Children's continues to explore new ground in pediatric medicine as we integrate nontraditional therapies into our treatment of a growing number of maladies.
Emily and Colette Behrens
Emily Behrens did not have an easy first year. Born on October 1, 2003, she was diagnosed with leukemia and immediately transferred to Seattle Children's Hospital, where she spent six months receiving whole-body radiation, chemotherapy and, at just six months of age, a bone marrow transplant.
To her parents' joy, the transplant was a success. Emily, though, was addicted to the morphine she'd been given to control her pain. "She couldn't come home until she was off morphine," her mother, Colette Behrens, recalls.
"We tried, but she'd start to shake and get extremely agitated and nauseous. We even tried methadone, but it didn't work."
With Emily facing a long, gradual weaning from morphine, Dr. Anjana Kundu, an anesthesiologist and pediatric pain specialist at Children's, suggested her parents consider using acupuncture and acupressure to assist Emily through withdrawal.
"I wasn't convinced it would work," Behrens says, "but I'd heard good things. So I said, what the heck — it couldn't hurt."
Dr. Anjana Kundu
Dr. Kundu grew up in India, where there is less of a division between traditional and alternative care, which inspired her to pursue training in acupuncture.
She taped tiny pressure beads to Emily's earlobes and banded minuscule needles to her wrists, and told the Behrens to tap them every few hours. "It started to work that first day. Her need for morphine dropped immediately, and we took her home just 10 days later. I was pretty excited," recalls her mother.
Emily's experience is one example of Children's increasing exploration of alternative therapies for treating an ever-widening group of maladies.
"We're the first pediatric hospital on the West Coast to have a pain program," says Dr. Corrie Anderson, who heads the Pain Medicine Clinic, "and there's been a move to bring complementary medicine into the program for about a decade. Acupuncture, massage and meditation have been proven effective therapies."
Dr. Kundu was recruited as the director of Complementary Medicine last year with the express purpose of expanding the alternative therapies program, which is called Complementary and Integrative Medicine (CIM).
"Anjana is creating a more comprehensive program here and bringing in more valuable options for families," Dr. Anderson explains. "We are fortunate that our CEO, Treuman Katz, supports complementary care."
Dr. Kundu applies acupuncture to a variety of problems. "I've used it to treat various pain syndromes, including abdominal pain, headaches, backaches and nerve injury. I also use it to help with nausea related to chemotherapy, and postsurgical nausea," she says.
She also employs acupuncture to manage medical illnesses such as asthma, allergies, bedwetting, mood disorders and gastrointestinal disorders. There are other treatments she'd like to explore.
"Data supports therapies like yoga, meditation, biofeedback and massage," she explains. "But Children's and I are cautious. We only want to bring in therapies that are supported by clinical data. Development of such a service will take some time, but I feel it is worth the wait."
Modern Support of Age-Old Practice
Acupuncture is based on the concept of stimulating specific points on the body, which are distributed along "meridians," or channels in the body through which energy flows.
Acupuncture helps the body's vital energy flow.
The meridians correspond to various organs in the body. An uninterrupted flow of energy is needed to maintain a healthy state. For centuries, practitioners have claimed that stimulating the proper meridian can result in pain reduction and other beneficial outcomes.
Although the precise mechanisms are not clear, modern clinical research shows that acupuncture enhances the body's production of internal pain-reducing compounds. In response to these studies, the National Institutes of Health cleared acupuncture as a therapy for many types of pain and nausea.
Kyle van Nostrand was a student at Woodinville High School when he severely sprained his ankle playing lacrosse nearly three years ago. Six months later, he he injured his other ankle. "It was taking a really long time to heal," his mother, Shirley van Nostrand, recalls. "He eventually had four surgeries to correct the problems, but was still in constant pain."
Kyle, who needed to be pain-free before undergoing more operations, came to Children's Pediatric Pain Clinic. "First, they put me on drugs," he says, "but they didn't work. Then I saw Dr. Anjana Kundu, who said she could try acupuncture."
Because Kyle had been in pain for so long, Dr. Kundu told him it would probably take a while for the acupuncture to work. "She puts the needles in my feet and my legs, and a few in my upper body. I exhale as they go in, and I don't feel anything," he explains. "I see her once a week, and I get relief for several days."
These are two examples of Children's increasing exploration of alternative therapies for treating an ever-widening group of maladies.
A Good Fit
Dr. Corrie Anderson says Children's exploration of complementary medicine fits well with regional culture: "There's an atmosphere in the Pacific Northwest that's more accepting of alternative treatments than in other parts of the country."
Dr. Corrie Anderson
The area is home to Bastyr University in Kirkland, a highly respected institute for research, education and treatment in alternative medicine, with which Children's works to jointly treat some patients and plan cooperative education and training programs.
Alternative approaches also are making inroads in areas that might seem unlikely. Dr. Anthony Avellino, a neurosurgeon at Children's, is intrigued by the possibilities of integrating complementary care into his practice.
"The more I talk to families, the more I realize that families and children are using a whole host of alternative treatments," he explains.
He is planning a study on the use of alternative treatments to enhance recovery from neurosurgery. "I'm interested in the role of prayer in recovery," Dr. Avellino says. "There is a lot of anecdotal evidence that it helps, perhaps by decreasing stress."
"In five years, acupuncture will be much more common," says Dr. Anderson. "But there is more to be explored. We want to look at some herbal medicines in a scientific way, as well as things like eating correctly, healthy belief systems and increasing people's coping responses.
"If you think back in history, people used touch and smell for healing long before modern expensive drugs were invented. We want to integrate a holistic approach."
Support for Alternative Treatments
Children's is fortunate to have several benefactors who are interested in the field of complementary medicine.
Treuman Katz, Children's president and CEO, and his wife, Sue Ellen Katz, recently established the Treuman and Sue Ellen Katz Endowment in Complementary and Integrative Medicine. Their endowment will support expanding research and treatment programs that use complementary medicine to improve patient care at Children's.
To enhance the education of practicing clinicians, Pamela and Greg Goff funded the Jaime Lynn Klavano Lectureship in Holistic Medicine, which brings an expert on complementary medicine to speak at Children's Grand Rounds each year.
In addition, the Goffs provided support to help start the CIM program, and recently established the Pamela and Greg Goff Family Endowment in Complementary and Integrative Medicine.