HAWAII DOC TALKS 2022 SCHEDULE

DAY 1

Thursday, February 10, 2022

8:00am

Breakfast

8:15 – 8:45

Welcome – Michael Traub, ND and Corinne Maul De Soto, ND

Opening Blessing by Kawena Mechler

8:45 – 9:15am

Alena Guggenheim, ND

Dismantling ableism in medicine: identifying our gaslighting tendencies to help ourselves and our patients

Physicians inadvertently perpetuate and cause harm within the therapeutic doctor patient relationship through many types of bias. Racism, classism, ageism, sizeism, sexism and ableism are each present within all of us, and each deserves it’s own dismantling process. This talk will help us recognize ableism within ourselves as physicians, and the insidious ways in which this impacts our patients. First we must acknowledge that we all hold able-bodiedness as the default experience of humans. Medical school taught us that “healthy” is “normal”, and “unhealthy” is “abnormal”. Our culture has simultaneously taught us that if we have bias we are “bad” and if we don’t, we are “good”. Together we can start to dismantle this binary system that holds us separate from ourselves and our patients. We will explore examples of able-bodied privilege, and patient impacts when our privilege impacts our care.

 

.5 Credits Pharm

9:15 – 9:45

PCOS – how are you treating it?

Polycystic ovarian syndrome is the most commonly diagnosed endocrine disorder in women of reproductive age. PCOS can cause significant symptoms and distress for women during their reproductive years. The hormonal dysregulation that accompanies the diagnosis can be regulated with well researched lifestyle, dietary and nutritional changes. Often patients will be recommended oral contraceptives from a young age without their diagnosis being properly explained. Let’s change that conversation and empower women to take action to help regulate the endocrine system to optimize their hormonal balance and future fertility.

 

.5 Credits Pharm

9:45 – 10:15

Ilana Gurevich ND, LAc

Diarrhea solutions: Treating exocrine pancreas insufficiency as an underlying cause

Talk centering around diagnosing and treating exocrine pancreas insufficiency (EPI). Discussion of presentation, underlying causes, testing and treatment. We will go into depth about how to rule in or out this condition. We will discuss pharmaceutical treatments as well as natural agents to treat. What testing is available and how much efficacy does it have. Also we will discuss using vegetarian verse animal based enzymes for treatment as well as prognosis of care.

.5 Credits General

10:15 – 10:45

Panel Q&A: Gurevich, Peacock, Guggenheim

10:45 – 11:15

Exhibit Break

11:15 – 11:45

How to Order and Interpret GI Imaging to Get the Case Solving Information

I see many patients that suffer from chronic digestive problems, have have extensive diagnostic workups and still either have no definitive diagnosis and, because of that, no effective treatment. I find it is often highly enlightening and often diagnostic to send for and study any esophagoduodenoscopy (EGD) and colonoscopy reports as well as biopsy reports. These will often will reveal essential information. I find a major pitfall is relying on patient recall for these details. 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 and some key things to consider in treatment. I will focus on how and why to order an esophagogastroduodenoscopy (EGD), conditions typically assessed by EGD/biopsy; how to order and key points to interpretation of a gastric emptying study, HIDA scan and colonoscopy with biopsy. Don’t ignore essential details hidden in the workup that can make all the difference for your patient’s outcome!

11:45 – 12:15

Peptide Therapy Introduction and overview
Within the integrated medical professional paradigms there is an emphasis on Individualized Care and Personalized Medicine. This approach is extremely valuable from a diagnostic perspective, as well as for addressing the root causes of disease, however is also highly variable in respect to implementation as evidenced by discrepancies between providers and the sheer volume of supplements and herbals available.
This lecture will make a case for the implementation of “Flexible Standardized Protocols” to address issues, using examples of common disorders such as SIBO. Many examples of this exist in our community already but tend to be
focused on things such as Mold or Lyme. Many of our more well known faculty teach protocols at various conferences yet widespread implementation is still minimal. The Biomedical and Functional medicine community has gained larger
traction by utilizing this concept, thought the majority of treatments are derived from the Naturopathic model.
In an environment that demands increasing evidence standardized protocols for our community provide a way to improve outcomes, measure data/evidence and increase patient compliance.

.5 Credits

12:15 – 12:45

Q&A Panel: Sandberg-Lewis, C. Kleronomos

 

 

5:00pm

Beach Picnic Family Dinner

Join us for drinks and apps on the beach. Bonus points if you have an instrument you want to bring for a jam session! If you’d like to bring your dinner, you’re welcome to!

DAY 2

Friday, February 11, 2022

8:00am

Breakfast 

8:30 – 9:00

What a headache!

 

The differential diagnosis of complex headache syndromes can be difficult. In this talk the speaker will review his 15 year experience with clinical management of headaches. Red flags, clinical pearls, referral strategies to help primary care providers with the evaluation and management of headache.

 

9:00 – 9:30

Small Fiber Neuropathy: Tiny nerves, terrible pain

Small Fiber Neuropathy: Tiny nerves, terrible pain

9:30 – 10:00

Smoking Cessation

10:00 – 10:30

Q&A Panel: Vespignani, Guggenheim, M. Kleronomos

 

10:30 – 11:00

Exhibit Break

11:00 – 11:30

How Bile, Intestinal Epithelium and the Microbiota Control Homeostasis

 

.5 Credits General

11:30 – 12:00

Diarrhea Solutions: Diagnosing and treating bile acid diarrhea

 

Talk centering around diagnosing and treating bile acid diarrhea (BAD). Discussion of presentation, underlying causes, testing and treatment available for this condition. We will go into depth about how to rule in or out this condition. We will discuss pharmaceutical treatments as well as natural agents to treat. We will discuss what testing is available and how much efficacy it has as well as amount of validation. Also, we will discuss using a variety of nutraceuticals options for treatment and pros and cons of different treatments.

.5 Credits Pharmacy

12:00 – 12:30

Bee Venom Therapy (BVT): Mechanism and Overview for Clinical Application in Chronic Pain, and Complex Disorders
Chronic Pain is an increasing problem with significant impact on both patients and the medical system. There are also significant concerns regarding safety of many interventions and the overall efficacy of typical therapy for many complex disorders is limited.
This lecture will introduce a novel therapy rooting in Traditional use that has significant emerging data to support it as an effective therapy for recalcitrant pain conditions as well as its potential use on a variety of chronic diseases such as autoimmunity, neurodegeneration and chronic infection. The lecture will serve as an introduction to the therapeutic application of BVT in a clinical setting and reviews in detail the pharmacologic, pharmacokinetic and dynamic mechanisms of constituents, as well as the extrapolated models of pain signaling such as DNIC, gating and modulation of fos expression.
Currently there is rationale for the therapeutic use of venoms as evidenced by several pharmaceuticals such as ziconotide (Prialt), which supports the long history of use and empirical reports.
It will discuss the framework for diagnostic application and outline basic testing and treatment protocols. We will review the current state of science, and extrapolated rationale for more advanced use as suggested by current research. We will discuss both “live” application and injectable delivery reviewing the pros/cons of each and how best to integrate into an integrated treatment plan.

 

.5 Credits 

12:30 – 1:00

Q&A Panel: Sandberg-Lewis, Gurevich, C. Kleronomos

2:30pm – 4:30pm

Workshop: Bettering the Brain: Neuro-rehabilitation for Every Patient

Bettering the Brain: A workshop focused on encouraging optimal brain function in patients to achieve better outcomes. Considering the patient’s neurologic status can change the lens through which we see their condition and give us a greater understanding of how we can help. Recognizing how each treatment modality alters neuronal activation, we can apply therapy with a more targeted, effective approach. This is a game changer for patients with a wide variety of conditions.

2 Credits General

5:00pm

HSNP Social Hour

HSNP Social

Hawaii Docs: let’s get together by the pool bar to see each other for the first time in two years! Grab an HSNP board member at the social to get a voucher towards food/drink!

DAY 3

Saturday, February 12, 2022

7:00am

Yoga Session

8:00am

Breakfast sponsored by Microbiome Labs

8:15 – 8:45

Mechanisms of Gut-Brain Axis Dysregulation and Innovative Science on Restoring the Gut-Brain Synergy

We are currently living in the “era of the microbiome”, and there is daily development in understanding of the complex and bi-directional relationship between our guts and our brains-evolving into the popular concept of the Gut-Brain Axis (GBA). The microbiome ecosystem can influence central nervous system physiology through production of anti-inflammatory compounds, maintenance of a strong intestinal barrier, production of neurotransmitters, regulation of stress response, and vagal nerve stimulation. While intricate, this system is delicate. Low gut diversity means less production of signaling molecules and neurotransmitters. The microbial ecosystem can help modulate stress response, but chronic stress can dampen microbial diversity. Thus, there is elaborate two-way cross talk between the gut and the brain and dysfunction in this messaging has strong potential for vicious cycles of ill health- including mental health-in today’s modern world. Fortunately, there are emerging therapeutic tools to “manipulate the microbiome” and improve the connectivity between these two fundamental organs. Learn about these mechanisms and promising new interventions in this talk!

8:45 – 9:15

Say "No" to Drugs [that Don't Work or Cause Harm]

Naturopathic physicians are sometimes placed in a difficult position of advising patients on alternatives to prescription drugs that have been recommended by other health care providers. When can you say “No- I’d recommend against taking that medication.” with confidence, based on evidence of non-clinically meaningful effects or the drug causing harm? This presentation will highlight several examples of commonly prescribed drugs for conditions like osteoporosis, GERD, hypertension, diabetes, joint pain, and others where a detailed informed consent process including the evidence can be an important clinical tool to help your patients make informed decisions about the prescriptions they have received and highlight some specific circumstances in which a recommendation against taking these drugs is justified.

9:15 – 9:45

Bouncing Back From Brain Injury

.5 Credits Pharm

9:45 – 10:15

Donald Abrams, MD

Expanding Access to Integrative Oncology Through Group Medical Visits

Individuals seeking integrative oncology consultation are often stymied by the paucity of providers practicing in the field. For many, this may mean that an initial appointment may be scheduled months down the line, after they have completed treatment of their malignancy, a time during which integrative interventions may be most valuable. In an effort to ameliorate this situation, a pilot program initiating integrative oncology group medical visits at the University of California San Francisco Comprehensive Cancer Center was established with funding from a philanthropic donation. Following the success of the pilot project, integrative group medical visits are now offered on a regular basis, greatly appreciated by participants and economically self-sustaining. Eight to 12 participants and their caregivers attend three sessions two weeks apart facilitated by the integrative oncologist. The session topics are 1) nutrition, 2) supplements including cannabis, and 3) additional integrative interventions including physical activity, yoga, stress reduction, traditional Chinese medicine and spirituality. The two-hour visit includes a 50- minute presentation followed by individual consultations with each patient. Use of note templates for each session greatly facilitates record-keeping. Following the three-part series, participants are invited to follow up clinic appointments at the UCSF Osher Center for Integrative Health if they so desire. Successful transitioning to virtual group visits has been achieved.

10:15 – 10:45

 

Q&A Panel: Krishnan, Abrams, Vespignani, Bradley

10:45 – 11:15

Exhibit Break

11:15 – 11:30

Sponsor Message

11:30 – 12:00

Native Hawaiian Concepts of Wellbeing

The indigenous people of Hawaiʻi (Kānaka Maoli) have a rich history of holistic wellbeing. There is much strength to be gained from the enduring values and wisdom of Hawaiian ancestors. It is upon this foundation that we can stand firmly and collaboratively create innovative solutions to systemic problems affecting the wellbeing of individuals, families, communities and beyond. This presentation will share a framework of wellness that overlaps with and expands upon naturopathic concepts of wellbeing with a focus on self care, ʻohana (family) care and community care.

.5 Credits

12:00 – 12:30

Melissa S. Barber, ND, MSc, E-RYT

A Naturopathic Treatment Approach for Mild and Moderate COVID-19: A Retrospective Chart Review

The COVID-19 pandemic has been a critical time and opportunity for naturopathic physicians to support patients and the community – when there were no known treatments and the medical community was in a quandary as to how to approach this infectious disease. This talk will feature a treatment protocol implemented in a rural, naturopathic primary care setting for patients presenting with mild and moderative SARS-CoV-2 infection and published in Complementary Therapies in Medicine. The treatment protocol designed to address the pathophysiology of COVID-19 is thoroughly referenced, supported by the evidence available at the time it was conceived. The therapeutic approach is tiered according to severity of presentation and risk factors. An aspiration of the speaker is to embolden other naturopathic physicians to increase reporting from the point-of-care and produce quality publications. She will share some freely available resources on generating case reports, case series, and/or retrospective chart reviews.

.5 Credits General

12:30 – 1:00

Q&A Panel: Lucille, Peacock, Opunui, Barber

 

 

2:30 – 4:30

Dr. Misha Kleronomos, PsyD

Workshop: The Psychology of Chronic Pain and Illness

Chronic pain and chronic illnesses have deep psychological components that need to be considered when treating them medically. This workshop will give the clinical foundations of the psychological issues facing patients with chronic pain and illness, including psychological and mind-body interventions to treat them.

DAY 4

Sunday, February 13, 2022

8:00am

Breakfast sponsored by Integrative Peptides

8:15 – 8:45

Valerie Phillips, ND

Post Covid Neurological Syndrome

Neurotropism and neurovirulence are significant features of SARS-CoV-2 resulting in the potentially devastating clinical entity of post-covid neurological syndrome.  Through blood brain barrier disruption, neuroogical toxicity and unresolving inflammation the nervous system is damaged.  This ultimately can result in thrombotic changes and lead to pathological features similar to Alzheimer’s.

This breakfast talk will discuss the mechanisms, assessment and most importantly interventions for this potential impending pandemic of dementia.

8:45 – 9:15

Compounds for Chronic Sinusitis
During this talk I will discuss treatment options for chronic sinusitis. I will discuss when to choose oral antibiotics and options for nasal spray and sinus irrigation treatments. I will discuss various formulations and the mechanism of actions of the drugs in the formulations.

.5 Credits General

9:15 – 9:45

Wired, Tipsy and Stoned: An Update

Does coffee shorten or lengthen your telomeres? Does alcohol really reduce mortality? Can cannabis be used safety for pain in patients with cardiovascular disease? This presentation will update the audience on evidence that has emerged over the last 3 years (since the original Wired, Tipsy and Stoned at HI Doc Talks 2018!) describing the health effects- positive and negative- on these commonly consumed recreational and dietary substances.

9:45 – 10:15

Q&A Panel: Phillips, Lucille, Rosenberg, Bradley

10:15 – 10:45

Exhibit Break

10:45 – 11:15

Naturopathic Oncologist as Navigator for our Patients – a case presentation

The dominant healthcare system is often woe-fully in adequate in providing helpful and compassionate guidance through a cancer diagnosis, treatment and survivorship. I can attest to this as a board-certified naturopathic oncologist with a rare cancer who experienced poor advice. and misdiagnosis; invaluable second opinions, compassionate treatment, and survivorship that were all left up to me to implement. The experience left me with a renewed commitment to serve as navigator for my patients with potential malignancy and with those diagnosed with cancer. Through sharing the story of my journey, I hope to instill in attendees a recognition of how we as naturopathic oncologists can fill an unmet need in our healthcare system.

.5 Credits

11:15 – 11:45

Melissa S. Barber, ND, MSc, E-RYT

Take a Stand: Write a Letter to the Editor!

In being stewards of naturopathic medicine, it is our responsibility to follow the medical literature in real-time, especially research in complementary and integrative health (CIH). Most notably, it is our job to scrutinize the methodology employed in different study designs. Negative CIH studies demonstrating no effect (or perhaps adverse effects) from CIH therapies are very prevalent. However, arguably a significant proportion are poorly designed. This could be due to an inaccurate intervention (wrong part of a plant used for example), the failure to account for different confounders, and several other reasons. Therefore, critical appraisal of the literature is paramount. Submitting a Letter to the Editor to elucidate shortcomings of a study is an important role we can assume, which can potentially lead to its retraction. In this presentation, we will discuss how to frame Letters to the Editor in response to a published study.

.5 Credits Pharm

11:45 – 12:15

Good Anxiety: The Five Ps to Combat Anxiety

 

.5 Credits General

12:15 – 12:45

Q&A Panel: Traub, Barber, M. Kleronomos

In addition to those talks above, the following presentations will be available via on-demand recordings for all registrants:

Kristen Coles, ND, LAc

  • The World of Fasting Mimicking Diets – A Practitioner’s Report on FMD Clinical Pearls
  • Deep Sleep and its Role in Patient Health Outcomes

Dr. Jean-Jacques Dugoua, HBSc ND PhD

  • Drug “Black Box” warnings: A refresher in prescribing vigilance
  • Sleep: A narrative review of clinical interventions for sleep

Safiya McCarter, ND, LAc

  • You’ve made a statement, now what?
  • History: Critical in both medicine and health equity.

Holly Lucille, ND

  • Cancer Stem Cell Research: Application in Clinical Practice Pt 1 & 2

Jaclyn Chasse – Smeaton, ND

  • Clinical Algorithms for Naturopathic Fertility

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Special Thanks to our Premier Sponsor:

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Join us for Hawaii Doc Talks
The Hyatt Regency Maui
February 10 – 13, 2022

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