When do you start considering alternative therapy?

[kheegster]

I have a friend who's has been feeling unwell and in pain since she got appendicitis 6 months ago. Even after her appendix was removed, she continued to suffer from chronic pain. After multiple consultations with doctors in two countries (she's a Russian living in London), no one seems to know what's wrong with her, and while medication helps to alleviate her discomfort, it doesn't help with the root cause, whatever that is. Her misery is disrupting her work and life due to frequent trips to the hospital.

I'm a (physical) scientist and I have no misgivings about modern medicine, but I'm beginning to feel that at this point she might want to try going for alternative therapy. I wouldn't recommend any obvious bullshit, but I think it might be worth trying out traditional Chinese medication, Ayurvedic medicine or something similar.

What would do you guys think?

[Superman]

I have a friend who's has been feeling unwell and in pain since she got appendicitis 6 months ago. Even after her appendix was removed, she continued to suffer from chronic pain. After multiple consultations with doctors in two countries (she's a Russian living in London), no one seems to know what's wrong with her, and while medication helps to alleviate her discomfort, it doesn't help with the root cause, whatever that is. Her misery is disrupting her work and life due to frequent trips to the hospital.

I'm a (physical) scientist and I have no misgivings about modern medicine, but I'm beginning to feel that at this point she might want to try going for alternative therapy. I wouldn't recommend any obvious bullshit, but I think it might be worth trying out traditional Chinese medication, Ayurvedic medicine or something similar.

What would do you guys think?

Let me throw something out. Is the medication she takes an opioid narcotic painkiller? That would be something like percocet, vicodin, oxycontin, nortabs, etc.

Also, is her chronic pain in her back?

Working with addiction medicine docs, I have often seen this exact scenario play out; only to have the person's pain be symptomatic of withdrawal from the narcotic pain killers. What is she taking? How much?

If not, has she seen a pain management physician?

Could the pain be somatic?

[The Kernel]

Dealing with chronic pain is a difficult issue; my best friend for many years had chronic back pain and all the doctor's could do for him was to prescribe heavier and heavier doses of opiates to control the pain, which always made him feel lousy and had an addiction potential.

His solution? Start smoking pot regularly. It didn't have the addiction of the opiates and it didn't make him feel like a walking zombie all day so he could comfortably smoke in the morning and before he went to bed and feel somewhat normal.

The point of this is that in certain things (like pain management) many alternative therapies might be useful since pain management is a highly personal thing--whatever works best for you is the best therapy. However, alternative therapies for things like cancer treatment or really anything outside of pain management? No way.

As for your friend, you have to figure out if this is a pain issue or an actual medical problem. No one should be having that kind of pain after such a routine procedure (I'm not a doctor, but I've never heard of such a thing), and if she's got constant pain then she needs to see a specialist to make sure she doesn't have some sort of freak condition (like a doctor leaving something inside during the surgery which is causing an infection; don't laugh, this actually has happened).

If it really is just some kind of chronic muscular pain she's living with, there are plenty of alternative ways to deal with pain that don't require heavy medication, but they can be hit or miss. I certainly wouldn't give up on the medical community though after six months.

[Wicked Pilot]

My biggest beef with alternative therapies is people substitute them for real medicine, causing illnesses to go untreated with terrible results. Since in your friend's case the appendicitis is gone such critism wouldn't be a player. The way I see it your friend wouldn't have much to loose as long as she selects noninvasive therapes or drugs/herbs not show to be dangerous. Even if she gets positive results based purely on the placebo effect it'd still be a good thing.



I'm not a doctor though, so take the above for what it's worth.

[brianeyci]

Are you sure this is not a case of something being left behind during the surgery, or something botched during the surgery? I've heard stories...

...the following alternative therapies are bullshit (IMO).

Chiropractic
Homeopathy
Qi Gong or Therapeutic Touch
Exorcisms (don't ask)
Reflexology

The following may or may not be helpful

Acupuncture
Accupressure
Chinese Herbal Medicine
Physiotherapy
Massage Therapy

As for drugs, the biggest beef is expense, dependence, and resistance. You can usually tell whether something's a placebo after one or two weeks, because if the good feeling doesn't "stick" it probably means whatever you tried was a placebo.

Exercise is an excellent painkiller.

I'm not a doctor either (needless to say.)

[Superman]

it probably means whatever you tried was a placebo.

Nooo, no no...

Placebos will never be prescribed to treat pain after a surgery. In fact, they won't ever be used for any sort of treatment, unless the patient is willingly participating in some type of study.

[brianeyci]

it probably means whatever you tried was a placebo.

Nooo, no no...

Placebos will never be prescribed to treat pain after a surgery. In fact, they won't ever be used for any sort of treatment, unless the patient is willingly participating in some type of study.

Oh, whops, I didn't mean that to refer to drugs, I'm not so paranoid to think that doctors will prescribe fake drugs and waste your money and time. Was meaning to refer to alternative treatments that didn't work instead.

[Darth Servo]

When nothing else works and you have nothing to lose.

[mr friendly guy]

When nothing else works and you have nothing to lose.

Except your money to a treatment which may or may not work and with no hard evidence for it. At least in a country like the UK Kheegan's friends has the benefit of government subsidised health care to keep the costs down.

[Broomstick]

Are you sure this is not a case of something being left behind during the surgery, or something botched during the surgery? I've heard stories...

There are other possibilities, such as internal adhesions, excessive scar tissue, infection in the intestine, the possibility of something other than her appendix either being the true cause, or now having a problem, and probably a couple others I can't think of off-hand.

...the following alternative therapies are bullshit (IMO).

Chiropractic

No, chiropractic actually has some use. Limited, but it's not total hookum. The theory behind it is, but over time some actual useful therapies have come out of it.

As for drugs, the biggest beef is expense, dependence, and resistance. You can usually tell whether something's a placebo after one or two weeks, because if the good feeling doesn't "stick" it probably means whatever you tried was a placebo.

Not true. The placebo effect can last for years, even decades in some cases.

Exercise is an excellent painkiller.

In some instances. In others it can make things worse.

I'm not a doctor either (needless to say.)

No, you're not.

As for the FOAF in the OP -- she needs to go to a disinterested third party for another medical workup to determine if there is a physical reason for her pain. If there is, it needs to be dealt with. If not, then we're looking at chronic pain which is still real pain. However, that sort of pain is not well suited to opiates. In which case she should could to a specialist in treatment of chronic pain, and at which point alternative therapies might well play a supporting role.

[PainRack]

Has she gone for a second opinion? There could be something wrong with her you know....

There was this case in Singapore where this guy went around complaining of angina pain for years, and no doctor could figure out what was wrong because the diagnostic reports were absolutely negative.. One fine day, someone did an OGD and discovered that he was suffering from an ulcer....

Physiotherapy

????? Physiotherapy is alternative therapy? Since when?

Physiotherapy is essentially therapy that aims to recover your body normal functions. Its an recognised Allied Health science.

Unless there this branch of physiotherapy that I'm not aware of, physiotherapy IS medicine.
wiki

Massage Therapy

Massage therapy for curing disease, no. But to alleviate pain? No its not.

[mr friendly guy]

Has she gone for a second opinion? There could be something wrong with her you know....

There was this case in Singapore where this guy went around complaining of angina pain for years, and no doctor could figure out what was wrong because the diagnostic reports were absolutely negative.. One fine day, someone did an OGD and discovered that he was suffering from an ulcer.....

Ah, if his pain wasn't due to angina then couldn't have angina pain.

Yes I know that you mean doctors thought he had angina, but it was an ulcer.

Physiotherapy is essentially therapy that aims to recover your body normal functions. Its an recognised Allied Health science.

Absolutely. It features quite prominently on stroke wards and rehabilitation wards.



Back to the OP I would be interested into what tests have been done and where exactly is the pain? Presumably it was at the site of the operation, but the OP wasn't exactly clear to me.

What I would suspect they would do is get a CT scan of the abdomen. I doubt a collection or any infection is likely 6 months after the operation, but you never know and a CT would help with diagnosing any other cause of abdo pain. The other thing I would do is a couple of standard blood tests for the moment.

Now if there is no obvious "organic" cause for the pain, then it should be treated via a chronic pain doctor. I am surprise that if doctors haven't been able to figure out what is going on, they haven't opted to try this. At this point we may not be able to deal with the "root cause", but the next best thing is to alleviate symptoms. Presumably opiod medications have been used so far.

The other medications that can be used are things like tricyclic antidepressants and some anticonvulsants, which while not normally used as a first line for pain relief, can have pain modifying properties. We don't actually want them to be on high dose opiods, its not a good thing.

The only other thing to do is consider psychiatric help if you suspect there is a somatic cause to it. And no, getting a psychiatrist to help is not an indication that your friend is "crazy" despite whatever social stigma we tend to attach to such things.

But then I haven't seen the patient so I wouldn't presume to give medical advice over a message board aside from getting a second opinion and asking " do I need to see a chronic pain specialist?"

[Darth Wong]

People generally go to alternative therapy when they're frustrated by a lack of results with conventional medicine. And this happens surprisingly often, especially with any health problem that could be considered "chronic". The use of marijuana to deal with seizures and pain is an example of one such popular alternative therapy.

[brianeyci]

Just because people call it alternative medicine that doesn't mean it's not medicine. Where do you think drugs come from, if not herbs? I'm well aware physiotherapy is used for athletes, burn victims, stroke victims, etc., but for problems like whiplash, tension headaches, chronic muscle and back pain, it's a lot harder to get the doctor to say go go go. If that's the case you might want to seek out a physiotherapist yourself, and to me the difference between alternative medicine and mainstream medicine is when the patient goes and seeks treatment for himself/herself instead of going to an MD and describing symptoms and getting a referral.

As for the placebo, I'm wrong about that apparently so I cede to the more knowledgeable members of the forum.

I am interested in what good chiropractic is for. I always thought it was a way to get arthritis faster or get strokes.

[General Zod]

I am interested in what good chiropractic is for. I always thought it was a way to get arthritis faster or get strokes.

Google it, nub.

Chiropractors, also known as doctors of chiropractic or chiropractic physicians, diagnose and treat patients whose health problems are associated with the body’s muscular, nervous, and skeletal systems, especially the spine. Chiropractors believe that interference with these systems impairs the body’s normal functions and lowers its resistance to disease. They also hold that spinal or vertebral dysfunction alters many important body functions by affecting the nervous system and that skeletal imbalance through joint or articular dysfunction, especially in the spine, can cause pain.

The chiropractic approach to health care is holistic, stressing the patient’s overall health and wellness. It recognizes that many factors affect health, including exercise, diet, rest, environment, and heredity. Chiropractors provide natural, drugless, nonsurgical health treatments and rely on the body’s inherent recuperative abilities. They also recommend changes in lifestyle—in eating, exercise, and sleeping habits, for example—to their patients. When appropriate, chiropractors consult with and refer patients to other health practitioners.

[ThatGuyFromThatPlace]

...the following alternative therapies are bullshit (IMO).

Chiropractic

I agree with all except Chiropractic which has been personally useful to me in that after carrying around a much to heavy book bag hanging off one shoulder for school for four years, I can now stand mostly straight with the help of my Chiropractor.
Like most 'alternative' therapies it works when it's used properly, and it worked properly for getting my prematurely crookeded back to straighten itself up.

[Admiral Valdemar]

You can do what John Diamond did for Snake Oil and go with it when you know there's nothing left to do with medicine, just to show up the fraud that is alternative medicine for the world to see (and ignore).

[aerius]

Generally speaking, I turn to alternative solutions when conventional can't find a clear cause of my problem or it can find a cause but can't really treat it.

To use an example, I got hit by a car about 6 years ago and ended up with a bad concussion and lots of weird upper body pains. No broken bones, no dislocated joints, no bad discs, just some non-specific soft tissue injuries. All x-rays and MRIs checked out just fine, they couldn't find any damage that wasn't there before but christ did my entire upper body hurt. So they gave me some codeine based painkillers which helped but left me in a complete haze, and when those ran out the 600mg Ibuprofen pills they gave me did nothing, and there was no way I was going back to opiates. So I self-medicated with some pot which worked pretty well and had some pleasant side-effects too.

I also have chronic neck problems thanks to a biking accident about 10 years ago. The docs say they can fix my neck, but the surgery's pretty risky (30% chance of death or paralysis IIRC) and it still doesn't guarantee an improvement. So I live with the pain & stiffness, some days are better than others, painkillers do nothing, so on some really bad days I'll help myself to some herb.

[Darth Wong]

You can do what John Diamond did for Snake Oil and go with it when you know there's nothing left to do with medicine, just to show up the fraud that is alternative medicine for the world to see (and ignore).

That's quite the generalization, isn't it? There are plenty of alternative treatments that actually have considerable scientific evidence to support their use (marijuana being the most well-known of these).

[Illuminatus Primus]

Well I think there's two beliefs in what "alternative treatments" are. There are treatments awknowledged by science but infrequently used or never used for some externality (pot being an obvious example). And then there are alternative therapies defined by quacks selling colon cleansers and herbal cures to cancer that define alternative specifically as treatment not endorsed by the evil medical establishment which is trying to keep you sick.

[Admiral Valdemar]

That's quite the generalization, isn't it? There are plenty of alternative treatments that actually have considerable scientific evidence to support their use (marijuana being the most well-known of these).

It is, but I'm talking mainly of the "therapies" that people turn to when they're irrational be it with pain or disorientation and come across those promising them miracles. Herbal remedies will alleviate suffering, but they're never cures. Diamond was going after those that make money from giving false hope under the "alternative" moniker where there is nothing but their word that they work. Anecdotal evidence being the most useless form (whereas I can cite studies for the effects on physiology of cannabis or even acupuncture now).

Really, when something is proven to have benefits, it becomes medicine, not alternative medicine/therapy. Marijuana is used by medical staff around the globe because THC is well known to numb pain and suffering: but you'll be damned before you come across homoeopathy clinics in publicly funded hospitals.

[Darth Wong]

Herbal remedies will alleviate suffering, but they're never cures.

Tylenol will alleviate suffering, but it's never a cure.

Really, when something is proven to have benefits, it becomes medicine, not alternative medicine/therapy. Marijuana is used by medical staff around the globe because THC is well known to numb pain and suffering: but you'll be damned before you come across homoeopathy clinics in publicly funded hospitals.

And how many decades did it take for THC to break through institutional barriers in this fashion?

[Admiral Valdemar]

Tylenol will alleviate suffering, but it's never a cure.

No, but they never purport it to be one. Most of these crackpot therapies promise the world, which is my main beef with them.

And how many decades did it take for THC to break through institutional barriers in this fashion?

A while, though it's unfortunate that research was slow because of political stances over the years changing from strict conservative to more open and liberal in the nations most likely able to afford such R&D (a similar situation with ESCs today in some nations). Many effects are still being looked at as technology progresses, even now, we are finding new ways the foods we eat and compounds abundant in society affect us. The medical benefits of cannabis are still being probed to this day from tumour reduction to helping mental disabilities recede. The effect such a drug has on mental state has been known for decades and is pretty much the primary reason for it being used over Vicodin etc. with anything else being a welcome bonus.

Science can't have all the answers all the time, though it'd be nice to lose this stigma attached to certain products, given cannabis was kept back (and still is) in the US thanks to the retarded "War on Drugs". Big Pharma having a monopoly doesn't help either, however, it's good to see companies look into obscure therapies and then bring them to the fray in a legal, safe form with hopefully good safety vetting.

[PainRack]

Just because people call it alternative medicine that doesn't mean it's not medicine. Where do you think drugs come from, if not herbs? I'm well aware physiotherapy is used for athletes, burn victims, stroke victims, etc., but for problems like whiplash, tension headaches, chronic muscle and back pain, it's a lot harder to get the doctor to say go go go. If that's the case you might want to seek out a physiotherapist yourself, and to me the difference between alternative medicine and mainstream medicine is when the patient goes and seeks treatment for himself/herself instead of going to an MD and describing symptoms and getting a referral.

I'm trying to understand why you claim physiotherapy is alternate medicine in this case.

Lower back pain, whiplash, muscle pain, all these are areas of specialties that fall under physiotherapy and its...... normal.

Obviously there's going to be differences in various countries, but aren't physiotherapists considered care providers in the US? Your statement suggest that they aren't, whereas the wiki states that they can be considered to be primary care providers.

[PainRack]

Generally speaking, I turn to alternative solutions when conventional can't find a clear cause of my problem or it can find a cause but can't really treat it.
--snip---

Pardon me for asking, but is smoking the herb really much more effective than just taking the pill? Or is THC in pill form still banned in the states?