Break a leg, and there’s nothing better than what an ER can do to
get you on the mend. Develop a puzzling, chronic illness or pain, and
sometimes modern medicine can use a little help.
“There are lots of things Western medicine does really well,”
says Kate Niehoff, MD, a family medicine practitioner at Torrance Memorial
Medicine Center. “And there also are areas where it can fall short.
Integrative medicine can help fill in those gaps. Many of the practices
optimize a patient’s health so we can cut off a condition before
it becomes a full-blown illness,” she adds.
Many Americans, including South Bay residents, are agreeing with Dr. Niehoff.
Nearly 40% of U.S. adults are using some sort of complementary or alternative
medicine (CAM), including supplements and herbs, lifestyle practices such
as meditation or yoga, or modalities like acupuncture or chiropractic.
“Really any condition can benefit from an integration of therapies,”
Dr. Niehoff says. “The ones I find people seek out the most are
for chronic conditions such as pain, insomnia, mood disorders, anxiety
and depression, metabolic syndrome, obesity, fibromyalgia, MS and others.”
Often patients seek out CAM as a last resort. “Any condition for
which the Western world hasn’t found a ‘miracle’ treatment,
those patients look for alternatives,” Dr. Niehoff explains.
Wade Nishimoto, MD, an oncologist at Torrance Memorial, used several tried-and-true
medications to relieve his chemotherapy patient’s nausea, with no
success. “Let’s try acupuncture,” he suggested. It worked.
Dr. Nishimoto has recommended a variety of nonconventional (non-Western)
therapies like acupuncture to his patients, thanks to success stories
like this one. And more and more, research is showing the benefits of
using Eastern medicine therapies to complement Western medicine, and in
the case of cancer treatment, to enhance standard chemotherapies.
“There are many things we can do in place of pills to relieve pain,
stress and nausea,” Dr. Nishimoto says. He is known to recommend
aromatherapy, herbal therapy and visual imagery to his patients before,
during and after chemotherapy, and he recommends meditation and massage
therapy too.
“I try to take a more natural approach when I can,” he says,
adding that more than half of oncology patients are using some form of
alternative therapy to complement standard-of-care treatment.
Acupuncture and Reiki (energy healing), meditation and breathing exercises,
yoga, Tai Chi and Qi Gong (movement and balance), massage, herbs and supplements,
nutrition and exercise counseling are some of the therapies that have
played a role in disease prevention and treatment in other countries for
thousands of years.
As these therapies gain popularity in the United States, with more Americans
turning to them for overall health and well-being, physicians and researchers
are taking note. And the use of integrative medicine—mainstream
medicine combined with complementary therapies to speed the healing process
(or prevent disease altogether)—is becoming increasingly common.
COMPLEMENTARY, ALTERNATIVE AND INTEGRATIVE DEFINED
The federal government is also taking the trend seriously. The National
Institutes of Health has an agency dedicated to research on integrative
medicine called the National Center for Complementary and Integrative
Health (NCCIH).
The NCCIH defines complementary medicine as “when nonmainstream practice is
used together with conventional (Western) medicine.” It defines alternative medicine
as “when nonmainstream practice is
used in place of conventional medicine” and adds that strictly adhering to alternative
medicine is uncommon. And it defines integrative medicine as “bringing
conventional and complementary approaches together in a coordinated way.”
The NCCIH has also set forth principles of integrative medicine, defined as:
• A partnership between patient and practitioner in the healing process
• Appropriate use of conventional and alternative methods to facili-
tate the body’s innate healing response
• Consideration of all factors that influence health, wellness and
disease, including mind, spirit and community as well as body
• A philosophy that neither rejects conventional medicine nor accepts
alternative therapies uncritically
• Recognition that good medicine should be based in good science,
be inquiry-driven and be open to new paradigms
• Use of natural, effective, less-invasive interventions whenever possible
• Use of the broader concepts of promotion of health and the prevention
of illness as well as the treatment of disease
• Training of practitioners to be models of health and healing, committed
to the process of self-exploration and self- development
IMPORTANCE OF AN OPEN MIND
“It’s generally a good idea for both physician and patient
to be open to exploring mind-body
therapies as treatment options,” says Tim Norcross, DO, of Norcross
Family Medicine in Rolling Hills Estates.
“As a healthcare provider in the year 2017, if you’re not in
step with integrative medicine, you’re going to fall behind,”
Norcross states. “More and more patients are asking about complementary
and alternative treatments. They’re reading about them online, they’re
increasingly skeptical of drugs and pharmaceutical companies, and they’re
taking a more proactive approach with their health.”
Despite the growing popularity, alternative therapies can still carry a
stigma. This is due in large part to some alternative practitioners refusing
to accept any Western medicine techniques, practice that can be dangerous—
especially with certain medical conditions.
And physicians can be hesitant to deviate from conventional medical care
because of liability concerns, or they may feel they’re not educated
enough on alternative therapies to confidently recommend them and there’s
only so much time in the day to study up on them, according to Dr. Norcross.
Patients are sometimes skeptical too, but being receptive means a greater
likelihood of positive response to the therapy, he adds. “I always
tell patients that if we’re not seeing results, no harm done; we
can stop and try something else.”
Radiologist Albert Grabb, MD, is a staunch advocate of mindfulness meditation
and commonly incorporates it into his medical practice. But that wasn’t
always the case.
“I was extraordinarily skeptical for a very long time,” Dr.
Grabb admits. “One day, I had an epiphany. I started meditating
20 minutes a day, every day, and after a few months I had stopped a 50-year
nail-biting habit. My anxiety had been dramatically reduced and I became
a believer.”
Today he teaches a mindfulness course at Torrance Memorial for staff and
has seen the positive effects of meditation in himself and others.
At work he commonly guides his patients through mindfulness using breath
exercises. “They’re often anxious when they come in for a
procedure,” Dr. Grabb says. “After a short session of having
them pay attention to their breath, they are usually more relaxed and
have a much easier time with the procedure.”
“I can’t say meditation will work for everyone. However, for
me it has been transformational. Plus, I’ve followed the scientific
literature for years now and there is increasing evidence that meditation
is beneficial in a variety of ways.”
KEEPING EXPECTATIONS IN CHECK
Conditions that are known to respond well to complementary and alternative
therapies include arthritis, type 2 diabetes, metabolic syndrome, preventative
cardiac disease and musculoskeletal conditions—those that are safe
to manage over a longer period of time.
And with that, Dr. Norcross advises giving the therapy a bit of time before
expecting to see results and to use that time to get more in tune with
your body. “Integrative medicine puts responsibility on the patient
to be more accountable,” he says. “It’s a more natural
process than taking medication, but that’s the way it should be.
We shouldn’t just swallow a pill and consider our part done.”
“At the same time, never just go rogue and leave all the prescriptions
behind, because that can be dangerous. Instead, these therapies should
be complementary to your treatment plan and also be a long-term approach
to wellness and good health.”
Melodie Blankinship of Torrance, a cancer survivor, is currently in treatment.
She also has Meniere’s disease, a disease of the inner ear that
causes vertigo. Four years ago, chemotherapy was exacerbating the frequency
and intensity of her dizzy spells. Desperate for relief, Blankinship was
directed to a local acupuncturist by her ear, nose and throat doctor when
the only other alternative was to remove her inner ear.
“Within a month of starting acupuncture,” Blankinship says,
“my Meniere’s disease was gone. That was three years ago.”
“Today my acupuncturist adjusts my treatment based on what is bothering
me due to chemo—whether it’s low energy, vomiting, pain levels,
trouble sleeping. It’s hard to put into words what acupuncture has
done for my quality of life. I truly believe in it.”
BODY IN MOTION: YOGA AND TAI CHI AT WORK
Lisa Columbus has been a dancer and a body builder, has done Zumba and
Pilates and
“countless yoga classes.”
But she underwent a back surgery and two neck surgeries and was in “constant
pain,” she says. Then, she discovered Fayzaneh Jafari’s Yoga
Therapy/Somatics, a class that teaches slow, very deliberate movement
designed to bring the body, muscle and mind together, at Torrance Memorial
Health Education Center.
It changed everything. “I went to a pain management clinic for more
than a year,” Columbus recalls. “I tried steroid injections,
major drugs and even acupuncture. None of it worked for me. I’ve
been taking this class for a little more than a year and am off the major
pain meds, my mobility has improved and more importantly, I’ve learned
to treat myself with kindness and respect.”
Instructor Jafari, like many who educate others in mind/body practices,
had her own experience with a condition that was not improving with conventional
therapies. “I personally had an illness, lots of treatments and
surgeries, and yoga therapy alone was not doing anything. I decided to
apply Hanna Somatics (named for its founder Thomas Hanna), which is a
form of neuromuscular reeducation.”
Somatics, she says, targets a condition called sensory motor amnesia, which
causes muscles that have been traumatized as a reaction to pain, injury
and even stress to stay contracted. “We first contract the muscle,
then allow it to lengthen slowly. We never ‘stretch,’ ”
Jafari explains. “The somatics part of the class is quite unexpected
to some,” Jafari says with a laugh. “In fact, I first tried
out the somatics when I was subbing in a yoga class; the students said,
‘What was that?’
Many people have tried other yoga classes, but this is better for them.
Some people walk into class and then never come back, but the people who
are seekers realize what it gives them.” She has seen some remarkable
recoveries as well: “My students with fibromyalgia are doing wonderfully
right now. I have two 79-year-olds who did nothing but somatics for six
months, and when we finally got to the yoga balance poses, they could
do them. They were so surprised.”
“It took me some time to understand the Somatic concept,” says
Lisa Columbus. “But I’ve learned to surrender my body to working
on a small and concentrated level and not try to override my limitations
anymore. And I’ve seen students who are also in physical pain do
things they haven’t been able to do before. It’s great to
see the look of amazement on their faces.”
No less remarkable are the results instructor Richard Goodman has seen
in his Tai Chi classes offered by Torrance Memorial. “People take
my class for many different reasons, mostly for health benefits and balance
issues. Then they start to like it because they feel more relaxed. And
some advanced classes want to do it for self defense. I have 80- and 90-year-olds
who got into the knives and swords classes.” Some of the most remarkable,
Goodman says, are patients with conditions such as Parkinson’s,
who find the slow, repetitive movement helps with their balance and control.
“Doing Tai Chi is fun, light, like swimming in air. It’s centering
and being present in the moment,” he adds. “And it’s
not a cure, but it definitely helps— especially if people also do
it on their own. We see students who come in using walkers and then canes
and then start using their canes as ‘double knives.’”
FINDING THE RIGHT ALTERNATIVE PRACTITIONER
Torrance Memorial employs practitioners trained to deal with medical issues,
and classes in
yoga, meditation and energy healing are also available for patients. “What
I talk to people about the most tends to be how to eat healthfully, on
the anti-inflammatory food grid,” Dr. Niehoff says. “Other
things include vitamins and supplements, what would be worthwhile and
what can cause problems. I also recommend Reiki and energy medicine.”
There is an abundance of alternative medicine practitioners in the community
as well. Discuss options with your doctor and then learn as much as possible
about the practitioner you are considering, including education, training,
licensing and certification.
It’s very important that any practitioner be willing to be part of
and work with a patient’s conventional healthcare team so everyone
can be in the loop. This is particularly important as it relates to oncology.
Communication is critical.
Insurance is another consideration. While more insurance companies are
covering alternative therapies, the amount of coverage varies, so check
with your provider and the practitioner.
PREVENTION IS GOOD MEDICINE TOO
Graziadio Wellness Center at Torrance Memorial offers a complementary therapy
program for patients and also sponsors free lectures for the public, centered
on integrative medicine and mind-body wellness.
Drs. Nishimoto, Norcross and Grabb are all members of the Graziadio Wellness
Center committee, which oversees the lecture series; previous topics have
included neurofeedback and the mind-body connection, nutrition and supplements,
and power foods for the brain.
An overarching goal of the committee is to inform people about how to reduce
stress and stay healthy and out of the hospital altogether. “Just
as we have a fight or flight response system,” explains Dr. Grabb,
“we also have a calm and connect system. When we activate that system,
we are able to engage with others more attentively and be more focused
and in the moment, which relieves stress. In the moment is where we’re
supposed to be—it’s trite, but it’s how we’re
made.”
“Meditation and simple breath work can have great effects on mood
and anxiety, and just dealing with day-to-day stress,” Dr. Neihoff
says, “And massage can be wonderfully beneficial.” Dr. Nishimoto
agrees, adding, “There’s so much we can do to enhance our
well-being. And that’s really terrific.
“Because who wants to take a pill for everything?”
For more information about the Graziadio Wellness Center and the lecture
series, please call 310-517-4711.