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Medical Edge Newspaper Column from Mayo Clinic

INTEGRATING EASTERN AND WESTERN MEDICINE

DEAR MAYO CLINIC: I believe the reason I’m still walking without pain after a car accident is that I’ve had regular care from a talented acupuncturist. I meditate and practice yoga 90 minutes a day; I’ve also worked with Chinese herbalists. On the high-tech end of medicine, I’ve had an amazing surgical team that removed a benign brain tumor. I love all my caregivers and wish they could talk to each other, because I now face major depression and would like them to come up with a solution that is more than a prescription. How can I get them in the same room? — Boston

ANSWER: You can find this blend of Western medicine and other healing techniques in an emerging medical field known as “integrative medicine.” This type of care is being offered at more and more medical centers around the country. To find one, ask your caregiver for leads or inquire at a university center.

Integrative medicine combines various healing styles and strategies under the guiding principles of Western medicine. Over the last five years, national surveys report that 50 to 70 percent of the respondents were using — or were interested in using — this expanded approach to medical treatment.

Typically, an integrative medicine specialist holds an M.D. from an accredited medical school and has advanced training in other healing techniques. The central tenets of integrated medicine are: 1) do no harm, 2) teach patients how to care for themselves, and 3) help patients seek alternatives when conventional treatments haven’t met all their needs.

Many patients express interest in integrative therapies when dealing with difficult health issues such as pain control, managing side effects of cancer treatments, reducing stress, controlling depression and anxiety, maintaining strength and flexibility, and restoring a sense of well being and vigor. Studies have demonstrated health improvements when people, working with their physicians, selectively incorporate acupuncture, therapeutic massage, guided imagery, nutrition or herbal medicine into their health care regimen.

While research to date is generally encouraging, not all therapies have been studied equally. Take special care if you take herbal medicines because interactions can occur with your regular medications. If you decide to incorporate any of these innovative approaches into your routine care, make sure you discuss your decision with your regular physician.

Brent Bauer, M.D., General Internal Medicine and Integrative Medicine,
Mayo Clinic, Rochester, Minn.

Additional Resources:
Alternative Medicine
Mayo Clinic Appointment Information

DEAR MAYO CLINIC: Regarding the balloon procedure for trigeminal neuralgia: Please advise what this entails, and whether it’s considered an experimental procedure. — Paducah, Ky.

ANSWER: “Percutaneous balloon compression of the gasserian ganglion,” or more simply, the balloon procedure, is not considered experimental. It is a well-accepted surgical treatment for the severe pain of trigeminal neuralgia.

Trigeminal neuralgia is recurring pain on one side of the face due to a disorder of the trigeminal (fifth cranial) nerve. Patients often describe the pain as a sharp, shooting, electric sensation that lasts from a few seconds to a few minutes. Patients may contract the facial muscles in response to the pain. Hence the common name for trigeminal neuralgia: tic douloureux. “Tic” in French means a twitching action and “douloureux” means painful.

If previous attempts to control this facial pain with medication have failed, doctors may consider the balloon procedure. To perform it, a neurosurgeon places a needle through the patient’s cheek and then through a hole in the base of the skull. The needle is advanced until it rests against the gasserian ganglion, the relay station of the trigeminal nerve that carries sensation from the face to the brain.

Once the needle is in place, the surgeon inserts a deflated balloon so that it rests against the gasserian ganglion. Then the balloon is inflated. This compresses the gasserian ganglion and relieves the facial pain in 90 percent of patients. Side effects of the surgery include numbness of one side of the face and weakness of the chewing muscles. Both of these side effects often improve with time.

J.L.D. Atkinson, M.D., Neurosurgery, Mayo Clinic, Rochester, Minn.

Additional Resources:
What is trigeminal neuralgia?
Treatment of trigeminal neuralgia
Appointment Information
Percutaneous balloon compression of the gasserian ganglion
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.