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Complementary and alternative medicine synergistic with classic medical and surgical therapy
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 Richard L. Lindstrom |
Complementary and alternative medicine is an important part of my personal health plan and my daily practice of ophthalmology. My own lifestyle choices and experiences significantly influence the advice I give to my patients. I suspect it is the same for most.
As I age and my experience continues to grow, I become more impressed with the contribution complementary and alternative medicine (CAM) can make not only to the quantity of life, but also the quality. I read broadly and am also a good observer of my own habits and those of others, both good and bad. There is no way my typical diet meets the daily recommendations of nutritional scientists. I am not short on calories, but it is a rare day that I meet the recommendations for helpings of fruit and vegetables. So I take a multivitamin every day. Makes sense to me for my own health, so I recommend it for my senior family members, friends and patients.
Everyone has a different barrier for proof, but as I read the science supporting the benefits of antioxidants, I find it convincing. We are exposed to a very toxic oxidizing environment every day, and as we age, our bodies’ ability to neutralize these with naturally produced antioxidants lags. The eye especially is subject to severe oxidative stress from sunlight and is loaded up with antioxidants in the cornea, lens and retina. Unfortunately, these decline with age and can be overwhelmed by environmental stress.
I participated in two clinical trials evaluating the ability of antioxidants to retard cataract and dry age-related macular degeneration. While the results were more impressive in regards to AMD, the studies I participated in suggested some benefit in delaying cataract as well. Studies in other fields are at a minimum, strongly suggestive to me that antioxidant vitamin supplementation reduces the risk of cancer, stroke and heart disease. So I take an antioxidant supplement each day and recommend it to my senior family members, friends and patients with evidence of cataract or AMD. I do not wait for significant signs of AMD to develop before recommending this form of nutritional supplementation.
I do not argue against the published conclusions and recommendations of the Age-Related Eye Disease Study, but medicine is an art as well as a science. If I want my mother with a few fine drusen, trace pigment dispersion and 20/20 vision to take antioxidant supplements, I believe I should make the same recommendation to my other patients. Of course, one must screen for the rare chronic smoker, but they are uncommon today in the senior population. The same for omega-3 supplements. I take them, my wife takes them, my mother takes them — so what should I tell my patients? I tell them I take them because I have a mild evaporative dry eye, hypertension and my diet includes meat and too many omega-6s, and they may find them beneficial as well.
Similar to the story with antioxidants, as I read the literature, omega-3s reduce the risk of heart disease, stroke and cancer, and seem in every way to be good for the eye.
What else? I take a baby aspirin every day. And a glass or two of red wine (resveratrol) is a great relaxant, quality-of-life enhancer, hobby and may even further retard my aging. At a minimum, a glass of fine red wine in the evening with dinner definitely enhances my quality of life. I exercise, surround myself with as much love as I can, and struggle after the elusive goal of a balanced life.
Finally, as a participant in decades of traumatic sports, including football, hockey, baseball, snow skiing, tennis, golf and the like, I have sustained my share of musculoskeletal injuries. I have undergone surgery on my right ankle, both knees, right hip and right lower back. In every case, the services of a quality massage therapist who was expert in active and passive stretching and a personal trainer to plan my recovery exercises were far more helpful to my recovery than the MD-recommended physical therapists, which as prescribed by my orthopedic surgeons have been universally disappointing. The same massage therapy has also been great for minor sports injuries and stress relief.
So for me, my family, my friends and my patients, CAM is a daily part of life. I strongly believe it is in patients’ best interests to have their care directed by an MD or equivalent, but we physicians would do well to remember that complementary and alternative medicine is synergistic with classic medical and surgical therapy in treating many of the most common maladies from which we humans suffer.