Integrating CAM therapies into Mainstream Practice: Part vI
Rising popularity of Ayurveda in America
We all know that Ayurvedic medicine using various herbal potions (kashayams), vegetarian diet, body massages with medicinal oil, meditation and prayers, is the traditional form of medicine in India. One of the oldest systems of medical therapies in the world, Ayurveda dates back to 5,000 years or even more. Many Ayurvedic practices predate even written records and the current-day practice is based on the two famous texts: “Caraka Samhita” and “Sushruta Samhita.” In the last decade, Ayurveda has been steadily growing in popularity in North America.
Here is an abbreviated report from The Los Angeles Times that attests to the rising popularity of Ayurveda in America. “Jon Mejia experienced heart palpitations after a particularly stressful period and his doctor diagnosed an abnormal heart rhythm. An echocardiogram detected no cause for the extra heartbeats. Although his doctor suggested that beta blocker drugs could control the symptoms, Mejia, 49, didn’t want to take them because of concerns about side effects. So, he turned instead to Martha Soffer and John Holmstrom, practitioners of the ancient Indian medical system Ayurveda. After some dietary changes and three days of massage and purification treatments called panchakarma at Surya Spa, an Ayurvedic Center in Pacific Palisades, “the heart palpitations are almost gone,” he says.
Although such glowing testimonials are often heard and published, we do not know how much of these benefits are from spontaneous remissions of the disease or other factors, unless you do carefully controlled studies using a large cohort of patients. There is still a paucity of such research in Ayurveda. However, Ayurvedic health retreats and spas are springing up in many states in the United States. Maharishi Mahesh Yogi, the popular guru of transcendental meditation, brought Ayurveda to the country three decades ago. And Dr. Deepak Chopra, the world-renowned mind body healing pioneer, made it popular to the American public through his lectures, healing services at Chopra centre for Wellbeing and bestsellers like “Perfect Health” and “Ageless Body Timeless Mind.”
Many of my friends in the U.S. take an annual trip to Kottakkal Aryavaidyasala or other Ayurvedic institutions in India for their medicinal massage therapy along with observation of other disciplines and austerities that go along with this treatment. When my American colleagues ask me about the famous resorts in Kerala where they can get a few days of rest and relaxation along with good Ayurvedic massage, I recommend some of the popular destinations such as Kumarakom in Kerala where they can get what they want along with a sunset cruise in the Vembanat Kayal (lake) thrown in. You can’t beat that!
Potential health risks
"Consumers should know that Ayurvedic products are generally not reviewed or approved by the Food and Drug Administration (FDA)," says Mike Levy, director of the Division of New Drugs and Labeling Compliance in the Office of Compliance, part of FDA's Center for Drug Evaluation and Research (CDER). Often, these products are purchased from the internet sites. Notwithstanding our loyalty toward Ayurveda with its rich cultural background, we need to know that “most Ayurvedic products are marketed either for drug uses not approved by FDA or as dietary supplements.” "The bottom line," Levy says, "is that consumers need to be on guard when purchasing any product using the Internet, especially medical products." This is an area that is challenging to regulate, just like many other CAM therapies.
One of the main concerns is the presence of heavy metals in some Ayurvedic preparations that make them potentially harmful. A study published in the Aug. 27, 2008, issue of the Journal of the American Medical Association (JAMA), demonstrated that one-fifth of U.S.-manufactured and Indian-manufactured Ayurvedic products bought on the Internet contained detectable lead, mercury or arsenic. All metal-containing products exceeded one or more standards for acceptable daily metal intake. The researchers concluded that “several Indian-manufactured products could result in lead and/or mercury ingestions 100 to 100,000 times greater than acceptable limits.” And these products are easily available in many South Asian grocery stores.
So be careful about what you take and always discuss with your family physician before doing so. As I mentioned before, combining Auyrvedic oral preparations with Western drugs should be done carefully with proper understanding of both systems. I am always in favor of meditation and mind control, yoga, massage therapy by a properly trained therapist, predominantly vegetarian diet, etc., as advised in the Ayurvedic system.
Dr. M. P. Ravindra Nathan is a Brooksville cardiologist.
GUEST COLUMN
FARSIGHTEDNESS: What are the options?
Farsightedness, or hyperopia, as it is medically termed, is a vision condition in which distant objects are usually seen clearly, but close ones do not come into proper focus. Farsightedness occurs if your eyeball is too short or the cornea has too little curvature, so light entering your eye is not focused correctly.
We all know that nearsightedness can be corrected but farsighted people are given fewer options.
Common signs of farsightedness include difficulty in concentrating and maintaining a clear focus on near objects, eye strain, fatigue and/or headaches after close work, aching or burning eyes, irritability or nervousness after sustained concentration.
Vision screenings, often done in schools, are generally ineffective in detecting farsightedness. A detailed and comprehensive eye examination will include testing for farsightedness (in young patients should include a dilated exam) and refraction including advanced technological diagnostics can then detect the amount of farsightedness and also the source and type.
In mild cases of farsightedness, your eyes may be able to compensate without corrective lenses. In fact, majority of cases farsighted patients (unlike nearsighted patients) present for Lasik surgery options in their late 40s and early 50s
The reason for this is farsighted people require a plus lens prescription to see. They go through most of their youth compensating for this vision error. Around the age of 40, most people get hit with presbyopia (that condition requiring after 40 reading glasses), which requires a plus lens prescription to read (that's why reading glasses are also called magnifiers). This is now a “double whammy” and patients finally breakdown at they cannot compensate so much more plus.
Of course, there are nonsurgical options such as glasses and contact lenses. The surgical options would include advanced Lasik techniques and also lens-based techniques, including combination concepts therein.
I like to further divide surgical options into:
- Patients with no cataracts (younger in their 40s and 50s) who can avail of all forms of advanced Lasik surgeries.
- Patients with cataracts who can take advantage (refer to August article in Khaasbaat: “Congratulations you have cataracts!) during cataract surgery and have premium lens implanted to correct farsightedness, presbyopia and cataracts.
- Patients can also have combination Lasik + cataract surgery
- Also, in some cases of high hyperopia (Farsightedness), they can plan for “Piggy Back” (One lens implant over another) Lens implants during cataract surgery.
I personally believe that farsightedness is a higher handicap than nearsightedness after 40 since it is frustrating for people to see distance or read up close without help.
With technology today, including no-cut Lasik and custom cataract surgery, you owe it to yourself to see your eye doctors and ask for the best options.
You are indeed a candidate and yes, very deserving!
Arun C. Gulani, M.D., M.S., is director and chief surgeon of Gulani Vision Institute in Jacksonville. He can be reached at [email protected] or visit www.gulanivision.com