Integrative Medicine with Dr. Jennifer Ashby, DAOM, M.S.

SPEAKER_00 0:02

The following is for informational purposes only. For medical advice, please see a medical professional.

SPEAKER_02 0:20

Welcome to Staying Alive with Margaret and Susie. As you can see, no Susie, she's gonna be out for another month, but that gives me an opportunity to bring in my very own acupuncturist, Jennifer Asprey. Welcome, Jennifer. Thank you, Margaret. Thank you. Uh I I was it's been a while, so I was trying to figure out. I think we work together around 10 years. And I'll get into that a little bit w within the uh episode. I'm I'm really fortunate because I live in a place where integrative medicine has a center as part of the place where I get all my medical care. And so when I started looking into healthy aging, I thought I want to include acupuncture as part of my healthy aging process. And and as I tried it out, I found that my body liked acupuncture more than any other form. And so um in this episode, we're specifically talking about uh integrative medicine because there are so many alternative medicines. Susie and I have tried many over the 50 plus years. We've been adults, and um not all of them are scientifically proven. And as you guys know, we're all about the science in this in this series, and we want scientifically proven stuff, which integrative medicine is now luckily accepted within Western medicine, and it is absolutely scientifically proven. So let's just start out with that, and and Jennifer, tell me what how you define integrative medicine and what it is we we don't we don't need to get into what isn't scientifically proven, but what are the practices that you are involved in as in your center? I know you're the acupuncturist there.

SPEAKER_01 2:20

So it's interesting. I think um I think the definition is has changed over time, and I've actually pulled up to read in a little bit the academic consortium, which is the consortium of integrative medicine and health, um, for the National Center for Complementary and Integrative Health at the NIH. So I brought up their definition, so we have it, but I think I think I think we are a grow, growing and evolving branch of medicine. And I think that there are very specific reasons behind that, mostly being supply and demand. People are wanting other approaches besides just traditional Western care. Allopathic medicine has its place. I am super pro-allopathic medicine, but it has its limitations. And I think that all approaches have our strengths and weaknesses. We all have our limitations. So I work at the OSHA Center of Integrative Health at UCSF, and I've been there now 12 years. Yay, if you can believe that. And even during my time there, I think it has changed. I remember when I first started there, I was thinking that, oh, I'm I'm I'm coming into an integrative health center. We're going to treat everything like a tumor board where all the doctors get together for each patient and decide on the best course of treatment based on what's available. And that is not the case. Um, I was so disappointed. But time and money also dictate how things like this can operate within a major medical institution. And within that, what we found was we were called, at that time, we were called integrative because the Western medical doctors had had integrative training. And I was like, well, that's a little biased, don't you? Don't you think? So it has changed in the 12 years I've been there. And now integrative health, at least, so I'm part of what we call the integrative East Asian Medicine team. We are integrative because not only do we bring the medicine that we practice, which is mostly acupuncture there at OSHER, but we incorporate labs, procedures, diagnoses, uh, polypharmacy, which is all the medications everybody's on. We incorporate everything else that's happening or will happen in the future, what's known that will happen in the future of these patients, and we incorporate those into our treatment plans. So there we see mostly very medically complex patients. We rarely get the, you know, acute back pain because nobody can get in fast enough for acute back pain. I think it's 18 months to get in to see me and my team. And that again, that is supply and demand. But integrative health combines evidence-based conventional medicine with evidence-informed complementary therapies. And so, and they are able to be used when it's appropriate and safe and effective to do so. So there's a level of communication that happens since this is a burgeoning area, about what can be safe. Um, I I know Andrew Weill came and spoke to us last year, and I remember a small group of us, yeah. And he walked out on stage. Were you there, Margaret?

SPEAKER_02 5:34

No, but but I heard all about it.

SPEAKER_01 5:36

So he walked out on stage, and the first thing he said was, I just came back from Beijing. Everybody there that's under in the oncology department and treatment gets their herbs with their with their chemotherapy. It is not reducing the efficacy of everything. We're really behind the times and we need to get our egos behind us. And I ran up to him afterwards and threw my arms around him. And he was like, I'm sorry, I who are you? But anyway, yeah.

SPEAKER_02 6:02

Um, so so can I just insert one thing? Jennifer's talking about scientifically proven evidence. It's not just any old thing that you find on the internet that, like, I have evidence that such and such does such and such. I'm not even gonna name anything, but scientifically proven according to Western doctors and and rigorous standards of very rigorous standards, yeah.

SPEAKER_01 6:31

Um, and that being said, I mean, all medicine started anecdotally. So somebody's got to be doing that like risky beat, like check it out, how's this gonna work for me, until it gets enough attention that somebody's willing to throw a buttload of money at it and do research on it. And with a lot of um complementary therapies that that can be benefit very beneficial, they'll never be profit-driven and they'll never be widely used. So then money might not just because it hasn't been studied yet, doesn't mean that it wouldn't have efficacy. We just can't promote it because we don't know it will.

SPEAKER_02 7:08

Right. And so I wouldn't promote it either. So could you just name the things besides acupuncture that fall under the umbrella of of the OSHAR? I know there's dietary.

SPEAKER_01 7:20

So within our within our system, we have nutrition, we had biofeedback, we have body, we had body work.

SPEAKER_02 7:28

Yep.

SPEAKER_01 7:28

Um, let's see, nutrition and body work. We've got integrative nephrology, integrative rheumatology, psychiatry, oncology, uh, gynecology, general medicine, Ayurveda.

SPEAKER_02 7:42

Well, that's interesting. I didn't know that.

SPEAKER_01 7:44

Let's see, manual medicine. We have two manual medicine um physicians now and and East Asian medicine. And the East Asian medicine team outnumbers any other discipline there just because of supply and demand.

SPEAKER_02 7:58

That's interesting. I I used to think of it more as really Chinese medicine, but uh so I know I noted when you said Eastern as opposed to Chinese medicine, because now you've incorporated Ayurveda as well, which I didn't even know.

SPEAKER_01 8:12

That and also like I was trained in traditional Chinese medicine, but I practiced Japanese needling. And yeah, so so so what we think of as acupuncture is really primarily Chinese, Japanese, and Korean um modalities of of East, so we call it East Asian medicine now, but our team of acupuncturists, even though we have Ayurveda, Ayurveda is part of, is of course part of East Asi medicine too. Um but within the acupuncture world, there is a like we're moving away from hormone replacement therapy to hormone therapy, uh, menopause hormonal therapies to differentiate it from other forms of um hormone therapy for like gender transitioning or anyway. So these names are getting more and more refined. Um, but I think what might be helpful is if we if I if I state um the Academic Consortium for Integrative Medicine and Health's definition. Okay. Yeah. So um they emphasize that integrative health, integrative medicine is whole person. So what it treats the body, the mind, the spirit, the lifestyle, and the environment. Um, it is practitioner-patient relationship focused, right? It's not about getting people through. It's about there's a relationship there. They're very intimate because in order to treat a physical body, a mind, a spirit, make emotion, make lifestyle recommendations and ask people to change their environment, a relationship should be built there. You get to know more about your patients when a relationship like that is built. Um, it's it's a lot about prevention and health promotion as opposed to like following. So, so I have a Substack, um, and at the end of all of my Substack writings, it's um preservation over reclamation. And my book that comes out in October, it's all about preservation over reclamation. So we're trying to preserve what we have and teaching people how to do that as opposed to reclaiming what we've lost. Um, and then it's the use, their definition is the use of all appropriate therapeutic approaches supported by evidence. So, like, and and so literally what falls under there that's not just at OSHER, it's it's lifestyle, right? So it's nutrition, exercise, and physical therapy recommendations, sleep optimization, stress management. We do MBSR and yoga actually at OSHER, social connection and community. So we're actually starting to do a lot of our medical treatments in group settings because there's evidence about the benefits of being treated and being seen and the experience of group healing. So, not just with acupuncture, but with integrative oncology, anything that needs to be taught or that is generalized information, we're trying to do more in groups, creating cohorts. So, integrative health is also education about unhealthy or toxic lifestyle habits. So giving tools and techniques for harm reduction with things like tobacco and alcohol. And then it's also just behavior change coaching.

SPEAKER_02 11:35

Yeah. Well, when I first came to you, I don't know if you remember this, but I was dealing with really severe osteoarthritis in my in my back and in my my hips, and and I had tried a lot in terms of diet, exercise, physical therapy, and I knew I was dealing with uh an inflammatory condition, and my doctor said I can refer you to OSHA because uh acupuncture can help with that. And that's how I ended up with you, and I was lucky to be one of the ones who did get in. I maybe I waited 18 months, I can't remember. I may have done, but I got in and it really did help.

SPEAKER_01 12:18

So yeah, your body, I remember your body loves acupuncture. I think you're one of those people where your body just drinks in what it has to and I also think that like integrative medicine um falls into different categories, right? It's not just all Western. So we went over like nutrition and exercise and behavioral coaching and things like that. But a lot of it is mind-body medicine. There's such a growing body of evidence around mind-body medicine and health, right? I mentioned MBSR. I think that um mindfulness types of meditation, which we offer a lot of online sources for yoga, I think falls into that mind-body medicine when it's not like power yoga, whatever that means. I feel like that's an oxymoron. Um and uh tai chi, East Asian, I like Chinese Tai Chi and Qigong. I think the biofeedback, even though that's somatic, learning how certain things give you physical responses, biofeedback is part of that mind-body connection.

SPEAKER_02 13:21

I remember a laughter yoga class that you guys had.

SPEAKER_01 13:24

I've taken it. Have you taken that?

SPEAKER_02 13:26

No, I have a friend who does though.

SPEAKER_01 13:28

It's okay. So I went in because I'm like, if I tell my patients to do this, I totally have to give it a shot.

SPEAKER_02 13:33

Yeah.

SPEAKER_01 13:34

And it was, I've done it twice. It is, I couldn't, I'm like, how do you make people laugh?

unknown 13:41

Yeah.

SPEAKER_01 13:41

I went in there a little skeptical. It is so much fun. You have to do it. It is so much fun. I crack up. It is and you feel better afterwards. There is a it induces a sense of lightness, like of heartedness. It's incredible. Yeah, but I think also hypnosis falls into mind-body techniques, especially when it's um therapeutic. Um, like people will do like internal family systems therapy under hypnosis and stuff, and you gain skill sets for managing difficult emotions. Um, yeah, and breathe. I'm a huge believer in breathing techniques. And the breathing techniques have proven physiological responses. So not all breathing techniques do the same thing. So there's one to fall asleep because it changes the ratio of carbon dioxide and oxygen in your body, so you get sleepy. That's the four, seven, eight breathing.

SPEAKER_02 14:34

Uh-huh.

SPEAKER_01 14:34

Hum breathing, the hmm, like chanting or like a cat purring on your chest, stimulates the vagus nerve, which calls forth your parasympathetic nervous system, which is your rest and digest. So breath work has been proven. It's physiological reactions are proven. So you have different types of breath work for different, different um for the outcome that you want. That's pretty cool.

SPEAKER_02 14:58

It is. And it's so great to work with a practitioner like you who reminds us of all these different things to integrate into our healthcare practices. Yeah.

SPEAKER_01 15:10

Well, you know what I say, Margaret, is like we all we all do this anyway. We breathe, we eat, we drink fluids, we move our body. So when we can, I say I teach medical literacy and lifestyle competency. So I am like the queen of like cause and effect. I'm not going to tell you to do something unless I tell you why how it affects affects you physiologically, spiritually, or emotionally. Like not like and why, to the greatest depth of my understanding. And when what I've found is that when people actually understand why the recommendation is being made for an integrative therapy, they are so much more likely to do it. So optimally eating based on reducing inflammation when you have a cancer history to reduce chances of recurrence or to get better outcomes of treatment if you're in cancer treatment. Um, most people don't understand how much water does in their body. I say it's the most underrated technique. Yeah. Um, and there's like equations to figure out the minimal amounts that you should drink every day, which I'll give you because it's so basic. It's your weight in pounds divided by two is the minimum number of ounces of water we should all drink every day. So if you're pounds with 50 ounces, 50 uh 200 pounds, it's 100 ounces, and there's 34 ounces and a liter.

SPEAKER_02 16:32

We have a hydration episode, and that's the formula. And and I I may may well have learned it from you. I very well may have learned it from you. Maybe so it's out there, yeah.

SPEAKER_01 16:43

So I just I go, there's eight that I teach that are all science scientifically backed, and you might be surprised by some of them. So I teach diet, not what to eat, but how to eat, hydration, sleep, breath work, constitutionally appropriate movement and exercise. So we all need 150 minutes a week of zone two heart rate. I had a major issue when I learned this from uh Dr. Marshall when she said it when we were teaching in a conference together. But some people, because I was like, how can you tell people that are like deep in chemotherapy and just want to nap that they need 150 minutes a week? And she said, Oh, Jennifer, if walking to the bathroom elevates your heart rate, that's part of your 150 minutes. It's just being stationary is not healthy. And I was like, Oh, now I get it.

SPEAKER_02 17:32

Oh, that's good feedback. Yeah.

SPEAKER_01 17:34

Yeah. Diet hydration, sleep, breath work, constitutionally appropriate movement and exercise. I say there's four different types of proven exercise that's beneficial. Uh, cardio, weight lifting, balance and flexibility, especially as we age. And the fourth one I call yin style exercise. It's movement that gives you more in return than the energy output it takes to perform it. So that's the walk on the beach, the walk in nature, yin style yoga, certain forms of tai chi and qigong. Um and then to those out, and then there's gut health and bowel movements. Our gut microbiome, I believe, is the beginning of all chronic illness.

SPEAKER_02 18:18

We have an episode on that. Yeah, we've covered it.

SPEAKER_01 18:21

And bowel movements are and and gut sensations are the best way to gauge the health of your gut microbiome. So to those to those six essentials, I add two practices the practice of finding joy and awe every day, which is proven especially by Dr. Keltner. We have an episode on that also. Great. So that it boosts our innate immune system, undeniably. And then tools to not embody stress because the release of chronic stress hormones is like shooting jet fuel through a Volkswagen engine continuously, and things are going to break down. So those are the eight integrative scientifically based and Chinese medicine-supported integrative health practices that I teach everyone. It's the basis of everything I write about and everything I teach.

SPEAKER_02 19:12

Oh, that's great. Well, I think we've covered everything for the overview because there's going to be a part two of this coming out in two weeks. And so unless you've got something else you want to say in this episode, I think we'll leave it here. What else?

SPEAKER_01 19:26

I think I want to, I just want to give an we can go more in detail next time, but I want to I want to just give an overview of other besides the mind-body medicine and acupuncture for integrative health. I mean, we mentioned we mentioned nutrition, the manual therapies, I think are important. Massage has scientific backing, osteopathic manipulation, certain chiropractic interventions, too. And then myofascial uh therapies are all scientifically backed. I think for the psychological behavioral stuff, to remember that cognitive behavioral therapy has scientific backing, acceptance and commitment therapy, uh, health, some health coaching practices, um, and all of the like positive psychology pattern breakers. And then there are actually some supplements and botanicals that have a lot of rigorous research behind them. Yeah, I wouldn't discount them all.

SPEAKER_02 20:20

Oh, that's great. Okay, I think we're gonna leave it here because this is a really good episode. And um I'm gonna say thank you to Jennifer. And um, like like and subscribe. And well, we'll we'll put somewhere in the information how to contact Jennifer and I think she wants to tell us about her work. And uh until next time, we are staying alive.

SPEAKER_00 20:50

You've been listening to Staying Alive with Margaret and Susie. This show is hosted by Margaret Cooley and Susie Hymas. To subscribe to our show, leave a comment, or ask a question, please visit staying alive with margaretandsusie.com. Our podcast is available on all major podcast platforms. If you've enjoyed our program, please feel free to leave us a five star review. Thanks for listening.