FOSTERING MEDICAL ALLIANCES BRING NEW ANSWERS TO PATIENT CARE

UNOFFICIAL DRAFT: NOT FOR PUBLIC DISTRIBUTION

On January 9, 2025 BardDiagnostics receives a special visit from Dr. Nino Mikaberidze, recognized expert  in rheumatology from Manhattan Pain Medicine (Greenwich Village / Washington Square Park). "Dr. Nino", as she is most often referred as, expressed great interest in brainstorming about Dr. Bard's published strategy called "image guided treatments". Seasoned in mitigating arthritis and other inflammatory disorders, Dr. Nino welcomed this exploratory exchange with NYC's top diagnostic researcher as another fine example of what is possible when doctors collaborate. 

According to Dr. Roberta Kline, BardDiagnostics director in genomics testing, "joint ventures and clinical alliances between independent clinicians offer a wonderful opportunity to build new ideas opening up visionary solutions to improve treatment results... I've witnessed Dr. Bard's passion to unite medical teams and join others in Zoom meetings and conferences with fellow luminaries in their respective crafts-- and the results have often been revolutionary!"  

Dr. Bard's belief in forging clinical alliances has been the cornerstone of his career in diagnostic medicine.  Furthermore, his customized and unfettered approach to patient care and his ability to expand the dial of diagnostics aligns opens new pathways to partnering with fellow visionaries.  Joining with leaders on "the treatment side" - from oncology to pain management and regenerative medicine further aligns with his aspirations in research, publishing and medical education. (See bardseminars.com)

Based on prior discussions, Dr. Nino received a tour of Dr. Bard's ever-growing collection of advanced medical imaging equipment. She was also introduced to the battery of non-invasive therapeutic technologies under validation testing through a door labelled IHRC (Integrative Health Research Center) where Dr. Bard is often called to conduct performance testing by medical device manufacturers.  In support of her expertise, Dr. Nino then received a firsthand demonstration of the various PEMF equipment models and the photobiomodulation (near infrared) device for pain management.  

This memorable visit was a meeting of the minds, exploring collaborative partnerships between the respective practices while covering a unique new ground for the wide range of health disorders that each practice specializes in.  An equally enjoyable visit from MPM's medical director Dr. Jason Siefferman (12/21/2024) was a collaborative exploration about PEMF treatments and a discussion about the innovation of the Stellate Ganglion Block- a  therapeutic modality showing remarkable response for pain and PTSD. Here, Dr. Siefferman impressed the room with his comfort level in performance testing one of Dr. Bard's latest equipment acquisitions.

In the spirit of collaboration, an enjoyable exchange unites the diagnostic and therapeutic connection while appreciating each others' unique insight and clinical approach.  "At Manhattan Pain Medicine, we have specialized expertise at the intersection of hypermobility spectrum disorders and autoimmune inflammatory conditions", states Dr. Siefferman.  "These conditions often co-occur, and patients often have many frequently associated comorbid conditions.  Clinically, pain in an area may be due to hypermobility, autoimmune inflammation, or a combination of the two.  Dr. Bard's imaging techniques allow for the differentiation of autoimmune inflammatory sources from hypermobility or overuse injury, which helps guide treatment in these patients.  We are excited to partner with his time to provide patients with the most accurate diagnosis and explanation for pain, so that the most appropriate treatment can be chosen first, rather than proceeding with a trial-and-error approach."

"Since day one, we marvel at the work of our friends from downtown", starts Dr. Bard. "I have great appreciation for the distinct achievements and the extensive depth of knowledge of (both) Dr. Siefferman and Dr. Nino.  I look forward to the continued exchange of ideas and joint efforts between our offices!"

Manhattan Pain Medicine is a multi-specialty practice offering comprehensive, individualized care for all causes of physical discomfort. Their specialists provide collaborative holistic care including Acupuncture, Feldenkrais, Opioid Therapy, Peripheral Nerve Blocks, Prolotherapy, Regenerative Medicine and Rheumatology. 

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2025 MEDICAL PARTNERSHIP: NEW INSIGHT ON WOUND HEALING By: Dr. Robert L. Bard In the spring of 2024, I traveled to Montreal Canada (McGill University) to meet Dr. Jose Ramirez-GarciaLuna, "The Wound Scientist"- who was undergoing dedicated clinical evaluation efforts to measure the severity of burn wounds. Helped me uncover the intricacies of wound healing and the many resources that comprise this highly valued study.  His work led to the use of infrared thermography to identify soft tissue viability to assess burn depth.  In support of this project, he also introduced the impressive properties and effects of the highly developed SYNTHETIC SKIN- what is obviously a major game-changer in burn care and traumatic injuries.  It was here that my attention was drawn to an exciting avenue of clinical care and an area where my diagnostic prowess and imaging expertise could contribute to furthering its advancement. The application of this critical care science has come a long way in the managing of burns, extreme skin disorders or post-surgical lacerations.  Dr. GarciaLuna and I had great discussions about the many possibilities of integrating regenerative technologies to optimizing the healing of bodily damage, and our collaboration continues to grow at this present day.   (See complete feature)

Direct from the Front Lines is an extra feature produced by the AngioInstitute and Prevcntion101.org

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 Psychotherapist Jessica Glynn welcomes you to the Women's Mental Health Coalition

WOMEN'S HEALTH COLLABORATIVE FOR 2025 is comprised of a major expansion program for public education, research, publishing and clinical care. We support global exchange of ideas and sharing concepts that advancing the dial when it comes to improving the state of health for women.  In support of this, our executive team has expanded our group's core (general) function to offer specific interest branches.  In the case of Ms. Jessica Connell, we are launching the WOMEN'S MENTAL HEALTH- which unites professionals in this dedicated field of study.  Furthermore, (as with all health studies), there will be overlaps into other interests that align with mental health and we encourage the hybrid thinking. This is the core of collaboration.

We look forward to your article submissions, useful resources, invitations to group events and other public education opportunities for all of our members and readers. Email us at: editor.prevention101@gmail.com (subject "SUBMISSION REQ.")

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HEALING STRESS AND THE PARASYMPATHETIC SYSTEM

Written by: Roberta Kline, MD

Analyzing STRESS & ANXIETY from a holistic point of view means identifying the body’s interconnected systems (ie. circulatory, cardiovascular, nervous, lymphatic, endocrine etc.) and its many touch points for stimulation.   This analysis should also offer a comprehensive breakdown of the body's HEALING capacity- which includes our hormones, digestive system, immune system, brain, heart-- all the way down to our cells and mitochondria.  

Stress is part of life, and comes in many forms including physical, emotional, mental and environmental. Foods we eat, unhealthy relationships, difficulties at work, toxins in our environment, even poor posture or lack of sunshine can all create stress on our bodies. But when stress is catastrophic or becomes chronic, it creates imbalances in this functioning that are much more likely to promote disease while at the same time preventing healing from taking place. [1]

With people under record levels of chronic stress, it is no wonder we have an epidemic of people suffering from all sorts of health issues and chronic diseases. Heart disease, diabetes, obesity, pain, anxiety, depression, infertility, cancer, autoimmune diseases such as arthritis, neurodegenerative diseases such as Alzheimer’s …. These are just some of the many health conditions that have been linked to diet and lifestyle including chronic stress. [2, 3]

But how does this work? And is meditation the answer to reversing this trend? Science is revealing some interesting clues.

THE NERVOUS SYSTEM

One big connection is our nervous system. Our nervous system is our superconductor network of information exchange throughout our bodies, and consists of two main parts. The first is the central nervous system (CNS). As it sounds, it’s our command center where all data comes to be processed, and is made up of the brain, spinal cord, and nerves. The second is called the peripheral nervous system (PNS) and it connects every part of our body to our CNS through individual nerve cells called neurons and clusters of neurons known as ganglia.

The PNS is further divided into the Somatic Nervous System, also known as the voluntary nervous system, and the Autonomic Nervous System. The Autonomic Nervous System (ANS) manages all bodily functions that are not under conscious control. This includes heart rate, blood pressure, digestion, respiration, cellular activity, immune system, hormones, brain function, sexual function, and even body temperature.

The ANS is further divided into two parts: the Sympathetic Nervous System (SNS), which regulates our “fight or flight” response, and the Parasympathetic Nervous System (PNS), which controls our “rest and digest” response. They work closely together in a complex dance, maintaining our bodily functions and ensuring our survival every second of our lives.

Many health issues, including most chronic diseases such as heart disease, autoimmune disease, diabetes, depression and anxiety, and cancer, are related to an imbalance of our autonomic nervous system. Most typically, it is too much of the “fight or flight” and not enough of the “rest and digest” that leads us into this imbalance. [4]

FLIGHT OR FLIGHT

The Sympathetic Nervous System is located in the CNS, and in the spinal nerves from T1 (the thoracic region) down to L3 (the lumbar region) out to the neurons in the regions of the body supplied by these nerves. This sympathetic response is designed to keep us safe in the face of immediate danger. It signals the brain to turn up the volume on any physiological function crucial to staying to fight or running away from the source of the danger. Catecholamines such as epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine are released and a cascade of events happens rapidly – before we are even consciously aware that there is a threat. These include:

• Blood flow diverted to the heart, lungs and skeletal muscle

• Increased heart rate, blood pressure and respiratory rate

• Enlargement of bronchioles (in lungs)

• Dilation of pupils

• Rapid conversion of glycogen to glucose for fuel

• Activation of immune system

All other functions, including digestion, urination, higher level thinking, even sexual function and cellular repair, are temporarily turned off, so that all of our energy and resources go only toward ensuring our immediate survival. If the threat goes on for a longer period of time, a secondary system called the HPA (Hypothalamic – Pituitary – Adrenal) Axis takes over and relies on elevated cortisol and other hormonal changes to continue the high alert state.

But our bodies are not designed to be in this activated high-alert state for long periods of time. Once the immediate threat is gone, we are supposed to go back to our normal state of relaxation. This is the job of the Parasympathetic Nervous System.

REST AND DIGEST

The Parasympathetic Nervous System (PSNS) is located in the brain stem, includes nerves to the eyes and face, vagus and 10th cranial nerves, and sacral nerves (S2-S4). Regulated in large part by the vagus nerve (75%), it impacts a vast array of crucial bodily functions. When the parasympathetic response is triggered, it counteracts the fight or flight response primarily through release of acetylcholine.

Parasympathetic activation results in production of tears, saliva, and constriction of the pupils; lower and more variable heart rate, lower blood pressure and respiratory rate. It enables creative and critical thinking, normal kidney function and urination, improves immune function, enables sleep, sexual arousal and replenishment of fuel stores in organs; plus everything involved in digesting and utilizing our food including elimination and insulin production. Even mood and social bonding and connection are linked. 

HOW THERAPISTS DIAGNOSE MENTAL HEALTH ISSUES By:  Jessica Connell, LCSW

HOW STRESS IMPACTS HEALTH AND HEALING

Healing requires coordination of a complex array of biological functional and systems. Research is rapidly expanding our understanding of the importance of the parasympathetic response, and how meditation helps to restore balance. While this impacts every biological system, here are some key areas:

Digestion
Nutrients must be properly digested to extract them from our food and into our cells, where they are critical to every function our bodies must carry out. From vitamins and minerals that are needed in every biochemical reaction, to energy production in our mitochondria, to building blocks of our proteins that form our enzymes, neurotransmitters, hormones, even our DNA - all of our cells need these basic materials to function. Stress shuts down our digestion, and if it goes on long enough our cells become depleted of the very nutrients needed to function and repair. 

Immunity

Approximately 90% of our immune system resides in our gastrointestinal tract. While it is needed to defend us against invaders such as bacteria and viruses, it can also go awry if unchecked. This “runaway” inflammation is linked to most chronic diseases, and paradoxically also reduces the ability espond to infections. Our immune system has other functions, including being a cleaning crew. It removes debris left over from battling invaders. It also removes our own dead or badly damaged cells, and signals new and healthy ones to replace them. Stress results in an imbalanced immune system, making us vulnerable to infections as well as chronic disease.

Mitochondria
These tiny structures exist within every cell in the body, and as the “power plants” of the cell they are responsible for producing all of the energy needed for every single function. This energy is produced as ATP and to make it requires key nutrients from food to be digested and absorbed from the gut. But producing this energy also creates toxic molecules, which are neutralized by antioxidants which also come from our diet. If the demand for energy is too great for too long, the mitochondria – and its cell – become damaged. Without healthy mitochondria, cells become damaged, dysfunctional and even die.

Brain

The brain normally utilizes about 20% of our energy supplies, primarily in the form of glucose or ketones. This requires good digestion and healthy mitochondria to keep the brain supplied with fuel to function.  Acetylcholine is a major neuro-transmitter in the brain and in nerve endings through the peripheral nervous system; it is also anti-inflammatory. It is made in the mitochondria using some of the same ingredients needed for ATP production. 

Serotonin, a major neurotransmitter impacting mood, is mostly produced in the gut. When the stress response is prolonged, this depletes the brain’s capacity for creative and critical thinking and mood regulation, often further impairing the ability to deal with stress.

MEDITATION AND HEALTH

While meditation has been practiced in various forms for centuries, and has long been associated with many parameters of improved health and well-being, science is only recently starting to understand the mechanisms by which it works. Studies are demonstrating the positive impact of meditation practices on various disease conditions, and the potential power for it to change the trajectory of this epidemic of chronic disease. Research findings on HOW it works are not all consistent though, as ways of meditating can be quite varied and this seems to impact the results. However, some common threads are emerging; two main mechanisms are outlined below.

Default Mode Network:
One mechanism by which meditation works is by altering connectivity in the brain – the so-called Default Mode Network, or DMN. This is a network of brain regions that is active when the brain is restful but awake. Meditation seems to decrease this DMN activity, leading to increased cortical connectivity [5] - in other words, there is activity connecting areas of the brain that aren’t normally part of this network that enables us to take a different, more detached perspective on things in our life. When we aren’t so attached to events, the sympathetic response is less likely to be triggered, or if it is triggered it is to a lower extent that is easier to recover from.

Vagal Nerve:

Meditation also activates the parasympathetic response, in large part through the vagal nerve. This not only impacts heart rate and other vascular parameters, it also connects our gastrointestinal tract to our brain. There is now a growing body of evidence that this bidirectional communication through the “brain-gut axis” is a complex system that is key to our health, and when it is out of balance is linked to many health issues. [6]

Meditation has been shown to increase vagal nerve activity, or tone, and restore normal functioning of these many systems including digestion, immune response, and brain neuroplasticity/resilience. [6] It is thought that one way this occurs is through deep breathing, although there may be other mechanisms in play.  As we learn more about how meditation works and how it influences our biology, we can develop more targeted and personalized approaches to maximize its potential – while making it easy and accessible for people to integrate into their daily lives.

EPILOGUE

In a recent MedTech Review of a meditation and brain optimizing device called BrainTap®,  Dr. Kline and her colleagues took on the task of assessing its ‘active ingredients’- binaural beats, isochronic tones, holographic music and blue/red light. (see complete tech review) It is found that these neurosensory applications have had a long history in other devices also supporting the science and wellness communities for their reactive properties.  Having collected the vast majority of user testimonials online, and clinical reports from fellow team mate, Dr. Leslie Valle Montoya (Santa Barbara, CA) who had already spent the better part of 3 years with the device on her patients, these reviews added greatly to our peace of mind about consumer safety.  

Academically, the appeal in assessing this specific product is partly due to the diverse and multiple points of wellness that the device was designed to target.  A wide range of brain and mental health-related specialists alike may truly enjoy conducting their own independent case study of this device, each using their specific level of science to assess its array of claimed benefits.  Areas like the parasympathetic nervous system, brain optimizing and stress & anxiety are just some of the key points of interest worth exploring.  If the device in fact aligns and supports Dr. Kline’s multi-layered physiological roadmap to wellness and the user’s reaction(s) in the meditation state, a fair and comprehensive tech review of this device should be best achieved under multiple streams of evaluators.  Reporting on its assessed benefits would then be a matter of the collective team trading notes for all areas of common ground.

ROBERTA KLINE, MD (Educational Dir. /Women's Diagnostic Group) is a board-certified ObGyn physician, Integrative Personalized Medicine expert, consultant, author, and educator whose mission is to change how we approach health and deliver healthcare. She helped to create the Integrative & Functional Medicine program for a family practice residency, has consulted with Sodexo to implement the first personalized nutrition menu for healthcare facilities, and serves as Education Director for several organizations including the Women’s Diagnostic Health Network, Mommies on a Mission. Learn more at https://robertaklinemd.com/

THE CRITICAL ROLE OF DIAGNOSTICS IN HEALTH AND WELLNESS  By: Dr. Jess Sabrowsky DNP, RN, FNP-BC What I have learned over the years is the importance of listening to the patient, but equally, the importance of using data-driven diagnostics to make real-time decisions about care. This is not just about numbers on a chart—it is about understanding the full picture of your health, long before symptoms arise. We need to use technology, diagnostics, and assessment techniques to gather real data. Data that can guide each patient on their unique health journey. Diagnostics help us understand the true state of a person’s health, even when they may not feel “sick.” This is where the rubber meets the road: when you find a PCP who truly understands the importance of these tools and works with you to achieve your wellness goals and who also has skills beyond the transitional medical model to help you live your best life. Having difficult conversations is uncomfortable, but it is necessary for growth. If you want a healthcare provider who will partner with you—someone who creates a safe space, builds trust, and encourages honest dialogue to support long-term growth—then you must also be willing to put in the effort. Finding a provider who matches your commitment to your health, and one who uses diagnostics to empower you, is key to achieving your goals. WHY DIAGNOSTICS MATTER In short, diagnostics are essential because they offer concrete, actionable insights into your health that go beyond surface-level symptoms. They help uncover hidden health risks and enable early intervention, which can be the difference between preventing a chronic condition or managing it effectively. Diagnostics allow for personalized care tailoring interventions to meet the specific needs of the individual based on real, measurable data. I also would add that as a provider I prefer to reference functional lab ranges when reviewing results as I find that I can make small preventative recommendations and also challenge individuals and providers to think outside the box when looking to help resolve health conditions, like in the case of my daughter who otherwise would still be suffering. Let’s aim to stop the suffering and optimize wellness for all who seek it.