- Excerpt
OWN YOUR HEALTH:
Choosing the Best from
Alternative & Conventional Medicine
by Roanne Weisman and Brian Berman, M.D.
INTRODUCTION
Own Your Health is the first comprehensive guide to Integrative
Medicine -- an emerging practice combining conventional and alternative
treatments. The book draws from three primary sources: conventionally-trained
doctors who have become experts in alternative therapies; scientific
studies compiled by the National Institutes of Health (NIH) and the Cochrane
Collaboration; and first- person accounts from patients who have successfully
blended conventional and alternative treatments.
Own Your Health is co-written by Roanne Weisman, a medical journalist
who works with the Harvard Medical School hospitals, and Brian Berman,
M.D., director of the Complementary Medicine Program at the University
of Maryland, who oversees a massive NIH program studying alternative medicine
in the treatment of pain. Dr. Berman is widely regarded as America's leading
authority on integrative medicine.
The excerpt, below, is called "An Introduction to Integrative Medicine." It
provides an excellent overview of this new field, concluding with a rousing
call for patient empowerment. More information about the book, Own Your
Health, and authors Weisman & Berman follows the excerpt.
An Introduction to Integrative Medicine
by Roanne Weisman and Brian Berman, M.D.
Janet Madden McCourt of Pembroke,
Massachusetts, hit what she describes as "rock bottom" in 1997, when she was fifty- five. Both kidneys had
failed -- one of the effects of a deadly bone marrow cancer called multiple
myeloma. She suffered from near constant pain in her bones and from an
eruption of shingles on her legs (a searing rash caused by the same virus
that causes chicken pox in children). She needed kidney dialysis (a several-hour
procedure that uses a machine to perform the blood-cleansing work of
normal kidneys) three times a week, which left her weak and nauseated
for the entire day following the procedure. "I couldn't even walk up
the stairs," she says. To make matters worse, her construction company
was on the verge of failure because she was too ill to manage it.
Janet could not tolerate chemotherapy
for the cancer because of her failed kidneys, so her doctor prescribed
steroids. "The steroids tore a hole in
my stomach, ruined my esophagus and blew me up to a size twenty-six," she
says. "I gained so much weight that I could barely fit into extra large
sweatpants. I hated to go out because of the stares and whispered comments
about women who 'let themselves go.' I couldn't believe that as a former
model I had once thought that appearance defined who I was." As a final
indignity, she had to cut off her long blonde hair because it kept getting
in the way of the vomiting.
She knew she did not have long to
live: After a bone marrow scan, her doctor asked her if she wanted
to know the truth. "I guess you've just
told me," was her answer. Later she learned from another doctor that her
life expectancy was less than one year. As the weeks went by, her weakness,
pain and despair grew. "You get to the point where you either want your
life back or you just want it to be over," she says. Then, in October 1997,
Janet's oldest daughter called with news: She was pregnant. "Right then,
I decided that I was going to live long enough to see my first grandchild
born," says Janet. "I had been a successful businesswoman all my life,
able to do anything I set my mind to. I decided that I could conquer this
illness, too."
Four years later, Janet has not only one, but three small
grandchildren. Her cancer has been in remission most of that time,
and she has a healthy new kidney, transplanted from her sister. At
age fifty-nine, she once again has the long, silky hair and striking
features that earned her modeling jobs in New York at nineteen. But
today, that hair is coppery red instead of naturally blonde. "When I realized a few years ago that
I wasn't going to die after all," says Janet, "I decided it was time
for a new color."
~ Take Charge ~
Janet Madden McCourt is one of a
growing number of people who are seeking creative solutions to serious,
even life- threatening health problems by combining the best treatments
available from the worlds of conventional medicine and "complementary" or alternative therapies. This book tells
the stories of several women and men who recovered from injury, disease
and trauma, managed chronic pain and other health problems through each
stage of life, and took care of their families and children in the same
way. Their methods may be varied, but they share one important quality:
At some point during the course of the illness, they made a decision
to "take charge" of their health by broadening their search for physicians,
practitioners, and particular treatments that would help them. They made
the decision to own their health.
Later in this chapter, you will
learn how Janet, for example, battled "incurable" cancer
by adding meditation, other "mind-body" techniques and nutritional supplements
to her conventional cancer treatment. She then became the first person
in the world with multiple myeloma and kidney failure to undergo a life-saving
experimental kidney/bone marrow transplant at one of the finest conventional
hospitals in the world. (The procedure has since been used successfully
in other patients.)
Janet knew that neither conventional
medicine nor alternative health systems alone would save her life:
She wanted both. By taking charge of her health care the way she had
always taken charge of her life -- and "owning" her
health -- Janet embodies the concept of the "patient as healer" who works
in equal partnership with caregivers in the search for health. I hope the
stories of patients, physicians and alternative practitioners in this book
will resonate with you, and that in reading them you will gain insight,
ideas and, perhaps, hope.
~ Health Explorers ~
An increasing number of people feel,
like Janet, that their greatest chance for good health lies in combining
the best that conventional medicine has to offer with alternative or
complementary therapies. In most cases, these people are like "health explorers" --
entering largely uncharted territory: Outside the world of conventional
medicine, the health care choices are overwhelming and often confusing.
Which to choose? Meditation? Yoga? Acupuncture? Which herbal supplements?
What kind of massage?
How to combine the various possibilities? And what to tell my doctor?
Why are these people "explorers?" Because,
despite the fact that more than 40 percent of all Americans now use
some kind of complementary or alternative (CAM) treatment, they are,
for the most part, making these healthcare choices on their own. More
than 70 percent of them do not inform their conventional doctors. In
1993, David Eisenberg, M.D., of the Harvard Medical School, reported
that there were more annual visits to providers of alternative medicine
(425 million) than to all U.S. primary care physicians (388 million),
at a cost of $13.7 billion. In 1998, Eisenberg and his colleagues found
that between 1990 and 1997, the number of annual visits to CAM practitioners
went from 400 million to more than 600 million, and that the amount spent
on these practices rose from nearly $14 billion to $27 billion, most of
it not reimbursed. People seem to be patching together (and paying for)
medical care from two separate worlds.
A visit to any major bookstore in
search of healthcare information can be an overwhelming experience.
One group of shelves -- with titles such as "Your Guide to Illness and Surgery" or "The Complete Family Medical
Encyclopedia" gives you information about conventional medicine. The group
of shelves next to it is filled with such titles as "Meditation is Good
Medicine," "Herbal Remedies" or "The Complete Book of Chinese Healing." On
this second set of shelves you will find information about "alternative" forms
of treatment.
But few if any books help you combine both types
of medicine: conventional and alternative. That is the purpose of this
book. First, let's look at the difference between these two "worlds" of
medical treatment.
~ Conventional Medicine ~
The world of conventional or allopathic medicine includes powerful and
well-financed academic medical centers -- perhaps epitomized by the vast
and imposing Greek architecture of the Harvard Medical School and its
teaching hospitals. Conventional medical education, research and clinical
care are supported by billions of dollars from the National Institutes
of Health, as well as private infusions of funds from the biomedical
and pharmaceutical industries in search of ever more effective medicines.
Some doctors trained in this world
deliver their services in sleek medical institutions, filled with the
high-tech tools of the trade: magnetic resonance imaging machines capable
of "seeing" blood flow and brain activity inside
the human body; chemotherapy infusion centers delivering the latest chemical
weapons against cancer; new laboratories capable of high-speed identification
of disease-causing genetic defects in human DNA; gleaming operating rooms
equipped for minimally invasive microsurgery. Other conventional doctors
practice family medicine in community health centers and small private
practices, even providing services from vans on the street to the homeless.
Public health relies on conventional medicine to prevent and treat disease.
Conventional physicians and researchers are identifying the origins of
disease at the cellular level, scrutinizing even the genetic information
contained in the DNA within our own cells. They then use this information
to design ever more specific treatments, targeting disease-causing cells
while sparing healthy cells. In the treatment of cancer, for example, such
methods hold the promise of less destructive, more effective chemotherapy
treatments. Conventional medicine is the method of choice for the treatment
of trauma (if you have a heart attack or are injured in an automobile accident
a conventional hospital emergency room is where you want to be!), infectious
disease and surgical care.
Those who practice conventional medicine are justifiably proud of the
achievements of their profession -- especially the diagnostic, pharmacological
and surgical advances of the twentieth century. Conventional medicine has
limitations: It cannot treat most viral infections or cure most chronic,
degenerative diseases, allergies or autoimmune diseases. Treatments can
be toxic. It is ineffective in treating diseases that are psychosomatic,
and it still cannot cure many forms of cancer. Perhaps the most visible
limitation of conventional medicine is in its delivery through an unwieldy
and expensive managed care system. Despite efforts to control costs and
improve services, the managed care system often puts tremendous economic
stress on doctors and hospitals, resulting in hurried relationships between
patient and caregiver that do not promote healing.
~ Complementary and Alternative Medicine (CAM) ~
Practitioners in the world of alternative
medicine are trained in much smaller schools in this country or around
the world. (For the purpose of this book, I use the terms "alternative" and "complementary" interchangeably,
although there is a growing preference for the latter term, since most
of these practices are considered as "complements" to conventional medicine,
rather than "alternatives.") Often, the medical traditions date back
several thousand years -- for example, Chinese medicine and Ayurvedic
practice. In addition to the more widely known Oriental techniques such
as acupuncture, alternative disciplines include homeopathy; energy medicine;
such "mind-body" techniques as meditation, guided imagery, and the Alexander
technique; herbal and botanical therapies; and neuromuscular therapies
such as craniosacral work, Trager and Shiatsu massage, and other therapeutic
massage techniques; and specialized exercise methods such as Pilates.
CAM remedies are usually less toxic than conventional medicines, and the
techniques used by CAM practitioners are almost always less expensive than
conventional treatments. CAM methods can help people cope with the effects
of chronic illness and often focus on healing rather than curing; on the
health of the spirit and mind as well as of body. There is also a strong
emphasis on disease prevention. CAM therapies are generally less effective
in treating serious infectious illness and often are no substitute for
surgery.
Growing numbers of patients are turning to alternative remedies, often
because of dissatisfaction with aspects of conventional medical care. And
the world of conventional medicine is beginning to pay attention. In 2001,
the National Center for Complementary and Alternative Medicine (NCCAM),
part of the National Institutes of Health, had a budget of $92 million
(up from $2 million in 1992) to fund studies on the effectiveness of alternative
remedies, including gingko biloba to prevent Alzheimer's disease, yoga
for insomnia, and massage for lower back pain.
~ Integrative Medicine: The Best of Both Worlds ~
Increasing numbers of healthcare consumers want the best of both worlds:
They want the technological arsenal of conventional medicine to take
care of traumatic injuries, provide lifesaving intervention for heart
attacks and strokes, and treat serious illness both medically and surgically.
They want the latest techniques emerging from clinical research studies,
the most highly trained, skilled doctors and the best, most advanced
equipment.
But they also want caring, compassionate and prevention- oriented relationships
with caregivers. They are growing increasingly intolerant of the frequent
tendency of conventional doctors to consider CAM treatments as archaic
or ineffective, and of the resulting divisiveness between those who favor
alternative therapies and those who oppose them.
Physicians who practice "integrative medicine" (a
term coined at the end of the twentieth century) address these concerns.
While they may incorporate aspects of both conventional and alternative
therapies, they do not uncritically accept either. The integrative
physician explores a wider range of options to select the most effective,
least invasive, least toxic and least costly medical interventions
that are appropriate to the patient's situation, regardless of whether
these methods are conventional or alternative.
Most importantly, integrative physicians
create relationships with their patients that are compassionate partnerships,
in which the physician recognizes and respects the patient's goals,
healthcare preferences and autonomy. Studies have shown, in fact, that
the more patients feel that they "own" their
own healthcare, the better the outcomes. There are, of course, many conventional
physicians (my own among them) who practice this kind of "partnership medicine" as
well.
In addition to providing the best conventional care, integrative medicine
focuses on the preventive maintenance of health by attention to diet, exercise,
stress management and emotional well-being, according to Ralph Snyderman,
M.D., Chancellor for Health Affairs, and Andrew T. Weil, M.D., Director,
Program for Integrative Medicine at the University of Arizona College of
Medicine. In an article in the Archives of Internal Medicine (March
2002), Snyderman and Weil identify several characteristics of integrative
medicine, including an insistence that patients become active participants
in their own health, and that "doctors view their patients as whole persons
-- minds, community members and spiritual beings as well as physical bodies." They
also note that, "Most Americans who consult alternative providers would
jump at the chance to consult a physician who is well trained in scientifically
based medicine and is also open-minded and knowledgeable about the body's
innate mechanisms of healing, the role of lifestyle factors in influencing
health, and the appropriate uses of dietary supplements, herbs, and other
forms of treatment, from osteopathic manipulation to Chinese and Ayurvedic
medicine."
David Spiegel, M.D., of the Stanford
University School of Medicine, points to a weakness in conventional,
Western medical practice as one reason for the increased interest in
complementary medicine: "By and
large, doctors no longer conceive of talking, comforting, guiding, and
educating patients as 'real' interventions. Rather, it is something to
do until the injection is ready. An illness can be a lonely journey and
patients crave people who understand what the journey is like and can
stay the course with them. Thus, the apparent appetite for complementary
and alternative medicine is stimulated by the vacuum of modern medical
care. This vacuum, by the way, is being intensified by the business managers
of modern North American medicine who pump even more time and energy
out of the doctor/patient interaction by saddling doctors with more patients
per hour, reducing their autonomy, and treating them like assembly line
workers instead of professionals."
As you embark on your exploration of integrative care and finding practitioners
who are respectful of your desire to be in charge of your life, here
are several points to consider:
You are at the center of your own
healing; it is your self- healing process that the therapies you use
and the practitioners you consult should be trying to facilitate. There
is no one "right" approach for everyone, just
as there is no one "right" system of medicine. Both conventional and alternative
medicine have their weaknesses and strengths; both have their share of
wisdom and foolishness. The challenge is to look around objectively and
take those elements that make sense to you for your condition, and then
to work with knowledgeable, experienced practitioners who will help guide
you and assist you.
Remember that medicine is an art -- and art that uses the tools of science
and the information gleaned from scientific research -- but that draws
on human qualities such as compassion and trust and works with the beliefs,
preferences, and needs of each individual person to make its practice truly
effective. You, therefore, are an integral and vital part, an active participant
in the process.
.Copyright ©2003
by Roanne Weisman and Brian Berman. All rights reserved. Reprinted
here with permission of the publisher, Health Communications, Inc.
Please feel free to duplicate and distribute this file as long as its
contents are not changed and this copyright notice is intact.
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