2018 HAWAII DOC TALKS :: SCHEDULE

DAY 1

Thursday, February 22nd, 2018

9:00am – 11:00am

Pre Conference Workshop

Paul Herscu ND, MPH & Amy Rothenberg ND – It’s Not Intuition: How to Use the Non Verbal Parts of Patient History Taking to Help You Better Understand Your Patients.

12:00pm – 12:45pm

Welcome Reception

12:45pm – 1:00pm

Welcome and Opening – Kawena

1:00pm – 1:30pm

Greg Nigh, ND, LAc

Information and the Vis: How we can be certain that the 'self-organizing' process of healing is purposeful

Our profession has been so bold as to state, “The healing power of nature is the inherent and self-organizing and healing process of living systems which establishes, maintains and restores health.” In this talk Dr. Nigh will review the capabilities of naturalistic processes to generate self-organization and complex information, the type that infuses every level of living systems, including the processes that move toward balance and health. Dr. Nigh will end with alternative ways of conceiving of this self-organizing ability, ways that embrace a non-materialistic model of physiological homeostasis and health.

1:30pm – 2:00pm

Paul Herscu, ND

See the World

Dr. Herscu will describe an easy to learn, easy to teach approach to helping children & adults who have all manner of processing issues. Such challenges impact academic learning, family and friend relationships and on the job success. Help patients fix the issue, not just compensate for difficulties.

2:00pm – 2:30pm

Melissa S. Barber, MSc, E-RYT 500, NTP

Perioperative Nutritional Protocol With Real-Food Sources

Nutritional recommendations surrounding surgery time typically restrict eating and/or endorse a dietary supplement regimen or liquid formula. Perioperative nutrition can be considered a time to prime the immune system to support wound healing and has been coined a number of terms such as “Immunonutrition” and “Pharmaconutrition”. Depending on the type of surgery, feeding is either enteral or parenteral, however, parenteral feeding has fallen out of favor unless absolutely necessary. Rarely, if ever, are patients oriented to actual food sources where immune supportive nutrients can be found. In this talk, a perioperative nutritional protocol will be discussed, highlighting nutrients of paramount importance to the healing process, where they are found, and the time frame in which to administer a diet to optimize wound healing. Constituents in the diet to reduce pain and inflammation and support emotional well-being will also be addressed, as well as the debate surrounding omega 3 fatty acids.

2:30pm – 3:00pm

Mark Davis, ND

Quite Rightly: the power of saffron

Saffron has been used as medicine for at least 3,500 years, but the beginning of this millennium has seen an eruption of research on this intriguing herb. Dr. Davis describes his favorite culinary and mixological uses of saffron, and explains why it is such an amazing herb for depression, anxiety, and impaired sexual function in males and females. The robust references will be included in the documents accompanying the talk.

3:00pm – 3:20pm

Q&A

3:20pm – 4:15pm

Exhibit Break

4:15pm – 4:45pm

Ryan Bradley, ND, MPH

Wired, Tipsy and Stoned: The Health Benefits of Three Common Recreational Substances

For as long as history records, humans have used plant substances to alter their dreary day-to- day realities. For decades, public health officials and clinicians have fought and failed to reduce intake of substances like coffee, alcohol and Cannabis, due to their beliefs about the detrimental health effects resulting from their use. Concerns about adrenal fatigue, the adverse effects of caffeine, and a general taboo around using stimulants are commonly cited reasons for advising patients away from coffee. Liver disease, cancer risk, and dependency are commonly cited reasons for advising patients away from alcohol. Common concerns for Cannabis intake include: memory deficits, respiratory disease risks, and reduced motivation. Yet, how great are the actual risks of these common concerns? And what does the evidence tell us about the health benefits of these common vices? Benefits of coffee intake appear to include: reduced risk for type 2 diabetes, liver disease and a dose-dependent reduction in mortality. Benefits for alcohol include: reduced risks for cardiovascular and type 2 diabetes from moderate intake. Cannabis may offer protection against pain, neurodegenerative disease, and type 2 diabetes. This presentation will provide a balanced viewpoint on these common recreational substances, weighing the evidence for harm against the evidence suggesting benefits, based on the available evidence.

4:45pm – 5:15pm

Allison Bachlet, PhD, ND, LAc

Are Heart Arrhythmias in Men on the Rise?

With four new male patients of different ages and vastly differing health histories presenting in my office with heart arrhythmias in the recent past, I had to ask: what is with all the men with arrhythmias? Let’s also add on a good friend who almost died of a fatal arrhythmia at 32 and a husband with sports related arrhythmia…the time for diving into this topic had come! This session will guide you through the most common and well known causes of heart arrhythmia, as well as some emerging and not so common causes and highlight when an arrhythmia is cause for concern and when it’s not. A review of the most common medications and therapies used by Western Medicine will of course be covered, as will the magical ‘natural remedies’ that have shown proven efficacy and / or promise in the treatment and cure of arrhythmias.

5:15pm – 5:45pm

Paul Anderson, ND

Primary Care Pharmacology Update

Based on a 2016 review of the top ten prescribed classes of drugs in primary care Dr. Anderson will look at examples from selected classes and discuss them as they relate to the primary care provider. Regardless of who prescribed the medication each one has potential benefit and concern based on the patient and reasons prescribed. Each example will have its pharmacology, interactions and potential alternatives discussed.
1. Lipid modulators:
a. Statin class
b. Triglyceride class
2. Antidepressants:
a. SSRI
b. SSNRI
c. Tricyclic
3. Cardiac:
a. Beta blockers
b. Ace inhibitors and ARB’s
c. Calcium Channel blockers

5:45pm – 6:05pm

Q&A

7:00pm

HSNP Reception & Dinner

HSNP Members Only

DAY 2

Friday, February 23nd, 2018

7:30am – 8:15am

Breakfast

8:15am – 8:45am

Greg Nigh, ND, LAc

Glyphosate and Modern Maladies: What it does, how to assess, and how to detox

Glyphosate, the active ingredient in Roundup, is the most widely used herbicide on the planet, with over 1.8 million tons applied in the US alone since its introduction. Dr. Nigh will briefly review its toxicology, then discuss the broad range of chronic conditions associated with exposure. In fact, glyphosate application to crops in the US has an uncanny correlation with the rise in many degenerative neurological, congenital and digestive diseases and conditions. Dr. Nigh will end the talk with a discussion testing options, and will discuss the most effective set of therapies that can mobilize and help to eliminate glyphosate from the body.

8:45am – 9:15am

Jaclyn Chasse, ND

Integrative Approaches to Female Infertility: Case Illustrations

The process of conception has become increasingly technological for those having difficulty conceiving on their own, yet naturopathic therapies continue to provide a reliable means to achieve pregnancy. This evidence-based presentation will prepare practitioners to confidently assess, diagnose and treat female infertility. We will discuss common hormonal, biochemical, and epigenetic barriers to conception, and discuss how to detect and manage them. The course will also cover the basics of assisted reproductive technologies (ARTs) and provide a comprehensive look into the naturopathic treatments that can safely augment or (even better) replace these technologies. This presentation will be conducted through cases only. In 45 minutes, 3 cases will be robustly discussed to illustrate how to workup and manage women for the most common causes of infertility.

9:15am – 9:45am

Allison Siebecker ND, LAc, MSOSM

Prokinetics for Digestive Symptoms and Disorders

Prokinetics stimulate and coordinate gastrointestinal motility. They can be used for symptomatic relief for multiple digestive symptoms such as acid reflux, nausea, bloating and constipation. Prokinetics are a standard therapy for motility disorders like gastroparesis, systemic sclerosis and SIBO. While some prokinetics have safety issues, many are safe. We’ll cover both pharmaceutical and natural options, including: mechanisms of action, safety, dosing, logistics, and practical clinical tips.

9:45am – 10:00am

Q&A

10:00am – 10:45am

Exhibit Break

10:45am – 11:15am

Aviva Wertkin,ND

Naturopathic Primary Care: What's our standard?

There is increasing emphasis in our profession that “primary care” equals conventional medical practices and standards. Dr Wertkin will discuss how we can practice successfully as primary care physicians while still utilizing naturopathic medical practices and standards. This will contain approaches to acute and chronic disease; including how to navigate the controversial vaccination topic.

11:15am – 11:45am

Steven Sandberg-Lewis, ND, DHANP

Understanding GI endoscopy - make your own assessment for the good of your patients

Sending for and studying esophagoduodenoscopy (EGD) and colonoscopy reports as well as biopsy reports often will reveal essential information. I find that you cannot rely on patient recall for these parts of the history. Key findings will be lost if the patient does not remember, was not told or did not understand. I will explain how to read these reports in order to gain the full benefit from these studies.

11:45am – 12:15pm

Paul Herscu ND, MPH & Amy Rothenberg ND

Remedies that Get Left on the Shelf & How to Use in Clinical Practice.

Drs. Rothenberg & Herscu will highlight a number of less utilized homeopathic remedies and their clinical application for particular ailments. This would be relevant for those less inclined to use homeopathy as well as those who use homeopathy often.

12:15pm – 12:35pm

Q&A

12:35pm – 1:00pm

Kiran Krishnan, Microbiologist & Chief Science Officer

The spectacular role of the human microbiome in preventing post-prandial or metabolic endotoxemia,

You are more bacteria than you are human with 10 trillion human cells outnumbered by over 100 trillion
bacteria cells in and on your body. The human genome contributes just 1% genetic material to daily
metabolic function compared to the 99% that is contributed by the microbiome. An often-overlooked
role of the microbiome is to prevent post-prandial endotoxemia and the inflammatory devastation that
follows. This lecture will illustrate the danger of having post-prandial endotoxemia and why this
condition is being called the number one cause of mortality worldwide as it sets up the body for virtually
every chronic disease. This condition is caused by eating and a failure of the microbiome to protect its
host from this response. You simply cannot completely correct any chronic condition without addressing
post-prandial endotoxemia.

1:00pm – 2:00pm

Sponsored Lunch with Megaspore Biotic

2:00pm – 4:00pm

Workshop – Alena Guggenheim, ND – Joint Hypermobility Syndrome: The Great Impersonator

Joint Hypermobility Syndrome: The Great Impersonator

This workshop will cover the joint hypermobility spectrum disorders including Ehlers-Danlos syndrome. We will cover the 13 subtypes of EDS with characteristic clinical presentations and co-morbitities. We will also explore the manifestations of these disorders outside of the musculoskeletal system. After completing this session, participants will be able to:
1. Examine the prevalence and common presentation of EDS
2. Contrast EDS with similar conditions and perform a differential diagnosis
3. Formulate appropriate interventions including diagnostic testing, referrals, lifestyle, physical, and activity modification
4. Explain the mechanisms of pain in hyper mobile patients
5. Understand co-morbid diagnoses
6. Understand the role of genetic testing

DAY 3

Saturday, February 24th, 2018

7:30am – 8:30am

Yoga with Melissa S. Barber, MSc, E-RYT 500, NTP

9:00am – 11:30am

Workshop – Steven Sandberg-Lewis, ND, DHANP

Up the nose with a rubber hose

Bilateral nasal specific (BNS) technique, perfected by Richard Stober, DC, ND in the mid-twentieth century, is a highly effective method of facial manipulation. It often “cures” or greatly improves the tendency toward recurrent sinus problems and may be helpful for most health problems that begin after a forceful blow to the face. I learned this useful technique from Stober in 1977 and have been employing it ever since.
In this practicum I will explain its indications, contraindications and the details of performing BNS and then in dyads you will practice on each other with supervision.

9:00am – 11:00am

Sara Thyr, ND and Doni Wilson, ND

Intensive on Reversing Cognitive Decline, Dementia and Alzheimer’s Disease

One out of every six Americans will suffer from Alzheimer’s Disease or other forms of cognitive decline. Cutting edge research shows that naturopathic approaches can help patients reverse these conditions. Early detection is critical, and there are no good lab tests to determine onset of disease. Therefore, part of this presentation will be devoted to reviewing and practicing mental status ques-tionnaires so attendees will be ready to implement them in practice. The presenters are passionate about bringing the most current information about the usefulness of evaluating genetics and nutrient status, and implementing diet and lifestyle changes to effectively prevent and reverse these incredi-bly impairing conditions. We will review naturopathic approaches that show promise, including diet changes to address inflammation, food sensitivities, dysglycemia, and oxidative stress; optimizing gut health and the microbiome; implementing mindfulness and stress reduction; and optimizing the HPA axis. This is a presentation that will leave practitioners with excellent tools they can utilize immediately upon their return to practice.

12:00pm – 1:00pm

Lunch Sponsored by Bio-Botanical Research

1:00pm – 1:30pm

Mark Davis, ND

Certainty and choice: How and why ND ethics and MD ethics differ

This talk explores how the differing historical origins of naturopathic and conventional medical doctors lead to differences in modern-day practice. Not only do these two groups use different tools, but even when we are using the same tools, we often have different reasons for selecting them.

1:30pm – 2:00pm

Jaclyn Chasse, ND

Endocrinology of the Endometrium

It’s a very mysterious place, the endometrium. While we tend to overlook the endometrium as an endocrinologically active tissue, simply shed each month with the menstrual cycle, the endometrium is quite actively involved in fascinating hormonal and biochemical processes which influence proper menstrual function, implantation of a fertilized embryo, and proper tissue health. This presentation will dive into the complex workings of the endometrium and will focus on a functional approach to evaluate and manage endometrial complaints including fibroids, endometriosis, and implantation-related infertility. Gain a deeper understanding on an approach to successfully treat some of these challenging conditions.

2:00pm – 2:30pm

Ryan Bradley, ND, MPH

The Yin and the Yang of Oxidative Stress

Staving off the scourge of oxidative rust in our cellular machinery has been a keystone in arch of rationale for the clinical use of “antioxidant” dietary supplements since Linus Pauling’s endorsement of vitamin C. Yet, while oxidative stress in excess does cause disruption in cellular function, and even cellular death, we wouldn’t be alive without it. Oxidative bursts help our macrophages combat invasive microbes; free radicals serve as cellular messengers telling our genes to ramp up production of critical antioxidant
enzyme systems; oxidation of some xenobiotics is a necessary step to detoxification and elimination. Notably, in some cases taking large doses of antioxidants appears to cause harm by neutralizing the beneficial effects of proven practices, e.g., pomegranate juice neutralizes increases in insulin sensitivity normally induced by exercise. Thus clinicians who use antioxidant dietary supplements need to appreciate both the potential health benefits and harms of this clinical practice, and consider their use carefully in select clinical circumstances. This presentation will provide a balanced overview of the dark
(yang) and the light (yin) aspects to oxidative stress, and once again demonstrate the best clinical path may be the middle one.

2:30pm – 2:50pm

Q&A

2:50pm – 3:35pm

Exhibit Break

3:35pm – 4:05pm

Paul Anderson, ND

Modern Biofilm Pharmacology – What have the last 200 Million Dollars in Research Taught Us?

Did you know a single colony of Pseudomonas can grow a biofilm matrix the size of a dime? No wonder it is so hard to kill. Quietly the CDC, NIH and US Military have declared biofilms to be one of the top dangers to human health and have spent many millions of dollars researching them in recent years. January 19, 2017 NIH “Directors Blog” featured new data on biofilm formation, its relevance to microbial resistance and potential for non-antibiotic eradication of pathogens. The comment here is quite telling: “In addition to killing bacteria outright with traditional antibiotics, it may someday be possible to fight infection by stopping bacteria from communicating with each other or forming biofilms.” Much of what we have been taught about biofilm formation and disruption is incorrect in the face of this research. Dr. Anderson will summarize, based on the latest data, the “phases” of pathogenic biofilms, which agents are best to treat and disrupt them as well as how to prevent them from forming after eradication.

4:05pm – 4:35pm

Allison Bachlet, PhD, ND, LAc

Patient Resistance – The Bane of Treatment Protocols Everywhere

You know the scenario: a patient comes in because he or she is sick of what Western medicine has to offer, and wants to try “something natural”. Is “something natural” code for “I really don’t want to do anything?” Sometimes it seems that way. Patient resistance to change and treatment is both frustrating for the provider and confusing for the patient. Helping patients see and address their psychological resistance is often key to establishing a good doctor-patient relationship and achieving success in reaching treatment goals. The most common psychological defenses and resistance methods will be explored, and reminders of the amazing natural tools we have as NDs to address this resistance will be highlighted!

4:35pm – 5:05pm

Melissa S. Barber, MSc, E-RYT 500, NTP

Is Case Reporting Worth Your Time? And, What Tools Are Available?

Well-developed case reports provide formal structure to document exceptional individual clinical observations. Case reports have the potential to serve as a strategic tool to providing feedback on clinical practice guidelines, supporting dialogue between providers, and informing clinical reasoning skills. A case report data collection tool using the REDCap platform (NUNM-Case Report or NUNM-CR) was developed and tested with a group of clinicians representing different healthcare disciplines. This tool was identified as useful to the production of systematic case reports, promoting collegiality, and improving clinical care. Another case report writing tool, the Explanation and Elaboration (E&E)document for the CAse REport (CARE) Guidelines, was recently published in the Journal of Clinical Epidemiology. Melissa will outline the NUNM-CR tool and the E&E document to inform the writing of a case report and identify with the clinician audience, why write a case report anyway?

5:05pm – 5:35pm

Glen Nagel, ND

Herb-Drug Interactions: Many shades of gray : A Simple and Practical Guide 5 point system

The media presents the grave concern about the potential interaction between herbal medicine and drugs. With up to 60% of Americans taking herbs and nutritional supplements, what are the real concerns with combining these meds and what is hype? This talk will give an overview of the problem with herb /drug interactions and a practical method for determining the potential for a mild, moderate or severe reaction. The talk will discuss how to evaluate the concern with a five question outline. Herbs discussed are St Johnswort, Saw Palmetto, Milk Thistle, Goldenseal and other. There will also review the current literature and reference material that are useful for the clinician. There are many shades of gray within the field of herb and drug interactions this talk hopes to bring more black and white to the complex area.

5:35pm – 5:55pm

Q&A

6:00pm – 8:00pm

Dinner on the beach

Dinner Party

Join us for a casual beach dinner. Kick off your shoes, take a dip in the ocean or lounge on beach blankets. We’ll have an assortment of salads, sandwiches and snacks for you to nosh on before we adjourn inside for a dance party!

Tickets will be $20 and available at the conference.

8:00pm

Hawaii Doc Talks Dance Party!

Rumba De Fuego

Join Kauai’s 8 piece Latin Dance band for an unforgettable night. Rumba De Fuego, led by our own Steve Dubey, ND will have you dancing the night away!

DAY 4

Sunday, February 25th, 2018

8:15am – 9:00am

Exhibit Hall Breakfast

9:00am – 9:30am

Allison Siebecker, ND, LAc, MSOSM

Diet to Support SIBO

Diet is an essential part of SIBO treatment. It can offer remarkable benefit and provides one of the best tools for symptom management. We’ll cover the underlying mechanisms of why diet helps and then focus on clinical application, including: the SIBO diets and how to choose between them, how/if to use diet with antimicrobial treatment, how to help a common problem from SIBO diets, and essential patient resources.

9:30am – 10:00am

Aviva Wertkin, ND

The Soul Reason - understanding the Spiritual components of Depression

Most often Depression is viewed as a mental illness with little regard for underlying causes. As Naturopathic Physicians we are trained to look into the various physical imbalances that can cause depression but often overlook the emotional and spiritual components. Dr Wertkin will help you understand how to address the emotional & spiritual components of depression in a clinical setting.

10:00am – 10:30am

Steven Sandberg-Lewis, ND, DHANP

A Deeper Dive Into Pumpaganda – New ACG Proton Pump Inhibitor Guidelines

I will use pictures and key words to enhance my presentation of the ACG guidelines, critiquing the major recommendations for proper use of proton pump inhibitors (PPI). I’ll give a quick overview of the fascinating mechanisms behind gastric acid physiology as these relate to the indications for and side effects of PPI. Then I will go into more depth about certain of these recommendations and the research behind them as well as explaining how to individualize ND decision making for your patients. We may also have time to discuss weaning patients off PPIs in efficient ways.

10:30am – 10:50am

Q&A

10:50am – 11:30am

Exhibit Break

11:30am – 12:00pm

Glen Nagel, ND

Herbal Vitalism: A unified paradigm, exploring the energetics of western herbs through the development of plant personalities. (including Q&A)

The study of botanical medicine in the last 20 years has been built upon the dual aspect of plant chemistry and clinical research. The focus on botanical medicine has moved away from vitalism into plants as natural drugs. For all the advances this has brought it has also led to the loss of the real vitalistic method of botanical prescribing. Almost all traditional cultures from Native American to Chinese, have had an understanding that the healing power of green plants is more that chemistry. Plants tell us stories about themselves and their connection to the natural world. It is this connection that includes the genius of each plant. It is in this rediscovery that I will discuss the power of intuition, observations, and wonder at the natural world. Each herb has a spiritual identity, a personality pattern which stands, so to speak, with its eternal light. I will use a multimedia method I call “herbdance” in which I illustrate with music and song the key lessons each plant can teach. In this journey, we can connect with the spirit of each plant that can directly influence and change our human consciousness and health. In our race to the future, in the domination of technology, in the concentration of constituents, there is a loss of wisdom of traditional ways of looking at medicine. The plant world can reconnect us to that oneness to the sense of place and purpose. In this insight, we can restore and further move herbal vitalistic botanical medicine into the future.

12:05pm – 12:45pm

Amy Rothenberg, ND

The Role of Resilience in the Prevention of Physician Burnout (Including Q&A)

Dr. Rothenberg will delineate specific skills, habits and attitudes that promote and sustain resilience, this key ingredient in reaching ones personal and professional goals and in preventing physician burnout.

12:45pm – 1:00pm

Close – Kawena