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ALSO | FAST FACTS | SAFETY ISSUES | PILL-POPPING SOCIETY Kaarina Decoster became a little edgy when her son’s cold and cough worsened as he played in an out-of-state tennis tournament. Concerned about his health, and his performance and hundreds of miles away from the family’s practitioner she wavered from her usual health practices and used an antibiotic to try to speed the healing process. The prescription, though, didn’t deliver the desired result. Instead, Mika, who turns 12 this month, developed an allergic reaction. His mother wasn’t surprised. The facial swelling and breakout of hives reaffirmed her long-held position that a natural approach to treating aliments is, in her mind, better than using medications. “I just think there are so many side effects from medications,” says the Coto de Caza mom who usually relies on diet, herbs and acupuncture to keep her son healthy. “It’s best to stay away from them as much as possible.” Concerned about complications and tired of meds being a primary solution, more and more families like the Decosters have turned to other sources to keep healthy. From preventive-type measures such as modified diets and supplements to therapies like neurofeedback to treat ADHD, alternative and complementary medicine (CAM) are becoming a more frequent choice in health care. Americans, for example, spent an estimated $36 billion to $47 billion on CAM therapies in 1997, according to figures supplied by the National Center for Complementary and Alternative Medicine (NCCAM). Of that, between $12 billion and $20 billion was paid out of pocket since these therapies often are not covered by insurance. As the names imply, complementary medicine is used together with conventional medicine. Alternative medicine, on the other hand, is used in place of conventional medicine. A newer term that is becoming a national trend is integrative medicine. As defined by the NCCAM, integrative medicine combines mainstream medical therapies and CAM therapies that have some high-quality scientific evidence of safety and effectiveness. Growing use How popular are these practices becoming? The NCCAM and the National Center for Health Statistics survey reports that 36% of adults in the United States are using some form of CAM. When megavitamin therapy and prayer specifically for health reasons are included, that number rises to 62%. Though the use is far less common among children than adults, says John Longhurst, director of the Susan Samueli Center for Integrative Medicine in Irvine, parents are seeking unconventional medicine for their children as well. In both instances, these practices are commonly used for chronic conditions such as pain, rather than acute conditions that require immediate attention. The reasons cited for this growth include marketing, availability of information on the Internet, the desire of patients to be actively involved with healthcare decisions and treatment, dissatisfaction with conventional medicine and doctor-patient relationships, and cultural influences. “We have tremendous influx in the U.S. Latinos, Chinese, Koreans,” says Longhurst. “And they are all bringing their cultural-based practices with them.” Acupuncture, developed in China more than 2,000 years ago, for example, is one of the most accepted and highly sought-after areas. This growing interest from the public in the use of complementary and alternative approaches for maintaining wellness, preventing disease, and treating specific illness has prompted the opening of dedicated facilities such as the Susan Samueli Center for Integrative Medicine. The academic center, part of UC Irvine, was established in early 2000 and is taking a leadership role in exploring new frontiers in CAM. In addition to conducting clinical research, the center is putting some of these approaches into practice with a new clinic in integrative medicine at Gottschalk Plaza. Other efforts include educating both the medical and the lay communities about the benefits and cautions associated with new approaches to medical practice. “The new interest and emphasis in this area and mainstream medicine, I think, will change the face of medicine over the next 10, 15, 20 years,” says Longhurst, a cardiologist and scientist. “And so what we’re calling today as unconventional, I think, years from now will be conventional. It’s changing.” Still, many have yet to buy into these practices that are often viewed by proponents as more natural and thus healthier. Many medical doctors, for example, are openly antagonistic about the procedures. There’s little evidence to support the effectiveness as well as a lack of understanding about how and why these therapies work, compared to the amount of evidence-based research found in conventional medicine. And a significant number of people don’t recognize CAM as real medicine, with critics claiming that the reported benefits are a result of the placebo effect. (The placebo effect, also referred to as the sugar pill effect, is positive responses to a medicine or treatment that cannot be attributed to physiological properties.) Clinical trial results released in July, for example, showed that taking echinacea had no significant effect on whether volunteers became infected with a cold, or, in those who developed colds, on how severe their symptoms were or how long those symptoms lasted. First-hand experience “I think it is lack of knowledge,” says Coto de Caza mom Decoster, explaining why some people are hesitant to try complementary or alternative approaches. “They are kind of trained with thinking, doctors are God and there’s nothing else.” Like many other parents, Decoster’s willingness to use unconventional approaches to keep her son healthy stems from her own personal experience. Decoster, who grew up in Finland, first sought unconventional treatment for allergies before her son was born. Her first course of action was a change in diet, which eliminated meat, white sugar, white flour and junk food. After researching and taking coursework at a local community college, she added acupuncture and homeopathic medicine. (Homeopathic medicine, which operates on a belief that “like cures like,” uses small, highly diluted quantities of substance that actually prompts those symptoms to treat conditions.) Today, Decoster follows a similar practice with her son, who plays and conditions for tennis four to five hours each day. Rated second nationally in the 12-and-under division, he follows the same diet as his mother and no longer fears the thin, metallic needles periodically inserted into his flesh. The preteen has received acupuncture treatments to help rid a cough as well as inflammation created by physical strain. Most recently, Decoster sought the services of Dr. Ali Meschi of Alternative & Complementary Medicine, Inc. in Laguna Hills. Meschi, who holds a number of credentials, treats patients through whole food, supplements and holistic herbal remedies. In Mika’s case, he recommended ones geared to help cleanse his body from an infection and his allergic reaction to the amoxicillin as well as ones to target the mental and physical stress associated with his competitive play. Decoster, who relies on these approaches largely as a preventive measure, says Mika rarely gets sick and has been on an antibiotic only one other time in his life. As for her, the allergy symptoms are gone and the family now has a pet cat. Getting in focus Jackie Westre, as with many other moms who do not have first-hand experience in CAM, relied in large part on the experiences of those she knew and trusted when her daughter began having difficulty focusing. In Westre’s case, this included several parents from her daughter’s school. “She’s actually very bright, but it was just focusing on the homework,” says Westre of her daughter Jennifer, who is now 17. “I can’t tell you what our evenings were like sometimes. We would sit there anywhere from two to four hours working on the homework.” At the time, Jennifer was 9 and in fourth grade. The Placentia resident sought the services of Dr. Steve Ferrari of Alta Neuro-Imaging in Brea, a psychologist who specializes in neurofeedback to treat a variety of conditions, including Attention Deficit Disorder, chronic depression and anxiety, and sleep disorders. With neurofeedback, also called EEG biofeedback, electrodes are applied to the patient’s scalp to monitor brainwave activity. The brain is then trained to function more efficiently through a series of mental exercises. “What I saw was really more of a willingness on her part to sit down and do her homework without being told,” says Westre. Other notable changes, which have been long-lasting, included increased confidence and the ability to study longer before her mind began to wander. Homework was no longer a period of dread and the entire family was less frustrated. Pleased with the improvement, Westre extended her daughter’s visits. In all, Jennifer worked with the practitioner twice a week for seven months. (The minimum recommendation by the practitioner is 30 one-half hour sessions, meeting at least once a week.) “The biggest thing I would say is just be patient because I think some parents don’t have the patience and they want to see results right away,” says Westre. “And for me, yeah, I did, too. But once I saw those little changes, it made me very happy. Then the bigger changes came along the way.” Numerous other families report having experienced such favorable results with CAM. However, as with conventional treatments, outcomes vary. Like many other parents, Tim and Katy Ward, (profiled in Inland Empire Family Magazine’s March 2004 issue on ADHD), tried other interventions before putting their son on medication to reduce symptoms associated with ADHD. Among the exhaustive list of treatments: speech therapy, tutoring, supplements, auditory processing therapy, diet changes, relaxation techniques and a host of others. The couple have collected so much information on CAM through workshops and seminars that they now have their own mini library. Despite their years-long efforts, none of these approaches helped. But even with the family’s disappointing experiences in CAM, Katy remains open-minded as she scours the newspaper day to day in hopes of finding the ultimate breakthrough: “A supplement that’s not a drug” to help her son. Sandy Bennett is associate editor. FAST FACTS CAM use in the United States The following are survey results on use of complementary and alternative medicine (CAM), released in May 2004 by the National Center for Complementary and Alternative Medicine and the National Center for Health Statistics. • 36% of adults use some form of CAM. When megavitamin therapy and prayer specifically for health reasons are included, that number increases to 62%. • The U.S. public spent an estimated $36 billion to $47 billion on CAM therapies in 1997. Of that, between $12 billion and $20 billion was paid out of pocket for the services of professional CAM healthcare providers. • Women are more likely to use than men, as are people with higher educational levels. • Most people who use CAM use it to treat themselves. About 12% sought care from a licensed CAM practitioner. • About 19% of the people surveyed used natural products. • Americans are most likely to use CAM for back, neck, head or joint aches, or other painful conditions; colds anxiety or depression; gastrointestinal disorders; or sleeping problems. • Most people use CAM along with conventional medicine rather than in place of conventional medicine. SAFETY ISSUES How to decide if CAM is right for your family Whether conventional or unconventional, there’s a potential for any intervention to have some harm associated with it including death. Take, for example, the numerous headline warnings in 2003 about the possible suicidal link between children and the anti-depressant Paxil. Reported emotional side effects ranged from mood swings to suicide attempts. Herbal remedies, which are not regulated, can have adverse and sometimes dangerous side effects as well. Ephedra, initially used as a cold remedy and then widely marketed as a diet aid, was pulled from store shelves after several deaths were associated with the product. The bottom line: Do your research. “The incidents of side effects by and large is much lower in all of these integrative medical therapies as compared to conventional therapy,” says Dr. John Longhurst, director of the Susan Samueli Center for Integrative Medicine. Still, people need to watchful. Here are some other tips from Longhurst for parents to take into account when considering an unconventional treatment for their child. • Make sure there isn’t some underlying problem, and if there is, talk to your medical doctor before you get any sort of therapy. • Make sure that there is some acceptance of the therapy. “There are some therapies that I think are very, very poorly defined and in fact make no sense whatsoever and are potentially dangerous,” he says. • Be careful what you read in lay magazines, but also keep in mind that physicians as a group tend to be overly cautious. • Stay clear of evangelical types, people who are trying to sell whatever they do, and make wild claims. • Ask lots of question. What evidence do they have that it works other than antidotal evidence? Personal experience, he says, isn’t good enough. “If a parent wants to try an unconventional therapy for their child, they should watch the child very carefully,” says Longhurst. “If the child is not responding to that therapy or is getting worse, they clearly need to seek the advise of their physician.” For more information, visit the National Center for Complementary and Alternative Medicine at www.nccam.nih.gov/ and the U.S. Food and Drug Administration at www.cfsan.fda.gov. The FDA offers a free guide titled “Tips for the Savvy Supplement User: Making Informed Decisions and Evaluation Information.” PILL-POPPING SOCIETY Despite an increase in complementary and alternative medicine usage, the nation’s medicine cabinets remain full. In fact, according to the U.S. Department of Health and Human Services’ annual check-up on American’s health, they are more crowded than ever. From medications that lower cholesterol and reduce the threat of heart disease to those that help lift people out of debilitating depressions and ones that keep diabetes in check, Americans rely on a number of tablets and capsules to improve their health. The report, “Health, United States 2004,” states that nearly half of all people take at least one prescription medicine and one in six take three or more medications. Increased drug usage is being seen among children as well. Among the greatest area of concern today is the growing use of psychotropic medications in young children. (These medications are capable of affecting the mind, emotions and behaviors.) According to a report, published in 2000 in the Journal of the American Medical Association, 12% of preschool-aged children at one study site, which consisted of more than 146,000 enrollees ages 2-4 years old, were talking a stimulant. During a five-year span (1991-1995), the prevalence of methylphenidate use in this group increased threefold. Methylphenidate is the generic name for Ritalin, which is a stimulant commonly prescribed to treat ADHD. |
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