Stayin’ Alive : Complementary and Alternative Medicine

“Tree of Life,” working design for Stoclet Frieze, Gustav Klimt, 1905/09.

Stayin’ Alive:
Towards a conscious self-health-care continuum

No system of medicine is static, and none has a monopoly on beneficial knowledge or tactics.

By Mariann G. Wizard / The Rag Blog / January 4, 2010

[Introducing a new periodic column by Rag Blogger Mariann G. Wizard, a professional science writer with a wide-ranging knowledge of natural health therapies. Readers may suggest topics for future columns, within the restrictions suggested below, in the Comments section of The Rag Blog.]

“Complementary and alternative medicine” (CAM), in the U.S. and several other nations, refers to health practices that are not currently part of “mainstream” or “conventional” medicine. This flexible definition allows for therapies that accumulate enough scientific evidence — or generate enough patient demand! — to become part of mainstream practices.

In the US, for example, chiropractic, once the domain of energetic and sometimes kooky “bone crackers,” has benefited from the experience of practitioners, the development of comprehensive theory and standards of care, and the establishment of accredited colleges, and is now paid for by most insurance plans — the true test of a treatment’s acceptance! Acupuncture, as well, with demonstrable benefits in pain relief at minimum, has gained mainstream acceptability in the U.S. within very recent memory.

However, the current CAM definition is rather misleading, having been imposed by conventionally-trained and -biased authorities. It is more accurate to think of CAM as all health practices developed over the course of human history, everywhere in the world, before the discovery of microbes, and including many health practices developed since then outside of “Western” medical facilities.

CAM includes, for example, entire multi-modal systems of medicine, such as traditional Tibetan medicine, Ayurveda, naturopathy, and others, some with continuous documentation of use and development over thousands of years. It also includes more recent practices: e.g., aromatherapy, Reiki, and Essiac, each with its own ancient roots.

One difference between most CAM therapies and “conventional” medicine, often cited by CAM skeptics, is a frequent lack of scientific evidence for CAMs, or even “disproof” of their worth. These criticisms are worth a closer look. “Scientific evidence” is not always best acquired in a laboratory setting, and what works in rats doesn’t always have the same effects in people.

Studies are often designed, depending on funding sources, to demonstrate certain hypotheses; their design may not be fair to competitors. Media coverage tends to focus on negative results in science reporting, as it does in other news. For example, a number of studies have found the herb St. John’s wort as effective as prescription drugs in treating mild to moderate depression. However, the most media coverage occurred when the herb was found to be not-so-helpful for serious depression. No one had ever claimed it would be.

So-called “anecdotal evidence” of practitioners and patients provides support for many CAM modalities, and is often discounted by those who understand only randomized, double-blinded, placebo-controlled clinical trials. However, lack of clinical studies is another misleading negative. Such studies are most often funded by pharmaceutical companies, and are extremely costly. Unless a unique, patentable, reproducible compound has been isolated for testing, there is little incentive to fund research on common herbal remedies such as echinacea, ginger, and aloe vera, or even more novel dietary supplements like shark cartilage.

Acupuncture. Image from Phiya Kushi’s Blog.

For some therapies, problems in adequate blinding or other study design factors present substantial obstacles to randomized testing. Acupuncture, for example, is difficult to administer in placebo form. Cannabis medications also present problems in blinding, since experienced cannabis users have no difficulty in distinguishing the real thing from placebo no matter how it is administered; the effects speak for themselves. Different study designs often make it difficult to compare “apples-to-apples” — but this is as true with pharmaceutical drugs as well as with herbal compounds!

Nevertheless, credible research is being done around the world every day on CAMs. For over 10 years, I have reviewed peer-reviewed journal reports of such work for the American Botanical Council’s HerbClips®, and have reported occasionally for ABC’s peer reviewed journal, HerbalGram®, on regulatory and other matters.

During that time, I’ve also — somehow — gotten older, and have begun to experience some of the annoying pitfalls of that process, as well as of ordinary hard knocks and exposure to modern living. While I began my work with ABC without any particular prejudice for or against conventional medicine or CAMs, today, I believe that each has its uses, and its distinct limitations.

I haven’t accepted medical or other advice to “get used to” chronic pain and increasing disability any more than I’ve accepted war, injustice, disharmony, or exploitation. These may all be losing battles in the long run, but what are we doing that’s any more important?

A year or so ago on a rainy day, a homeless guy at the downtown library asked me why so many — pardon the expression, “older ladies in Austin” — were sporting, as I was, a knee or elbow athletic brace. I stopped and thought about it for a minute. “Because,” I finally said, “we are fighting death to the finish!”

No system of medicine is static, and none has a monopoly on beneficial knowledge or tactics. ABC’s knowledge base — including my own work — has been priceless in helping me assess CAM options for my use, and even for friends and family facing health concerns. Like a growing world majority, I now consciously combine CAM practices with conventional medical care in a personal health continuum, making the decisions that affect, literally, my life, for myself, like we used to say in Students for a Democratic Society. I consider myself a “health independent” in the same sense that some voters claim independence from major political parties!

The fact is that conventional medicine is very poor in its ability to treat chronic illnesses, and most CAMs are ineffective or unnecessarily slow in treating acute illnesses such as infections. The fact is that professional health care providers of any kind are becoming less accessible to many of us, and that the costs of health care seemed doomed to skyrocket. The smart thing to do, it seems to me, is to use whatever we can to stay healthy!

Meanwhile, there is a skill to assessing unfamiliar health practices, products, and practitioners that I believe can be applied whether these are “conventional” or CAM-related, and I propose to try to impart some of that skill to readers of The Rag Blog.

If you have questions or suggested topics related to natural health practices, please post them in the Comments section of this article! For the record, I will NOT attempt to diagnose any symptoms, diseases, or medical problems. I will NOT recommend specific products, practices, or practitioners, except as examples of alternatives to be considered. I will NOT answer any questions of an intimate nature, e.g., what to do if you have an erection lasting longer than four hours! If none of you slackers have any interesting questions, I will merely regale you with my own adventures in health care; Lord’a’mercy; we are getting old!

I WILL freely discuss health-protective measures such as diet, exercise, and stress relief. I WILL consult with and drag in health care practitioners, researchers, and patients of all kinds as needed, some of whom may let me quote them. I MAY prescribe familiarity with controversial theories, regulatory policies, and historical tirades; take as directed: always with a grain of salt. Your life and health are your most valuable possessions — guard them well!

Next week: “Osteoarthritis: it takes a village.”

“Bee’s Knees,” by tyrone_31 / photobucket.

Prevention tip of the week:
Save your knees now!

Everybody should do this mild exercise several times a week if at all possible! Especially if you have weak knees, or “bad knees run in the family,” if you’ve had any kind of knee surgery short of a replacement, or if you do any running or jumping, this is a great way to strengthen and protect the most complex joint in your body.

  1. Lie flat on your back on the floor, with feet more or less in line with your shoulders.
  2. Extend your arms comfortably from your shoulders, so that, seen from the ceiling, you make a sort of “t” shape.
  3. Pull your knees up and your feet towards your buttocks as far as you comfortably can, keeping your feet slightly separated and your feet flat on the floor. Seen from the side, you look a little like this: _/\__o
  4. Keeping your upper body flat on the floor, gently lower both bent knees as far as you comfortably can to the right side of your body. Your left hip will lift off the floor. Seen from the ceiling, your knees look like a double chevron: >>. Stretch a little tiny bit closer to the floor with both knees, and hold for 20 seconds.
  5. Return to position 3 and reverse, lowering knees to the left side: . Stretch and hold.
  6. Repeat twice, three times a week, for six months. If you feel the improvement, KEEP DOING IT AS LONG AS YOU CAN GET DOWN ON THE FLOOR AND GET UP AGAIN! Don’t do it in bed or lying on the couch; you may throw your back out, and I don’t want you blaming me for your sciatica!

Hint: If your low-side knee doesn’t go all the way flat to the floor, or the high-side knee doesn’t go parallel to the floor when you stretch to left or right, well, that is a goal you can set. Gently stretch as far as you can without discomfort; and next time go a millimeter further!

This stretch, unlike the bicycling motion often used in post-surgical knee rehab, strengthens muscles and ligaments along both sides of the kneecap that help keep the joint stable — if you’ve ever felt the sickening sideways lurch of thigh-bone or leg-bone pulling away from knee-bone, you know the importance of these supportive structures!

Thanks for this tip to Wendee Whitehead, Doctor of Chiropractic, Austin, Texas, whose exact words to me were, “Knees are totally fixable!” Keep yours strong and flexible with this simple, zero-impact move.

–mgw

The Rag Blog

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12 Responses to Stayin’ Alive : Complementary and Alternative Medicine

  1. Anonymous says:

    Thanks Mariann for this thoughtful piece. I’d comment however, that “scientific evidence” doesn’t just refer to laboratory or animal studies. Professional “Western” medical associations, healthcare facilities, insurance companies and even some states legal standards are indeed moving toward “evidence-based” medicine. But that notion favors peer-reviewed & published, double blind controlled studies of appropriately matched human subjects. That standard, as currently practiced is admittedly flawed – but moving, I think in the right direction. While there are economic matters at issue also, EBM is chiefly aimed at improving the efficacy of theraupeutic interventions. It is certainly not intended to minimalize or marginalize the efficacy of “traditional”, “alternative” or “complemantary” approaches to healing. Actually, EBM provides a vehicle by which one of those approaches could more swiftly and surely enter the arena of offically “acceptable” therapeutic choices for the ill & injured (and accordingly be more likely covered by medical insurance). I do not mean to devalue complementary medicine. In fact, I applaud it, along with right with the pro-active virtues of healthy diet & and exercise, and taking responsibility for one’s own health. But most Americans are accustomed to our present, fix it once it’s broke Western medical tradition. So it might benefit other traditions, their practitioners & their adherents to play the big guys’ game – submit to their standards rather than inch to acceptance over decades – they might even win big & help us all.
    chris

  2. Janet Gilles says:

    Thanks Mariann for bringing complementary and alternative medicine into the light of the scientific viewpoint. Yes alternative medicine could spend millions of dollars to prove that herbal remedies work in double blind placebo studios in some cases, but as there is no patent on an herb, it would not make sense to do so. Nonetheless, efficacy can be proven and we are free to utilize the evidence. In other instances, there are remedies with patents approved by the US government proving efficacy of non toxic plant based nutritional remedies, but the FDA will not approve them because they cannot meet the standard of showing what dose will kill half the cats, rats, and mice in the study because as a food, the remedies are not toxic. So good of you to point out that the evidence exists and worth considering, both for our health and our pocketbook.

  3. Mariann says:

    Thanks for both comments — yes, evidence-based medicine offers some open doors to “proof” of CAM therapies in some instances, but, as both Janet and I point out, unless somebody can see a way to patent something, there’s little incentive for the terribly costly tests required for, say, FDA approval.

    One thing I didn’t mention in this article, and am a little surprised Janet didn’t mention because I know she knows about it, is the horrible number of FDA-approved drugs that turn out later to have deadly side effects. There seem to be at least one or two every year.

    Also, as anyone who watches teevee knows, Big Pharma is finding it more profitable to treat previously undrugworthy conditions (e.g., restless leg syndrome, wrinkly old lady skin) than to find, for the classic example, a cure for AIDS. Meanwhile, it isn’t only multiply-resistant staph bacteria (MRSA, etc.) that are beating the pants off pharma products in the real world of microbes, but malaria, tuberculosis, and others, following the good old Darwinian code of survival of the fittest.

    It is definitely in the interest of CAM adherents to “play the game” of scientific validation, to the extent possible. Organizations such as the American Botanical Council are in the forefront of this effort. However, it’s also in our interst, as health consumers, to examine our notions of “evidence” and be willing to consider, on a case-by-case basis, evidence accumulated before the scientific method itself was invented.

    As “modern” people, we have been taught to devalue the knowledge of our “primitive, ignorant” human ancestors. I think this is a big mistake. Ethnomedical researchers are often able to interpret the OBSERVATIONS of the ancients — as accurate as any today of the same phenomena — in light of modern scientific knowledge to demonstrate that our human ancestors were pretty intelligent folks, all around.

    By the way, African witch doctors and South American shamans often report about the same cure rate as Western-trained psychiatrists for mental illnesses such as depression, even though their methods are quite different. “Cultural illnesses” are recognized — and successfully treated — in many places that Western medicine doesn’t identify at all. Does the fact that Western medicine doesn’t recognize the effects of, for example, evil eye, make those effects any less harmful to a person who believes him/herself to have been viewed by such an eye? Does the fact that a witch doctor in Ghana may not call “paranoia” by that name make a New York psychiatrist’s treatment of the condition less valid?

    This promises to be a fun discussion!

  4. Fed Up says:

    Thanks so much!

    I had restless leg syndrome, but when I was diagnosed with sleep apnea, and complied with the CPAP therapy, the restless leg syndrome simply went away.

    I believe anyone who has restless leg syndrome and is over weight ought to request a sleep apnea test.

    Even after CPAP therapy, I still got leg cramps when I woke up, but Googled and tried different things; what worked for me was 3 Magnesium tablets before bed. I almost never have cramping in my legs when I wake up anymore.

    Different things do work for different people, because we are all biologically different on a Bell Curve.

  5. Anonymous says:

    Mariann,
    Thanks for getting attention on this blog to alternative medicine.This is a method that works for many people
    outside of the health care system. We need to know the best databases (Dr. Duke, Michael Moore and many others)and the experiences of people. Lots to do!
    Pax et amor,
    smp

  6. Janet Gilles says:

    Of course there are a lot of side effects and deaths from pharmaceuticals, since you have to prove toxicity to get approved. The scary part about all these new “disease conditions” is that once a drug is developed for one, it becomes a crime to claim that your non toxic remedy can help. You are supposed to take your remedy to FDA, but they won’t look at it until they know how much it takes to kill the rats. Non toxic, no FDA approval.

  7. Anonymous says:

    Good to have this sort of info on the Blog. Kudos to you, Mariann. Please plan an article to discuss the role of vitamin and mineral supplements in maintaining health in this wilderness of unhealthy food being forced on the unsuspecting public. Gets into agribusiness, I know, but the earth that should be growing healthy crops is being steadily depleted of nutrients and the crops being grown are no where as nutritionally rich as those grown, say, 100 years ago. So, a column on the value of organic food? You don’t have to condense Fast Food Nation or condemn Phil and Wendy Gramm:):)

  8. Mariann says:

    Y’all, I’ve had a lot of feedback directly on this column as well as the comments here, MOST of it positive, and the negative, I’m convinced, simply due to me not being clear enough, or being too much of a smart-ass sometimes. Please keep reading, keep commenting, and keep sending your ideas about good topics for future columns. There is SO MUCH information out there, and SO MUCH about which I know zilch, zip, and nada, but you know me: your intrepid Wizard will try almost anything once!

  9. Clarity is essential, Wiz. Strive for it at all times.

    But just as important: To thine own self be true. Never stop being a smart ass.

    .t

  10. Anonymous says:

    What a great idea! Thank you.

    How ’bout a little discussion of homeopathy?
    People against it say it defies logic, but it is a very old system of medicine with many benefits. Acute care can be DIY with a good medica although more serious issues need a good practitioner to guide the process. It is a far superior-and safer- method than much of what exists through western medicine. I’ve used it with my family and friends
    for many years as an alternative to pharmaceuticals, many of which are dangerous and very expensive in comparison.
    BTW I would support almost any health care reform that would allow us to choose our own way of healingand put our health into our own hands again just to put that notion “on the table”.
    As a product of the generation that read books like OUR BODIES, OURSELVES, it seems rather absurd that someone should legislate how we heal and maintain our health.

    PS as to knees, i will add this exercise to my arsenal.
    I discovered not eating nightshade vegetables(potato,tomoato,eggplant, peppers)makes a big difference in my rheumatoid arthritis-anybody else have any experience with this?

  11. Anonymous says:

    There are two things about homeopathy that I have a bit of trouble with. First the dilutions; just how far does one go in making a medicine? Second is the “bumps”; how hard do you have to “shock” the extracts?
    mps

  12. Anonymous says:

    Thanks Mariann, I thought you might also be interested in reading Southwest Institute of Healing Arts new blog – http://www.holistichealthandme.com

    As a holistic healthcare school, SWIHA posts a variety of articles about alternative medicine and the wellness industry.

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