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Cognitive Behavioral Therapy

3/9/2017

22 Comments

 
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Cognitive Behavioral Therapy (CBT) is a method of psychotherapy used for treating various mental health disorders. Individuals receiving this treatment are taught to explore the interconnections between their thoughts, moods, body sensations, and behaviours.  Evaluations of one's actions and cognitions are encouraged to increase awareness of a problem’s origin and a need to alter patterns of thinking and behaving to bring about positive change. CBT has been tested successfully in many studies and has proven itself to be an evidence based practice. Due to the positive results in research, CBT is currently the most recommended form of therapy, as it offers powerful tools for client introspection, problem solving, and improvements in mood.

CBT is the most recommended form of evidence based therapy today for improving one's mood and relationships!

         Mental health problems such as mood disorders, eating disorders, obsessive-compulsive disorder, hoarding disorder, borderline personality, trauma, substance abuse, and marital distress have been treated effectively in research using CBT.​ A popular approach called exposure therapy is often used to desensitize individuals from perceived fear, threat, or anxiety. Discussing or visualizing the feared topic, thought, or situation over time and at length results in reductions of the anxiety and avoidance behaviors. Some exposure techniques like Eye Movement Desensitization and Reprocessing (EMDR) induce the client into a dream simulation state, using side-to-side eye movements, to enhance emotional processing during virtual exposure to past traumatic events. 

Discussing the feared topic, thought, or situation repeatedly over time results in reductions of anxiety

Mindfulness is a technique used to increase awareness of one’s inner reality and emotional state. Practicing mindfulness increases the focus on the mind body connection. Thoughts can be triggers for distressing physiological and emotional reactions in the body. Mindfulness techniques can be used as exposure to ones own disturbed internal environment. Mindfulness exercises, such as deep breathing, can be very relaxing and useful as a tool to shift the autonomic nervous system from sympathetic (fight and flight) activation to parasympathetic (resting) state. An individual at the mercy of anxiety will find tremendous relief discovering how to use a mindfulness “dimmer switch”. Emotion regulation is a problem solving approach that teaches various strategies to reduce emotional intensity. A person may be asked to write a pro’s and con’s list for continuing behaviours that trigger negative emotions. Alternatively, they may be asked to act in an opposite way than they often choose to break the unproductive pattern. For example, a depressed person may be asked to go out and socialize even though he feels like isolating himself.

Emotion regulation strategies are used to reduce overwhelming emotional experiences 

Distress tolerance is a problem solving approach often employed for suicidal or self-harming individuals. Solutions that prevent bodily harm are practiced to assist the person to tolerate enduring and intensely painful emotional experiences. One example, is to have the individual squeeze ice cubes or submerse her face in a bowl of ice cold water. Another could be the use of tapping techniques on pressure points to elicit a temporary emotional release. The goal is to bring focus away from the emotionally painful thoughts by using harmless physical sensations as a distraction. Emotions arrive in waves and these techniques allow people to shorten the wavelength.

Physical sensations are used to distract and shorten the waves of emotional pain.

Response shaping is an operant behavioral technique that uses a reward system to gradually teach a new behavior while replacing an undesirable behavior. For example, a chart showing a desired behavioral step can be regularly checked and reinforced with gold stickers until the next step in taught. Respondent behavior therapy focuses on reflex like connections demonstrated in the experiments conducted by Pavlov on his dogs. Pavlov showed his dogs steak to make them salivate and then rang a bell. After a few repetitions for a number of days, the bell ringing stimulus alone would produce the salivation response. Negative emotions and their antecedent behaviors function in the same way. The sound of a backfiring car can elicit tremendous fear and alarm in a war veteran who was wounded in combat by gun fire. Emotions and antecedent stimuli are identified and uncoupled using demonstrations of safety in the presence of both the conditioned stimulus and conditioned response.


The sound of a backfiring car alone can elicit tremendous fear and alarm in a war veteran who was wounded in combat. 

Cognitive restructuring is a central strategy in CBT, where people are made to examine their thoughts, check for errors/ accuracy of the thought, and the effect the thought has on mood or interpersonal relationships.  CBT also aims to delve deeper into the psyche of clients to uncover core thoughts, values, and/or beliefs. These core beliefs are very important as they are strongly held and, if factually erroneous, can distort a client’s perception. For example, a person may believe that she is unlovable. While holding this core belief, she may choose to recall experiences of rejection, abandonment, and disappointment in relationships instead of seeing a balanced view of reality. Accepting that others do act loving at times would be difficult for this person as it would counter her set core belief about self and others.

Core beliefs are very important as they are strongly held and, if factually erroneous, can distort a person's perception​
     
      Cognitive behavioral therapy is a broad analytical therapeutic approach equipped with many behavioral tools. The research on its effectiveness also varies, but is quite favorable for many mental health disorders. It can be used alone or in combination with other therapies. CBT is client-centered approach that uses useful mood tracking tools and outcome measures. It keeps therapy interesting, relevant, and focused by helping people keep track of their progress in improving mood and functioning.  
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Essential Nutrients and Mental Health

6/17/2015

3 Comments

 
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There is a connection between the food we eat and one's mental health.  In fact, paying more attention to what we eat can make a big difference towards managing one's wellbeing.  We all recognize the effects of stress on our eating habits.  When under stress we may eat more convenience and comfort foods, such as sweets and unhealthy processed snacks.  We do this to derive joy from those foods and to save time in order to get more work done. 

"What many people don't realize is that over time a nutrient deficient diet results in a worsening of mental health symptoms."

Existing mental health problems like anxiety or depression typically fuel the development of poor eating habits. There may be a tendency towards overindulgence of processed foods or to deny oneself enough calories as a method of feeling in control.  What many people don't realize is that over time a nutrient deficient diet results in a worsening of mental health symptoms.

"Without nutrients one's body runs out of reserves and can't effectively complete metabolic tasks such as activating enzymes, balancing hormones, defending from illness, or building/repairing tissues."

Nutritious food is very important for the maintenance of health. The brain, nervous system, and immune system all need essential polyunsaturated fats for proper functioning. These omega fats are essential because the body can't produce them on its own.  The muscles and organs need enough calories and protein for maintenance.  Nearly half of the amino acids that we consume from protein are essential from the diet. Consuming sufficient nutrient dense foods, a.k.a. unprocessed food, ensures that the body has enough building blocks and other chemical/ molecular tools to maintain optimal cellular functioning.  Good sources of nutrient dense foods include vegetables, fruits, grains, seeds, meat, and dairy. Our bodies need sufficient amounts of water, protein, fat, fiber, carbohydrates, vitamins, minerals and phytonutrients from plants every day. Without regular nutrients one's body runs out of reserves and can't effectively complete metabolic tasks such as activating enzymes, balancing hormones, defending from illness, or building/repairing tissues.  Dysregulated hormones and neurotransmitters are often the culprits behind mental illnesses. So don't just eat healthy for your physical health... do it for your mental health too!

For more assistance with managing your anxiety or depression with nutrition interventions...
Call 204-299-7334 today!

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 Dysphoria: The emotional aftermath of Domestic Abuse

12/5/2014

4 Comments

 
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Working with victims of trauma or domestic abuse is challenging to say the least.  It takes tremendous trust in the therapist and the therapeutic process to feel safe, open up, and begin healing.  These individuals have tremendous fear and apprehension not only of flashbacks of traumatic memories but also of their internal emotional state.  Dysphoria is the word that describes the inner experience of the trauma survivor.  Many of us are familiar with the antonym, euphoria, which is a state of bliss, the best feeling in the world.  Dysphoria as the opposite of euphoria can be described as the worst feeling in the world.  It is a chronic emotional state that is so uncomfortable that it compels many trauma survivors to suicidal ideation (thinking about suicide), self-injury, or suicide attempts.  It brings to mind those teenagers we hear about in the news who had bright futures, but took their own lives due to the emotional impact of bullying or domestic abuse experiences. 

"An emotion like numbing coldness from ice or the burning pain from a raging fire"

Dysphoria is not a singular emotion like happiness or sadness.  It is more of a dialectical (opposing and fluctuating) emotion which can be described as feeling like either the numbing coldness from ice or the burning pain from a raging fire.  An individual suffering from dysphoria may appear very calm and vacant or alternatively highly irritable and troubled.  The adrenal hormone cortisol produced from the HPA (hypo-pituitary adrenal) axis or fight, flight, or freeze system causes changes in brain chemistry and emotional functioning overtime.  In response to a chronic recurring threat that cannot be fought or evaded, the nervous system shuts down the emotions as part of the freeze mechanism.  This mechanism is useful in certain hopeless cases such as being captured by a large hungry predator per se. Being in a chronic state of freeze resulting from trauma, however, is often unbearable and described as feeling empty or dead inside.  Accompanied with this feeling of nothingness is a disconnect and detachment from relationships and a profound sense of aloneness.  Some sufferers use self-injury to temporarily bring on or break out of the freeze state.

"Emotions may include overwhelming feelings of rage, fear, anxiety, sadness, shame, and/or guilt."

The painful fiery side of dysphoria is the mixture of unpleasant felt emotions that are experienced when memories of abusive events are triggered.  These emotions may include overwhelming feelings of rage, fear, anxiety, sadness, shame, and/or guilt.  It is a small wonder that a person experiencing such unmanaged distress may prefer narcotic drugs or the dissociative (detaching) freeze state.

Treatment for dysphoria involves establishing a safe and trusting relationship, DBT (dialectical behavioural therapy for teaching distress management) and Mind Body Trauma Therapy (for emotional pain and psychosomatic symptom relief). The combination of feeling safe, controlling and limiting pain, exploring anger, anxiety, and shame, and problem solving for lasting change can prove very effective.  Once a trauma sufferer stops avoidance behaviour and starts engaging and working towards learning new coping skills, he/she is on the path to recovery. 


Advocating for your health,


David Chochinov, O.T. Reg. (MB)
Occupational Therapist


4 Comments

Crohn's: Genetic Predisposition or Lifestyle choice

11/25/2014

2 Comments

 
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I recently had an engaging dialogue with a friend on the topic of colitis symptom management using a balanced nutritional approach.  As anticipated, I encountered the familiar defenses against using foods for wellness.  I realize that many people, not just my friend, are surprised by my point of view that food choices can be used effectively for disease prevention and symptom management. 

Researchers have yet to identify the genes responsible for the development of Crohn's and colitis.

Our discussion moved towards the genetic factor involved in colitis.  She expressed that due to the genetic predisposition it was futile to attempt a dietary approach.  (Crohn's and Colitis affects those with specific genetics, passed down to some but not all family members. Interestingly, researchers have yet to identify the genes responsible for the development of Crohn's and colitis.)

I remained undeterred by her argument and I expressed that because there was a genetic component nutrition was not just important but vital.  My friend then stated that I must know that colitis had to be managed by pharmaceutical medications, it was the only way.  Given the pain and distress experienced by those newly diagnosed it is understandable why there is an urge to choose pharmaceuticals, which offers quick relief.  However, there is no reason why a nutritional intervention cannot be implemented afterwards with the goal of weaning off of the pills.  Medications function the same way as other substances we put into our bodies, by affecting chemical and physiological reactions.  Using balanced nutrition to treat nutritional deficiencies, bacterial overgrowth, and/or food allergies, we affect the physiological and immune functioning of the body.  Pharmaceutical interventions for Crohn's and colitis don't treat causative factors but instead target and repress the immune system, leaving the underlying causes of inflammation and resulting damage to the body unaddressed.  That is the reason why individuals on biological medications (Remicade or Humira) are at 3x's the risk for some cancers than those not using immune compromising drugs.

The very thought of putting controls on what she ate was more terrifying to her than the disease itself.

My friend's second set of defences were interesting and very sincere.  She acknowledged that she had not attempted to balance her nutrition, at all, to improve her colitis and overall health.  The very thought of putting controls on what she ate was more terrifying to her than the disease itself.  "When I go to the transfusion clinic for my Remicade I get to sit there for a few hours dreaming about all the bacon, gluten, and treats I will be able to eat pain free", she told me. "My doctor told me that just because my risks for other health problems, like cancer and infections, are higher than the average person due to the medications, it doesn't mean that I will develop those problems. "So bacon, bacon, bacon", she repeated triumphantly." Shortly after that we parted company, each of us content with our different lifestyle and health choices.

Advocating for your health,

David Chochinov, O.T. Reg. (MB)
Occupational Therapist
2 Comments

Make it stop for Life!

11/16/2014

3 Comments

 
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On November 7-9th, 2014, I was honoured to attend the annual Congress for Crohn's and Colitis Canada, at the Chelsea Eaton Hotel, in Toronto, Ontario.  Congress is an educational event for new volunteers and a year end awards ceremony for those who excelled the previous year at fundraising for research dollars.  Overall I was very impressed with the great food, social networking, current research, and dynamic speakers. The slogans presented for next year were "Make it stop for life" and
"Pain isn't the only thing a kid with Crohn's feels."  One startling statistic presented was that there are currently 28 new cases of Crohn's or colitis diagnosed each day in Canada (including children under 10 years old).

The guest speaker and master of ceremonies for the awards dinner was none other than local CFL football legend, Winnipegger, and colitis hero, Obby Khan (as seen in the photo above). Obby's personal story of his struggle with colitis was captivating and inspiring.  He described how in 2006 he was at the peak of his football career with the Blue Bombers and stardom.  It was at that time when his symptoms of colitis began to emerge.  He gradually lost ground in a few short years despite his best efforts to manage symptoms and went from 310 lbs down to 180 lbs.  The inflammatory disease would not relent but neither would Obby's determination to play football.  He eventually chose a surgical intervention and had his entire colon removed.  Following the surgery, Obby heroically regained his strength and most of his weight.  He kept pushing for his dream to regain his 2006 stardom.  However, other injuries to his hands and knees (not from colitis) caused him to exit the world of professional football in 2013. Obby Khan continues to be a champion for Crohn's disease by sharing his colitis management nutrition game plan.  Obby recently made his secret available to all by opening a juice business called the Green Carrot Juice Company, where he squeezes fresh fruit and vegetable Juice with industrial grade machinery.  At Congress Obby claimed to have "survived in professional football with colitis by eating rice, salmon, and fresh fruit and vegetable juice." 

http://globalnews.ca/video/1365939/how-juice-helped-keep-obby-khan-on-the-field-and-in-business/

Advocating for your health,

David Chochinov, O.T. Reg. (MB)
3 Comments

The Sensory challenged child

10/29/2014

3 Comments

 
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Children face different environmental challenges than adults.  Their developing brains and bodies work toward mastering the intensity of the signals received from their senses (vision, hearing, etc.).  We should keep in mind that some children struggle with this job of sensory development.  They have difficulty regulating sensations and may become frustrated or upset by overwhelming signals. It is not uncommon for social and educational problems to present with these "difficult" to manage children.

Children arrive into the world from the womb accustomed and hard wired to the sensations provided them from their mother's body.  The routine sounds (heart, breath, digestion, etc.), vibrations, warmth, and firm pressure are predictable and safe.  At birth, infants need to readjust their nervous systems to new and unfamiliar sensations.  The safe feelings are replaced by new and frightening experiences offered by parents and caregivers.  Cold temperatures or quick movements are overwhelming for many babies' nervous systems.  Savvy caregivers recognize that baby prefers experiences that provide the reassurance of familiarization and habituation. 

Most of us would believe that school aged children had enough time to adjust to the world around them.  However, children continue to work at mastering their nervous systems into their early adolescence and beyond.

Social environments can be cruel to children with sensory processing challenges.  A child who either misses cues thereby appearing not to be paying attention can be teased or labeled a poor learner.  A seven or eight year-old who cannot sit still may be considered disruptive by teachers and referred for prescription medications.  A boy who finds the lighting or sounds in the classroom overstimulating may not be able to cope and may exhibit behavioural problems.  A girl who finds touch overwhelming may retaliate aggressively against a classmate (who touched her) for no apparent reason.

Parents and teachers alike often have difficulty understanding childhood behaviours.  As adults, we rarely find our sensory environment overstimulating or challenging.  If the light was experienced as too bright we would wear sunglasses or withdraw to a shady location. If the noise was too loud we would seek out ear plugs or withdraw  to a quieter spot.  Young children are often unable to communicate their difficulties and seldom are capable of solving their own problems.

Occupational therapists are trained at administering assessments for sensory profiling to determine whether a child may be processing under or over threshold compared to other children her age.  Occupational therapists assist the child, parents, and teachers with interventions to manage the challenges associated with poor sensory integration.  Only when the child's behaviour is fully understood can we best assist her to thrive.

Providing your way to a better quality of life!

David Chochinov, O.T. Reg.(MB)
Proactive Rehabilitation Manitoba
3 Comments

How to Respond to Elder Abuse

9/4/2014

4 Comments

 
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Being a victim of abusive treatment can be frightening and overwhelming for anyone.  For the elderly it is even more so due to vulnerability, isolation, frailty, and limited resources.  A senior will often find him or herself at the mercy of the perpetrator of the abuse, who is frequently a caregiver or relative. 

Fear can be a major factor that allows elder abuse to continue over time and not get reported.  There may be a fear of not being believed, of not being taken seriously, of embarrassment/ stigma, of causing the abuser harm, and/or of a possible reprisal by the abusive person.

       -Seniors may fear the possibility of causing harm to the abuser-

The first thing to do if you suspect that you or someone you know may be experiencing elder abuse is to recognize the signs. 

  • Emotional abuse often presents through the verbal treatment towards the elderly such as ridiculing, threatening, blaming, and/or yelling. 
  • Physical abuse includes causing injury and pain to the elderly.  There may be bruises, fractures, cuts and scratches.  Some other forms of physical abuse that occurs mostly in nursing homes or institutions includes inappropriate use of chemical restraints (medications used as sedatives), physical restraints (such as unnecessary wheelchair seat belts or fastened lapboards), and/or confinement.  
  • Sexual abuse involves any contact or sexual behaviour towards an elderly person without the elder’s consent.
  • Neglect is the failure to meet the actual care needs of a senior by ignoring, even unintentionally, established care plans, routines, protocols or policies.
  • Financial Abuse is any form of monetary exploitation such as fraud, a con, or theft.
    -Neglect is abuse by not meeting the care needs of an elderly person-

Once you have recognized the abusive treatment for what it is you will be better equipped to proceed to the next step of supporting yourself or the elderly person.

A good place to start is to learn about available support services designed to advise or protect seniors facing abuse.


One support line available in Manitoba is the Age and Opportunity number at #204-956-6440.  Age and Opportunity offers some over the phone counselling and other in person counselling services.  I was informed that the service is a 24 hour phone service but that the Klinic crisis line is used after hours at #1-888-896-7183 or #204-786-8686.

Sometimes if there is a criminal act (an assault, battery, fraud or theft) it is appropriate to contact the police and make an official police report on the non-emergency line at #204-986-6222. The police also have a vulnerable person's unit that specializes in elder abuse concerns but it functions at an administrative level to assist officers better manage cases of abuse.

At an institution, in addition to considering making a police report, one should also determine whether the PPCO should be contacted for an investigation.  The Protection for People in Care Office (PPCO) was established to look into complaints of abusive treatment occurring in institutions in order to educate staff and prevent future occurrences. The number listed to reach the PPCO is 204-788-6366 or Toll-free: 1-866-440-6366.

Following interventions to protect the elderly from abuse, it is advisable to provide treatment to prevent the long term and possibly devastating effects of traumatic stress.  EMDR (Eye Movement Desensitization and Reprocessing) and other mind-body trauma talk therapies are particularly effective for resolving the heartbreaking effects that often linger following abuse.

Call David Chochinov at 204-299-7334 for assistance with elder abuse prevention strategies and traumatic stress therapy.

  -Prevent the effects of traumatic stress with a mind-body talk therapy- 



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Walk for the Cure!

7/6/2014

2 Comments

 
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On June 8th, 2014 I participated in my first Gutzy Walk.  As a newly appointed member of the volunteer planning group I wanted to experience this major funding event.  I was also curious in a scientific way about "the cure" for which everyone was gathering together to raise money. 

The event planned by the Crohn's and Colitis Foundation of Canada had something enjoyable to offer for everyone.  There was a live band, BBQ and food, free photos, a dog show, face painting, etc.  I found the volunteers friendly and helpful. It was definitely a function for the whole family and I regretted not bringing all of my children.

There was optimism in the crowd about finding "the cure".  I overheard many families exchanging stories about medications that were currently helpful for symptom control.  One mother asked her eight year old son if he was satisfied using Remicade.  His reply was less than enthusiastic, but he agreed while looking sadly down at the ground that it was helping.

I walked though the throngs of people and engaged in discussions about Crohn's and Colitis management.  Nearly everyone I spoke to was relying almost solely on medications or surgery for symptom management.  None of them, however, considered their current medications to be "the cure". 

I pondered the phenomenon of annual fundraisers as I drove home in rain that held out to the last few minutes of the event.  It certainly seemed important to continue efforts in raising funds towards finding new scientific discoveries that will guide sufferers along the road to recovery. The Gutsy Walk while not as successful as previous years earned $20,000 in one day towards inflammatory bowel disease research. 

While I affirmed the value of the fundraiser, I also felt disappointed.  I wondered about all the years of research that have already been paid for.  What have we learned from the research of yesterday? From the Gutsy Walks of years gone by?  Who are we paying to compile the thousands of studies that have already been completed?  Is "the cure" truly waiting to be discovered... or is it already here? Maybe recovery doesn't look like a pill we take for the rest of our lives? Maybe our genetics aren't flawed and in need of chemical support? 

I believe recovery is about learning how to help our bodies along... learning how to take better care of ourselves so that healing can occur. 

http://crohnsandcolitiscanada.akaraisin.com/Common/Event/Home.aspx?seid=8140&mid=8

2 Comments

Inflammation Alert

6/1/2014

1 Comment

 
The body communicates through inflammation when something is wrong and needs healing.  Whether it's an acute (recent) physical injury, an infection, or worn out cartilage in the joints, inflammation is on site. Swelling and stiffness causing pain prompts many to the doctor's office for a quick remedy to reduce the discomfort.

In most circumstances, inflammation does its job, heals the problem, and clears, soon to be forgotten. However, there are situations when the body cannot effectively heal and inflammation is a recurrent theme. One such example is with autoimmune diseases; where the body goes into a state of chronic inflammation without any discernible cause.

Autoimmune diseases are described as being idiopathic (cause unknown), as the mechanism of the disease is not fully understood. Doctors frequently treat the immune system as the problem as they do not yet understand the physiology producing the inflammation; As a result, the term "autoimmune" has become a popular buzzword used to describe a large group of quite diverse inflammatory conditions.

What has become clearer in recent years in the medical field is that inflammation can be managed by directly targeting and weakening the immune system. However, by doing so the body becomes more susceptible to infections, aging, and cancer.

Immunomodulation (manipulating the immune response) can alternatively be performed in a safer fashion in which wellness and health are promoted; thereby reducing malignancy (illness) rates compared to the general population vs. matching or increasing them. The "trigger elimination" method has been demonstrated as one effective approach for controlling the immune response. Once the trigger of inflammation for an autoimmune disease is known immunosuppressive therapies, such as Humira or Imuran, are no longer recommended. 

Coeliac disease, for example, is a known allergic autoimmune condition in which the immune system damages the microvilli of the intestines when gluten is consumed.  Once gluten is removed from the diet the immune system shuts off the inflammatory process and the body considers the digestive system healed.
"Doctors frequently treat the immune system as the problem as they do not yet understand the physiology producing chronic inflammation."













"The immune system is not 'out of control', but rather failing at attempts to heal and protect the body." 













 "Alternatives to pharmaceuticals offer a safe and viable course of action for achieving remission from autoimmune disease symptomology."














Recent studies on harmful bacterial growth in the digestive tract, leaky gut syndrome, and/or oxidative stress (damaged cell structures) triggering inflammatory responses demonstrate that the immune system (in many cases) is not "out of control", but rather failing at attempts to heal and protect the body. 

Some treatment approaches used successfully to halt autoimmune disease symptoms have been performed through dietary changes, caloric restriction, or monitored fasting.  Studies in these areas reveal that changes in diet and use of probiotics have the potential to eliminate harmful bacterial growth in the intestines. When combined with lifestyle changes (healthy living) reversal of cellular damage in the affected areas of the body can occur bringing about remission from the symptoms of inflammation.  

Conclusion: Alternatives to pharmaceuticals offer a safe and viable course of action for achieving remission from autoimmune disease symptomology. Seek professional assistance and give your body the tools it needs to heal through diet, exercise, and lifestyle changes.


Advocating for your health,

David Chochinov, O.T. Reg. (MB)


References:
-Bongartz T, Sutton AJ, Sweeting MJ, et al. Anti-TNF antibody therapy in rheumatoid arthritis and the risk of serous infections and malignancies. Journal of the American Medical Association. 2006;295:2275-2285.         http://jama.jamanetwork.com/article.aspx?articleid=203993
-Kes VB, et al. The role of complementary and alternative medicine in therapy of multiple sclerosis. Acta Clin Croat. 2013 Dec;52(4):464-71. [PubMed]
-Liu Y et al. Cutting edge: fasting-induced hypoleptinemia expands functional regulatory T cells in systemic lupus erythematosus. J Immunol. 2012 Mar 1;188(5):2070-3. [PubMed]
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749767/
-Immunobiology. 2011 Sep;216(9):1010-7. doi: 10.1016/j.imbio.2011.04.001. Epub 2011 Apr 13. [PubMed]
http://www.ncbi.nlm.nih.gov/pubmed/21601309
-Neurology February 12, 2013; 80(Meeting Abstracts 1): P03.232 [PubMed]
http://www.neurology.org/cgi/content/meeting_abstract/80/1_MeetingAbstracts/P03.232
-Collins SM, A role for the gut microbiota in IBS. Nat Rev Gastroenterol Hepatol. 2014 Apr 22. doi: 10.1038/nrgastro.2014.40. [Epub ahead of print]
-Vieira S1, Pagovich O, Kriegel M., Diet, microbiota and autoimmune diseases. Lupus. 2014;23(6):518-26. doi: 10.1177/0961203313501401 [PubMed]   -Fuhrman, J. (1995) Fasting and Eating for Health.  New York: St. Martin's Press.
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A New Champion for crohn's and colitis treatment

4/2/2014

3 Comments

 
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David Chochinov was 19 years old when he began to experience pain in the lower right quadrant of his abdomen.  Fatigue, dehydration, and urgent sprints to the washroom followed.  He was eventually diagnosed with Crohn’s disease in 1999.  David’s quality of life suffered from Crohn’s as he had difficulty concentrating on his post-secondary studies.  His participation in sports, particularly Judo was also affected.  Judo is a modern Japanese martial art and combat sport that requires optimal health, strength, and endurance.  Having lost over 10 pounds from his disease in his first year and feeling physically depleted, David accepted that he was no longer in condition to continue with Judo.  He reluctantly bowed out of the sport only a year or two away from earning his black belt and opportunities to advance to higher levels of competition.

“I felt lost and outmatched,” recalled Chochinov, “Crohn’s had me beat.” David followed the recommendations of his gastroenterologist and went on a pharmaceutical regime. “I used 5-ASA or Mesalamine anti-inflammatories to treat my symptoms.  I didn’t get great results, but my symptoms were blunted just enough so that the pain was more manageable.”

For the next few years, David looked into dietary changes, supplements, and probiotics to improve his health. “I wasn’t satisfied with a pharmaceutical intervention, I wanted to fight back against my Crohn’s and win back my health.” David learned from his Judo training that a champion doesn’t quit even when the odds aren’t favorable.  “I kept digging deep and refused to accept defeat.” Chochinov says. David gradually demonstrated such effective Crohn’s management that his gastroenterologist questioned whether he had been correctly diagnosed from the start.  In 2011, after a period of prolonged stress, David began experiencing a significant flare up.  “I had to go through re-diagnosis again using two separate screening methods.  My GI was convinced it was Crohn’s when he saw the MRI images. 

I was prescribed a high dose of Mesalamine (Salofalk), which I had discontinued years before.  The drug proved ineffective, and I was offered stronger medications with more side effects, such as Humira, Imuran, and Entocort.  I chose to put my faith in my own treatment regime of dietary controls, supplements, and probiotics.  After a few months, I was feeling great, both pain and side effects free.”To prove that he had achieved mastery over his Crohn’s, David had one challenge remaining.  “I needed to get back into Judo and compete again.” He said, “Over the past year, I began training to see how my body would tolerate the aggressive demands of Judo.  I was pleased to find that my symptoms remained under control despite the twisting motions and intense physical exertion.”  In January 2014, David registered for the Selkirk Judo tournament.  He matched his body, after 15 years of Crohn’s inflammation, against a younger man in perfect health, and came out with the gold medal. “The best part of the experience was that I felt free from my Crohn’s to compete, win or lose,” said Chochinov.

“Crohn’s disease was a nightmare that I finally feel I can wake up from.”  Chochinov says, “Had someone taught me how to manage my Crohn’s so that I could improve my quality of life, I would likely have recovered in my early twenties, and enjoyed many opportunities denied me.”David Chochinov is a private practitioner in the field of occupational therapy.  Having recently founded his own company, Proactive Rehabilitation Manitoba, he is now prepared to champion Crohn’s and colitis for Manitobans. 

Occupational therapy is a form of rehabilitative therapy that aims to assist people at succeeding in their activities of living.  These occupations include leisure or sporting activities, work and productivity, as well as self-care.  Occupational therapy focuses on methods to either improve or compensate for health impairments.  A person recovers quality of life by making physical gains and/or by learning to do their activities differently.  Occupational therapy is a service that is covered by many health insurance plans.  David’s top five tips for managing Crohn’s disease: 

  • Pay attention to what you put into your body and how your body responds.  Some foods/drinks trigger inflammation and worsen symptoms. Mobile application software such as Mysymptoms Food Diary can help track possible symptom triggers.
  • Eat mostly simple non-processed natural foods such as chicken, fish, eggs, whole grains, fruits and vegetables. 
  • Stay hydrated by regularly drinking unprocessed, caffeine free beverages like herbal teas or water.
  • Supplement with high quality probiotic capsules that assist the cultures to survive digestion through the stomach’s acid.
  • Crohn’s and colitis often results in malabsorption or deficiencies of certain nutrients (due to inflammation).  High quality supplements should be considered if you suspect deficits in B6, Folic acid, B12, vitamin D, iron, Selenium, Zinc, etc.
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    David Chochinov is a private practitioner in the field of occupational therapy, mental health counsellor,  nutrition consultant, and an advocate for the prevention of elder abuse.

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