Books on natural and noninvasive medicine abound. Since I like to read, and since I have not yet written a book of my own, I thought I'd review some of the books that come across my desk--usually by way of my local library. We'll start off with:
Arthritis Rx: A Cutting-Edge Program for a Pain-Free Life, by Vijay Vad, M.D. Gotham Books: NY, 2006.
The author is a specialist in "minimally invasive arthritis therapies" at Manhattan's Hospital for Special Surgery. He also works as a physician for the PGA golf tour and the ATP tennis tour. Impressive credentials.
Grain of salt: I am wary of the term "minimally invasive", as it can have a range of meanings. Dr. Vad's specialty is the use of hyalan injections to lubricate arthritic joints. Hyalan is a synthetic version of the body's own hyaluronic acid, a component of joint lubrication. On the scale of invasiveness, not too high, especially compared with joint replacements.
Second grain of salt: I don't believe that doctors who practice at surgical hospitals are the best references on noninvasive therapies. Doctors with surgery at their disposal are inclined to use it. That has been my experience, anyway.
Third grain of salt: each time I pick up a book purporting to discuss integrative therapies, I check the index for references to Naturopathic Medicine. This book had none. The author does discuss osteopathy, chiropractic, massage therapy, and acupuncture, and in quite reasoned tones, which did make me feel better about his view of "alternative" medicine.
The book begins with an anecdote about Dr. Vad's grandfather, who dealt with 2 decades of arthritis through daily use of ginger, a daily yoga practice, and daily walks. This is the inspiration for the book. Grandfather Vad was a native of India; I don't know where Dr. Vad grew up, but I am impressed by doctors who go through conventional medical training without losing respect for traditional medicine.
The meat of the book consists of dietary guidelines, supplement recommendations, and exercises for maintaining mobility and flexibility and diminishing pain from osteoarthritis. Reference is made to the inflammatory arthritides (Rheumatoid arthritis, lupus, and so on), but the book really deals with the more common osteoarthritis, once considered an unavoidable part of aging.
Nutritional guidance consists of encouraging an anti-inflammatory diet--in this case, fruits, vegetables, whole grains, & fish--and cautioning against pro-inflammatory foods, defined as red meat, most dairy, and processed foods. Mention is made of food allergies/intolerances and their effect on inflammation. An emphasis on *real*, whole foods (as opposed to food substitutes like green food powders and the like), and the importance of the essential fatty acids. A good introduction to eating for health and healing.
The author next deals with supplements. He focuses on ginger (510 mg per day reduces pain, according to the study he quotes), glucosamine, and chondroitin. Use of the latter two is backed up by reference to the GAIT study** results, refreshingly summarized as "...(this combination) was at least as effective as the anti-inflammatory Celebrex in treating knee arthritis."
**The GAIT study was commonly misrepresented in the media as proving that glucosamine and chondroitin were ineffective, as they showed no significant effect on "mild" knee pain. Of course, these supplements shouldn't be given for mild pain that would resolve, with supportive care, on its own. They are used in cases of chronic inflammation, not as temporary painkillers... But back to the review.
Dr. Vad then surprised me by plugging his own supplement, Zingerflex, a combination of glucosamine, chondroitin, and ginger. He claims it is the only supplement available with this combination. I checked Emerson Ecologics, distributor of professional-grade supplements to many doctor's offices (including mine), and it's true, there was no exactly comparable formula. However, the amounts of ginger recommended (about 1/2 gram) are easy to incorporate into the diet, so is a supplemental ginger really necessary? Quality glucosamine/chondroitin supplements abound.
Still, I can hardly blame Dr. Vad for formulating his own product, as plenty of Naturopathic Docs work with supplement companies. Interestingly, the Zingerflex website makes no mention of the doctor's name, referring simply to a "leading physician researcher", but this may be standard practice for MDs. The product is reasonably priced, approximately $29.99 for a one month supply.
The next part of the book are the exercises, given in 3 series, from mild to strenuous. The author claims that many of his patients have done just fine sticking to the first series, with no need to progress to the others. Looking at the exercises (and I must admit, I did not try the sequences myself), they seem to be well-thought out combinations of Yoga with Pilates variations. Kudos to Dr. Vad for his emphasis on proper breathing during the exercises. I agree with him that controlled breathing is just as important to health as strengthening the muscles, if not more so.
The last part of the book deals with other approaches to healing arthritis, including a well-thought-out synopsis of several integrative therapies. The author balances the conclusions of Evidence-Based Medicine** with his own clinical observations. For instance, though EBM tells us that chiropractic has not yet been shown to be effective for arthritis, Dr. Vad adds that it has been quite effective for the low back pain of several of his patients. Good for you, Dr. Vad!
**Evidence-based medicine can be roughly summarized as the theory that only those interventions which have been tested in approved, double-blind studies and shown to be effective should be recommended to patients. While there is a great deal of logic to this, it ignores the importance of the observations of a learned physician.
The book concludes with a description of future treatments for arthritis, with an emphasis on gene therapy, in which stem cells (from the patient's own body; no need to be alarmed, GWB!) are used to grow new bone or cartilage. Ooooooh, cooool, I thought; and then I remembered something... In my country, the U.S. of A, we are so very good at creating extremely expensive interventions for medical problems. We are not so good at taking care of our citizen's basic medical needs. What would one stem cell procedure to ease one person's knee pain cost? And how many uninsured women could get good prenatal care for that money? Or how many cooking classes for diabetics could we fund?
But that is not Dr. Vad's fault. And he seems to be doing his best to promote the "interventions" of good food, good exercise, and good care to prevent the "need" for such expensive procedures.
Would I recommend this book? With reservations; I believe that the personal guidance of a provider with experience in nutrition, exercise, and herbal medicine is key to success with natural medicine. This book could then provide an adjunct, as it is a nice summary of valuable methods. The exercise and recipe sections alone could prove quite useful.
Until a book on arthritis from the standpoint of Naturopathic Medicine is widely available, Dr. Vad's book will do fine.
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