Whole healing

An infusion of integrative therapies helps kids manage pain and feel better faster — without more drugs
By Elizabeth Foy Larsen

Megan Voss, D.N.P., walked into the room of a 12-year-old girl who was recovering from a bone marrow transplant (BMT) at the Pediatric Blood & Marrow Transplant Center at University of Minnesota Masonic Children’s Hospital. The girl was in intense pain, but it was difficult to determine what was causing her discomfort.

Voss’ role with patients goes beyond assessing vital signs and monitoring medications. That’s because as the integrative therapies program manager for pediatric BMT, Voss provides patients with additional therapies that complement the more mainstream traditional Western methods. 

Megan Voss, D.N.P. (Photo by Brady Willette)To help ease her patient’s pain, Voss used Reiki, a hands-on Japanese technique that noninvasively harnesses the energy force that its practitioners believe surrounds all living beings. In addition to providing relaxation, Reiki has been shown to decrease stress and increase healing. In fact, Voss’ patient fell asleep within five minutes of beginning the treatment.

When the session ended, she told her mother and Voss that not only was her pain better, she also was much less anxious. The transformation was nothing short of dramatic.

Moments like this are becoming increasingly common at University of Minnesota Masonic Children’s Hospital. Thanks to lead philanthropy from Children’s Cancer Research Fund and a new collaboration between the Center for Spirituality & Healing and the Pediatric Blood & Marrow Transplant Center, all of the roughly 90 kids undergoing blood or marrow transplants every year at the hospital will have access not only to Reiki, but also a menu of other integrative therapies, including aromatherapy, acupoint, massage, healing touch, guided imagery, hypnosis, and stress management techniques.

In addition to lessening stress, integrative therapies have been shown to reduce nausea and manage pain with fewer side effects than medications.

“Today, there is more recognition that we have to provide care and support for all aspects of health in order to get the best outcomes,” says Brenda Weigel, M.D., who directs the Division of Pediatric Hematology/Oncology and is an associate professor of pediatrics at the University of Minnesota Medical School. “Well-being isn’t just physical. It also includes spiritual, mental, and emotional health.”

This whole-person approach is now considered the gold standard of leading pediatric BMT and oncology programs.

“A bone marrow transplant is one of the most life-threatening, complex procedures we do,” says John Wagner, M.D., who directs the Division of Pediatric BMT and holds the Hageboeck Family/Children’s Cancer Research Fund Endowed Chair in Pediatric Oncology and McKnight Presidential Chair in Hematology and Oncology. “We want to figure out ways to reduce the patient’s pain, to reduce the patient’s and the family’s anxiety, and to promote healthy living before and after the transplant.”

That is why University leaders, including Wagner and Center for Spirituality & Healing director Mary Jo Kreitzer, Ph.D., R.N., hope to create one of the world’s most comprehensive and innovative integrative health programs for children who are undergoing blood and marrow transplants. In addition to Voss, University of Minnesota Masonic Children’s Hospital has hired Lynn Gershan, M.D., as medical director of pediatric integrative health and well-being. She will begin by working with outpatients in hematology and oncology at the hospital’s Journey Clinic.

An active part of your own healing

Unlike mainstream medicine, many integrative techniques can be taught and modified so that they can be performed by even young patients or their caregivers. 

Lynn Gershan, M.D., says that both resiliency and compliance increase when patients are an active part of their own treatment processes. (Photo by Brady Willette)“In medicine, many of the ways we care for patients are passive: ‘Take this pill and feel better,’” says Gershan, who is also board-certified in medical acupuncture. “Now we can say, ‘In addition to taking this pill, we are going to teach you some relaxation strategies that you can learn so that you can contribute to your healing.’ The evidence shows that both your resiliency and your compliance increase.”

Having a hand in your own care is empowering for all patients. But it’s especially so for children, who aren’t always able to articulate how they feel about having a very serious disease that requires invasive and often painful treatments, not to mention months of hospitalization.

“If you are 6 years old and you are in the hospital for chemotherapy and have a central line and are having surgery for tumors, your life is now dictated by your disease,” says Jason Albrecht, manager of patient/family interactive services for University of Minnesota Masonic Children’s Hospital. “Integrative therapies give patients options. And with options comes a sense that you have more control.”

That’s also true for parents and families, whose lives are completely upended not only by the shock of their child’s diagnosis but also by the disruption to their daily lives that many families face.

“Many integrative therapy techniques can be taught to parents so that they can actively nurture their child in a positive, holistic way,” says Lyn Ceronsky, D.N.P., system director for palliative care at University of Minnesota Medical Center.

Under one roof

Voss’ and Gershan’s full-time work in BMT, hematology/oncology, and the Journey Clinic is a welcome addition to the treatments — including music therapy, art therapy, guided imagery, and massage — that have been performed by child-family life professionals and a network of volunteers in other parts of the hospital for years. In addition to doing research, both plan to teach nurses and hospital staff integrative techniques to help them in their roles as caregivers.

“The goal is to train staff so that we can provide seamless care,” says Voss. “If a patient wakes up at 3 o’clock in the morning, a nurse can offer an integrative therapy to help them sleep.”

“This is allowing us for the first time to really integrate all of these services under one roof,” adds Weigel, holder of the Lehman/Children’s Cancer Research Fund Endowed Chair in Pediatric Cancer. Both she and Wagner also are Masonic Cancer Center members.

While the work is starting in pediatric hematology/oncology and BMT, the ultimate goal is to make these treatments available to all children at the hospital, whether they are undergoing a kidney transplant or a tonsillectomy.

Despite the hospital’s commitment, funding these treatments remains a challenge, since many integrative therapies aren’t covered by health insurance.

“It’s important to get philanthropic support,” says Gershan. “These approaches can help how a body reacts to stress. And who could be more stressed than a kid who is coping with cancer and chemotherapy?”

Published on February 25, 2015

A note on healing

Girl playing musical instrument

What is it about music that’s so therapeutic? Though the relaxing qualities of music may seem intangible to many of us, there are certainly tangible aspects, too, says music therapist Annie Heiderscheit, Ph.D.

“Rhythm is such a foundational element to music, but it’s also a foundational element to our body,” she says, “from our breathing to our heart rate to our brain waves to our digestion to how we walk and how we talk. We can use rhythm to slow down our breathing, slow down our heart rate, slow down our brain waves … to foster this relaxation response.”

The stresses of being sick and being hospitalized tend to push up those vital signs, which over time weakens the immune system — which in turn keeps kids in the hospital longer.

Music therapy is considered an integrative therapy that can be used alongside traditional Western medicine to potentially speed the healing process or, at the very least, improve patients’ quality of life. Though researchers around the world are adding to a growing body of knowledge about the value of music therapy, today much of the evidence that suggests it works is anecdotal.

Enter cancer survivor Ruth Bachman. Throughout her treatment and continuing today, practices such as yoga and meditation helped Bachman move through the fears and uncertainties of cancer.

In gratitude for the care she received from physicians associated with the Masonic Cancer Center, University of Minnesota, she has set out to raise funds for collaborative research on integrative cancer care.

Bachman’s Hourglass Fund is currently supporting a pilot study of a soothing instrument called a reverie harp, directed by Heiderscheit and partnering with University pediatric BMT physician John Wagner, M.D.

“I have heard that the patients and their parents are finding the presence and use of the reverie harp to be a meaningful form of relaxation and communication during the very stressful time of BMT,” Bachman says. “I could not have asked for a more meaningful program or two better researchers to be leading it.”

- Nicole Endres

Integrative therapies

Acupoint
A Chinese medicine staple, acupoint works like acupuncture but without needles. It stimulates points on the body to restore the circulation of Qi, or energy flow.

Aromatherapy
The use of essential oils to promote well-being. Aromatherapy has been shown to reduce nausea and increase relaxation.

Guided imagery
Using words and music to help a patient create imagined scenarios that promote relaxation and healing.

Healing touch
An energy therapy that uses gentle hand techniques to help shift the patient’s energy field in order to accelerate emotional, spiritual, and physical healing.

Music therapy
The evidence-based use of music interventions to manage stress, alleviate pain, enhance memory, or promote healing. Music also can help patients articulate their experiences in a way that they might not be able to articulate in an ordinary conversation. 

Reiki
A healing technique that uses light, nonmanipulative touch to promote balance and healing. Reiki can result in increased relaxation, pain relief, decreased anxiety, and a general sense of well-being.