Women's Medicine
Men's Medicine
DR. JASON MCNEIL, NMD
Action is about living fully. Inaction is the way that we deny life.
While the life expectancy gap between men and women has decreased, it’s no secret that men still need to pay more attention to their bodies. Several things work against men. They tend to smoke and drink more than women. Aside from this, they also don’t seek medical help as often as women. Some men define themselves by their work, which can add to their stress.
There are also health conditions that only affect men, such as prostate cancer and low testosterone. That is why it’s important to have regular checkups and screenings. Many of the major health risks that men face, such as colon cancer or heart disease, can be prevented and treated with early diagnosis.
Screening tests can find diseases early, which is the stage when they are easier to treat. Talk to your doctor about which preventive medical tests you need to stay healthy.
intravenous nutrient therapy (IVNT)
Weight Loss
The hCG Diet
The hCG Diet
The Hypothalamus controls distribution of adipose tissue (fat) throughout the body. hCG encourages the hypothalamus to trigger a hormonal cascade which increases mobilization of stored adipose tissue, particularly from the abdomen, hip and gluteal areas. This mobilized body fat is then taken to the liver and turned into glucose through a process known as gluconeogenisis (new production of sugar). For every pound of mobilized body fat, roughly 1000-2000 calories of glucose is then released into the bloodstream to be utilized by the body for energy. This is part of why only 500 calories of food are needed with the diet and why we are not hungry with this drastic caloric restriction, we are essentially living off body fat.
First, you come in to the office and consult with Dr. McNeil or Dr. Pangia. A full physical exam is done and body fat % and BMI is calculated. Then we will discuss your overall goals and how you will achieve those goals. We will instruct you on how to inject hCG (don’t worry, they are tiny needles). We will also give you a B-12 shot to boost your energy and metabolism. Then we send you off to gorge for the first 2 days of the diet (the fun part!).
Day 3-28:
The calorie restriction starts day 3. We give you 7 syringes. Each morning you’ll wake up, weigh yourself and inject yourself. Dr. McNeil and Dr. Pangia have designed an easy to follow diet plan so that you don’t have to figure out a 500 calorie diet for yourself. You have choices of proteins, veggies and fruit that you are able to eat on the diet, and of course we make room for a small snack in between meals!
Each week you come in, drop off empty syringes so we can safely dispose of them, receive another B-12 shot and meet with Dr. McNeil for a few minutes to ensure weight loss goals are being achieved. Then you are sent home with another 7 syringes with a stronger dose than the last week. Ultimately you will work yourself up 4 doses of hCG.
At the end of the program you will meet with Dr. McNeil or Dr. Pangia for another consult, this is where we give detailed instructions on Phase 2, “The Maintenance Phase”. In Phase 2 we teach you how to eat to maintain your weight loss results. This phase lasts about 12 weeks and is so important to reset the body at its new weight. Weight loss slows down in phase 2 but most people continue to lose weight during this period. Sugars, starches, trans-fats, artificial sweeteners and nitrates (processed foods) are not allowed during this phase. Patients can be cycled back on the hCG diet after Phase 2 if there is still more weight that needs to be lost.
More Americans are becoming overweight or obese, exercising less, and eating unhealthy foods. According to the latest Gallup-Healthways Well-Being Index, 63.1% of adults in the U.S. are overweight or obese (36.6% are overweight and 26.5% obese).
- 59.2% of obese Americans exercised at least one day per week, compared to 69.9% of overweight people, and 73.8% of normal-weight people.
- Obese people are less likely than people in every other weight category (overweight, normal weight, underweight) to have eaten five servings of fruits and vegetables on at least three days of the past seven.
- Obese Americans also are less likely to say they ate healthy “all day yesterday.”
Body mass index (BMI) is a common measure of body fat based on height and weight. A BMI of 30 or greater is considered obese, overweight if it’s between 25-29.9, normal if it’s 18.5-24.9, and underweight if it’s less than 18.5. People who are obese are far more likely to report being diagnosed with high blood pressure, high cholesterol, diabetes, or to have had a heart attack. The survey says that African-Americans were among the most likely to be obese, at 36.2%, compared to the national average of 26.5%. The obesity rate among Hispanics, at 28.3%, is also higher than the national average. Asians are far less likely to be obese, with only 9.6% falling into that category.
The survey also reports that:
- 18.3% of young Americans are obese, compared to 27.6% between ages 30-44 and 30.6% among 45- to 64-year-olds. Of people 65 and over, 24.2% are obese.
- Men are more likely than women to be obese, 27.8% compared to 25.2%.
So, what are we to do?
The simple answer is move more and eat less. Our modern society has geared us toward inactivity and convenience food. So, if you want to deal with being overweight or obese, if you want to immediately increase your quality of life, sense of well being, health, and appearance, then you must fight against the sedentary quick fix status quo.
Here at NVMC, our primary approach is education. We provide the knowledge necessary to make educated changes. For those that already have the knowledge, we also provide programs to help get you motivated and headed in the right direction.
Pain Management
What is pain?
Pain is an evolutionary trait helping us protect damaged tissue by warning us with a feeling of distress, suffering, or agony. Pain induces the sufferer to remove or withdraw from the source of pain. The body recognizes tissue damage through chemical substances released by damaged tissues. These substances stimulate pain receptors and/or cause damage to the nerve endings. Nerves send signals to the brain for interpretation and subsequent action. Perception of pain is complex and individualized, and can be influenced by a variety of external and internal influences. In addition to neural signals and sensory input modulation, pain perception can be influenced by psychological and cultural responses to pain stimuli. There are theories related to physiologic control of pain. Pain impulses are mediated by internal systems such as neural pathway gates, the opioid system with endogenous analgesics enkephalins and endorphins, and the stimulation of large sensory fibers extending from the tactile receptors in the skin thus suppressing the transmission of pain signals from thinner nerve fibers. This last internal system eludes that nerve pathways to the brain can accommodate only one type of signal at a time, thus superficial tactile sensation trumps pain sensation. Endorphins and the inhibition of pain transmission by tactile signals has provided a reasonable scientific explanation for the success of relaxation, massage, application of liniments, and acupuncture in the control of pain and discomfort. Pain is generally a subjective phenomenon. The person reporting personal discomfort or pain is the most reliable source of information about its location, quality, intensity, onset, precipitating or aggravating factors, and measures that bring relief.
Objective signs of pain can assist in verification of a patient's subjective reports of pain:
- Physiologic signs of mild to moderate superficial pain are responses of the sympathetic nervous system, also know as Fight or Flight. These objectively measurable signs include changes in respiratory patterns, pallor, sweating, increased heart rate, increase blood pressure, dilated pupils, and muscle tension.
- Physiologic signs of severe deep pain are responses from the parasympathetic nervous system. These objectively measurable signs include decreased blood pressure, decreased heart rate, pallor, nausea and/or vomiting, weakness, and syncope.
Psychosocial aspects include our personal tolerance and reactions to pain. Due to a varietal plethora of psychologic and cultural influences, psychosocial aspects of pain tend to be much more complex and less identifiable than physiologic responses, thus harder to modify. One’s degree of attention to and distraction from painful stimuli can also affect one’s perception of the intensity of pain.
Types of Pain
Acute Pain: Pain that is caused by traumatic injury, surgical procedures, or medical disorders; clinical symptoms include increased heart rate, blood pressure, and respiratory rate, shallow respiration, agitation or restlessness, facial grimaces, or splinting.
Chronic Pain: Pain that is persistent, lasting more than six months; clinical symptoms may be the same as for acute pain, or there may be no symptoms evident.
Bearing-Down Pain: Pain accompanying uterine contractions during the second stage of labor.
Cancer Pain: One of the three categories of pain established by the International Association for the Study of Pain, denoting pain associated with malignancies and perceived by the individual patient; there are various scales ranking it from 0 to 10 according to level of severity.
Pain Disorder: A somatoform disorder characterized by a chief complaint of severe chronic pain that causes substantial distress or impairment in functioning; the pain is neither feigned nor intentionally produced, and psychological factors appear to play a major role in its onset, severity, exacerbation, or maintenance. The pain is related to psychological conflicts and is made worse by environmental stress; it enables the patient to avoid an unpleasant activity or to obtain support and sympathy. Patients may visit many health care providers searching for relief and may consume excessive amounts of analgesics without any effect. They are difficult to treat because they strongly resist the idea that their symptoms have a psychological origin.
False Pains: Ineffective pains during pregnancy that resemble labor pains, not accompanied by cervical dilatation; braxton-hicks contractions. Also called false labor.
Growing Pains: Any of various types of recurrent limb pains resembling those of rheumatoid conditions, seen in early youth and formerly thought to be caused by the growing process.
Hunger Pain: Pain sensed within the GI tract and perceived as a need for food
Intermenstrual Pain: Pain accompanying ovulation, usually occurring 10 days after termination of menses.
Labor Pain: The rhythmic pains of increasing severity and frequency due to contraction of the uterus at childbirth.
Lancinating Pain: sharp darting pain.
Phantom Pain: Pain felt in an absent or amputated limb or organ.
Psychogenic Pain: Symptoms of physical pain having a psychological origin.
Referred Pain: Pain felt in an area where it is not caused. Referred pain typically originates in a visceral organs and is felt on the skin or in another area deep inside the body. It’s hypothesized that referred pain occurs because pain signals from the viscera travel along the same neural pathways used by pain signals from the skin. The person perceives the pain but interprets it as having originated in the skin rather than in a deep-seated visceral organ.
Rest Pain: A continuous unrelenting pain due to ischemia of the lower leg, beginning with or being aggravated by elevation and being relieved by sitting with legs in a dependent position or by standing.
Root Pain: Pain caused by disease of the sensory nerve roots and occurring in the cutaneous areas supplied by the affected roots
How we treat pain
Acupuncture
What is Acupuncture?
Acupuncture is a method in which very fine needles are used to stimulate the body’s natural healing. After careful assessment the acupuncturist can identify energy patterns that are disrupted and insert needles into specific anatomically defined locations to help restore the energy patterns to their optimal state. As such, the acupuncturist is using needles to assist the body’s own self healing response. Some conditions may call for additional electrical stimulation to enhance the effects of the needles. They may also use heat therapy by burning a specially processed herb next to the needle.
What does Acupuncture treat?
Acupuncture has been used as an effective medical modality for over 2000 years. It has been recognized by the World Health Organization to treat over 300 conditions. In the US, people commonly seek treatment for the following conditions:
- Digestive disorders: gastritis, colitis and hyperacidity, spastic colon, constipation, diarrhea, nausea, weight loss.
- Respiratory disorders: allergies, asthma, sinusitis, sore throat, chest infections, colds & flu.
- Neurological and muscular disorders: migraines, neck pain & tension, bursitis, low back pain, sciatica, osteoarthritis, acute trauma.
- Urinary, menstrual, and reproductive problems: infertility, pre-menstrual syndrome, prostate, problems.
- Emotional disorders: insomnia, addictions, stress, detox for chemical dependencies, PTSD.
What can I expect during my Acupuncture session?
Your treatment begins with an extensive conversation about your medical history, current health and lifestyle. Many first-time patients are amazed at how comfortable they feel during an acupuncture treatment. When the needle accesses the flow of Qi, a slight tingling, a heaviness, or a tugging sensation may be felt. Acupuncture needles have been scientifically proven to release endorphins giving patients a pleasant experience.
Course of Treatment
Initial treatments take approximately 2 hours in which a full history and overview of patient health is assessed. Follow-up appointments generally last between 1 hour to 90 minutes. Patients need to eat at least 20 to 30 minutes prior to their treatment. The length of the course of treatment depends upon several factors such as age, severity of condition and length of disease. Everyone reacts differently to acupuncture and will respond at different rates. Typically, acute cases resolve more rapidly than chronic cases which may take of course of approximately ten acupuncture treatments. Many people continue to use acupuncture to maintain good health by keeping the body’s immunity strong and emotions balanced.
battlefield Acupuncture (bfa)
What is Battlefield Acupuncture?
Battlefield Acupuncture (BFA) is a form of auricular therapy (ear acupuncture) for pain relief, where a sequence of specialized needles are placed in up to five specific sites in the ears.
Battlefield Acupuncture (BFA) found its origins in the US Military. Developed in 2001 by US Air Force colonel Dr. Richard Niemtzow, MD, PhD, this technique was initially used to quickly reduce pain in the battlefield where proper medical care was not available. It is now widely employed on the battlefield and in VA and military hospitals worldwide, as both a stand-alone and adjunct treatment for acute and chronic pain.
How does Battlefield Acupuncture work?
BFA provides rapid and effective relief of many types of pain. Acupuncture releases chemicals that promote tissue healing and decrease inflammation. Relief from pain may also be achieved by the suppression of pain transmission at the spinal cord and by release of chemical transmitters like endorphins. Additional positive effects are found in the neuroendocrine system and the immune system, including the release of anti-inflammatory cytokines. Finally, BFA appears to work by stimulating the autonomic nervous system, mainly through the vagus nerve. The standard protocol addresses pain; Advanced BFA protocols effectively treat a range of ailments, including PTSD.
What can I expect during my Battlefield Acupuncture session?
A BFA acupuncture treatment is not like a typical acupuncture visit. Instead, ASP semi permanent needles are inserted in succession at each of the five points in each ear until pain relief is achieved. Between each needle insertion, the patient walks around for 30 to 60 seconds to activate the needles and assess pain relief. These ASP needles remain in the ear for several days until they fall out on their own, usually within 3 to 4 days.
Course of Treatment
Successive treatments provide more and more prominent relief, with the duration of pain relief progressively extending from hours to days to weeks. The benefits can last several weeks to months after just a couple of treatments.
NADA auriculotherapy
What is NADA Auriculotherapy?
The NADA Protocol is an evidence-based best practice, developed in 1979 by Dr. Michael O. Smith, MD to assist in addiction treatment. Since its successful use after 9/11 on first responders for relief from trauma, its application has expanded to address mental health and emotional trauma.
Its mechanism of action is not entirely clear, but the theory is by stimulating the vagus nerve. Three cranial nerves run through the ear: trigeminal, cervical plexus, and vagus. The vagus nerve has 13 branches that connect to most of the visceral organs, so auriculotherapy may work on a deeper, organ level via the vagus nerve.
What are the benefits of NADA Auriculotherapy?
• Increased calmness
• Sense of peace
• Improved sleep
• Decreased agitation & anxiety
• Relief from stress and trauma
• Reduced cravings for alcohol, drugs & nicotine
• Minimizes withdrawal symptoms
• Enhances counseling and other healing treatments
• Promotes inner quiet and strength
What can I expect during my NADA Auriculotherapy session?
NADA auriculotherapy involves the gentle placement of up to 5 sterile acupuncture needles in specific points in the ear. It is performed with patients fully clothed and is non-verbal, meaning you do not need to share your thoughts or concerns with your practitioner. Because it is nonverbal, there are no personal inquiries that can become barriers in initiating or continuing treatments.
For those averse to needles, special seeds or beads can be applied to the NADA points.
Course of Treatment
Once the acupuncture needles or seeds are applied, patients will relax in a quiet, darkened room for 45-60 minutes. Results are cumulative, so weekly treatments provide the best results, though single treatments can have profound effects with anxiety, panic attacks, and sleep.
PROLOTHERAPY
Definition
Prolotherapy is the treatment of connective-tissue damage through the use of injections. The injections instigate delivery of collagen and growth factors to the damaged tissue thus stabilizing the joint and decreasing pain. The term prolotherapy is derived from the word prolo, short for proliferation, as the therapy is intended to proliferate tissue growth in the damaged area.
Origins
The idea behind this therapy dates back more than 2000 years to Hippocrates, who used it to treat soldiers with injured shoulders. Instead of injections Hippocrates used a hot poker, which he speared into the shoulder joint, causing inflammation and stimulating the body to repair itself. Prolotherapy was derived from a treatment developed by H.I. Biegeleisen called sclerotherapy, used to treat varicose veins. In the 1950s, George Hackett, often called a pioneer of prolotherapy, was experimenting with and touting the benefits of the procedure.
Benefits
Prolotherapy has been used to treat chronic neck and back pain, joint pain from arthritis, headaches,fibromyalgia, sports injuries, carpal tunnel syndrome, and partially torn tendons, ligaments, and cartilage. It’s a low cost, effective, non-surgical outpatient procedure, saving patients from undergoing anesthesia and surgery followed by a long recovery period. Patients can walk out of the office and go straight back to work.
Description
In prolotherapy, a doctor injects a mix of concentrated dextrose and lidocaine into the damaged ligament or tendon at the point where it attaches to the bone. The injection produces an inflammation, which increases blood flow, swelling, and pain. The body then launches a course of healing and stabilization known as the fibrosis of repair. The inflammation mimic’s an injury, the body responds by sending in cells called macrophages that ingest and destroy damged tissue cleaning up the area. The body then sends in fibroblasts, which are cells that help build fibrous tissue. The fibroblasts excrete collagen, a protein that makes the ligaments denser and stronger. The stronger ligaments provide more support for the joints, often alleviating the pain. The same process happens when we cut ourselves, notice a scar is tighter and less sensitive than the surrounding tissue. The length of treatment sessions varies and depends on the area being treated. For example, treatment of an injured elbow involves injections only in one site, whereas treatment of larger areas, like the neck and back, involve more injections. Treating an elbow may take only a few injections, whereas the back may involve up to 50 injections for one treatment. The treatment generally involves several sessions, usually 3 to 6, occasionally more, Treatment sessions are separated by 3 to 6 week intervals depending on patient healing time and budget, both of which can vary from patient to patient. Another solution used in prolotherapy is Platelet Rich Plasma/PRP. Blood is drawn from the patient and centrifuged to derive a platelet concentrate that is then injected into the damaged area. This platelet concentrate is basically what we are trying to proliferate with standard dextrose prolotherapy. Both solution accomplish the same goal, PRP just does it more quickly. The entire procedure is done in office and takes around 90 minutes.
Preparations
Analgesics and sedatives may be given before treatment to reduce discomfort. Many patients, however, forgo sedation because they cannot drive home afterward. Many doctors use topical freeze sprays, ice packs, oranaesthetic cream to reduce skin sensation. It is recommended that patients drink plenty of water in the 24 hours before the procedure because it helps with cell hydration.
Precautions
As with all procedures, there are risks. Patients are asked to sign a consent and waiver. Since the treatment involves inserting a needle into the body, there is a chance of puncture to arteries, nerves, or even lung tissue, depending on the area to be treated. Although extremely rare, some patients may have allergic reactions to the substance injected.
Side Effects
The most common side effects include pain during the injections and soreness/stiffness afterward. Patients are reminded not to take any anti-inflammatory drugs, such as ibuprofen or aspirin, because these will impede the healing process prolotherapy aims to set in place.
PLATELET RICH PLASMA
Definition
Platelet rich plasma (PRP) is a volume of autogenous (meaning your own) plasma that has a platelet concentrate above the body’s normal level. Normal platelet concentrates in a person’s blood tend to be in the range of 150,000 and 350,000. Scientific proof has unequivocally demonstrated drastically improved bone and soft tissue healing using platelet rich plasma injection therapy with concentrations of 1,000,000. The clinical applications of platelet-rich plasma are many and varied. It is used in denistry, orthopaedics and other areas.
Advantages of Platelet Rich Plasma
- It’s safe. PRP is a by-product of our patient’s own blood; hence, disease transmission is not an issue.
- It’s convenient. Platelet rich plasma is processed under strict sterile conditions.
- It allows for faster healing. The super saturation of the wound with PRP produces an increase of tissue synthesis and thus faster tissue regeneration.
- It’s cost effective. Platelet rich plasma harvesting is carried out with only a small amount of blood in the doctor’s office. The patient does not incur the expense of the harvesting procedure in the hospital or at the blood bank.
Trigger Point Injection
What is a Trigger Point?
Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. Acute Trauma or repetitive microtrauma may lead to the development of stress on muscle fibers and the formation of trigger points. Patients may have regional, persistent pain resulting in a decreased range of motion in the affected muscles. These include muscles used to maintain body posture, such as those in the neck, shoulders, and pelvic girdle.
How do I know if I have a Trigger Point?
Trigger points may manifest as tension headache, tinnitus, temporomandibular joint pain, decreased range of motion in the legs, low back pain, and pain referring into the shoulder, arm or hand. Palpation of a hypersensitive bundle or nodule of muscle fiber of harder than normal consistency is the physical finding typically associated with a trigger point. Palpation of the trigger point will elicit pain directly over the affected area and/or cause radiation of pain toward a zone of reference and a local twitch response. Trigger point injection has been shown to be one of the most effective treatment modalities to inactivate trigger points and provide prompt relief of symptoms. (Am Fam Physician 2002;65:653-60. Copyright 2002 American Academy of Family Physicians.)
What is used in a Trigger Point Injection?
The severity, duration, and location of the Trigger Point dictates the solution used. We use a customized solution of vitamins, minerals, anesthetics to include lidocaine, procaine or marcaine, and even NSAID’s.
How many treatments will I need?
It depends on the condition. The most common ailment treated with Trigger Point Injections is Thoracic Outlet Syndrome (TOS). TOS is pain, numbness and/or tingling referring into the shoulder, arm and even the hand secondary to Trigger Points within the major upper thoracic and lower cervical muscle bellies. Tension headaches are often secondary to this condition. Successful treatment indicates 2-4 sessions, once weekly.
Will the Trigger Points come back?
Over time, if the situation that caused the Trigger Points is not identified and corrected, the pain will return, typically within 3-12 months. To help avoid this, Dr. Mcneil prescribes deep tissue massage, physical therapy and lifestyle modification.
Medical Marijuana (MMJ)
NVMC is Proudly Offering Medical Marijuana Certifications for Qualifying Patients.
In order to obtain a MMJ card, you must show care from a doctor within the past 12 months that verifies the qualifying diagnosis. There are a few ways to obtain medical records. You can bring records with you to the visit OR NVMC may contact your doctor to obtain medical records for you OR NVMC can create a new medical record for you.
After a visit with the certifying doctor, the office will file all of the necessary paperwork to complete the application through the Arizona Department of Health. NVMC strives to make the process quick and easy, the process is the same for both newly qualifying patients and renewal patients. The state requires MMJ cards to be renewed every two years.