Transcription of Stephen Donnelly for the show Out of the Box, #86
Dr. Belisle: As we move forward in health care, we need to be spending time looking back at traditions that have worked for us, both from a Western standpoint and an Eastern standpoint, through nutrition and herbs and yoga, things that have an evidence base behind them and also anecdotally work for our patients. I’m pleased to have with me today Dr. Stephen Donnelly, a pediatrician, that trained with me at the Maine Medical Center a few years ago and went and got additional fellowship training in integrated medicine with Dr. Andrew Weil in Arizona and has come back to the state of Maine and founded the Maine Center for Integrative Medicine. Thank you for coming back and bringing integrated medicine to the state Maine.
Dr. Donnelly: Great to be here.
Dr. Belisle: Dr. Donnelly, why did you become a pediatrician in the first place?
Dr. Donnelly: I love working with kids. It’s a funny story how I ended up becoming a physician to begin with. I actually started college as a music major. I wanted to be a music teacher. Got in there and realized that I just want to keep music as a hobby. I didn’t want to do it as a profession, and then from there I decided to be a psychology major and found to do anything in psychology you have to have a Ph.D. and I said, “Geez, I might as well be a physician.” I fell into it that way. Ultimately, when you look at the underlying themes I like working with people and ultimately I like working with kids, from music teacher to pediatrician there is that one link, although it does seem a little round about.
Dr. Belisle: You chose to go into the type of medicine which I’ve always considered to be very integrative. From the beginning, you actually have an osteopathic degree rather than an allopathic degree. You are trained as what we say is a D.O.
Dr. Donnelly: Correct.
Dr. Belisle: Why did you make that decision?
Dr. Donnelly: I researched it and I liked the philosophy behind osteopathic medicine. Honestly, a big part of it was it was right in my backyard. I grew up in Maine. I was born in Bangor, graduated high school from Caribou High School. University of Southern Maine is where I went to college. Knowing that medical school can be very stressful, I figured let’s take the changing my location of where I live, let’s take that out of the equation and UNE was right in my backyard. Again, I liked their philosophy and their approach and it just made sense.
Dr. Belisle: We hear a lot about the brain drain and people leaving the state of Maine once they have gotten their education because theoretically they can’t make a living here, but it seems like you are proving the opposite.
Dr. Donnelly: I’m hoping to. I have been an employed physician really from the get go, since ’98 when I finished residency. Back in July of 2011 I decided to open up my own practice at the Maine Center for Integrative Medicine. I’m working at it and it’s very, very satisfying. I’m hoping to make that a long lasting fixture in the Maine medical community.
Dr. Belisle: We had Dr. Craig Schneiderwho is the head of integrative medicine at Maine Medical Center on our show last year, but for people who haven’t been listening and perhaps they’ll all go back and listen to that podcast, but for right now, tell us what integrative medicine really is.
Dr. Donnelly: Integrative medicine is really a blend of conventional medicine with everything else that’s out there. There’s a lot of focus, as you said, on nutrition which boggles my mind that nutrition would be considered like an alternative or complementary type of medicine. It’s what makes us us. Anyway, it’s a lot of focus on nutrition, herbs, supplements where appropriate, other modalities of delivering health care like osteopathic medicine, manual medicine like osteopathy, chiropractic, physical therapy, traditional Chinese medicine, acupuncture, Ayurvedic medicine, naturopathy, homeopathy, mind-body medicines, spirituality, probably leaving something out, but it blends all of those modalities in with conventional medicine and to try to optimize by plan of care for an individual.
Dr. Belisle: Why did you decide that you wanted to go back and get this fellowship training with Dr. Andrew Weil in Arizona?
Dr. Donnelly: The big thing that I was really interested in was nutrition. It’s embarrassing the lack of that that we get in our traditional medical training. We learn that if you don’t get enough vitamin C you get scurvy. If you don’t get enough vitamin D you get rickets. From the nuts and bolts of practical application to give to patients and families on diet and nutrition just isn’t there. I was trying to research that on my own. It’s sometimes hard to weed through. We all hear don’t look at the Internet because you’ll find a whole gamut of things. That was really the big thing because I knew Dr. Weil was really big into nutrition, and actually Matt Hand who’s a pediatric nephrologist locally or was locally, he did the fellowship a few years before me. He and I got talking and he showed the program. I said, “I have to do that. That’s exactly what I want to do.” Lo and behold, a few years later I went and did it. Nutrition was the driving piece given that I felt lacking in my ability to educate patients and families based on my conventional training.
Dr. Belisle: For people who are interested in reading about Matt Hand, Maine Magazine actually did a profile of him in the Wellness issue about a year ago, again, along with Dr. Craig Schneider. This is something that we’ve been, actually maybe two years ago now, but this is something that I think people are paying more and more attention to. They’re paying more and more attention to it for themselves as adults, and you treat children. Is there an upsurge of interest in integrative medicine for kids?
Dr. Donnelly: I don’t know if there’s an upsurge, but I think these parents or these adults that are looking at it for themselves are wondering about it for their children as well. Yeah, a lot of people are looking at … or dissatisfied with just the conventional approach to a lot of things and looking for that integrative approach for their children as well as themselves like you said.
Dr. Belisle: One of the things that you and I talked about before we came on the air was this idea of inflammation and inflammation being a problem that has been more recently recognized as underlying many of the diseases that cause not only acute but chronic problems. Talk to me a little bit about that.
Dr. Donnelly: There’s some interesting research based on a hypothesis that one common thread between those big ailments that are killing us, basically, as a society is like you said inflammation. If you look at the big two, heart disease and cancer, those have been the big two killers since the ’50s or ’60s and nothing’s really changed despite all our conventional technology and pharmaceuticals and stuff. These are the two big things that are killing us and they’ve been killing us for decades.
What’s come out is, again, this root cause of inflammation being behind these ailments, but things like arthritis, inflammatory bowel, asthma, all these things are on the rise. New research, actually, is looking at even mental health issues, things that we didn’t think of as having an inflammatory component. There’s an interesting theory of depression called the cytokine theory of depression which is cytokines are inflammatory mediators.
Where is coming from? There’s probably a lot of areas where it could be coming from, but one interesting thing is diet. A lot of research now is coming out about how really pro-inflammatory the standard American diet is. Standard American diet is very processed, very high in carbohydrate and lacking in some varying important fats, omega-3 fats to be specific. One thing we know about large fluctuations in blood sugar, for example, based on a high carbohydrate diet that’s what’s going to happen, all carbs are converted to sugars. If there’s no fat or protein or fiber in the mix what happens is you have a very volatile blood sugar, and so you’ll have peaks and valleys. We know at the peaks and valleys of these blood sugars that inflammatory markers or mediators are made. That’s one driving factor for inflammation.
The whole high carb diet probably stems back to the not so good food pyramid of the early ’70s where we were told low fat, low fat, low fat with all good intention, but as we can see today that really hasn’t made a difference in heart disease and certainly we’re more obese now than we ever were. Low fat is synonymous with high carb. We may have set ourselves up for what we’re dealing with right now.
From the fat standpoint, like I said, omega-3 fats, we know we get from fish for the most part. As a society, we don’t eat a lot of fish. That’s your omega-3 fats are going to come from. Omega-3 fats are the building blocks in the body of hormones that down regulate inflammation and also down regulate cell division.
Omega-6 fats on the other hand which we get an abundance of, more than we need, come from the oils of grain, corn oil, sunflower oil, cottonseed oil, soybean oil. We get more than enough of those, but those in the body become the building blocks of hormones that up regulate inflammation. We have this unopposed pro-inflammatory drive of the omega-6s and the high carb diet. It’s felt that that can be a big factor in a lot of what is ailing us. When I talk to families I talk to families in a broad sense about that, and then depending on what we’re dealing with if there’s any issues like ADHD or inflammatory bowel or anything like that or asthma, then I might tweak it to be more specific for that illness. Everyone who comes and sees me either in my general pediatric practice in Windham or my integrative practice they all get the diet talk.
Dr. Belisle: How can people find out about the Maine Center for Integrative Medicine?
Dr. Donnelly: They can look at the website, www.themcim.com, or give a call, 899-038.
Dr. Belisle: I did spend time on your website. You have some really nice blog articles that people can read that talk about nutrition. I also went and looked at the Apothecary by Design presentation you did, so anybody who has an interest in integrative medicine and nutrition and as it relates to pediatric or ADHD I do recommend that they go and check you out a little bit.
Dr. Donnelly: Great.
Dr. Belisle: We’ve been speaking with Dr. Stephen Donnelly who is the founder of the Maine Center for Integrative Medicine here in Portland, Maine. I appreciate your having this open mind and bringing all of your knowledge back to our state and helping people integrate wellness into their lives.
Dr. Donnelly: My pleasure.