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What do we know about holistic therapies to manage symptoms of rare neuroimmune disorders?

January 30, 2023

Krissy Dilger of SRNA was joined by Megan Weigel, DNP, 200RYT for an “Ask the Expert” podcast titled “What do we know about holistic therapies to manage symptoms of rare neuroimmune disorders?” Megan began by introducing holistic therapies and integrative medicine. Next, she explained where medical providers can locate information regarding supplements, their interactions with medication, and evidence in medical publications. She described how holistic therapies such as nutrition, mindfulness, yoga, chiropractic care, and acupressure may benefit rare neuroimmune disorders. Megan also emphasized the importance of working with properly educated and licensed providers. Finally, she recommended resources for those who are curious to learn more about these topics.

[00:00:00] Krissy Dilger: Hello and welcome to the SRNA “Ask the Expert” podcast series. This podcast is titled “What do we know about holistic therapies to manage symptoms of rare neuroimmune disorders?” My name is Krissy Dilger, and I will be moderating this podcast. SRNA is a non-profit focused on support, education, and research of rare neuroimmune disorders. You can learn more about us on our website at wearesrna.org.

[00:00:30] Our 2023 “Ask the Expert” podcast series is sponsored in part by Horizon Therapeutics, Alexion, AstraZeneca Rare Disease, and Genentech. Horizon is focused on the discovery, development and commercialization of medicines that address critical needs for people impacted by rare, autoimmune, and severe inflammatory diseases.

[00:00:53] They apply scientific expertise and courage to bring clinically meaningful therapies to patients. Horizon believes science and compassion must work together to transform lives. Alexion, AstraZeneca Rare Disease, is a global biopharmaceutical company focused on serving patients with severe and rare disorders through the innovation, development, and commercialization of life-transforming therapeutic products. Their goal is to deliver medical breakthroughs where none currently exist, and they are committed to ensuring that patient perspective and community engagement is always at the forefront of their work.

[00:01:30] Founded more than 40 years ago, Genentech is a leading biotechnology company that discovers, develops, manufactures, and commercializes medicines to treat patients with serious and life-threatening medical conditions. The company, a member of the Roche Group, has headquarters in South San Francisco, California. For additional information about the company, please visit www.gene.com. For today’s podcast, we were pleased to be joined by Megan Weigel. Megan Weigel, DNP, 200RYT, is a nurse practitioner specializing in neurological care in Jacksonville Beach, Florida. She has been a multiple sclerosis certified nurse since 2005 and a nurse practitioner for over 20 years. She is also a board-certified Advanced Practice Holistic Nurse. She earned her Doctorate of Nursing Practice from the University of Florida, where her research emphasis was on preventive healthcare.

[00:02:29] She completed a fellowship in Integrative Medicine at the University of Arizona in the fall of 2018 which complements her practice focus on wellness and holistic care. She is the past president of the International Organization of MS Nurses and the co-founder of oMS Yoga, a non-profit organization that brings free yoga classes to people living with MS (www.omsyoga.org). Her bestselling book, Monday Mantras with Megan, offers an approachable mindfulness journey and is available on Amazon. Welcome, and thank you for joining me today. So, can you just begin by giving us a brief introduction to holistic therapies? What does the word holistic mean and what does integrative medicine mean?

[00:03:22] Megan Weigel: Sure. I think it’s a great place to start, because there is a lot of overlap in this world of what I would call wellness. So, I think that holistic tends to infer that something is natural and perhaps alternative to what we would call conventional or allopathic Western medical care. I think when a person says that they’re seeing a holistic doctor, it infers that they’re not using medicine, prescription medication, that they’re not having traditional testing done, so on and so forth. So, it’s sort of like if you have a spectrum, holistic is on one end of the spectrum and conventional western medicine is on the other end, and in the middle is integrative medicine. And integrative medicine really is a blend of therapies and lifestyle changes that include both conventional medical care but also holistic therapies that have evidence for the condition that you’re wanting to treat. And that integrative care focuses on treating the whole person.

[00:04:26] So, mind, body, spirit, it’s not a disease-based type of medicine. The other term that is often used is complementary and alternative medicine. And so, I think that it’s worth just kind of floating that in here, complementary therapies are used in addition to medical therapies, and alternative therapies are used instead of. So, a holistic therapy could be complementary, but it could also be alternative, so an example would be for NMO. If you’re seeing a massage therapist and also receiving physical therapy, you’re receiving complementary care, but if you’re getting acupuncture and having treatment with a Chinese herbalist instead of using disease-modifying therapy, then that would be considered alternative medicine.

[00:05:19] Krissy Dilger: Okay, great. Thank you. And then, can you just describe what health wellness and healing mean in the context of an integrative approach to medicine? What is the goal of each of those?

[00:05:31] Megan Weigel: Absolutely. So, I like the World Health Organization’s definition of each of these terms. They define health as a state of complete, physical, mental, and social well-being, and not merely the absence of disease or infirmity, which I think many people would be like, oh, really, they define health like that, sometimes we think of being healthy as meaning that you can’t have any medical problems, right? But it’s actually more along the wellness continuum, whereas wellness is this multidimensional state that can be considered to be in a continuum, the optimal state of health of individuals and also groups. And the two concerns are realizing your fullest potential among physical, psychological, social, spiritual, and economic areas as well as fulfillment of your role expectations in a larger group, like your family, your community, maybe your place of worship or service, your workplace, those sorts of things.

[00:06:31] So, health is sort of confined to your person, and wellness has more to do with your relationship to not just yourself, but also the people who touch you and whose lives you touch. Healing is my favorite thing to talk about because we define it in integrative medicine as always possible, even when a cure is not, and many people would consider themselves not healed unless their disease is gone. And I think that what I’ve heard from patients over the years is that this diagnosis was the best thing that ever happened to me, because it caused me to slow down, change my lifestyle, address my past trauma, take care of myself better than I ever have. And actually, those people would say that they feel healed as human beings, even though they still have a medical condition. Healing is a subtle individual process, and I like to ask people what gives them a sense of purpose, what brings them joy. It involves exploration and connection rather than fixing and curing. So, those are the definitions of those three terms.

[00:07:49] Krissy Dilger: Great. Thank you. That is definitely a distinction that you might not think about in everyday life, but those distinctions are important, and I think that’s good to know. Can you please describe the optimal healing environments, Internal, interpersonal, behavioral, and external?

[00:08:09] Megan Weigel: Sure. So, these environments come from the work of Dr. Wayne Jonas, who is a wonderful physician who practices integratively and has created a movement of this holistic care, and when I say holistic care, I say it W-H-O-L, so you’re taking care of the whole person. He talks about the HOPE note instead of a SOAP note, and for those people who are listening, who have a medical background, they might be familiar with a SOAP note; it’s the way that we document an office and fit in the chart and so HOPE note addresses many components of mind, body, and spirit for a person. And so, some of those components are these internal, interpersonal, behavioral, and external environments. The internal environment is the relationship that you have with yourself. The interpersonal environment is the relationship that you have with others. The behavioral environment is that relationship that involves your healthy or unhealthy behaviors, and choices that affect your health. And the external environment is your relationship with the environment around you. And that can be quite literal, so it can be like feeling anxious, because your office is cluttered or because your house is a mess. It’s not just an egocentric thing, it’s the effect that your environment has on your well-being.

[00:09:46] Krissy Dilger: Okay, great. Thank you. So, how does a nurse, a nurse practitioner, or physician determine what may be a beneficial treatment or treatments that may not be offered by a traditional medical practitioner?

[00:10:03] Megan Weigel: The most important thing to consider when you’re looking at non-traditional treatments really is the risk-to-benefit ratio. And in my opinion, that also includes financial risk, because many of today’s popular integrative therapies or things that we do that are part of this quote wellness industrial complex are very expensive, and the return on the investment isn’t as high as claims would say that it is. So, looking for evidence and considering that risk-to-benefit ratio is important, and I think a good way to do this is to establish a network of trusted providers and resources in your community. Also, patients always seem to be interested in supplements. I think we’ll talk about that later on. But there is a subscription for providers called the natural medicines database where you can find so much information regarding supplements and interactions and evidence and medical publications about those supplements. Also, finding local Integrative providers who are fellowship trained to align with that, you feel comfortable referring to is a great way to know that you’re offering a resource for a patient that’s safe.

[00:11:25] Krissy Dilger: Great. Yeah, that’s good to know. You never think about those things when you’re taking supplements possibly, but the interactions and such are important. So, may be an individualized situation, but generally speaking, are there any specific symptoms or situations where holistic therapies may work best or provide the most benefit?

[00:11:52] Megan Weigel: Sure. That’s a great question. And some of it has to do with the current research that’s available. So, holistic therapies seem to work best in the rare neuroimmune disease world and in the neurological world for things like pain, depression, anxiety, insomnia, and even digestive symptoms. There are many holistic therapies that work well for treating very mild bacterial or viral illnesses. Much of this has to do with the fact that the research for, say can a holistic therapy modifying a disease, or can a holistic therapy modify a disease? It just hasn’t been done on a large scale, so we do have research that tells us that things like yoga, mindfulness, dietary changes, there are things like that that can affect symptoms in a positive way, and so far, that’s where we have the most data.

[00:12:59] Krissy Dilger: Okay, great. So, I was hoping we can kind of go into more of the types of holistic therapies. And so, if we can, I’d like to start with nutrition. So, how does nutrition relate to rare neuroimmune disorders, and how can it be used as a holistic therapy? Are there resources you would recommend for those trying to utilize nutrition as a therapy?

[00:13:23] Megan Weigel: Yeah. So, I think nutrition is probably the place where people usually start when they’re looking at making a lifestyle change, and we go back to more than 1000 years ago, and Hippocrates said, let food be thy medicine and medicine be thy food, and it really couldn’t be more applicable than it is today, because so many medical conditions are quite literally fed by unhealthy eating. Healthy and unhealthy foods both create reactions in the body that lead a person down the road to health or down the road to disease. So, many people look for instead of changing their nutrition style, they look for stuff in a pill, like I’m going to take a — I’m trying to think of something like a Super Green’s pill instead of eating more greens with my meals or I’m going to take a — I’m trying to think. I’m going to eat only acai for a week, because I heard it’s a super food and I think that one of the most important things to understand about nutrition is food is also chemistry.

[00:14:34] So, it’s tough to say that getting high doses of a nutrient in a capsule are going to be as effective as eating healthy, and with the exception of eating disorders, allergies, and food-drug interactions, eating healthy is certainly not going to hurt you. So, one example that I like to talk about as we talk about nutrition is Omega-3. There were large meta-analyses that were published within the past five years that showed that taking Omega-3 fatty acids and a capsule may help with specific markers of cardiovascular health, but didn’t change the overall outcome of all-cause mortality, for example, but eating a diet high in Omega-3s actually seemed to work better for most of those things. So, eating the foods is better than taking the capsules is what I’m trying to say, what we do know about nutrition in autoimmune disease, and this is a kind of a global statement, not just specific to rare neuroimmune disorders, because as you can imagine, there’s not a lot of research, there is that foods that are high in fiber and Omega-3s stimulate anti-inflammatory effects, as do foods that are high in flavonoids. So, these are high-fiber foods, Omega-3s, and really colorful vegetables and fruits.

[00:16:01] Short-chain fatty acids that are made in the gut from the high-fiber foods produce anti-inflammatory chemicals in the body. Foods that are high and polyunsaturated fatty acids are anti-inflammatory, and in animal models, they actually have evidence for neuroprotection with that type of food. Foods high in fiber from whole grains, fruits and vegetables activate receptors that decrease the recruitment of inflammatory cells in the body. These are the good things. And then if we move over towards, what will happens if I’m eating a diet that’s high in processed foods, fast foods, saturated fats, then you’re moving into this pro-inflammatory state which obesity actually is, so overweight and obesity actually lends the body to staying in this pro-inflammatory state, and you have an increase of inflammatory immune chemicals in the body like interferon-gamma, IL-6, long-chain fatty acids from processed foods, and seed oils as well as foods that are high in Omega-6 like red meat, stimulate baby T-cells to become inflammatory instead of anti-inflammatory.

[00:17:14] So, nutrition really plays just a huge part in how the body works. I think of it as the soil for the rest of the things that we do. And when we talk about nutrition, I know that we’re here looking at the population of rare neuroimmune disease. I am most well versed in the literature for multiple sclerosis, and all of these things that we do that cause unhealthy changes in the body increase the risk for vascular disease, which increases the risk of disability progression in MS by several years. So, we know that healthy nutrition is certainly important in modifying disease and certainly in keeping a person’s nervous system healthy.

[00:18:02] Krissy Dilger: Great. That was very informative. And I think this topic, specifically nutrition is when our community is very interested in. So, hopefully, more research and more information come out in the future to build upon those. The research that’s already —

[00:18:19] Megan Weigel: Yeah. It’s becoming more studied from the conventional medicine side of things versus the nutrition side of things, and I think that we’ll see more of that in the next few years.

[00:18:33] Krissy Dilger: Yeah. Great. So, you kind of touched on this a bit already, but I’m just going back to the topic of supplements. We are often asked about supplements by our community members from the rare neuroimmune disorder community. Are there any supplements that are frequently used in rare neuroimmune disorders? And also, on the flip side, are there any specific supplements to avoid or use cautiously?

[00:19:02] Megan Weigel: This is a great question. The first place I’ll start is with vitamin D, because that would be the most common supplement that is frequently used in rare neuroimmune disorders. Certainly, that’s something that when you go to your neurologist or your neuro-ophthalmologist, or your advanced practice provider, they will probably be measuring and recommending that you take based on your serum level. But at a higher level, what we need to think about is what’s happening on social media and google, and when you go to the chiropractor or to heck, when you go to get a facial, people will say, oh, you need to take this, I heard this is good for your immune system, everyone’s taking lion’s mane, and basically, you’re being given these red recommendations by people who aren’t trained appropriately to understand the potential for harm, plants aren’t just plants. Many heavy-hitting prescription medications are actually derived from plants. One of the ones that some people might be familiar with is digoxin, which is an old medicine used for heart rate control, and it comes from the foxglove plant, and it can have significantly serious effects on the heart and on the kidneys.

[00:20:25] So, it’s important to understand that plants are powerful supplements, can cause the same types of damage that prescription medications can cause; they can interact with each other. They can interact with your medicines, and they can even reduce the efficacy of disease-modifying therapy. So, if your neurology provider isn’t well-versed on supplements and you want to take some, I would ask that person to refer you to a person who is well-versed in conventional prescription medical treatments and supplements. The things that I would say to stay away from are things that claim to quote be immune boosting or boost your immune system because your immune system works wrong when you live with a rare neuroimmune disease, and that’s what caused the problem in the first place. So, if you give it something to boost, it’s going to work more wrong, and so, that’s something that people seem to go, “Hmm, oh, yeah, that makes sense. It’s just adding fuel to a fire.”

[00:21:33] So, I pray every day for larger studies for things like ashwagandha, Lion’s mane mushroom, these kind of big buzzwords in neuroimmune disease, but I have to be cautious with recommendations, because we truly just don’t know the answer. And there’s a lot of science that’s available in studies of these supplements in history. So, some of these supplements have been used for thousands of years. I tell people to get their vitamin D level checked, their B12, B-6, folate, and magnesium levels checked, see if you need to supplement any of those things, because your levels are deficient or insufficient. I also tell people to get their copper level checked if they’ve been taking zinc because of COVID. So, here’s an example where oh, I heard on the internet I should be taking zinc to prevent COVID, and so here I am taking zinc.

[00:22:28] Well, zinc and copper compete with each other, and so we’ve been seeing in my neurology clinic, we’ve been seeing people coming in with neuropathy from copper deficiency, because they didn’t realize that all the zinc they were taking was competing with their copper and now they’re actually having a problem from the supplement that they were taking. So, I hope this kind of helps people to understand that the quote holistic pharmacy still has implications, and that’s why they’re naturopathic doctors, that’s why there are people certified in holistic therapies and herbalism. So, it’s really important to seek out advice before you start taking supplements.

[00:23:10] Krissy Dilger: Yeah, great. That’s really eye-opening, for sure. And a great overarching advice is to consult people about the things you put in your body.

[00:23:20] Megan Weigel: Exactly.

[00:23:21] Krissy Dilger: Great. So, moving on to another type of therapy that we get asked about often. What is mindfulness exactly, and how does it benefit those with rare neuroimmune disorders?

[00:23:34] Megan Weigel: Mindfulness, in my opinion, it’s essential. So, let’s just say that people with rare neuroimmune disorders deal with a sense of loss of control, loss of independence, loss of old societal or familiar roles, and this can really cause a cascade of issues that may open up the room for emotional anxiety and then more mental and physical issues. So, mindfulness helps a person rain in that spinning out of control of — I don’t know what’s going to happen. What if I wake up tomorrow and I can’t see? Mindfulness practices as study dampen the fight or flight nervous system, and they teach the mind that it’s not in danger all the time.

[00:24:19] And so, when the mind calms down, it can settle the reactions that it causes in the body. For example, when you take a deep breath, it’s slower and longer and deeper than usual, and when you exhale slower and more calm and a longer exhalation than you usually do, your blood pressure goes down, your heart rate goes down. So, it’s this feedback mechanism between the mind and the body that mindfulness causes, and this is likely to reduce the inflammation caused by chronic stress, which in turn causes illness. So, I think it goes without saying that mindfulness is essential in rare neuroimmune disorders, and it doesn’t have to be a 20-minute meditation session a day. It can be as simple as noticing that your thoughts are spinning out of control and stopping and taking a few deep breaths.

[00:25:19] Krissy Dilger: Yeah, thank you. A therapy that is new to me personally is manual medicine. Can you explain what manual medicine is and how it is used in your practice?

[00:25:31] Megan Weigel: Absolutely. It’s pretty simple. It’s a category of trying through hands-on therapies. So, physical therapy is actually a form of manual medicine; it’s chiropractic, so is osteopathy as it was traditionally used. Doctors of osteopathy would manipulate, and then other hands-on therapies, like acupressure, part of the tenets, the root tenets of these therapies, particularly massage, acupressure, and even osteopathy in some forms of chiropractic, is that the issues are in the tissues, and manual therapies help a person not only to literally move better, have less pain and spasticity, but also to move perhaps blocked energy that might be in caused by stress or trauma that’s stuck in their body. So, I very often refer people to manual therapies, particularly physical therapy, and massage.

[00:26:27] Krissy Dilger: Great. Thank you. Another therapy we get asked about is spirituality. Do you mind explaining what spirituality is in the context of holistic therapy and how it is practiced?

[00:26:39] Megan Weigel: Yeah. So, spirituality is really foundational for healing, and if we go back to that definition of healing, it involves sort of self-exploration. A person needs to find the well they draw from for resilience and hope, and self-efficacy. And that’s where spirituality comes into play, it can be practiced simply by asking yourself what really matters to me, what’s my purpose, who am I really, and the answer isn’t, I’m a mom, I’m a doctor, I’m a journalist, I’m a car salesman. It’s who am I, really, and ultimately, it’s your connection to something that’s bigger than yourself. I say it’s not religion, spirituality is very different from religion; I think is a practice, it’s a set of beliefs, whereas spirituality involves that feeling you get when you’re dancing your favorite song, like when you’re breathing fresh air, it’s your intuition, it’s your sense of peace when you attend a religious service, or when you’re around people that you love, really that is your connection to something bigger.

[00:27:47] Krissy Dilger: Great. Thank you. So, can yoga be used as a form of holistic therapy? And can those with disabilities practice yoga?

[00:27:57] Megan Weigel: Oh goodness, gracious. Absolutely, yes. So, yoga is a holistic therapy, and it can be practiced by anybody, no matter the level of ability in that body. When people with disabilities practice yoga, we use modifications just like we use for people without disabilities, and that can include using a chair, it might include staying on a map, it might include using props or assistance, and also creativity from the standpoint of the instructor and making shapes with the body. Like, some people are making a shape with their body standing, some people are in a chair, and some people are on a mat. Yoga can help with symptoms that are common to people who live with chronic neurological disorders, like pain spasticity, bound bladder issues, anxiety, and balance. And we have seen just really a tremendous growth in the interest in yoga in the neuroimmune community and a great sense of community when folks get together to practice.

[00:29:06] Krissy Dilger: Yeah. That sounds great. Another holistic therapy I’d like to know more about is acupressure. So, what is acupressure, and how is it used as a part of holistic therapy?

[00:29:19] Megan Weigel: Acupressure uses gentle fingertip pressure to acupoints along acupuncture meridians to help move stuck energy. The treatments very relaxing, if I had to give it very — I guess, I’d the definition that when I say it’s acupuncture without the needles that it’s sort of true, acupuncture actually moves energy whereas acupressure allows the person’s body to work through that process on their own. The treatment is helpful for anyone, but the gentleness of the treatment is good for people who may need massage but can’t tolerate the touch or the pressure of massage or who are afraid of needles but would really benefit from acupuncture. So, it can be used as a part of holistic therapy for those folks who are interested in a manual therapy, but one that’s a bit gentler, so to speak.

[00:30:24] Krissy Dilger: That makes sense. Great. Thanks. Yeah, and finally, can you describe what the Neuro Emotional Technique or NET is?

[00:30:36] Megan Weigel: Yes. So, NET is an energy medicine type practice. It’s an approach that uses muscle testing to identify stress responses that are stuck in a person’s body, and these responses may be related to an unresolved event to an injury to, poor nutrition or to an emotional stressor. The person receiving the treatment identifies the stressor, and then the practitioner offers a correction that is based on identification of a pulse. According to Chinese meridians, the patient then applies the correction releases the pattern. It involves muscle testing, which is a very simple technique. Many people may have had it at a chiropractor’s office or the kinesiologist’s office, and it involves some breathing exercises or, if done by a chiropractor, chiropractic adjustments during the breathing exercises. Like I said, I would consider it a form of energy healing, but at the same time, the Neuro Emotional Technique, NET Mind-Body Foundation, has produced very good MRI research that shows the benefit of the treatment in the brain according to MRI.

[00:31:54] Krissy Dilger: Okay, great. So, moving on to kind of general questions for people who are new to holistic therapy and interested in trying it out. First off, how much time does a person need to dedicate to practicing these therapies or one of these therapies to see a difference? Do these practices need to be ongoing, or can a person stop if they no longer experience symptoms?

[00:32:22] Megan Weigel: That’s a really great question, because many of these therapies that don’t involve, say, lifestyle changes that you can make on your own, they can be expensive. So, the duration of the therapy really depends on the therapy itself. Manual and energy therapies can be stopped and started according to symptoms. For example, you go to physical therapy for increased spasticity, and it stops in six to eight weeks once you’re a little bit better. Those types of therapies can also be used for maintenance treatment. If you wanted to like for your general well-being and for your health, you may get a massage once a month or go to acupuncture once a month. The therapies that should be done regularly are things like mindfulness practices and also eating healthy, moving your body, exercising, whatever that looks like for you; those things need to be done regularly to truly modify the nervous system and reap the health benefits of them.

[00:33:31] Krissy Dilger: Great. Yeah. You make a great point about assessing the expense versus the things that are free to all of us in everyday life. So, should these complementary therapies or holistic therapies be directed by a licensed medical practitioner?

[00:33:38] Megan Weigel: Thank you so much for asking this question, and I think about it in two ways. One is that a licensed medical practitioner being if that person is your MD and PPA, may refer you to a physical therapist or an acupuncturist or chiropractor, but then that person directs the therapy, your physician, your nurse practitioner has no idea what to tell the physical therapist to do or what to tell the acupuncturist to do, right? But another way to look at this question is should your alternative providers be licensed and absolutely. So, even for alternative or holistic therapies, their certification or licensing requirements that are according to discipline or your state, and it’s really important to make sure you’re working with a properly educated and licensed provider. Unfortunately, many medical providers don’t arm their referral to toolboxes with complementary therapists, and I think it’s really important to do that so that you can make safe referrals.

[00:34:48] Krissy Dilger: That’s a really important point. Thanks. So, in general, do people have better results using these complementary therapies and combination with traditional methods of managing symptoms? For example, someone using gabapentin to treat neuropathic pain in combination with yoga or mindfulness, and that may offer better pain control than gabapentin alone?

[00:35:19] Megan Weigel: It’s a really great question. It’s also a hard question to answer because there are no studies that I know of that. Look at the differences in results of people who use and don’t use CAM in combination with conventional therapies. My patients tell me that the therapies they use that are alternative or holistic fill in the gaps that conventional therapy doesn’t, and that’s specifically a tuning to the needs of their mind, body, and spirit in a different way. A really good example of this would be actually the example that you gave with gabapentin with, yoga and mindfulness, and pain. Gabapentin may not adequately control pain but taking more gabapentin may make a person feel sleepy or dizzy, and if they’re taking their current gabapentin and then using, say, mindfulness meditation or guided imagery that’s specific to their pain, that may offer them a better experience as a whole, because it provides them with coping mechanisms rather than side effects.

[00:36:28] Krissy Dilger: Great. Thank you. And do people do better with these holistic therapies when part of a treatment plan with a holistic or integrative medicine practitioner in lieu of implementing them on their own?

[00:36:45] Megan Weigel: So, I’m biased about this. I think that patients should have good resources for care, and that includes someone that’s well-versed in integrative care, but they’re not easy to find. So, when you do seek this kind of stuff out on your own, you miss out on the risk-benefit ratio of knowledge. And without an integrative medicine practitioner, you might get a hard no, and so what I mean by that is if you go seek someone out on your own, because you read on the internet that signing up for this $1600 treatment over four weeks is going to cure your fatigue, then you don’t have the opportunity of talking to say someone like me who’s done the research that says well, we really don’t have evidence to know if X, Y and Z is going to fix your A, B and C. So, if you have an extra $1600, that’s great, but if you don’t, I wouldn’t waste the money. And on the flip side, if you have a really staunch medical provider who chooses to be closed-minded to complementary therapies, then you’re just going to get to know, right? So, I think if you can, it’s important to have an integrative medical provider in your back pocket to run things by and get really good information from.

[00:38:07] Krissy Dilger: Yeah, that’s a great point. I think also it kind of ties into what you were saying about healing and that not being equivalent to a cure, right? So, knowing with expectations going into these therapies with the goal of healing and not necessarily a cure.

[00:38:25] Megan Weigel: Exactly. Exactly. That’s a really good point.

[00:38:29] Krissy Dilger: So, how does a practitioner such as yourself evaluate the success of a holistic treatment plan?

[00:38:37] Megan Weigel: I ask the patient questions, are there any side effects or any adverse events from the treatment? Is the patient feeling better? Do they feel well? Do they have a better sense of well-being? Is their quality of life improved? If they’re making changes that are related to nutrition or maybe to supplementation or herbal treatments, then I might check blood work to see if markers are moving, make sure that their treatment plan that they’re using is safe for their body. But ultimately, that success comes down to the same measuring in the same types of ways that we would with our modifying therapies, and then ultimately, is their sense of wellness improved? Do they feel like you mentioned that they are healing?

[00:39:29] Krissy Dilger: Thank you. Well, this is all been really helpful, I think, especially for someone who is new to holistic therapy, but really anyone who is interested in the topic. Are there any resources you recommend for those trying to begin a holistic therapy method, integrative approach or are curious to learn more?

[00:39:49] Megan Weigel: Certainly, I think you kind of go to the source for what you want to do. So, I’m fellowship trained by the University of Arizona’s Andrew Weil Center for Integrative Medicine, and there’s a find a practitioner website through the University of Arizona where you can find integrative providers in your area that our fellowship trained. There are other fellowships in the country for physicians, and there is a holistic nurse practitioner program certification program as well. The Institute of Functional Medicine lists functional medicine providers who have, at the very least, completed their core course, and those providers may be physical therapists, nurses, nurse practitioners, chiropractors, physicians, and so on. The American Holistic Nurses Association will list nurses like myself who are board certified in holistic nursing. There are national acupuncture organizations that list their licensed providers. Similarly, asking around with a trusted provider who they might recommend for other things like Reiki, massage, or chiropractic care. In a community, people tend to know one another, so once you find one, it’s like the spokes in a wheel, right? Once you find one person, you’ll start to find a lot of other people. So, it starts by knowing just one good person.

[00:41:22] Krissy Dilger: Great. Well, thank you so much. That’s all the questions I have for you today. Was there anything you wanted to add or wrap up with, or any closing thoughts?

[00:41:32] Megan Weigel: I think the biggest takeaway for me about holistic therapies that I’d like to impart to people living with rare neuroimmune diseases and to providers who may be interested in listening is that with holistic therapies, one of the greatest benefits that we can give a person is in healing from a standpoint of well-being, spirituality and just a sense of better quality of life and things like that. And so, if you can open your mind to treatments that are financially safe, physically safe, that may help a person, then you’ll really improve the lives of people living with these diseases.

[00:42:23] Krissy Dilger: Yeah. Thank you so much. That’s a great closing sentiment, and we’re just so grateful for you to dedicate your time to helping our community members and also to volunteering to come on this podcast and impart some of your knowledge. We hope to continue this conversation in the future and hopefully hear from you again.

[00:42:46] Megan Weigel: Yeah. Thanks so much for having me.