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Meeting Schedule Day 2
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Schedule

Day 1  | Day 2  |  Day 3  | Day 4

Friday, October 20, 2017

7:00-8:00 AM

Morning Exercise
This morning exercise session will work to stabilize neutral posture and restore physiological motion from head to toe. Be sure to wear comfortable clothing.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Utilize the integrated spinal stabilization pattern in breath; 2) Address neutral posture and dysfunctional compensation patterns; 3) Employ a sufficient warm up and cool down to optimize cardiovascular benefits of exercise; 4) Mobilize postural keystones with sequential muscle activation.   
Faculty: Roger Mignosa, DO

 

9:00-10:00 AM

Conference Assembly: Interdisciplinary Functional Restoration Programs for Chronic Pain
This program will focus on evidence-based content that supports the efficaciousness of a successful private clinic functional restoration program in an effort to promote best practices for managing chronic pain conditions, and to open discussion toward more unifying approaches among such programs. The presentation will provide examples and case studies of how key common chronic pain problems are well-served via a functional restoration program in comparison to traditional approaches. Presenters will also discuss the impact that treatment philosophy, outcome studies, and accreditation practices all have on measured and subjective outcomes. Lastly, the role of chronic pain education and movement-based exposure therapies to reduce fear of movement and improve ADL independence in a chronic pain population as well as the biopsychosocial considerations of functional restoration treatment will be discussed.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Identify five different diagnoses that can be appropriately treated in an interdisciplinary functional restoration program; 2) Discuss three key characteristics of a successful functional restoration program; 3) Administer and discuss the value of the Tampa Scale of Kinesiophobia (TSK) as a tool for guiding treatment; 4) Illustrate the usefulness of emphasizing decreased pain interference as a more salient goal than decreased pain intensity.  
Faulty: Mark Johnson, PhD, Peter Abaci, MD, Michael Sullivan, PT

 

10:50-11:20 AM

Fibromyalgia: Best Practices for Integrative Treatment Approaches
This session will give a brief overview of the diagnosis and management of fibromyalgia.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Identify challenges of diagnosing fibromyalgia; 2) Discuss practical approaches to the work up; 3) Outline a strategy for managing fibromyalgia.
Faculty: Lynette Cederquist, MD

 

Mind Body Therapies for Pain and PTSD in the Military Setting
How mind-body medicine has become an integral component of healthcare in the military, especially at the Naval Medical Center San Diego Mind Body Medicine program.

CDR Jeffrey Millegan, MD, MPH, will provide an overview of the Naval Medical Center San Diego Mind Body Medicine program and discuss recent progress in the integration of mind body therapies into the treatment of pain and PTSD in the military setting.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Describe the core elements of the Naval Medical Center San Diego Mind Body Medicine program; 2) Discuss the role of mind body medicine as an integral component of health care delivery in the military; 3) Identify critical outcome metrics and stakeholders in successful integration of mind body medicine in the military setting; 4) Develop new strategies to advance mind body medicine within the military.
Faculty: Jeffrey Millegan, MD, MPH, FAPA, CDR MC USN

 

Update on Complex Regional Pain Syndrome
Course Description: This program will review the epidemiology, pathophysiology, current diagnostic criteria, and both the current and potential treatments of complex regional pain syndrome.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Identify the risks factors associated with developing CRPS; 2)Recognize the current diagnostic criteria; 3) Discuss available treatments and potential treatments.
Faculty: Paul Christo, MD

 

11:25 AM-11:55 AM

Case Study Session: Fibromyalgia         
This session will present a case study on fibromyalgia.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Propose the differential diagnosis for a patient who presents with diffuse pain and fatigue; 2) Outline the work up for the case presented; 3) Develop a management plan for the patient presented.
Faculty: Lynette Cederquist, MD

 

Connecting Foods with Symptoms: The Allergy Elimination Diet and Pain
Uncovering hidden food allergies and sensitivities through an elimination diet

The idea that foods can harm as well as heal is gaining traction in those who care for patients with chronic disease. Due to the exposure-dependent nature of food allergies and sensitivities, connecting foods with the symptoms they cause presents a challenge to clinicians and patients alike. In this lecture, we will examine the gold standard of uncovering hidden food allergies and sensitivities: the allergy elimination diet. We will examine the current body of literature, discuss a specific protocol, and use a case study to illustrate the concepts discussed.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Discuss the pathophysiology of food allergy, sensitivity, and food intolerance; 2) Describe the allergy elimination diet protocol; 3) Illustrate the concepts inherent in the allergy elimination diet with a case study.
Faculty: Nancy, Cotter, MD, FACN, CNS

 

Virtual Reality Is a Reality—and It’s Helping Chronic Patients Right Now
Decades of research have now made this technology a helpful tool in patient care.

An explanation of what Virtual Reality (VR) is and how it can help to decrease pain will be presented. The session will discuss study results using VR in pain management over the past two decades. Studies using VR for both acute and chronic pain, as well as for alleviation of comorbid anxiety, will be presented.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Discuss the clinical use of VR; 2) Discuss the objective of clinical studies performed with VR for pain management; 3) Review the uses of VR in the continuum of pain management; 4) Explain the future directions in the use of VR.
Faculty: Brenda K. Wiederhold, PhD, MBA, BCB, BCN

  

1:55-2:55 PM

Keynote: Reflections on Pain in the Brain                   
Using mirrors, we demonstrate, both in patients and in normal individuals, the extraordinary malleability of brain modules and their striking interactions with each other, with the skin and bones, and with other people. This program will discuss the clinical utility of these findings.  

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Explain the Golden Age of Neurology (late 18th-early 19th century: Broca, Charcot, Freud, Goldstein, Babinski, etc.); 2) Demonstrate clinical utility of mirror visual feedback in treating various chronic neurological conditions including phantom pain, neglect, hemiparesis, and RSD/CRPS; 3) Illustrate the dominant role played by vision in both health and disease; 4) Demonstrate that the value of a scientific discovery is often inversely related to the sophistication of data acquisition and analysis.     
Faculty: Vilayanur S. Ramachandran, PhD, MBBS          

 

3:00-3:30 PM

Migraine: It Doesn’t Have To Be a Headache
Migraine is the most common headache requiring medical treatment. It is estimated that there are 37 million migraine sufferers in the US. Migraine is responsible for half of all neurological disability. It is believed that only half of those with migraine are ever diagnosed—and even when they are, their care is often inadequate. However, there are times when migraine or other primary headches progress in the face of appropriate care. This presentation will prepare the provider to: recognize the clinical features of migraine, distinguish which headaches require  additional investigation, and identify the components of a successful migraine plan.       

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Explain primary headache epidemiology; 2) Demonstrate knowledge of the risk factors for migraine progression; 3) Demonstrate knowledge of appropriate imaging for headaches; 4) Demonstrate knowledge of migraine staging.   
Faculty: Duren Michael Ready, MD, FAHS, ADAAPM


Low Risk, High Success: Prolotherapy Regenerative Medicine for Osteoarthritis
The science behind regenerative injections

Osteoarthritis is a common condition, affecting over 30 million adults in the U.S. alone. Insufficient healing of ligament or tendon connective tissue surrounding a joint is believed by some medical researchers to be the most important factor in the later development of osteoarthritis. Prolotherapy is a nonsurgical regenerative injection treatment that stimulates healing of joint connective tissue and may also promote cartilage regeneration. It is low risk, with a high success rate. This lecture discusses the science and studies supporting the three prolotherapy formulas—traditional dextrose, platelet-rich plasma (PRP), and biocellular (stem cell)—and how prolotherapy works to reduce or eliminate pain.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Explain the most common etiology of osteoarthritis; 2) Discuss what is prolotherapy, its history, and how it has evolved; 3) Discuss the different forms of prolotherapy regenerative medicine and how and why each works to treat joint osteoarthritis.
Faculty: Donna D. Alderman, DO

 

Orofacial Neuropathy: Appropriate Diagnosis and Treatment
The presentation will offer a brief review of orofacial neuropathies of the trigeminal and facial nerves and proposed neurological mechanisms. Diagnostic testing will be stressed along with the importance of early diagnosis, prevention of missed diagnoses, and avoidance of inappropriate treatment. The balance of the presentation will provide a review of medical management of orofacial neuropathy and introduce novel treatments including effective intraoral topical medications and delivery mechanisms. Topicalformulations will be offered along with specific directions for compounding pharmacies. Case studies will punctuate the presentation with a short discussion period.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Distinguish between orofacial neuropathy and other pain in the orofacial region; 2) Briefly describe possible mechanisms of central and peripheral trigeminal neuropathic pain; 3) Prescribe treatment for orofacial neuropathies.
Faculty: Joseph Matthews, DDS

 

4:20-4:50 PM

Case Study Session: Migraine
This presentation will apply the prinicples of recognizing the clinical features of migraine, distinguishing which headaches require additional investigation, and identifying the components of a successful migraine plan, to demonstrate how they are applied with real world patients. 

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Demonstrate recognition of primary and secondary headache disorders; 2) Demonstrate ability to develop an effective headache plan for primary headache disorders.    
Faculty: Duren Michael Ready, MD, FAHS, ADAAPM

 

Chemotherapy-Induced Neuropathic Pain: Victories and Defeats
Chemotherapy-induced peripheral neuropathy (CIPN) is among the most lingering and difficult of chemotherapy-associated adverse events. Etiologies are various, and the evidence base for treatment is sparse. We will explore the mechanisms and epidemiology of CIPN, survey the literature for current treatments, and look ahead to next steps in the development of treatments.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Name three chemotherapeutic agents or classes associated with CIPN; 2) Name the one current therapeutic agent that demonstrated efficacy for CIPN in an NCCI-sponsored randomized controlled trial; 3) Discuss the potential role of peripheral sensitization in CIPN and how new treatments may target this pathway.
Faculty: W. Clay Jackson, MD, DipTh

 

Hormone Therapy for Pain Management
Back by popular demand
! Using hormones to treat the underlying microglial activation, neuroinflammation, and neurodegeneration.
This course discusses the hormone therapies in pain management that consist of: 1) replenishment of deficiencies and 2) administration for analgesia, neuroprotection, and neurogenesis. The use of hormones, including neurohormones, is intended to treat the underlying microglial activation, neuroinflammation, and neurodegeneration as opposed to symptomatic pain relief.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Replenish hormones that show serum deficiencies; 2) Understand and name the neurohormones produced within the central nervous system; 3) Obtain and prescribe neurohormones.
Faculty: Forest Tennant, MD, Dr. PH

 

4:55-5:25 PM

How to Reboot the Body to Release Stress
This interactive presentation will review how stress plays an important role in facilitating chronic pain. The psychological effects of stress will be discussed, and hands-on methods will be demonstrated to release tension from areas of the body that commonly hold stress.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Perform techniques to release stored stress in the body; 2) Describe physiological mechanism of stress.
Faculty: Chuck Renner, OTR, CHT

 

Virtual Reality—Technology and Advanced Medical Imaging in Medicine
This will be an exploration using the advanced imaging techniques of 3D software and virtual reality to get a better visualization of the patient to make informed decisions regarding the patients path to healing. The course will explore the use of technology from radiologist to end-user physician and patient and how to use this technology as a tool for communication for healing.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Illustrate use of virtual reality in medical imaging; 2) Discuss the importance of communication between radiologist, technologist, patient and doctor; 3) Use technology as a tool for communication in the patient’s diagnosis and treatment.
Faculty: Michael Kurisu, DO, Jurgen Schulze, PhD

 

Advanced Medication and Procedural Options for Headache
This course will define what chronic migraine is and discuss the options for relieving acute migraine and medication overuse headache.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Define chronic migraine; 2. Demonstrate understanding of pharmaceutical options for acute migraine relief; 3. Illustrate options for treating medication overuse headache.
Faculty:  Christy Jackson, MD

 

5:30-6:00 PM

Identifying and Managing the Red Flags of Opioid Misuse
Using a synergistic integrated team approach to combat the opioid epidemic
A major focus of this presentation centers on effective identification, intervention, and integrated treatment of prescription drug abuse, dependence, pseudo addiction, or addiction for chronic pain patients. We will cover multidisciplinary evidence-based interventions, including family system specialists to help resolve this epidemic. Participants will also learn what suffering means for the chronic pain patient and how to help them find relief. This presentation will focus on four important areas: A) physical/biological; B) psychological (thinking /feeling); C) social/cultural; and D) spiritual. Each area is impacted when a person is living with chronic pain and coexisting disorders on a daily basis.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Identify at least 25 red flags that indicate that clients are using their prescription medication problematically and discuss simple interventions to address those problems; 2) Identify and explain the three core components of an effective chronic pain management treatment plan and why it takes an integrated multidisciplinary team in order to obtain positive treatment outcomes; 3) Explain at least four unique needs and/or obstacles confronting patients and their families who are living with chronic pain conditions and other coexisting psychological disorders, including addiction, and may need to be on prescription medications; 4) Articulate the importance of using a synergistic integrated team approach including family systems specialists with this challenging population in order to improve treatment compliance and success to help resolve the chronic pain and opioid epidemics.
Faculty: Stephen F. Grinstead, LMFT, ACRPS

 

Insomnia and Pain: Nonpharmacological Solutions
Cognitive Behavioral Therapy for Insomnia (CBTi) is a nonpharmacologic evidence-based treatment approach for insomnia. The links between pain and sleep are bidirectional.  Inadequate sleep can reduce pain threshold, facilitate inflammation, and inhibit healing and restoration. The significant challenges facing sleep in a setting of chronic pain distinguish this group from those with typical chronic insomnia. Despite challenges, nonpharmacologic interventions for insomnia have an important role in insomnia comorbid with pain. This talk will discuss sleep challenges, CBTi, and potential adaptations relevant to a population suffering with pain.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Discuss the different types of insomnia; 2) Discuss research showing the bidirectional relationship between pain and sleep; 3) Discuss the tenets of Cognitive Behavioral Therapy for Insomnia (CBTi) and other nonprescription medication strategies.
Faculty: Mindy Cetel, MD

 

Integrative Options for Headache: Out of the Medicine Cabinet and into the Pantry 
Non-pharmacological approaches to treating headache such as nutrition; biofeedback; herbs and supplements.

Historically, integrative therapies have been utilized sporadically in the treatment of headache. More recently there has been renewed interest in their incorporation as a component of patient-centered headache care. Research has also demonstrated that the incorporation of certain therapies may provide both clinical and cost efficacy in the setting of headache. This presentation will discuss the background and pattern of use of various integrative treatments. Additionally, the presentation will review evidence-based guidelines and resources for incorporation of integrative therapies for optimizing headache care.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Discuss the prevalence and rationale for the use of integrative therapies; 2) Review the evidence for the most common integrative therapies utilized for headache; 3) Discuss approaches for coordination of integrative therapies in the management of headache disorders.
Faculty: Robert Bonakdar, MD, FACN

 

Day 1  | Day 2  |  Day 3  | Day 4

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