Janine Blackman, MD/PhD
Speaker, Practitioner, Advocate
About
Janine A. Blackman, MD/PhD
(240) 863-2478 (this is new phone number starting June 2011)
Bethesda, MD
Baltimore, MD
Adjunct Faculty, Georgetown Univeristy Medical Center (2008)
Special
Interests: Dr.
Blackman has particular interest in applying Integrative Medicine to
helping people with chronic health conditions such as pain, fatigue; complex bowel disorders such as irritable bowel, Crohn's
disease, Ulcerative Colitis; diabetes; high cholesterol; and women's
health issues including PMS, menopause symptoms, and
osteoporosis.
Board Certified: Family Practice
Medical Degree: University of Maryland School of Medicine,
Baltimore, MD
Graduate Degree: PhD, Epidemiology, University of Maryland
School of Medicine, Baltimore, MD
Internship and Residency: Department of Family Practice,
Franklin Square Hospital Center, Baltimore, MD
Fellowship: Integrative Medicine, University of Maryland
Center for Integrative Medicine
Academic Appointments: Assistant Professor, Family Medicine
Awards:
ISPE-Pharmacoepidemiology & Drug Safety (PDS) Prize to authors of the best papers published, 2002:
Janine A. Blackman, MD, PhD.
Estrogen Replacement Therapy and Risk of Lung Cancer
Volume 11 Issue 7:561-7, Oct-Nov. 2002.
Co-authors: Coogan, Rosenberg, Strom, Zauber, Palmer, Langenberg, Shapiro.
Other:
Dr. Janine Blackman is an Integrative Medicine physician. Previous to
co-founding and directing The Center for Nutrition & Lifestyle Medcine practice, she served as the Medical
Director of University of Maryland Integrative Medicine, LLC.
She
provides Integrative Medicine Consultations for advice on optimal
wellness, and for management of chronic conditions. Dr. Blackman is
committed to helping people on their journey for improved physical and
spiritual health, and to providing a caring and compassionate
environment. She takes account of the whole person (body,
mind,
and spirit), and makes use of all appropriate therapies, both
conventional and alternative. Dr. Blackman's interest in nutrition
began at a young age while in college, and continues in her clinical
practice today. She has taken several courses in nutrition
and on
the use of nutritional supplements for improving health.
Dr. Blackman's interest in Integrative Medicine began during her
residency training in family practice when she became aware that while
conventional allopathic medicine can be very good at treating acute
illnesses or traumatic injuries, it also has many limitations for
treating serious chronic conditions. In her journey to learn
new
methods for helping people with chronic conditions, she has studied
various mind-body techniques and acupuncture, and gained experience
directing a team of alternative practitioners at University of Maryland
Integrative Medicine. She strongly agrees with the
philosophy utilizing natural methods to restore the body to
balance and promote healing, and prescribes western medicines and
surgeries only when more natural approaches have been inadequate.
Another important aspect of Integrative Medicine that Dr. Blackman
likes to emphasize is the value of establishing a therapeutic
relationship with each patient. "When I have spent an hour or
longer listening to a new patient tell their story, and this person
feels heard and validated for the first time in their life, then our
time together can be very healing. Similarly, when I have
worked
with a patient for several months, and have helped them learn to listen
to their own body's signals about optimal nutrition and mindfulness
techniques, then they are further empowered and on the road to healing."
In her practice at River Soul Wellness, Dr. Blackman offers individualized treatment
and programs for weight loss, chronic illness, being over stressed. In addition to her clinical practice and role as
Medical
Director, Dr. Blackman also lectures frequently at local and national
conferences on Integrative Medicine approaches to
arthritis, inflammatory bowel disease, women's health, nutrition, and
the use of dietary supplements.
The Return of Soul to Medicine and The Role of the Integrative Physician
Based on presentation by Janine Blackman, MD, PhD, to the
Nova
CFS/FMS Support Group
Mason Governmental Center
Annandale, VA
October 21, 2006
Notes by Elly Brosius, MS
Contact information above for Dr. Blackman updated 3/2011
Dr. Blackman came to our group's attention
in 2004 while at Kernan Hospital in Baltimore, treating some of our
members at The
Center for Integrative Medicine at University of Maryland
School of
Medicine. Elly first
met Dr. Blackman at at CFIDS Lobby Days 2005. Dr. Blackman was on the Maryland team,
speaking up within the halls of Congress on behalf of people with
CFS.
How She came to Medicine
Dr. Blackman introduced
herself and told us a little about herself. Medicine is her second
career, after being an engineer. She was attracted to medicine to study
health and found the work of Larry Dossey. MD, and others who have a
holistic, health approach inviting. She was intrigued by studies that
showed prayer could affect health. She quickly found out that US
medicine is mostly diseased based and not health based. She wanted to
talk to people up front about what health is and how to maintain it,
not wait for them to get sick before interventions began. Somehow, she
found the inspiration to complete her training in spite of the disease
model of medicine being taught, but she always figured she would remain
in academic medicine. Her double degree in family practice and
epidemiology is suited for just that. Instead, she now finds herself
in private practice, working directly with patients. She offers the
services of a physician who has embraced and embodied the role of a
truly integrative physician, respecting patients preferences and making
available a wide choice of healing modalities, encouraging patients to
examine and heal their inner world, thereby returning some
soul to practicing medicine.
"When people come to see me, they are already outside the box." - Janine Blackman, MD, PhD
Since there is often no insurance coverage for supplements, certain
tests, Dr. Blackman's patient's tend to be motivated and
already committed to the concepts of integrative care. While an
excellent family practice doctor with impressive credentials, she
receives almost no referrals from other physicians! They don't know
whether to trust this integrative stuff, even though it is also
evidence based medicine. Both she and the patient bring extra
motivation to create this special space of care and respect. And that's
what you need when things don't go as expected. Dedication,
patience, and persistence are key to unraveling the complexity and
finding a new direction for successful treatment.
What is Integrative Medicine?
Dr. Blackman brought 4 handouts for us. We started by going over the first one, a definition of Integrative Medicine. It
is
grounded in the healing relationship — practitioners and
patients
sharing information as well as compassion as they seek ways to
achieve optimal health together. It draws upon many traditions and
treatments and includes prevention as an important component. Its seeks
to return the soul to medicine, with care focusing on healing the whole
person and addressing a person’s physical self, a person's mental
and emotional state, a person's community, and a person's personal
connection to the transcendent. More soul for a new role as whole.
Dr. Blackman noted that the term Integrative Medicine may or may not
last. It seems to be a needed name for now. Its not particularly
descriptive. Maybe the evolution of medicine in the west will be
such one can get this encompassing approach everywhere and the word
Integrative will be dropped.
How she works as an Integrative Doctor
Next, our speaker took us through handout 2: how I work as an integrative physician. Dr. Blackman stays mindful of the patient’s goals, she remains respectful of a patient’s desire to use or avoid
conventional medical options, and she tries to identify new areas in which the patient may improve his or her health. Enhancing nutritional intake
is one important area and we detoured to handout 3– Ten Simple Nutritional Principles & Vitality Foods.
The nutrition handout is for
individuals with a high level of digestive and food preparation
functioning. Dr. Blackman noted for a person with CFS/FM, the
first suggestion "Eat
> 4 cups of colorful produce daily", is probably a horrific thought
and would make one feel terrible!
Our digestion is too weak and needs help and healing before it could
handle processing all those veggies. She went into detail about the
quality of grains available to us even in health food stores being so
poor, that unless you are the most careful
of shoppers and follow good preparation techniques, eating grains is
probably not as helpful as you might guess from all the advice out
there. Dr. Blackman mentioned here about phrasing things, doing things
in the form of the positive with the example being to focus on what can
be added to a diet instead of what can't eat anymore. She encourages
the planning and readiness of healthy snacks (small amounts of very
dark chocolate made the list) to help make a shift to eating
differently.
She talked quite a bit about the benefits of Cod Liver Oil for its
Vitamin A and Vitamin D and some omega 3 fatty acids. These are so
important and so difficult to get
in one's diet otherwise, especially A & D if limiting animal
products. Vegetarian multis will not have vitamins A and D. A good
brand of cod liver oil she mentioned is Green Pasture Blue Ice.
She recommends the liquid over the capsule for cod liver oil because
you call tell more easily if the oil has gone rancid. If using soft gel
caps for any oil based supplement, she recommended puncturing and
smelling one capsule of
each bottle you open to verify that the product inside is still fresh.
Dr. Blackman uses other nutritional supplements to help her patients.
The cod liver oil is the only non-plant based supplement she
recommends. She talked about the importance of supplement quality and
offers professional grade nutritional products in her practice. Other
good brands for cod liver oil that came up are Nordic Naturals and
Carlson.
Continuing along with Handout 2, Dr. Blackman talked about offering ‘state of the
art’ laboratory screening including newer conventional lab tests, including vitamin levels and “Functional Medicine” testing for interested patients for whom it may help. Tests can pick up imbalances and excesses and deficiencies and more.
Dr. Blackman feels it important to challenge patients to live a full and balanced life. For example, she may ask one to examine if they having been taking large quantities of supplements for a very long time for deficiencies or to compensate for a non-healthy lifestyle. She'll explore with patients how there isn’t a pill (or
vitamin or herb) for every problem. She encourages looking inward at how we are living, often necessary for the big health issues. She helps to uncover the sources of problems and works to
facilitate healing of the core issues. There is more to do than simply prescribing therapies to mask problems.
People have often sought out stimulants for short term coping or as a
long term strategy, thinking it is a good thing. At best, she said, one
gets only temporary help. At worst, they can "squeeze out the last bit
of energy you have." Her program is designed to support people and
nourish them while they stop the push crash cycle and practice a new
way of being.
Dr. Blackman reminded us our physical bodies need loving relationships
and various interests and passions. We were not born to simply eat, sleep,
and work.... we need play!
"Play is our primary nutrition. The food is secondary."
"Remember when play was
more important than food? she asked. Remember when your Mom would call
you in for dinner and you didn't want to stop what you were doing
because it was so fun. You didn't care if you ate." Immersing yourself totally in something that brings you that much satisfaction - that is a kind of
nourishment as important as food, more important than food. She asks patients to cultivate
mental, emotional, intellectual Nourishment, to play once again. Its
good and important self care. Find it through joy-filled
activities, art, meditation, journal writing, reading on a new subject.
Even while ill, especially because one is ill, play is a vital strategy
for healing.
We talked about the importance of touch. And even if it is a pedicure,
pampering touch can be quite an important connection/ interaction. A
massage is good for some, but she cautioned many with fibro don't feel
with massage. We talked about making appointments such as for a massage
may make us get to that event so we can relax and feel cared for. If we
plan something at home, it is easily and often brushed off. Find a way
to regularly do things that recharge you. Hmmm, maybe weekly visits to
the hair salon by the older ladies in my past was never about hair, but
about community, touch, connection.
Applying an Integrative Approach in a CFS/FM Program, the Physician's Role
Because there are long term weaknesses, imbalances, acute and chronic stresses, food and other
sensitivities, and more individual variables, an integrative program
for people with CFS and FMS needs great flexibility. The structure is
important, too. It takes commitment on the part of the provider and the
patient to make it through the rough spots. Dr. Blackman talked about
creating a team feeling, a family, giving you support as you attempt healing in her clinical program.
Dr. Blackman's 4th handout is The Role of the Physician [in integrative programs] describes an integrated approach to the treatment of fibromyalgia
and chronic fatigue syndrome to ensure that the maximum chance of the
patient's recovery is possible, and for that recovery to be
sustainable without the need for further care.
A restoration of heath includes physical, mental, emotional
Nourishment & Rebuilding; Regulating & Rebalancing the nervous
& endocrine system; Clearing
Obstacles ("Detox" and much more); and Awakening Your Healing Energy which involves identifying unrecognized and unresolved stressors.
Following a pathway that is is not linear ,
the is guiding people along a transformative path from
"An Extreme State of Exhaustion" → → to → → "A Sustainable Restoration of Health & Resiliency."
It requires an individualized treatment approach
to help patients with
Cleansing and Regulating, Building and Nourishing, and Maintenance and
Transition to Health. It takes a multi-directional and synergistic
approach to facilitate a mind-body through this transformation.
We spent some time talking about unrecognized stressors as being very
important. If we could recognize them, we would do something about
them. Sometimes it takes someone with special training and gifts to
help people see the strain they are under from what is eluding them
about themselves. Dr. Blackman has witnessed that even
if people have done 10 years of therapy and thought they covered
everything, they tend to have breakthroughs in just a few sessions with other practitioners. We all have stress that is unrecognized. But when you are ill, you have less spare energy to spend
on it or the drain from denying it.
The role of the physician for chronic illness patients interested in
programs includes screening
potential patients, confirming diagnoses and looking for missed ones,
communicating with primary care physician as requested, optimizing
medications -- weaning from drugs only as patients improve, nutritional teaching (food and supplements), optimizing sleep and exercise, and teaching life-long optimal health planning.
For Clearing Obstacles, the removal of processed foods, stimulants,
alcohol, emotional stress, vigorous exercise, and disempowering &
limiting thinking is encouraged and supported. There is ZERO prescribing of anything to
force detoxing. Instead, the body is allowed to do it on its own. It
can do it better given the chance! People with exhaustive, painful illness do not have the strength to handle detoxing fast or by force. Medications are adjusted as people improve and weaning off occurs as is medically appropriate and tolerated. See handout 4 for specific examples.
The physician's role in Physical, Mental & Emotional Nourishment
& Rebuilding is to support good nutrition, improve digestion &
absorption, optimize medications so herbal therapy can improve function
of the GI tract and clear old waste, encourage clients to eat slowly,
calmly and at regular intervals, provide whole food nutritional
supplements, optimize a patient's sleep. Sleep is a priority in this
program. The physician also encourages Gentle Movement such as gentle
yoga or stretching daily, gentle walking and avoiding exercise that
"breaks a sweat" until told otherwise (late in Phase II). Exercise is
greatly discouraged at the beginning since people are just too tired.
There is no energy return for that energy spent. The physician also
encourages emotional nourishment (remembering when play was more
important than food), love and loving touch, and intellectual or mental
nourishment.
Discussion Highlights
Dr. Blackman talked about the process of shifting people's current
medications to different, temporary ones, to allow the other
part of the treatment to be more effective and to regulate people's sleep
patterns. The ultimate goal is to withdraw from
medications and other treatments only when full health has been restored, and she has seen that happen
repeatedly in people. She had just completed some research looking at case files
for the last few years (she is an also epidemiologist) and the news was good for people with CFS and FM.
Dr. Blackman has observed resistance not in people's willingness to
take a drug or
make a change to shift to a new pattern, but in their resisting finding
out what might have led to abnormal patterns such as a turned around
sleep pattern. If you are sleeping in the day and up at night, she
encourages finding out what about night is appealing - is it being
alone? the quiet?... ? Complex
chronic illness patients need significant medical, medicinal,
emotional, and other kinds of support to get all the body systems and
the mind-body-spirit all in harmony again. And although she is the
physician, she considers her self a participant in the team, not its
leader. Everyone, including the patient, has valuable input and work to
do in the healing process.
We thanked Dr. Blackman for her time and sharing her wisdom and
experience. She stayed another 1/2 hour to answer questions afterward.
The room had been very cold, so several people had to leave to go warm
up or we might have even stayed longer! It was a great meeting.
Meeting Handouts from Dr. Janine
Blackman, Text & PDF
Web Links
for Janine Blackman, MD/PhD
Family Practice, Integrative Medicine, Epidemiology.
Who and where
on the web is Dr. Blackman:
On this site / CFSupport:
Articles/video by, quoting, or
mentioning Dr. Blackman:
- Effectiveness of Chinese Herbal Treatment for Fibromyalgia and Chronic Fatigue Syndrome (PDF)
(Abstract Only) - TV: The Learning Channel - When Sleep Goes Bad. Premiered 3/14/2007. Repeats.
- When They Ask, Tell - Experts urge full disclosure on alternative treatments - HealthDay News 9/30/06
- Finally,
getting his zzz's: After coping with a sleep disorder, a Woodbridge man
gets help from TV - Richmond Times Dispatch 9-1-06
- Clinical
Care for CFS by Marcia Harmon. Special Issue CFIDS Chronicle 2005-2006:
On the
Frontier, A New Model for Treating CFS (last page)
- Yoga Increases Weight Loss, Prevents Pounds in Middle Age
The exercise may be related to healthier overall lifestyles (Healthday) July/August 2005
Dr.
Janine Blackman, ... , has another theory: The "mindful" nature of yoga
creates a healthier response to stress, which in turn prevents
stress-driven eating and lowers stress hormones. "Middle age is a full
time in life," she told HealthDay. "A better response to this stress
can lower cortisol and other stress hormones, which helps
physiologically. If cortisol is elevated, you're more likely to have
insulin resistance, which is central to obesity."
- Video:
Blackman lectures on FM: Women & Alternative/Complementary
Medicine at NIH June 2004
- Women
& Alternative/Complementary Med. FM Lecture. June 2004. Story, photos.
- MindBody
Medicine, by J Blackman MD/PhD. Maryland Family Doctor,
Spring 2003
- IBS
and Alternative Therapies - WebMD Medical Reference.
- Treating
IBS and Diarrhea - WebMD Medical Reference
- Talk
to Your Doc About Your Alternative Meds - HealthDay News
- Massage,
Chiropractic Top Medical Alternatives - Consumer Reports Survey
- Are Supplements the Solution for a Sex Life Gone South?
- Health Effects of Omega-3 Fatty Acids on Asthma; Agency for Healthcare Research and Quality (PDF)
A Few Speaking Engagements
- New Twists on Old Problems: Diagnosis & Treatment for Fibromyalgia & Chronic Fatigue Syndrome
Maryland Academy of Family Physicians, Ocean City, MD. Fri, June 30, 2006.
- Integrative Medicine Approaches for the Treatment of Fibromyalgia and Related Disorders
Panel Discussion on Multidisciplinary Approach to Fibromyalgia
American Association for Pain Management; San Diego, CA.. Sat, Sept 24, 2005.
- Effective Long-Term Treatment for Chronic Fatigue and Fibromyalgia
Utilizing a Unique Integrative Health Care Strategy.
American Holistic Medicine Association; Philadelphia, PA. Fri, May 13, 2005.
- Sex and Rx: A Symposium on Women and Medications
"Integrative Medicine Approach to Menopause"
Tenth Annual Symposium on Women's Health Research by The Women's Health
Research Group and the Department of Epidemiology and Preventive
Medicine, University of Maryland, Baltimore;
October 24, 2003.
Janine A. Blackman, M.D., Ph.D.
- Essential Fatty Acids/Roles in Our Health
American Holistic Medicine Association, 2003. Janine A. Blackman, M.D., PhD
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