Complementary and Alternative Medicine
Horizons in Hemophilia, Spring 2007
By Rueleen Kapsch, RN, Quality Assurance Nurse
Complementary medical treatment (or supportive therapy) is used along with conventional therapy your doctor recommends, such as using T'ai Chi or massage in addition to a prescription medicine to treat a problem.
Alternative medicine is generally used instead of conventional medicine, and people who help with this are called practitioners. Basic philosophies of complementary and alternative medicine include:
- Your body heals itself. Practitioners see themselves as helpers to encourage your own natural healing process.
- Prevention is key. The practitioner may want to see you while you are not sick to make sure you are doing all you can to keep yourself healthy.
- Education and learning. Practitioners see themselves as teachers or mentors who offer guidance.
Many therapies are available in five broad categories:
Healing systems are sets of theories and lifestyle practices which involve the power of nature or energy fields in the body. This may include some medications or noninvasive treatments to help your own body heal itself. Traditional Asian, Native Indian and Tibetan practices can also fall into the healing system.
Mind-body connections strengthen the connection between the mind and your body. Complementary and alternative practitioners believe that these two systems should be in harmony for you to stay healthy. Examples of this might include yoga, aromatherapy, biofeedback, prayer, hypnosis, and relaxation therapy.
Dietary, vitamin, mineral supplements, and herbs. These treatments use ingredients found in nature. However, just because a product is "natural" that does not mean it is safe to take if you have a bleeding disorder or other medical problem. Herbs and food supplements are not regulated by the FDA as medications are, but can have some of the same risks of medications. Some herbs that should not be used by someone with a bleeding disorder are ginseng, ginkgo, Echinacea, and glucosamine sulfate since their chemical ingredients often are very similar or mimic effects of aspirin or heparin, a blood thinner. Other food supplements that the National Institutes of Health have identified as risky to take by someone with a bleeding disorder include alfalfa, anise, Coenzyme Q-10, Danshen, Dong quai, feverfew, Fucus, garlic, ginger, Omega-3 fatty acids, St. John's Wort, Valerian and vitamin E. It is extremely important to talk to your hematologist if you are considering taking any of these supplements.
Manipulation and Touch. Examples of these methods that use human hands to move or manipulate a part of your body include massage therapy, osteopathy, craniosacral therapy and acupressure. Deep tissue massage should not be performed on someone with a bleeding disorder since it might provoke internal muscle bleeding.
Energy Therapies. Some complementary and alternative practitioners believe an energy force flows through and around your body. If this flow of energy becomes blocked or unbalanced, it can result in illness. Different traditions call this force of energy by different names such as chi, prana and life force. Some practitioners of acupuncture believe that the insertion of thin needles into energy points in your body restores the flow of natural energy. There is some disagreement among doctors and practitioners about whether acupuncture should be done with anyone with a bleeding disorder for fear of causing muscle bleeding. Other energy therapies are therapeutic touch, where practitioners move their hands back and forth across your body without touching it to manipulate your energy field or smooth it out. Reiki is a Japanese technique that transfers healing energy from one person to another.
Benefits of complementary and alternative therapies may include reduction of stress and tension, reducing pain perception, restoring a sense of balance in the body, improving sleep, and helping restore a sense of well-being. It is important that you inform the doctor who treats your bleeding disorder about any medications or herbs that you are taking or plan to take in case they interfere with any factor products, increase your risk of bleeding, or might contain harmful substances for the liver if you have Hepatitis B or C.You can contact Handi, the National Hemophilia Foundation's information service (firstname.lastname@example.org), or websites such as the National Center for Complementary and Alternative Medicine (NCCAM) at http://nccam.nih.gov/; or the Mayo Clinic website at http://www.mayoclinic.com/health/alternative-medicine/CM99999. Websites created by major medical centers or national health organizations are the most credible sites for accurate information. Beware of false claims such as "satisfaction guaranteed" or "miracle cure." If the product were actually a cure, it would be reported in the media and your doctor would be recommending it. People giving testimonials are no substitute for scientific proof.
Scientific studies should contain words such as "double blinded," "controlled" and "randomized". Look for peer-reviewed studies. Those are articles reviewed and published by an independent panel of medical experts who have experience and interest in scientific investigations. Very small studies are not considered valid to make an accurate scientific conclusion.
Choosing a practitioner should be done after checking the state government list of practitioners in your area or with national associations and their list of local licensed practitioners. Weigh the risk of treatment of any form of therapy with the benefits to make sure the benefits outweigh the risks. Be sure you know the complete cost of treatment and how long treatment is expected to last. Ask for this information in writing if possible.
Many forms of treatment are not covered by medical insurance, so always ask the provider if your insurance is accepted, or call your insurance company. Any form of treatment should be discussed with your family doctor or hematologist.
Practitioners should be willing to talk to your hemophilia doctor about your treatment to assure that they can safely treat you and not create bleeding complications. As with any other form of therapy, be well informed, ask lots of questions and talk to your doctor about the risk and benefits of any of these therapies. Beware of things that may sound too good to be true, for often they are.