Check out this week’s excellent Grand Rounds roundup of medical/health posts in the blogosphere, hosted by David Williams of the Health Business Blog. I’m happy that my post about “The Unhealthy Health Care System” was included. Topics of other posts include the complexity of doctor-patient relationships, patient tales, wellness, health technology and health policy.
Tag Archives: Healing
How progressive of the US military to use yoga as a treatment for soldiers returning from Iraq with post-traumatic stress disorder. As reported in the May 6 Washington Post, the Specialized Care Program at Walter Reed Army Medical Center focuses on helping service members returning from Iraq and Afghanistan cope with the flashbacks and nightmares typical of post-traumatic stress disorder, which affects 20 percent of the approximately 1.6 million U.S. military personnel who have served in Iraq or Afghanistan, according to a Rand study released last month. The program uses a guided meditation technique called yoga nidra, which I know from personal experience to create a profound state of relaxation.
We can exercise, watch what we eat, take cold showers, practice yoga and Tai chi, meditate for peace of mind. But even if we are doing everything we can to “own our health,” we’re still going to need a doctor someday. Good luck finding one.
The Massachusetts Medical Society’s 2007 Physician Workforce Study found physician shortages in primary care (family practice and internal medicine), psychiatry, and vascular surgery for the second consecutive year. Anesthesiology, cardiology, gastroenterology, and neurosurgery remain in short supply, while urology appears on the list for the first time. In public opinion surveys conducted as part of the study, the Society also found that access to primary care physicians, as well as some specialists, remains strained, and waiting times for appointments are increasing.
The American College of Physicians recently warned that “primary care, the backbone of the nation’s health care system, is at grave risk of collapse.” Fewer internal medicine residency graduates are choosing to become primary care physicians (PCPs)—18 percent in 2006, down from 50 percent in 2000—and existing PCPs are unhappy in their jobs, with many choosing to leave the field.
What this means is that it is harder and harder to find a primary care physician, and, when you do find one, it is likely that he or she is overburdened with a large patient panel and hours of bureaucratic paperwork.
How then, to create the kind of meaningful healing partnership with a physician that we all need and want? These kinds of relationships take time, something that is in short supply in this era of the 15-minute medical visit. One doctor told me, “if we just saw patients in the office the way we used to, we’d go out of business. No one can break even practicing medicine alone, because the health care finance system pays you to do things to patients—colonoscopy, MRI, CT-scan, endoscopy—not merely talk to them.”
But “merely” talking is the only way to get to know us patients; the only way to understand and help us manage the stress in our lives that may be causing physical or mental illness; the only way to educate and encourage us to make healthy lifestyle choices, to take responsibility for our health. And “owning our health” may help to make those expensive tests unnecessary or avoid even more expensive hospitalization and surgery.
While we are talking about mental health, I have just read an amazing story of Duane Sherry’s intervention to help his son recover from a frightening psychotic disorder that he reports was caused by psychiatric medication. The story appears in an article on Bloomberg.cm, about overuse of psychiatric medicines for children. Mr. Sherry replaced the drugs with alternative methods and now, two years later, his son is free of all symptoms and medication. In an e-mail, Mr. Sherry commented to me that “I simply believe in the body’s own ability to heal, and that in the case of ‘mental illness’ there may be something that is out of balance in the body and not functioning correctly. This might be the thyroid, a candida or yeast infection, food absorption difficulties, lyme disease, sensitivities or allergies to various foodsor chemicals.. Whatever it is, it may be getting in the way of healthy mental function. In addition, of course there is abuse and neglect and trauma which may need to be taken into account in the treatment of mental illness. But, any sane person can see that locking people up against their will, and/or forcing them to take large amounts of mind-altering drugs is not the solution. If we had done this with my son, I believe we would have lost him.”
Today’s Boston Globe cites several studies demonstrating the effectiveness of exercise in the treatment of depression and other mental health problems. Dr. James A. Blumenthal–a professor of medical psychology at Duke University and the principal investigator of several of these studies–is quoted in the Globe as saying, “There is growing evidence that exercise may be comparable to other established treatments such as antidepressant medications.” He also found that depressed patients who were helped by exercise were less likely to relapse after 10 months than those helped by antidepressants, according to the article. In consultation with your doctor, experts cited in the Globe suggest 20-40 minutes of exercise, including weightlifting and aerobics, 3 times a week, at a level that “makes you break a sweat,” for treatment of depression, anxiety, ADHD, addiction, stress, and aggression.
We have already seen evidence that exercise can help prevent chronic disease and hospitals around the country now have “boot camp” programs for chronic back pain. Now, there is evidence that exercise is also “medicine for the brain,” in the words of Cambridge psychiatrist and author, John Ratey, MD. So let’s get out and move our bodies! Here is the link to the article.
Some people have questioned the evidence behind hydrotherapy, especially the cold water treatments that are described in the book that Alexa Fleckenstein and I co-authored. German research supports the effects of cold water used on the skin as therapy. Unfortunately, the studies are in German, and they are small. (1) Because Pharma firms have no interest in inexpensive water cures, there probably won’t be big studies any time soon. Fact is, the German insurance system pays all or part of physician-prescribed treatments, including hydrotherapy and herbs. The importance and therapeutic potential of water, and especially cold water, are now simply taken for granted in Germany.(2) Here are some specific research studies supporting the health benefits of cold water treatments. Citations are listed at the end. (More cold water research details in Own Your Health (2003)
Boosting the immune system
A pilot study of immune effects from cold water therapy with a small number of breast cancer patients found significantly increased disease-fighting cell counts in every category examined, including neutrophils, lymphocytes, monocytes.(3)
Reducing the perception of pain
In a study in Japan, cooling by ice water was one of the “competitive stimuli” that reduced the perception of the pain of a laser beam on the skin. (4)
Improved circulation and function in the legs
A Swedish group administered three weeks of alternating cold and hot hydrotherapy to the legs of patients suffering from intermittent claudication (reduced blood flow) and found that improved systolic blood pressure in ankles and toes, reduced pain, and markedly better walking ability went beyond the results of standard treatment and persisted for at least a year after treatment.(5)
Swimming in the winter?
Ten healthy subjects who regularly swim during the winter were evaluated at Berlin’s Institute of Biochemistry at Humboldt University Medical School. Their blood and urine showed increased levels of anti-oxidants, which prevent cell damage, indicating their bodies’ increased tolerance to stress.(6)
(1)Summarized in Bühring, M., Naturheilkunde: Grundlagen, Anwendungen, Ziele (Natural Medicine: Basic Application and Goals), Munich, Verlag CH Beck, 1997.
(2)Haas, S.S., Hydrotherapy and more: Adapting Kneipp’s Natural Medicine to the U.S., Complementary Medicine for the Physician, 2000; 5(8):57,61-64.
(3)Kuehn, G., Sequential hydrotherapy improves the immune response of cancer patients. In: Mizrahi A, et al., (eds.) Potentiating Health and the Crisis of the Immune System: Integrative Approaches in the Prevention and Treatment of Modern Diseases. New York: Plenum, 1997.
(4)Kakigi R., et al. Pain relief by various kinds of interference stimulation applied to the peripheral skin in humans: pain-related brain potentials following CO2 laser stimulation. J peripher Nerv Syst 1996;1:189-198.
(5)Elmstahl, S. et al., Hydrotherapy of patients with intermittent cluadication: a novel approach to improve systolic ankle pressure and reduce symptoms. Int Angiol. 1995;14:389-394.
(6) Siems, W.G., et al., Uric acid and glutatione levels during short-term whole body cold exposure. Free Radic Biol Med. 1994;16:299-305.
This is the title of an article I wrote for the current (May) issue of Prevention Magazine. It is about three women, myself included, who overcame medical catastrophes: stroke, Crohn’s disease, cancer, kidney failure. Writing these stories has convinced me yet again about the power that each of us has to “own our health.” Yes, there are times when an illness or injury is just too overwhelming, and it may be right for the person to let go. I have the utmost respect for people making that decision. At the same time, I always like to think of the possibilities of hope and fighting back, at least to increase our chances of recovery.
While it may not be sufficient, belief in one’s own ability to recover from serious illness certainly appears to be an important factor. I recently came across an interesting 2004 article by Stanford psychologist Alfred Bandura, Ph.D., in which he argues convincingly that:
“Belief in one’s efficacy to exercise control is a common pathway through which psychosocial influences affect health functioning. This core belief affects each of the basic processes of personal change—whether people even consider changing their health habits, whether they mobilize the motivation and perseverance needed to succeed should they do so, their ability to recover from setbacks and relapses, and how well they maintain the habit changes they have achieved.”
I know that my own recovery from a paralyzing stroke centered on my belief that I had the power to influence my health, and every patient I interviewed for my Own Your Health book said the same thing. Belief may not always work, but it sure gives us a fighting chance! Here is the citation for Bandura’s article, which is called “Health Promotion by Social Cognitive Means.” Health Education & Behavior, Vol. 31, No. 2, 143-164 (2004) DOI: 10.1177/1090198104263660.© 2004 Society for Public Health Education.
The slow, flowing movements look like a dance, but it is what goes on inside the body that makes Tai chi different: During a class recently, I felt as if my body were getting hooked up to a universal “filling station” and being replenished with energy. The result? Better ease of movement, increased flexibility and a sense of peaceful well-being. I do a “short form” almost every morning that takes all of ten minutes, one of the helpful ways I have found to live with Marfan syndrome.
Tai chi originated thousands of years ago as part of the ancient system of Traditional Chinese Medicine. The movements have their origins in martial arts, but are performed slowly, with controlled breathing and an awareness of the flow of energy inside the body. Tai chi has been called “moving meditation.”
Studies have found that Tai chi strengthens the immune system and can help with pain caused by osteoarthritis of the knee. In other research, Tai chi has been found to improve balance and coordination in older people, and reduce falls. It can also help with osteoporisis by increasing bone density.
All in all, not a bad ten-minute investment of time. Anyone else have Tai chi stories to share?
News from The Discovery Channel: “Treatments for depression range from medicines that can come with scary side effects to electric shock therapy, but a new paper suggests a simple cold shower might sometimes cure, and even prevent, the debilitating mood disorder.” Now I understand why I always feel so uplifted and, well, happy, after my morning cold shower gush. Continue reading