The Lybbaverse / wellness  

It’s All In The Data: Cincinnati Children’s Hospital Gets Wonky To Transform The Health Of Its Community


iStock_000022532736XSmallLybba’s partner, Cincinnati Children’s Hospital Medical Center (CCHMC), was recently featured in Forbes’ Profiles in Innovation, a weekly series of interviews with pioneering health leaders who are improving both population and individual health. CCHMC, renowned for children’s cancer care, is now working tirelessly to reduce health disparities in the local Cincinnati community. Its Community Health Initiative, led by program director Robert Kahn, is using comprehensive data collection to implement preventive measures against injury and illness.

An early example from this data collection indicated that particular Cincinnati neighborhoods had high rates of childhood asthma whereas other neighborhoods had virtually none. Neighborhoods with more asthma cases tended to have poor housing conditions, and more families without medical insurance and access to medicines. Since such factors are difficult to detect during a 10-minute conversation in the exam room, CCHMC’s Community Health Initiative partnered with the Cincinnati Health Department and Legal Aid to provide home inspections and legal advocacy. Preliminary data collection, therefore, enabled pattern recognition which led to problem solving and a larger, more sustainable impact on the community.

CCHMC’s commitment to health, not just health care, extends to their James M Anderson Center for Health Systems Excellence where a dedicated team of individuals is re-thinking chronic illness care. For the past several years, Lybba has been working side-by-side with CCHMC’s Anderson Center on the Collaborative Chronic Care Network (C3N), which is using software-based data collection tools to enable patients with chronic illness to become more active participants in their health and to spread discovery amongst doctors and hospitals.

C3N has reported significant increases in remission rates for patients with Inflammatory Bowel Disease (IBD), without the use of new medications. A few weeks ago, C3N was awarded PCORI funding to continue their transformative work in IBD. To learn more about C3N and Lybba’s involvement, visit

Read the Forbes article here.

MusiCares supports musicians in need


I recently returned from attending my second National Association of Music Merchants (NAMM) show. This year, as in the past, I was working with MusiCares, the charitable health and human services arm of the Recording Academy (GRAMMYs).

MusiCares offers support for musicians in need. Among other benefits, it helps them pay their rent, subsidizes the cost of medical services, and provides free support groups for musicians who are dealing with staying clean and sober.

As a bass player I go to NAMM to check out the latest gear. I especially love playing with the beautiful handcrafted basses, guitars, and boutique amplifiers. As a chiropractic ergonomist, I enjoy observing the equipment modifications made over the past year to minimize the physical wear and tear on musicians bodies.

Finally, as a doctor I volunteer in the MusiCares booth so I can answer the questions of musicians who are dealing with pain. I advise them about proper exercises and stretches. I recommend appropriate treatment modalities to address their complaints. And I provide reassurance that there is a lot they can do to heal themselves. MusiCares, essentially, lets musicians know that they are not alone; that such healing is possible.

This year, like last, I anticipated writing an article about the industry’s latest ergonomic innovations. I saw wonderful light weight guitars, amps, and drum hardware. I saw improved gig bags with chest and waist supports. I saw core stabilizing piano benches.  There were many advances that excited my attention. But on this visit, to my surprise, it was the MusiCares story itself that drew me in.

During my hours in the MusiCares booth, I spent a good deal of time talking to older players: mostly rockers in their 50’s and 60’s. These were players who have been on the road for decades. Some have gone from playing in dive bars to filling stadiums; from traveling in vans and living on Cheetos to cruising in luxury tour buses and sleeping in five star hotels. Some of them are now back in the dives and the vans—but all remain dedicated to their music.

And all feel the cumulative physical and emotional effects of the rock and roll life. I spoke to the lead singer of one well known punk band who told me how he had collapsed on stage during a set, a fully blown (herniated) lumbar disc leaving him without feeling in his legs, his back in fiery pain. Emergency surgery in a Hamburg hospital followed. His health insurance “provider” in the US (to which he had been paying premiums for fifteen years) denied payment of the 6000 Euros (about $9000 US at the time) as the surgery was performed without prior authorization.

I spoke to another player who’d recently turned fifty. The previous year he’d been playing an arena show when, in the middle of a thrashing windmill chord (a la Pete Townsend), he felt a sharp twinge in his neck; then a bolt of electricity shot into his right arm. He powered through the set, but the next morning he couldn’t get out of bed. Somehow he made it through the tour, but afterward he hobbled home–unable to work for months. He had no health insurance.

I also talked to young players; guys in their twenties; the “invincible” ones. From gig to gig, fueled by burgers, chips, adderall, and beer, they madly pound drum kits and crowd surf. They haul their own gear onstage and off. Sleep is an afterthought. The early signs of wear are already showing on these young warriors: constant low grade pain, an occasional spasm. But they accept these tweaks as “normal”: obligatory battle scars on the long crusade to fame and fortune.

Others just came by to sit and talk, and to thank MusiCares for the help it has given to them or their friends; for the money to get the customized hearing protection, for the psychologist referral, or for just being there when no one else was.

I realized then and there that NAMM is far more than a trade show. NAMM is a gathering of kindred spirits. It’s an annual meeting of the tribe; a place where we can all come together after another year spent pursuing the holy musical grails of rock and roll, country, jazz, and classical.

Staffing that MusiCares booth with my fellow musician/healers–social workers, addiction specialists, administrative support staff–I felt like part of an ancient shamanic priesthood, serving the needs of our troubadour family.

Musicians are called to make music because of the joy it brings to them and those around them. But few of those players recognize the toll that this path can take. When more dreams have been lost than have been fulfilled; when the adoration of the crowds has waned; or when the sheer physical duress of the working musicians life fully demands attention, there is a need to heal. And from the alchemical blend of music, open listening, therapeutic wisdom, communion and love, such healing arises.

NAMM provides the meeting ground for this process; MusiCares, the healing space.

Read more articles like this on Dr. Fishman's blog, or visit his website.

Levels of healing: psycho-energetic dimensions


With seemingly clear boundaries between our bodies and the world through which we move, it’s easy to feel separated from everything outside our skin.  But as physical, chemical, emotional, and energetic beings, this perception belies our true nature.

Our five senses–hearing, touch, smell, taste, and sight–are directed primarily outward. They help us to navigate the material world, to survive so we may pass our DNA on to future generations.

This Darwinian narrative has framed many of our modern ideas about health and healing. We’ve come to see our bodies as biochemical capsules moving through space and time. As a result, modern medicine has developed a reductionistic, physico-chemical model to describe, diagnose, and treat disease.

We now have laser-tipped endoscopic tools that can snip off cancerous colonic lesions, nano-engineered, pharmaceuticals tailored to bond only with diseased cells, and MRIs that allow us to study brain activity during meditation, sleep, and sex.

Yet the deeper we probe, the further away we move from knowing other levels of our being. We simply 're-enforce' the model that has been in place for the past 100 years.

A Parallel Journey

Western medicine, at the end of the 19th century, recognized the role of mind in health and healing. Sigmund Freud, a Viennese medical doctor, systematized psychotherapy while treating the neuroses of his (mostly female) upper class patients. The field grew rapidly. From the collective unconscious of Carl Jung to the somatic psychology of Wilhelm Reich, these early pioneers built upon (and challenged) the foundation Freud established, expanding our understanding of mind.

But compared to other western medical disciplines, psychiatry (and its non-medical offshoot psychology) is considered a junior partner to fields such as cardiology, orthopedics, and nephrology. These latter specialties are deeply rooted in classical mechanics, a physics that has long been viewed as the most accurate way to explain the world. The more snugly stories fit into this Newtonian framework, the more  “real” they are. The study of mind has not lent itself to the same sorts of mechanical analyses. Yet the recognition that our minds and bodies are connected and can be treated as one has opened a doorway to understanding other more subtle levels of our beings.

Even if mind emerges from brain biochemistry—still a subject of passionate debate—it expresses itself through our nervous and endocrine systems. Stimulation from the outside world sets off a cascade of electrical impulses and hormonal surges. Muscles contract, blood pressure and respiratory rates rise and fall, serotonin and dopamine are released. Our thoughts trigger chemical releases that give rise to fear, love, anger, and trust. Quickly the line between inside/out and outside/in becomes blurred and confused. Where does mind begin? Where does it end? Where exactly is it located?

As we go deeper into the matter (stuff) of which we are made, we enter the microcosmic world of molecules, atoms, subatomic particles and quantum probability waves. Here we are buzzing fields of energy. The bounded selves we experience through our five senses vanish; the duality of I/it dissolves into one great energetic dance.

And as the understanding of our bodies expands beyond the sensed, our notions of health and healing must also change.

We see that pulling on a single thread in this intricate web–the post traumatic stress of a violent encounter, a moldy basement, the break up of a relationship, a poorly designed work station, an unhealthy diet, the low grade despair of a life lived without meaning—will affect the whole of it.  Each experience, each event has its own energetic frequency that reverberates throughout our chemical, emotional, and physical bodies. We may be  thrown off balance. But our bodies automatically push back, innately seeking a center, seeking the sympathetic vibration of resonance. Because in resonance energy flows smoothly. Blood flows smoothly. Neurons work in harmony, orchestrated by a brain focused on integration, moving its body agilely through the world.

Whether offered as a chiropractic adjustment to support joint movement, an acupuncture needle to assist the flow of chi, or a Peruvian medicine ceremony to help align ones life with ones purpose, the process of healing is the same. It is the creation of balance—physical, chemical, emotional, and energetic. It is the creation of an “ease” which enables the body to function optimally. It is in this space of ease that we are able to connect what is within us to what is beyond, and to allow the energies of the vast cosmic field through which we move to nourish and sustain us.

Read more articles like this on Dr. Fishman's blog, or visit his website.

Mindful eating helps lower weight and reduce blood sugar


Eating mindfully is just as effective as adhering to nutrition-based guidelines in reducing weight and blood sugar levels in adults with Type 2 diabetes, a new study at Ohio State University suggests.

In a comparison study of the effectiveness of the two types of behavioral interventions, participants lost about the same amount of weight – an average of between 3 1/2 and 6 pounds – and lowered their long-term blood sugar levels significantly after three months.

One treatment group followed an established diabetes self-management education program, with a strong emphasis on nutrition information. The other group was trained in mindful meditation and a mindful approach to food selection and eating. Both interventions, involving weekly group meetings, also recommended physical activity.

“The more traditional education program includes general information about diabetes, but with more emphasis on nutrition and food choice: What are different types of carbohydrates and fats and how many am I supposed to have? What should I look for when I read a food label? What are healthy options when dining out? That was the traditional diabetes education program,” said Carla Miller, associate professor of human nutrition at Ohio State University and lead author of the study.

“We compared it to an intervention where mindful meditation was applied specifically to eating and food choices. This intervention group did not receive specific nutrition goals. We said we want you to really tune into your body before you eat. Take a few minutes to assess how hungry you are and make conscious choices about how much you’re eating. Stop eating when you’re full.

“We studied two very different approaches, and we found they both worked. This means people with diabetes have choices when it comes to eating a healthy diet,” Miller said.

The research is published in the November issue of the Journal of the Academy of Nutrition and Dietetics.

Participants were adults between age 35 and 65 years and had been diagnosed with Type 2 diabetes for at least one year. To be eligible, they had to have a body mass index, a measure of weight relative to height, of 27 or more, indicating they were overweight, and a hemoglobin A1c (HbA1c) reading of at least 7 percent. HbA1c measures blood glucose levels in the previous two to three months; normal HbA1c is 5.6 percent or lower.

Study participants were randomly assigned to a treatment group. Twenty-seven completed the mindful eating program, and 25 completed the traditional diabetes self-management program called “Smart Choices.” Each intervention involved eight weekly and two biweekly 2 ½-hour sessions with trained facilitators.

Trainers of the mindfulness program encouraged participants to cultivate “inner wisdom,” or mindful awareness related to eating, and “outer wisdom,” which referred to personal knowledge of optimal nutrition choices for people with diabetes. Each session included guided meditation oriented toward participants’ experiences and emotions associated with food. Participants received CDs for help with home meditation practice.

“We have so many environmental cues to eat in America that we’ve tuned out our normal physiological signals to eat. Being mindful means stopping long enough to become aware of these physiological cues,” Miller said. “We also tried to generate awareness, staying in the moment, and living and eating in response to hunger instead of habits and unconscious eating.”

The mindful intervention also included basic information about what is known as medical nutrition therapy: the relationships among calories consumed, carbohydrate and fat intake, weight regulation and high blood sugar.

In contrast, the Smart Choices program focused specifically on the condition of diabetes itself, including factors that can lead to the diagnosis, common complications (which include heart disease, kidney and nerve damage, eye problems and stroke), the importance of blood sugar control, and appropriate food choices when blood sugar levels spike. Every session included a medical nutrition therapy discussion such as calorie-intake goals, percentages of carbohydrates and fats in an ideal diet, and portion control. Many sessions included a 15- to 20-minute walk to further emphasize the recommendation for regular physical activity. Problem-solving regarding choosing healthy foods in high-risk situations, such as the holidays, were a focus of the program.

The interventions took place over three months. Researchers assessed participants’ health measures and dietary habits immediately after the programs concluded and then again three months later at the study’s end.

Miller said that because nutrition education is particularly important to people with a new diabetes diagnosis, she sees the mindful meditation and eating option as a potential supplement to basic diabetes education that patients need.

She also said that participants adapted well to the concept of mindfulness even though it is generally considered an alternative health practice.

“One of the things we were evaluating was how well this was accepted by people who had no experience with it. It was very well accepted by participants in that group,” she said. “And this tells us that people with diabetes have choices.

“The fact that both interventions were equally effective suggests that we should let people choose. If mindful meditation is appealing and people think that approach is effective, then it very well could be the best choice for them.”

Reblogged from wildmind, with permission of the author.

Yes on Prop 37




Our partner Wondros just created a series of films for Food & Water Watch, supporting Proposition 37 - to make GE Labeling the Law.

The ballot measure requires simple, clear labels letting consumers know if foods are genetically engineered. Just as labels list fat, sodium, and sugar, they should tell the buyer whether or not the product includes GE ingredients. 

Prop 37 was written with broad input from food groups, industry, science, legal, and health experts and qualified for the November ballot with more than 1 million signatures from California citizens.

Please share the films far and wide with the message: "Vote 'yes' on Prop 37" because consumers should have a right to know if their food is genetically engineered. 

Learn more about Food & Water Watch's campaign here.