Thinking Out of the Box

Posted 06/23/2009

Patients linked me to a couple of interesting articles last week, one from Newsweek (a magazine I thought no one read anymore) bashing the health advice given on Oprah’s TV show as harmful to your health because it was unscientific and unproven. The other, a thoughtful rebuttal by Dr. Deepak Chopra, was posted at Huffington Post.

If you’ve got time for these, they’re worthwhile reading. For those of you who’ve had the experience of trying to tell a conventionally thinking doc about something you saw on Oprah and getting that slightly pained look that says “Oh, here’s another patient about to ask me about…,” you’ll relate.

What Dr. Chopra discusses is not simply alternative medicine, but the willingness of alternative practitioners to think out of the box, to look at your health problem beyond the confines of the standard American medical education, whose primary treatments are prescription pad or operating room.

At WholeHealth Chicago, our weekly staff Case Conferences demonstrate this sort of out-of-the-box thinking. Occasionally, a conventional physician-in-training will join us, wanting to learn (in less than one day) “how the other half lives,” or how alternative practitioners including me, an MD, approach our patients’ concerns. Generally, these visitors depart feeling a bit unnerved by the experience. This is stuff they never knew existed.

Recently at our staff conference we discussed a patient who had been suffering from chronic urticaria, better known as hives, for several years. Every two or three days, without any specific triggers, her skin would erupt in a red and itchy rash. She would then take antihistamines and, for bad cases, sometimes strong corticosteroids and the rash would subside. Though the antihistamines were working somewhat, she didn’t like the idea of taking a chemical every day.

When she came to see us, she’d already seen four allergists, had undergone many diagnostic tests, and had finally been advised to take antihistamines twice a day, every day, to prevent the hives from appearing. The big guns, such as regular corticosteroids or anti-cancer immune suppression drugs, would be reserved in case things worsened.

Truth be told, the helplessness on the part of most physicians trying to solve chronic hives is not uncommon, and dealing with recurrent and unexplained hives is frustrating for both patient and physician. The simplest treatment for hives is avoidance. Strawberries give you hives? Avoid them. But in almost half the people with hives, there’s no apparent trigger.

Today I’m going to open the door a crack and let you eavesdrop on the voices of our own circle of practitioners during the Hives Case Conference:
From a holistic perspective, it’s possible that some unknown event in her life, like a psychological trauma, which she may or may not remember, has shifted her immune system to “attack” imaginary enemies. I think we’ve got to focus on the weeks or months before she developed hives. What was going on in her life? Why is her immune system suddenly so hyper-alert? What is it trying to protect her from?

I agree there’s a disruption to her energy system, her chi, at play here. I doubt they included an energy reading in the allergy department over at Northwestern, but I’d guess the flow of her chi is pretty chaotic.

In Chinese medicine, this chi disruption could affect the detoxifying systems in her body. She could be eating something harmless, not be able to clear it properly from her system due to a sluggish liver, and then react to it. You could use acupuncture to restore the flow of chi and Chinese herbs to strengthen her liver.

The same basic principal would apply with homeopathy. A tiny and highly diluted substance that in a large dose would cause hives in a healthy person would restore her energy imbalance and reverse the whole process in her. We often use the remedy Rhus tox for hives. It’s actually made from highly diluted poison ivy.

If she has an issue with a sluggish liver failing to remove toxins, the simplest way to begin might be an allergy-free detoxification using Ultra-Clear and nutritional supplements to support liver function. Clear out all toxins and give her liver a clean slate, hoping the immune system will reset itself. Remember, the human body is geared toward self-healing if we can give it the right atmosphere to do it in.

I’d go back to possible biographical issues. Everybody agrees that stress is a common trigger for hives, sort of like a blush that’s spun out of control. Clinical studies have also shown that relaxation techniques like regular meditation can actually reverse hives and reduce the number of flare-ups.

The general consensus seems to be to explore biographical issues in greater depth, consider an energy reading, and get her on an allergy-free detox program. If something jarring shows up in the energy reading, think Chinese medicine or homeopathy. If something shows up in biography, recommend counseling. Everybody comfortable with this?

Nothing I learned in med school prepared me to look at hives this way. If there’s one outstanding flaw in conventional medicine, it’s the arrogance of being “certain.” To pass over ancient healing systems as unscientific and unproven and therefore not meriting serious consideration simply shows the minds of too many physicians remain narrow, their thinking trapped–in a box.

Be well,
David Edelberg, MD