Which doctor would you choose These twins treat patients with chronic conditions – but one sticks to traditional medicine, the other opts for the holistic approach
21:02 GMT, 7 July 2012
21:02 GMT, 7 July 2012
Last summer, Julie Mathias collapsed suddenly, paralysed down the right side of her body. She was suffering a severe form of a condition called a hemiplegic migraine. It is not fully understood, but the paralysis is caused by a communication failure between the nerves.
In most sufferers – it affects between 8,000 and 10,000 Britons – these terrifying episodes often last for hours or days. But Julie, 47, did not recover.
She was left barely able to walk without a stick, her speech was slurred and she had to give up working at her hair salon. Her neurologist prescribed an anticonvulsant drug called Topiramate, yet the symptoms remained.
Double take: Dr Chris Van Tulleken, left, and his twin Alexander will feature in a new documentary
Julie is now the subject of a documentary on Sky One called Which Doctor In the programme, patients desperate to resolve chronic conditions are given a choice of conventional or complementary medicine.
They then choose between two doctors: Dr Alexander Van Tulleken, who uses standard medical methods, and his twin Dr Chris Van Tulleken, who takes a holistic approach.
Julie visits each of them for a consultation. First, Chris asks Julie about how her symptoms. When she manages to leave the house, it renders her exhausted for three days, she explains.
Chris advises her to come off the medication, which he believes is prolonging her symptoms rather than preventing another attack, and he prescribes physiotherapy instead.
‘A hemiplegic migraine was not a certain diagnosis because there is no definitive test for it,’ he explains later. ‘Julie needed to be released from this scary diagnosis and there’s little evidence a drug such as Topiramate is an effective treatment for it. Topiramate wasn’t working in any meaningful sense.
‘I wanted to empower her with the physiotherapy, to make her feel she could get better herself.’
Complementary versus convention: The documentary explores the effect of traditional and holistic treatments
By contrast, his twin brother recommends more tests to see if Julie has nerve damage and to monitor her blood pressure over 24 hours. He advises her to stay on the medication.
Julie chose Chris’s approach. Over the next five weeks she came off the medication and underwent physiotherapy to improve her posture and regain the use of her right side.
In a scene when Julie returns to see the doctors, she walks without a stick, and is moving and speaking normally. She beams with relief as she announces that she is back at work.
‘The physiotherapist has been working on my neck and it seems to be releasing muscles that were causing tension,’ she says. ‘I had the start of a migraine in my eye and just by doing a few simple neck stretches I controlled it. I’ve got my life back.’
So why did conventional interventions fail where complementary ones succeeded
‘Doctors are essentially trained to prescribe medicine,’ says Chris. ‘Patients often fall outside diagnostic criteria so treating something we’re not sure about with a toxic drug isn’t very sensible. Julie’s was not a very real diagnosis – she probably had some nasty drug reactions [from the Topiramate].
Alex was shocked by the remarkable results of his brother's treatment
‘The very labelling of someone as having a serious disease can make them ill. So to say to Julie “You don’t have a terrible condition” made all the difference.’
Shocked by the remarkable results of his brother’s treatment, Alexander concedes: ‘We as doctors don’t engage people enough in conversations about their care – patients are simply caught up in a psychological and physiological loop. Stopping her medication was brave and I was proved wrong.’
Julie wasn’t the only person to benefit from the choice of treatments offered on the show.
Michael Makianer, 39, has suffered haemorrhoids for ten years and, despite continued use of over-the-counter creams, his problem persists. Michael is often left in so much pain he is unable to work.
Alexander recommends referring Michael to a proctologist – a specialist in colon, anal and rectal problems – who will give Michael an injection to shrivel the haemorrhoids or surgically remove them.
Chris, keen to avoid surgery, advises Michael to change his diet so it becomes rich in fibre. He also recommends a caffeinated drink such as tea first thing to speed up the time Michael spends on the toilet, and to take regular hot baths, which relax the area around the haemorrhoids.
Again, the patient opts for Chris’s approach, this time to avoid any complications from surgery. Six weeks later, Michael is back and the haemorrhoids have disappeared.
‘Michael is a great illustration of why if you make the prescribed changes to your lifestyle you can get better,’ says Chris.
‘All I did was give him sensible advice. I’m not saying in general everyone should throw away their pills or refuse surgery – I’m just saying those things are hugely overused.’
The show altered Alexander’s view of holistic medicine. ‘It allows you to explore with the patient broader issues about their health,’ he says.
It has also made him more optimistic about patients’ capacity for taking control of their health.
‘Build a relationship with your GP that allows you to try different treatment options. If you think you’re not getting the right results with your treatment, see another doctor,’ he advises.
‘What came out of the programme is that as a patient, you are your best advocate – ask questions, take notes and engage in the problem yourself.’
Which Doctor will be shown on Sky One on Wednesday at 9pm.