Should I go to a medical spa? In efforts to deliver better health to your doorsteps, alternative and complementary medicine are moving next door. Get to know your neighbour. By Dr Mary Tabacchi The desire for holistic and natural treatments to relieve stress and help treat chronic disease has people hopping on planes and flying to spas in the Far East. But do we really understand what they are about? Medical spas Generally there are four types of medical spas: (1) allopathic medicine combined with spas treatments, (2) alternative medical treatments combined with spa activities, (3) a combination of allopathic and alternative medical treatments called integrative medicine      combined with spa treatments and (4) medi-spas which are more specifically dedicated to skin treatments and cosmetic surgery.      All of these approaches are indeed beneficial to guests and clients and a boon to the spa      and medical environment. Allopathic medicine Patients at hospitals, outpatient clinics, and spa guests who are relaxed heal rapidly and efficaciously. There are several studies that suggest that chronic disease symptoms erupt during stressful times and decrease during times of relaxation. Hence, a new day is born for those with autoimmune diseases and for pain management of the chronically ill. Individuals with asthma, arthritis, allergies, diabetes, skin eruptions and other ailments benefit from exercise, proper nutrition, and meditation. Dr. Dean Ornish, founder, president, and director of the non-profit Preventive Medicine Research Institute in Sausalito, California, has shown that cardiovascular lesions can be reversed following a low-fat, vegetarian regimen complimented by exercise and meditation. There is evidence that asthmatic French school children are able to reduce the levels of medication they use when treated with inhalation of various sulphur-containing waters. Joint pains and skin lesions are often mitigated by European therapies that use a combination of spa treatments and drug therapy — the spa treatments reduce the levels of drugs needed. Alternative medicine There is a shift in the medical paradigm from viewing the body as a machine to the idea that interconnectedness of body, mind, emotions, social factors, and the environment strongly determine health status. As shown above, the Ornish approach is indeed beneficial — if patients fail to change their lifestyles, they will undoubtedly suffer bypass surgeries several times in their lives. Many individuals may prefer lifestyle changes over the economic and health risks of surgery. Alternative medical practitioners adhere to four basic principles: 1. Nature has the power to heal, and we should facilitate the body’s ability to heal itself. 2. First do no harm. Medical treatments throughout the Western world are not perfect, and some     mistakes can be life-threatening. 3. Identify and treat the cause of disease. Evidence supports the claim that some drugs and     some surgical treatments are effective only in suppressing symptoms. 4. The physician is a teacher who assists individuals in making lifestyle changes and     encourages them to help themselves heal. Integrative medicine This is a key concept around the world. More and more medical centres are combining allopathic and alternative medicines, a field now known as integrative medicine. This allows the client, guest or patient the benefits of both types of healing. Many physicians believe that this combination of treatments allow synergistic healing and recovery after invasive surgical techniques or after radiation or chemotherapy. In this, there is an economic and health care issue. It is much less expensive to treat coronary artery disease with a proper diet, exercise and meditation than it is to insert a stent or perform bypass procedures. Additionally, the “traditional” Western medical approach requires longer recovery times, prolongs absence from work, and delays the ability to return to everyday life. The cost of health care has risen astronomically in the Western world. There are questions as to whether the next generation can pay for the almost exorbitant health care expenses of an aging population of baby boomers. In the US, the famed Canyon Ranch is combining forces with the renowned Cleveland Clinic to frame a new model of health and healing. The study of how energy is transferred from healer to patient is an integral part of the model. Their work could lead to new recovery protocol in the medical system. Additionally the integrative approach allows for more prevention in the new model. Some allopathic physicians see prevention as detection, whereas the spa medical approach to prevention is exercise, diet and meditation — the positive affects of a lifestyle where a person strives to combine the healing force of the mind, body and spirit. Medi-spas Medi-spas are those medical spas that deal mostly with skin and facial procedures. Many cosmetic surgeons and dermatologists are transforming their practices to include relaxing and therapeutic massage, aromatherapy, hydrotherapy and so on. Hence, physicians who administer Botox, perform microdermabrasion, peels and surgery, and similar treatments and include spa offerings as part of the package are offering medi-spa services. Again spa treatments are used to relax and refresh the patient, and to enhance and speed up healing, and medi-spas are growing fast as an aging population looks toward cosmetic procedures to enhance its quality of life. Looking good does indeed enhance a person’s self-confidence and self-esteem, which in turn may increase the production of endorphins and energy and a strong sense of well-being. The philosophy of medical spas There are words that are confusing to the public and the allopathic medical profession. Among these words are “detox,” “juice fasting”, and “anti-aging”. Let’s clear these up. “Detox” is derived from “detoxify”, meaning to remove toxins. It is hard to believe that a special diet or beverage by itself can detoxify. Removing toxins is a complex series of processes involving many organ systems, chiefly the skin, liver, kidney, urinary tract, blood, lungs, spleen, gall bladder, and the intestinal tract. It would seem logical that drinking of water, which promotes these bodily functions, would be the best and least harmful stimulant. Exercise indeed stimulates many of these organ systems. It is unclear how “cleansing the colon” by some “juice fast” or other similar protocols detoxify. From a nutritional and biochemical standpoint, colon health is best promoted by high-fibre of whole grains, legumes, fruits and vegetables. This type of diet is recommended for those with high blood cholesterol and diabetes, and the average person. I It is also medically accepted that antioxidants in fruits, vegetables and green teas help protect many organ systems from cancer. It is clearly understood by biochemists and physicians that various mitochondrial systems within liver cells are the prime “detoxifiers”. The kidney also plays a large role in detoxification. Furthermore, juice fasting, repeated colonics, and other methods could disturb the essential microflora of the gut. For the same reason that a person should use antibiotics only when absolutely necessary (these drugs may destroy the symbiotic relationship of organisms in the intestine), he or she should avoid treatments that have laxative-like effects. Cells in the intestine turn over about every 3 days. This means that the colon is a very active organ system. As cells age, they slough off and mix with metabolites of digestion. Additionally, the body reuses metabolites of digested hormones and enzymes. This system is very important in the recycling of proteins among other nutrients. Hence, it appears almost contradictory to good health that some well-meaning spa health providers suggest that this system be disturbed by colonics and treatments that cause diarrhoea. I would ask health care providers to examine “detox” treatments very thoroughly. Clearly there is no better treatment for healthy, glowing skin than exercise and hydration. A good diet that encourages the growth and function of all healthy cells is critical to young, firm skin. Does “anti-aging” imply that we are not going to age? Or that somehow we are against aging. It is true that a person’s biological clock may not be the same as his or her chronological clock. Due to heredity and lifestyle, we age at different rates. But the implication that creams or massive doses of vitamins can somehow slow aging more than fitness of body, mind and spirit is almost antithetical to the spa concept. The idea of alternative and complementary medicine is to cut down on the use of drugs and similar agents, replacing them with exercise, good nutrition and relaxation. There is no doubt that we all want to look our best. We are a youth-fixated culture. But to infer that if we change our facial features or improve our skin by chemicals, nutrient supplements or surgical procedures can some how make us age more slowly is naïve at best. Caveat emptor! However, exercise, hydration, good nutrition, meditation and a balanced life improve not only appearance but also enhance life at the very cellular and sub-cellular basis in all organ systems. First do no harm, said Hippocrates. It is clear that spas should not profess to be medical spas unless they are strongly founded in a thorough knowledge of biochemistry, nutrition, physiology and medical knowledge of trained practitioners. The educated consumer Spa consumers are highly educated often with post-graduate degrees and a strong knowledge of health and medicine themselves. Consumers are savvy. If they suspect that medical spas are not true to self-healing through exercise, stress control (meditation), mindfulness, and a balanced diet, then they will look upon allopathic practitioners as pseudo-scientists. If this occurs, spas, medical practitioners and consumers lose. Hence spas, especially medical spas, need to have practitioners who are highly experienced, carefully educated, and who interpret and apply evidence-based research diligently. We speak to you Medical spas should be clear about who they are and what they offer. Some consumers may attend a medical spa, such as that offered at Chiva-Som and Canyon Ranch, for preventive reasons. Other consumers may wish to frequent a medi-spa where special attention is paid to their skin. Others may want the attention of a health-and-healing centre because they need treatment. These may be hospital spas in the future. Letting the consumer know the strengths and limitations of medical offerings is key to credibility for spas. Choose wisely There are many types of medical spas. The consumer may be confused if marketing communications are not clearly defined. Consumers need to know that not all medical spas are created equally. Spas that are medically oriented should “clean up their language”. Words such “detox” and “anti-aging” are used by so many that their meanings are truly unclear, and the efficacies of such treatments remain unsubstantiated at best. Some detox and anti-aging treatments seem unnatural and may indeed interfere with the body’s own self-healing mechanisms. In the future massage, touch therapy, relaxation, meditation, positive imagery and energy healing will hasten the recovery of surgical patients. Oncologists will urge clients to build up their bodies with physical exercise and to mentally prepare for treatment, endurance and recovery. Those who must undergo invasive therapies can be trained for receiving healing therapies, to develop mindfulness, and to focus on the natural healing powers of their own bodies and minds. Wellness centres will school younger individuals in lifestyle habits that will vastly improve the quality of their lives. Anti-aging will not be just skin deep; it will involve exercise, energy, meditation and mindfulness as well as healthful food. The quality of the lives of young professionals will improve as they age because of prevention. They will not need supplements, nutraceuticals or anti-aging treatments. They will lead happy and productive lives, they way nature intended. Dr Mary Tabacchi is an associate professor at Cornell University’s School of Hotel Administration. She writes on behalf of Asia Spa Institute.