Conventional and Complementary Medicine: Skills for the Health Care Consumer

Self-Care: Managing Medical Problems Self Assessment Being a good observer, what makes it worse/better Monitor vital signs Temperature, HR, BP, BS, UTI, pregnancy detection See a Physician if a symptom is: Severe Unusual Persistent Recurrent

Self-Care: Managing Medical Problems Emergencies: Major trauma or injury Uncontrollable bleeding Severe shortness of breath Persistent abdominal pain Poisoning or drug overdose Loss of consciousness Stupor, drowsiness, or disorientation Severe or worsening reaction to an insect bite or sting

Self-Treatment: Many Options Watchful waiting- body can heal itself in many instances Nondrug options-drink water, cold/hot pad, rest, etc.

Self-Treatment: Many Options OTC drugs have been identified as safe by the FDA ~ 60% of all medications are OTC When Self-medicating with OTC medications Read labels Do not exceed the recommendation Try to buy generic Never take a drug from an unlabeled container Be cautious if pregnant and nursing Pay attention to the expiration date (~90% of prescription drugs potent for years after) Store medication properly Special caution with aspirin

Conventional vs. Complementary Medicine Conventional (Western) Medicine – a system of medicine based on the application of the scientific method Diseases are thought to be caused by identifiable physical factors like pathogen causing microorganisms Every disease is defined by a certain set of symptoms and that these symptoms are similar in most patients suffering from this disease

Conventional Medicine Approach to Treatment: Focuses on the causes of illness not a spiritual or mental imbalance Relies heavily on prevention, surgery and pharmaceuticals Based on scientific ways of obtaining knowledge: Empirical, Rational, Testable, Parsimonious, General, Tentative

The Providers of Conventional Medicine Medical Doctors (MD) Doctors of Osteopathic medicine (D.O.) Podiatrists Optometrists Dentists Allied health care professionals Registered Nurses (R.N.s), Licensed Vocational Nurses (L.V.N.s), Physical Therapists, Social Workers, Registered Dietitians (R.D.s), Physician Assistants (P.A.s), Nurse Practitioners, Certified Midwives

Getting the Most Out of Your Medical Care The Physician-Patient Partnership Be assertive, ask questions, do your part Your Appointment with Your Physician The Diagnostic Process Why do you need it? What are the risks? Preparation? Medical and Surgical Treatments Non-drug options? What is the medicine supposed to do? Is surgery necessary? Any other options?

Complementary and Alternative Medicine Belief about Health: Disease is a disturbance or imbalance of physical processes and forces/energies in the body. These life forces/energies are called qi (chi) Treatment aims at reestablishing equilibrium, balance and harmony

Five Domains of Complementary and Alternative Medicine (CAM) Alternative medical systems Mind-Body interventions Biological-based therapies Manipulative & Body-Based Methods Energy Therapies Alternative medical systems Ex. Traditional Chinese medicine, Homeopathy Homeopathy -treats patients with heavily diluted preparations which are thought to cause effects similar to the symptoms presented. Homeopathic remedies are prepared by serial dilution 2. Mind-Body interventions Ex’s. Hypnosis, Meditation, Prayer Hypnosis – a deep relaxation during when the patient is more suggestible and the practitioner will help him/her change unwanted behavior or deal with pain and other symptoms 3. Biological-based Therapies Herbal therapies – consist primarily of herbal therapies or remedies, botanicals and dietary supplements 4. Manipulative and Body-Based methods Ex. Chiropractic, Massage Therapy Most commonly accepted of the CAM manual healing methods Focuses on the relationship between structure, primarily of joints and muscles and function, primarily of the nervous system to maintain or restore health Manipulation of the joints especially the spinal column 5. Energy Therapies Ex. Qi gong, Reiki

Figure 20-4 The five domains of CAM practices

Complementary and Alternative Medicine Alternative medical systems Ex. Traditional Chinese medicine (TCM) Harmonious flow of qi defines health Primary treatments: Herbal remedies & Acupuncture Herbal remedies- herbs, plant products, fungi, animal parts, minerals are used as medicines Acupuncture-used to correct disturbances in the flow of qi by inserting needles through the skin at appropriate sites (meridians) Homeopathy Treating an individual with highly diluted substances hoping to trigger the body’s natural system of healing

Mind-body Interventions Makes use of the connection between mind and body and the effect they have on one another Meditation Hypnosis Prayer Mental healing Biofeedback Placebo effect is one of the most widely know examples of mind-body interdependence

Biological-Based Therapies Consist primarily of: Herbal therapies or remedies Botanicals (a plant or plant part valued for its medicinal or therapeutic properties, flavor, and/or scent). Extracts from animal tissues (shark cartilage) Dietary supplements Many overlap with conventional medicine’s use of dietary supplements Cranberry Saw palmetto Soy Garlic Gingko Echinacea Milk thistle Black cohosh St. John's Wort Ginseng

Manipulative and Body-Based methods Manual healing based on the idea that misalignment in one part of the body causes pain or dysfunction in another part Ex. Chiropractic medicine, massage, osteopathy (manipulation/massage of bones, joints, muscles)

Energy Therapies Forms of treatment that use energy originating from the patients or from other sources (therapeutic magnets) Qigong (involves rhythmic breathing coordinated with slow stylized repetition of fluid movement, a calm mindful state, and visualization) https://www.youtube.com/watch?v=SzO7Eo0xeQ0 https://www.youtube.com/watch?v=vJNYLBIfq8M

Energy Therapies Reiki (intended to correct disturbances by use of specific hand positions on or near the patient’s body to promote balance

Evaluating Complementary and Alternative Therapies Questioning the CAM practitioner Do your own research about the safety and effectiveness of a given procedure Why does he/she think the therapy will be beneficial etc. What is the cost? How long should therapy continue? Expected cost of treatment? Will insurance cover any portion of it? 19