Friday, December 30, 2011

Primer on Happiness

This photo came to me in a Facebook feed and I thought it would help set the appropriate tone as we reflect back on 2011 and create our mindset for 2012. Happy New Year!

Friday, December 23, 2011

Quick Coherence for Holiday Peace

We have been using a lot of Biofeedback for soldiers with PTSD to decrease anxiety and increase mindfulness. I am currently in the process of reviewing the emWave by HeartMath to determine if it is a good fit to use and recommend at Jing, and one of the initial practices suggested is a short heart meditation that does not require the aid of a device. Detailed information is available on their website along with a number of free tools and research. Try out this quick, proactive practice for your own centered presence before taking on holiday traffic or that pesky family drama!

Step 1: Focus
Bring awareness to the area around your heart in the center of your chest.  Place your hand over your sternum to help maintain this focus.

Step 2: Breath
Begin by taking your normal breaths gradually deepening each inhale and elongating each exhale. Imagine each inhale and exhale originates and flows freely from your heart center. Continue this practice until the breath feels natural and relaxed.

Step 3: Feeling
As you maintain your heart focus and breath, recall a positive memory or pleasurable feeling. Try to re-experience that moment, taking in all of the enjoyable sensory and interpersonal aspects that bring joy and peace. Linger here, allowing yourself to rebalance and recharge before moving forward.

Sunday, December 11, 2011

Top 5 Self-Care Experiences of 2011

Many patients ask me what I do for my own self-care regimen - after all, if you are going to preach it, you need to practice it. One of my main sources of R&R are spa adventures both for my own personal enjoyment, but also as a way to research a variety of therapies to recommend as part of a total individual treatment plan for my patients. This year I had the opportunity to try several modalities in various locations  across the country, and the following are my reflections on those experiences.

Maya Abdominal Massage - I have only had one "full body" massage in my life where abdominal work was part of the treatment.  I have asked a number of massage therapists why, and answers range from "nobody likes it" to "we didn't learn that in school."  I agree, it feels a little weird partially because it is natural to guard the area, but also because most of us are not used to being so aware of our liver, stomach, or ileocecal valve.  Maya abdominal massage requires additional training and involves the entire core. This therapy addresses issues including pelvic discomfort (including hips and low back), sexual function, and gastrointestinal irregularity. My favorite place in Louisville is Balance in Motion.

Ashiatsu - I had this done while at a conference in Orlando at Rosen Shingle Creek Spa. This is an intense deep tissue massage where the therapist stands over holding parallel bars for balance and uses feet instead of finger pressure to target common trigger or acupuncture points.  This is sometimes called Oriental Bar Therapy and has become more popular in recent years. Deeper does not mean better or more effective and is not an appropriate therapy for everyone. Folks who have a lot of scar tissue or adhesions may like this therapy, however those with fibromyalgia or myofacial syndrome may find it makes their condition worse.

Reflexology - Perhaps my favorite treatment when done by someone formally trained, I have yet to get through one of these without falling asleep! More than a foot, hand, or ear massage, this modality uses sustained finger-pressure techniques to find areas of the body in need of attention without having to touch them directly. This is a great alternative to full-body massage for those who have discomfort but prefer to remain clothed. Those who tend to do well with this therapy can often tell when the therapist is touching the neck area of the hands or sinus area of the foot.  I have had this done at Mandara spas in Orlando and Anaheim, Rachel's Salon in Memphis, Gould's Salon at the Peabody Memphis, and locally at my favorite place, J.R.s Salon.

Hot Stone - This is the number-one patient favorite, even in the summer and for those experiencing hot flashes! It is fantastic for people who like light-medium pressure with the goal of increasing circulation and relaxation. The stones are usually warm but some therapists will incorporate cold stones if appropriate.  The stones warm and relax the muscles to allow deeper but less intense work with hands with less post-treatment soreness than with other types of massage. I am lucky enough to have a very talented therapist at Jing who also brings aromatherapy and a foot scrub into the session. Genevieve's Healing Arts

Body Wraps - I get questions about these from folks who want to "detox" after surgery, as a seasonal cleanse, or to remove excess water weight. Those who like it enjoy the warm, cocoon feeling, improved circulation, and skin softening or tightening effects. Again, this is a good therapy for people who like to spa, but may be touch-sensative.  To be honest though,  I do not like the feeling of being swaddled in plastic wrap and wet towels saturated by algae powder and my own sweat. I have had about three of these in my whole life and all were a bit different, but nonetheless, not for me.

***Disclaimer: None of these companies listed provided compensation for reviewing their services

Monday, November 21, 2011

A little Monday Morning Advocacy from the Coalition for Safe Acupuncture Practice

I received this in an email newsletter this morning and I believe it is important to get this information out. While crossover practice exists in multiple western medicine disciplines, proof equivalent training is always part of the equation. I have long maintained there is a problem with MDs, DOs, DPTs, and DCs being able to take a quick (if any) course of acupuncture and have it fold into their scope of practice. Stating that techniques like dry needling are not TCM and therefor do not require TCM theory is fine, however there is ample training in technique and clinical supervision that is necessary regardless of the guiding theory. By that rational, anyone who draws blood, administers injections, pierces body parts, gives tattoos, or otherwise has a needle meeting skin as part of their discipline should be eligible to take a course for a few hours and hand their shingle. If that does not sound like a good idea, neither should this . . . 

Please join us in responding to Dry Needling...  

Dry Needling for Pain Management, as developed by Yun-Tao Ma, PhD., is a 24 classroom hour work-shop designed for Physical Therapists who wish to use Dry Needling in their patient practice. After completion of Dry Needling for Pain Management, Physical Therapists are encouraged to insert needles into their patients as part of their treatment protocols. Dry Needling is,by definition, the insertion of solid, acupuncture-type needles into body tissue. Dry Needling technique is acupuncture technique.  

Training in Dry Needling, as provided to Physical Therapists, does not include the 6 hour Clean Needle Technique safety course and Clean Needle certification exam that all Acupuncture students must complete and pass. Training in Dry Needling, as provided to Physical Therapists, does not include the 150 hours of clinical observation plus 118 hours of needling technique classroom instruction required of all Acupuncture students prior to beginning their clinical internships. Training in Dry Needling, as provided to Physical Therapists, does not include the Illinois state mandated additional 660 hours of needling and acupuncture technique practice that all present Acupuncture students must complete while being supervised by Illinois State licensed acupuncturists at an ACAMO-accredited and Illinois state approved educational institution.  

The Coalition for Safe Acupuncture Practice (CSAP) seeks to bring attention to the inadequacy of clinical, classroom and Clean Needle Technique instruction received by Physical Therapists who are using Dry Needling in their treatment practices. Please read the CSAP mission statement at end and consider joining us so that we may bring social awareness to this public health issue.

CCAOM Position Paper on Dry Needling 

American Association of Acupuncture and Oriental Medicine Position Statement of Acupuncture Trigger Point Dry Needling and Intramuscular Manuel Therapy 

Wednesday, November 02, 2011

‎"Melting You Icebergs"

A Facebook professional contact posted this recently and I thought it was worth sharing because, chances are, you are reading this on a computer and susceptible to frozen icebergs!  


You keyboard right?  

Midway between the far end of your shoulder and your spine there is a gathering point for stress. It feels both good and bad whenever someone presses on it. 1 iceburg on each shoulder. Not quite as bad as Atlas.  So let's melt them.

Push your shoulders up to your ears or as far as they will go. Then let them fall slowly and SOFTEN. Think of hot butter. Think of ice melting. Move your right hand to your left shoulder and gently GRAB that point and squeeze, not like you are wrestling with an enemy, but like you are embracing a wounded loved one. With care. And work out sone of that tender stiffness. Do the same with the other hand and shoulder.  Then make some really REALLY BIG circles with your shoulders. All the way up back down forward, and around and around.  

W O R K I T O U T.

Now step away from your computer and do something else for a while. Take care of you!

Saturday, October 15, 2011

Engage With Grace

Death. The big "D" word. We only die once, yet the subject is often taboo to discuss even when terminal illness or unexpected event occurs. Just as preventative healthcare is preferable to interventional disease care, having these kinds of discussions are important not just for the one who is dying, but for those who are left to grieve. Many acupuncturists provide palliative care both for the individual and their families and can play a role in facilitating these discussions. When you and your family know the answers to the following questions, the burden of decision-making and potential for conflict in the midst of grief and shock is greatly lessened. This movement is just as important for those in the bed as it is for those standing by it. Please pass it on!

Engage With Grace/The One Slide Project

Saturday, October 08, 2011

Acupuncture's Method of Action: Adenosine (?)

"A patient's report of pain is to be believed." This basic assessment is taught to all aspiring healthcare providers. Their report of pain relief, however, is often accepted only if there is a scientific explanation. Acupuncture is constantly being called quack medicine with all of it's "Qi" and "meridian" hocus-pocus, while patients who support it's efficacy cajoled for being so simple or desperate that they experience nothing more than a placebo effect.  Thanks to an ever-expanding body of research, we may start referring to "Qi" as both energy and chemical transmission.

Researchers from the Center for Translational Neuromedicine in Rochester now offer another plausible scientific explanation for the analgesic effect of acupuncture. A study on peripheral nervous system pain in animals found acupuncture increases formation of adenosine, a nucleoside that produces anti-inflammatory and pain-relieving effect.  Although deeper insertion and stimulation produced a greater effect, a moderate increase in adenosine may be observed with application of pressure, heat, or vibration to this skin.  This may also explain why non-invasive "sham" acupuncture treatments can elicit a therapeutic effect, but also why these benefits do not endure over the course of follow-up. Previous studies focused on the central nervous system determined acupuncture also stimulates the release of endorphins in the brain. Bring on the science!

For the full article, visit Nature Neuroscience

Monday, September 26, 2011

Pain Relief for Veterans

For several years, the military has recognized the benefit of incorporating acupuncture therapy in a holistic treatment plan for PTSD and substance abuse issues, even if they generally do not used trained, qualified, and licensed acupuncturists to perform it. As miffed as I am that they allow the "jab-and-go" providers instead of hiring people with an actual degree in the medicine (yes, I am jealous . . . and available for collaboration), at least they recognize the contribution of the modality. Our soldiers and veterans are returning with some interesting autoimmune and auto-inflammatory diseases at a rate higher than the general population. Rheumatoid arthritis,  scleroderma, pernicious anemia, chronic recurrent multifocal osteomylitis - whether contracted by inhaling burning trash, as result of traumatic-brain injury, excessive vaccination (double vaccination in the cases where they lost a soldiers records "just in case") or physical manifestation of a psychological malady, there is no denying many of our vets are in physical and emotional pain. And so, I put aside my professional irritation and offer nothing but praise for using acupuncture as an adjunct for pain control in our wounded warriors.

Army looks toward new ways to fight the pain

Soldiers are getting alternative medicine.
Published 01:55 a.m., Monday, September 26, 2011

Sgt. 1st Class Jennifer Wright used to jog, walk, lift weights and ride her Harley-Davidson Fat Boy, the motorcycle she bought after serving in Iraq.

Today, she's among a growing legion of war veterans suffering from scleroderma, a painful and potentially fatal disease. Wright, 40, feels pain in her face, joints and toes. She's lost some of her hair, and her toenails fell off.

“It's to the point I want them to deaden the nerves in my face. But (the doctor) said if you do that you take a chance of developing muscle atrophy, Bell's palsy with the real bad facial droop, no muscle control,” she said. “I said I'm willing to take my chances. Just do something about it. It's just consumed me, and I'm miserable.”

Pain pills are part of the treatment, but in her case they don't last long, so an orthopedic physician's assistant last week performed an acupuncture treatment, injecting small gold needles into selected parts of her ear.

Her care is part of the Army's fledgling complementary alternative medicine program, which is testing new therapies, some of them unproven and one literally out of this world.

It's another option for GIs who have returned from combat with pain from a variety of wounds and illnesses, for whom the Army has spent billions on drugs that have resulted in complications, dependency, abuse and even accidental deaths and suicides.

Read more

Monday, August 29, 2011

Providers Treating Providers

The past several days I noticed many people posting about a study reporting the increasing popularity of acupuncture and other CAM among healthcare providers over the general population. Shock? Nope. I see my fair share of MDs, RNs, NPs, DPTs, PharmDs, LMTs and folks who work in the healthcare administrative arenas. They, more than anyone else, see the end effects of poorly managed chronic illness and reactive rather than proactive self-care. Contrary to popular opinion, they often make the best patients . . . and even joke about how bummed out they are that this stuff actually works!

My only gripe with the CAM classifications in the study is they include self-administered therapies like nutrition (which is an alternative to what, exactly, starving?) and exercises like pilates and yoga. I do not think anything that is diet, exercise, or rest related is complementary or alternative - you either do those things or you drop dead of something. Overall it was well done and I am glad to see an increase in acceptance that a patient's report of relief is a reliable resource, with or without an impressive postscript after their name!

Discussion Excerpt:

This study provides the first population-based description of CAM use by U.S. health care workers. Our analyses reveal that, overall, health care workers are significantly more likely to use CAM therapies, particularly mind-body therapies, than the employed U.S. population. This is not surprising as health care workers, particularly those in ambulatory care settings, are more exposed to these methods, and exposure is probably correlated with higher use. Our results are also consistent with findings of previous studies documenting a high prevalence of CAM use in narrowly defined health care worker populations. For example, one study found that 63 percent of nurse practitioners in Connecticut reported personal use of CAM (Hayes and Alexander 2000), whereas another reported 96 percent of critical care nurses across the United States had personal experience with CAM (Lindquist, Tracy, and Savik 2003). Studies of physicians reveal a lower prevalence of personal CAM use. One study reported that 24 percent of physicians in Denver had personally used CAM (Corbin Winslow and Shapiro 2002), whereas another found that 49 percent of primary care clinicians in Kentucky reported personal use of CAM in the past year (Flannery et al. 2006). A high percentage of health professions faculty report CAM use, with 83 percent of primary care faculty at one medical school having ever used CAM (Levine, Weber-Levine, and Mayberry 2003) and 100 percent of nursing faculty in another university having personally used a CAM therapy (Halcon et al. 2003).

Read More
Johnson, P. J., Ward, A., Knutson, L. and Sendelbach, S. (2011), Personal Use of Complementary and Alternative Medicine (CAM) by U.S. Health Care Workers. Health Services Research. doi: 10.1111/j.1475-6773.2011.01304.x

Tuesday, August 23, 2011

Engineering Explanations

Lately I have noticed my usual answers to the common questions "how does acupuncture work? I mean, what do the needles really do?" have not been working for the folks who want an explanation in 20 words or less. Although I provide excellent literature on theory, a few months ago I jettisoned my TCM explanation and shortened it to "the needle sensation helps direct the release and flow of endorphins to stimulate the body's self-healing processes." This seems to satisfy those who find things like Qi and meridians either too esoteric or too hippy dippy to accept as viable healthcare.

As it turns out, my simple explanation has evidence-based research to back it. The Columbia University electrical engineering department and University of Hong Kong medical faculty of the collaborated on a study published in the June 2011 issue of The European Journal of Physiology to explain how acupuncture works. Needling acupuncture points sends slow-moving acoustic waves into the muscles. This triggers a flow of calcium that interacts with white blood cells and produces endorphins which can relieve pain and nausea throughout the body. Accuracy and point selection are important. Correct placement generates a 6-8 centimeter wave whereas incorrect placement up to 1 centimeter generates only a 3-4 centimeter wave. This finding may help explain why sham acupuncture can have a therapeutic effect even if delivered via toothpick (as I have been saying as nauseam!).

Here is the abstract:
This article presents a novel model of acupuncture physiology based on cellular calcium activation by an acoustic shear wave (ASW) generated by the mechanical movement of the needle. An acupuncture needle was driven by a piezoelectric transducer at 100 Hz or below, and the ASW in human calf was imaged by magnetic resonance elastography. At the cell level, the ASW activated intracellular Ca2+ transients and oscillations in fibroblasts and endothelial, ventricular myocytes and neuronal PC-12 cells along with frequency–amplitude tuning and memory capabilities. Monitoring in vivo mammalian experiments with ASW, enhancement of endorphin in blood plasma and blocking by Gd3+ were observed; and increased Ca2+ fluorescence in mouse hind leg muscle was imaged by two-photon microscopy. In contrast with traditional acupuncture models, the signal source is derived from the total acoustic energy. ASW signaling makes use of the anisotropy of elasticity of tissues as its waveguides for transmission and that cell activation is not based on the nervous system.

Link to Study

Tuesday, August 16, 2011

The "Other" Provider: It's Time to Talk

Despite most intake forms including a section for vitamin, supplements, and other therapies, many people keep complementary and alternative treatments from their primary care provider. Sometimes this is because of a lack of knowledge that a particular health behavior is an actual therapy, that it has the potential to interfere with conventional treatment, or that it should be reported. Providers neglecting to ask,  lack of time to bring up the topic, and concern of provider disapproval or embarrassment over what they might think also contribute to underreporting. Although we are moving to a partnership model of healthcare, many of those in the "greatest," "boomer," and even "X" generations in the US are more comfortable with the paternalistic paradigm. The National Center for Complementary and Alternative Medicine, a division of the National Institute of Health, launched a program called "Time to Talk" for providers, patients, and organizations to foster communication and improve care coordination. The site provides a variety of material to help get the discussion started. I am especially impressed that it reassures providers they are not expected to be CAM experts and encourages them to refer patients to available evidence-based education materials rather than, as I have seen, run into their office to Google an herb or supplement to fein expertise.

asktell.gifCheck out the program at Time To Talk

What People 50 and Older are Using and Discussing with Their Physicians

Thursday, July 07, 2011

"Will Acupuncture Work for Me?"

The July/August 2011 issue of the Clinical Journal of Pain includes a German randomized-control study investigating potential patient characteristics that could predict positive outcomes to acupuncture for the treatment of chronic pain. Nearly 10,000 individuals were included in the study, all of whom received routine standard therapies with half receiving acupuncture over a three-month period. Although not statistically significant, the acupuncture group showed greater pain relief than the routine treatment only group. Potential predictors of positive outcomes include living in a multi-person household, former positive experience with acupuncture, female gender, and failure of other therapies.

These results support the contention that acupuncture, like many other therapies, is a helpful modality that may work better in some people than in others, Naturally, more studies are necessary to further investigate potential effect modifiers, however there is no strong evidence that you have to believe in acupuncture for it to work or that a practitioner can tell acupuncture is going to work for an individual based solely on their demographics and health history.

Friday, June 17, 2011

Research: Acupuncture and Moxibustion for IBS

An article examining treatment modalities for irritable bowel syndrome revealed acupuncture is promising as a stand-alone or adjunct therapy. In all of the studies below, improvement was demonstrated by adding or using acupuncture to treat IBS symptoms. Although sham groups also showed improvement, I do not agree with the authors that this means it is all an "in-your-head" placebo effect, especially as the last study cited showed the best improvement came from a combination of acupuncture and moxibustion therapy. Many "sham" controls elicit a therapeutic effect because all forms of acupuncture release endorphins, but the effect is more masking than curative. Long-term relief comparison studies between sham and true acupuncture are remarkably absent in the literature and are necessary to dispel the notion that you can stick a needle anywhere and get the same outcome.  Additionally, there is no "standardized" acupuncture treatment protocol for IBS because acupuncture uses pattern discrimination, not medical diagnosis, to determine individual treatment plans. 

Excerpt from the June 2011 issue of Alternative Medicine Review:

Acupuncture and Moxibustion
Acupuncture can cause physiological changes that affect various endogenous neurotransmitter systems. Of specific interest to the treatment of IBS is the influence of acupuncture and moxibustion on the serotonergic and cholinergic neurotransmission of the brain-gut axis. Both animal and human trials indicate specific targets for acupuncture on serotonergic, cholinergic, and glutamatergic pathways as well as reductions in blood Cortisol levels.

In a controlled, randomized pilot study, 30 subjects received routine clinical care or acupuncture for IBS. After three months of treatment, outcomes of acupuncture intervention revealed statistically and clinically significant improvements in symptom severity, including pain, distension, bowel habits, and QOL compared to usual care only. In this study, however, the type of IBS was not defined for the sample population.

In a large, randomized, controlled study, 230 subjects with IBS were assigned to one of three groups. The two intervention groups were either three weeks of true or sham acupuncture following a three-week run-in period of sham acupuncture therapy with a "limited" (friendly, interactive) patient-practitioner relationship, while the third arm was a waitlist control group. Findings indicated no significant difference in global outcome measurements between real and sham acupuncture, but both interventions showed significant improvement over the waitlist control group.

In another similar study, Schneider and colleagues randomized 43 subjects to receive either
acupuncture or sham acupuncture for 10 sessions(an average of two per week). Although the Functional Diseases QOL questionnaire (FDDQL) in this study revealed that both groups improved significantly in overall QOL, there was no difference between the two groups, suggesting that the effect of acupuncture was primarily a placebo response.

According to Anastasi and colleagues, a combination of acupuncture and moxibustion (acu/moxa)can be highly effective in IBS treatment. Twenty-nine subjects who met Rome II criteria were randomized into either individualized acu/moxa treatments or sham/placebo acu/moxa treatments. Results indicated that acu/moxa reduced abdominal pain, significantly reduced gas and bloating, and improved stool consistency over a four-week, eight-session intervention period. A Cochrane meta-analysis suggests larger-scale studies are warranted to confirm the benefits of acu/moxa in alleviating IBS symptoms.

Thursday, June 09, 2011

Another Blog Award!

Very happy to announce another blog award for Acupuncture News. While I do not bring Reiki into the writing often, both disciplines work with energy in their own way to help the body optimize functioning.

Monday, June 06, 2011

Symptoms Without a Diagnosis? Acupuncture Helps!

A recent study from the UK found significant improvement in patients with multiple physical symptoms after a series of five-element style acupuncture sessions. When the control group was offered the same treatment after the initial series was completed, they reported similar improvement. What I find interesting about the "mystery symptoms" moniker is the bypassing of somatoform disorder as a diagnosis. This condition tends to do well with psychotherapy, an aspect of treatment many acupuncturists include as part of their practice, whether or not it is formal or intentional. I do not downplay the significance of acupuncture as a contributing factor to recovery and improvement - as part of my current doctoral training in mental health I have been integrating auricular acupuncture as part of CBT with impressive success. It is important to give credit to the interpersonal aspect that contribute to symptom improvement and look at designing future studies that make clear differentiation between interventions and with clear measurement of  their individual and/or combined effects effects. 

Acupuncture for mystery symptoms

The researchers looked at a group of 80 adults with an average age of 50 years, 80% of whom were female. All of the patients had consulted their GP at least eight times in the past year; they had symptoms such as chronic pain, fatigue and emotional problems that affected work; around 60% had symptoms of musculoskeletal health problems which had been ongoing for a year. The patients had each had different experiences: some had spent time in hospital, visited outpatient clinics, undergone physiotherapy, chiropody and counselling, some had also had MRI scans and visited complementary therapists.

Dividing the study participants into two random groups, one was given acupuncture treatment of up to 12 sessions over a period of 26 weeks. (The same treatment was offered to the control group, once the 26-week period was complete.) At the end of the treatment period, the patients completed questionnaires to assess their overall health. The acupuncture group had a significantly improved score, when compared to the control group. Once the control group were also given the acupuncture treatment, their results also improved. The beneficial effects continued for up to a year afterwards.

Read More

Tuesday, May 24, 2011

Massachusetts Bill to Mandate Acupuncture Coverage

Most all of us can agree we have been operating under the model of disease care, not health care, for the past several decades.  Prevention is the best medicine and acupuncture is one of several modalities that help individualizes make lifestyle choices to benefit their health and well-being. While passing national legislation as proposed in HD 1593 would be a boon to my practice (I would have to hire someone to run the office - yeah, an excuse for an annual Christmas party!),  mandating coverage for procedures not commonly used by the majority of the people bothers me on a personal (and self-insured) level.  Since KY is still fighting for "license" instead of "certification" and none of the large insurance companies will accept acupuncturists directly into their network, I do not see this state leaping on the bandwagon without an angel lobbyist trumpeting the cause. The argument is pretty compelling, in any event:

Acupuncture Insurance Legislation
● Under Massachusetts’ mandated universal healthcare and insurance system very few insurers
cover acupuncture services.
● Bill HD 1593 makes acupuncture services accessible to all families in every income bracket.
● Bill HD 1593 requires that all individual or group accident or health insurance policies, issued
by an insurer or non-profit health service corporation, provide benefits for services rendered by a
licensed acupuncturist in the state of Massachusetts.
● The consumer should have equal choice among all professionals licensed to practice acupuncture.
Acupuncture Training:
● Acupuncturists licensed in Massachusetts are regulated by the Board of Medicine .
Acupuncturists take a minimum of 2050 hours of training in acupuncture in addition to required
basic science and western biomedical courses. This is the equivalent of 3 to 4 years of study to
achieve an entry level degree of Master of Acupuncture and Oriental Medicine.

Cost-effectiveness of Acupuncture:
● According to a study in Washington state, the addition of mandated insurance coverage for
acupuncture and other complementary medicine did not significantly escalate healthcare costs.
● Costs actually decreased for acupuncture and complementary medicine users in high disease
burden groups due to a reduction of more expensive conventional care.
● The carpal tunnel syndrome study by Naeser et al. 2002 showed a significant cost savings with
the use of acupuncture compared to conventional treatment. A case of CTS medically treated
without surgery costs $5246 compared to $1000 for 15 laser acupuncture treatments at $65 per
treatment. This represents a saving of $4246 per patient with acupuncture treatment. The cost for
CTS surgery was $21,000 per patient and some patients were able to avoid surgery with 15 laser
acupuncture treatments totaling $1000.

Clinical Efficacy:
● In 1997 the NIH approved acupuncture as an adjunctive treatment for several conditions
including pain, nausea,asthma, carpal tunnel syndrome and paralysis from stroke.
● Over 500 positive clinical trials, measuring the efficacy of acupuncture, have been conducted in
the past three decades.
● There are 50 systematic reviews of acupuncture in the Cochrane databases. Overall, the trend has
been favorable, advocating the use of acupuncture in a clinical setting as an adjunct treatment
with conventional therapies, where suitable (Witt et al. 2006).
● Positive studies include acupuncture treatment for low back pain, neck pain, osteoarthritis of the
knee and hip, fibromyalgia, rheumatoid arthritis, TMJ, headaches, infertility, pain and nausea in
cancer patients.

Safety of Acupuncture:
● Acupuncture is a safe and cost-effective form of medicine that has been practiced and refined for
more than 2500 years. Acupuncture uses ultra-thin needles to balance and increase energy and
stimulate the nervous system to release brain chemicals for relaxation and well being.
● As of 2008 the Committee on Acupuncture shows 679 acupuncturists licensed in Massachusetts.
● From 2004-2008 the total number of complaints lodged against acupuncturists in Massachusetts
numbered 14, with 2 of those leading to disciplinary action and 2 to denial of license. This
reflects the general safety of the practice of acupuncture and this is true nationwide as well.
● Studies in Europe and Japan showed that less than 0.2% of all individuals treated with
acupuncture experienced adverse effects.

Friday, May 20, 2011

Spring Cleanse

I just encountered a press release selling a Chinese Medicine-Based 21-day Cleanse developed by an acupuncturist, Reiki practitioner, yoga instructor, feng shui expert, and behavioral neuroscience something-or-other.  Off the top of my head, there are half-a-dozen excellent Chinese Medicine diet books on the market that contain guidelines for cleanses - most notably The Tao of Healthy Eating and Healing with Whole Foods. Perhaps this program offers something new and revolutionary and  am not going to knock it unless I try it. In the meantime, here are the instructions to a similar cleanse program I give to my clients for a lovely 3-day spring detox.

Why Cleanse? Clearing your schedule for a cleanse allows you to watch, moment to moment, the cause and effect of food and lifestyle choices that often remain unnoticed. It also provides a time for reflection and fresh insights into how diet and lifestyle habits are serving to support or undermine our health.

5 Herbs for Cleansing

* Milk thistle (Silybum marianum), known for centuries as a liver cleanser, has been clinically shown to increase levels of glutathione, the amino-acid compound that's necessary for toxin removal.

* Licorice (Glycyrrhiza glabra) supports the liver, the adrenals, and the immune system. It also acts as a gentle laxative. Licorice may not be appropriate for patients with high blood pressure, so consult your doctor before using it if you are at risk.

* Dandelion (Taraxacum officinalis) stimulates the gallbladder, the kidneys, and the liver.

* Schisandra (Schisandra chinensis), a Chinese tonic herb, is a multitasker. "It's an antioxidant, an anti-inflammatory, and a liver protector. Talk to your doctor if you have high blood pressure.

* Burdock (Arctium lappa), helps protect the liver and clears toxins that lead to skin eruptions like eczema and acne.

7 Detox Foods These foods harbor healing promise for those looking to detox--and they're safe to consume every day. Apples and grapes are high in fiber to cleanse the colon. The pectin present in apples helps detoxify the gut, while the phytonutrients in grapes support the immune system, which in turn addresses toxins in the body. Artichokes are a source of antioxidants and liver-supporting cynarin. Artichoke not only cleanses this organ, but also helps convert the inactive T4 thyroid hormone to an active T3, which helps to increase metabolism and weight loss. Artichoke also helps the liver decongest fats. Cranberries kill bacteria in the urinary tract and contain digestive enzymes that cleanse the lymphatic system. Leafy greens like chard, kale, spinach, dandelions, chickweed, and salad leaves not only are among the most nutrient-rich vegetables, they help purify the GI tract. Lemons contain antioxidant, antiseptic, and cleansing substances. Once ingested, lemon's alkaline effect helps counter excess acid, while its high vitamin-C content bolsters the immune system. Whey, a milk protein that's rich in amino acids, offers immune-system and bone support. Research has shown it also helps the body produce more glutathione, facilitating toxin removal.

The following is a recipe for a basic cleanse; you can follow it exactly or adjust it to meet your personal needs. It calls for a light diet, herbs to support organ function, and beneficial yoga poses. This cleanse provides the benefits of fasting without the hardships. When toxins are released from fat reserves during a fast, the body has insufficient nutrient support to rid itself of toxins. This may result in headache, fatigue, and other problems, so anyone tempted to fast should consult a physician.

As you cleanse your inner dwelling, take time to purge your outer environment as well. Do you slather yourself with lotion containing artificial colors? Fill your shopping cart with only non-organic foods? Bit by bit, you can lessen your body's toxic load, leaving more energy for battling factors you can't control.

We are creatures of habit, and can get into familiar patterns of eating, moving, resting, thinking, and feeling that aren't necessarily optimal. Spring cleansing challenges those bad habits and sets a standard for a healthier lifestyle.

8 ounces filtered water
2 tablespoons lemon juice
1 tablespoons maple syrup
Dash cayenne pepper powder/concentrate 

2 teaspoons green superfood
1 ounce unsweetened cranberry juice
8 ounces water
Three Day Cleanse
Drink plenty of filtered water each day, take a multivitamin, and allow time for extra sleep. Each day include 8 ounces of lean protein, fresh or steamed vegetables, and 4 servings of fruit, including 2 organic apples for fiber.

Morning: Drink 8 ounces each of Master cleanser and Cranberry Elixir. Take one tablespoon of cod liver oil and/or Omega complex oil, and 50 drops Schisandra tincture.                                                  
Yoga Pose: Cobra pose Lie on your stomach with legs outstretched. Place your palms on the floor near your rib cage. Inhale as you press your hands into the floor and lift your chest, keeping your hips anchored on the floor and pressing down with your pubic bone. Hold for 3 to 5 smooth breaths, then lower to the floor. Repeat 3 times. Cobra Pose puts pressure on the abdomen, assisting elimination. 
Afternoon: Take 2 packets of whey protein, 2 heaping teaspoons of ground milk thistle seed, and 1 cup of dandelion tea.                               
Clean up your environment. Swap your household glass cleaner, bathroom scrub, and floor wax for natural alternatives from the health-food store. Or save money by making your own greener cleaners with natural ingredients such as vinegar and borax.   
Evening: Drink 8 ounces of Cranberry Elixir., one tablespoon of organic flaxseed oil, and 50 drops of schisandra tincture.                        
Yoga Pose: Corpse: Lie on your back, feet and arms extended and comfortably relaxed. Let your weight sink into the floor, and relax everywhere. This pose keeps bringing attention back to the sensations of the body, so we get glimpses of where we're holding tension. Releasing nervous, mental, and emotional stress is of utmost importance when we cleanse.  

Morning: Repeat day one routine. Yoga Pose: Lying Twist. Lie on your back, your arms stretched out to the sides, in line with your shoulders. Bring your knees to your chest. Slowly let both knees fall to your left side; turn your neck and look to the right. Breathe for a few moments, then return your knees to center and repeat on the opposite side. Twists massage the internal organs, encouraging sound digestion, improving circulation, and helping to detoxify the organs.  
Afternoon: Repeat day one routine.  Commit to whole foods. Start with one or two packaged foods you consume most, or those most likely to be contaminated with pesticides (peaches, strawberries, apples, spinach, nectarines, celery, pears, cherries, potatoes, and sweet bell peppers).  
Evening: Repeat day one routine and Corpse Pose. 

Morning: Repeat day one routine.  Yoga Pose: Seated Forward Fold. Sit with your legs crossed, back straight. Slowly lean forward, relaxing your neck, shoulders, and spine into a  rounded position. Remain folded for 5 to 10 smooth breaths, rise up, switch the cross of your legs, and repeat. Forward folds put pressure on the legs, triggering the liver, gallbladder, and lymph channels and promoting proper elimination patterns  
Afternoon: Repeat day one routine. Reassess your beauty routine. Pick one or two products to swap for natural options. Start by assessing your skin cream, since the ingredients end up in your bloodstream.   
Evening: Repeat day one routine and Corpse Pose.

Thursday, May 12, 2011

Jing Office News

Since April showers brought May . . . . showers, it seemed the perfect time to rearrange the office for a fresh perspective. We are excited about the new layout, upcoming extra touches, and expansion of hours and products. A quick reminder that Jing will be closed next week while I am in Memphis finishing up my doctoral work for this semester. It is going to be a great Summer!

Thursday, March 31, 2011

China Gives Limited Approval to Western Medicine

China Gives Limited Approval to Western Medicine
(humor, fictitious, April Fools!, author unknown)
Sin Hua, China News Agency, April 1, 2001

At the conclusion of a 3-day meeting held in the Great Hall of the People in Beijing, March 28-30, an elite panel of 12 Traditional Chinese Medicine (TCM) practitioners declared, "There is sufficient evidence of Western Medicine's effectiveness to expand its use into TCM and to encourage further studies of its physiology and clinical value". "In particular", the panel's report stated, "Western Medicine shows promise as adjunctive treatment to TCM. As a stand-alone medicine, however, its efficacy is mainly in the areas of acute and catastrophic care that comprise a relatively minor percentage of total patient complaints."

The consensus report was particularly critical of biomedical research design, since the panel had based their assessments solely on data from randomized controlled trials. Key points of the critique were:

Biomedical trials are designed to determine the mean response to treatment. This outcome is of limited value to TCM practitioners who are trained to devise individualized treatment protocols. Biomedical trials test one drug at a time. This approach is bound to reveal unwanted side effects. In contrast, TCM seeks combinations of herbs to balance out adverse effects of individual herbs.

Diseases chosen for study in biomedical research are, too often, imprecise collections of symptoms, such as Irritable Bowel Syndrome or Chronic Fatigue Syndrome. These categorizations lump together different conditions that are readily distinguishable by TCM diagnosis.

"It is also our impression", the report continued, "that Western Medicine is based in a belief system that is powerfully reinforced by the large sums of money patients and insurance companies are willing to pay for treatment."

"We strongly recommend", the panel concluded, "that patients should be treated with Western Medicine only on a referral basis from a practitioner of TCM".

The most significant recommendation of this group is that only qualified TCM practitioners should be allowed to practice conventional medicine. There should, in effect, be no 'lay' doctors. In light of this, T.C.M. practitioners are advised to acquire at least 200 hours training in order to competently practice conventional medicine.

Friday, March 18, 2011

Sleep Tight!: New Study Shows Chinese Herbal Medicine Works for Sleep Difficulty

A prospective follow-up study evaluating the efficacy and safety of the popular Chinese herbal preparation Suan Zao Ren Tang (SZRT) found a significant reduction of sleep disturbances and daytime dysfunction in women undergoing climacteric change (aka: the menopausal era) after four weeks of therapy. Several self-report scales were used to measure outcomes including the Pittsburg Sleep Quality Index (PSQI), the World Health Organization Quality of Life (WHOQOL) assessment, and the Menopause Rating Scale (MRS). Results indicate that the more severe the symptoms, the more noticeable the alleviation o disturbance. Out of the 67 patients who began the study, 3 withdrew after reporting stomachache, diarrhea, or dizziness. These side effects may have been avoided by simultaneous administration with food or with dose adjustment. This is an excellent indication that SZRT, which has been used clinically for over a millennium, has a measurable and statistically significant benefit. Further large scale double-blind, randomized-controled studies may be developed based on this research to compare the efficacy of SZRT to placebo or other pharmaceutical or medicinal therapies.

Suan Zao Ren Tang as an original treatment for sleep difficulty in climacteric women: a prospective clinical observation by Chia-Hao Yeh, Christof K. Arnold,Yen-Hui Chen, and Jung-Nein Lai was published in the March 2011 issue of Evidenced-Based Complementary and Alternative Medicine

Tuesday, March 08, 2011

The Gardacil Debate

As a Western and Eastern medicine provider that focuses on health promotion and disease prevention, I strongly hope for that the quest for the ultimate cancer vaccine will end for the good and we will all get our shot, go home, and be healthy. I also strongly advocate for due diligence in researching any substance you plan to put into your body rather than succumbing to emotional fear tactics used to convince you that taking, or not taking, a particular regimen makes you ignorant and irresponsible.

Vaccination for HPV and cervical cancer is something parents and individuals need to decide in partnership with their provider. However, I have to voice my own irritability at the manner in with Merck initially used their "One Less" campaign to insinuate getting the vaccine for your daughter made you a responsible parent because it would prevent her from contracting HPV or cervical cancer ever . . . mostly. I found it interesting that, unlike commercials for other pharmaceutical products where use in conjunction with lifestyle recommendations are made, this one left out safe sexual practices as a means of prevention. I am also piqued that even though Garacil has been approved for use in males, it is not getting the same goose-for-gander recommendation for vaccination (it reminds me of the very old condom commercials that told young men not to let the women stop you from using one . . . as if women are the ultimate apple-wielding culprits of STIs!).

For those who are or have children ages 9-26 who want to look at both sides of the propaganda campaigns, here are some resources.

CDC Information on Gardacil

Merck's Gardacil Page (remember Vioxx?)

Truth About Gardacil (remember when the MMR caused Autism?)

One More Girl Pledge Page

Thursday, February 10, 2011

Another Top-50 Mention

We are proud to announce Sonography Technician named Acupuncture News one of the top blogs by a pro. They also list top sites and blogs by area, specialty, and groups. Check it out here!

Sunday, February 06, 2011

Hawaii Has it Right & Needs to Keep it That Way!

Acupuncture certification in Kentucky took several battles to get through the legislature, and while our minimum standards for practice are not as rigorous as they are in other states, at least we restrict other allied health professionals from practice unless they have the same level of training. Except MDs, of course. Even in New Mexico where I still maintain my DOM license, the minimum standards that require the entire NCCAOM certification series, a full MSOM degree, and a live clinical exam exempt MDs from having even a modicum of real training. PTs ("dry needling"), DCs ("meridian therapy"), or MDs ("medical acupuncture") are allowed to practice in many states with token training hours citing that acupuncture is somehow in their scope of practice even though no formal education is provided. By that rational, I should be able to call myself a nutritionalist and a psychologist since I took classes in those disciplines as part of my APRN and TCM training.

Much as passing the NCLEX and graduating from an AACN-accredited school are the minimum for state licenser as an RN and passing the all three USMLE exams and graduating from an ACGME accredited medical school are required for MD licensing, NCCAOM certification and masters-level training from an accredited ACAOM school should also be the minimum requirement for state licenser (with one nationally recognized credential, thank you).

States like Hawaii have it right. Everyone has to attend a 3200+ masters degree program to be eligible for licenser regardless of other degrees, licenses, or certifications. This regulations helps ensure safe standards of practice and the consumer can feel confident that their provider is qualified provided they are licensed.

Hawaii should be the national model.

Unfortunately, a new bill has been proposed that will damage the credibility of the profession by letting unqualified practitioners be eligible to practice without adequate training. For a profession gaining support for mainstream use in healthcare as the result of increased research, this action is embarrassing and a hazard to safety and efficacy. Not only does Hawaii need support to maintain their current standards, we all do.

Acupuncturists to fight bill they say will lower standards

Thursday, January 27, 2011

Addiction, Acupuncture, and the Army

Prescription drug abuse is a rampant problem in the civilian world, so it should come as no surprise that misuse of medication plagues a military that has been both physically and mentally drained over the past decade. Pain happens and narcotics can be used appropriately and effectively to treat and manage discomfort. Addictions frequently have a root in liberal prescribing practices, inability to deliver non-pharmaceutical pain management modalities, and underlying or untreated mental health disorders. However, we do live in an era where putting the blame solely on the prescriber or claiming ignorance of the abuse potential of the drug are becoming anachronistic excuses. Increasingly, VA and military facilities across the country are using CAM therapies like acupuncture, yoga, and meditation for treatment of PTSD, addiction, and pain. While this solider incorporated some modest acupuncture in his therapy, the fact he has shared his struggles and openly advocates for holistic approach to pain will help both the profession and the heros.

3-star opens up about battle with addiction

Army Lt. Gen. David Fridovich says that, for years, he has regularly consumed narcotics and painkillers to deal with chronic pain — and now he’s sharing his story
By Gregg Zoroya - USA Today
Posted : Wednesday Jan 26, 2011 21:38:59 EST
TAMPA, Fla. — Standing before a packed hall of 700 military doctors and medics here, the deputy commander of the nation’s elite special operations forces warned about an epidemic of chronic pain sweeping through the U.S. military after a decade of continuous war.
Be careful about handing out narcotic pain relievers, Lt. Gen. David Fridovich told the audience last month. “What we don’t want is that next generation of veterans coming out with some bad habits.”
What Fridovich didn’t say was that he was talking as much about himself as anyone.
Fridovich agreed in recent weeks to talk openly about his reliance on drugs as part of what he says is a personal commitment to push the Army into better addressing pain management and drug addiction.
“I was fighting the pain. And I was fighting the injury. And I was fighting the narcotics,” he says. “We have an obligation to the soldiers to look them in the eye and say, ‘I know what you’re going through. You don’t want to be like this for the rest of your life. You don’t have to be.’ ”
Pentagon statistics show the number of pain-relief prescriptions given to troops, including narcotics, growing 86 percent from 2001-09, when 3.7 million doses were handed out. That dipped last year to 3.5 million prescriptions, the data reveal, but is still more than any year prior to 2009.
He says Army medicine must be better prepared to treat pain with aggressive monitoring of medication, drug education, acupuncture, nutrition and proper exercise.

Sunday, January 16, 2011

The Balancing Act

I normally do not promote promotion of medical acupuncture since, contrary to the contention of this article, most physicians who practice medical acupuncture are not experts in both fields, but rather specialists in one and dabbles in the other. I will forgo my usual rant about weekend courses, dry needling practices, and cookbook style acupuncture and instead be mollified that the EU and USA appear to be on the same 1/4 page of acceptance when it comes to insurance coverage for evidenced-based CAM therapies.

Getting the Balance Right (excerpt)
By Lizzy Beckwith for CypresNews Jan. 16, 2011

Even diehard medical traditionalists accept that acupuncture is excellent for pain relief. Back pain, knee pain, tennis elbow as well as pain caused by many other health issues, including cancer, can be greatly relieved. It is also beneficial when traditional drugs have ceased to be effective or dosages need to be reduced due to side-effects. Acupuncture’s approach to pain relief is more holistic, using the body’s own abilities to find balance, heal, or release pain relieving chemicals. Mainstream medical specialists often recommend" acupuncture to patients to help with their recovery.

Read More

Saturday, January 01, 2011

Setting Goals for 2011 and Beyond

Setting SMART Life Goals

Setting goals is the key to staying on track and providing a clear direction to your life. Start with an overall self-concept that you want to achieve. It can be as simple and straightforward as “I am kind” or “I am content,” and as complex as “I am a holistic success” or “I am an accomplished innovator.”

In order to become the person you want to be, it is important that goals be SMART goals. They should be specific, measurable, attainable, relevant, and time-bound. Set short-term goals for as little as 1-3 months, medium term goals for 6 months to a year, and long-term goals for 5 years or more. You can also include a lifetime accomplishment list. Start with short term first and experiment. Set your goals in the following categories:


Make sure to dedicate plenty of time and though into this task. Goals should be neither fickle nor fixed. Goals are dynamic. As you change, your goals will change.

Put your list in a place where you can look at them often, ideally every day.  If you feel you are getting off track, set small and precise weekly or even daily goals to give yourself a sense of accomplishment. You can also involve your loved ones and have a set of both personal and family goals. Check out this 30-day challenge to get you started on the right foot.

Enjoy the process and may all your goals be achieved!