Holistic approaches to chronic disease
I have nonalcoholic chronic liver disease. The condition does not cause me any symptoms; however the doctors wanted to treat it.
Author describes how the holistic philosophy allowed her to continue healing beyond traditional medicine
by Heidi Emmerling Muñoz, RDH, PhD, FAADH
I have nonalcoholic chronic liver disease. The condition does not cause me any symptoms; however the doctors wanted to treat it. The GI specialist contacted a bile duct while performing a biopsy, which caused excruciating pain. Next, they recommended chemotherapy. I went a year injecting myself three times a week with interferon, which caused me to be nauseated, fatigued, achy, and anemic. It was hard to focus and I suffered mental fogging, depression, and anxiety. I exhausted my sick days because working was nearly impossible. Although the treatment did not work, going through this ordeal allowed me to learn about the benefits of taking a holistic approach to health.
I believe toxic physical environments, long-term negative relationships, poor choices regarding nutrition, and neglecting self-care all contributed to my condition. I now know the way to turn it around is to address the mind-body-spirit aspects of holistic health.
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This was counterintuitive for me and, I believe, for many people, especially women and dental hygienists, who are programmed to put ourselves last. Self-care is often seen as a selfish luxury. "Just suck it up." The painful and expensive lesson I learned is that putting myself last is simply not worth it. What makes matters even sadder is we are not helping those we purport to love because we don't have our full selves to give when we are so run-down.
My story is not unique. There are many out there who live with chronic conditions that conventional medicine does not address. According to the American Holistic Health Association (AHHA), the focuses of holistic health include an approach to lifestyle that prevents or mitigates chronic conditions; a focus on the entire person rather than the illness or a specific body part; the incorporation of mind, body, and spirit; and having people accept responsibility for their own level of health.
Some people call holistic healing "new age" but there is really nothing new about it. Socrates suggested that we should avoid focusing on just one sick part of the body saying, "for the part can never be well unless the whole is well." However, during the 20th century, holistic health fell out of favor as medicine began focusing on germs and pills to rid the body of the germs. The result is that we lost sight of health. People were duped into thinking that synthetic pills could compensate for unhealthy lifestyle choices. We are seeing the result with harsh treatments for diseases; oftentimes, such as in my case, treatments are worse than the disease, not to mention ineffective.
According to Suzan Walter, MBA, cofounder and president of AHHA, "When an individual is anxious about a history exam or job interview, his or her nervousness may result in a physical reaction — such as a headache or a stomach ache. When people suppress anger at a parent or boss over a long period of time, they often develop a serious illness such as migraines, emphysema, or even arthritis." And who among us hasn't had chronic stress in our lives? This stress often begins in childhood.
Based on a comprehensive study of 17,000 Kaiser members, one out of every five members has had three or more adverse childhood experiences (ACE). See "What Is My ACE Score?" The more ACE experiences one has, the more likely psychological and medical problems will increase. In the study, researchers found that one of six people had an ACE score of four or more. One of 10 people had an ACE score of five or more. Fifty percent of women were more likely to have an ACE score of five or more. My ACE score is six. The links to ACE and medical conditions are alarming. Kaiser reports that there is a strong relationship between ACE and heart disease, liver disease, COPD, and consequently health-related quality of life.
Kaiser physicians explain that ACE disrupts the normal development of the nervous system. When children's brains are still developing, they are vulnerable to stressful life events. ACE promotes hypervigilance and a tendency to have chronic worry about danger. Chronic high anxiety levels leave the body exposed to stress hormones that keep us ready for fight or flight with rapid heart rate, increased blood flow, and narrow focus on danger clues. Therefore, since so many people have had ACE incidents, not to mention experiences with everyday chronic stress, as well as physical challenges from our environment and food, it is really not surprising that many people suffer from chronic conditions that conventional medicine alone cannot undo.
Robert Ivker, DO, outlines the differences between holistic medicine and conventional medicine, stating that holistic healing addresses the entire person: body, mind, and spirit. See Table 1 for the differences between holistic and conventional medicine, according to Ivker. What we notice is that the primary and secondary treatment options are opposite for the two approaches, and that conventional approaches work on acute and life-threatening illness while holistic ones work best for chronic conditions. We need both approaches. Most of us were taught the conventional method and have not had formal training on holistic approaches.
The American Holistic Medical Association views illness as a manifestation of a dysfunction of a whole person, not an isolated event. Holistic physicians encourage patients to "evoke the healing power of love, hope, humor, and enthusiasm and to release the toxic consequences of hostility, shame, greed, depression, and prolonged fear, anger, and grief." They continue: "Optimal health is the conscious pursuit of the highest qualities of the physical, environmental, mental, emotional, spiritual, and social aspects of the human experience."
Daniel Benor, MD, a diplomate on the American Board of Holistic Integrative Medicine, writes of themes of complementary/alternative medicine (CAM). He claims that CAM therapies are potent interventions for allergies, arthritis, asthma, heart disease, backaches, headaches, IBS, menopausal problems, UTIs, PTSD, cerebral palsy, strokes, cancers, AIDS, chronic fatigue, and more. Benor claims that, contrary to the linear either/or model of Western medicine, CAM "awakens and nurtures intuitive and spiritual awareness" and CAM includes "contributions of emotions, minds, relationships (people and our environment), and spirit." CAM introduces the concept of body-mind and person-spirit connections. Furthermore, Benor asserts that philosophies of holistic integrative care enrich the lives of health caregivers through addressing diet, meditation, and yoga. This is great news for dental hygienists and behooves us to investigate holistic health further.
Inspired by Andrew Weil, Deepak Chopra, Louise Hay, and other healers, I incorporate their suggestions for my medical recovery. These are what worked (and continue to work) for me:
- Educate yourself as much as possible, particularly as it relates to health. Keep an open mind to new ideas. Talk to others about healing.
- Learn something new, whether it is dance, fly fishing, crocheting, gardening, or cooking — anything you believe would support your overall health. I always try to have a book in progress.
- Learn and practice different coping mechanisms to detox your life and your mind of negativity. This might require outside expertise from a counselor and most certainly support from your inner circle. Sometimes situations work themselves out that seem devastating at the time but, in reality, are blessings in disguise (broken relationships, job changes, etc.). Realize that things really do happen for the best.
- Affirm yourself. Your mind and body believe what they hear. I really used to think this was hokey but it has made a huge difference in my life. The affirmations can be audio recordings, physical notes, and self-talk. Louise Hay has some great affirmation tools. It goes without saying that one should shun negative self-talk and overly critical colleagues and family members. Negativity is counterproductive.
- Practice intentional breathing and meditation to clear and calm the mind. Turn off the TV, especially the news. Let go of things you cannot change.
- Rest. Research shows we really do need seven to eight hours of sleep a night, regardless of the fact we all think we are superheroes. I used to fool myself into thinking I was superhuman and did not need as much sleep as mere mortals. Getting adequate sleep allows the body to rejuvenate, and sleep helps with weight management as well. During my medical recovery, I discovered I had neurologic sleep apnea (the nonobstructive type where my brain forgets to tell me to breathe when I am asleep). If I had it and did not know it, I suspect others might unknowingly have it as well. If you wake up fatigued, consider being evaluated for sleep apnea. I now wear a very (un)attractive bi-PAP machine but my brain and my heart are much happier.
- Eat mindfully and maintain ideal body weight. This isn't about looking hot; it's about living life fully and preventing disease. I am working on weight management and am very mindful of what I eat. I have resigned myself that this is something I will need to be aware of my entire life. There will never be a point where I can ignore it. Weight Watchers has a very common-sense, tried-and-true program of which I am a member. In addition to following the program, I avoid alcohol, most animal proteins, artificial flavorings and preservatives, processed foods, refined sugar, and conventionally grown produce. I drink plenty of water and take recommended vitamins and supplements (B, C, E, calcium, magnesium, milk thistle). The other benefit of clean eating is it helps clear the mind as well as decrease anxiety and depression. The other part of eating well is eating regularly. Having breakfast is key, as is eating lunch. And try not to eat dinner too late. Again, I used to think it was selfish to carve out a lunch when there were patients or students who needed me, or meetings to attend. Eat healthy food, distraction free, and take your time to eat consciously. I try to eat my breakfast and lunch outside wherever possible. When I must eat at my desk, I close the door, turn on a desk lamp (not the overhead florescent lamp) and flip on some soothing music from my iPhone. I always have real dishes and silverware at work, as well as a cloth placemat and napkin. Self-care is number one.
- Move. It is really easy to get caught up in telling ourselves we have no time to exercise. After all, there are people we need to take care of (except ourselves, of course). My new doggie has helped me in this area. She needs her walk every day and it forces me to move. It gets me outside in the fresh air and I am out walking for an hour a day. The movement triggers the endorphins, the sunshine helps with depression, I am getting stretching and aerobic activity, and I am enjoying my doggie. My husband joins me so it makes a very pleasant time for us to visit as well. We get to see and interact with our neighbors and get good landscaping ideas. Indoors, I have a stepper in the living room where I can watch TV and move, and I have 5-pound weights next to my chair in the living room. I can grab them when I am watching some mindless entertainment. At work, when I am at my desk for hours at a time, I force myself to get up and move at least five minutes every hour.
- Sweat or detox. Whenever I can, I use a sauna. When I walk my doggie, I rarely work up a sweat and sweating helps purge our bodies of toxins. Since I want a healthy liver, I try to regularly detox and a sauna allows me to do this.
- Wear sunscreen and take care of your skin. When I was younger, I felt invincible but as I age I see more sun spots. I never leave the house without applying moisturizer with SPF to my face and body. I also use lip balm with SPF in it.
- Keep up with well-checks including annual physical, mammograms, blood work, your own dental prophylaxis (we are always the last ones), and so forth. Don't forget about your hair and nails. It is OK to splurge on the occasional massage and mani-pedi. This all ties in to self-care and being responsible for ourselves. If you feel paying for an outside mani-pedi is too much, you can do very affordable in-home spa indulgences. In fact, this is why I became a BeautiControl consultant, so I can get wholesale spa products. I observed when others started seeing me taking better care of myself, they actually started respecting my time more and treating me better too. After all, you model what you expect others to mirror in regard to how you want and deserve to be treated.
- Connect to a spiritual source, whether it is a deity or Mother Earth. I am not fortunate enough to have a window in my office so I like to bring the outside in. At work I always have fresh-cut flowers, either from my garden or from the floral department, in a beautiful vase in my office.
- Do things you love. Go to concerts or the theater. Watch funny movies. Bring music into your life. Dance, paint, or draw. You may discover a hidden talent and, the best part is, you will have fun doing it.
- Take pride in your appearance. Try a different shade of lipstick; curl (or straighten) your hair. My favorite advice that I take to heart is to get a new pair of shoes. I used to slink around with my hair stuck up in a butterfly clip, with no makeup, and in oversized sweats and flip flops because it was comfortable, and I simply didn't have the time or energy to make the effort. This was especially easy to do when I had to wear scrubs for my job. What did it matter? That attitude did nothing for my mood or self-esteem. When I look better, I just feel better. I am worth the effort it takes and so are you.
- Reconnect with important people from your past. This can be extremely difficult yet extremely healing. Obviously, stay away from the toxic people; some folks you need to love from a distance. If possible, forgive them, not for their sake but for your own. Remember, it is your health at stake, not theirs. Instead of "forgive and forget" you might need to "forgive and remember" to avoid repeating the same mistake. If you need to make amends, do so as long as you are not harming yourself or others in making those amends.
- Volunteer. Give of yourself because it nourishes your spirit and makes the world a little shinier because you are in it. You may choose to volunteer for your professional association, for a battered women's shelter, the Humane Society, or something totally different. It opens up your world, increases your social network, and allows you to use and give of your strengths.
- Keep a gratitude journal. Start your day listing several things you are grateful for. It is impossible to feel angry or depressed when you feel grateful.
On my journey toward optimal health, the holistic philosophy has allowed me to thrive where traditional medicine left off. I encourage us as a healing profession to embrace the possibilities in the holistic philosophy and to find ways to practice this in our own lives to be a living, breathing resource for our patients. RDH
Heidi Emmerling Muñoz, RDH, PhD, FAADH, is a professor of English at Cosumnes River College and former interim director of dental hygiene at Sacramento City College. She is owner of Writing Cures (www.writingcures.com), a writing and editing service. Dr. Muñoz is coauthor of The Purple Guide: Paper Persona and creator of the Career Development Center for Friends of Hu-Friedy. She is a frequent contributor to RDH Magazine and has written articles and columns for a variety of publications. Dr. Muñoz can be reached at email@example.com.
Integration of allopathic (MD), osteopathic (DO), and naturopathic ideas
All allopathic (MD)
Promote optimal health and, as a by-product, prevent and treat disease
Empower patients to heal themselves by addressing causes and changing lifestyle
Focus on eliminating symptoms of disease
Primary Treatment Options
Diet, exercise, environmental measures, attitudinal and behavioral modifications
Drugs and surgery
Secondary Treatment Options
Botanical medicines, homeopathy, acupuncture, manual medicine, biomolecular therapy, physical therapy, drugs, and surgery
Diet, exercise, physical therapy, stress management
Shortage of holistic physicians, time-intensive therapy
Ineffective in preventing and curing chronic disease, expensive
Teaches patient to take responsibility for their own health; cost-effective; treats acute and chronic illness
Highly therapeutic in treating acute and life-threatening illness and injuries
Prior to your 18th birthday:
- Did a parent or other adult in the household often or very often swear at you, insult you, put you down, or humiliate you, or act in a way that made you feel afraid that you might be physically hurt
- Did a parent or other adult in the household often or very often push, grab, slap, or throw something at you, or ever hit you so hard that you had marks or were injured
- Did an adult or person at least five years older than you ever touch or fondle you or have you touch or fondle their body in a sexual way, or attempt or actually have oral, anal, or vaginal intercourse with you
- Did you often or very often feel that no one in your family loved you or thought you were important or special, or your family didn't look out for one another, feel close to one another, or support one another
- Did you often or very often feel that you didn't have enough to eat, had to wear dirty clothes, and had no one to protect you, or your parents were too drunk or high to take care of you or take you to the doctor if you needed it
- Was a biological parent ever lost to you through divorce, abandonment, or other reason
- Was your mother or stepmother often or very often pushed, grabbed, slapped, or had something thrown at her, or sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard, or ever repeatedly hit over at least a few minutes or threatened with a gun or knife
- Did you live with anyone who was a problem drinker or alcoholic or who used street drugs
- Was a household member depressed or mentally ill, or did a household member attempt suicide
- Did a household member go to prison
Score one for each YES answer and that is the ACE score
Source: Centers for Disease Control and Prevention
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