The prevention and treatment of heart disease, America's number one killer, are expanding with the emergence of integrative therapies that are designed to support, not replace, conventional medical care. The new program Healing the Heart provides integrative therapies that treat the body, mind and spirit.
Music therapy, guided imagery, relaxation skills, massage, nutrition therapy and spiritual care are supportive treatments offered to patients undergoing open heart surgery and other conventional medical treatments and procedures. In individual care planning, these therapies are integrated with medical care to address the whole person. High tech and soft touch are combined in order to stimulate and complement the natural healing process of heart, mind and spirit. For those with health concerns, building the bridge to healing and renewal at any stage of the life cycle can be a meaningful reality.
Healing the Heart complements the leading edge conventional medical care and technology provided by the Minneapolis Heart Institute and Abbott Northwestern Hospital. Vibhu Kshettry, M.D., a cardiovascular surgeon, is the medical director and Linda Flies Carole, Psy.D., a licensed psychologist, is the healing coach and clinical program manager. Research development and support are contributed by the Minneapolis Heart Institute Foundation. Therapies offered enhance mind/body interactions in a way that encourages individuals to call upon their own inner healing resources and more actively partner with medical staff.
These treatments are not new. In fact, all had origins in ancient times. They continue to be used in other parts of the world sometimes as primary methods of care. They are often combined with Western medicine. Hippocrates, the father of medicine, is known to have used massage. The ancient Egyptians and Greeks used aromatic oils and Native Americans often seek meaning, purpose and a spiritual path in life through vision quests. For centuries, India, China, Japan and Tibet have used systems of traditional medicine that diagnose imbalance or illness by reading the flow of energy in the body. Mind/body exercises such as yoga, tai chi and qigong are used as preventive and healing techniques and are incorporated into the awareness and lifestyle of individuals from birth. If these treatments are not new, what makes them of interest now?
Two forces drive today's interest in complementary therapies. The first is consumer demand. David Eisenberg, M.D., and colleagues in two consecutive National Institutes of Health-supported studies document the use of unconventional medicine services in the United States between 1990 and 1997. Results first published in 1993 showed that one in three adults used at least one form of unconventional medicine. The therapies were used most often for chronic conditions. The majority (83%) who used unconventional treatments for life threatening illness also sought treatment from a medical doctor. However, 72% of the respondents who used the therapies did not discuss this with their medical doctors. Healing the Heart provides an environment where these conversations can take place. In addition, individual differences are considered so that the treatments Ūt the needs identified.
Of the 16 therapies Eisenberg surveyed, the most frequently used were mind/body techniques that included relaxation skills, massage, imagery and spiritual healing. Results drawn from the 3,500 individuals surveyed suggest that more visits were made to alternative care practitioners than primary care physicians. By 1997, 629 million visits were estimated.
Hands that heal the whole person - hands of the heart surgeon, cardiologist, nurse, healing coach, massage therapist, music therapist, nutritionist, and spiritual advisor.
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The innovators of Healing the Heart heard and responded to requests for this combination of services from patients and family members. Medical staff recognizes that the array of complementary therapies, herbal medicines, and vitamin supplements can be confusing if not a waste of time, money and energy, if not considered within an individual's unique health profile. Consequently, the second driving force is research into the efficacy of body/mind approaches in light of what we know about distress and heart disease.
The damaging effects of persistent stresses have been defined in research studies. The Journal of the American Medical Association reported that mental stress during daily life, such as tension, frustration, and sadness, can more than double the risk of myocardial schema (deficient blood flow to the heart muscle resulting in injury and often pain) in the subsequent hour. Other studies have reported that depressed mood adversely affects rehabilitation after heart attack and predicts increased risk of death from cardiac causes. In a 27-year study of 730 patients with heart disease, researchers found that individuals were 70% more likely to experience a heart attack if they suffered depressed mood and they were 60% more likely to die than those who were not depressed. A 1995 Mayo Clinic study concluded that psychological stress is the strongest predictor of cardiac events. Another found men who experienced high anxiety were six times more likely to suffer sudden cardiac death. A Harvard Medical School study of 1,122 heart attack survivors stated that those who remained calm during emotional conflicts had half the risk of repeat heart attacks.
Individuals with heart disease have been described as having behavioral characteristics that contribute to emotional distress. Heart disease is a leading cause of death in women. Women are said to more frequently suffer vital exhaustion due to caring for others before themselves and ascribing symptoms of heart disease to other more benign causes. The number of women dying from heart disease (1 in 2) greatly outnumbers the number of women dying from cancer of all kinds (1 in 9). Anger, hostility, time pressure and persistent responses to stress as if all were emergency events, is sometimes referred to as Type A behavior. These perceptions and behaviors affect mind, body and spirit in ways that contribute to the onset or experience of heart disease and related deaths.
While more study is needed to better understand the appropriate dosage for individual treatments and the mechanisms by which the complementary treatments work, results that demonstrate positive benefits are available. Herbert Benson, M.D., and colleagues at Harvard Medical School as early as the 1970's and 1980's discovered the relaxation response. As a result of his and other studies, we know that the body is 'wired' by the brain. We often think of the brain as the mind. We know that through the nervous system, the mind reaches into all the organs including the heart and the walls of the connecting veins, and arteries throughout the body. The nerves connect with tissue and influence the heart's behavior affecting blood pressure, heart rate variability, and other areas of the heart's functioning. The heart is often visualized as the energy center of the body in physical as well as psychological and spiritual terms. Therapies that access mind and body by inducing the relaxation response give the body that time to heal and self-repair.
Michael Shamblin rests and relaxes with the music of Mozart on the first day after open heart surgery. His surgeon, Vib Kshettry, M.D., provides medical care and Linda Flies Carole, Healing Coach and psychologist, provides skill-based support for healing and recovery.
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Complementary therapies provide this access. Dean Ornish, M.D., a California cardiologist/researcher, examined the effects of a group program for people suffering severe heart disease in a controlled study. Relaxation, meditation, yoga, nutritional therapy, and social support were some of the strategies offered. Those in the group treated with complementary or non-medical therapies showed significant reductions in coronary artery blockage or a reversal in heart disease while those with usual care generally showed more blockage.
In other complementary modalities, 40 heart attack patients were treated with either 25 minutes of relaxing music or 25 minutes of rest only. A significant reduction in state anxiety and heart and respiratory rates was found for the music group. Music has been shown to entrain or pace the heart to musical rhythm thus stabilizing the heartbeat in healthy individuals and in some cases those with heart disease. A New York hospital reported a drop in heart attacks and a death rate 8 to 12 percent below the national average after installing a music listening system in a 6-bed intensive care unit.
Imagery has been called imagination medicine. It has been used as the communication vehicle between perception, emotion, and bodily change. It has been used for centuries in shamanic healing ceremonies. Imagery has been researched in combination with the relaxation response, and those studies have repeatedly shown effectiveness in stress reduction and reducing heart rate reactivity, blood pressure and resting heart rate.
Spirituality is defined as more than religion and prayer. It has come to be seen as what gives meaning and purpose to life beyond the physical experience. However, individual belief systems are often expressed through these means. Columbia Presbyterian Medical Center surveyed patients with coronary artery disease treated in their complementary therapies program. Fifty percent of those patients defined prayer as a healing modality.
The positive effects of intercessory prayer were studied at San Francisco General Medical Center. Close to 400 patients treated in a critical care unit were assigned to two groups over a 10-month period. One group was prayed for and the other was not. Those doing the praying were located outside the hospital. The prayer group had less congestive heart failure, required less diuretic and antibiotic therapy, had fewer cardiac arrests, and were less frequently assisted in breathing by a ventilator. Severity scores were compiled and the author concluded that the prayer group had an overall better outcome.
The good news is that individuals can engage in an integrated health promotion and healing plan. It is possible to learn skills for behavioral and lifestyle change that benefit not only the individual but family, even friends. This time of self-repair and renewal can be created. Quality of life is a primary consideration of an integrated health plan that includes complementary therapies. With chronic heart disease, cure is not always possible. Creating a "new normal" after diagnosis, is the goal of an integrated healing plan that is designed with quality of life in mind. Such an integrated plan can be of benefit at any stage of the life cycle and in any state of health.
For more information, please contact Linda Flies Carole, Psy.D., medical director of Healing the Heart at 612/863-5765.
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