25 February 2010

Northwestern Memorial’s Integrative Oncology Program aims to ease pain and help patients manage cancer

CHICAGO- The very instant Penny Kukovec was diagnosed with breast cancer her world permanently changed. Suddenly, it felt as if her life was out of her control. She felt powerless and overwhelmed. There were so many unanswered questions. Why me? What’s next? What about my family? The feelings Kukovec experienced are felt by many cancer patients following their initial diagnosis and as they pursue treatment. In an effort to effectively and compassionately respond to these worries, as well as address common side effects associated with cancer treatment, Northwestern Memorial Hospital and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University now offer integrative oncology services.

“When a patient is diagnosed with cancer many of them want to fully participate in their recovery, but don’t know where to begin. This program gives them control over their treatment,” said Julian Schink, MD, chief of Gynecologic Oncology at Northwestern Memorial and the Robert H. Lurie Comprehensive Cancer Center of Northwestern University.

The integrative oncology services are part of a larger 360 Care Program that recently launched aimed to address cancer patients’ needs from every angle through treatment that extends beyond medical therapies, to include counseling, stress management and integrative medicine. Integrative oncology services include acupuncture, massage, energy healing and naturopathic medicine offered by Northwestern Memorial Physicians Group’s Center for Integrative Medicine and Wellness.

“Our goal is to treat the whole person, not just their illness,” said Melinda Ring, MD, medical director of the Center for Integrative Medicine and Wellness. “Research suggests that a holistic approach can alleviate stress and anxiety, as well as the physical pain and discomfort patients often experience while undergoing cancer treatments by activating the body’s innate healing process.”

While there is little research to explain exactly how integrative approaches like acupuncture work, researchers at the National Institute of Health state complementary therapy such as acupuncture do improve the body’s immune system. In an oncology setting, integrative approaches provide an effective way to manage symptoms, alleviate side effects, and help patients restore their sense of control and vitality.

“My body was hit hard with trauma. I was so tired, my joints hurt and my muscles were tense. I knew I needed more help. When I began massage therapy my muscles relaxed, and it helped me release my emotions. It reminded my body that it can relax in spite of what I am going through,” said Penny Kukovec, patient at Northwestern Memorial.

Common side effects of chemotherapy and radiation treatment for cancer include muscle tension, aches, pains nausea, vomiting and fatigue. The main role of complementary medicine is to provide supportive care and reduce adverse effects while helping the patient cope.

“Unfortunately, the side effects associated with conventional therapies often cause patients to end their treatments prematurely, or require that we take a less aggressive approach,” said Schink. “We’ve seen this occurrence decrease with the addition of integrative oncology services.”

“The medicine I was taking for my cancer caused nerve damage in my hands and feet. It was very uncomfortable. Acupuncture helped relieve the pain,” said Nancy Amicangelo, patient at Northwestern Memorial.

There is evidence that integrative approaches may also play a role in reducing the rate of depression among cancer patients. Services such as massage therapy are believed to have a short-term effect on reducing anxiety related to depression among patients.

“You’re sick, your hair falls out, and your family is stressed. When you are diagnosed it’s sometimes all that you can think about. The massages offer me a chance to escape,” said Kukovec.

While integrative medicine does not offer a cure for cancer, there is strong evidence that it positively affects the patient. Studies show 77 percent of cancer patients who incorporate complementary approaches believe it improves their quality of life, and 73 percent state it makes them feel hopeful. In addition, 71 percent say it helps to boost their immune system.

All patients under the care of a Northwestern Memorial oncologist are eligible to receive free integrative medicine services as part of their cancer treatment. The 360 Care Program was made possible by a generous gift from Abra Prentice Wilkin, board member of Northwestern Memorial Hospital and longtime supporter of the hospital.

Source:
Angela Salerno
Northwestern Memorial Hospital
Photo credit: Emory University

The study shows that an inpatient integrative medicine program can have a significant impact on pain in an environment where pain management continues to be a major challenge, and traditional medications can have negative consequences.

“Roughly 80 percent of patients report moderate to severe pain levels after surgery,” says Gregory Plotnikoff, M.D., one of the study’s authors and medical director of the Penny George Institute for Health and Healing at Abbott Northwestern Hospital.

“We struggle to provide effective pain control while trying to avoid the adverse effects of opioid medications, such as respiratory depression, nausea, constipation, dizziness and falls.”

The study included 1,837 cardiovascular, medical, surgical, orthopedics, spine, rehabilitation, oncology, and women’s health patients at Abbott Northwestern between January 1, 2008, and June 30, 2009. They scored their pain verbally on a zero-to-ten scale before and after treatments.

The treatments included non-pharmaceutical services and mind body therapies to elicit the relaxation response including:

• acupuncture
• acupressure
• massage therapy
• healing touch
• music therapy
• aromatherapy
• reflexology.

The study, “The Impact of Integrative Medicine on Pain Management in a Tertiary Care Hospital” was published March 5 in the Journal of Patient Safety.

“Earlier studies narrowly focused on whether specific integrative therapies manage pain in either cancer or surgical patients,” says Jeffery A. Dusek, Ph.D., research director for the George Institute.

“Our real-world study broadly shows that these therapies effectively reduce pain by over 50 percent across numerous patient populations. Furthermore, they can be clinically implemented in real time, across, and under the operational and financial constraints within an acute care hospital.”

Dusek says future research will focus on defining appropriate intervention doses, duration of pain relief, and developing profiles of which patients are most likely to respond to nonpharmacologic treatments. Reductions in total hospitalization costs, medication use and adverse events will be quantified in future prospective research using the electronic medical record.

“I think we will find that integrative approaches to pain management during the hospital stay will improve patient satisfaction and outcomes, and we will see cost savings from patients using fewer drugs and experiencing fewer adverse events,” said Lori Knutson, RN, BSN, HN-BC, executive director of the George Institute.

Practicing evidence based homeopathy

Evidence based practice (EBP) revolves around improved patient outcomes. Health professionals use the best evidence possible to make clinical decisions for individual patients. It involves complex and conscientious decision making based on the available evidence, and also on patient characteristics, situations, and preferences.

EBP recognizes that health care is individualized and ever changing. Finally, I would say EBP is the formalization of the care process based on requirements of individual patient. This individualization is practiced by homeopathic physicians for the last 200 years.

Homeopathy is a system of therapeutics founded in 1796 by Samuel Hahnemann on the principle that “like cures like”. Homeopathy, since its inception, has been used to treat a wide range of illnesses based on individualisation or in a way EBP. Hahnemann was the first person who advocated this strongly. (more…)

Amy Lansky has written an insightful article to address some of these concerns, here is a link.

Also why do we need (allow) these individuals to decide if we want access to medical freedom, choices and options in our health care? Medical freedom is a necessity, not an option.

September 18, 2009-In a small “proof of principle” study, stroke researchers at Johns Hopkins and the University of Illinois have found that a simple, one-minute eye movement exam performed at the bedside worked better than an MRI to distinguish new strokes from other less serious disorders in patients complaining of dizziness, nausea and spinning sensations.

Results of the study of 101 patients , who were already at higher than normal risk of stroke because of factors including high blood pressure or high cholesterol, were published online ahead of print on Sept. 17 in Stroke. The patients were all seen at OSF St. Francis Medical Center in Peoria, Ill.

The project, spearheaded by a Johns Hopkins neurologist in collaboration with colleagues at the University of Illinois in Peoria, found that the quick, extremely low-cost exam caught more strokes than the current gold standard of MRI, suggesting that if further research on broader populations confirms these results, physicians may have a way to improve care and avoid the high costs of MRI in some cases.

“The idea that a bedside exam could outperform a modern neuroimaging test such as MRI is something that most people had given up for dead, but we’ve shown it’s possible,” says David E. Newman-Toker, M.D., Ph.D., assistant professor of neurology at the Johns Hopkins University School of Medicine.

Dizziness is a common medical problem, Newman-Toker says, responsible for 2.6 million emergency room visits annually in the United States. While the vast majority of dizziness complaints are caused by benign inner-ear balance problems, about 4 percent are signals of stroke or transient ischemic attack (TIA, a condition that often warns of impending stroke in the coming days or weeks). Because more than half of patients with dizziness who are experiencing strokes show none of the classic stroke symptoms — one-sided weakness, numbness, or speech problems — emergency room physicians are estimated to misdiagnose at least a third of them, losing the chance for quick and effective treatment.

“We know that time is brain, so when patients having a stroke are sent home erroneously, the consequences can be really serious, including death or permanent disability,” says Jorge C. Kattah, M.D., chairman of neurology at OSF St. Francis Medical Center, who co-led the study.

The study of eye movement tests was suggested by previous research showing that people experiencing a stroke have eye-movement alterations that correlate with stroke-damage to various brain areas and that these are distinct from eye-movement alterations seen with benign ear diseases. Some patients, for example, can’t immediately adjust their eye position if their heads are quickly turned to the side, or they experience jerky eye movements as they try to focus on a doctor’s finger when looking to either side.

Newman-Toker and his colleagues at the University of Illinois College of Medicine in Peoria wondered whether testing eye movements in dizzy patients might help them sort out which ones were having a stroke from those with other problems.

All of the patients in the current study were seen after complaining of severe dizziness that had lasted for several hours continuously, and all had at least one risk factor for stroke. The researchers selected them to increase the chance that they would find strokes in this population. None of the patients had a history of previous dizzy spells and more than half sought care at the Peoria medical center’s ER, though some were inpatients at the hospital or were transferred from other area hospitals.

The researchers gave each patient an exam comprised of three eye-movement tests: looking for inability to keep the eyes stable as patients heads were rotated rapidly to either side, looking for jerkiness as patients tracked a doctor’s finger to look right and left, and checking eye position to see if one eye was higher than the other. Each patient then received an early MRI, the highest-quality neuroimaging test available to confirm stroke in dizzy patients. Patients with eye tests suggesting stroke but without stroke on the first MRI scan underwent a repeat scan.

In the end, 69 patients were diagnosed with stroke and 25 with inner-ear conditions. The remainder had other neurological problems. Using only the three eye-movement tests, the researchers had correctly diagnosed all of the strokes and 24 of 25 with inner-ear conditions. By contrast, initial MRI scans were falsely negative in eight of the 69 stroke patients, who were later correctly diagnosed with follow-up MRIs.

Though the researchers emphasize the need to verify their results in a larger and more general population of patients with dizziness, Newman-Toker says the initial findings are “incredibly promising.” If they hold true, he adds, testing eye movements could have several advantages over MRI beyond reliable diagnostics. For example, while the wait time for an MRI can be several hours or more, physicians can perform all three eye-movement tests in a minute or less. Also, the eye-movement tests are “basically free,” compared to $1000 or more for an MRI, Newman-Toker says.

“In an era where cost containment is butting up against issues of quality in health care delivery, there’s tremendous potential for bedside approaches like ours that could reduce costs while improving quality at the same time,” says Newman-Toker.

For more information, go here

Is there a role for complementary therapy in the management of leukemia?
Expert Rev Anticancer Ther. 2009 Sep;9(9):1241-9
Patients with leukemia often seek additional treatments not prescribed by their oncologist in an effort to improve their cancer treatment outcome or to manage symptoms.

Complementary therapies are used in conjunction with traditional cancer treatments to decrease symptoms and side effects associated with cancer or cancer treatment, and to improve patients’ overall quality of life. Complementary therapies are distinct from so-called ‘alternative’ therapies, which are unproven, ineffective and may postpone or interfere with mainstream cancer treatment. Complementary therapies are pleasant, inexpensive, nonpharmacologic and effective. For patients with leukemia, the complementary therapies that are always appropriate include mind-body interventions, such as self-hypnosis, meditation, guided imagery and breath awareness. Massage and reflexology (foot massage) decrease symptoms with effects lasting at least 2 days following treatment. Acupuncture is very beneficial for symptom management without adverse consequences. Physical fitness with regular exercise and healthy dietary habits can significantly decrease side effects of cancer treatments and may prolong survival. Botanical extracts and vitamin supplements may interfere with active cancer treatments, and should be discussed with the oncologist or pharmacist before use.

Integrative Medicine Service, Memorial Sloan-Kettering Cancer Center, 1429 First Avenue, NY 10021, USA.

“Everybody likes you.” “I wanted that.” These thoughts led a teen to write what could be called hateful and spiteful notes in her diary of fellow classmates. She thought it was private. No one would ever know. And no one did until the fateful day that someone found the secret book and made it very public. Her secrets were now out in the open.

So what is jealousy?
Jealousy
foolish and irresistible
Meaning: (Webster)
Suspicious fear or apprehension; painful apprehension of rivalship in cases nearly affecting one’s happiness. Uneasy through fear that good will, interest, affection or the like, regarded as belonging to one’s self is transferred to another; pained by suspicions of preference given to another.
Synonyms: suspicious; anxious; envious

In the Complete Repertory, the rubric: Ailments from jealousy, lists 65 remedies. Among some of the remedies listed are Apis (honeybee), Lachesis (Bushmaster Snake) and Platina (Platinum metallicum). As you can see just from the three listed remedies, homeopathic remedies come from the natural world around us. What is important to understand is that the young lady’s jealousy was a reflection of some lack of inner peace. The cause we do not know and we are offering any type of diagnosis.

Homeopathy focuses on healing the person,their unique way of being in the world. By identifying similar substances in nature that can produce a similar pattern one is able to heal internally. Homeopathy is quite helpful in balancing emotions.

Emotions are powerful forces. Ignored the energy often remains blocked and can lead to physical ailments or further emotional problems.

Flower Essences such as the Bach Flower remedies are also very helpful for emotional balancing. The Bach Flower essences recognize 38 conditions which are aligned to the following seven headings:
For Fear
For Uncertainty
For Insufficient Interest in Present Circumstances
For Loneliness
For Those Over-Sensitive to Influences and Ideas
For Despondency and Despair
For Overcare for the Welfare of Others.
Dr. Edward Bach discovered the remedies through an intuitive process, while in the English countryside. The Bach flower essences focus on Type Remedies which relate to a personality pattern and the Helping Remedies which help to resolve transient mood of the psyche. For more information on the Bach Flower Essences click, here. And here is a questionnaire, you can explore.

One does not have to be undone by the thought pattern labeled as ‘jealousy.’ See it as a sign that you simply need some healing. Ultimately you are not your thoughts.

There are many ways that one can heal emotional states that will lead one to ultimately balance and fulfillment.

“Resentment of someone’s good will serve as a barrier to one’s own growth.”

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www.continuumwellness.org

Question:

Lately, my husband has started sweating profusely when he is asleep.  His sweat has a strong cheesy smell. He is showers regularly so that is not the problem.  Is this serious?

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A Homeopathic Look

I’m not speaking to the, is this serious question, as I am not an medical doctor.  Let’s take a peek at this situation from a homeopathic perspective.

I decided to repertorize these few symptoms and see what comes up.  Look below.  Of course, other factors have to be taken into consideration to make a remedy decision.
Cheesy perspiration, could also be close to “fetid” and “offensive”, but I like this rubric since it quite distinct and in the person’s own language.

Perspiration
ODOR, cheesy, (8)

Perspiration
PROFUSE (224)
night (97)

Based on this limited information what homeopathic remedy might you suggest for this individual?

For a doctor’s perspective on the question read here.

Help for High Blood Pressure

Enter the Polypill.  Researchers want to create a pill a 3 in one that can reduce the risk of heart attack, stroke and high blood pressure in one.  article here
Truth is it has been created or should I say they have been. When we eat whole foods, contained therein is a synergistic blend of vitamins, proteins, amino acids, flavonoids, solar and lunar energy and maybe even (hopefully) love from the gardener. We cannot get this from a pill.

Run This Way

Instead of running from nature, run to nature. Nurture yourself with learning how to live in balance. It’s free. It’s the healthiest choice for yourself and the planet. Give it a try. Polypill? Try basking in the sun, or hugging a dear friend, cook yourself a meal with a big dose of love in it…you’ll be glad you did, for benefits no Polypill could ever provide.

At Continuum Wellness we offer homeopathic care and wellness coaching to promote wholeness, health and well-being.