Alternative Lifestyle

In holistic medicine, patients find healing and hogwash

Back Longreads Sep 1, 2012 By Jean Yung

On a spring day in 2011, 60-year-old Russell Edgar checked himself into a 14-day Newstart residential program at the Weimar Center. In the Sierra Nevada foothills above Sacramento, the center promised to teach people with diabetes, obesity and cancer how to reverse their health problems through natural healing methods.

Overweight and strung out from a high-stress job at a hospital, Edgar had found himself increasingly dependent on caffeine, alcohol, nicotine, meat and cheese. He was taking blood pressure medication and had been told he was at high risk for everything from a heart attack or stroke to emphysema if he didn’t quit smoking and lose weight. He refused his doctor’s suggestion to take Wellbutrin and nicotine patches, saying he didn’t want to take two drugs to get off one. But as days passed, Edgar, a Grass Valley resident, grew more anxious about finding his way back to health.

Edgar came across Weimar on the Internet. Founded by Seventh Day Adventists, Weimar championed what it calls God’s principles of wellness, encapsulated in the acronym “Newstart” for nutrition, exercise, water, sunlight, temperance, air, rest and trust in God. Edgar wasn’t religious, but he considered it an opportunity to get away and simply quit his detrimental lifestyle cold turkey. Still, it wasn’t until the day before his family dropped him off that he told them his plan.

“I smoked ’til the day I went up there,” says Edgar, who had smoked for 45 years. “In the back of my mind, I thought that I might just panic and not do it.”

Under physicians’ supervision, Edgar and the other 15 patients ate and learned to cook a vegan diet, walked in the fresh air, prayed and underwent three to five hydrotherapy and massage treatments a day. By the end of his first day, however, Edgar was ready to quit. He had jitters from nicotine withdrawal, headaches from caffeine deprivation and felt dejected overall.

“I could barely get out of bed and barely ate breakfast. I sat by myself because I didn’t feel like I was somebody that someone would enjoy hanging out with,” he says.

But things started to turn around as the toxins drained from Edgar’s body. He felt himself liven up, and he started taking short strolls on the grounds with Weimar doctors, who also live on campus. On the third day, doctors told Edgar he might be ready to stop taking his blood pressure medication. As worried as he was about possible side effects, Edgar was astonished to find his blood pressure back in a normal range. A week later, his glucose and triglyceride levels had normalized.

More than a year later, Edgar is 45 pounds lighter, a medication-free vegan, nonsmoker, teetotaler and daily walker. “I don’t know if it was divine intervention or feeling like if I wanted to live; I had to do it. I’m still amazed at how I did all that.”

Nearly half of Americans suffer from a chronic illness such as diabetes, heart disease or cancer. But many like Edgar are choosing to treat themselves with alternative or complementary medicine, rather than drugs, surgery or other traditional forms of Western medicine, and a growing number of hospitals throughout the Capital Region offer therapies such as acupuncture, meditation, hypnosis, relaxation and chiropractic care.

A study from the National Center for Complementary and Alternative Medicine (NCCAM) in 2007, the last year for which data is available, shows 40 percent of adults use some form of alternative medicine to treat an assortment of conditions.

A 2012 update to the survey is underway, and though preliminary results won’t be available until next summer, data suggests that use of complementary and alternative therapies has remained relatively stable. However, Americans are spending more on those treatments.

The 2007 study found patients that year spent about $33.9 billion on complementary alternative medicine, or about 11 percent of total out-of-pocket health expenditures, a 26 percent climb from 1997.

But does alternative medicine work? Arguments on either side of the issue are strong, with some physicians and patients praising the methods for their success and other experts lambasting the lack of scientific evidence.

The answer also depends on whether one is talking about prevention, treatment for benign chronic conditions, or treatment for life-threatening conditions such as cancer or AIDS.

A study from the National Center for Complementary and Alternative Medicine in 2007, the last year for which data is available, shows 40 percent of adults use some form of alternative medicine to treat an assortment of conditions.

Most holistic medicine products emphasize overall wellness and prevention, something entirely mainstream but which “alternative medicine doctors have hijacked,” claims Edzard Ernst, professor emeritus of complementary medicine at the University of Exeter in England and co-author of “Trick or Treatment: The Undeniable Facts about Alternative Medicine.”

“Any mainstream doctor will treat diabetes or hypertension with a prescription of diet and exercise,” he says. “You’re trying to prevent a stroke.”

David DeRose, one of the four resident physicians at the Weimar Center, acknowledges that many treatments considered “new therapies” have been around for decades. The Newstart principles date back to the 1970s, but more research has emerged since then supporting the approach that diabetes can be reversed with lifestyle treatment.

“More people are realizing that when it comes to health care, we’re not just talking about medication or high tech surgery devices. We’re talking about an individual’s own commitment to his or her health,” DeRose says.

But there are limits to what alternative medicine alone can do. The Newstart program worked wonders in helping Russell Edgar prevent diabetes, but he noted that one of the sicker patients in his program came in with a respirator and was sent to intensive care after the first night.

Ernst, who published his book in an attempt to explore the totality of scientific evidence on alternative medicine, has become a well-known voice of skepticism to expose methods that lack strong evidence or for which contradictory evidence exists.

“Some forms of alternative medicine may help to improve quality of life, but there’s pretty good evidence that no alternative treatment will cure a condition like cancer or other disease,” he says. “Because of that, the value in my view is zero. In some conditions, alternative medicine might have a place in supportive care.”

Area hospitals seem heedful of that risk. “Our integrative medicine center works hand in glove with the conventional medicine. We do get concerned if there is something people should avail themselves of, and we do send patients back to get surgery and medicines,” says Margaret Chesney, director of the Osher Center for Integrative Medicine at UC San Francisco.

“Few people use only alternative medicine. What they are doing is supplementing their usual, conventional care by adding things from complementary medicine, like dietary supplements, acupuncture, deep breathing and meditation or mind-body management.”

Chesney, a former acting director of NCCAM, says holistic medicine’s rising popularity has paralleled a growing body of scientific evidence that supports its effectiveness.

“For example, we know there’s an interaction between stress and health, and that certain practice areas like mind-body and changing our behavior can help manage our health effectively.”

Mind-body approaches are an important focus of research at the Osher Center, where doctors are studying how mindfulness can affect long-term weight loss for obese patients and the effects of meditation on HIV infection progression.

“Integrative medicine tries to use less invasive approaches first and move to more conventional medicine as needed,” Chesney says. In 2011, the Osher Center recorded more than 6,700 patient visits, a 13 percent increase from a year earlier and the highest growth rate among the outpatient clinics at UC San Francisco. It’s on track to reach more than 7,700 visits this year.

The Stanford Center for Integrative Medicine has seen a similar swell in demand, though budgetary constraints have stood in the way of allowing the number of visits to rise above 4,500 a year, director David Spiegel says.

“Some forms of alternative medicine may help to improve quality of life, but there’s pretty good evidence that no alternative treatment will cure a condition like cancer or other disease.”

Edzard Ernst, professor emeritus of complementary medicine, University of Exeter, and co-author, “Trick or Treatment: The Undeniable Facts about Alternative Medicine”

Half of the patients at the Stanford Center are dealing with pain problems, and half are dealing with cancer-related issues, some of whom overlap with the pain patients, Spiegel says.

“Acupuncture is our biggest business, and it has been since near the beginning,” he says. “People like it primarily for pain and chronic joint diseases, but it’s also being used for infertility and fatigue.”

Doctors say the body of evidence on acupuncture’s benefits in relieving pain and nausea from chemotherapy is generally strong and well established, and the risk of infection or blood vessels breaking is low. But Ernst points out that the evidence of acupuncture for conditions other than pain and nausea is inconclusive.

Another popular therapy at Stanford — one of special research interest to Spiegel — is hypnosis. It’s sought for pain, to break habits such as smoking, for help enduring painful medical procedures, and to manage stress and trauma, such as post-traumatic stress disorder, Spiegel says.

He recalls a young female patient who had bladder problems at birth. In her 20s, she had undergone about 30 surgeries and had been addicted to medications.

“I taught her self-hypnosis, and it brought her pain down from a 7 out of 10 to a 3,” Spiegel says. “She told my secretary she was going to practice it all the way home to Southern California.”

Over time, what begins as an effortful exercise can become automatic, Spiegel says.

Kaiser Permanente, Sutter Health, and, to a lesser extent, UC Davis Medical Center also offer complementary options, primarily driven by staff physicians with an intense personal interest in alternative medicine. Their models differ in that Kaiser aims to fully integrate complementary medicine with traditional Western medicine, and patients are covered under their flat-rate fee arrangement, whereas Sutter has a separate alternative medicine department that operates on a mostly out-of-pocket payment model.

Davis is the only UC facility that doesn’t have a complementary alternative medicine program, but it seeks funding to start one, says Peter Gerritz, a physician in the Department of Physical Medicine and Rehabilitation. Gerritz, who completed a fellowship in integrative medicine and has spent time in a Buddhist monastery in India, practices acupuncture along with two other doctors to meet the very large patient demand.

The therapy is not covered by most insurance plans, and cost is a deterrent. Patients likely will have to pay $90 an hour with a minimum of four sessions to gauge if they respond to acupuncture. About 20 percent of the population doesn’t respond, Gerritz says.

Risks associated with other forms of alternative treatments may be higher.

“The safety issues are mostly with herbs and supplements and certain drug interactions,” says Hillary Campbell, a physician with Kaiser Permanente Sacramento and vice chair of Kaiser’s Northern California committee on complementary and alternative medicine. “If something doesn’t work, it may not hurt you, but you may have spent hundreds of dollars.”

Campbell says some of the most common unwanted drug interactions are St. John’s wort, which reduces the effectiveness of birth control, and a Chinese herb called dong quai, which interacts negatively with Coumadin, a blood thinner.

A Kaiser survey found that 56 percent of respondents found alternative medicine important to their health. Of the people who use an alternative therapy, 86 percent say they would be interested in trying another one.

That interest might be undisputed, but Ernst characterizes as misguided the politically correct culture of putting the patient at the center of health care and asking what they want.

“Medicine is not a supermarket,” he says. “The patient has always been in the center, but it’s not what patients want. It’s what they need.”

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