New Age 2001 - Lawrence B. Palevsky, MD

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IT T L E
NOA H
F ONG \VAS NOT A HAPPY
respectfullytelling him what wasgoing
observed
that childrer.r who are
camper.
At theageof eightmonths,he on."Noahtrustedhim immediately,"
she depressed
willoftencomplair-r
of astomdeveloped
an earinfectionandthena recails."lt wasa welcomechangefrom achache.Psychological
stresscan conc ought hat of t e n l e d to v o m i ti n g .H i s
ian prescribedone antibiotic
her,but after10months.Noah
wasstill sick.Finailythe doctor decided
to put him on asthmamedication,even
though Noah didn't haveasthma.For
the boy'smother, SharonFong,that was
the laststraw."We'dbeenstuckin this
treatment routine,"sherecalls,"but suddeniy I looked at Noah and thought, this
is an awful lot of medicationfor sucha
little kid!" Frustratedand concerned,
Fongand her husband,|amesWistman,
decidedto leavethe conventionalmedical superhighwayand seekan alternative route to healthfor their child.
With this decision,FongandWistman
joined a smallbut growingnumber of
A m er ic an par e n tsw h o a re tra v e l i n g
beyondmainstreamWesternmedicine
in the searchfor betterhealthcarefor
t heir k ids .A c c o rd i n gto a 1 9 9 9s ru d y
publishedin Pediatrics,10-l 5 percentof
children nationwide havereceivedsome
form of complementaryor alternative
c ar e,s uc hasc h i ro p ra c ti ca n d h e rb a l
medicine.Perhapsnot surprisingly,parentswho seekout suchcarearewell educatedand haveoften tried alternative
treatmentsthemselves,
accordingto a
studypublislredin 1998inthe Journalof
ClinicalOncology.
Conditionssuchas
asthma,eczema,allergies,bedwetting,
irritablebowelsyndrome,chronicrespiratory infections,nasalcongestionand
migraineheadaches
canbe successfully
t r eat ed wit h co n p l e me n ta ry c a re ,
accordingto the physiciansir.rterviewed
for this story.
Holistic therapiesfor kids areoffered
in a varietyofsettingsacrossthe nation,
rangingfrom privateofficesand group
practicesto major n-redical
centerssuch
ast he B et hI s r a e lH o s p i ta lC e n te rfo r
Healthand Healingin New York City,
whereNoah'sparentsfound Lawrence
Palevsky,
M.D., a holisticpediatrician.
During Noah'sfirst 60-mirruteappointment rvith Palevsky,
Fongwasinpressed
t hat t he doc t o r h e l d th e l i ttl e b o y ,
64
NE W A GE MA Y /JUNE 20Ot
th e u s ualManhattan doctor factory
wherethe physiciansrarelyinteractwith
your baby."Thkingtime to build rapport
helpsa holistic physicianget to know a
childin orderto understand"the big picture,not just the physicaisymptoms,)'
Palevskysays.It's important to explore
"body,psyche,emotions,spirit and relationships"because
theseareall potential
fa c to rs i n i l l ness, concurs K athi I.
Kemper,M.D.,directorof the Centerfor
H o l i sti c P edi atri c E ducati on and
R e s earchat C hi l dren' s H ospi tal i n
B o s ton and author of The H ol i sti c
Pediatrician.For instance,Kemperhas
tributeto pain and to othersymptonts,
suchasdiarrheaand rashes.That'swhy
doctorslike Kemperand Palevskysa1,
that gettingto the botton.rof a child's
health problem requireslooking at tl-re
whole child-and the family,too.
At Noah'sfirst appointment,in additi on to taki ng hi s n-redi c alhist or y,
Palevskyaskeda wide rangeof questions
about the family-their dietary habits,
howtheyliketo spendtime togetherand
more. H e al soprobed to un der st and
their beliefsaboutnaturaltreatments.
"It's importantto learna family'sphilosophy about health care,"saysHarvey
'.:
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tion-stimulatingfoodsaswell asantibiimbalotics,which can causeir-rtestinal
P al evskytook
a n c e sa n d w eaknesses.
Noah off antibioticsand recommended
Karp, M.D., a Los Angeles pediatrician
d i e ta ry changes:el i rni nati ng dai ry,
an d assistan t pro f es s or at t he UCLA
and other mucus-stimuglutengrair-rs
School of Medicir-re."lf they prefer that I
treat their child's mild yeast infectior.r l a ti n g fo ods;i ncreasi nghi s i ntakeof
food; addi ngconfre s h ,u n processed
with baking soda and water, ratl-rerthan
foods like oily fisl-r
gestior-r-reducir-rg
use an expensiveantifungal medication,
(mackerel,
sahror-r),
tuna,bluefishar-rd
I want to knowthat."
asn ell asbeans,herbszrndgreenvegetaChild rerr th emre lv e: c ot r tt r r ut tic at eI
food tl.ratNoah
bles.'fofu,a processed
gre at d ea l to a p ed iat r ic ian, if he oby the
l i k e s ,i s n orvonl y occasi onal l on
servesand listerrs."Cl-rildren are ope It
fa mi l y ' smenu.To support thei r son,
bo oks," Pale vsky s ay s ."And t hey r eF o n g a n d W i strnan adopted these
spo nd a lo t q uicke r t o t r eat t t t ent t han
c h a n g e s,too. N orv,si x months l ater,
adults do ." Whe n he s aw Noah, he
Fongreportsthat Noal-ris healthyagain
quickly ruled out an ear infection. The
a n d h a sstuckto Iri sdi et 75 percentof
like ly cau se o f th e t oc ldler ' s c oughing
he has
and vo miting : a ller genic and c ol. ) ges - the time,fallingoff it onl1,u'hen
A CHILD' SDIETOR
SONIE T IMECSHA N GING
TIM EWITHYOUR
MOR EQU A L ITY
SP E ND ING
HERHEALTH
L I TT L EONECA NHE L PIM PROVE
indulgedin birthday-partycupcakesor
crackerswith juiceat daycare.
"When childrenon specialdietswish
they could eatIike their peers,it helpsif
their parentsstayon the diet with them,"
Rechtschaffen,
the motherof
saysVasant
nine-year-o1d
Eii,a Palevslypatientu'ho
suffersfrom asthma.To avoidprescrib
ing steroidsfor Eli (the drugscanhave
negati veeffectsor.rthe bones,eyes,
adrenalgl andsand i mmune sy st em ) ,
Palevskyreconrmendeda diet simiiarto
Noah's."1 try to producedeliciousalternati vesat home, such asr,r' heat - f r ee,
dairy-freechocolatebrownies-evenif
for
Eli'steer-rage
siblingsgo exclusively
junk food,"saysRechtschaffen.'And
it's
w orki ngl " A l though E l i usedt o t ir e
C ON T1N U EON
D P A GE107
2OO 1 ]\IAYi J U N E N EW A G E 6 5
HolisticHealthfor Kids
C O N T I N U EFDR O MPAGE6 5
quickly and get short ofbreath during
activeplay,Rechtschaffenreports that
"he is now gettingstrongerand stronger.
He'sa regularlittle sportsman."
Holistic pediatricians,like PalevskS
t y pic allyint eg ra teh o li s ti ctre a tm e n ts
into a patient'shealth regimen,referring
a child,when appropriate,to a nutritionist,chiropractor,acupuncturistor other
complementary- care provider,asthey
would traditionallyto other medicalspecialists.At the BethIsraelCenter.which is
organizedasa sort of medicalcooperative, staffspecialistsin thoseand other
disciplineswork closelywith the M.D.'s.
IncreasinglnM.D.'sare taking active
stepsto study and useholistic therapies.
But eventhosewho don't practicecomplementary modalities are often willing
to referto practitionerswho do, according to JamesGordon, M.D., chairman of
t he W hit e Ho u s e C o m m i s s i o n o n
Com plem enta ry a n d Al te rn a ti v e
MedicinePolicy."In our area,there are
HOWTOLOCATE
A SKILLED
H O L I ST IKI
C D S' DOC
There is currently no nationwide Fora copy,senda checkor money
r o q n r rr.p fnr hnl i cti .' npdi atri c nr:ni i orderfor $10 to: 6728Old McLean
tioners,so locatingonein yourarea Village
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McLean,
VA22101.
takesa littledeteciive
work.Tryasking I The AmericanBoardof Family
otherparents
for referrals,
oryourown Practice
hasan excellent
"finda docchiropractor,
or other tor" pageon their Website (www
acupuncturist
holisticpractrtioner
for referrals
to .familypractice.com).
practitioners
with pediatric
training. I BethlsraelCenterfor Healthand
yourpediatricianmay Healing,NewYork,NY;(646) 935Alternatively,
knowcompetentareachi ropractors, 2220.
nursepractitioners
or herbalhealers, f Children'sHospitalCenterfor
amongothers,
whospecialize
in chil- Holistic PediatricEducaiionand
dren'shealthcare.JamesGordon, Research,
Boston,MA;(617) 355M.D.,director
for Mind- 6000.
of theCenter
BodyMedicine
in Washington,
D.C., I UniversityMedicalCenterDeparents
advises
notto overlook
family- partmentof Pediatrics,
Tucson,
AZ;
nr ar - tir - o,- l nnfnr c
And e L^^r , +L^ r ^l
(520) 626-5170.
lowingorganizations
and medical I Unrversity
of Minnesota
Centerfor
centers
for referrals.
Spiritualityand Healing,St. Paul,
I The AmericanHolistic Medical MN;(612)624-9459.
provides
Association
a partialiistof I UCLAPedratrrc
PainProgram,
Los
theirmembers;
18 arepeoiatricians.Angeles,
CA;(310)825-O73I.
p 'u u L r v w
u vu L vr J.
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ullgLn
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A G R OWINN
GU M B ER
O FAMERI CAN
F AMI LI ES
ARE
TRADINGANTIBIOTICSFORALTERNATIVETREATMENTS
W HE NT H E IRC H IL DREN
G ETSI CK.HERE'S
A LO OK
AT
T HE S T A TE
OFTHE ARTO FT HI S MEDI CI
NE.
BYI VIN
I D YP IN N Y BACKER
By puBLlsHERs
I N E W W OR L D L IB R A R YprsrRtBUTED
cRoup wEsr . www.newworldlib
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2001 M AY/J U N E N E W A G E ro 7
&Auglg-24,'01fifii'';8ii
June| 7-22,luly22-27
*'lffit:*,:jlthe
onlyoneor twopediatricians
whointegrate complementaryand alternative
treatments,"saysGordon,whoseCenter
for Mind-Body Medicineis locatedin
Washington,D.C."But therearemany
more who referyoungpatientsto doctorswho do."
An important facetof a holisticdoctor' s rol e, w hateverh i s pr act ice,is
teachingparentshow to providebasic
"We haveto teacha
carethemselves.
much broaderversionof healthto children of al l ages,"saysGord on, who
hopes that the W hi te H ouse Com mission will recommendthe creation
of health-educationprogramsspecially
targetedat parentsand kids. Palevsky
agrees:"In casesof minor childhood illness,we want the parentsto feelconfident in moving closerto the child, not
steppingback and handingthe child
over to a doctor." He regularly trains
parentsi n " hands-on care";f or instance,kids like Noah and Eli who have
upper-respiratoryinfectionsmay benefit from massage
with essentialoils.
On his new diet, Noah catchesfewer
coids,but when he doessuccumb,his
parents massagehi m w it h olive
oi l enhancedw i th a drop or t wo of
essentialoils of thyme (a natural expectorant),oregano(a natural antibiotic) and peppermint(afeverreducer).
Treatmentslike massagealsopromotea warm interactionbetvveen
parent and child, saysLori Nafshun,who
consultedHarveyKarp for her daughter,Mica, now four,who had a bad case
of col i c as an i nfant. K arp, who describeshimselfas"15percentdoctor,85
percentgrandmother"due to his fondnessfor simplehome remediessuchas
chickensoup,urgedNafshunto takean
infant-massage
class.It was,shesays,
" one of the smartestthi ng sI 've ever
done."MassagingMica'sbellyhelped
relieveher intestinalgasand her colic.
Plusthe massage
wasfun. "AssoonasI
put her on the bl anket and r ubbed
lotion on my hands,she'dstartto smile,
wiggleand giggle,"saysNafshun,who
alsomassaged
her next baby,a boy.She
believesthe massage
may havehelped
"#:ITilili
ARTIST'S
Jil'J;,il,Ht
!\Aycreffitr
CIRCLE#223 ON READERRESPoNSEFoRI\,i:P. 104-105
ALAN COHEN
"No one in rrrylife has contributed.
more to mrymovement ta expanded
consciousness
arTdgreater clwdrenessthan ALo;nCohen. He is one
of those humcutscuhoseimpact has
been intmeasurable.We are bLessed
in you, Al'on:,,for Leadingthe way
for so many of us."
NEAL E DONA LD W A LS CH
Author of Conq.,ers
ations with Qod
HAWAII
MasteryTrainings
August19-25
December
1-7
July21-28
with Alan Cohen &
Mary Manin Mo\risey
ro E N E W A GE MA Y/JUNE 2001
# I tr.rsprna
FICTION
BESTSELLER
IS HE
N .qrsH uN '.tt'
s to
s ro R l E SLIK EFON G' s,
Rechtshaffen'sattestto the efficacyof
holistictreatmentsfor kids,but to date
therearefew formal studiesto back up
A holisticspethe anecdotalevidence.
cial-interestgroup hasbeenformed by
the Ambulatory PediatricAssociation,
and theAmericanAcademyofPediatrics
starteda taskforceon complementary
medicinelastyearto educatedoctors
and the public.Thesestepsshouldhelp
ensurethat studiesare done and that
more doctorsaretaught complementary
QU A LI F I E D?
Onceyou rdentifya holistrcphysito checkout his
cian,it's important
At
andapproach.
or hercredentials
seehowthe
i nlerview,
a preliminary
pediatricraninteractswtth Your
child and how he or she responds.
aresomekeyquestions:
Following
r Whatis the extentof yourholtsttc
training? Whereand with whom
haveyousiudied?
r Do you refer to or work closely
Do
withotherholisticpractitioners?
you havean activerile of thoseyou
recommend?
do youlrketo use?
r Whattherapies
Whattreatmentoptionsmightyou
for, say,a chronicear
recommend
i nfectron?
or respiratory
convention: Howdo youintegrate
al andholistictreatments?
prevent
colicin herson.
Whetherholisticcarecallsfor tough
or fun activitieslike
dietarychanges
theseparentsfeelit'sworthmassage,
while. SaysFong,"Before,when Noah
wastaking antibiotics,it would takehim
l0 daysto recoverfrom a cold. Now,
without antibiotics,he'sbetteraftera
day or t wo. "T h e s etre a tm e n tsd o n ' t
come cheap,however."Our insurance
doesn'tcoverall of it," Fongsays.Doctor
visits,which canrun from $i25 to $350,
aretypicaliy covered,but feesto other
practitionersoftenaren't.Visitsto a chir opr ac t or( $50to $ I 5 0 ),a n u tri ti o n i s t
($90and up) and a massage
therapist
( $35t o $100)ca n a d d u p . O fc o u rs e ,
antibioticscan be costly,too-a prescriptioncansetyou back up to $ 100.
But whereasinsuranceusuallyrequires
t r p re s c ri p ti o n
onlya low c op a y m e nfo
drugs,parentsmust Payout of pocket
That isbeginningto
for holisticservices.
c hange.S om ei n s u ra n c ec o mp a n i e s ,
I ik e O x f or d an d U n i te d H e a l th C a re ,
offer at leastpartial reimbursementfor
performedby a desigholisticservices
nat edlis tof lic e n s cpdmc ti ti o rre rs .
medicine.
Gordonfeelsthat,properly
used,mostcomplementary
therapies
tend to be saferand lesstoxic than conventional ones.And asPalevskypoints
out, "many of the pharmaceuticals
we
useon childrenaremadefor adults,and
their specificeffectson childrenhave
neverbeenproperiy,scientificallystudiedl'He notesthat Prilosec,
for example,
which adultstakefor.aciclreflux,was
widely prescribedfor chilclrcnwithout
any studi es.Then w hen ki d s exper iencedserioussideeffects,
doctorsbegan
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to usethe drug far more cautiously.
Despitethe lack of efficacystudies,
parentsaremore and more frequently
turning to complementaryand holistic
care,particularly when their kids are
s e ri o usl yi l l . A ccordi ng to the 1999
report in Pediatrics,50-70 percentof
kids with arthritis, cancerand cystic
fibrosis havereceivedcomplementary
tre a tm entssuch as herbsand mi ndbody therapieslike hypnosis.And a survey of pediatriccancerpatientsby the
U n i v ersi ty of B ri ti sh C ol umbi a
Children'sHospitalbetween1989and
19 9 5 found that 42 percent of 366
re s p ondentsused therapi essuch as
g u i d e d i magery,therapeuti ctouch,
herbs,vitamins and massage.
"You selectthosetherapiesmost likely
to be beneficialand leastlikely to cause
harm," saysKemper,who works with
s e ri o usl y i l l pati ents at B oston' s
Children'sHospital and asa consultant
to specialistsin oncology,cysticfibrosis
and severejuvenilerheumatoidarthritis.
F o r e xampl e,w hen a young hospi tal
p a ti e ntw antedto practi ceqi gong,a
Chineseexercisedesignedto raisevital
energy,Kemper assuredoncologistsat
Children'sthat it would not be unduly
taxing for him. For cancerpatients,she'll
often recommendacupuncture,which
h e l p squi et the nauseaand vomi ti ng
causedby chemotherapy,in addition to
antinauseadrugs.Simple,inexpensive
remedieslike gingercanbe helpful,too,
shesays.
Ke mperal so treatsyoungpati ents
with Reiki,a Japanese
healingtechnique.
L a s t s ummer she used i t on Josh
H a rd i ng,18,ashe l ay unconsci ousi n
intensivecare,strickenwith a rareliver
infection."When Joshfinally awoke,he
askedfor her,"sayshis mother,Karen
Harding."Evenunder very hear.yrnedication,he hadknown shewasthere,and
that the Reikiheiped."As a psychiatric
n u rs ecl i ni cal speci al i stw ho recommendsnutrition therapyfor kids with
attentiondeficitdisorder,Hardingwas
a l re a dfami
y
l i arw i l h hol i sti ctreatrnenl s.
But evenwith her educationand skiils,
sheneededKemper'shelp in communi-
cating with the hospital medical staff.
"Dr. Kemperwasour family's only consistentcontactin the month Ioshwas in
the hospital,"Harding says.The doctor's
constantsupport freedHarding from
havingto fight for complementaryremediesand insteadlet her focuson her child.
Kemper'sinterventions often tilt into
lifestylemodifications. Sheencouraged
one father to stop smoking asan example to his kids.ShehaspersuadedfamiIiesnot to let a child with insomnia drink
Cokein the evening."Kids mirror their
parents,who focuson a healthylifestyle
when they havea baby,but then lapse
back into McDonald'sunder the influenceof fast-foodadvertising,"Kemper
notes.Pediatricians,
Kemperbelieves,
havea largerrole to play than just getting
ki ds through the fl u season."They
shoul d be tal ki ng to fami lies about
organicgardeningandwhetherour food
supplyis safej'shesays.
For parentslike SharonFong,whose
child'shealthhadn't improved under
standardcare,the good newsis t hat
holistictherapiesareincreasinglybeing
integratedwith mainstreammedicine.
"It's unstoppable,"saysKarp, pointing
out that, in a sense,pediatricsis really
returning to its origins."Throughout
ti me, parentshavebeen the pr im ar y
caretakers.They had the l ove,basic
know l edgeand experi enceneeded, "
Palevskysays."But the adventof modern
medicineunderminedtheir confidence
and supplantedtheir role."He urgesa
redefinitionof thehealth-care
provider's
role."We want to re-empowerparents
so that they use doctors as a guide.
Childrenspeakwhat theyneed.Our job
i s to teachparentshow to l ist en and
understand,"he says.When a child falls
ill with a customarychildhoodillness,
i nsteadof fi rst reacti ngw i th f ear ,he
advisesparentsto "be with your child,
staywith your child.Yes,the remedies
arehelpful,but the besthealingis your
connecti onw i th your chi i d. "Pr act itionerslike Palevsky,
Gordon and Karp
confi rm w hat parents have always
known-the most effectivemedicine
islove.+