RENEW ISSUE: A Q&A with integrative medicine expert Dr. Julie Chen
RENEW For a brief moment, we here at the Guardian are taking a break from listing the best places to host more damage to your liver to give some soapbox time to a health care professional. Meet Dr. Julie Chen, who has a private practice in San Jose that specializes in integrative medicine, an approach combining conventional Western health knowledge with holistic care options. That's right, just like Tron's Kevin Flynn, Chen is able to operate in multiple dimensions when it comes to your physical well-being. We asked her some big-kid questions about health and her innovative brand of medicine that you should probably know the answers to.
SFBG What's the most commonly held misconception about integrative medicine?
Julie Chen The fine line between "alternative" and "conventional" medicine is frequently erased and redrawn. For example, fish oil used to be "alternative." So was vitamin D supplementation. But now we have Lovaza and vitamin D prescription versions that insurance companies will pay for.
Integrative medicine is frequently seen as "alternative medicine," but — especially if the physician is fellowship-trained and board-certified — it is heavily evidence-based, just like "conventional" medicine. We utilize clinical research as a basis for treatment plans that integrate aspects of conventional and complementary medicine like supplements and herbs, energy medicine, manual therapy, acupuncture, and hypnotherapy. It's not about one or the other, it's about utilizing all appropriate modalities available out there to achieve optimal health outcome.
SFBG You're an expert on stress-reducing mind-body exercises, so let's get practical here. Recommend one for people sitting on Muni or at a computer.
JC Breath work is relatively unobtrusive and inconspicuous, as is meditation or self-hypnosis. You may even try abridged versions of progressive muscle relaxation: tightening shoulder and upper back muscles, then relaxing; tightening hands and arms, then relaxing; tightening gluteal muscles, then relaxing; tightening leg and feet muscles, then relaxing.
For people who say they can't sit still long enough to do meditation or self-hypnosis, this exercise may be an option — it offers something active to focus on.
SFBG Eating healthy is hard. What are some ways people eat wrong?
JC Patients frequently think they have to make all the right changes all at once with their diet, and then feel defeated when they can't sustain them. I'm a big fan of setting smaller, more attainable goals, and using positive reinforcement that helps you to move onto the next.
I'm also a big fan of mixing foods if you're not ready for a complete change. For people who don't like brown rice, mix brown and white or use less white rice and mix it with vegetables. That way you can increase complexity of the food you are eat and decrease simple carbohydrate intake with food that is still palatable. Many patients also think that as long as they eat vegetables at one main meal, that's enough for the day. But our bodies function better if we can provide those phytonutrients and flavonoids all day long. That means that we should incorporate healthy foods like whole grains and vegetables into every meal.
SFBG We live in an age of health info oversaturation. With all the conflicting theories out there, how can we tell if we're living healthily or not?
JC This is a great question. First, it's important to educate ourselves about what's considered "healthy." At the end of the day, we physicians do not go home with you. Your readers should know that they are the most important member in their health care team, and that they should utilize their doctors as informational tools. Second, our bodies usually will tell us if we are living as healthy as we can. If you feel chronically fatigued, or have insomnia, or a "foggy" mind, there are probably steps you can take to improve your overall health by evaluating and maximizing aspects of your lifestyle, nutritional intake, or health status.
SFBG What should someone do if the advice they are getting from their HMO differs from or conflicts with what is prescribed by their holistic health care provider?
JC In this situation, it would be beneficial for the physician to speak with the holistic health care provider. The extent of training among holistic care providers can be vastly different — it can range from those who have taken weekend courses or are self-taught versus those who are board-certified or fellowship-trained. By increasing communication between physicians and holistic practitioners, it provides an additional level of protection for the patient in case the holistic provider is suggesting something medically dangerous. On the other hand, if the treatment plan from the holistic provider is medically appropriate, then it provides an opportunity for the physician to learn more about holistic care and how it can augment conventional care.
SFBG Are there real health benefits to going vegetarian?
JC There are tremendous benefits to a vegetarian or vegan diet. Plant-based diets tend to be much more anti-inflammatory and thus are more beneficial. The trick is to make sure that the diet is high in plant-based proteins, minerals, vitamins, and phytonutrients, and not processed or fried fatty foods. If the vegetarian or vegan diet is composed of things like steamed vegetables, legumes, and whole grains, it has tremendous health benefits like improving cholesterol levels, insulin sensitivity, and decreasing inflammation.
SFBG Are there positive health benefits of living in a big city?
JC San Francisco is one of the healthiest cities in America — access to healthy, organic, and diverse foods allows us to eat well throughout the year. Another tremendous benefit of living in San Francisco is the easy access to hiking, biking, and other forms of outdoor exercise. Even for those who aren't interested in outdoor activities, the simple act of getting around the city allows us to get in regular exercise thanks to the hilly streets.