Integrating Complementary Medicine Into Your Health Care Regimen

If you feel overwhelmed by the amount of information available today on nutrition, exercise and stress reduction, you're not alone.

The field of complementary and alternative medicine (CAM) is growing by leaps and bounds, and it's hard to keep up. Harder still is figuring out how to integrate this abundance of information into day-to-day living. But the reality is that many people want an integrated health care approach and don't know how to talk to their doctors about creating such a regimen.

Here are some tips that may help you create the health care team you need to keep healthy:

• A good doctor-patient relationship is essential for getting and staying healthy. Choose a doctor you can talk to and trust. You deserve a doctor who listens to your questions and concerns. The bottom line is that communication is key in planning an integrated approach to your health.

• Talk with your doctor about CAM. This may not be easy because you may be afraid your doctor will judge you or that he or she won't know about or hold high regard for the therapies you are asking about. But you don't know how your doctor will react until you ask. Initiating a conversation to see what your doctor's beliefs and knowledge are about CAM is a good first step. Most doctors actually want to know what CAM therapies their patients are using.

• Tell your doctor about all the CAM therapies that you use. Ask his or her opinion about these specific therapies. Ask your doctor how you can use nutrition, exercise and stress reduction to optimize your health and how to best incorporate the CAM therapies you are interested in into your health plan.

• Few doctors will have knowledge or expertise in every area of CAM. If your doctor isn't familiar with a particular therapy such as an herbal supplement or acupuncture, ask for a recommendation for a practitioner who does have expertise in that area or for a credible informational resource such as a website or book. Your doctor must be willing to work with you even if he or she is not an expert in CAM. It is better when doctors say they don't know — rather than acting like they do.

• Plan your doctor's visit. This will help you get the most out of the visit. At the beginning of the appointment, ask the doctor if he or she can reserve some time to talk about CAM. If the doctor has an agenda that includes checking your blood pressure and getting some blood tests, those tasks may take up much of the appointment. If there isn't time for your CAM questions, ask if you can schedule a follow-up visit to discuss your specific concerns or to schedule a phone conversation.

• Make a list before the appointment. Bringing a briefcase full of material might overwhelm the doctor. It is better if you can bring a list of specific questions that you want to cover.

• Follow up after the appointment. This is one of the most important aspects of integrating your health care regimen. You and your doctor can't possibly discuss everything — your blood pressure, cholesterol, diet, exercise plan and ways to reduce stress — all in one visit. It will more than likely take multiple and ongoing visits. Take each topic step by step, choose those topics that you feel are most important and don't try to cover too much. What one aspect of your health — if addressed with your doctor — will help everything else improve? Save what you don't cover in the initial appointment for next time.

• Share information. If you take a tai chi class to reduce stress, follow up with your doctor and tell him or her what you have learned and what you have experienced. Ask your doctor what he or she has been reading or learning about CAM therapies. By sharing information, you will grow together as a team in your knowledge about CAM.

Creating a health care team for your CAM therapies
It is important that you work with your doctor in creating an integrated health care regimen and that you tell your doctor about the CAM therapies you are using or considering.

A doctor's input on these therapies can help optimize the effects of these therapies and reduce the risk of harm. So, if you are seeing a CAM practitioner for a particular problem, encourage your primary care physician and that practitioner to speak with one another and to coordinate your care.

For example, a woman who is recovering from breast cancer treatments and is now interested in taking a yoga class can take several steps to get a great health care experience. First, she should work with a yoga practitioner who has worked with other cancer patients (preferably breast cancer patients). It is also a good idea for the yoga teacher and the woman's doctor to speak to each other in order to optimize the effects of the yoga class for the student and to reduce her risk of injury.

Perhaps this woman also wants nutritional advice. Again, referral to a nutritionist who has worked with breast cancer patients and has specific advice and knowledge about their needs is critical. The nutritionist and the doctor should be in communication with each other to optimize her care and safety.

Creating an integrated approach to your health care regimen can reap great benefits for your health. Remember that communication, follow-up, perseverance and teamwork are key for an integrated approach.

Portion control fact sheet

It's important to pay attention to the portions of food you eat because of the effect on your weight. There are a variety of ways to keep track of portions. The Hand Method is often used by dietitians to help people think about portions. Another method is to "eyeball" the food on a plate and compare it to another visual reference, like a deck of cards. When preparing food at home, you can use measuring tools. Each method is described below followed by a list of portion sizes of some common foods. It may be hard at first to pay attention to portion size, but with time and practice, it will get easier!

Hand Method

A thumb is about the size of 1 ounce of food. Your palm is about the size of 3 ounces of food or one serving of meat. Your fist is equivalent to 1 cup or 8 ounces. For example, a portion of rice as large as your fist is equal to about three servings of rice. The tip of your thumb is the same size as a teaspoon. Using the thumb tip is a good way to keep track of fat portions, such as the amount of margarine that counts as one serving.

Visual References

Here are some common items to use as visual references for portions. A deck of cards is the same size as a 3-ounce serving of meat, the recommended amount for a meal. A golf ball is the size of a single ounce of meat. A tennis ball is about the size of a healthy serving of fruit. Four dice equals 1 ounce of cheese. Invent your own visual references for your favorite foods to help with portion control.

Measuring Tools

Measure solid foods such as rice, pasta, or vegetables in a dry measuring cup, which is different from a liquid measuring cup. Measure cooked foods after cooking. Use measuring spoons for fats such as oil, margarine, and salad dressings. Do not use tableware to measure because it may be inaccurate. Use measuring tools to find out how much the cup, glass, and other pieces of dishware you use actually hold. Notice how a serving of food, such as 3 ounces of meat or 1/3 cup of cooked pasta, looks on the plate or bowl you typically use.

Hand	Visual	Measuring Tools
1 baked potato = fist 1 ounce of chips or pretzels = 2 handfuls 1 ounce of nuts = thumb 1serving of fat (margarine) = thumb 3 ounces of meat (one serving) = palm 1 serving of vegetable = 1 handful	2 Tbsp peanut butter = ping pong ball 3 ounces of cooked meat = deck of cards 1 piece of cornbread = bar of soap 1 serving of bread = one slice ½ cup cooked broccoli = scoop of ice cream 1½ ounces of cheese = 3 dominoes Medium piece of fruit = baseball 1 ounce of cheese = 4 dice ½ bagel = hockey puck	Liquids 1 cup = 8 ounces fat-free or 1% milk ½ cup of canned fruit (no sugar added) ½ cup juice Solids ¼ cup of dried fruit ¾ cup dry unsweetened cereal ½ cup yams or peas 1/3 cup cooked pasta or rice