ORLANDO, Fla. — Kim Ricci is lying on her back on a table with hair-thin needles stuck in the hollows of her ears, five on each side. Several more puncture her wrists.
Ricci, 50, says she was surprised when her doctor suggested she get acupuncture to relieve the pain and discomfort she was experiencing after her breast-cancer surgery.
She was even more surprised when the therapy worked.
Pick a good practitioner. Ask what medical facilities they are affiliated with. Those providers linked to well-established medical institutions or practices likely have the proper training and credentials.
Get a doctor's recommendation. Don't just go for a therapy because "it worked well for your neighbor," said Diane Robinson, program director of integrative medicine at UF Health Cancer Center at Orlando Health.
Don't seek treatments online. "Almost every week on the Internet some mushroom is being touted as a cure for something," said Dr. Lisa Barkley, assistant dean for diversity and inclusion at the UCF College of Medicine. "But who knows what you're putting in your body?"
Beware of interactions. The area where most harm can happen is when patients combine herbal supplements, which haven't been studied, and prescription drugs. The interactions are unknown and can be dangerous.
Don't use them to replace traditional medicine. "My concern with alternative therapies is when patients turn to them to relieve symptoms for problems that need mainstream medical treatment," said Dr. Frank Stone, an internist at Florida Hospital. Pain, for instance, can be a sign of a problem that needs traditional medical attention.
"While I can't say I thought of it as voodoo, I never thought it was a solution for me," the Orlando woman said.
Though acupuncture, meditation, massage and yoga are not typically what the doctor orders, that's changing as more mainstream medical practitioners incorporate therapies once considered alternative into their conventional practices.
UF Health Cancer Center at Orlando Health started an integrative-medicine program last year, and at the University of Florida's medical school, a course in alternative medicine is about to become part of the curriculum. At the University of Central Florida's College of Medicine, students are learning how to make unconventional therapies part of conventional treatment plans.
"It heartens me to see more doctors starting to treat the whole person rather than just cutting them and giving them medicine," said Diane Robinson, a neuropsychologist and the program director of integrative medicine at the cancer center.
Applications for alternative medicine reach far beyond cancer treatment.
Physicians from many fields who just a few years ago would have balked at the idea of incorporating therapies once considered "mystic" into their treatment plans are now recommending them to treat a range of ailments, including headaches, pain, arthritis, stress and depression, said Dr. Irene Estores, an integrative-medicine physician who started UF Health's Integrative Medicine Program a year ago.
When Paula Duffy of Groveland, Fla., developed low thyroid, and her doctor put her on prescription thyroid medication, "the side effects were violent," she said.
Though her dose was low, the 75-year-old woman had the shakes and her heart raced. About a month ago, she went to Estores, who prescribed botanical supplements, including selenium and seaweed containing iodine. Duffy tolerates the combination well.
"I was so lucky to find a doctor like her. I want to try everything first that's not invasive, but regular doctors do not understand about supplements, and few believe in meditation and yoga," said Duffy, a Brazilian native who has practiced yoga, meditation and tai chi for decades.
That acceptance will likely increase as, across Florida, more medical students are being trained in the emerging field of integrative medicine. This fall, Estores will teach a course on the subject to fourth-year UF medical students.
At UCF's College of Medicine, Dr. Lisa Barkley, assistant dean for diversity and inclusion, said, "We teach our medical students to incorporate complementary methods into their care plans along with more traditional approaches. It's important they understand other perspectives, alternatives and cultures."
Ricci is grateful for the philosophical shift. After her double mastectomy in December 2011, the business analyst and mother of three grown daughters experienced painful muscle spasms and skin tightening around her chest and back.
She took pain medication and muscle relaxants but didn't want to become dependent on pills.
"I was pretty miserable," she said. "The muscles were so tight through my breast and back it was a struggle to breathe or move or just get through the day."
She began getting treatments in March at the Gynecologic Cancer Center, part of the UF Health Cancer Center in Orlando. "I feel completely different. Now I can take a deep breath," she said. "My muscle pain is 95 percent better."
This is exactly how Orlando Health's Robinson wants doctors and patients to use alternative therapies, she said, adding that good scientific evidence is emerging to support many alternative methods.
Acupuncture, for instance, has been shown to bring pain relief in animal studies, which would rule out a placebo effect.
Massage, yoga and mindfulness are also "very well supported by science for relieving pain, tension and stress," she said. However, other areas, including light, energy or magnet therapies, are "very questionable."
"Some treatments are not studied and not tested," said UCF's Barkley, who cautions medical students to note the line between evidence-based treatments and quackery.
Though proponents of the integrative trend argue that adding alternative treatments to traditional medicine could reduce health-care costs overall by lessening pain and increasing compliance, insurance companies approve few treatments. Most patients, including Ricci, pay out of pocket.
Ricci pays $50 for each one-hour acupuncture session.
Dr. Frank Stone, an internist and pediatrician at Florida Hospital, understands the resistance among some of his colleagues. "We like to think we're scientists and can prove what works, but not everything in life lends itself to that approach."
Whether it makes sense scientifically isn't really relevant if it helps, said Stone, who doesn't prescribe alternative therapies himself.
"Modern medicine often ignores the connection between mind and body," Stone said. "If the brain thinks it's helping, then the body has a related response. If people believe it will make a difference, it makes a difference."