What Is Complementary Alternative Medicine medical and health

*What Is Complementary Alternative Medicine? … medical and health care practices and products outside the realm of Complementary: together with conventional medicine, conventional practices ( aroma which are yet to be validated therapy for surgery patients) using scientific methods Alternative: in place of conventional practices. Relies on certain stimuli for body’s natural healing

*Types of Therapies *Homeopathy- “like cures like” Small amounts of substances can cure while larger amounts can cause symptoms (exallergy shots) *Herbal therapy- most popular but not covered by law or tested by FDA *Acupuncture - manipulation of energy flow by inserting needles into the meridians of this flow *Naturopathic medicines- assists body’s natural healing; includes diet, massage, exercise, acupuncture *Prayer

*The Big “Seven” *Chinese herbal medicine *Western herbalism *Acupuncture *Chiropractic care *Massage *Homeopathy *Diet and nutrition therapy

*CAM Practices Now in Mainstream Medicine *Codeine for pain *Behavioral therapy *Digitalis for headache *Hypnosis for smoking cessation *Ipecac for *Low fat, low *Quinine for *Exercise *Aspirin for *Support groups heart failure poisoning malaria fever cholesterol diets for diabetes for breast cancer

*The CAM Domains

*The Appeal of CAM § § § Patient empowerment Focus on spiritual and emotional well-being Therapist providing “touch, talk, time” Feeling of “natural” treatment Tradition

* CAM Use in the United States *Phone poll- 62% of adults 18+ used CAM in the past year

*Who Is the Practitioner? *Medical doctors *CAM practitioners *Traditional healers

*CAM Economics *Americans spend more out-of-pocket for CAM than for all other health care needs *CAM is big business *56% of Americans believe their health plans should cover CAM

Who uses CAM? § § § More educated More affluent Possess a holistic orientation to health Had a ‘transformational experience’ Identification with environmentalism, feminism, spirituality § Report chronic anxiety, pain, UTI, back problems (Astin et al. JAMA , 1998)

*Many mainstream doctors * do not approve of CAM therapies *Most patients do not report alternative therapies to their doctors *Communication is key to prevent further damage especially with alternative meds

* Therapy Condition Status Co-Sponsors Glucosamine-Chondroitin Osteoarthritis Fully recruited; ongoing NIAMS, VA Ginkgo Biloba Dementia Fully recruited; ongoing NIA, NHLBI, NINDS Vitamin E-Selenium Prostate Cancer Fully recruited; ongoing NCI Shark Cartilage Lung Cancer Recruiting NCI EDTA Chelation Therapy Coronary Artery Disease Recruiting NHLBI St. John’s Wort Minor Depression Recruiting NIMH, ODS Vitamin E Down Syndrome Recruiting NICHD, NIA Phytoestrogens Atherosclerosis Recruiting ODS, ORWH SAMe Depression Recruiting Acupuncture Low back pain Recruiting

* *Product intended to supplement the diet *Contains one or more of the following: * * * Vitamin Mineral Herb or other botanical (not tobacco) Amino acid Any other dietary substance *For oral intake as a concentrate, metabolite, extract, constituent, or combination

* *2590 participants 18 years + *Telephone survey, random sample Feb 1998 - Dec 1999 *In the preceding week: *14% of population used herbals and/or supplements *16% of prescription drug users used herbals and/or supplements JAMA, 2002

Patterns of Supplement Use: Ten Most Commonly Used Herbals / Supplements *Ginseng *Ginkgo biloba *Allium sativum *Glucosamine *St. John’s wort *Echinacea *Lecithin *Chondroitin *Creatine *Serenoa repens

Patterns of Supplement Use Ten Most Common Reasons for taking herbs / supplements *General health/good for you (16%) *Arthritis (7%) *Memory improvement (6%) *Energy (5%) *Immune booster (5%) *Joints (4%) *Supplement diet (4%) *Sleep aid (3%) *Prostate (3%) *No reason (2%) *All other reasons (45%) JAMA, 2002

* *Safety is assumed, not proven *Lack of product standardization *Contamination with drugs, heavy metals *Allergic reactions *Inherent toxicity *Interactions with drugs *Replacing proven therapies

* *Ma huang (Ephedra sineca) – Short -term treatment for asthma, decongestion *Contains L-ephedrine, pseudoephedrine *Major current use in U. S. in combination with caffeine for weight loss, athletic performance *Dozens of reports of severe and life-threatening adverse events in young people

* *Used as cold and flu remedy *Some studies show it increasing phagocytosis and release of interferon *Some studies have shown it to reduce duration of colds *Problem- only anecdotal evidence and no consistency in dosage of product

* *Many alternative medications lack studies to verify their efficacies *FDA approval not required so standards for dosage is not set *Some dosages vary as much as 10 X other dosages *Alt meds cannot make claims or promoted as curing or preventing disease

* *Chi is an energy that, according to ancient Chinese beliefs, permeates all things *Chi must be able to flow freely throughout the body in order for a person to maintain overall health *Chi flows along the meridians of the body

* *Acupuncture needles are inserted in an attempt to balance the opposing forces of yin and yang *Yin and yang are balanced when a person is healthy and chi is therefore able to flow freely *Injury or illness cause yin and yang to become distressed and unbalanced

*Originally there were 365 acupuncture points, but through the years this number has increased to over 2, 000 *Each point is believed to correspond with a particular illness or injury

*Depression *Arthritis *Kidney problems *Flu *Fatigue *Chronic pain *Migraines * *Paralysis *Hypertension *Tendonitis *Vision problems *Sexual Dysfunction *And many others…

*Stimulation of natural painkilling chemicals such as endorphins *Needles block the transmission of pain impulses to the CNS *

*Bladder or lung puncture *Allergic reaction to needles *Infection from unsterilized needles *Fainting *Convulsions *Nerve Damage *Putting off treatments that are known to be effective *

* *Chiropractic- means “done by hand”, referring to manipulation of the spine. *Greek words cheir (hand) and praxis (action) *Chiropractic is a form of spinal manipulation, one of the oldest healing practices. *Spinal manipulation was described by Hippocrates in ancient Greece.

* *Daniel David Palmer * Healing philosophies * Spiritualism * Magnetic therapy * Background in osteopathic training

*The body has a powerful selfhealing ability. *The body’s structure (primarily the spine) and its function are closely related, and this relationship affects health. *Chiropractic therapy is given with the goals to normalize the relationship between structure and function and assisting the body as it heals. *

* *Back pain including low-back pain *Neck pain *Headaches including migraines *Sports Injuries *Repetitive strains *Others * Asthma, Arthritis, Bursitis, Cerebral Palsy, Flu symptoms, DM, Infertility, etc

* * Effectiveness of treatments * Non-manual treatments * heat and ice, magnetic therapy, nutrition counseling and dietary supplements * Potential risks * Presumed to be safe from what is known * Potential Osteoporosis compared to healthier bone

* *Natural reaction to when the body hurts is to rub it *Dates back to at least the ancient Olympics *Massage is derived from 2 sources *Arabic verb mass “to touch” *Greek word massein “to knead” *Egyptians, Romans, Japanese& Chinese were known to practice massage

* *Used to manipulate the body’s tissue *Effective in promoting local & systemic relaxation, increasing local blood flow, encouraging venous return *Act of rubbing, kneading, or stroking the superficial parts of the body with the hand or an instrument for the purpose of modifying nutrition, restoring power of movement

* *Need to know underlying pathology *Need to know basic massage *Avoid constant hyperextension or hyperflexion of any joints *Must obtain correct positioning that will allow for relaxation, prevent fatigue & permit free movement of arms, hands, & body.

* *Depending on the amount of pressure applied & the speed of the stroke *Light, slow stroking – evokes systemic relaxation *Fast, deep strokes increase blood flow to the area *Cardiovascular changes – deep friction or vigorous massage was thought to produce vascular changes *Massage can produce decreased heart rate, breathing rate, & blood pressure if the purpose is for inducing system relaxation

* *5000 year old healing art *First originated in China *Used in preventative care, immune boosting and stress relief *12 Meridians of healing energy pathways *Blockages occur with illness or injury both physical and/or mental

* * Can use fingers, hands, palms, knuckles * Shiatsu- Japanese massagedeep pressure held for 3 -5 seconds * Jin Shin- two points are held for a few seconds * Reiki- channeling healing energy * Qi. Gong often combined with martial arts (breathing and slow fluid movement)

* *Increases circulation *Reduces pain *Releases stress *Balance body energy *Beauty treatments (improves muscle tone and skin circulation)

* * Homeopathy is a system of medicine based on three principles: * Like cures like For example, if the symptoms of your cold are similar to poisoning by mercury, then mercury would be your homeopathic remedy. * Minimal Dose The remedy is taken in an extremely dilute form; normally one part of the remedy to around 1, 000, 000 parts of water. * The Single Remedy No matter how many symptoms are experienced, only one remedy is taken, and that remedy will be aimed at all those symptoms.

* *The symptoms between a bee sting and a rash are similar. A bee sting swells and itches. *Hives, a rash or even another insect bite itch *the homeopathic medicine is made from a tiny amount of a bee. * Instead of masking symptoms, the medicine sends the body a signal to help it rebalance and heal.

* *Your eyes burn, itch and water when you peel an onion. You might have a runny nose too *You have a runny nose and begin to sneeze during a cold or allergy attack, *A homeopathic micro-dose of the remedy Allium cepa (red onion) would help your body heal itself.

* *Not to be confused with herbalogy *Homeopathic remedies are very dilute doses of natural ingredients including plants or minerals *Herbal remedies are made solely from plants.

* *Remedies are so diluted, they are rendered useless for treatment *Even in dilute cases, some treatments are made of toxic chemicals

* *Treatment of medical conditions with diet and nutrition *Usually based on whole food diet with supplements *Many feel diseases worsen by an improper diet

* *Relatively recent practice *Dietetic Association began in the 1900 s *Began as treatment for surgery patients *Now healthy patients seek diet therapy to remain healthy or even reverse aging effects

* *Cancer patients *Obesity *Diabetes *Elderly *Paralysis *Intestinal diseases

*Cupping *Gua sha