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Complementary Therapies

Imagine the anguish a mother feels when her child suffers discomfort or pain.

Sharon and her daughter

Sharon Sanchez used to rock her 4-year-old daughter while they waited for the medication to take effect and lessen the girl's excruciating headaches. It wasn't that Sanchez didn't trust the medicine but that she couldn't wait; she had to do something to help right away.

"I used to hold my daughter and picture positive, healing energy coming through my hands," says Sanchez, a registered nurse who works in the operating room at Community Hospital. "I found I was able to help her with her headaches. I wanted to understand what was happening, so I began studying healing touch, what it is, and how it can be used to enhance well-being. It's not a replacement for medicine in any way, but a complementary process actually intended to support traditional medicine."

Healing touch is just one of a host of complementary therapies designed to foster healing by helping patients become more physically and mentally prepared to benefit from medical care. Guided imagery, spirituality, nutrition, acupressure, and aromatherapy are just some of the many other complementary therapies that can effectively supplement traditional treatments.

"Where conventional medicine tends to focus on symptoms," says Community Hospital pharmacist Brian Ellinoy, "complementary medicine, derived in part from Eastern philosophies, emphasizes prevention and well-being. Conventional medicine forces the body to do something via drugs or surgery, while complementary medicine can give the body clues to heal itself." According to a study done in 1998, 42 percent of the U.S. population uses complementary therapy, to the tune of $21 billion per year. Most of this is paid out-of-pocket because insurance seldom covers complementary therapies.

For those receptive to these therapies, says Community Hospital's Comprehensive Cancer Center director Dr. Grant Swanson, it is clear they have the capacity to improve the quality of life during cancer treatment and beyond. The question of whether these treatments prolong life is more difficult to answer.

"However," Swanson says, "because of political pressure from advocacy groups, the traditional medical field is rigorously evaluating the impact of complementary therapy. This is important if for no other reason than it gives us solid evidence of a positive impact. Only through solid research do we have the chance of making these therapies readily available."

In exploring this potentially vast and sometimes controversial world of supplemental therapies, it is important to distinguish between complementary and alternative therapies, terms that often are but should not be used interchangeably.

"I am very careful about distinguishing between complementary and alternative therapies," says Community Hospital educator Joy Smith, R.N. "I look at alternative therapy with a direct goal of curing or shrinking or making the disease go away, which is largely unproven. As an educator, I see my role as helping people evaluate different therapies to determine the best treatment for them. This is where my role starts and ends. We don't endorse any of these alternative treatments; our job is simply to help patients come to their own decisions."

While alternative therapies tend to seek a cure, complementary therapies are best used in addition to standard medical treatments to help the traditional treatments work more effectively or to help patients tolerate their treatments with more ease and less discomfort. Complementary therapies are designed to put a person's mind in the most receptive, centered, healthy, balanced place possible to maximize the benefits of medical care.

To avoid any possibly harmful interactions, it is important that patients inform their medical care team if they are using any complementary therapies.

"Many people are involved in complementary treatment," says Community Hospital clinical instructor Amy Laboda, R.N. "And patients often don't tell their nurses and doctors about it. We as nurses need to educate ourselves about what our patients are involved in. If what we do in nursing is serve as the patient's advocate, we need to ask the right questions in a safe and nonjudgmental environment."

When a nurse or doctor asks a patient if he or she is currently on any medication other than prescription drugs, the usual answer is no. However, if the question is framed differently, asking instead whether the patient is taking any herbs or supplements, the answer is often completely different.

"Complementary medicine is not totally benign," explains Swanson. "It has its effects and potential, under certain circumstances, for adverse reactions, especially when patients don't share what they're doing with doctors who need to know." For instance, if you are taking herbs that may thin the blood, that information would be important to share with your doctor before certain surgical procedures are considered.

Guided imagery and spirituality are more intellectual and emotional, less physical approaches to healing. Guided imagery, for instance, is designed to relax the mind by getting the patient to focus on a safe, soothing emotional place.

"The way visualization works, and I believe very strongly that it does," says Mary Welschmeyer, Community Hospital R.N. and M.F.T., "is if you mentally go to an alpine lake at sunrise, your body can't tell the difference between actually being at that lake versus what your mind is visualizing. So it releases all the relaxation hormones as if you were there. Your mind is on a journey to a peaceful, beautiful place, although your body is still resting on the couch."

According to Welschmeyer, people were not intended to live in a constant state of high stress. We may have been designed during early civilization to flee the saber-toothed tiger but not to live with a chronic high level of stress.

In this often overstimulated, demanding lifestyle we've carved out for ourselves, we may be subject to the increased illness, pain, or discomfort that can accompany stress and anxiety. Or we can learn how to relax our minds, our muscles, and our breathing by lifting our thoughts and our spirits, if not our bodies, out of our stressful environments.

"Guided imagery is a reasonable addition to traditional medicine," says Welschmeyer, "because many illnesses require more than one approach to healing. Through visualization, patients can learn how to quiet their minds, to be in their bodies and hear their inner adviser to determine their highest and best good. We feel helpless when facing a life-threatening illness. We have to find a way to regain our mental strength so we can act on behalf of ourselves."

In addition to guided imagery, there is a practice called narrative medicine. The doctor interviews the patient, takes notes, and then uses that information to develop a more comprehensive understanding of the patient. The interview helps the doctor develop insight into the spirit and the mind as well as the body of this individual, making it easier to treat the whole person and not just the illness.

"I don't think most of us realize how much we are changed by telling our own personal stories of triumph, love, faith, and loss," says Community Hospital chaplain Chris Williams. "Some of us appear to remind ourselves into healing and determination. By naming our own ways of facing difficult decisions, we sometimes also remember who we are and how we have previously faced challenges. Among other things, we review how we've survived our past. We think about who helped us do it and how we endured all the waiting, as well as what belief, ritual, practice, or thought kept us hoping and fighting for life. Sharing stories can be lifechanging for anyone, especially during unexpected life events."

Chaplains seek to create a sense of safety for patients and their loved ones, Williams says. This allows them to become aware of their own strength and resources and reminds them that they are "whole, respected, and capable of finding their own way to do new things.

"We can't duplicate spiritual experience; we can't even predict it," Williams adds. "Part of the complementary piece is to help people in the middle of a challenge stay connected to what gives them life. Sometimes it is their relationships to ideas, gods, beliefs, self, partners, friends, members of the medical care team — whatever or whomever they love and trust. Encouraging people to share their stories gives their bodies and their souls a sense of well-being. And isn't that a nice complement?"

Profile

Mary Lou Hulphers

Mary Lou Hulphers was a trendsetter in the world of repetitive stress injuries long before it was fashionable, before it was understood, even before it had a name. Having at first completely lost the use of her hands and arms, her abilities remained limited. More importantly, she hurt. All the time.

The combination of pain and disability forced Hulphers to give up her Bay Area business in direct marketing, writing, and design, and she ended up moving back to Carmel, her hometown.

" At a very low moment," she says, "when I knew there was no hope for me anywhere, I noticed a Community Hospital ad for a pain management support group. Who could know it would be not only my hope but my salvation?"

In the three years Hulphers has been meeting with nurse Mary Welschmeyer's pain support group, she has found friends; she has found something to keep her mind off the pain; and she has found peace.

"In all of these sessions," she says, "Mary begins with a visualization exercise. From there, during the art sessions, we play like kindergarteners, using paints and pastels to express ourselves. Then, we discuss the experience afterward in a safe and structured setting with Mary as our wonderful leader."

Hulphers particularly looks forward to Welschmeyer's periodic art therapy days, when the whole day focuses on creative expression.

"Art has given me my mind back," Hulphers says. "It offers a break, relief from the pain with no critics, no editors. What we do is truly expressive. Because of my pain, I had been locked out from any creative work for years; but this opened a door I thought had been nailed shut. After these sessions, I feel like I've had a whole summer vacation in one day."

The way Hulphers explains it, the art process provides a creative distraction and the opportunity to learn from others in a productive environment. With chronic pain, she says, you wear out your family, and friends become paralyzed in their attempts to help. But in the group, members not only understand, they are working alongside one another to improve the quality of their own lives.

"When Mary told me we were going to do art," says Hulphers, "I thought, ‘You're out of your mind. There's no way I'll be able to do anything; this is what I did before and what I can't do any more. That's the whole problem.' But it gave me a key to open the door and let my life back in."

For more information about Community Hospital's chronic pain support group, call 625-4753.

Profile

Rachelle Lackman

Before she ever got to the hospital, Rachelle Lackman made a conscious decision that her surgery would be a good experience and that she would do her part to ensure that it was. Although it has been almost three years since then, Lackman keenly remembers the aura and energy surrounding her surgery as much as, if not more than, the procedure itself.

"Before going into surgery that morning," says Lackman, 53, a former marriage and family counselor, "my doctor went over what the surgery would entail so I could prepare, mentally and physically. She gave me tapes to help me relax, and a certified hypnotherapist came to the house to walk me through guided imagery to help get my mind and body to a peaceful, receptive state."

When Lackman arrived at the hospital, there was some confusion with paperwork, which began to erode her confidence and her calm. Until nurse Sharon Sanchez stepped in with the practice of healing touch to allay her fear and anxiety. Sanchez used healing touch techniques before and during the surgery. Another nurse continued the process after surgery in the recovery room.

"I wasn't sure how much I needed to relax and just trust or how much I wanted to remain vigilant," Lackman says. "There is a part of me that's kind of a rebel; even when it was in my best interest to relax, I wasn't sure I wanted to. But before Sharon was even done, I was floating. I was conscious and mentally sharp, but I felt so relaxed. It actually was amazing how quickly, how easily I relaxed into her healing touch."

Lackman remembers waiting for her surgery near another patient who was visibly anxious, even distraught. And she remembers thinking of the "dream team" of support she had in her doctors, her anesthesiologist, and Sanchez, and how fortunate she felt to have experienced the healing touch that led to her peaceful, even grateful state. She also remembers wishing at the time that she could transfer some of her serenity and sense of well-being to the other patient.

"When I came into recovery," she says, "I remember coming out of my fog much more quickly than they expected; I remember how quickly I recovered from the anesthesia, and how sharp I was. I even went home a day earlier than expected. I believe surgery patients simply respond better with healing touch. I wanted to write thank-you notes to everyone about the services I received. I never thought of surgery as a healing ritual, but because of the healing touch it was."

Profile

Terese Jorstad

It started after a routine dental procedure with shooting pains in her jaw and tingling in her lip, coupled with a persistent burning across her cheek. And it stayed that way for weeks, months, an entire year actually. It still flares up; and when it does, it feels like a recurring slap in the face, offering equal parts indignity and pain.

It's something she wouldn't wish even on the dentist who performed the procedure, and certainly something she wishes would go away. But it doesn't. And it may never.

In addition to the medications that have helped her cope with the pain, Teresa Jorstad was looking for help — a way to manage her pain, to live with something she was certain she could not.

When she found Mary Welschmeyer's chronic pain support group at Community Hospital, she found others who know what it is to live life in almost constant pain. She found people who never tire of hearing her story, of witnessing her tears, of commiserating with her. Most important, she has learned new ways to manage and cope with her pain.

"In this group, we start with a guided imagery exercise to music, a relaxation technique that takes us away from the world and gets us ready to come into the group. The visualization and deep breathing help take my mind off the pain."

Relaxation is something Welschmeyer recommends that her group practice throughout the day, making it a routine element in the management of their pain. The details of Jorstad's guided mental tour aren't important, so she often doesn't recall the imagery. What matters most to her is getting to that relaxed, calm, and soothing place.

"What I've learned," says Jorstad, "is that it's very important to practice this relaxation technique even during the low-pain days. You can't expect to use this technique well during a severe pain flare-up if you haven't practiced consistently during low pain levels."

Summer/Fall 2004

Brian Ellinoy

"Where conventional medicine tends to focus on symptoms, complementary medicine, derived in part from Eastern philosophies, emphasizes prevention and well-being. Conventional medicine forces the body to do something via drugs or surgery, while complementary medicine can give the body clues to heal itself."
— Brian Ellinoy, Community Hospital pharmacist

"The way visualization works, and I believe very strongly that it does, is if you mentally go to an alpine lake at sunrise, your body can't tell the difference between actually being at that lake versus what your mind is visualizing."
— Mary Welschmeyer, R.N. and marriage and family therapist

"We can't duplicate spiritual experience; we can't even predict it. Part of the complementary piece is to help people in the middle of a challenge stay connected to what gives them life."
— Chris Williams, Community Hospital chaplain