Healing Arts for Marfan and Chronic Pain

I recently helped to organize a Healing Arts workshop for the National Marfan Foundation annual meeting, which was held in Boson this year. More than 30 participants heard and asked questions of a panel of complementary/alternative practitioners who discussed managing the symptoms of Marfan syndrome—particularly chronic joint pain—with Tai chi, the Alexander Technique, acupuncture, Traditional Chinese Medicine (TCM), nutrition, and craniosacral therapy. Combining alternative treatments with conventional care is called “integrative medicine,” and putting together your own personal healing combination is an excellent way to take responsibility for your health. These healing modalities have applications for anyone suffering from chronic pain.

The workshop began with Tai chi and Alexander teacher Jamee Culbertson leading us in the opening movements and breathwork of a Tai chi form that is thousands of years old. Research has found that these ancient, graceful, meditative movements improve balance and reduce falls. As we breathed deeply and moved slowly in unison, the room seemed to transform into a kind of “sacred space,” as the group united with a shared purpose and energy. With two volunteers, Jamee then demonstrated how the Alexander Technique reduces pain and eases body movement through simple awareness of habitual actions that may be restricting activities. Both Tai chi and the Alexander Technique are gentle, non-invasive practices, and do not stress joints or ligaments.

Eurydice Hirsey, a trained chiropractor and craniosacral therapist, then talked about the use of craniosacral therapy to ease pain and improve movement by enhancing the circulation of cerebrospinal fluid. This is done through gentle touches on the head and sacrum, following the body’s own natural rhythms and movements, without force or pressure. While chiroporactic may not be indicated for most people with Marfan syndrome, the light touch of craniosacral therapy can ease tight muscles and reduce pain, even in those who have had spinal fusions, by focusing on other areas of the body where movement is possible.

Acupuncturist and researcher Stephen Cina shared his orthopedic investigations into the nature of connective tissue and its possible relationship to the meridians (energy pathways) used in Traditional Chinese Medicine. A practitioner either inserts tiny needles into “points” on the skin that correspond to the energy meridians (the needles are usually painless), or applies pressure with the hands (acupressure) on these same spots, in order to reduce pain. And naturopathic intern Amanda Daeges–who has Marfan syndrome, talked about maintaining integrity of connective tissue through what we eat and drink: specifically whole foods and whole grains that include nutrients and trace minerals. She also stressed the importance of drinking enough water. (Divide your body weight in half to find out how many ounces of water you should drink each day.)

All of these complementary modalities (and many more) are described in detail here, has well as profiles of practitioners and personal experience stories.

VERY important: Before you try any complementary/alternative practices, always check with your doctor.

The Perils of Plastic

In case you are not already motivated to stop using plastic bags, check out this disturbing slide show. Did it for me!

Foxglove: History and Medicinal Uses

There has been a great deal of interest on this blog lately about the foxglove plant, so I asked herbal expert and integrative physician Alexa Fleckenstein, M.D., to give us some background. Here is what she wrote:

Foxglove is a beautiful plant in the garden – it likes a moist soil. The pinkish bells on graceful spikes cheer me up. Moreover, it self-seeds when it likes its home – carefree summer joy. It seems.

Foxglove is also one of the deadliest plants when ingested. The powerful medication digitalis has been derived from the plant to help ailing hearts. The story goes that William Withering (1741-1799) became aware of people self-medicating the “dropsy” (body swelling from what we now call congestive heart failure) with this plant; he then searched for the “active” ingredient and found it in digitalis.

Digitalis is safer than the mother plant because in a plant it is difficult to gauge the poisonous quantity the patient is ingesting. Even with digitalis, we physicians rely on a blood test to tell us whether the patient is receiving a safe dose. We say the therapeutic margin is narrow – which means it is but a small step between digitalis helping the heart and digitalis killing the patient.

For these reasons, I would not recommend adding foxglove into your home herb chest. Better to rely on herbs that are safe. With my patients I rely on herbs that have a large therapeutic margin. It is close to impossible to kill yourself with peppermint, for instance (don’t try at home - because, as Paracelsus knew, every single agent in the world can become poisonous if we ingest a large enough dose of it; sugar is a prime example; even water!).

How do we know an herb is safe? Often, they have been tested through centuries or millenniums of use. One person who developed a list of about one hundred safe herbs was Sebastian Kneipp (1821-1897). Better known for his “cold water cure,” Kneipp had learned about plants from his mother, who was the herbalist of the little village in Bavaria where he grew up. He tried to get away from the cold water (a long story, which I will tell you another time!), and therefore systematically searched for herbs that people could use for themselves, experimenting on himself for safety. Nowadays, science has better tools to examine an herb. Of the about one hundred herbs Kneipp had deemed safe, only abut three were removed from the list by the famous Commission E (which studies herbs for safety and efficacy in Germany).

The “safe” herbs can – and should – be used for everybody. And they should be taken whole – in a reputable tincture or a tea - and not manufactured and put into a pill. Because the plants have evolved with us over millions of years; their biochemistry fits into our physiology like a key in its lock. The many different compounds of a plant work in “synergy” (all for the same purpose – or: The sum is more than its parts. If you are interested in herbal synergy, I have written about it in my book).

Beautiful as it is, foxglove is an example of an unsafe plant – it belongs only in the hands of an experienced herbalist or your doctor. So content yourself with admiring the lovely foxglove flowers, and make yourself a nice cup of soothing herbal tea. Try lemon balm!

More about “the power of the flower.”

Cold Water for Babies?

Rose asks an interesting question about whether to use cold water for babies. Here is an answer from Alexa Fleckenstein, M.D., my cold water expert and the author of Health 2 0:

Dear Rose,
Yes, you can apply cold water to babies. This is done in the tradition of European Natural Medicine to raise strong, robust children.
When my son was four months old, I started him. I filled his little pink tub with cold water, cradled the naked baby in my hands and very quickly dunked him in—but not his head. It took a second or so. For babies, the head always stays outside the water.
He took a deep gasp but never cried. He was so astonished about what had happened and so busy with thinking that he never had time to protest.
Can’t remember when I stopped it - but certainly I would not force a protesting toddler under cold water.
Now that our son is a young man, he follows the family tradition and ends each warm shower with a cold one, and he has become a healthy outdoorsman.

Tell us how your baby likes it!
Alexa Fleckenstein M.D.

You can see all comments on this post here:

Weeds for Health: Live from Your Garden!

The summer solstice is a wonderful time to harvest nourishment from your garden. I caught up with herbal expert Alexa Fleckentein, M.D., just coming in from her garden with an armful of grapevines (vitis vitifera), considered a bad weed here in the Northeast. “I used to swear and mutter when I pulled them out,” says Dr. Alexa. “Now I delight: A study has shown that grape leaves are even higher than red wine in resveratrol, a phytoalexin known to prolong life and prevent cancer.” The Greeks have been making little dolmades from grape leaves—stuffed with rice, herbs and pine nuts – for thousands of years. Dr. Alexa’s cooking method is simpler: She adds the grape leaves to her vegetable stir-fry (recipes in her book), and freezes them to use all winter long. “Simple, cheap, and healthy,” she says.

If you live in the South, advises Dr. Alexa, you might substitute kudzu (pueraria montana). “Kudzu has some marvelous properties too,” she says. “It is high in vitamins A and C, and also contains calcium. It comes in handy as an anti-inflammatory food (and is a much better source of calcium than inflammatory dairy products). Everybody in the South complains about this obnoxious weed. How about eating it as a revenge?”

And when you are done with your stir-fry, enjoy Dr. Alexa’s famous Garden Tea, described in her book and in this article. “I throw all the other edible weeds in my garden—as well as many plants and flowers—into my daily Garden Tea, which is filled with the healing properties of Nature’s pharmacy,” says Dr. Alexa. “Everything that’s not poisonous can go in there – from kitchen herbs to dandelions, from rose petals to pine needles. But REALLY: You have to know what you are doing and what to avoid. One hundred percent!!” Details are in her book, but she strongly advises taking an herb course to be sure you know what NOT to include!

The first time I made Garden Tea, for example, I proudly threw in a hydrangea flower—it was so pretty! Then I called Dr. Alexa while it was steeping to check on whether this was OK to include. “Throw the whole tea away!” she commanded at once. “Hydrangea leaves and flowers are poisonous.” I was sad to see it go, but I head learned my lesson: When in doubt, throw it out!

Grand Rounds is up

This week’s Grand Rounds is hosted by Dr. John Crippen, who writes about “the pleasures and pitfalls of family medicine in the modern British National Health Service.” I am honored that he has chosen to include my post.

To fight—or not to fight. Is that the question?

Senator Kennedy’s recent diagnosis of a malignant brain tumor has sparked an animated debate in the Boston Globe among health columnists and letter writers: Should patients diagnosed with a deadly cancer be encouraged to fight their disease, or should they focus more on quality of life and the journey towards spiritual—if not physical—healing? The “fight” proponents use the vocabulary of warfare: “vanquishing” the cancer “enemy” with every available “weapon” in the “arsenal.” One problem with this approach is that if you fight and lose, there may be guilt: Perhaps you didn’t fight “hard” enough.

The advocates of acceptance and healing say control what you can, choose your doctors and your treatments wisely, but also choose to spend time and energy on family, relationships, meaningful work, and finding joy in every moment. As one letter writer said, “Cancer is a disease, not an enemy. It also presents a deep opportunity to learn. My quest is to live each day as fully and richly as I can, to enjoy all that I have, and all the beauty and meaning of this world.”

A contrasting view came from an oncology nurse, who wrote that the notion of “fighting to win,” is too narrow: “Perhaps one’s fight could mean mustering resources against an enemy - cancer. Or it could mean winning against symptoms, or against the urge to stay at home during treatment and not work. Or beating the maze of our healthcare system, and getting the treatment you need when you need it!”

Perhaps “to fight or not to fight” is the wrong question, since there is no universal approach to illness that is right for every person. Several years ago, when I recovered from my own health challenge, and wrote my first book filled with the stories of people who fought and prevailed against cancer, paralysis, pain and deadly diseases, I thought that fighting was the only acceptable way to deal with illness.

Now, I am not so sure. Marshalling every available medical, alternative, emotional and lifestyle resource does give us more of a chance to overcome illness and injury, and perhaps to discover the latest “silver bullet” in the arsenal. But at what cost? There is also a value to the inward journey for peace, and nurturing loving connections with others. How best to combine these approaches given the limitations of energy and time?

Once, I interviewed a wise rabbi about the ways in which he helps people deal with suffering and illness. He described a state of holding two simultaneous beliefs: The desire to become well and “vanquish” the disease; while at the same time accepting the possibility of—and preparing yourself and your loved ones for—a different outcome. This is clearly very hard to do: One must gather the inner strength and energy—as well as the time—to pursue treatments, seek medical options, eat well, and think positively. All while somehow recognizing and accepting that you may not succeed. No easy answers. I’m still thinking.

More Evidence About the Health Benefits of Cold Showers

Two detailed and lengthy comments about research on the health benefits and history of cold water bathing were recently posted here. This is a fascinating dialogue, made all the more so by the care with which the writers of these comments have described their own research and sources. I appreciate your efforts and would especially like to know more about the writer called “cold shower,” whose post is dated May 22. Can you tell us something about yourself, your interests, and your work?

Alexander Technique for Depression

This is the beginning of an interesting post about the Alexander Technique as a treatment for depression and mental illness: “In our culture today the connection between physical and emotional problems is gaining currency. Surprisingly, the best answer to coping with the stresses of life is by using a hands-on approach that straightens the body. This technique can help in balancing moods, changing behavioural patterns and managing life’s challenges.”

I have studied the Alexander Technique for years and found it useful for body alignment and functioning without pain. The beneficial effect on depression and psychological problems is news to me, but I can certainly believe it. Here is a link to the post. And here is a link for more information about the Technique.

Grand Rounds is up

Check out this week’s excellent Grand Rounds roundup of medical/health posts in the blogosphere, hosted by David Williams of the Health Business Blog. I’m happy that my post about “The Unhealthy Health Care System” was included. Topics of other posts include the complexity of doctor-patient relationships, patient tales, wellness, health technology and health policy.