health care - new & improved

7/29/2019 Health Care - New & Improved

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Stacy and MikeBrindise withbaby Davis.


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Stacy Brindise, 30, was eager to havechildren. But a ter trying or several years to conceive, she and her husband,Mike, were still childless. Like millions

o couples, the Brindises were aced withwhat doctors re er to as unexplainedin ertility.

Couples diagnosed with unexplainedin ertility are t ypically active, health-conscious people o childbearing agewho ind themselves or no apparentreasonwithout a crib or a bottle in thehouse. Like many, the Brindises olloweda amiliar route, irst consulting doctorswho recommended hormone treatment,which Stacy reluctantly decided to try.

The arduous six-cycle program involveddaily medications, sel -administeredhormone shots, and monthly intrauterineinsemination with a catheter.

But the Brindises still couldnt getpregnant.

Physicians next suggested that Stacy try in vitro ertilization. It would involvedoses o medication, a considerable pricetag (starting at $12,000), and increasedchances o her having twins actors thatgave the couple considerable pause.

Nothing had worked and it was t ime,Stacy decided, to change her approach.

When people have a medical problem,everybody seems to jump right to drugs

$34BAme icans spent nea ly$34 billion out o pocket oalte native t eatments in 2007,acco ding to a NationalInstitutes o Health su vey.

Health CareNew &Improved

A tio of p ti t d do toi i t f of A i di i .

It bout o t u i di o it lt fo t ol p o .

Stor b Emma S ppalaPhoto raph b Cam ron Witti

April 2013 mindful 35

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as the solution, she says. I wanted tosee i improving my overall health andwell-being would increase our chanceso getting pregnant naturally.

Stacy is not alone in her gut eeling that irst addressing her overall healthand well-beingbe ore investing inmore invasive solutionsmight be akey element in her health care. High-tech, high-cost approaches clearly havetheir place, and modern medicine can boast many silver-bullet solutions. Butmillions o Americans eel thats notenough. They spend more than $30 billion a year out o their own pockets

or alternative treatments, according todata compiled by the National Center

or Complementary and AlternativeMedicine. Funding or NCCAM theU.S. governments lead agency or sci-

enti ic research on complementary andalternative medicinehit $128 millionin 2012, a 156% increase since its incep-tion in 1999.

Complementary and alternative isthe ederal governments current label

or approaches that lie outside the main-

stream. However, a nationwide survey shows that approximately 38% o U.S.adults aged 18 years and over use some

orm o complementary and alternativemedicineanything rom acupunctureto meditation. Thats starting to lookpretty mainstream, which is one reasonmany doctors pre er the term integra-tive health care.

In 2010, 600 health care pro ession-als assembled in Washington, D.C., or asummit on integrative medicine. It wassponsored by the Institute o Medicine,which de ines integrative medicine ashealth care that addresses together themental, emotional, and physical aspectso the healing process or improving the breadth and depth o patient-centeredcare and promoting the nations health.

The doctors who champion integra-

tive approaches are not simply proposing alternatives. They advocate an updatedmodel o health care that integratesmind and body, promotes more interac-tion and communication in the doctor-patient relationship, puts the patient atthe center, and encourages sel -care.

Florence Strangs successful battle with breast cancer is a prime exampleo integrative medicineo taking careo the whole person while trying to curea disease. She is alive today because o radiation, chemotherapy, and surgery. ButStrang also attended a mind ulness retreatled by an oncologist, and she credits mind-

ulness and awareness practices withhelping her cope with the su ering thatcame with those li e-saving t reatments.

I was undergoing a lot o lengthy,pain ul, and uncom ortable treatmentsand procedures, she says. In one yearI had six rounds o chemo, 25 radiationtreatments, three surgeries, and I wouldnot be able to tell you how many di iculttests and procedures.

Strang is a registered psychologist whoworks as an elementary school guidance

counselor. She knew the chemotherapy treatments were helping her ight cancer.But in the process, her body was weaken-ing and su ering pro oundly. By her sec-ond round o chemo, she knew that i shewas going to get through it, she needed tostay ocused on the positive.

Florence Strangis alive todaybecause o radiation,chemotherapy, a ndsurgery, but shecredits mind ulnesspractices withhelping her copewith the stress o hertreatments.

The averagedoctor spends7 minutes per patient, whilethe average

integrativepractitioner spends 30minutes.

Dr. David Spiegel, director othe Center on Stress and Healthat Stan ord University

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Mak a LisBe nha d saysgoing into anappointment with alist helps you keepyou attention on the task at hand.The key is cla ityand setting anagenda, saysKo sch: Get youconce ns into the

inte action ea lyand also allow thedocto to state whathis o he plansa e. Be ealisticabout the amounto in o mation thatmay t easonablyinto one appoint-ment, but dont letany issues d op of you ada o youdocto s. I need be,book an additional

appointment to geteve ything cove ed.

B in hRoom

Its a a e appoint-ment when youdont have at leastsome waiting todo, and Be nha dsuggests two wayso app oaching that. I shes eelinganxious, she sitsand concent ates

on he b eathing. Itcalms my body andgives me cou age. Ib ing my attentionback to my bodyand eel wholeagain, athe thanall scatte ed. I she

eels estless andbo ed while waitingin the examining

oom, she p acticesbeing p esent. I

ocus on my senses

and scan the oom,looking at the equip-ment, the pictu eson the wall. This t ans o ms waiting times into times o engagement.

B KindWhile its easy toget swept away byyou own ea s anddisappointments,Be nha d says, t y to emembe youdocto is human, too. And dont takeit pe sonally i aninte action doesntgo the way you had

hoped. Being kind,espect ul, and patient in any elation-ship can do nothingbut good. Thisdoesnt mean that i you e sick you have to put on a happy

ace. You just need to emembe that the two people in the oom a e bothseeking the bestoutcome possible.

ConsidTakin

Som onwi h Yo

I you have a lovedone o a iend in the oom wi th you, this can t iggeg eate communi-cation. Docto s cansometimes be mo e

detailed in theiexplanations o the bene t o that thi d pe son,says Be nha d.I complicatedmatte s a e beingdiscussed, anotheset o ea s andmo al suppo t canbe excellent. How-eve , acco ding toKo sch, o outineappointments, you

may not want tocomplicate you

elationship withyou docto .

S kAnsw s

I you e con usedabout something,dont let it slide. Butdont take a con-

ontational stanceeithe , says Ko sch.Go with an openmind and with ques- tions and conce nsand state them up

ont. Be nha dadds: Dont bea aid to question t eatment and askabout alte natives.It spu s docto s to talk to you aboutwhats going on in thei heads, andyou want them tosha e that withyou. While eelingill and needing helpis a highly vulne -

able position to bein, dont let that t anslate into be-ing emba assedabout you needso cu tailing youquestions. Onceyou stop blamingyou sel o needinghelp, you can eallysta t to take ca eo you sel .

1 2 3 4 5

By Line Goguen-Hughes

When it comes to getting the most out o a doctorsappointment, the goal is to get the doctors attention, so he or she sees you as a fesh-and-blood humanbeing, not just as a body with symptoms, says ToniBernhard, author o How to Be Sick . We also askedDr. Barbara Korsch, author o The Intelligent PatientsGuide to the Doctor-Patient Relationship , to share herinsights. Heres Mindful s summary:

Getting You& Your Doctor

Tuned In



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When Richard Lowreturned rom Iraqand started breathingpractices, he learneda lot about PTSDand how much it hadafected him.



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The most important thing I did iswhat I would call mind ulness o heal-ing, says Strang. Instead o ighting against these treatments, which le t me

eeling in such misery, I just observedand accepted what was happening. And Iwould think to mysel , Chemotherapy ismy riend. Its going to save my li e.

I I observed the treatment rom aplace o being kind and healing to mysel ,rather than looking at the treatment assome horrible thing that was happening to me, it made it easier. Bringing mind-

ulness and kindness to your care gives you a di erent perspective.

This is when Strang came up withwhat she calls her survival plan, whichtookand continues to takeher own body and mind into account. To help o-cus her mind on the positive, she started

a blog, www.perkso cancer.com, whichchronicles her approach to dealing withthe disease.

Strangs way o coping with her can-cer re lects the approach that integrativehealth care doctors take, according toDr. Margaret Chesney, director o theOsher Center or Integrative Medicineat the University o Cali orn iaSan in bringing attention to post-traumatic

stress disorder be ore it was a clinically acknowledged diagnosis. He is inter-nationally renowned or his work withtrauma and was asked by the U.S. govern-ment to train critical-incident and trauma

teams a ter the 9/11 attacks. Meshad uses atechnique called TFT, in which a practi-tioner asks the patient to recall a traumaticevent, then helps them tap di erent partso the body known as meridian points(mostly on the ace) in order to releasethe trauma. This practice is o ten coupledwith breathing practices.

Combat veterans in particular areo ten averse to talking about their traumato a stranger. The great thing with thismethod, says Meshad, is that they donthave to go into the details that distressthem. They just need to describe the

moment that led to the trauma and whathaunts them, and then we go throughthe procedure. I ask them to rate theiranxiety on a scale o 1 to 10. I they are at10, my goal is to get them to 1.

People think Im a miracle worker, butI know this stu works. Ive watched adecorated combat vet laughing or crying with joy like he won the lottery becausehe eels ree. Its reedom, a release romthe imprisonment o the brain, a release

rom hell.

Francisco. Chesney emphasizes thatthe best way to enhance health and healillness is o ten a combination o conven-tional medicine and healing methodsthat address the person as a whole, thatsee where they are in their lives rom thepoint o view o mind, body, spirit, andcommunity. For a patient at the OsherCenter who wants to prevent heartdisease, or example, the treatment planmight include an appointment with acardiologist or appropriate testing butalso a stress-management program suchas yoga, meditation, or massage.

Richard Low served for 16 months in Iraq as an ofcer in the 4th Battalion o the 23rd In antry Regiment. He didntthink o himsel as the sort o personwho needed yoga to round out his li e

and help him heal. He wasnt even surehe needed healing, but he volunteeredanyway to be part o the Veterans Well-ness Study at the Center or Investigating Healthy Minds in Madison, Wisconsin.

During the study, I learned a lot aboutwhat PTSD was and just how much I had been a ected, Low now says. He alsolearned how to use a yogic breathing technique called sudarshan kriya , whichhas been ound to be particularly e ec-tive or trauma su erers. With traumausually comes agitation, and that makesmost meditation techniques di icult. Its

hard or people with traumatic thoughtsto sit still and relax, but breathing tech-niques give them a way to eel their body and ind relaxation there.

Low came to some realizations. Ireally numbed mysel out a ter returning

rom Iraq, he says. I was disconnected, but I didnt really know it.

Other amily members noticed,though. His dad, or one.

We were out deer hunting, says Rich-ard. We were talking about the study and my dad said, I can see that youre younowthe you rom three or our years

ago. I was happier, joking around again,relaxed.

Standard treatments or post-trau-matic stress include therapy and medi-cation. However, recent studies haveshown that both therapeutic and drug treatments have high dropout rates, ando veterans who do complete treatment,only about hal experience a reduction insymptoms.

Shad Meshad, ounder o the National Veterans Foundation, was instrumental

Funding o NCCAM the U.S.gove nments lead agency oscienti c esea ch on complementa yand alte native medicinehit $128million in 2012, a 156% inc easesince its inception in 1999.

I really numbedmysel out afer returning

rom Iraq.

Richard Low, who servedor 16 months as an ofcer

in the 4th Battalion o the23rd In antry Regiment

+156%2012


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For more resourcesand reporting onintegrative health go tomindful.org/health

The power of integrative medicine doesnt just lie in techniques. Accord-ing to Dr. David Spiegel, director o the

Center on Stress and Health at Stan ordUniversity, part o whats power ul aboutany integrative approach is that it helpspatients eel more involved, more in con-trol and responsible or their own healthcare. It also allows or more time with amedical practit ioner. The average doc-tor, says Spiegel, spends seven minutesper patient and the average integrativepractitioner spends 30 minutes.

The medical care system in this coun-try is broken, says Dr. Je rey Brantley,director o Mind ulness-Based StressReduction at Duke Integrative Medicine

in Durham, North Carolina. One o theways its broken is that both people inthat seven-minute exchangethe patientand the doctorare being short-changed.Many actors weave together to createthis problem: our medical culture, ournational view o health, our reimburse-ment models.

The ee- or-service reimbursementapproach is a cornerstone o the U.S.health care system. It pays doctors orservices supplied. It does not evaluate the

Read/Watch/Click

Leaves Falling Gently: LivingFully with Serious & Life-Limiting Illness throughMindfulness, Compassion& Connectedness by SusanBaue -Wu

Mindfulness Meditation for Pain Relief: Guided Practices

for Reclaiming Your Body andYour Life by Jon Kabat-Zinn

Womens Bodies, WomensWisdom by Ch istiane No th up

Calming Your AnxiousMind: How Mindfulness andCompassion Can Free You from Anxiety, Fear, and Panicby Jef ey B antley

Escape Fire: The Fight toRescue American Healthcare,

documenta y, eleasedOctobe 2012

Fo in o mation on Suda shanK iya o vete ans, visit P ojectWelcome Home T oopswww.pwht.o g

Fo in o mation on TFT andShad Meshads wo k withvete ans, visit www.nv .o g

To nd an integ ative healthca e cente nea you, visit the

Conso tium o Academic HealthCente s o Integ ative Medicinewww.imconso tium.o g

quality o their care, as measured by thehealth o their patients. This approachstems rom a health care system thatresponds to health problems more than itprevents them rom occurring in the irstplace. Disease management tends tooutweigh health care in such a model.

But change is a oot. The system isshi ting, says Dr. Adam Perlman, execu-tive director o the Duke Center or Inte-grative Health. Were seeing much moreemphasis on prevention and li estyle. Itsan exciting time or integrative health.

It was a friend of Stacys who helped the Brindises solve their unexplainedin ertility. She was a nurse in an obstetri-cians ofce and she told Stacy that shehad met many women who had usedacupuncture success ully when they

were trying to get pregnant. Despitesome misgivings about the little sheknew about acupuncturenamely, thatit involved a lot o tiny needlesStacy booked an appointment at the Acupunc-ture and Chinese Medical Center inEdina, Minnesota.

My irst surprise was that the doctorspent a good hour and a hal with me,Stacy says. She asked me detailed ques-tions about my eating habits, stress levels,and li estyle. She took the time to get toknow all o my habits so I could makechoices that were more conducive to

pregnancy. Her assessing my overall well- being made me eel really com ortableand taken care o .

The acupuncturist advised once-a-week acupuncture sessions and dietary adjustments. Five weeks later, Stacy gother second surprise: She was pregnant.Stacy and Mike welcomed a healthy baby boy into the world in November.

38%App oximately 38% o U.S. adultsaged 18 yea s and ove use someo m o complementa y and

alte native medicine, acco ding toa nationwide gove nment su vey

eleased in Decembe 2008.

Emma Seppala is associate directorof the Center for Compassion andAltruism Research and Educationat Stanford University and a researchscientist and honorary fellow withthe University of WisconsinMadisonsCenter for Investigating Healthy Minds.



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