Top 10 Tips (I Wish I Had Known) for Evaluating Integrative and Holistic Health Care Providers

When I began my journey with a brain tumor at the age of 24, I knew nothing about cancer or how to choose quality integrative and holistic health care providers. After two awake brain surgeries in 1998 and 2011, four major integrative cancer care protocols and countless other therapies and providers, my experiences have taught me ways to navigate and make better choices. Some episodes and chapters have not been easy, yet I see challenges and crisis as opportunities to learn and grow.

I wish I had known more almost 14 years ago when I started this journey. At times I haven’t chosen quality health providers, but over the years, I learned to better assess, make choices and re-evaluate.

How can you evaluate an integrative and holistic health care provider? Consider using these tips to make the best decisions. Some providers who work with cancer patients do not need training for the disease type. That’s why these tips apply to a range of integrative and holistic health care providers useful for people with and without cancer.

1. Qualifications and Experience
Know who you are with and where they came from. What is their degree, certification, length of training, time in practice, number of patients treated, and most importantly, why did they choose their field?

2. Success
What have been their results with the number of patients they’ve treated? What is their definition of their treatment success and how does that compare with your definition? Make sure you are given accurate information from a provider with integrity. Be clear to avoid any confusion later.

3. Passion vs. Substance
What is the methodology and foundation for their practice? Providers sometimes express more passion about their work versus substance. This may cloud a therapeutic relationship, including a patient’s ability to know the value of the treatments.

4. Study Results & Evidence-Based Medicine
How many research studies evaluated treatments used by the provider? What are the results? Ask the provider and also look for published studies. Seek providers offering evidence-based medicine that combines research results with the provider’s clinical expertise as well as patient values and expectations. Know that while this applies to many high-tech integrative and holistic health providers, some low-touch therapies are not evaluated through studies for many reasons, including the cost of clinical trials.

5. Individualized & Patient-Centered Care
Do they treat patients as individuals and give customized care, or is it general knowledge and one-size fits all? Is their attitude “my way, or the highway”? Does the provider support and guide you to self-care and decision-making? Do they provide patient-centered care? Find providers with these essential holistic and integrative health care components.

6. Integrity, Consistency, & Reliability
Are they consistent in what they say and do, or do they continually suggest new experimental therapies without any positive study results? Do they walk their talk? Are they available outside of appointment times in case of an emergency?

7. Empowerment
Is the provider empowering and guiding you to find power and wisdom within, or do they want you to rely on them fully? True healers teach and inspire people to become their own healers.

8. Finances
Are the provider’s fees appropriate to their qualifications and services? Providers must earn a living, but many therapies are not covered by insurance and then paid out of pocket. Take the time upfront to ask questions about money so you can make a fully informed decision.

9. Boundaries
Is the provider appropriately leaving their private life outside of the treatment room? Appropriate boundaries between providers and patients must be established and maintained so that your needs are the focus of this therapeutic relationship.

10. Trust Yourself
Does the provider and treatment feel right to you? Trust your intuition and instinct! Moving on is better than staying with a provider and continuing a treatment that is not conducive to your health and healing.

Only choose and work with integrative and holistic health care providers that offer high quality service. Consider using these important tips now and in the future to help you advocate and make the best decisions for yourself. Cancer patients and caregivers also benefit from over 100 questions for evaluating integrative, holistic, and conventional cancer treatments and providers.

How will you better evaluate an integrative and holistic health care provider?

Jeannine Walston is co-founder and Executive Director of EmbodiWorks, a non-profit organization that provides integrative cancer care education and advocacy supporting whole person health and healing to reduce cancer risk, improve cancer related survival, and quality of life. Jeannine is a cancer survivor with extensive experience in cancer education and advocacy, health care policy, and both conventional and integrative cancer care through work in the U.S. Congress, government agencies, cancer non-profit organizations, and health care practices.

4 Tips to Manage Your Hair Loss During Chemotherapy

There is no question that the skin-related side effects from cancer treatment can be some of the most traumatic – both physically and emotionally. One of the most common of these is hair loss, which is so intimately associated with cancer treatment that it has become an expected side effect. Perhaps because it is so common, the emotional impact is often overlooked by physicians. The emotional impact can be enormous though – patients rank hair loss as the second most severe side effect from chemotherapy and 8 percent of women say they would consider turning down life-saving chemotherapy due to fear of hair loss. Many women feel that losing their hair was a worse experience than losing their breast during breast cancer treatment. If you haven’t embraced going bald – you’re not alone. So many patients battling cancer start their doctor appointment saying, “I don’t want to complain, but …” I’m here to say that it’s OK to complain – in fact, it’s great. It’s your doctor’s job to listen to you! If you are deeply affected by your hair loss, you are completely normal and you are definitely not alone.

Why It Happens
Alopecia is the medical term for any type of hair loss. Chemotherapy-induced alopecia is the hair loss caused by many different types of chemotherapy drugs. Some of the chemotherapies that are most likely to do it are cyclophosphamide, etoposide, topotecan and paclitaxel. These drugs work for cancer because they target the cells in your body that are dividing very quickly – which is what cancer cells do. Unfortunately, your skin, hair and nails are also dividing quickly and become innocent bystanders in the attack on your cancer. The most common type of alopecia that is caused by chemotherapy is called anagen effluvium. All hairs cycle through phases of growth, resting and then shedding. Anagen is the growth phase and this is when the hair cells are most rapidly dividing to form the new hair. This rapid growth is what makes them vulnerable to the chemotherapy, which causes weakening of the hair so it can fall out with just mild pressure or sometimes break off when it reaches the surface of the scalp. The broken, traumatized hairs then go into their resting phase called telogen, and stay there until the chemotherapy is over. This type of alopecia can affect most of the hair on your head quickly – about one or two months after you start treatment. The important question though is – what can you do about it?

Flaunt It
Although not embraced by many, there is always the option to show off your new low-maintenance ‘do. Hey, hair only detracts from your beautiful face anyway! I was recently inspired by a photographer from Michigan who started the Oldham Project – an organization that provides free portrait sessions to people suffering from life-threatening illnesses. If you want be inspired by some gorgeous, confident, bald women, check out the website.

Disguise It
The most common current treatment for alopecia is covering it up. While some women embrace this and rock a bright purple wig or 70’s patterned turban, others opt for a wig that closely matches their pre-chemotherapy hair. When shopping for a wig, you should look for an experienced person to help you find a good match and comfortable fit. They may even be able to get your insurance company to cover all or part of the cost. You can order wigs and other head coverings through the American Cancer Society’s Tender Loving Care website. Make sure you learn how to take care of your wig so you can keep it looking great.

Prevent It?
The hope for many is to prevent the hair loss from starting in the first place, and research is being done! The most promising studies so far are using a device to keep the scalp cold during infusion of the chemotherapy. The idea is that cooling the skin makes the blood vessels shrink and slows down metabolism so less of the chemotherapy is able to reach the hair follicles. While some studies using scalp cooling were done more than 20 years ago, it hasn’t been widely used because doctors were afraid that keeping the scalp cool would protect not only the hair but also cancer cells that might be hiding out in the scalp. More recent studies though show that, while scalp cooling may not be safe in patients with hematologic cancers like leukemia, it is probably safe for breast cancer patients. Ask your oncologist if it is something he/she recommends and offers at your infusion center. Research is being done about other preventive measures for hair loss, so hopefully in the near future, patients will have more options.

Make It Grow Faster
If you can’t prevent the hair loss, then at least make it grow back faster! Believe it or not, regular old Rogaine or the generic minoxidil may speed up your hair growth after chemotherapy. You should apply 1 milliliter of 2 percent minoxidil solution (available over the counter) to the entire scalp throughout chemotherapy and up to four months after treatment. In one study, this regimen shortened the time to first hair growth by over a month! While people using minoxidil for age-related hair loss have to keep using it indefinitely to maintain the effects, this is not the case for chemotherapy-induced alopecia. Make sure to keep the minoxidil off your face and anywhere else you don’t want extra hair growing.

Watch Out For …
Some chemotherapy drugs can affect the scalp in ways other than just causing hair loss. If you have bumps, lumps, flaking, itching, drainage or pain associated with your hair loss, you should see a dermatologist who is experienced with chemotherapy side effects.

Beth McLellan, M.D., is a board certified dermatologist at the New York University Langone Medical Center. She focuses on the treatment of diseases of the skin, hair and nails in cancer patients.

Photo credit: Dee

Cancer Full Moon: Open Your Heart

January 9, 2012—The first full moon of 2012 is here, and it’s in sensitive, heart-centered Cancer. Since this zodiac sign is naturally ruled by the moon, it’s a super-powered date that will bring out our highest, most intuitive selves—along with a whole range of emotions. Consider this a holiday hangover of all the fuzzy family vibes, and catch up with your clan if you didn’t get enough bonding time in last month. Open your heart to other people everywhere you go. The “power of love” is no joke, so make compassion your engine. We once heard Dr. Christiane Northrup say that the electromagnetic field of the heart can expand up to eight feet outside of the body. Pretty cool!

This week, get ready for a blast of feminine energy, and maybe even a few unexpected pregnancy announcements. The Cancer full moon puts us deeply in tune with our feelings. This full moon is extra special, because it’s the grand finale of a three-year series of change-making eclipses that fell on the Cancer/Capricorn axis. These eclipses (which won’t return for another 30 years) have sparked a global reshuffling of the way we live and work—awakening a need to integrate the two.

Here in New York City, new apartment complexes have on-site health food stores and entire floors set up as community areas, where people can interact, share resources and even compost their food. The soulless, corporate cubicle model is bankrupt, and many people are waking up to the dis-ease this causes. Hospitals and other institutions are slowly adopting a more homelike and personal touch—although we’ve only seen the tip of the iceberg. In 2012, we can continue exploring this balance in our own lives. Even in small ways, a little return to cyclical living can heal the planet, and keep our bodies healthy and whole.

Here are a few practical rituals for the Cancer full moon:

Honor thy mother.
Cancer rules the zodiac’s fourth house of motherhood and femininity. Today, pick up the phone or write a letter to your mom or a mother figure. Set out a photo of a special female ancestor and light a candle to channel her divine wisdom. Change your Facebook profile picture to one of you and a special woman in your life. If you’re a mother, do something to honor yourself. This is the cosmic Mother’s Day. Spend extra time with kids who look up to you, or connecting with the people you call family—whether the bond is based on biology or chemistry.

Nourish yourself.
Cancer is like a cosmic Jewish mother demanding to know, “Did you eat?” Our appetites are large at the full moon, so honor yours. Find a healthy comfort food recipe or treat yourself to a great cookbook and indulge! If you’re kitchen-averse, have a friend come over and teach you how to whip up a simple recipe. Or, barter for his/her gourmet skills—if you’re great at crunching numbers, trade tax planning tips for a delicious demo on braising or blanching veggies that keeps the flavor in.

Set up a savings plan.
Cancer is ruled by the Crab, whose steely claws can hold tight to whatever they grip. Why not hang onto a little more of your money? Even if you’re just putting $10 a week in savings, that can add up over the years. The point is to start the habit now. The Cancer full moon spotlights financial security and a need to be prudent with our funds. It’s not how much you make; it’s what you do with it. The Cancer full moon could inspire pleasurable lifestyle ideas that don’t break the bank. Gather with friends and pool your resources around Cancerian needs, like potluck meals, vacation home swaps (instead of paying for hotels) and co-op childcare.

Zhush your home.
Cancer rules the domestic sphere, so do some new year’s nesting. Pick one area of your home and make it a sanctuary for relaxation. Skim the design blogs like Curbly and Design Sponge for DIY and makeover ideas. But before you do that, check the energy in your living space. Wherever it feels blocked, do some rearranging, purging and softening. Add sentimental or beautifying touches that stir your heart: framed photos, art, flowers, a vintage vase. Cancer energy is especially fond of flea markets, so reduce your carbon footprint and bring some retro style in from a secondhand store.

Get free daily, weekly and monthly horoscopes from The AstroTwins at astrostyle.com.

Photo credit: Mirandala

Talking To Kids About Cancer

Six weeks ago, totally out of the blue, I was diagnosed with incurable metastatic bone disease. My spine and pelvis were apparently riddled with tumors that were the cause of my recent backache. At 38 and as the active mother of two very young children, I had put it down to a pulled muscle from making up the top bunk bed. I’m an elementary school teacher, too, so I have loads of opportunities to pull weird muscles chasing (or dancing with) kids. And loads of reasons for “forgetting” about them, expecting them to go away of their own accord.

Within minutes, my husband and I were wondering: “How the hell do we tell the children this?” Our two are ages 7 and 4, utterly incredible (of course) and really close to us. We have always made a point out of being honest with our kids, even about the difficult stuff, but somehow this one seemed insurmountable. So we did a lot of soul-searching and rehearsal. Literally. Practiced being the kids hearing bits of information and putting two and two together to make 42. Making sense out of the fragments we had was almost impossible for us, let alone for my little boy, whose tiny hands still stroke my cheek to wake me in the morning. It took a while, but we came up with a plan.

The fact that we only had a partial diagnosis initially was helpful, because it enabled us to stagger the news we shared. This allowed the children to process the information in little bits and think of questions. Realistically, they followed our lead and were calm, factual and positive, because we were.

At first, we just explained what would affect them: that we had to cancel our family vacation this summer because the doctors wanted to try and work out why my back wasn’t getting better. As we always flew to the States for the summer, this would be their first in England, and we’d try to do lots of fun things closer to home. They were devastated about cancelling the trip to Grandma and Grandpa’s but quickly understood that we’d go next summer and that perhaps they could come to us soon.

A few days later, while we were all curled up reading books, we stopped to explain that the doctors had discovered that there was a disease in my backbones that had started somewhere else in my body, but we didn’t know where yet. We were clear that no one had given it to me and no one could catch it from me. As kids are so drilled about “Coughs and sneezes spread diseases,” we thought this last bit was particularly important.

Then I got out a chocolate bar called an Aero (I’m sure there must be some equivalent in the States; it’s chocolate-filled with bubbles but smooth on the outside). I explained that a bone is a bit like the chocolate bar. The outside looks smooth and hard, but when you look inside, it’s made up of little bubbles.

“If the bubbles were bigger, how would it taste?”

“Not so chocolatey.”

“Would it be stronger or more crumbly if the bubbles were bigger?”

“It would break more, or bits would cave in.”

So then, of course, we explained that my bone was like the bar, but in places there were bigger bubbles growing because of the disease. That was making the bones delicate and painful. Then they got to eat the bar, but I wasn’t allowed any.

“But Mummy loves chocolate!” my daughter protested. We went on to explain that there were certain foods that would make my back worse, and some that would make it better. Simply speaking, white foods were out, and rainbow foods were in — especially green foods. We listed all the white foods we could think of: sugar, milk, ice cream, flour, rice, pasta, mashed potatoes, white sauce. Then we went into the kitchen and introduced other things I could have instead: agave, almond milk, wild rice or spelt, yams. No decent alternative to béchamel sauce yet. They loved tasting everything and made their preference clear (agave=yum, wheatgrass= yeurgh!).

As my juicing and vegan diet reached into our days, they became engaged with exploring all sorts of flavors. The spiralizer is a great favorite, and they love the carrot-zucchini spaghetti — who wouldn’t? We grow a lot of our own produce, so juice inventions have become a daily game. Beet, black currant and red grape; watercress and kiwi; carrot, pineapple and ginger; spinach and apple were all quickly popular (actually, only I liked the watercress and kiwi one, but I like it enough for everyone else put together!). We tried to juice like colors together to keep the end product bright and appealing; that really helped. The children felt empowered to help be a part of my healing through diet and are learning a lot about what goes into their own bodies as a result.

Our chickens love the pulp, so the kids are delighted to give the vitamins to them, too.

We still hadn’t used the word “cancer” yet because we didn’t know whether they had any prior knowledge of the word, and we certainly didn’t want to confuse the issue when we were still trying to build their understanding of what we were facing. But now it was time.

I had a few biopsies taken, and the nurse put stars over the incisions so that the kids would be proud of me. They were, and they kindly kissed each spot better just as I would have done for them! When the results came through, we got both children into the big bed with us and explained that Mummy’s disease had a starting place now, and a name. The name was “cancer;” had they heard of that before? Our daughter, who’s 7, had heard about it but didn’t know anything about it. Our son looked blank.

We explained that there are hundreds of types of cancer, and everyone’s story is different. If they saw or heard anything about cancer, they could ask us, but they shouldn’t think it was anything to do with my story just because it shared the same name. We felt this was particularly important because children could easily say, “My Grandma died of cancer” or “Cancer makes your hair fall out,” and we wanted information to come from us, not the playground. This conversation was something we had anguished over, but they heard it and then said “OK. Can we read some books now?”

Throughout these weeks, they have had very few questions. But they also have had very little anxiety. I think striking the balance between pace and pitch is so important. Small chunks of information spread several days apart helped them process and feel part of the learning curve along with us. We are empowered in the face of this diagnosis and are riding the tsunami rather than swept away by it. They are along for the ride, too.

Last week, I had radiotherapy. Beforehand, we talked about cough syrup. Who likes cough syrup? No one, right? It makes you feel horrid and sticky, and your mouth is all weird. Yuck! But then after a while, your cough’s gone, and you can go back to sleep and get well. So my medicine was going to be a bit like that. It would make me feel worse for a while and then better. Except that my “worse” would last a few days, even a week or so. But then my “better” would last longer, too. I wouldn’t have to take so many pills for the pain, and I’d be able to do more yoga and dancing with them again. Everyone’s a winner!

Now it’s September, and I’m not going back to teaching yet. The children are delighted that I’ll be walking them to school in the mornings, and I’ve let my friends at the school gates know that these times are CFC (cancer-free-conversation) times. Even when they’re just trying to show they care, it’s not the time. Walking to school is when my kids deserve my attention.

My cancer is omniscient but not a source of fear or anxiety for any of us. We will embrace this challenge like any other: as a loving, honest family unit. Talking often and openly.

Emily Evison is taking a year off from life as usual to create an anti-cancer lifestyle after her unexpected diagnosis. She lives in rural England with her husband, two children, six chickens and cat. They garden, craft, make music, play games and love life.

10 Things I Learned from People Who Survive Cancer

When I interviewed women who had survived breast cancer for my art project The Woman Inside, I noticed that they all had one remarkable thing in common.

They had all faced down death and decided to live every day like it might be their last. And then they all beat cancer.

The more interviews I did, the more I noticed that these women were living differently than most of the people I knew who had not been diagnosed with cancer. Here’s what I learned from those survivor women. Learning these lessons changed my life, and I hope they’ll change yours.

1. Be unapologetically YOU. People who survive cancer get feisty. They walk around bald in shopping malls and roll their eyes if people look at them funny. They say what they think. They laugh often. They don’t make excuses. They wear purple muumuus when they want to.

2. Don’t take shit from people. People who survive cancer stop trying to please everybody. They give up caring what everybody else thinks. If you might die in a year anyway (and every single one of us could), who gives a flip if your great aunt Gertrude is going to cut you out of her will unless you kiss her ass?

3. Learn to say no. People with cancer say no when they don’t feel like going to the gala. They avoid gatherings when they’d prefer to be alone. They don’t let themselves get pressured into doing things they really don’t want to do.

4. Get angry. Then get over it. People who survive cancer get in your face. They question you. They feel their anger. They refuse to be doormats. They demand respect. They feel it. Then they forgive. They let go. They surrender. They don’t stay pissed. They release resentment.

5. Don’t obsess about beauty. People who survive cancer no longer worry about whether they have perfect hair, whether their makeup looks spotless, or whether their boobs are perky enough. They’re happy just to have boobs (if they still do). They’re happy to be alive in their skin, even if it’s wrinkled.

6. Do it now. Stop deferring happiness. People who survive cancer realize that you can’t wait until you kick the bucket to do what you’re dying to do. Quit that soul-sucking job now. Leave that deadbeat husband. Prioritize joy. They live like they mean it.

7. Say “I love you” often. People who survive cancer leave no words left unspoken. You never know when your time is up. Don’t risk having someone you love not know it.

8. Take care of your body. People who survive cancer have a whole new appreciation for health. Those who haven’t been there may take it for granted. So stop smoking. Eat healthy. Drink in moderation. Maintain a healthy weight. Avoid putting toxic poisons in your God pod. Get enough sleep.

9. Prioritize freedom. People who survive cancer know that being a workaholic isn’t the answer. Money can’t buy health. Security doesn’t matter if you’re six feet under. Sixteen hours a day of being a stress monster is only going to make you sick. As Tim Ferriss writes in “The 4-Hour Workweek,” “Gold is getting old. The New Rich are those who abandon the deferred-life plan and create luxury lifestyles in the present using the currency of the New Rich: time and mobility.”

10. Take risks. People who survive cancer have faced their fear and told it to go to hell. They know life is for living. Fear is powerless. And joy lies in taking risks. So go skydiving if you want. Bungee jump. Hang glide. Spend your savings. Live like you might die tomorrow.

Are you doing these things? Or are you waiting for cancer to test out how much you want to live?

Don’t wait for cancer, my love. Don’t tempt the universe that way.

Be brave enough to live now.

For more on how to optimize your life, visit owningpink.com.

Photo credit: .imelda