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Thursday, October 19, 2017


9:00 AM-4:30 PM

Autonomic Self-Regulation for Chronic Centrally Sensitized Pain
Emerging evidence for how ASR and heart rate variability (HRVB) can result in pain reduction – and a feeling of empowerment for patients.

This six-hour demonstration, hands-on, and instructional course will foster understanding of how autonomic self-regulation (ASR) empowers patients to manage centrally sensitized chronic pain. This course will explain how heart rate variability (HRV) brings about “left foot braking at the sino-atrial node,” and attendees will learn about the empirically measurable benefit, which this integrative clinical intervention has for pain reduction. ASR will be considered from both a research and a clinical perspective. The autonomic and central nervous system pathways that are shared by centrally sensitized chronic pain and autonomic nervous system (ANS) self-regulation will be presented and elucidated. Emerging data from our ongoing VA-funded research on ASR and chronic pain in veterans and other studies, including cancer survivors, along with clinical insights and experiences, will be shared. Many chronic pain conditions are associated with central sensitization, including fibromyalgia, irritable bowel syndrome, chronic fatigue syndrome, osteoarthritis, musculoskeletal and dental pain, headaches, and visceral and postsurgical pain. Fibromyalgia will be explored in greater depth as an example of a centrally sensitized pain condition that is responsive to ASR.

Learning Objectives: After completing this educational activity, participants will be better able to 1) Define and describe the meaning of integrative medical management, chronic sensitized pain, and autonomic self-regulation (ASR); 2) Describe the basic science of heart rate variability (HRV) and its relationship to ASR; 3) Summarize the nervous system pathways shared by chronic sensitized pain and ASR; 4) Describe case studies of the application of ASR to chronic sensitized pain; 5) Identify HRV parameters that are biomarkers of emotional health; 6) Identify HRV parameters that are biomarkers of emotional and physical health; 7) Discuss how ASR can be used for health assessment and behavioral change; 8) Explain ASR techniques and tools; 9) Discuss how to incorporate ASR into a therapeutic practice model for chronic pain patients.
Faculty: Raouf S. Gharbo, DO; Jay P. Ginsberg, PhD; Melanie E. Berry, MS, BCB, Aubrey Berry, BS, ABT CP-TLP, CES, CHP OMC, FAIS
This is a Pre-Meeting Workshop; additional fees apply.


9:00 AM-4:30 PM

Certificate in Nutritional Pain Management Workshop (CNPM)
The only program of its kind! Prove your knowledge about how food, diet and supplements can help manage pain.

This six-hour workshop is a practical clinical program covering the importance of food as a pain management intervention. This program, chaired by Robert Bonakdar, MD, FACN, and Nancy, Cotter, MD, FACN, CNS, will include a discussion of where to start the conversation with patients about using diet and supplements to treat pain. It will also include the five components necessary in a diet for those in pain. Evidence and case studies will show participants how to incorporate this vital intervention into their practices. 
Interventions include:
Initiating a specialized diet in specific pain conditions
Antiinflammatory diet
Elimination diet: when and how: FODMAPs, specific carbohydrate diet, etc.
Role of herbal supplements (curcumin, boswellia, ginger, etc.) in pain management
Role of non-herbal dietary supplements (omega-3s, CoQ10, B-vitamins, probiotics, etc.) in pain management
The faculty will discuss nutrition and supplements for common conditions, including:
Chronic low back and musculoskeletal pain

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Describe the pathophysiology of osteoarthritis and how it may be impacted by diet; 2) Illustrate dietary patterns that modulate inflammation; 3) List the mechanisms by which nutrients and compounds affect pain; 4) Discuss ways in which inflammation related to pain states may be assessed; 5) Discuss the prevalence and rationale for the use of common integrative therapies in pain management; 6) Review the evidence for the most common integrative therapies utilized for pain; 7)Discuss approaches for coordination of integrative therapies in the management of pain.
Faculty: Robert Bonakdar, MD, FACN, and Nancy, Cotter, MD, FACN, CNS
This is a Pre-Meeting Workshop; additional fees apply.


9:00 AM-4:30 PM.

What’s Appropriate and What’s Not? Safe Opioid Prescribing in a World of Ever-Changing Regulations
The ins- and outs of prescribing opioids safely -- and legally.

This 6-hour, program is intended to provide education on the optimal management of chronic pain, particularly using opioids appropriately and managing patients’ risk for harm. Our distinguished faculty, led by pain expert Paul Christo, MD, will discuss the elements of appropriate opioid prescribing for chronic pain and engage the program attendees in interactive discussions of two illustrative case studies.  W. Clay Jackson, MD, will provide the primary care perspective on proper assessment for pain; strategies for assessing a patient’s risk for opioid misuse, abuse, and addiction; initial considerations in selecting an opioid, and alternative treatment options. Howard Heit, MD, will discuss safe prescribing;  use of the “Universal Precautions in Pain Medicine;” strategies to wean patients from opioids; and how to manage an inherited patient with substance abuse issues; and  Dr. Christo will discuss the various opioids, including abuse-deterrent formulations, the use of naloxone, suboxone, opioid interactions, and opioids in patients with complex issues such as addiction. Jen Bolen, JD, will provide the legal and regulatory perspective on opioid prescribing and will discuss how clinicians can best protect themselves and their practices from regulatory action and litigation.   

Learning Objectives: After completing this educational activity, participants will be better able to 1) Summarize the incidence of opioid overdose and the high percentage of unintentional overdose; 2) Describe the risk factors for prescription opioid overdose; 3) Identify assessment criteria for chronic pain and appropriate strategies for patient monitoring; 4) Explain the role of abuse-deterrent opioid formulations, naloxone use, and suboxone; 5) Describe the risks of opioid-drug interactions and identify groups at increased risk of harm from opioid use; 6) List three elements that must be included in the patient record of the chronic pain patient.
Faculty: Paul Christo, MD, Howard Heit, MD, FACP, FASAM, W. Clay Jackson, MD, DipTh, Bob Twillman, PhD, and Jen Bolen, JD
This is a Pre-Meeting Workshop; additional fees apply.


Keynote: Presence, Patience, and Perseverance: A Veteran’s Story
Col. Gadson will tell his story of recovery from an improvised explosive device (IED) attack in Iraq that cost him both legs above the knees and normal use of his right arm and hand. As a career military officer and a college football player for West Point, he is a hard-wired team player, all of which give him an appreciation for team-based, integrative pain care.

Learning Objectives: After completing this educational activity, participants will be better able to: 1) Discuss the concept of resilience; 2) Describe the benefits of mindfulness; 3) Discuss the importance of team-based care.
Faculty: US Army COL (Ret) Greg Gadson 


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