Gastroenterologist moves from Virginia to CNY; she now practices integrative medicine in Chittenango
By Chris Motola
A: There’s a lot of confusion out there regarding the meaning of integrative medicine, and it’s often confused with the phrase “alternative medicine.” Alternative medicine is the use of non-mainstream practices in place of conventional medical treatment. With integrative medicine, conventional and alternative approaches are used together in a way that combine to benefit the patient and, hopefully, help them regain health.
Q: What appeals to you about integrative medicine as a physician?
A: I like the model because, at least in the two integrative medicine practices I’ve worked at, I’ve been able to spend more time with patients. Getting their complete history and story, finding out when they last felt well. We look at the patient as a whole; I know that sounds kind of cliched, but it’s true. We take into account not only their physical symptoms, but also their emotions, their state of mental health, their spiritual health, environmental influences, their beliefs surrounding health and healing.
Q: What types of non-traditional medicine do you use?
A: A lot of the time, patients are already receiving conventional medical care. It depends on what they’re coming for. But I always want to address what I call core principles of health, such as one’s diet and nutrition. Movement. Exercise. Stress management. And especially sleep. I feel like the quality of our sleep is overlooked. I haven’t seen a patient get better if they don’t get a good night sleep. It just doesn’t work. I also incorporate herbs and nutritional supplements that have shown efficacy for certain types of symptoms and conditions. I’ve seen people with gastrointestinal issues like inflammatory bowel disease see improvement in their symptoms after taking polyphenols, for example, curcumin. I tend to choose therapies that have some research behind them.
Q: Beyond the research supported efficacy, do you find there’s value in any placebo effects that might come with alternative treatments?
A: Yes, I do. There have been studies on that. If a patient is told something is going to happen, good or bad, it can happen. Honestly, I think if a patient improves, I’m happy, even if it’s a placebo effect. Aside from the placebo effect, research shows that things like yoga, meditation or journaling, can affect a patient’s emotional health, which in turn can help their quality of life. In some cases, that can even affect inflammatory markers in their blood so it also has physiological effect.
Q: You’ve also practiced integrative medicine in Virginia. Are there differences between the state’s regulatory regimes that affect what you can and can’t do?
A: There probably are, but I’m not entirely aware of them. It’s mostly the same. One thing that I have noticed is that a lot of the integrative medicine tests I could order in Virginia, I couldn’t get here, like certain stool and blood tests. There are still less optimal tests I can get here, but that’s a little bit frustrating.
Q: Is that a matter of insurance or regulations?
A: It has to do with the New York state regulatory process and how they certify lab tests. So it’s a state-driven aspect. The most restrictive states are New York, California and Maryland. I think the companies just find it’s not worth the effort or the money to get those tests certified in this state.
Q: I interviewed your colleague Dr. Heidi Puc recently. We talked a bit about integrative medicine in the context of Lyme disease. Are you involved in treating Lyme?
A: Yes, I am. Lyme and other tick-borne illnesses are commonly seen in Virginia, too. Many times patients present with a wide range of seemingly unrelated symptoms from various bodily systems and many times they don’t get the typical bulls-eye rash. They may just have a summer time flu, with fever, joint pain and headaches, but they’ve never seen a tick on them. This can go on to chronic Lyme, which can be misdiagnosed as other diseases. The current blood tests for Lyme are far from optimal for diagnosing it. Many times we have to rely on symptoms and the history of possible tick exposure, which can be done through the use of a validated screening questionnaire. These patients often have lots of gastrointestinal complaints, too. The bacteria that causes Lyme disease has been found through PCR testing in tissue samples from the gastrointestinal tract of children with chronic gastrointestinal and other symptoms despite negative blood tests for Lyme. These samples were obtained at the time of colonoscopy or upper endoscopy. And ticks that carry Lyme disease are not just in the Northeast now, so it’s something to consider in patients who present with multiple symptoms in a lot of different bodily systems, from any part of the country.
Q: What kinds of effects do you see in the gastrointestinal system, and what kinds of therapies seem to help?
A: It can affect the gastrointestinal tract at pretty much any level. It can affect motility. Symptoms patients can present with include chronic constipation, diarrhea, abdominal bloating, nausea, vomiting and heart burn. Those are the GI symptoms we tend to see.
Name: Amy L. Lazzarini, M.D.
Position: Physician at Integrative Medicine of Central New York, P.C., Chittenango
Hometown: Vestal, NY
Education: Georgetown University School of Medicine; residency in internal medicine and fellowship in gastroenterology through SUNY Upstate Medical University; fellowship in integrative medicine through George Washington University School of Medicine and Health Sciences
Career: Virginia Center for Health & Wellness, Aldie, Va.; BodyLogic MD of Aldie, Aldie, Va.; adjunct instructor, integrative medicine program, George Washington University; gastroenterologist at Crouse Hospital; assistant professor, SUNY Upstate Medical University
Organizations: American College of Gastroenterology; American Gastroenterological Association; Institute for Functional Medicine; Metabolic Medical Institute; and ILADS (International Lyme & Associated Diseases Society
Family: Husband, stepchildren
Hobbies: Hiking, working out, cycling