Analyzing Stress: A Holistic Approach

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Analyzing StressA Holistic Approach

• Stevan Cordas DO MPH

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What Is Stress?

• Stress is a response of the organism to a
  stressor. It is basically an imbalance or
  perturbation created between an environmental
  factor and the genetic-adaptive mechanisms of the
  host.

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Types of Stressors

• Dietary abuse, excesses and deficiencies.
• Environmental factors infections, metals,
  pesticides, work related chemicals, additives,
  radon etc.
• Structural stress - genetic and acquired..

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Types of Stressors

• Emotional and social problems genetic and
  acquired. (Engel).
• Genetic and acquired biochemical and immunologic
  abnormalities.

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When to Consider Looking

• Look for stressors that contribute to illness
  with this pentamic model in more chronic
  persistent illnesses.
• Consider this model when the etiology is not
  known or mutifactorial.
• The goal is to modulate the illness by modifying
  aggravating stressors instead of conducting a
  frontal attack.

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Problems!

• In the real world, the physician has little or
  time to be a detective. If simple palliative
  methods are not effective, a treatment failure is
  likely.
• We tend to focus on what we know well and forget
  other areas.
• The third party payer doesnt understand what you
  are doing.

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Examples

• Fibromyalgia
• Chronic fatigue
• Recurrent headaches
• Irritable GI syndrome
• Diarrhea
• Rheumatism
• General sensitivities

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Facts

• It is better to shut off the water at the spiquot
  than to keep up wiping the floor.
• This model may find the cause of the problem
  rather than treat the effects.
• Many times multiple causes are present and are
  cumulative.
• Bioindividuality is real. (Williams)

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Fact

• 50 of what you learn in medical school will be
  incorrect or obsolete when you leave training and
  no one knows which 50.
• I know of nothing more laughable than a physician
  who does not die of old age. Voltaire 1694-1778
• Physician heal thyself. St. Luke 423

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Nutritional Factors

• Obesity is increasing - one out of three
  Americans.
• Caloric concentration and excesses. Lack of
  physical effort and exercise to match.
• A majority of stress is caused by adverse
  personal habits and behavioral factors related to
  them.

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Nutritional Factors

• Vitamins useful due to cooking practices, food
  choices and increased sustained stress.
  Overemphasized in popular press.
• Antioxidants may be helpful in reducing coronary
  artery disease but little effect after it is
  present. Free radical theory.
• Herbs are drugs and can cause drug drug
  interactions. Some have value.

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Nutritional Factors

• Certain nutritional deficiencies common (NHANES
  studies) these include iron, zinc, chromium,
  pyridoxine.
• Most common cause of immunodeficiency worldwide
  in malnutrition. (Bellanti)

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Environment (External) Factors

• Various infectious processes occur as an external
  event. Genetic and nutritional factors play an
  important role in patients with infections.
• The milieu is everything and the microbe nothing
  Pasteur.
• We are surrounded by a sea of poisons.

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Examples of Environmental Stressors

• Carbon monoxide
• Solvents
• Heavy metals
• Radon and radiation
• Pesticides
• Food additives
• Allergens

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More Environmental Stressors

• Ethanol - alcoholism common
• Substance abuse ruins lives and relationships.
• Tobacco use most common correctable risk factor

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Other Environmental Issues

• The federal government has stated that
  environmental medicine is under-represented in
  the medical school curriculum. (IOM 1994)
• Mold issues are a popular example of confusion
  and hysteria due due poor patient and physician
  education
• Bioterrorism issues are causing confusion and
  more hysteria.

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Allergies

• Probably the most common inherited disease.
• Most cases recognized and treated effectively if
  they seek medical attention
• Immunotherapy and avoidance methods are helpful
  for more severe cases.
• Sometimes foods or chemicals cause intolerance or
  idiosyncratic responses.

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Case 1 38 Year Old b/f

• Recurrent Candidiasis
• Sleep disorder
• Ekboms syndrome
• Job stress
• Dysthymia
• Allergic sinobronchitis with secondary bacterial
  infections

• Diet with excessive calories, refined sugar,
  alcohol
• Tobacco abuser
• Estrogen deficiency
• Adrenal exhaustion
• Panic attacks
• Mood disorder
• Low self esteem

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Case 1

• Treat allergies conventionally. Rule out
  mechanical obstructions. May need surgery.
• Sleep evaluation
• Activate mental health practitioner
• Tobacco cessation counseling
• Change diet, acidophilus, etc.

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Case 254 Year Old W/f

• Persistent pain neck and head.
• Atypical facial neuralgia
• Recurrent rashes
• Reactive hypoglycemia
• Mood swings
• Hot flashes

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Case 2Recurrent Migraines

• Discovered specific food intolerances
• Osteopathic cranial-sacral methods coordinated
  with dentist.
• Maxillary splint for TMJ defect.
• Changed diet to reduce refined carbohydrates
  after an elimination diet.
• Improved her hormone balance. Reviewed natural
  verses synthetic hormones.

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Stress QuestionnaireAdvantages

• It takes none of your time to administer it.
• Directions are easy to follow.
• Doesnt tire the patient out since it is brief.
• Reflects the patients view of where his main
  stressors are.

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Shepard System - Biocybernetics

• Another tool to help qualitatively assess the
  patients needs.
• Similar to Chapmans reflexes but more
  comprehensive.
• Used qualitatively to guide whether any
  bionutrients are needed as well as many other
  areas poorly evaluated by standard blood tests.

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Shepard System

• Used to overview the neuroendocrine system.
• Based on book Healing Energies by Stephen Paul
  Shepard.
• No additional charge to the patient for testing.

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Summary

• Stress related conditions cause most human death
  and suffering
• A majority of these are caused by tobacco,
  alcohol, diet and destructive behavioral
  patterns.
• A logical holistic method to treat these complex
  cases is not alternative but common sense.

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Summary

• The ultimate goal of a integrative health care
  practitioner is to obtain the highest state of
  psychological, social and physical health for the
  individual.
• The methods of traditional and alternative
  medicine are only the tools to accomplish this,
  not an end itself.

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