Alternative treatments go mainstream

Marissa Coviello was 18 years old when she was diagnosed with Crohn's disease, a chronic and sometimes painful inflammation of the intestine. At 34, she was heading into her eighth surgery. Worried about a painful and slow recovery that might keep her away from her two-year-old son, Coviello signed up for a study at Lahey Clinic designed to help patients better relax and heal.

With the help of her husband and the clinic's staff, Coviello prepared for surgery using a set of relaxation techniques that included meditation. She envisioned herself in comforting places such as the beach and imagined what she wanted for her health after the operation.

She also saw herself working out in a gym within two months of her successful surgery. It worked. Coviello was home with her family in five days-previous surgeries averaged seven to ten. Heading into and coming out of surgery she was calmer. "I have woken up both angry or anxious and often in tears. This time, I was calmer when I woke up, and I don't remember being in much pain. I found it empowering. For me, something worked.

Coviello is one of a growing number of hospital patients able to take advantage of nontraditional therapies as hospitals across Massachusetts incorporate them into their traditional care.

A national trend
Nationwide, the number of hospitals offering complementary and alternative medicine (CAM) has doubled, from 7.9 percent in 1998 to 16.6 percent in 2002, according to the American Hospital's Association's Annual Survey of Hospitals. The survey found that the most common CAM services offered at hospitals are massage therapy, stress management relaxation techniques, yoga, pastoral counseling, acupuncture, and biofeedback, a technique that trains patients to gain voluntary control over certain physiological conditions.

Hospitals commonly refer to these therapies as integrative because they complement traditional medicine and are integrated into the fabric of how care is provided, says Sandy Skinner, the administrative director for Wellness and Complementary Services at North Shore Medical Center (NSMC), a hospital network that includes four sites, all offering integrative services. "In the last two to three years, demand has exploded," says Skinner. The number of [integrative] therapies is growing.

Patients are saying I want more of these services… and I [now] see traditional healthcare embracing these ideas."

Success breeds acceptance
In Massachusetts, the demand for integrative therapies, coupled with a growing body of evidence of their effectiveness, has led hospitals and healthcare facilities to add a range of services. Many facilities train staff to perform certain therapies. At Brigham and Women's Hospital, nurses can learn how to perform therapeutic touch, guided imagery, and meditation. At Newton-Wellesley Hospital, a handful of physicians practices acupuncture.

Along with other complementary services, Massachusetts General Hospital has a massage therapist who visits the oncology unit twice weekly and a pet therapy program aimed at using pets to make patients feel better. The hospital even invites a harpist to play soothing music in the unit. NSMC's Wellness Services Department at Salem Hospital offers alternative treatments such as dance kinetics, hypnotherapy programs, meditation and osteo-prevention classes, massage, yoga, therapeutic touch, and reiki, a hands-on treatment meant to balance the patient's energy field.

There is great value in coordinating traditional and non-traditional therapies, says Cynthia Medeiros, administrative director of Dana Farber's Zakim Center for Integrated Therapies. "Patients were getting complementary therapies on their own, but there was no integration of these therapies; one practitioner was not talking to another," she explains. Offering the therapies on site allows for "enhanced communication and quality of the care." Patients at the Zakim Center can now take advantage of services that include acupuncture, massage, reiki, nutritional consultations, and yoga.

Getting to Om
For Ann Donovaro, it was being introduced to complementary therapies at Salem Hospital that persuaded her to give them a try. Recovering from gastric bypass surgery and having experienced panic attacks for years, Donovaro was searching for something calming, when she saw a yoga demonstration by one of the hospital practitioners. She joined the hospital's yoga program for surgical patients, began aerobic classes at its gym, and then started biofeedback.

Now 240 pounds slimmer, active, and starting to go off her anti-anxiety medication, Donovaro continues to take yoga twice a week at the hospital and credits the integrated therapies with her improved health. "I feel comfortable with the hospital programs. I have never joined an outside gym and never found the need to because I can get all the aerobics and everything else I've needed through the programs they offer," she says. "It's been quite a journey."