Chi
experts representing the Osher Center for Integrative Medicine at Brigham and
Women's Hospital and Harvard Medical School, The Parkinson's Disease and
Movement Disorders Center at Beth Israel Deaconess Medical Center, and The Motion
Analysis Laboratory at Spaulding Rehabilitation Hospital, we offer a program
specifically tailored for individuals recently diagnosed with PD. This class is open to
both individuals with PD as well as their partners. The course will be offered again in January 2013.
Dates and Times – Tue / Thu – 7:00-8:00 PM - October 2, 9, 23; November 6, 13, 20; December 4, 11, 18
Fee - $100.00 / 10 week series
Location – 850 Boylston Street – Fishbowl Conference Room
Registration – contact Jared Miller – 617-667-9890
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
7
Maintaining a healthy body begins with enjoying a healthy attitude. Optimist International is a service club
organization with 2,900 clubs and almost 87,000 members in more than 35 nations throughout the world. The
international headquarters is located in St. Louis, Missouri. In 1922, the Optimist Creed was adopted as the official
creed of the organization. Consider reading this out loud every morning, before embarking on your daily routine.
The Optimists Creed
Promise Yourself
To be so strong that nothing can disturb your peace of mind.
To talk health, happiness, and prosperity to every person you meet.
To make all your friends feel that there is something worthwhile in them.
To look at the sunny side of everything and make your optimism come true.
To think only of the best, to work only for the best
and to expect only the best.
To be just as enthusiastic about the success of
others as you are about your own.
To forget the mistakes of the past and press
on to the greater achievements of the future.
To wear a cheerful expression at all times and give a smile
to every living creature you meet.
To give so much time to improving yourself
that you have no time to criticize others.
To be too large for worry, too noble for anger, too strong for fear,
and too happy to permit the presence of trouble.
To think well of yourself and to proclaim this fact
to the world, not in loud word, but in great deeds.
To live in the faith that the whole world is on your side,
so long as you are true to the best that is in you.
Click here for a jpg version.
Please join us in sharing your health tips and feedback.
For comments on the content of this newsletter, please contact Donald Levy, MD at [email protected]
To submit ideas for future newsletters, please contact Matthew H. Kowalski, DC at [email protected]
Courtesy of the Osher Clinical Center for Complementary and Integrative Medical Therapies
8