Symptom Approach or Systems Approach
In contrast, western medicine tends to be more focused on diagnosing and
treating disease versus optimizing health. As a result, its interventions,
though powerful, tend to disregard how it affects the body as a whole. The
treatment of menopause is a perfect example of this. Hormone replacement
therapy or HRT was developed in response to help relieve women’s
debilitating peri- and menopausal symptoms: hot flashes, mood swings,
insomnia, vaginal dryness, memory problems and urinary problems. Back
then, the hormone replacements were derived from pregnant horses. Now,
bio-identical hormones, BHRT, are available. These hormones are chemically
equivalent to what the body produces but, they are not yet approved by the
FDA. However, in 2002, the Women’s Health Initiative released its first
results of a large-scale randomized study of post-menopausal women on HRT.
The study found there were a slight increase of heart disease, breast
cancer, stroke and blood clots for women who took a combination of
estrogen and progestin,
http://www.nhlbi.nih.gov/health/women/pht_facts.pdf.
What followed was a lot of confusion amongst women, and many, including my
mom, stopped HRT altogether because of this. I’m still confused today on
whether the benefits of HRT outweigh the risks. But I’m also baffled by
the intervention. Why introduce a synthetic hormone to alleviate the
symptoms of a normal process? Isn’t that tinkering with the body’s
physiology? Aren’t there better, less invasive ways to alleviate the
suffering without creating long-term side effects later? That’s where I
feel western medicine falls short…it’s so good at understanding
physiological functions and pathways for medicine, but when it comes to
interventions such as drugs, they’re disruptive. They don’t seem to
enhance or work with the body’s natural mechanisms but rather, overtake it
altogether.
TCM, on the other hand treats menopause as a natural process not to be
interfered with. Instead of replacing hormones, TCM practitioners
facilitate the process of menopause while treating the symptoms with
acupuncture and herbal medicine. The plus side of this approach is that
there are no introduced risks of heart disease, breast cancer, etc that
are typically associated with HRT and best of all, symptoms are typically
relieved. In 2006, Stanford University released a study of acupuncture in
the September issue of Fertility and Sterility, showing the efficacy of
acupuncture to treat hot flashes. Their findings showed a significant 28%
decrease of hot flashes amongst women who received acupuncture treatment
vs. the 6% who received the “sham” acupuncture treatment. Their
conclusions were that acupuncture is “promising” in alleviating menopausal
symptoms and more studies need to done to validate acupuncture’s
effectiveness from an “evidence-based” perspective. It should be noted,
though, that TCM practitioners would treat menopausal symptoms not just
with acupuncture alone, but also in tandem with herbal medicine, exercise
and nutrition specially tailored for the individual.
Herbal Medicine and Powerful Drugs
Acupuncture tends to get a lot attention, even though Chinese herbal
medicine is the oldest and longest practiced modality in TCM. Herbal
medicine in conjunction with acupuncture can be effective in treating many
conditions. Niemiec gave the example of using acupuncture and herbs to
treat PMS. “PMS is a function of the Liver (TCM’s classification of the
liver) and causes emotions to be stuck. Herbs can relax that tension to
release that energy.”
Although Niemiec is trained mostly in Chinese herbal medicine, she is also
quick to point out “almost all cultures have had an herbal pharmacopeia
that has been passed down as collective knowledge. People and cultures
have always been self-sufficient in healing themselves.” Similarly, her
graduate students at Phoenix Institute of Herbal Medicine receive
instruction primarily on Chinese Herbs, but they also explore and include
herbal medicinal practices of Native Americans, India (Ayurveda) and the
Philippines. (For a useful resource of healing traditions from around the
world, check out Stanford’s Vaden Health Center website:
http://vaden.stanford.edu/library/healing_trad.html).
There are benefits to learning from the indigenous knowledge of other
cultures. Niemiec gave an example of a relative who was recently in the
hospital for dengue fever, a mosquito-borne disease. “She was in the
hospital undergoing blood transfusions, when a friend of hers suggested
that she drink an herbal tea made from a weed in the Philippines.” The tea
worked. The weed Niemiec was referring to is called “gatas gatas” or “tawa
tawa” depending on the region of the Philippines. Its botanical name is
Euphorbia hirta and it’s purported to help increase blood
platelet counts for those with dengue hemorrhagic fever. Upon learning
about this herbal remedy, I was disappointed that I couldn’t find any
accessible published studies regarding tawa tawa tea, only anecdotal
stories. This is still valuable, but I must admit, as a westerner myself,
I also like to know how and why things work and tawa-tawa deserves to be
studied.
Still, I believe the benefits of herbal medicine are great from an
economic and health standpoint—they’re cheap, accessible and an effective
way to deliver medicine when the knowledge is there. On the other hand,
the western arguments against it are safety issues, such as toxicity
levels, quality and whether they really are effective to begin with.
Interestingly enough, these very same arguments can be used to question
the efficacy of modern drugs (e.g. are statins really safe and effective
in the long run?). At any rate, I think both western and herbal medicine
can learn a lot from each other. Herbal medicine can benefit from research
explaining its efficacy and western medicine can learn how to use herbal
medicine as a way to assist the body in healing itself vs. overcoming it,
or as Catherine described it “going after a problem with a sledgehammer.”
Most of our drugs are from plant derivatives anyway. The difference,
according to Niemiec is that “western medicine isolates the active
ingredient in certain plants and as a result, they’re potent, act quickly
and usually have side effects. They also tend to be tested on an adult
male population. Herbal medicine, on the other hand, is gentle, has no
side effects, has been tested and tried on everyone of all ages and sexes
in China, and, when the right diagnoses are made, the operative word being
‘right,’ it can help fight many health conditions.”
Mind-Body Connection
Finally, it seems fitting that I would end this blog on meditation. The
practice of Ayurveda and Traditional Chinese Medicine are robust because
of their holistic philosophy and aggregate wisdom. This is especially
apparent in their practice and awareness of the “mind-body connection.”
Ayurveda developed yoga and TCM, Qi gong. Both these techniques encourage
meditation through breathing and movement.
Probably the most valuable aspect of meditation is just doing it. Niemiec
simply describes meditation as a chance to just “stop and let it be.” As a
practice, meditation seems so simple, but it can also harness extremely
profound and powerful energy. Niemiec cites Qi Gong masters who are able
to block people from ten feet away just from their energy alone. And if
that doesn’t sound miraculous enough, she even talks about the ability of
Qi gong to reverse and redirect the DNA of cells. At PIHMA, Qi gong is
part of the curriculum and all students are encouraged to incorporate
meditation as part of their daily practice and I suspect, as a way to
teach their minds to heal. When I asked Niemiec how to meditate, she said
“We teach by doing and the more you do it, the easier it gets to return to
a place of balance.” That, I thought, was a perfect place to start. Q&A
with Catherine Niemiec, Attorney, Acupuncturist, Herbalist and my wellness
leader.
Catherine was in law school at UC Hastings when she came down with a
serious flu she couldn’t shake off. After fruitless visits to her
physician, a nurse practitioner finally suggested that she see an
herbalist in Oakland. The practitioner didn’t speak any English, but
looked at her tongue and gave her an herbal tonic to drink. She felt
better instantly and that was her first introduction to Chinese Medicine.
Fast forward many years later, Catherine is now a licensed acupuncturist,
herbalist, co-author of Arizona’s licensed acupuncture law and founder and
president of Arizona’s first accredited acupuncture college, the Phoenix
Institute of Herbal Medicine and Acupuncture (PIHMA).
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