Alternative medicines are used by patients either on their own, or complementary to medical treatment. Known as CAMs (Complementary and Alternative Medicines) they are often viewed as a ‘natural’ treatment. Natural is often associated with less risk, less negative side effects and better for overall wellbeing than mainstream, gold standard treatments. However; alternative treatments have their own list of side effects and can impact negatively on your health, interact with medicines and be dangerous for your upcoming surgery.
The History of Complementary and Alternative Medicines
The history of what we know today as CAMs is long. Many of the herbs and extracts used in CAMs today were once mainstream medicine as far back as prehistory and some modern medicines have their roots in herb lore. Aspirin, derived from willow bark, is now part of mainstream medicine and is used as an analgesic and anticoagulant.
Commonly used cardio-stimulatory drugs used to treat the symptoms of heart disease also have a history rooted in herbal and alternative medicine. Practitioners of herbal medicine were considered wise and often branded by the Church as heretics and burnt as witches.
Just because it is old, doesn’t mean it’s broken: complementary and alternative medicines have played their part in the development of modern medicine and the ongoing management and treatment of diseases.
CAMs today
It is estimated that 15% of the United States population is currently using a CAM to treat an ailment or complement their medical treatment. Though some are restricted by the Therapeutic Goods Administration here in Australia, many CAMs are easy to access at the supermarket, pharmacy, health food shop, supplement store or even off the internet. Self prescribing is common, and without understanding the side effects, drug interactions and the impact it might have on your surgery next month, patients can come to serious harm.
Some alternative medicines are used complementary to medical treatment and may be recommended by your doctor if it is right for you. Always check with your doctor before starting or stopping any CAM drug and keep them updated about the all of the medications you take.
So what are the risks and what should you do if you are taking a CAM?
Immunosuppression
Echinacea, a herb commonly used during cold and flu season has been shown to be effective in reducing the severity and duration of cold symptoms. However; prophylactic use is ineffective and prolonged use is dangerous. The most concerning risk for surgical patients is immunosuppression: Echinacea is harmful to your immune system after long-term use rather than helpful. The outcomes for immunosuppression include infection, prolonged hospital stay, delayed wound healing, scarring and death.
Drug Interactions
Many of the drug interactions between CAMs and conventional medicines are unknown; hence it is strongly advised to speak with your surgeon early about all of the medications you take, including CAMs. Combined with anaesthetic drugs, Chinese herb Ephedra or Ma-Huang can causes life threatening cardiac problems. Drugs with calming properties like St John’s Wort can enhance the effects of anaesthetic drugs, potentially causing you too remain sedated for too long or too deeply.
Risk of Bleeding
Haematomas (bruising) can inhibit wound healing and excessive blood loss can be life threatening. Chondroitin, ginger, ginko, garlic and high doses of vitamin E are some of the commonly used CAMs that can increase your risk of bleeding. The risk increases again when combined with anti-inflammatory drugs.
What to do
It is important that you tell your surgeon and anaesthetist what medications you take, including any complementary or alternative medicines. As a general rule of thumb, it is recommended that all CAMs are ceased 2 weeks prior to surgery. If you are unsure if any of the medication you take will interfere with your upcoming surgery or are thinking about including CAM in your medication regime, speak to a health care professional.
