Recovery International—An Adjunct to Internal Medicine

Recovery International Interviews Jorge Lindenbaum, MD, and Donald Warde, MD

Jorge Lindenbaum, M.D., is a board certified internist specializing in hypertension and geriatrics. He is a graduate of Buenos Aires University School of Medicine and finished his fellowship in clinical pharmacology and hypertension at the University of Pittsburgh.

Donald Warde, M.D., is a board certified internist and cardiologist. Warde is past President of Allegheny General Hospital Medical Staff in Pittsburgh and a graduate of the University of Dublin and Trinity College Medical School.

Recovery: As a practicing internist/cardiologist, how has Recovery International helped with patient management?

Lindenbaum: Recovery International has been a tremendous help because it enhances my own treatment regime by teaching the patient important self-management skills for coping with their illness. Recovery International is also a no cost, supplemental support group to which I can refer patients. This is a prime consideration in an era of managed care, cost containment, or the patient already burdened with medical bills.

Warde: In patients with conditions such as mitral valve prolapse (M.V.P) or benign rhythm disturbance, Recovery International has been a great help in getting such patients to come to grips with their medical condition. Recovery International enables patients to achieve greater insight into their condition and the confidence that they too can overcome their fears.

Recovery: After a complete physical examination has ruled out organic disease, what common symptoms may indicate an underlying nervous condition?

Warde: The presence of undue anxiety in the absence of a known medical/cardiac condition is a major indicator. The presence of agoraphobia or excessive claustrophobia can be indicative of a "nervous condition." Obsessive/compulsive or ritualistic behavior can also be present in many of these patients.

Lindenbaum: The garden variety of anxious, panic, depressive symptoms are always present in these patients and most often do not correlate with any particular medical pathology.

Recovery: Can Recovery International help you handle a patient who feels insulted or "angry" when told his physical problems are really nervous in origin?

Lindenbaum: Yes, without a doubt. I stress to my patients that the symptoms they are experiencing are indeed very real, but not at all life threatening. By attending a Recovery International group, the patient will find others with exactly the same problems who are improving by using the Recovery Method.

Dr. Warde: Absolutely! Frequently patients such as M.V.P. patients, have not had a sympathetic hearing given to their complaints. A comprehensive history and physical exam, with appropriate diagnostic studies will help to reassure patients that their complaints have been taken seriously and Recovery International can help greatly in giving them insight into their conditions.

Recovery: Do you feel Recovery International is helpful for the patient who is depressed and/or anxious due to a true medical condition?

Warde: Yes, when the medical condition is reasonably stable. Recovery , Inc. helps patients to cope with their physical limitations as well as the anxiety that accompanies illness.

Lindenbaum: Recovery International can help many patients with underlying medical conditions. The obvious benefit is that as the symptoms of anxiety and depression decrease, successful medical management increases.

Recovery: How do you convince your patients of the long term benefits they can gain with the Recovery International program when most are looking for the "quick fix" or "perfect pill" to solve their problems?

Warde: I tell them to "try it." Recovery International shows them how to regain control over their lives and reduce their need for anxiety, lowering medication.

Lindenbaum: It's imperative to have a good rapport with your patients in order for them to believe and trust your judgment. It may take extra time on my part, but once my patients realize the consequences of not treating nervous symptoms, most are willing to at least give Recovery International a trial. Once basic Recovery International techniques are learned, the patient has simple, effective tools which complement the physician's treatment.

Recovery: What improvements have you seen in your patients who regularly attend Recovery International meetings?

Lindenbaum: These patients help me with management and in essence become part of the therapy team. Their response to treatment is greater, they report feeling better, they have fewer hospitalizations, less need for medication, and they learn to differentiate between true medical ailments and psycho-somatic complaints.

Warde: Patient compliance (with their medical regimen) improves significantly as patients develop a better understanding of themselves.

•