Dr. John Tew was the Frank H. Mayfield Professor of Neurosurgery from 1993-2002 at the University of Cincinnati. Dr. Tew has been a neurosurgeon since 1969 serving for 20 years as the Chairman in the Department of Neurosurgery at the University of Cincinnati Medical Center. For 19 of those years he was the Director of the Division of Cerebrovascular Surgery.
Dr. Tew has authored more than 300 journal articles and book chapters, and he has co-authored four books, including the Atlas of Operative Microneurosurgery. Dr. Tew was kind enough to sit down with us to talk about the use of an integrative approach to treating chronic disease and inflammation, as well as how to improve general health and quality of life.
A lightly edited transcript of our interview follows below.
Integrative Medicine
FT: Can you tell us what integrative medicine is, for those that might not know?
Dr. Tew: It is a basis for prevention, alleviating pain, treating diseases like cancer and diabetes that have known causes. The best prevention is natural processes that we can use to avoid an issue.
FT: in a video that you made, A Challenge to Change from Disease Care To Wellness Care, you gave the three principles of wellness care. They were finding meaning, life force, and personal behavior. I would like to address those one at a time as the apply to fibromyalgia.
For finding meaning and purpose in life, you said that meaning allows for passion and creativity. What would you say to someone who suffers from chronic pain and has trouble finding greater meaning, or the pain tolerance to pursue their passion? How can they overcome that hurdle and get momentum going in the right direction?
Dr. Tew: Options are always better if you can focus on something that brings you joy. Focusing on aspects of life that bring joy it will reduce the effect of pain because of proteins that are produced in the body as a response to joy. There are exercises that you can do with Fibromyalgia like water aerobics, or warm salt water water aerobics. Exercise can produce an almost narcotic effect in the brain that can take your mind off of pain and negative thoughts.
FT: in the video you talked about using the life force to heal, transform, and regenerate . What are some beneficial ways that people who suffer from chronic pain or chronic disorders can tap into that life force to improve their quality of life?
Dr. Tew: The best example is through laughter and humor. Depression always makes pain worse. When you focus on pain it becomes a vicious cycle. Humor is one of the main things. A colleague had a cardiovascular issues. He took a week off and got a bunch of laurel and hardy movies. He watched all of them in a row for the benefits of laughter.
There are always people that are in a worse place than you are. Find those people and try to improve their situation. Focusing on those kinds of things have a great effect on distracting the mind from pain. The body has great power to heal itself, and sometimes we have to allow it to heal itself. Often we hinder it with medications and the food we eat.
Nutrition
FT: When you spoke of personal behavior you broke that down into diet and exercise. You said that our personal behaviors have the power to transform genetics, alter nature to prevent or reduce chronic disease. In regard to nutrition, you advocate a mostly plant based diet with reduced dependence on meat and processed foods. Sugar has been found to be a dangerous thing to consume for health in general, but how does Sugar affect the body’s inflammatory response?
Dr. Tew: Processed sugar is highly inflammatory because it damages the liver, and creates processes in the body that makes it harder to heal itself. It desensitizes the pancreas and makes it secrete insulin surges that give a pain-like response. When Blood sugar drops, it also makes our body react with pain-like responses. It makes you need more.
Taking in vegetables high in phytonutrients, green and red vegetables, have a great anti-inflammatory effect.
Other foods that are beneficial are spices like curcumin in turmeric, ginger, sage, thyme, and cinnamon all have a positive effect on pain.
Omega three fatty acids are important for inflammation, and can be gotten from cold water fish, or in supplement form.
Some of the most effective things are cherries, blueberries, and any intensely colored fruits and vegetables. The darker the color the better anti-inflammatory effect.
Also, beans, legumes, nuts, whole grains have anti inflammatory properties.
There are some unsubstantiated claims about nightshades (tomatoes, eggplants, potatoes) causing inflammation, but that has not been substantiated.
Exercise
FT: In the video you say that the “enormous benefit of exercise… has potential medicinal properties… and can effectively relieve pain, depression, anxiety, and cognitive decline.” All of these are common symptoms of Fibromyalgia. What would be your advice to someone who suffers from these symptoms, who feels that it is not possible for them to start exercising?
Dr. Tew: Just get up and get moving. Not moving or stretching gives greater pain around the joints, and increases arthritic symptoms. Water aerobics, and warm salt water aerobics are great options. Many pools now are salt water pools. Simple exercises can be done right in the home using resistance bands and range of motion. One of my favorites is a stationary bike. One of the most effective is the Schwinn Airdyne bike that allows you to work the whole body, arms and legs. You don’t have to do 2-3 hours, but aggressively High Intensity Training (H.I.T.) exercise for 2-3 minutes and then break. And then, repeat.
It is pretty well known now that exercise that causes an aerobic effect has a better effect than anti-depressants, and can have the narcotic effect that we mentioned earlier in treating pain symptoms. Exercise is an effective way of healing and relieving depression. There are several other approaches including meditation, healing touch, massage, mindfulness, staying positive and grateful. People that have hope and gratefulness do better in adverse situations than those that have a contrary approach. It takes a major sustained effort to make change.
FT: In the video you said, “Exercise Promotes neurogenesis… resulting in brain transformation and growth of new brain cells.” Fibromyalgia is potentially a disorder of how the brain operates the nervous system. What is the potential of Neurogenesis for improving the brain function that controls neurological triggers?
Dr. Tew: Neurological issues from a hypersensitive nervous system may not be something that neurogenesis may be able to help. That is an issue of rewiring the way that the brain functions.
Probiotics
Dr. Tew: Another aspect of this approach that we have not mentioned are the importance of probiotics.
FT: Can you talk about that more?
Dr. Tew: Probiotics are important for anyone who is in contact with antibiotics. 80% of food animals are given antibiotics. Whenever we have colds or even viral infections are given antibiotics. It is almost impossible to avoid contact with antibiotics now. These antibiotics have great affect on the gut biome. Many issues can be entering our body through the digestive system. It is thought that Fibromyalgia could be an autoimmune disease, but this is speculation because the cause is not known. But, it is clear now that It is not an imagined disease. There are theories now that Dementia and Alzheimer’s may also have a gut connection.
Farm to Table
FT: You grew up on a farm in NC. What experiences and insights from your youth did you find so important, when you later became a doctor, that made you want to use the UC farm as a teaching tool?
Dr. Tew: It was very important. I grew up knowing about the advantage of good food on the farm. I see the issues of behavioral choices, specifically food choices, in causing disease. Heart disease, cancer, diabetes, and others.
FT: Can you tell me about the UC farm where you teach food preparation to patients? What kinds of things are you teaching them?
Dr. Tew: It is an organic farm that is affiliated with the integrative medicine center, but it is not owned by the medical center. We work very closely with them. As you may know, medical students do not get a lot of education about nutrition, and how it impacts disease. That is a goal of the farm. It also teaches people to learn to prepare the food. It uses community sustained agriculture. The community volunteers to grow and care for their food. Teaching people where their food comes from is important.
FT: That is an incredible program that you are doing, and I hope that it is a model that other medical schools can emulate.
Dr. Tew: Our program is part of a national collaborative of 56 schools that have similar integrative medicine departments to teach young medical students about the importance of nutrition and its role in preventing disease.
I read a piece on your website about forest bathing, and I think that getting into nature is a great thing. There is an element of that in being out on the farm, and seeing the animals. We recognize that the farm and the kitchens are all an approach that have benefits, and that disease has multiple targets and pathways of entry.
This is not a new concept, food and exercise were, at one time, the most important things for treating and preventing disease. We have lost contact with the things that we know work. We need to rely more on our own bodies for the change that can be more sustaining.
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