AMEN 2018: Call to Service

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Adventist Medical Evangelism Network (AMEN)

Breakout Session A

Ken Pierson

The Nuts and Bolts of Global Dentistry

So Carlos helped me come up with some objectives.

To just go over them real quick, to provide real-world practical tips for excellent dentistry and an effective dental practice regardless of location.

Illustrate the importance of medical missionary service locally and internationally and its impact on patient outcomes.

Discuss how to apply professional talents and responsible stewardship.

Well after kind of doing a little bit more looking into it, I was like, man, how am I going to talk for an hour?

And then I was thinking, how am I only going to talk for an hour?

Because that was a little too much to kind of bite Off in in just an hour, but anyway this little bit about us I think I know most of you, But Crystal here is my beautiful wife.

And we have 4 daughters, Shila, Ava, Leia, and Brinley.

That was taken a few months before we left Saipan, up on the hill.

And you can see kind of the ocean in the background.

Tinian, yeah, Tinian is the neighboring island and that's right over there.

That was when it was still pretty because just a few days ago it got stomped by a major super typhoon.

So I'll show you pictures in just a little bit.

Crystal graduated in 2005 And right after she graduated, we took off to Saipan.

And we've been there until just this last July.

Actually, there was about an 11-month period when we came back to California, which was a planned kind of return back to California to help out the family and work at my dad's practice.

And then we went back for 2 more years and then just came back in July.

I did a little bit in Malawi right after dental school, and I thought there might be some dental students here, but I don't think there's any dental students.

So, to you specifically, right after graduation is a perfect time, because you've got, guess what?

So I guess if you're really smart, you'll earn that, you know, you'll spend time earning some money to make that first payment easy.

And with the amount of debt these days that might be necessary.

But anyway, when I graduated I went straight out to Malawi and covered a mission practice, the Lelongwe Administration Clinic, for 3 months while the guy that was stationed there went on furlough and it worked out great.

It was really awesome to go, that's where I'd grown up, so it was awesome to go back.

Then I was in a group practice here in San Bernardino from 2001 to 2005 and then we've been at the Saipan Symptom Avis Clinic until July.

And then since July, we've moved back to the Central Valley, California, and joined my dad's practice.

It is specifically pediatric general anesthesia dentistry.

So it's kind of the end stop for everybody that has extensive decay or problems or issues, behavioral, whatever it is to prevent them, or on the spectrum or whatever it might be to prevent them from having dental work done.

And then they come, they're referred to us, and we do everything under general anesthesia.

It's an actual surgery center, so it's a JCO certified ambulatory surgery center, which is pretty unique to our field, to dentistry.

And anyway, so it's something getting used to working with kids that are all asleep, but that's what I had done 2 years prior.

And actually we had gotten that going in Saipan.

So there was, we made connections with the local anesthesiologist.

There was 2 of them at the time at the hospital in Saipan, and so they would give us kind of their post-call days, and so they would come over, would have these kids lined up, maybe do 4 or 5 cases in a day and they'd give us about 5 days a week.

So that was really, it was a, it was great for the island because you know, it was a way that these kids could be treated because you see so much rampant decay.

But anyway, so now we've got our 4 girls and my brother's 3 girls all together.

They were able to come out to Saipan a couple months before we actually left, seeing the time clicking down and having never made it out there for like 13 years, they found these super cheap tickets on coming through Hong Kong.

And so they nabbed them, and they came out to see us.

Whenever they're together, I mean, it's all 7 girls all together, you know, it's just, it's crazy.

Okay, so, everybody, well, I guess there weren't any single, so yeah, OK.

You guys have to Get out your phone and snap a little picture of that and then go on Amazon and buy it for 15 dollars or whatever it is or get it used or buy the audio version.

It is not the kind of how to fix your marriage book.

It's understanding marriage from a biblical perspective.

We were listening to it on the way down again.

And you get this type of thing, just rampant decay, and fistulas, let's see, where's that thing?

So these teeth all came out, and they're doing pulps and crowns on the ones that you can save.

And so, actually I think this case was in Saipan.

I don't think this is 1 of the ones that was here in California.

Access to care is a little bit better here, so things don't get quite as advanced, but we still see crazy stuff.

So okay, moving on, I'm going to start from the bottom and move up, because it's going to give our foundation.

So we'll talk about the clinical stuff a little bit in a minute and practice stuff.

But I just wanted to talk a little bit about your professional talents and stewardship.

And I think a lot of times we when we think about stewardship stewardship we kind of Automatically go to oh they want money, right?

It kind of always when you think of stewardship you're thinking about managing a lot of times.

I think about managing my money giving money that type of thing I believe that we have to change our understanding of stewardship and understand that Money is just a small little fraction of stewardship.

Your time, your talents, Everything that God has given to you is a gift, and it's not actually something that is innately yours.

It's something that God has entrusted to you, and you have the ability and responsibility to move forward in using that talent for God's glory and benefit.

The parable of the talents, you guys all know that story.

You remember the owner is going to go on a long trip, gives each of them a talent or talents, and then returns and says, what have you done?

And so, you know, I would not say that it's, I believe that all of you are here because you feel that you have been called and you have a responsibility for service.

So just, moving forward in that kind of mentality, like understanding that a lot of times, I remember when I first graduated, I'm like, I busted my tail to get through dental school.

And it's very easy to kind of think that it was you, that it was because you studied hard, because you're smart enough, because you had the discipline, whatever it is.

Who gave you the ability to actually complete your dental school, your residency training, whatever it might be.

And When you think of it in those terms, that it wasn't something that originated in you, it just helps in being able to be a good steward.

That's my youngest daughter, Leia, right there.

She would always come over to the clinic and kind of help out with, you know, this was her classmate, actually.

Being a small island, you know, everybody kind of knows everybody, and so she would come and help out.

He was a dentist in the Philippines and a dental therapist in Saipan.

We would do a clinic with a heart, kind of based off of the clinic with a heart that Loma Linda always did.

So this is on 1 of those clinic with a heart days where we get the kids out there helping and everything.

Just a baptism that, you know, out in the lagoon.

David DeRose

The Far-Reaching Grasp of High Blood Pressure

Father in Heaven, thank you so much for the privilege we have of coming apart and studying, really, the crowning act of your creation on this planet, the human organism.

And yet we're in a world of sin and things go wrong, and yet you want your children to be ambassadors of your good news, not only the gospel as far as the saving power of Jesus, but also how you want to save us from ourselves and our poor lifestyles and the environment that we find ourselves in.

Give us things that we can take away that will not only change our lives, but change the lives of those we touch.

Well, we truly are in the midst of what we'd call a pandemic.

It is a worldwide epidemic when it comes to high blood pressure.

Sometimes we think these chronic diseases are just happening in the United States.

But earlier this year I was invited to speak at a division-wide conference in Europe.

The Inter-European Division was hosting a health conference, and I said, I got to look at data throughout the world.

Are we dealing with high blood pressure worse than other nations?

Well, I looked at data from the World Health Organization and it is amazing.

Using guidelines, some people would say a little bit older guidelines, we'll talk some about changes in guidelines as we go through the CME event this afternoon, but historic guidelines for high blood pressure up until fairly recently, greater than or equal to 140 for the systolic number, greater than equal to 90 for the diastolic number, or on blood pressure lowering medication.

The World Health Organization looked at this across nations throughout the world.

This is the prevalence, the percentage of the population with high blood pressure.

And you can see it doesn't matter where you go, whether it's a developing nation or a developed nation, about 30 to 50% of the population have high blood pressure.

Ghana, Iran, Israel, 30 to 50% across the board as you look at the rates of high blood pressure.

Mongolia, that's right, Mongolia, Poland, doesn't matter, 30% to 50% with high blood pressure.

So we want to look today at some key messages, first about epidemiology.

And the first key message is this is a pandemic, an estimated 1.4 billion people worldwide with high blood pressure, and the number continues to climb.

So let's look at 7 key messages that especially relate to the epidemiology, but also give us some special insights that can help us when we reach out to our patients and to our communities.

The second 1, it's not just someone else's problem.

If you don't have high blood pressure today, it's likely waiting for you down the road.

If we look at what happens as a population ages, the rates of hypertension increase dramatically.

This is even with older data, older cutoffs for high blood pressure.

We'll show you what they look like with newer guidelines.

But what I want you to notice is once we get into our 60s, our age is roughly the percentage likelihood that we have hypertension.

I know we just ate, so let's make this a little bit interactive.

Let's say someone is 65 years old in America.

What is the likelihood that they have high blood pressure?

How about if there's 75, what is the likelihood?

If you look at the World Health Organization data, it's the same.

Worldwide as we get older, our likelihood of having hypertension dramatically increases.

And if you look at some very good data that we have from here in the United States, the data suggests that only about 1 in 10 of us, these are the newer guidelines, you can see it just shifts things up a little bit higher, but only about 1 in 10 of us, if we're like the average American, will evade the grasp of hypertension.

About 90% of individuals, look at this statistic here, 55 to 65 years of age, they have no hypertension.

90% chance that before they die, they will have a diagnosis of high blood pressure.

So if you're talking about high blood pressure, you're basically talking about a problem that relates to every single person, whether we realize it or not.

We either have high blood pressure or it's likely waiting for us.

Now you say that's being quite pessimistic.

Well, not really, because we want to try to look at some of the reasons why that's the case and some of the things we can do or some of the things we can help our patients do so that they don't develop high blood pressure.

Well, I don't want to spend a lot of time with the obvious.

High blood pressure is extremely dangerous even though it is underappreciated as such by most people who have high blood pressure.

Here's how the World Health Organization put it, really in a very impressive monograph if you're interested in worldwide risk of non-communicable diseases.

Chronic disease is very nice monograph here published in 2011 by the World Health Organization.

Common preventable Risk factors underlie most non-communicable diseases.

These risk factors are a leading cause of the death and disability burden in nearly every country.

It says nearly all countries, Same message, regardless of economic development.

What is the leading risk factor globally for mortality?

So high blood pressure is not just a risk factor that we get concerned about.

It is really a worldwide problem that is cutting millions of lives short.

You know many of the complications that go along with high blood pressure.

We won't take a lot of time with this, but I will highlight a couple.

More and more data really underscoring just how compelling the link is between even relatively mild levels of blood pressure elevation and dementia.

Men often don't realize that it's not just agents that are sometimes used to treat prostate problems that actually lower blood pressure.

It's true with 1 class of drugs, you know, the alpha agonist.

But, prostate problems are increased if you have high blood pressure.

But of course, the leading concerns, stroke, heart attack, kidney failure, blindness.

If you have diabetes, you're dramatically increased risk of just about everything on this list.

Add high blood pressure to the equation, and it increases your risk even more.

So Here's the first take-home point from these first 3 epidemiology points, and that is if we're interested in ministering to our patients, if we're interested in ministering to our communities, and if we're interested in preserving our own abilities to minister effectively, we need to be concerned about high blood pressure.

Do you think that's a fair conclusion to draw just from what we've looked at?

OK, some of you are alert enough to nod your heads.

I'm not 1 of those preachers who like to get people saying amen, work them up into a fervor so that they will assent us to about anything that the speaker says.

So you're doing very well to have your critical regard and your critical faculties honed even after a lunch on a warm day.

Well here's my story and how I got involved being especially interested in public health approach to high blood pressure.

I'm from Northern California outside of Sacramento.

David Woosuk Lee

Type II Diabetes, Addiction, & “The Loud Cry”

Dear Father in Heaven, thank you so much for bringing all of us here to AMEN conference.

Today we're going to talk about helping people with diabetes, you know, helping them to reverse.

Please keep our minds sharp and open hearts that we can understand that only by your grace, we can help others and they can be helped.

So, initially when I was invited to speak, I was very ambitious.

So I want to talk about reversing diabetes and also going to addiction mechanism and then also talk about fasting and prayer.

In fact, that's 1 of my most, it's my favorite topic to cover.

I'll cover a little bit of that, how it's related to reversing unbalanced mind.

And at the end, we'll connect the frontal lobe and limbic system connection to the story of Gideon and then how it is connected to the loud cry.

It was 2011 that we understood for the first time scientifically that type 2 diabetes is reversible.

Have you guys heard of this study, the 2011 counterpoint study?

It's pretty well known because we consider this study to be the landmark study to scientifically prove that type 2 diabetes is reversible.

This study was done by Newcastle University in England that is considered to be 1 of the top endocrinology programs in the world.

They had 11 patients who were diabetic, average length of about 10 years, and there are 9 control patients who are non-diabetic.

And they gave about 700 kilocalorie diet every day for 8 weeks.

So that in order to control the food intake, what they gave is about 2 and a half cups of a protein shake and a little bit of salad, like broccoli, to prevent constipation.

And these patients received that diet for 8 weeks.

You know, 1 serving of haystack is about 340 calories.

So you're talking about getting 2 plates of haystack within 24 hours for 8 weeks.

And Every time I do this presentation, I've probably done this maybe 30 presentations on this topic, everybody asks me this question, has anyone died during this study?

Praise God, no 1 has died during this 8-week procedure.

While they're eating 700 to 800-calorie diet, they're monitoring, number 1, their blood sugar, number 2, glucose production from liver, Number 3, fat content in pancreas.

And when you look at the first thing is the plasma glucose, you can tell the first week, just 1 week, 7 days of calorie restriction therapy, the fasting glucose has dropped in those 11 patients who were diabetic.

Second thing, they measured the storage form of glucose coming out from the liver.

You can tell there's much less of a stored glucose.

As you're going into this calorie restriction diet, There's not much storage of the glucose or being transferred into the fat, into the liver.

So there's much less reverse production of a gluconeogenesis coming from the liver after first week.

And the third slide is the most important thing.

That is a fat content in the pancreas that they were measuring through MRI weekly, was showing that their fat content in the pancreas were going down.

So the question is, you know, when you want to confirm that type 2 diabetes is reversible, you have to prove by the level of insulin production without any help, without taking any medicine or insulin shots, right?

This is a normal profile of a non-diabetic patient when they receive glucose infusion.

This is their insulin production profile.

Usually when we receive IV fluid with the glucose, your insulin level goes up, response to the glucose.

And then the latter spike is they use arginine, 1 of the proteins, amino acids, just to confirm the pancreas is not completely dead.

Let's say you had a diabetes for 30 years and your pancreas is no longer producing, you're nearly type 1 diabetic patient, that pattern's not gonna be there at the end.

So just to confirm that, your diabetic for your pancreas is not quite there yet.

That's normal pattern for healthy non-diabetic patient.

Now, that's what I talked about just now.

So this is a baseline for diabetic patient.

They're lying there in the hospital bed receiving IV fluid with glucose, right?

And then there's no spike of insulin pattern.

There's no production of insulin coming from their pancreas.

However, they're not type 1 diabetic patients, nor the patients who were diabetic for many years.

They still generate a little bit of insulin when you CPR them, when you shock them with arginine.

That's the pattern of a normal diabetic patient with diabetes for about 10 years.

So after the first week of a near-fasting diet, you kind of see this little jump here.

They start to produce insulin After 4 weeks, after 8 weeks, and almost after 8 weeks of a calorie restriction diet, these are the patients who are diabetic for about average 11 years.

Their insulin production pattern is identical to healthy patients.

This is the first scientific evidence that type 2 diabetes is reversible, produced by Newcastle University in England.

And they call this study the counterpoint study because up to this point, let's say you're a medical student and there's an exam, type 2 diabetes reversible?

And if you say yes, they'll kick you out of the med school.

Because up to that point, Earth was flat, right?

But after this study came out, we realized actually type 2 is reversible.

So how does low calorie intake reverse type 2 diabetes?

So with weight gain, we hear about the fatty liver disease all the time.

And liver is not the only organ that collects extra calories in the forms of glycogen and then fat, triglyceride often.

In fact, pancreas collects those fatty substances also.

And so with the infiltration of fatty substance like often triglyceride, there's inflammation.

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Series

Breakout Session A

Painful Past: Medical Effects and Eternal Opportunities

Transcript

Parent Series

Parent Conference

Sponsor

Recorded

Attachments

Parts

The Nuts and Bolts of Global Dentistry

53m

The Far-Reaching Grasp of High Blood Pressure

52m

Type II Diabetes, Addiction, & “The Loud Cry”

57m

Painful Past: Medical Effects and Eternal Opportunities

58m

Structuring Efficient Short-term Overseas Medical Missionary Trips

1h 1m

Sound Doctrine