Integrative (Blended) Medicine

Integrative medicine blends the best of conventional with the best of alternative medicine

How to Talk to Your Doctor About Alternative Medicine (Part Two) – Six Questions to Ask

Continuing yesterday’s topic, let’s take a closer look at how to talk to your doctor about alternative medicine.

First, let me preface this with a few thoughts about talking with medical professionals in general.

When I schedule a “get acquainted” or first-visit appointment with a new doctor, I ask for extra time to discuss the doctor’s views on practice. I bring a list of questions – sometimes two copies, one to hand to the doctor, one to keep and jot notes on as we discuss the questions – and treat that part of the appointment as a job interview in which I’m the hiring manager.

That may seem strange to some.  After all, it wasn’t long ago that doctors were perceived as nearly godlike figures to be respected, revered, and obeyed but never questioned. Today, as medical professionals and medical schools recognize the importance of cultivating a partnership between doctors and patients, attitudes on both sides have changed.

You may not know which signs and symptoms indicate which diseases, as the doctor does. You may not know which medications have been proven most effective for which conditions, as the doctor does. But nobody knows how you feel better than you do, and nobody knows what’s normal for you and your body better than you do. You’re the CEO of your health and welfare. Medical professionals advise, but when it comes to your health, you make the decisions.

You wouldn’t hire a plumber or electrician or heating contractor or automobile repair service without asking about qualifications, areas of expertise, and attitudes that could affect the job he or she could do. Why not approach that first doctor-patient partnership interview the same way?

 

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Ready?  Great. Now let’s look at SIX QUESTIONS to discuss with your doctor when you have The Talk. To help spur ideas, I’ll include samples of good answers that can lead to productive discussions with your doctor, and bad answers that lead to dead ends.

1. What is your opinion of alternative medicine?

Good answers:

* It depends on which treatment you’re talking about; some have proven successful in studies; others are useless or dangerous.

* I am open to treatments that are backed by scientific research.

* I haven’t given it much thought but am open to discussing it.

Bad answers:

* No.

* Alternative medicine is nothing more than a modern version of the old time snake oil scams.

* What’s that?

2. How knowledgeable would you say you are about alternative medicine?

Good answers:

* I have read several studies about it.

* I have attended a few conferences and presentations.

* I keep up with the latest research and reports on it.

Bad answers:

* Zero. I know next to nothing about it and am not interested.

* I’ve heard of it.

* I know someone who believes in that stuff who is a total nutcase.

3. Have you ever recommended an alternative medicine treatment?

Good answers:

* Often.

* A few times, when it seemed appropriate.

* It has not come up yet but I would if it seemed right for a patient and the patient wanted to try it.

Bad answers:

* Never.

* Anybody who wants that woo-woo-world medicine should go to a witch doctor, not me.

* Why do that when we have drugs and surgery?

 

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4. Will you look into a treatment if I want to try it?

Good answers:

* Yes.

* Yes, if you tell me why you want to try it and what credible information you have about it.

* Probably. If I think it has some merit, yes, but if I know it doesn’t work or is fake, I will tell you that and won’t waste time researching further.

Bad answers:

* No.

* I have better things to do with my time.

* I wouldn’t know where to look.

 

5. What if I you recommend a prescription and I prefer to use a supplement, or you recommend a conventional treatment that I refuse in favor of an alternative treatment?

Good answers:

* As long as your health was not in danger and you keep me posted and come in for regular checks, I would go along with that.

* I would tell you what I think and recommend but it’s your body and your decision.

* If it is safe and it works for you, it’s fine with me.

Bad answers:

* I expect my patients to follow my recommendations or go elsewhere.

* I would tell you to take the prescription, period.

* I will mark your chart “patient is non-compliant.”

6. Would you write a referral if I needed one to have an alternative medicine treatment?

Good answers:

* Yes.

* If I know anyone to refer you to, I would.

* It may not always be possible but I would if it is possible.

Bad answers:

* No.

* I only make medical referrals.

* I don’t know any quacks and would not send my patient to one if I did.

Bottom Line:  These questions and variations have worked well for me. Fortunately, most of the doctors I’ve talked to have been very pragmatic about alternative medicine. And being open-minded and willing to discuss the topic is a good start. 

I don’t expect them to know all the answers – whether we’re talking alternative medicine or conventional medicine – but as long as they’re willing to discuss options and research what they don’t know, I think we will be able to work together as partners to find the treatment that works best for this patient.

Comments are very welcome… let us know if you would use different questions or add new ones to this list.

© 2012, All rights reserved

 

(Images courtesy of Microsoft Office Clip Art)

 

 

 

 

 

 

Alternative Medicine Wordle

On this Memorial Day (in the US), as we honor those who have fallen in wars and we take a day off from work to reflect on the past and honor their memories, AltMedForYou brings you a lighter topic.

 

Today’s theme for the WordCount 2012 Blogathon challenges bloggers to create a Wordle “word cloud” image composed of words that define the blog or that are used in the blog. Users choose the layout, colors, fonts, and other design elements that best suit the blog.

 

Here’s our AltMedForYou Wordle for today:

 

AltMed-Wordle-4thTry0003

 

 

It’s interesting to see the same image presented vertically, too:

 

AltMed-Wordle-4thTry0001

Supplement Problems: Calcium

(Original article posted May 25, 2011; updated information added on May 26, 2011.)

Yesterday we told you about the concerns that have recently been raised about vitamin E supplements. Today we take a look at the latest on calcium.

 

A new study published in the June 2012 issue of the journal Heart reported that taking high amounts of calcium supplements may increase risk of heart attack and stroke.

Previous research showed calcium was beneficial, especially post-menopausal women and others who are at risk of osteoporosis. Calcium supplements were also to help lower the risk of high blood pressure, type 2 diabetes, and obesity, heart attack, and stroke. No wonder many people say their physicians advised them to take a calcium supplement every day, and others decided on their own that taking calcium would be a good idea.

But now the new study raises serious questions about calcium. 

German researchers analyzed data collected over an 11-year period from 23,980 people aged 35 to 64 who did not have cardiovascular disease when they joined the study between 1994 and 1998.

Participants were asked to take a self-administered “food frequency” test that asked about their consumption of 148 foods over the preceding 12 months. They were also asked about supplement use during a baseline interview and then in periodic follow-up questionnaires.  Analysis of that data told the researchers how much calcium the participants were consuming and in which form (dietary calcium in foods and beverages or calcium supplements such as tablets and chewables).

Next they looked at the cardiovascular disease in the participants. Information obtained by surveying participants and survivors of those who had died was verified through medical and death records. After compensating for other confounding factors that could skew the results, they concluded that dietary calcium did not have a significant impact on heart health risks but calcium supplements actually increased risk of heart attack and stroke.

Why the difference? Calcium in food is consumed in smaller amounts scattered over the course of the day, which means that the calcium in food is absorbed more slowly, a press release about the research explains. Supplements, on the other hand, deliver a bigger dose of calcium all at once and that causes “calcium levels in the blood to soar above normal range.” The researchers think that spike of calcium or “flooding effect” is the key that explains why supplements can be harmful when dietary calcium is not.

The bottom line, the study authors say, is that calcium supplements should be used with caution and patients should be discouraged from taking calcium supplements.

Others who have read the study disagree, according to a report by NutraIngredients-USA. They point out the importance of calcium, especially for elderly people who are at risk of falls and fractures caused by weak bones. And, they note, this single study is not proof that calcium supplements do cause heart attacks, nor does it provide a strong enough reason to disregard the good things calcium can do. Until additional research confirms this study’s findings, it’s way too early to conclude that the possible harm calcium might cause outweighs the benefits studies have shown it provides.

If you’re not sure what to do — and heaven knows, the back-and-forth can be very confusing — ask your doctor to read this study, if he or she hasn’t already done so, and tell you what’s good or bad about it and what he or she recommends for you. Does your doctor think you should continue taking calcium supplements as you have done up to now or does he or she think you should stop taking the supplements?  And if you do stop taking them, ask about food sources of calcium. Which foods does the doctor recommend, in what amounts, and how often should they be consumed?  Be sure to ask about other calcium sources too, such as antacid tablets that contain calcium (like Tums®).

If you don’t have a health care professional to help you with this question, read ConsumerLabs.com’s Review of Calcium Supplements. Cautions and factors to consider if you are concerned are listed toward the end of the review. Or ask knowledgeable staff or nutritionists at your local health store.

Want to read the full text of the Heart article will find it in the June 2012 issue? See:  Calcium and cardiovascular disease. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European Prospective Investigation into Cancer and Nutrition study (EPIC-Heidelberg), Heart 98:920-925 doi:10.1136/heartjnl-2011-301345

© 2012, All rights reserved

 

A Look at Change: Growing Blogs, Medicine, and Alternative Medicine

 

Prompted by the “If I started blogging today, I would…” question that is the May 23 Theme Day topic for bloggers who are participating in the WordCount 2012 Blogathon, today’s topic is a look at change.

 

It is always worthwhile to take time to reassess what’s working and what’s not working, whether the focus is a blog, as it is with today’s theme, or other aspects of work and life, such as adjusting expenditures as goals and income change our personal finance profiles or changing our daily habits as we reassess things we can, should, or might do to maintain and improve our health.

For me, the short answer to the blogging theme question, what I would do if I started blogging today, is keep learning, growing, thinking, acquiring new information, modifying, and evolving.

People who have followed this blog for a while may have noticed new pages have been added while a few old ones went away. Categories have changed a bit as a few new ones were added, a few old ones deleted, and a few expanded or condensed to provide a better framework and organization for the topics covered here. The blog’s overall “voice” has become more casual. And there have been a few other tweaks.

But to me, these are all part of the natural reevaluation and growth process.

And don’t we all do that, whether it’s a conscious effort or just part of living?

After all, nothing is static in life. Things change in our world. Our bodies change. Our attitudes and goals and thoughts change. We discover that things we once though were absolute fact may not be so absolute after all. Some things we “knew” or believed may turn out to have been wrong. Heroes turn out to be flawed. Villains turn out to have redeeming qualities. New information comes along that changes our perceptions and alters what we knew — or thought we knew. Our needs, our desires, our interests, our hopes, our challenges, our goals change and evolve as we go through the stages of life.

That’s how the shift toward acceptance of alternative medicine happened for many of us. Once upon a time we thought conventional medicine could cure every ill, fix every problem, make any ailment “all better.” 

All it took was pill MP900398845[1]or, worst case, an operation and we’d be fine.

I’ve heard people say their doctors tried to tell them they should change their diet, exercise more, stop smoking, curb drinking, or do other things that would improve their health and the response they gave the doctor was a brusque, “Why go to all that trouble? Just give me a pill.”

 

It’s not hard to see why that attitude took hold and lasted so long, even among doctors. After all, didn’t the discovery of wonder drugs cure many once-deadly diseases? Didn’t surgery MP900313990[1] make it possible for cataract-covered eyes to see again and arthritis-crippled joints to walk normally? Didn’t vaccination erase the terror of smallpox and other diseases that once wiped out huge swaths of the population?

Why bother with time-consuming and boring ancient ways when easy-to-use quick-fix new tools worked so well?

In fact, the new tools still work well – for some things. An integrative medicine doctor told me in a telephone interview recently that he still thinks conventional medicine the best choice for acute problems such as a cut, a burn, a broken leg, an infection, but for chronic problems, alternative medicine’s holistic approach offers better results and will save health care dollars, a factor that has taken on even greater importance now as health care costs continue to soar higher and higher.

The fact that the field of integrative medicine exists is a hopeful sign because it means medicine as a whole is recognizing that the conventional approach can’t cure everything so let’s put everything on the table and use whichever approach works best for the problem at hand.

And at the same time, researchers are getting the funding they need to conduct studies to find out whether alternative medicine treatments work, and how to use those treatments safely, for maximum benefit to the patient. The evidence those studies add to the body of medical literature will help in many ways. Insurance companies looking for the most cost-effective methods of treating health problems have already begun to make the shift by expanding their coverage to include evidence-based alternative therapies.

That’s why questions like the one posed for this Theme Day are useful…because assessing and reassessing can spur improvement, whether it’s for a blog like this one, or our whole system of health care.

© 2012, all rights reserved.

(Images courtesy of Microsoft Office)

Alternative Medicine Thoughts in Haiku…

 

Today is Haiku Theme Day for bloggers who are participating in the 2012 Blogathon

 

My first thought was “haiku on an alternative medicine blog?  Seriously?” I can’t recall ever seeing the art of haiku blended with the concepts of alternative medicine… but since both are about the beauty and wonder of nature, perhaps this is not as unlikely a pairing as it first seems. 

 

The form of haiku, when written in English, is simple enough: a first line of five syllables, a second line of seven, and a third line of five, for a total of seventeen. And the object, purpose, or goal of haiku is to capture and distill into those seventeen syllables the purest possible essence of a moment, an experience, a phenomenon, or a thought.

 

As a former poetry editor who judged haiku contests in times long past but has not dabbled in the poetic arts for many years, this theme day posed a unique challenge.

 

I look forward to seeing your comments. Thank you for stopping by today and be sure to visit again tomorrow when this blog returns to more traditional ways of exploring the world of alternative medicine. 

 

*   *   *   *   *   *   *   *   *   * 

(on herbal therapies)

fragile flowers soothe

jangled nerves and angry skin

gentle healing herbs …

CB033230

 

 first to be planted

as settlers conquered the west

herbs for medicines …

 

 

*   *   *   *   *   *   *   *   *   * 

(on acupuncture)

  

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               tiny needles rouse 

                    powerful healing genie

                                life-force energy…

    

 

*   *   *   *   *   *   *   *   *   * 

 (on nature’s vitamins)

 

  Assorted fruit 

 

bright colors wrapping

tempting fragrance and flavor

fruit-borne vitamins …

 

 

 

*   *   *   *   *   *   *   *   *   * 

(on medical practice)

    MP900321070[1]open western eyes

to ancient eastern healing 

health must integrate …

           

*  *  *

 

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healing universe

grows when alternative is

mainstream medicine …

 

 

 

 

 

 

 

 

© 2012, all rights reserved (haiku and layout)

 

(Images courtesy of Microsoft Office.com)

What Makes an Alternative Medicine Source Credible (or Not)?

 

The wonderful thing about having access to information on the Internet is that everything you want to know or could ever want to know is “out there” somewhere. It may be easy or hard to find, depending on how obscure it is and how well you use search tools, but odds are the answer is there, somewhere.

 

And the not-so-wonderful thing about it is that everything is out there, whether it’s valid or false, useful or frivolous, sincere or scam. Sometimes it’s easy to brush off the baloney, weed out the wacko, and spot the scams. But not always.

 

That’s why it’s important to think about what signs to look for before you believe (or buy) what you find online.  Conventional health and medicine websites may display the HON (short for Health On the Net) Code  symbol, which tells you the site has gone through a fairly stringent vetting process and passed. I can’t recall seeing the HON Code on an AltMed site but if I found it on one, I’d consider that site trustworthy.

 

But even without such a clear cue, other signs can tip the balance toward or away from credibility. Here are a few of my “red flags.”

  • Too much hype. Enthusiasm is fine but when an email or post or website that raves too enthusiastically about how wonderful a supplement or treatment or product, it casts a big shadow of doubt. If the item – whatever it may be – is really THAT fantastic, why do you have to push it so fervently? Can’t it stand on its own merits?  If facts and evidence show it really does what the hype claims, that goes a lot further to convince me than shouting and touting it with slick sales spiels.

 

  • Selling. It’s disappointing to discover an otherwise promising report about a supplement, product or device, book or treatment is really just fancy packaging for a sales pitch. If the person or group that created that report weren’t selling the item, would they still praise it so highly? 

 

  • Secrets “they” don’t want you to know. If this really is true, how did this report manage to sneak past the mysterious “They” who don’t want us to know about it?  And how did the author of this article or email or web page get past “them” to discover this “secret” information? To me, that “secret” tag means “be skeptical.”

 

What are your red flags? What tells you that you can trust what you’re reading? Please share your comments and we’ll revisit this topic in the future.

 

 

© 2012, all rights reserved

Autism and Nutrition Factors

 

The lead article in the latest open-access issue of IMCJ Integrative Medicine: A Clinician’s Journal takes a look at the role of nutrition in the causes of and management of autism. The prevalence of autism is now double that of Down syndrome, the authors report, with at least 40 cases in every 10,000 children.

 

If you are interested in autism or concerned about autism and autism spectrum disorders, you may wish to read this open access article and the companion news article. Both are listed and linked below.

 

If you do read the articles, please share your thoughts here. Do you agree with the researchers’ conclusions? Is there a factor you think they have overlooked? What do you think might account for the increasing number of autism cases?

 

And if you do not read the articles, what deterred you from doing so? 

 

Nutritional Factors in Autism: An Overview of Nutritional Factors in the Etiology and Management of Autism, Balasubramanian Santhanam, MD; Barry Kendler, PhD, FACN. Integrative Medicine, Vol. 11, No. 1, Feb/Mar 2012, pp. 46-49.

 

Autism 360: The Development of an Online Database with Patient-entered Data, Sidney MacDonald Baker, MD, Integrative Medicine, vol. 11, No. 1, Feb/Mar 2012. p. 18

 

© 2012, all rights reserved

Benefits of New “PAP” Acupuncture Method Last 100 Times Longer

Here’s another news item from the world of acupuncture.

 

A new approach to this 4,000-year-old treatment for pain relief and other problems may prolong the benefits of treatment by as much as 100 times longer than traditional acupuncture, researchers at the University of North Carolina at Chapel Hill reported in the April 23 online edition of a journal called Molecular Pain.

 

The new element is a substance called prostatic acid phosphatase, or PAP for short. The same researchers had previously tested PAP by injecting into rodent spines and found the substances relieved chronic pan and the effects lasted as long as three days. But that procedure is usually reserved for those in excruciating pain. And, lead researcher associate professor Mark J. Zylka, PhD, said in a UNC news release, “spinal injections are invasive and must be performed in clinical setting.”

 

Zylka became interested in how acupuncture relieves pain. When an acupuncturist inserts a very fine acupuncture needle into a specific spot called an acupuncture point and manipulates the needle to stimulate that acupuncture point, molecules called nucleotides are released and converted into pain-reducing adenosine. The resulting pain relief usually lasts for hours after treatment.

PAP makes adenosine too and when injected in the spine, its pain relieving effects last for days. Zylka wondered if blending the two could boost pain control even more so his team tested the idea by injecting PAP into an acupuncture point behind the knee.

They learned two key things: 

1. When PAP was paired with acupuncture, pain relief lasted 100 times longer than conventional acupuncture. Researchers dubbed the combo “PAPupuncture.”

2. Choosing a different injection site (other than the spine) allowed PAP doses to be increased and as a result, one injection worked to reduce inflammatory pain and neuropathic pain symptoms.

The tests on animals worked so well that human trials are coming up next.

 

Those who want to read the study can click this title: PAPupuncture has localized and long-lasting antinociceptive effects in mouse models of acute and chronic pain, by Julie K. Hurt and Mark J. Zylka, Molecular Pain 2012, 8:28. doi: 10.1186/1744-8069-8-28

 

© 2012, all rights reserved

Dr. Andrew Weil’s “Spontaneous Happiness” works for Jackie Dishner

 

Today brings several firsts for AltMedForYou – our first guest post, first book review, and first exchange of posts between blogs. We begin with our guest’s great review of a book by a giant in the field of alternative medicine. I hope you’ll enjoy this review as much as I did and I encourage you to visit the writer’s blog often. (You’ll find my article about positive visualization posted there today.)

JackieDishner_2129Web

GUEST BLOGGER  Jackie Dishner, author of BACKROADS & BYWAYS OF ARIZONA, is a freelance writer who specializes in design, self-help and travel. She writes for consumer magazines, trade publications and websites. She blogs at BIKE WITH JACKIE, where she posts inspirational messages and discusses her BIKE philosophy and its mind-body connection, which can lead you to spontaneous happiness, a topic Dr. Andrew Weil recently wrote about in his latest book. Jackie has the review for you here.

Spontaneous Happiness

By Andrew Weil, MD

282 pp. Little, Brown and Company, $27.99

 

If you think being a happy person means you have to smile 24/7, you can relax. In Spontaneous Happiness, Dr. Andrew Weil, one of the founders of integrative medicine and a professor at the University of Arizona in Tucson dissolves that fallacy.

 

Spontaneous happiness, he says is more about finding that middle ground, that sense of contentment, serenity, comfort, balance and resilience. You won’t have all of this all the time, and you don’t have to. Are you relieved?

 

You should be. In his book about happiness, the New York Times bestselling author – he’s written 12 books that deal with some form of integrative medicine – shares his theory about how you can achieve this emotional well-being.

   SpontaneousHappiness_book

Starting with his thoughts about why people are so depressed – Do you realize 1 in 10 of us here in the U.S., including our children, take one or more antidepressant drugs and that the World Health Organization predicts that by 2030 more people worldwide will be affected by depression than any other health condition? – Dr. Weil’s book goes on to offer solutions for your unhappiness. His prerogative would be that you make a few lifestyle changes, as opposed to filling another prescription. Yet, he doesn’t fully discount medication for those with extreme mental health issues, such as bi-polar disorder.

 

 

But he doesn’t hold back, either, when it comes to suggesting a depression epidemic is taking place that might have in fact been manufactured. Pharmaceutical companies, the big insurers, and corporate healthcare prosper and have huge incentive to keep the epidemic growing. More than 164 million antidepressant prescriptions were written in 2008, worth $9.6 billion in U.S. sales, he writes.

 

Dr. Weil cites various research and includes interviews with other integrative or alternative medicine practitioners. One, a Native American healer, says something as simple as gathering a circle of friends for support and prayer can do wonders for all dimensions of the human experience: physical, mental, social and spiritual.  

 

Among the many informative points, Dr. Weil addresses how physical disease can be tied to your emotions, the critical importance of physical activity, the importance of touch, and he also mentions visualization, breathe work, and his concern that technology is socially isolating us from each other.

 

The part I like best about this book is the “8-week Program for Optimal Well-Being” he walks you through at the end. After explaining the various types of alternative therapies you can do to connect with your own sense of contentment, serenity, comfort, balance and resilience, he gives you a plan to see it through. The program requires you to answer a lot of questions each week about your general health and lifestyle, followed by some very specific tasks to take care of your body, mind and spirit. His point is to get you to connect with where you really are in life right now so you can get where you really want to be.

 

Clearly, spontaneous happiness doesn’t happen overnight.

 

                                                       *   *   *

© 2012 by Jackie Dishner, all rights reserved.

Acupressure Tap Technique

 

Acupuncture can be a wonderful remedy for many conditions. It’s one of the oldest healing practices in the world.

 

Studies investigating its effectiveness for knee pain, lower back pain, cancer pain, alcohol addiction, chronic stress, polycystic ovary syndrome, asthma, allergies, and other ailments have been mixed, according to Research Results posted on the National Center for Complementary and Alternative Medicine website. 

 

How it works:

 

A trained acupuncturist inserts super-fine acupuncture needles at “meridians” or acupuncture points where energy flow may be blocked or stagnant to elevate spirits, ease pain, and promote healing. The needles are so thin that they’re barely noticeable when inserted just under the skin.

 

There’s also a no-needle version called acupressure that works on the same principles, but instead of using needles to stimulate acupuncture points, pressure is applied with fingers, thumbs and hands. 

 

Yet another variation uses tapping instead of needles or fingers to activate the same acupuncture points. It’s designed for do-it-yourselfers—people who want to learn how to use these techniques on their own to manage their own health concerns.

 

If you’re interested in trying it, check out the 20-something how-to demonstration video that expert Gina Green has uploaded to YouTube.com. They show  exactly how to use the techniques for various problems. Green’s  instructions are clear, direct, and easy to swallow.

 

I believe many of her techniques work. What do you think?

 

 

 

© 2012 all rights reserved.