Range of alternative medicine options considered at Navy health summit
By JEANETTE STEELE | The San Diego Union-Tribune | Published: February 27, 2016
SAN DIEGO (Tribune News Service) — For years, advocates have pushed the Departments of Defense and Veterans Affairs to provide alternative treatments for veterans, instead of focusing narrowly on Western medicine, surgery and pills.
In a sign of changing times, no less a New Age figure than Deepak Chopra headlined the Navy's first-ever "resiliency medicine" summit this week, which included discussion of the healing effects of meditation, yoga and "compassion" therapy.
In what may be a pivotal point for the no-nonsense military, researchers said they have figured out the "scientific face" of how these largely Eastern medicine techniques operate on the physical body.
"Stop thinking of your body as a thing," Chopra, the Carlsbad-based alternative-medicine guru, told the audience at San Diego Naval Medical Center on Friday. "If you think of your body as a structure, you can only use mechanical means, like surgery or drugs. ... Understand that your gene expression is influenced by your thoughts, your emotions, your social relationships."
For example, two doctors from Massachusetts' Benson-Henry Institute for Mind-Body Medicine said their research shows meditation leads to changes at the genetic level, as shown by measuring markers in blood tests of people with inflammatory disease.
They also have demonstrated a 40 percent reduction in doctor visits among their "mind-body" patients -- an important point because health care costs are one of the fastest-growing parts of the defense budget.
In this marriage of Eastern and Western ideas, there's potential for culture clash -- and it was perhaps embodied in Chopra on Friday. In an auditorium full of military personnel in dress blues and camouflage uniforms, the author and medical doctor wore flowing garments and said, "We are stardust beings who have become self-aware."
But the San Diego Navy psychiatrist who organized the conference said "the time is now" for this focus in military medicine.
"The evidence is there for a lot of the underlying science behind what meditation does in particular -- what these self-care, resiliency skills do," said Cmdr. Jeff Millegan, a doctor stationed at the Navy hospital in Balboa Park.
And while Navy medicine has offered some of these techniques for a decade, in five years he hopes to see a standard "mind-body" component at military hospitals, just as there are the obligatory obstetrics, primary care and surgery departments.
Millegan has put about 500 Navy personnel around San Diego through a seven-session "mind-body" curriculum since mid-2013. The list includes discussion of healthy sleep, regular meditation, keeping up social connections, healthy diet and regular exercise.
It's not just for patients already coming to Navy hospitals, he said. These ideas can help sailors stay out of sick bay.
"We have a lot of sailors who go on ships that deploy by themselves, without a mental health provider, for seven months. These guys are trying to manage stress as best they can," Millegan said during a break. "If we give them skills, tools to regulate their emotions, they are less likely to be overwhelmed."
The core issue is stress and the way it causes illness or magnifies existing health problems.
Post-traumatic stress disorder is a signature wound of the post-9/11 war generation. But even older patients with heart failure die more quickly if they also suffer from depression, which can be addressed by techniques such as meditation and tai chi, San Diego VA researchers have found.
Researchers from the Rand Corp. said meditation has shown promising results for PTSD and depression patients.
Rand's Santa Monica office did a review of research trials on behalf of the Defense Centers for Excellence for Psychological Health and Traumatic Brain Injury.
While they showed significant impact from meditation on PTSD and depression, the news was not as strong for substance abuse relapse or chronic pain, two hot issues in military and veterans circles.
"We need better-designed trials with larger groups of people," said Margaret Maglione, a Rand researcher.
There were signposts of where the rough patches may come.
Military personnel took to the microphones to describe the pushback they see, both high and low.
One researcher said, "At the end of the day, all I care about is generating actionable information to deliver to leadership."
And a Navy psychiatrist who works with young Camp Pendleton Marines said meditation can be a tough sell.
"They won't do it without us sitting them down and saying, 'You will do this now,'" he said.
But savvy advocates for the mind-body approach have made cost central to their argument.
Between 2000 and 2012, military health care costs increased 130 percent, after adjustment for inflation. By 2028, the Defense Department could be dedicating 11 percent of its funding to health care, up from 6 percent in 2000, according to a Congressional Budget Office analysis in 2014.
"If we don't change our practices, health care in the military will bankrupt the military," said Army Col. Richard Petri, chief of physical medicine and integrative health services at Fort Bliss, Texas.
To change the cost equation, Petri said a paradigm shift will be required in military medicine. Instead of doctors being in charge of a patient's treatment, the patient needs to feel it's in his or her hands.
"It's not about yoga. What it's about is empowering the patient to take responsibility for their own health and healing," Petri told his audience on Thursday. "Surgery is passive. You lay on the table and get surgery. ... Active is, if you have diabetes, I give you a medication and I tell you, get your health in order by exercise, proper eating, proper mood care. That becomes active."
One of Millegan's mind-body class subjects, a Marine gravely injured in Afghanistan, spoke to the summit audience via video interview. He said he entered the class with few expectations but left it with his "spark" back.
"There's hope for tomorrow, that things are going to be better. And that attitude in my mind has reflected into my body," the Marine said.
"After three years walking around on these crutches and being on narcotics, I've been able to cut my prescriptions in half."
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