By Merrily Manthey, MS
Choices of treatment make a powerful difference for patients at the King County Natural Medicine Clinic. For example, one patient who grew up in China described how he feels much more at ease with a natural approach for treating hypertension. He told his MD at the clinic that he felt a significant amount of anxiety about taking a prescription drug to control dangerously high blood pressure and that he had a strong preference for Chinese medicine. His concern led to a collaborative process not seen in other community clinics. His MD, in consultation with a naturopath, placed the 57-year old on a regimen of garlic. When his blood pressure still remained elevated, the MD referred him to a naturopath. The naturopath began treating him with garlic and Coenzyme Q10. Anxiety was identified as a contributor to the patient's hypertension, so he was also referred to the clinic acupuncturist for relaxation therapy. His naturopath continues to monitor him closely and coordinates the management of his hypertension with his MD. Choice was clearly very important to this patient.
Another patient who came in to the clinic was very frustrated with how her physical symptoms were affecting her ability to enjoy her life. She was experiencing mood swings and hot flashes she associated with menopause. She said she was miserable but had put off coming to the clinic because she was very worried about beginning estrogen. replacement therapy. She explained her fear of such treatment was related to a strong family history of breast cancer. She was also concerned about her weight gain. She had not been sleeping well because of chronic shoulder pain. Fatigue associated with the shoulder pain discouraged her from getting regular exercise.
She was seen by a women's health care nurse practitioner who provided her with information about various choices she could consider for treatment. The nurse described the choice between conventional estrogen replacement therapy vs. a natural regimen. The natural options included daily soy supplementation (a natural phytoestrogen whose efficacy has been well studied in Japan and Europe) combined with Remefemin, a nutritional supplement shown in European studies to reduce the vasomoter symptoms such as hot flashes those women often experience with menopause. A nutritional assessment revealed the patient ate a healthy diet with the exception of high sugar desserts. A nutritional supplement that included chromium and other minerals was recommended to help decrease a strong craving for sugar.
Her shoulder pain was diagnosed as arthritis. She was given Motrin to reduce the pain and she also began taking Glucosamine Sulfate, a nutritional supplement that is effective in promoting joint repair in some patients. The nurse practitioner consulted with the clinic acupuncturist and referred the patient for acupuncture treatment of her shoulder. The 54-year-old patient was also referred to the registered dietitian who provided ongoing nutrition counseling which included cooking classes, a trip to the local grocery store for shopping advice, and encouragement to restart an exercise program. Three months after her initial visit, the patient reports that the hot flashes and mood swings have almost disappeared, her shoulder pain has significantly decreased; she has been losing 1-2 pounds a week "without," as she says, "having to fight the sugar battfle." This patient says she feels better than she has in a long time.
The health care team reiterates the value of choice. One natural medicine provider said, "It's really enjoyable to be working in a place where the patient can get whatever they need, whether it's a natural remedy, an allopathic prescription or a combination of the two. The patient is able to receive what's appropriate for them medically. The patient is able to get what they desire."
Winter 1997/1998 CAHC CHOICES Page 7