As the face of health care continues to change with the increased use and popularity of "natural", "holistic", "alternative", "complementary" medicine, the focus of attention is now moving more towards what is being termed "integrative" medicine.
The idea is a simple one, (not necessarily easy): how to integrate the best of conventional medicine, the use of drugs and surgery, with the best of "alternative" medicine, natural and mind-body therapies, all within a more comprehensive individualized treatment plan for each person.
In this way, attention is given to how the different approaches and therapies can work together both simultaneously and synergistically if possible to support the health and healing of the patient. In the integrative medicine approach, in addition to proper diagnosis and possible treatment with conventional therapies, the role of nutrition, stress, environment and psychological factors are also examined and addressed.
Appropriately chosen natural therapies are considered and may also be prescribed. For some patients treatment may involve the use of effective natural therapies instead of drugs and surgery. For others, treatment may consist of natural therapies and techniques in conjunction with lifestyle counseling as a complement to drugs and surgery.
These support and stimulate and mobilize each person's self healing ability. This individualized approach treats the whole person and searches to find and address the underlying causes which may be present, such as diet, attitude, stress and or exercise or other possible factors. Treatment of each patient is individualized as no two patients (though they may be suffering from the same disease and symptoms) will have the same physical or psychological make-up.
The following is a case study, (cited with the permission of the patient) that illustrates how various therapies and approaches working together and synergistically can successfully manage a health problem. From an Integrative Medicine perspective, clinical, psychological, and behavioral aspects are all components of a comprehensive treatment program and the engaged involvement of the person in their health and healing.
A 48 year old attorney was diagnosed as having psoriatic arthritis. This is a progressive disease that involves the joints and the skin, and in our experience has a component that relates to lifestyle and an imbalance in the immune system. His rheumatologist had told him that gold salts, cortisone, and methotrexate (an anti-cancer drug that has severe side effects, such as hair loss) would be necessary to prevent irreversible crippling damage to his joints. He was seeking another approach, if possible.
After a careful history, it became apparent that many of his symptoms were related to stress and the sources of stress in his life were identified. His physical, mental, emotional, familial, lifestyle and environmental history were all evaluated. It was further found that he was suffering from insomnia and other complaints.
Physical exam revealed red, swollen hands that he could not close, and large red psoriatic patches on his skin. Dietary analysis revealed sensitivity to certain foods. Laboratory and blood test evaluation revealed a very high sedimentation rate, indicative of inflammation. The patient was also being constantly monitored by his rheumatologist.
A whole person approach was used. We developed a health promotion program with his active involvement, not only to treat his psoriatic arthritis, but also to make him healthier in general.
Botanical medicine was prescribed along with a homeopathy, and other food supplements. Therapeutically, we gave him vitamins, did guided imagery, and administered a cleansing juice fast and physiotherapy. The patient played an active role by changing his diet, doing yoga and prescribed aerobic exercise, and by utilizing stress management techniques. All of these methods were used to help activate and mobilize his self-healing mechanisms by strengthening various body components, including the immune system and by removing obstacles to proper functioning. We were, in short, addressing the underlying causes and contributing factors of his illness.
His progress was significant over a period of the next six months. Healing and improving a chronic disease is a process and takes time. Just as illness does not usually happen overnight, but develops slowly over time, so too, the healing process too does not happen overnight. It requires patience. His sedimentation rate was nearly normal, indicating that his joint and skin inflammation had gone down dramatically. His grip strength was near normal (enabling him to once again beat his tennis opponents) and his psoriasis had become almost unnoticeable. Upon returning to his rheumatologist it was determined that he had made such improvement that the the methotrexate and gold salts would no longer be necessary; he was spared the potentially severe side effects of these drugs. A number of other symptoms improved as well. He also found he no longer had a need for pain killers.
This case illustrates that an individualized whole person approach using natural therapies can be safely and advantageously used to control and improve chronic degenerative disease, to decrease dependency on powerful medications (with side effects) for symptom control, and to enhance general health and well being.
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Paul Epstein, ND is a naturopathic physician specializing in mind-body medicine and relationship centered care.