Change Your Brain Every Day - What Can Patients Do to Heal Themselves Without a Physician? PT. 1 - Dr. Wayne Jonas
Episode Date: February 13, 2018It may be shocking to learn that up to 80% of what needs to be done to heal a patient’s chronic illness comes from what happens OUTSIDE the doctor’s office. Therefore, it’s important to take res...ponsibility for the legwork required to work with your doctor to make his job easier. In this episode of The Brain Warrior’s Way Podcast, Dr. Daniel Amen and Tana Amen are joined by Dr. Wayne Jonas, who elaborates on this and other concepts from his new book, “How Healing Works.”
Transcript
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Welcome to the Brain Warriors Way podcast.
I'm Dr. Daniel Amen.
And I'm Tana Amen.
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visit brainmdhealth.com. Welcome to the Brain Warriors Way podcast.
Welcome, everyone. We are so excited to have one of our friends, but also a world leader
in integrative medicine.
Dr. Wayne Jonas, who I've known, goodness, for more than a decade,
he has a new book called How Healing Works,
drawing on 40 years of research in patient care.
Dr. Jonas explains how 80% of healing occurs organically and how to activate the healing process.
Dr. Jonas is a practicing family physician, an expert in integrative health, healthcare delivery,
widely published, a retired lieutenant colonel in the army.
I was a retired major.
That seemed like forever ago.
He was the president and chief executive officer of the Samueli Institute,
a nonprofit medical research organization supporting the scientific investigation of healing processes,
stress, pain, and resilience, often using alternative medicine.
So I could go on and on with the bio, but
Wayne, just welcome to the Brain Warriors Way podcast. We are grateful that you will spend
some time with us. Yes, thank you. And we love what you're doing over at the Samueli Institute
too. So it's fantastic. We love integrative medicine. This is refreshing. This is fantastic.
Thank you. It's a great honor to be on this podcast. Thank love integrative medicine. This is refreshing. This is fantastic.
Well, thank you.
It's a great honor to be on this podcast.
Thank you for having me.
And as you know, there's a new Samueli Institute now embedded at University of California,
Irvine.
Right.
And so it's run by Dr. Shaisna Malik.
And they're just getting going to try to create an entire college focused on integrative health that deals with physicians, nurses, public health, pharmacologists, and the undergraduate school.
Fantastic.
So that's just getting started.
And that'll be the new Samuel Institute.
Fantastic.
So tell us why you wrote How Healing Works. how healing works? So, you know, I have been seeing patients for a long, long time,
almost all in the military, where they have platinum level health insurance. So they get access to specialists and procedures, top of the line health care. And then I've had the great
opportunity to kind of look at healing traditions outside of the mainstream. I'm trained as a mainstream
primary care doctor, family doctor, and practicing the minister. I did mainstream medicine for many,
many years. But I also had the opportunity to look at other types of practices in Asia,
in Germany, in Africa, and a variety of other places to look at traditional healing
practices or what are sometimes called complementary and alternative practices to Western practice.
I also then was able and had the great fortune to look at it through a research lens,
being at NIH and at Walter Reed Army Institute of Research and teaching research. So I was able to
kind of examine a variety of healing practices from around the world, including the ones that
I practiced. And I discovered through those lenses and through that practice that there's certain
things that conventional medical care is really good at and certain things that basically I'm not good at. It's really good at saving your life.
So it is good at acute care. If you have a heart attack or a stroke or an accident or an infectious
disease, it's going to be serious or cancer or something like this. It's very good at intervening
quickly, stopping that. And everybody loves that, of course,
obviously, because they want to be saved.
But then it's not very good at preventing or managing and reversing chronic illness.
And because we're so good at stopping us when we're dying, we have an aging population now
which has more and more chronic illnesses of a variety of types, diabetes, obesity, heart disease, brain diseases, this type
of thing. And I'm not very good at that. The system that I learned in medical school is not
very good at that. Only about 5% of resources are invested in that. I wasn't trained in that type of thing. And so you need to
realize that the kind of thing that you're going to your doctor is going to help you
for and the kind of thing that they need a little help in getting done. And that's what
this book is about. I think the key point I wanted the public to know is that 80% of
healing and health for chronic illnesses comes from
outside the healthcare system outside of your doctor's visit and so you need to
work with your doctor on that your doctor wants to help you with that but
if you don't actually address that if you just go to your doctor and do that
you're gonna be only getting about 20% of health and healing you're leaving the
80% on the table so I want people to realize that they can actually get that 80%
and bring it into their lives and begin to do that, even within the current healthcare system.
You know, I love what you said. And it takes me back to when I was in nursing school and when I
first became a nurse. It's really interesting. So I went to school at Loma Linda
and I worked at Loma Linda, which is a Christian college, Christian medical school, nursing school,
you know, all the medical arts. And I remember going through all the training and having to go
through all of the different, you know, practices and they put us in community health, nursing and
all the different types of nursing.
And when I got to trauma, I actually felt like I could do something. So I got to the trauma unit and I'm like, okay, now I get to actually do something. Cause I felt helpless when I was
working in some of the other, as you said, chronic, um, illness settings. I did, I didn't feel like I
could do anything because with Western medicine,
I felt like my hands were sort of tied and it felt depressing to me. So, and they were better,
I thought, than a lot of places because they incorporated the spiritual aspect. So they
didn't really incorporate a lot of the Eastern medicine stuff, but they did incorporate at least
the spiritual component. And also lifestyle. And lifestyle. They were very good at lifestyle.
Because around Loma Linda is one of the blue zones.
It's one of the blue zones.
So exercise and those types of things were getting rid of alcohol and processed foods
and things like that they were very focused on.
So they were better than most for sure.
But I felt so helpless with some of the chronic pain and things like this
that when I got to trauma, I'm like,
all right, this is where I'm
going because I can do something. And so what you're saying just really takes me back to my
training. And what you're saying makes so much sense that we could be doing better. And I don't,
you know, I never could figure out what that was that we could be doing better at the time.
Now I have a better concept of it and I love what you're doing. It makes sense to me. But I remember feeling lost when I got sick myself for the very reason
you're talking about. So let's juxtapose two statistics. 80% of what patients need to do
with chronic illnesses are outside the medical system. So they need to take responsibility for
their own health, which is what we talk about all the time here. But then juxtapose that against
75% of the healthcare dollars spent in the United States are spent on chronic preventable illnesses.
And so that's why this podcast is called the Brain Warrior's Way,
because you're in a war for the health of your brain. If you're not arm prepared and aware,
you're going to lose the war. And that not only hurts you, it hurts people you love,
because we're now with epigenetics in a generational battle for your health.
So we actually have three podcasts with Wayne and the first one we're going to focus on
what are things patients can do for themselves to work toward their own recovery.
So tell us from the book and from your experience, what are the most
important things patients or people can start doing for themselves? Now, happy to do that. And
you're right. Actually, the data is out. National Academy of Medicine and many other groups have
shown that if suddenly everybody were to have platinum health insurance, like the patients that I see in the military, if we were to solve the whole health coverage process and give everybody health care coverage, it would only improve the health by about 15 to 20 percent.
So where does the rest of it come from?
Where does health come from if medical care is only providing 15 to 20%. The first area, which is about 40% at least,
has to do with what's sometimes called lifestyle,
but I prefer to call behavior.
And this has to do with some very simple things
that hit all of the chronic illnesses.
And that has to do with things like nutrition,
an appropriate food and diet.
It has to do with movement, activity, sometimes called exercise,
but it's really just about moving. It has to do with stress and stress management,
which have a huge impact on the ability and has to do with our social relationships.
Sleep is a major part of that behavioral component of it. And we're growing,
we're learning more and more about the ubiquitous impact of sleep,
lack of sleep or inadequate sleep on all kinds of problems, all kinds of chronic problems.
So those are the four lifestyle areas, sleep, nutrition, activity, and stress and stress
management. Then a big chunk of health actually comes from things that enable you to engage in those kinds of behaviors or don't.
And those are called the social determinants.
And that's another 30 to 40 percent of what results in health.
That has the social environment.
For example, are you in a relationship or with friends and family where you have connection, social support.
Huge issue in people that are in the blue zones, okay, for example.
They have huge social support.
And then also they need to have increasingly resources so that they can get the education,
and I don't mean just financial resources, but they need some of that too, financial
resources, educational resources, and they need to of that too. Financial resources, educational
resources, and they need to be in places, for example, that aren't food deserts. Maybe that
doesn't happen too much out where you are, but certainly as I go around the nation and talk,
I was just in Chicago, huge problem with food deserts, with places where there's violence,
where people can't actually get outside and walk
and that type of thing because the way the city is structured. And those social determinants either
are enablers of the ability to engage in the things that keep you better and actually help
heal you if you have a chronic disease or not. And then there's the physical environment,
the actual place that you live in. And that means not only the light and the ambience and the beauty and a place where you can go and just feel like you can relax and heal,
but also the chemicals that are in the environment, what you're exposed to in terms of pollution and toxic things that can interfere with those metabolism.
All of this is driven by the spiritual component, and I'll put that on hold for just a minute,
because the core determinants I just described, those are the things that if you can engage
in those and optimize both the behavioral lifestyle and the social determinants, you're
going to not only prevent a lot of chronic illnesses, but you're also going to be able
to deal with chronic illnesses, including things like chronic pain, heart disease, obesity,
brain injury, that type of thing. So if someone was going to do three things to begin to take
control of their health, how would you prioritize that for them? So I see a lot of patients that
have PTSD, chronic pain, traumatic brain injury in the military, because I see a lot of patients that have PTSD, chronic pain, traumatic
brain injury in the military, because I see a lot of patients in the military. And I always ask them,
I do something with them that asks them the question about to try to get at their personal
determinants. And so I'll always ask them about their sleep, for example, often a very important thing to talk about.
Are they rested? How much sleep are they getting?
Are they suppressing their melatonin by looking at their cell phones and TVs and stuff right before they go to bed?
Is the room that they're in a place that can allow and is conducted to sleep?
Are there any medications that might interfere with their sleep? So I'll ask about sleep. I
ask everybody about what their nutrition is and a simple way to do that is just
say what did you have for breakfast, lunch, and dinner of the night before and
just count the number of fruits and vegetables servings that they had. I'll
always ask about movement. What do they
do in terms of exercise in those areas? And I'll ask if they have a social support environment or
if that's been a problem for them. So those are the core kind of three or four areas that impact
most chronic illnesses in this country. And if we can begin to bring
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along with, in partnership with the medical care that they're getting.
I call this integrative health. And I think it is the, it's the integrative health is the
intersection between conventional medicine. You need conventional care. it's not bad. Evidence-based complementary and
alternative medicine like mind-body practices, yoga, acupuncture, that type of
thing, and evidence-based self-care, lifestyle medicine it's sometimes called
in the medical profession. The juxtaposition of those three things I
call integrative health. And this is the kind of system we need to manage a chronic illness population instead
of the acute care system that hits at people with pills and procedures on the surface.
One thing that is frustrating as a patient, so I had thyroid cancer that metastasized and came back a number of
times and to go through not only several surgeries but other treatments when I
was no longer a candidate for surgery because the scar tissue and whatever so
I remember being a patient and Western traditional Western medicine and believe
me I am grateful for what it was available me. And I had top-notch medical
care, but going in and hearing, because I was very frustrated, didn't feel good. I was on nine
medications at 40 years old and was extremely frustrated. And honestly just felt like, what
was the purpose of life? Like, why am I doing this at At 40 years old, why am I doing this any longer?
And so not that I was suicidal, I just didn't understand why I had to do this. This didn't
make sense. I don't feel good. And so I went into the doctor and he said to me,
you should be grateful for all these medications because you have to take them and you need to
accept it. And he actually suggested I see a psychiatrist because he thought I was in denial.
That is not how we met. And we were already married by then. And I'm like, what? And so that was one thing. The other thing he said to me that sort of blew my mind,
as he was telling me that I needed to accept this. Maybe you can comment on this. He said that it is
not only acceptable, but it is average. It's normal.
That for every, one of the reasons that people live so long now is that for every decade of life,
we expect that people should be on one medication for every decade of life. And if you have a
chronic illness or you've had something like cancer or some other, illness, that it could be up to double that.
And I was like, my jaw hit the floor.
It was literally at that time I walked out of that office and became my own advocate.
And I took every class I could take in integrative medicine to figure out there's got to be a better way.
This is ridiculous.
I mean, that's when I hit the floor.
I was like, there's no way I can do this any longer. Well, and he was an endocrinologist.
And when I walked in his office, there were candy and cookies for patients. And for me,
I would have just walked right out. No, he doesn't deal with diabetes though. Let me just clarify.
He deals with cancer patients. He wasn't a kinship. There was no kinship there because I believe if you don't live the message as a healthcare
professional, you suck as a messenger.
And didn't you say that when you were at Loma Linda and you were doing all the healthy things
that an overweight cardiovascular-
Cardiothoracic surgeon told me, why are you doing it? He was overweight and he smoked. And he said, why are you doing all of healthy things that an overweight cardiovascular... Cardiothoracic surgeon told
me, why are you doing it? He was overweight and he smoked. And he said, why are you doing all of
those things? You're only going to live maybe, you know, five to 11 years longer. And I'm like,
have you looked around our unit? There are patients on ventilators and dialysis. It has,
I don't care if I live five less years, if my years are better on the planet,
like I don't want to be on dialysis. Like, what are you talking about?
But you can understand why I have education in the health field,
in the medical community.
I know more than the average person, and I have resources.
And I was confused.
And it's hard.
And you've got people fighting you on it.
What is someone supposed to do who doesn't have that? It's frustrating. It's hard. And you've got people fighting you on it. What is someone supposed to do who doesn't have that? It's frustrating. It's hard.
You're preaching.
I am. I'm mad to demonstrate in the book is that if you do true integrative
practice, then you get good conventional medicine like this doctor was trying to provide to
you and was providing to you for your cancer.
And he's also, he or she is also working with you as a partner to identify those things
that you can do to help optimize your health even along with and with that kind of treatment.
That's why this filling this gap
with integrative health is necessary.
You know, as I was writing this book,
my wife also went through cancer.
And I write about it in there,
she gave me permission to do that.
And what it involved is working with her oncologist
who was a very good oncologist, and opening up the
questions to the other dimensions of a person, the social and emotional components. You've
talked about the spiritual components, which are key. Why are you here? What do you want to live
for? We had a new grandchild at the time. My wife said, I'm going to take care of that grandchild. So I've
got to do the things necessary to kind of keep me able to do that in those areas. If you can connect
that deeper spiritual mental component, which is at the heart of why people are here in the world,
with the behaviors and the social components and the medical treatments, so that those are lined up, all four components, the external, the behavioral, the social and emotional,
and the mental and spiritual.
When those get integrated and aligned and you're actually delivering that, then that's
when you're all on the same team and you optimize health.
I'll give you an example.
I actually write about this in the book.
He was, he didn't have cancer.
He'd had other conditions. But he had 20 years of back pain.
And this was a retired military guy.
He had had full health care benefits.
He had medications.
He had injections.
He had electrical stimulation.
And he had had surgery three times.
Okay.
He still couldn't get in the car and drive for five hours and really function.
So I did something with him to do what's called an integrative health visit. I call it the hope
note. And I asked the questions about what are the core things that matter to him rather than
just what's the matter with him. And so I asked this fellow, you know, he, you know,
first said, well, I've got this pain and all that type of thing. But then I asked him, you know,
if you were pain free, what would be the most important thing you wanted to do in life? Okay.
And he immediately knew, he said, I would get in my car, I drive down to see my grandkids,
and I would get on the floor to play with them. That's
the most important thing for me right now in my life is getting up on down up and down off the
floor. And I can't do it. And I said, Okay, why don't we see if we can just get that for you.
So we forgot about his pain. He'd had lots and lots of pain treatments, okay, poked and prodded
and surgeries and everything. We said, Okay, forget about your pain for a minute. Let's go over to
the physical therapist and show some strengthening moves, yoga type moves, et cetera. And we're going
to work on that just to get you up and down off the floor. He worked on that. It took him about
three to four weeks of constantly working on that. It hurt.
Okay. But it was meaningful for him. It was so important to him that he did it. And now he was
moving better. Okay. And he was actually feeling better. He drove down and about a month, he drove
down, saw his grandkids, got down on the floor and was able to play with him. And he called me up
after that. And he said, thank you. This is, you've made my life. Guess what? He kept doing that. And within about four or five months,
his pain was much less. He's empowered now. He's taken charge of his back pain after two decades
of getting, you know, pills and procedures. So if you know why and then have good care. It goes so much faster. Stay with us. When we come back, we're going to talk about the prescription medicine crisis and lessons from Dr. Jonas on how to manage chronic pain without opiates based on his experience with veterans who suffer from PTSD and chronic pain. Thank you for listening to the Brain Warriors Way podcast.
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