We live at an exciting crossroads in the world of health care. Ancient medical systems like Ayurveda and traditional chinese medicine are as accessible as modern medical treatments like pharmaceuticals and surgery. One excels at systemic issues, the other excels at acute issues. While the choice is something to celebrate, it can also be overwhelming: We can end up confused about when to choose what and how to sift through the possibilities.
To help you navigate through the maze of integrative medicine treatment options, both for your loved one and for yourself (hey, what caregiver couldn't use a massage?), I have interviewed leaders in the field and will be writing a series of blog posts on topic. To kick off the series, here is my interview with Andrew Weil, M.D., founder and director of the Arizona Center for Integrative Medicine at the College of Medicine at the University of Arizona.
Tory Zellick: What are the benefits of taking an integrative approach to medicine?
Andrew Weil: I define integrative medicine as healing-oriented medicine that takes into account the whole person (body, mind, and spirit) and that includes all aspects of diet and lifestyle. Integrative medicine emphasizes the therapeutic relationship between patient and healthcare practitioner and makes use of all appropriate therapies -- both conventional and alternative. While open to new paradigms, the field is inquiry-driven and based in good science.
Following healthy diet and lifestyle practices enhances overall balance and supports the body's innate healing capacity, thereby helping to optimize physical, emotional, and spiritual health and to prevent disease. I consider many complementary and alternative medicine (CAM) therapies to be core components of integrative medicine. I respect and honor the traditions behind these practices and believe they can offer therapeutic benefit in a variety of clinical settings.
Integrative medicine -- with its emphasis on diet and lifestyle, disease prevention and health promotion -- is the only practical way to transform our healthcare system and bring lower-cost, health-enhancing treatments into the mainstream, for the benefit of all.
TZ: If someone is only familiar with conventional medicine options, what is your general guidance for getting to know the world of CAM?
AW: Speak with your doctor about the CAM therapies you are considering or already using and ask for his or her opinion. A healing relationship between patient and health care practitioner is based in open, non-judgmental communication. If your doctor voices concern, ask for an explanation. There are clinical situations where a particular CAM therapy should not be used or could prove dangerous. If you suspect your doctor may not know about a specific CAM therapy that interests you, bring information about the method or agent to your appointment, so that your doctor can evaluate it with you. If your doctor simply is not open to lifestyle and CAM interventions, it may be time to find a new doctor.
Look for a knowledgeable primary care physician with whom you can partner to make good health care decisions about which diet, lifestyle changes [and] conventional and CAM therapies might be indicated, safe and most effective for you. Ask around for an experienced conventional medical provider who exemplifies good health in appearance, diet and lifestyle. The doctor should respect your value system, honor the complex nature of health and healing, and focus not only on symptom relief but also resolving the root cause of symptoms and illness. Ideally, work with a doctor who has personal experience with CAM therapies as well as relationships with the licensed CAM providers in your community.
The demand for physicians who practice integrative medicine, or who are at least open to its goals, is still far greater than the supply, but things are improving. I recommend looking for a practitioner in your region who has completed training at the Arizona Center for Integrative Medicine (AzCIM), which I direct.
TZ: What are some especially safe CAM therapies, with the lowest possible risk, that are useful in responding to most health conditions?
AW: Many conventional health care providers consider nutrition to be a complementary therapy, which speaks to the sad state of medicine in this country. Good nutrition is one of the most important factors shaping health, and it is important to learn how specific foods affect inflammation in the body -- as part of an overall strategy for reducing the risk for chronic illness.
I believe that the cornerstone of a healthy lifestyle is a nutritious and satisfying anti-inflammatory diet that emphasizes a wide range of brightly-colored fresh fruits and vegetables; whole grains and other slow-digesting carbohydrates; fatty cold-water fish, for their anti-inflammatory omega-3 fats; vegetable sources of protein including beans, lentils, and fermented whole soy products; seeds, nuts and spices; and the appropriate use of vitamins and supplements. Beverages of choice should be pure water and good green tea. In addition, it is important to lessen exposure to foods that promote inflammation by reducing the intake of highly-processed, manufactured foods and rapidly-digesting carbohydrates; avoiding fast food and products containing partially-hydrogenated oils or vegetable shortening; and minimizing the use of polyunsaturated oils such as sunflower, safflower, soy, and corn.
Specific CAM interventions offer the potential for general health benefits -- such as mind/body therapies, including meditation and guided imagery, massage therapy, clinical hypnosis, chiropractic and osteopathic manipulation, and acupuncture. These treatments can be considered safe and effective for the prevention and treatment of disease, when used appropriately and delivered by experts in the respective fields.
TZ: How can someone know when it is time to use a conventional therapy and when it is time to use a CAM therapy?
AW: Symptoms that are unusually severe, persistent, or out of the range of your normal experience warrant immediate medical attention by a conventional medical doctor. A dose of common sense helps, too: Do not rely on CAM therapies for a health condition that conventional medicine can manage well.
Physical trauma is a good example of a clinical circumstance where conventional medical care is unquestionably indicated. If I were involved in a serious automobile accident, I would hope that paramedics would be called. I would want to be transported directly to an emergency care facility, in a modern hospital, not to the office of a massage therapist or acupuncturist. That said, once out of danger, I might use the massage and acupuncture resources to help speed up the natural healing process.
There are a few other clinical situations where a conventional medical approach is definitely warranted: Acute surgical and medical emergencies such as a ruptured appendix or heart attack, treatment of bacterial infections, and the diagnosis of complex medical problems. Conventional medicine, however, is generally less effective in the treatment and cure of viral infections, chronic degenerative diseases, chronic pain and most forms of allergic or autoimmune disease. These types of clinical scenarios often respond well to carefully-chosen CAM modalities.
Explore diet and lifestyle changes or CAM therapies individually, allowing enough time -- usually six to eight weeks -- to experience benefit and judge results, before moving on. If symptoms worsen or fail to subside, schedule an appointment with your conventional doctor, for evaluation.
TZ: How open do you find that today's conventional doctors are towards CAM therapies?
AW: Conventional medical doctors are even more fed up than patients with the drug-only approach to preventing and treating illness. Today's health care providers are hungry for the opportunity to better help patients access their innate healing capacities, even if the environment in which they work does not readily support the approach -- for example, if insurance company refuses to reimburse alternative treatment.
In recent years, there has been an exponential rise in the number of conventional medical practitioners exposed to integrative medicine, and through our educational programs, AzCIM has played a prominent role in shifting the perspectives of conventional doctors. AzCIM is working toward the day where integrative medicine will be a standard part of the medical school and residency curriculum, so that no future doctor will leave medical training without a working concept of health, an in-depth understanding of the importance of healthy dietary and lifestyle measures, and an appreciation for the therapeutic potential inherent in healing traditions from around the world.
AzCIM also has sponsored national integrative medicine conferences for practicing health professionals, and these conferences have been consistently well-attended. In addition, AzCIM offers a variety of popular educational courses for the public, on the topic of integrative approaches to health. The success of AzCIM has catalyzed or influenced the creation of similar programs across the country.
As far as the lay public's recognition of integrative medicine, some people may not have recognized the term, even five years ago. But the dissemination of integrative health care information among health care providers, combined with an explosion in media coverage and a growing number of credible websites devoted to integrative health care, has resulted in widespread awareness of integrative medicine and its potential to help heal not only individuals, but also and our entire health care system.
TZ: What are some of the simplest and/or most helpful CAM-based stress management tools that caregivers can utilize, to improve their sense of wellness?
AW: Everyone needs to practice effective means of stress management to optimize health and wellbeing, and nowhere is this advice more applicable than for caregivers. I teach a variety of techniques, including meditation, regular exercise, and laughter, but my favorite method for managing stress is the 4-7-8 (or "Relaxing Breath") exercise. Here is how you do it:
Sit or lie in a comfortable position and place the tip of your tongue just behind your upper teeth, throughout the exercise:
- Exhale completely through your mouth, making a gentle "whoosh" sound.
- Close your mouth and inhale quietly through your nose to a count of four.
- Hold your breath for a count of seven.
- Exhale completely through your mouth ("whoosh") to a count of eight.
- Inhale and repeat the cycle three more times, for a total of four breaths.
My heartfelt thanks to Dr. Weil for sharing his time and expertise! I hope this information helps guide you and your loved along the journey through the world of integrative medicine. Stay tuned for the next post in this series -- an interview with New York Times best-selling author Joseph Mercola, MD.
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