Hormones in Harmony

Living abundant joy through bio-psycho-spiritual balancing

Location: Ojai, California, United States

Welcome to Hormones in Harmony where I shall share pearls of wisdom gathered over two decades of consulting with the hormonally challenged. As a holistic nurse practitioner specializing in neuro-immune-endocrinology, I have merged my western education with eastern philosophies, but the key to being a successful healer is to embody physical, mental, emotional, and spiritual wellbeing. At 54, married for 32 years with two grown children, I strive to keep my Hormones in Harmony with a positive attitude, a loving environment, and faithful consumption of Genesis Gold.

Thursday, October 29, 2009

How About Holism for Health Care Reform?

When are we going to think out of the box? I just got off the phone with Bob, the local cardiologist. Last week, I did an urgent run down to the valley to pick up my gravely ill mother-in-law and brought her to our small community hospital. Admitted through the emergency room with aspiration pneumonia and congestive heart failure, she was at death’s door. Bob took over her care in the Intensive Care Unit and literally saved her life. Bless his heart, Bob called to check on her.

As a family nurse practitioner and her only daughter-in-law, I am her health care agent, the one who legally has the responsibility to make medical decisions for her if she cannot make them herself. My 70 year old mother-in-law is a retired nurse and primary caretaker for her 90 year old mother. I had to take them both…Gran to the house to be cared for by my husband and my mother-in-law to the emergency room. Having her in the ICU close to home was easier on all of us.

The family questioned if she would be better off in a tertiary care center. I said “No, too many cooks in the kitchen ruins the soup.” So all on his own, our small town cardiologist used his head to figure out what was wrong. I assisted by gathering all her pertinent medical records so he didn’t have to start from scratch. I gave him a thorough history on her and my blessings.

Within 48 hours, we had discovered that the cause of all this woe was a slipped lap band. You know…the surgery to lose weight…well, her lap band slipped causing the regurgitation that resulted in aspiration pneumonia, hypoxia and an ischemic event of the myocardium….AKA…a heart attack. Now she had a biliary obstruction….quickly becoming jaundiced and heading to liver failure. She was a poor surgical risk to begin with and now she was worse. But to leave in the lap band was more risky than the risk of surgery. So once stabilized, she was shipped to an advanced state of the art hospital so her bariometric surgeon could remove the offending device.

That was five days ago. She is getting worse…bilirubin rising, more jaundiced, less lucid, unable to make her own medical decisions. Why? Because the cardiologists in the grand medical center cannot agree, so the surgeon fears to remove the lap band until he has cardiac clearance. Everyday they wait, she gets weaker.

This is modern medicine. Oh, she’s had all the state of the art testing. Two MRI’s, a CT scan. Lots of look-sees, but no action. I had to pull teeth to get her surgeon to talk to me! He believes she’s lucid…while she is clearly delusional, wondering when we will have the nursing staff over for a barbeque! He ordered a brain scan because of her weakness and memory loss, while it seems obvious her liver is poisoning her brain. My grandfather died of cirrhosis of the liver. He too was swollen, weak, yellow and delusional… just like my mother-in-law.

Lots of tests and no one is looking at the patient. No one is looking at the whole picture. Too afraid of liability. Warped by their boxed in myopic vision. Something has to give. Unfortunately, my-mother-in-law may give her life for the ineptitude of modern medicine. Not because of lack of education, lack of technology, lack of science, but for the lack of thinking out of the box, for the lack of viewing the patient holistically.

What is happening to my mother-in-law is the reason heath care costs are so out of control and health care outcomes are so poor in this country.

I got a call a few weeks ago from my father…also a Medicare patient. He had been suffering from progressive weakness, climbed up a ladder and fell. Nothing serious. He was more concerned that he lost his balance and didn’t have the strength in his arms to catch himself. So in fear and pushed by frantic relatives, he went to the emergency room. Of course they found nothing related to this chronic condition. Nothing on the CT scan, the blood tests, the x-rays. He couldn’t understand, so he called me.

I explained that emergency rooms are great to save your life. Testing is to rule out life threatening conditions that could cause immediate demise. Using the ER to diagnose chronic illness is an inefficient waste of resources. Unfortunately doctors and hospitals often use technology to protect themselves from malpractice. Another reason health care costs are so high.

No one—not his primary care provider, not the ear, nose and throat doctor, not the neurologist—asked my father about his living situation. He lives alone in a toxic environment. He won’t listen to his family, not even his three daughters who happen to be nurses. But a quick review of his blood work together with knowing him as a human being, socially, emotionally, mentally…it seems clear that his woes are rooted in his home. A doctor, he would listen to. If only a doctor would get to know him.

Oh well. Family can be the most challenging for all of us, especially us health care providers!

I am stymied by the attitude of medicine. At the last conventional medical conference I attended, one lecturer reported research on how Tylenol interfered with Coumadin. Lots of data, but nothing on the biochemistry of the problem. So I went up and asked what aspects of the hepatic detoxification pathways were involved in the drug interaction. Phase I P450 enzymes or phase II conjugation? The doctor held up his hand and said very slowly and very loudly, “I am a lung doctor, not a liver doctor.”

I was flabbergasted! “Doctor, don’t all your pulmonary patients have livers?” He nodded. “So wouldn’t it behoove you to know the biochemistry of this drug interaction so you can guide them regarding the foods they eat and the supplements they take?” looked at me hopelessly. Had he forgotten basic human physiology—the college course all health care professionals must take? In the managed care system, he doesn’t have time to learn let alone educate.

Medicine has splintered into so many specialties that health care is fractured. Patients do not receive holistic care in most conventional medical practices. How dependent we have become on medical tests. Lots of technological data that provide “sound bites” of information. But no musical score, nothing to dance to…so few partner with their patients. Few get to know their patients. Few spend the time to provide wellness counseling. Have we sacrificed the art of healing for the science of medicine?

I am blessed to be able to practice outside of conventional old paradigm medicine in a community that rewards holistic thinking. The current health care system does not reward holism which is why I do not accept insurance. Yet patients come from around the world to pay out of their pocket for a consultation with me. Why? Because I spend the time to get to know them well enough to get to the root of their problem. I blend the science of medicine with the art of healing to partner with patients that are committed to do their healing work. It is time for a change! I am not the only one who can practice in this manner.

Ironically, the day before I picked up my gravely ill mother-in-law, I was in New Mexico speaking at the national nurse practitioner conference. I taught my colleagues how to recession proof their practices by adopting a holistic medical model and practicing integrated medicine. Not as well received as I would of liked, but as well as I expected. Few believe they can escape the rigid cage of insurance/pharmaceutical driven health care. I do have hope for my profession. But more so I have faith in the patients to force us to change.

I propose a new paradigm of medicine. I call it Intuitive Integrative Medicine. One in which we utilize all our gifts as healers, our intuitive knowing, coupled with our vast education, and really listen to our patients. Partner with them. Teach them how to access the healer within. Most of my colleagues would greatly benefit from learning to heal themselves holistically. I am not professing that we throw out all our modern technological wonders, but to use technology judiciously, to look at the patient, not just the tests.

When health care providers begin to think out of the box to evaluate their patients holistically only then will we be a healthy nation…physically, psychologically and financially.

Deborah Maragopoulos MN APRN BC FNP
practices Intuitive Integrative Medicine in Ojai, California.

Labels: , , , , , ,


Post a Comment

<< Home