Back to the basics

My clients often ask me why I chose to switch over from conventional modern medicine to alternative medicine. The truth is I haven’t really switched over. I still use my training in conventional medicine on a daily basis, be it in diagnosing an endocrine imbalance or narrowing down the differential diagnosis in a patient with peripheral neuropathy. A fairly recent example is a client with a history of severe excruciating one-sided headaches that would appear several times a day for about half an hour even waking her from sleep. These episodes would last for a month or two and then vanish only to reappear a few months later. This pattern of intermittent headaches had persisted for several years. No medication had made any significant difference. She had reached the point where she could take it no longer and had contemplated suicide many times. A well-known neurologist had diagnosed cluster headaches but she had not responded to treatment. When I saw her she was in great distress and had an episode of headache in my office that was obviously agonizing. The temporal pattern of the headaches, the timing, the frequency and the severity strongly suggested a variant known as Chronic Paroxysmal Hemicrania. The good news with this particular diagnosis is that a specific drug, Indomethacin, not only elicits a favorable response that is diagnostic but can also be used to terminate these attacks and in small maintenance doses can prevent them from recurring. Her headaches stopped completely within 3 days of starting Indomethacin. She has successfully prevented further attacks of headache in the past year and a half with a small maintenance dose of Indomethacin.

    I have related this story simply to highlight the fact that basic clinical skills such as history taking and clinical examination should always be the bedrock of medical practice and should not be usurped by technological advances in imaging and laboratory testing. The process of reasoning and logical deduction based on thorough history taking and clinical methods that enables a trained physician to arrive at a final diagnosis is honed over many years of practice. Modern medical practice ignores these skills at it's own peril. It is time to go back to the basics.