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Recently, major medical schools have added programs to teach what were once fringe treatments. FITNESS reports on why doctors are changing their minds about alternative medicine, and how you can benefit:
Elizabeth Granai's first pregnancy nearly killed her. Diagnosed with severe preeclampsia and HELLP (hemolysis, elevated liver enzymes, low platelet counts) syndrome, a serious pregnancy disorder that put her into liver and kidney failure, she delivered her daughter six weeks early by emergency c-section. Three years later, in 2005, after several miscarriages, Granai, at age 35, was expecting again, only this time her health was even more fraught. She'd been diagnosed with an autoimmune disorder that causes blood-clotting problems in pregnancy. "It was a very high-risk pregnancy, and I didn't feel comfortable taking the blood thinners the doctor prescribed," she says. While doing research on the Internet, she read that acupuncture could help with blood flow to the baby, and decided to give it a try. To her surprise, after just one session, Granai's upper abdominal pain (typical of HELLP syndrome) and severe morning sickness were gone. "I didn't know it was possible to feel healthy while pregnant," Granai says. Impressed, she went back for 23 more sessions, and in conjunction with her ob-gyn, consulted a doctor who specialized in integrative medicine.
It's not revolutionary that Granai used acupuncture -- more than one-third of Americans take herbs, get massages, or use acupuncture or some other form of complementary or alternative medicine, according to a National Institutes of Health survey. What is notable is who the doctor she consulted was: Tracy W. Gaudet, MD, who heads Duke Integrative Medicine, a multimillion-dollar program with a beautiful new building on the campus of Duke University School of Medicine -- one of the most prestigious medical institutions in the country.
Under the care of her ob-gyn, using integrative health strategies mapped out by Dr. Gaudet, Granai gave birth to a healthy baby boy in December 2005, without taking blood thinners or experiencing any complications. "Elizabeth's case powerfully illustrates the value of an integrative approach," says Dr. Gaudet. "Often, the patients who benefit most are those whose cases are the most confusing to conventional medicine."
Granai's experience is also proof of the turnabout that's happening in relation to alternative and complementary treatments: Mainstream physicians and major medical institutions are increasingly using these nonconventional therapies in their everyday practices. In a recent Mayo Clinic survey, for example, 57 percent of doctors believed that doing so would make patients more satisfied with their care, and 44 percent said they?d refer patients to a credentialed alternative therapist. What's more, these programs have taken root at Johns Hopkins, Columbia, Stanford, and Harvard universities, as well as the Mayo Clinic -- to name just a few. "To me, the fact that Johns Hopkins is offering acupuncture as a clinical service is revolutionary," says Adrian Dobs, MD, director of the Center for Complementary and Alternative Medicine at Johns Hopkins School of Medicine. "We're a conservative institution, but we've realized that therapies we used to think were worthless may in fact help our patients."
You can also tell doctors' thinking has changed by listening to them talk. "Today we think in terms of 'integrative medicine,' in which both approaches are embraced as standard medical treatment," says Brent A. Bauer, MD, director of the Mayo Clinic's Complementary and Integrative Medicine Program. "'Alternative' sounds pejorative, while 'complementary' means the two approaches are used next to each other."
The switch from "alternative" to "integrative" has been slow, albeit steady, and not all doctors are on board. But patient demand is pushing physicians to be at least somewhat knowledgeable about nontraditional treatments, and a body of research is building. "Patients used to come in with questions about treatments, and we didn't have answers. If you wanted to know whether acupuncture could help, there weren't 10 good studies we could pull, and that was frustrating," says Dr. Bauer. That started to change in 1992, with the establishment of the Office of Alternative Medicine (OAM) within the National Institutes of Health. With the support of lawmakers, the office started funneling money into studies of alternative therapies. By 1999, the OAM had morphed into an NIH Center -- the National Center for Complementary and Alternative Medicine (NCCAM), with a $50 million budget. "With funds available, more researchers began to say, 'Maybe there is something here,' and started studying," says Dr. Dobs. "As a result, there's now a base of knowledge that many doctors feel comfortable with."5 Steps You Can Take
Not every town has a world-class medical school with doctors trained in integrative medicine. But many MDs have some familiarity with alternative therapies and can refer you to practitioners. Here's how to identify therapies for you -- and find someone qualified to administer them.
1. Do research online.
Put the most trust in reputable institutions like the NCCAM (nccam.nih.gov) and academic sources like the University of Maryland School of Medicine's Center for Integrative Medicine, which has an extensive online library (umm.edu/altmed). The National Library of Medicine (nlm.nih.gov) lets you search published studies easily. Type the words "review" or "meta-analysis" into your search to bring up articles that summarize all the research out there on a treatment, says Dr. Dobs.
2. Run it past your doctor.
"Say, 'I'm interested in XYZ and I'd like your opinion,'" recommends Sara Warber, MD, who trained with a Native American healer before she became a doctor and, eventually, codirector of the University of Michigan Integrative Medicine program. "That won't put your physician on the defensive, and it gives him or her an opportunity to weigh in." Also pay attention to how the doctor phrases a response. "Loaded words like 'worthless,' 'junk' and 'waste of money' are the language of bias, not knowledge," says Dr. Warber. "A knowledgeable doctor can make the same point by saying something like, 'The current evidence doesn't support this treatment, but it doesn't appear to be harmful.'" A physician who doesn't know a lot about the therapy you're interested in should refer you to someone who does.
3. Evaluate practitioners.
Check national certifying organizations, such as the American Herbalists Guild or the American Academy of Medical Acupuncture, to find practitioners near you who meet the group's professional standards. For links to a wide range of professional organizations, go to the American Holistic Health Association at ahha.org.
4. Meet the expert.
Choose a doctor who sees your treatment as a complement to medical care -- not a replacement -- then sit down to talk. "Often, patients have never told anyone the whole story of their illness, and that alone can be therapeutic," says Dr. Warber. In addition to your medical history, Dr. Gaudet explains that she wants to know about the psychological and spiritual aspects. "Health extends beyond the physical body," she adds.
5. Discuss the downsides.
Natural doesn't mean harmless. Talk with your doctor about a treatment's potential side effects and whether it could cause drug interactions with any other medicine you're taking. Because few doctors have extensive background in complementary medicine, there's a greater burden on patients to do the homework about treatment options, says Dr. Bauer. But those who do say it's worth the effort. Says Granai, "Integrative medicine played a big part in saving my pregnancy -- and probably my life."
5 therapies that really work -- research shows it:
Studies have found that acupuncture, a traditional Chinese procedure in which ultrafine, sterile needles are inserted into specific points of the body to redirect energy (chi) and improve symptoms, can quell nausea and reduce some types of pain. But doctors say its effectiveness may not come just from energy flow. "Acupuncture could just as plausibly stimulate the release of neurotransmitters, chemicals in the brain that can act as natural painkillers," says Dr. Bauer. Acupuncture needling sites can sometimes bleed or bruise, so acupuncture isn't generally recommended for anyone who has a bleeding disorder or who takes blood thinners.
Beyond the "mmms," studies show that massage eases anxiety and pain -- even for patients who have serious, chronic conditions like cancer or who are recovering from heart surgery. Preliminary research at the University of Miami School of Medicine suggests that massage boosts the immune system in women with breast cancer and young people with HIV, and helps ease withdrawal symptoms for smokers trying to quit.
3. Imagery and Meditation
Both techniques calm the mind by focusing on breathing, for example, or a mental picture of a peaceful setting, which helps the body relax and relieves stress. They also engage the brain in ways that can have other beneficial effects. One recent study found that people who watched their own brain activity while undergoing a brain scan could use a technique like imagery to consciously control their perception of pain.
4. Herbal Medicine
Herbs that seem to work and have a good safety profile include peppermint for digestive problems, valerian for insomnia, butterbur for hay fever, ginger for motion sickness, and ginseng for enhanced mental performance, such as improved concentration. Research suggests that green tea may lower the risk of several types of cancer, improve cholesterol levels, and reduce the risk of stroke. Be sure to tell your doctors about all the herbs you take, to make sure they don't interact with any other medical treatment. For example, ginseng can raise blood pressure and cause you to bleed more easily. "Make dosage decisions with the help of your physician," says Dr. Bauer.
5. Spinal Manipulation
This treatment (usually done by a chiropractor or osteopath) is helpful mainly for relieving chronic low back pain, headache, and neck pain. One review of 43 studies concluded that spinal-manipulation therapy may relieve back pain as effectively as prescription nonsteroidal anti-inflammatory drugs do. Avoid it if you have symptoms of nerve damage or any cardiovascular problems involving arteries in your neck. And ask upfront how many sessions you'll need, so that you won't be told to come back indefinitely for "adjustments."
Originally published in FITNESS magazine, July 2007.