#i hate you external pressure to achieve certain goals by a certain age

[natasha-in-space]

The next time someone is going to tell me that my twenties are supposed to be the best time in my life and that I shouldn't waste them, I will simultaneously explode actually.

[billion-heartbeats]

Medical pluralism: Modern medicine + Ayurveda + Medical yoga:

:

                            Medical pluralism: Modern medicine + Ayurveda + Medical yoga

Health Is “a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity.

 Medicine is the science and practice of establishing the diagnosis, prognosis, treatment, and prevention of disease.

 In fact, now the term “alternative medicine” is out. Integrative medicine is the new medicine!

 Integrative medicine is an approach to care that puts the patient at the centre and addresses the full range of physical, emotional, mental, social, spiritual and environmental influences that affect a person’s health.

 1994- Dr Andrew Weil, the Harvard-educated physician, author, lecturer, and internationally recognized pioneer of integrative and holistic health, founded the Program in Integrative Medicine at the University of Arizona. Today approximately half of America’s medical schools and many institutions globally have signed on to an integrative medicine consortium.

  Integrative medicine is an emerging field described as the blending of conventional and evidence-based complementary medicine with a focus on healthy habits in a healthy habitat. Broad categories for integrative therapies include:

·       lifestyle - nutrition, exercise, environmental and mind body medicine,

·       biochemical - medications, herbal remedies, nutritional supplements,

·       biomechanical- massage, spinal manipulation chiropractic and osteopathic adjustments and surgery,

·       bioenergetics - acupuncture, therapeutic touch, prayer and spirituality, homeopathy. 

 Principles of integrative medicine

 All people have innate healing powers.

The patient is a person, not a disease.

Healing takes a team approach involving the patient and doctor, and addresses all aspects of a person's life using a variety of health care practices.

 The state of medical and health care is in crisis!  

 The health care crisis is the progressive and massive rise in costs coupled with a failure of the system to provide care. Poor quality and yet expensive healthcare, is becoming a national crisis for India.

 In the current Allopathic system, we have an acute-disease system for a chronic-disease population. There is a trust deficit of a serios magnitude between the doctors and the patients. The bottom line is that those who were meant to be healers are beginning to be hated. The anger is almost palpable. Stories of feeling cheated abound. Under market pressure, clinical medicine has been transformed into finance-based medicine…

   Most Popular Alternative Healing Therapies

  Acupuncture – One of the better-known alternative healing therapies is acupuncture. ...

Acupressure – Acupressure just like acupuncture works on the principal of various specific points being energy centres of the human body. ...

Ayurveda – Ayurveda is an ancient healing practice that originated in India.

Yoga and yoga chikithse/ treatment

Hypnotism

  Modern medical practices have attracted criticisms, for an emphasis on intervening in disease rather than preventing it beforehand. But in health, an alternative approach called wellness has emerged, focused on investing in health before it breaks down. Wellness argues for cultivating health a little every day, not just restoring it during calamities. 

  Go to the roots. 

 Western medicine tends to fight symptoms, whether suppressing coughs or flooding the brains of the depressed with serotonin. Wellness is interested in underlying causes. Wellness sees the causes of and remedies for ailments as lying within us. Avoid infection by building immunity. Defeat disease by eating foods that help the body heal itself.

Each medical stream has strengths and weaknesses. if they are integrated then the health care will be comprehensive. In medical education such integration should start at graduate and post graduate levels.

 Combining AYUSH with modern medicine will be effective, especially for treating non-communicable diseases. India is faced with a highly complex scenario. On the one hand, there is the unfinished agenda of under-nutrition and communicable diseases, on the other, the burden of non-communicable ailments is crippling the lives of millions.

 Unlike modern medicine, alternative systems follow a more holistic approach, with the objective of promoting overall well-being instead of focussing on curing illness alone. Such an approach assumes even greater significance in the case of non-communicable diseases which are difficult to treat once they have developed into chronic conditions. Internationally, greater scientific evidence is becoming available regarding the health impact of alternative systems of medicine, especially Yoga. For instance, a study conducted by Massachusetts General Hospital and the Benson-Henry Institute demonstrated that Yoga and meditation could result in a 43 per cent reduction in healthcare costs.

 While TCAM-Traditional, Complementary and Alternative Medicine and modern medicine stay as separate watertight compartments in theory, but in practice, things have been quite different.

The TCAM and modern medicine systems have not been harmonised. Health being a state subject adds an extra layer of complexity to any national level initiative. Indeed, there are states like Maharashtra who have adopted a realistic approach where TCAM professionals are allowed to practice modern medicine and prescribe drugs, after completing a one-year course. There is strong resistance to any such initiative by professional bodies representing modern medicine.

 Modern medicine

 Allopathic medicine is very unbalanced in placing all its emphasis on external interventions.  some patients feel lost in our current health care system- from high-touch, high-tech, specialized, expensive, sometimes impersonal health care. They see specialist after specialist and receive prescription after prescription and test after test. Yet the cure is distant!

  Increasing numbers of medical colleges have started offering courses in alternative medicine. Integrative medicine began to have an impact on medical education in USA when 8 medical school deans met in 1999 to discuss complementary and alternative medicine. This meeting led to the establishment of the Consortium of Academic Health Centres for Integrative Medicine, composed initially of 11 academic centres. By 2012, this group had grown to 54 medical and health profession schools in the United States, Canada, and Mexico that have established integrative medicine programs. India is yet to take concrete steps in the process of integration.

A 200-hour curriculum for Integrative Medicine in Residency has been developed and is now in place in 30 family practice and 2 internal medicine residencies in USA. The curriculum includes many of the topics that are not covered in the medical school curriculum, such as nutrition, mind–body therapies, nutritional and botanical supplements, alternative therapies- acupuncture, massage, and chiropractic, and lifestyle medicine. A similar curriculum for paediatric residencies is being developed. The eventual goal is to include integrative medicine skills and competencies in all residency programs.

 Biofeedback

Biofeedback is a type of mind-body therapy. Using feedback from a variety of monitoring procedures and equipment, a biofeedback specialist will try to teach you to control certain involuntary body responses, such as: brain activity, blood pressure, muscle tension and heart rate. Biofeedback has been shown to be helpful in treating several medical conditions, including asthma, Raynaud’s disease, irritable bowel syndrome, incontinence, headaches, cardiac arrhythmias, high blood pressure, epilepsy, etc.

 The term meditation refers to a variety of techniques or practices intended to focus or control attention. Most of them are rooted in religious or spiritual traditions. These techniques have been used by many different cultures throughout the world for thousands of years. Scientific investigation of these practices has begun quite recently, however, to better understand whether they work; if so, how; and for what diseases/conditions and populations.

 Death is ultimate. But Not before it is due! 

 The ultimate reality is death, whatever manoeuvres one may carry out to prevent it, which explains why modern medicine’s propulsion is towards control, not cure or prevention. The epitome is palliation, not of cure, or prevention. Motto of Modern medicine-To cure, what can be cured, to comfort always, to hurt or harm the least! 

Prevention and cure must be consciously, and vigorously, promoted. Why allow what must occur only at the end to override this process?

if ultimately death must prevail, one must know when to give way, and stop struggling, to ensure a dignified exit. The whole expenditure of human resources to avoid the inevitable when it has to occur will then stop. Modern medicine’s role of helplessness mixed with grandiosity that promotes life at any cost e.g. in persistent vegetative states, will then end. Cure and prevention must guide our consciousness, and our efforts, even as we accept the truth of death, which will ultimately prevail.

  The first goal of medicine is that “no one gets sick”. This is what I mean by Primary prevention. Early detection and prompt treatment is secondary prevention. Restoring function and reducing disability is tertiary prevention!

 Modern medicine has done much in the fields of infectious diseases and emergencies to aid cure. In most other fields, it is mostly control that it achieves which is another name for palliation. Modern medicine has progressed, and we must thank the whole bunch of researchers and clinicians for it. But so, has pathology, micro biology, pharmacology and research. It is not that the number of diseased has reduced, nor total quantum of distress related to it.

 Modern Medicine has increased longevity, made old age liveable, reduced infant mortality, made everyday living itself more distress-free by the numerous medicines and procedures in our armoury; as also of course some remarkable successes with emergency care. we have not reduced the number of diseased, nor found cures for diseases except the infectious.

 What medicine needs to do is propel towards cure on one hand and prevention on the other. What should the modern doctor be doing? He should either prevent a disease so that it does not occur, or cures it if it occurs. What does the modern doctor, me included, do? He neither prevents, nor cures in any but a few conditions. He only controls spread of the disease, and palliates while so doing.

 Why prevention is not the first goal of physicians?

 clean water, nutritious food, clean and disaster free habitation, proper sanitation, control of pollution, poverty alleviation, empowerment of the deprived and disadvantaged, life-style modifications are the pre-requisites- which involves multiple agencies, not in control of medicine and its movers. This is one prime reason why it is not top of the agenda of clinicians, perhaps! 

 The thrust and focus must shift from control and palliation to cure and prevention. The ultimate goal is longevity with well-being, of which freedom from disease is a very important ingredient. Major research funding must guide these efforts, even as we do not neglect greater refinements in modern ‘palliative’ medicine.

 Medical Yoga Therapy

   Within the past decade, yoga has infiltrated not only Western culture, but also Western medicine. The more we learn about this ancient practice, the more we realize that its benefits go far beyond increasing flexibility and muscle tone. 

Modern medicine has made enormous progress in controlling communicable diseases over the past century, such that it is now the non-communicable diseases that have reached epidemic proportions and cause the majority of deaths worldwide. The World Health Organization estimates that 80% of NCD deaths are due to four main disease types: cardiovascular disease, cancer, diabetes, and respiratory diseases.

  Lifestyle is the major causative factor in NCDs, including tobacco use, sedentary lifestyle, lack of regular exercise, unhealthy diets and chronic psychosocial stress. Chronic inflammation and stress are a common factor of many of the NCDs, and an area where yoga has been found to be extremely beneficial.

 Science of Yoga

   Yoga is a science. It is an applied science, a systematised collection of laws applied to bring about a definite end. It takes up the laws of psychology, applicable to the unfolding of the whole consciousness of man on every plane, in every world, and applies those rationally in a particular case. This rational application of the laws of unfolding consciousness acts exactly on the same principles that you see applied around you every day.  

 It thickens the layers of the cerebral cortex, the part of the brain associated with higher learning, and increases neuroplasticity, which helps us learn new things. The emotional brain is able to initiate a ‘stress response’ via the sympathetic nervous system which culminates in adrenaline and cortisol racing through our circulation. The logical brain is always trying to ‘turn-off’ this stress response and it is also trying to restrain the emotional brain. The stronger our logical brain, the better it becomes at doing these two things. When the stress response is ‘turned off’, our parasympathetic nervous system signal is ‘turned on’. This signal ‘relaxes’ the body. So, a strong logical brain goes hand in hand with relaxation.

 “Yoga is training this entire stress circuit at two levels. First, every time we are ‘holding’ a posture, staying very still to concentrate or trying to balance, our logical brain is being activated. When we are bending forwards, our ‘relaxation’ signal is being turned on through the ‘switches’ in the neck. Bending forwards and concentrating at the same time is triggering both the logical brain and the relaxation signal at the same time.”

  Medical Yoga Therapy or Yoga chikithse is defined as the use of yoga practices for the prevention and treatment of medical conditions. Medical yoga also incorporates appropriate breathing techniques, mindfulness, and meditation in order to achieve the maximum benefits. Yogic breathing- the Pranayama is a unique method for balancing the autonomic nervous system and influencing psychological and stress-related disorders.

 Medical yoga therapy, ideally, is an individualized, personalized and holistic approach that considers not only the patient’s mind, body and spirit, but also their family, support network, work situation, and culture, as part of the patient’s individualized treatment plan

 There is sufficient evidence to consider Sudarshan Kriya Yoga to be beneficial, low-risk, low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder, depression, stress-related medical illnesses, substance abuse, and rehabilitation of criminal offenders. Yogic breathing, defined as a manipulation of breath movement, has been shown to positively affect immune function, autonomic nervous system imbalances, and psychological or stress-related disorders.

 Ayurveda

   The main classical Ayurveda texts begin with accounts of the transmission of medical knowledge from the Gods to sages, and then to human physicians. Ayurveda envisages body, mind and consciousness work together in maintaining balance.

Ayurveda is “The Science of Life.” Ayurvedic knowledge originated in India more than 5,000 years ago and is often called the “Mother of All Healing. Knowledge of Ayurveda enables one to understand how to create this balance of body, mind and consciousness according to one’s own individual constitution and how to make lifestyle changes to bring about and maintain this balance.

 Ayurveda has eight ways to diagnose illness, called Nadi - pulse, Mootra- urine, Mala - stool, Jihva- tongue, Shabda - speech, Sparsha - touch), Druk - vision, and Aakruti - appearance. Ayurvedic practitioners approach diagnosis by using the five senses. Ayurveda follows the concept of Dinacharya, which says that natural cycles - waking, sleeping, working, meditation etc. are important for health. Hygiene, including regular bathing, cleaning of teeth, tongue scraping, skin care, and eye washing, is also a central practice. panchakarma are techniques to eliminate toxic elements from the body.

 Ayurveda identifies three basic types of energy or functional principles that are present in everyone and everything. Since there are no single words in English that convey these concepts, we use the original Sanskrit words vata, pitta and kapha. These principles can be related to the basic biology of the body.

 The basic difference between Ayurveda and Western allopathic medicine is important to understand. Western allopathic medicine currently tends to focus on symptomatology and disease, and primarily uses drugs and surgery to rid the body of pathogens or diseased tissue. Many lives have been saved by this approach. In fact, surgery is encompassed by Ayurveda. However, drugs, because of their toxicity, often weaken the body.

 Ayurveda addresses all aspects of life — the body, mind and spirit. It recognizes that each of us is unique, each responds differently to the many aspects of life, each possesses different strengths and weaknesses. Through insight, understanding and experience Ayurveda presents a vast wealth of information on the relationships between causes and their effects, both immediate and subtle, for each unique individual.

 In a 2008 study, close to 21% of Ayurveda U.S. and Indian-manufactured patent medicines sold through the Internet were found to contain toxic levels of heavy metals, specifically lead, mercury, and arsenic. The public health implications of such metallic contaminants in India are known to cause toxic deleterious effects on the vital organs of the body.

Currently, Ayurvedic practitioners are not licensed in the United States, and there is no national standard for Ayurvedic training or certification. However, Ayurvedic schools have gained approval as educational institutions in some states.  

 Conclusions

Let’s turn the course from palliation and control to prevention and cure. Let’s first think it’s possible.

To ensure longevity with well-being, let’s not discount the work of complementary and alternative medicine. Rather submit them to rigorous scientific scrutiny.

We also need to promote longevity studies.

While the demand for alternative systems of medicine has been on the rise, there is still some scepticism perhaps due to the paucity of large-scale studies in India and elsewhere demonstrating its effectiveness.

Resistance of some modern medicine practitioners is another key roadblock.

The time is ripe to systematically promote and mainstream integrative medicine. We are faced with a dual disease burden on the one hand and have a rich history of traditional medicine to tap into, on the other. While the last few years have witnessed a number of enabling policy interventions, more needs to be done to reap the full benefits of integrative medicine.

Many forms of alternative medicine are rejected by conventional medicine because the efficacy of the treatments has not been demonstrated through double-blind randomized controlled trials; in contrast, conventional drugs reach the market only after such trials have proved their efficacy. 

 Take home message

A paradigm shift in mainstream medicine from control and palliation to prevention and cure must prevail. The ultimate goal is longevity with well-being.

 Modern medicine must look closely at the claims of alternative and complementary medicine, including yoga, meditation and spirituality. Rather, it must submit their claims to rigorous scientific and experimental scrutiny. Some recent studies in yoga in general are promising in this direction. Studies of meditation as an adjunct to modern medicine deserve special mention here. Some promising leads are in works on Longevity and health through yogic meditation and meditation in general meditative practices for health and their clinical trials.

   Dr N prabhudev

Former Director

Former VC Bangalore university

Former Chairman Karnataka Health commission