4 Myths of Community Acupuncture

August 11th, 2010

There is a new style of acupuncture being practiced all over the country. Practitioners in this field see more patients per hour and treat multiple individuals in the same room, allowing them to still cover their overhead but divide their cost per treatment accordingly. This makes them less expensive, but comes with limitations on time and access to the acupuncture points. For those who have never been to see a regular acupuncturist, these differences are not readily apparent. Unfortunately, those who practice community-style acupuncture erroneously advertise their services as traditional and more effective, without mentioning the drawbacks of these limitations. Below are four quotes found on the FAQ page of the Community Acupuncture Network’s website, and a refutation of each.

 1. “Acupuncture has been a community based medicine for most of its long history. In Asia, acupuncture has traditionally been practiced in group rather than individual settings.”

In the ancient tradition of Chinese medicine, acupuncture was practiced in different settings. There were some who practiced in clinics and some who were traveling healers (the famous “barefoot doctors”). But the most skilled practitioners worked for the royal families and did treatments on a strict one-on-one basis, which was considered to be the optimal ratio for the highest quality health care. Even today in China practitioners work in a variety of settings, just as it is here in America. Some have private practices, some work in hospitals, and some work in clinics. Those in private practice see patients on an individual basis. Those in hospitals work side-by-side with physicians and patients can choose to be treated with eastern or western medicine or even a combination of both, an option we don’t even have here. The third group work in clinics where patients are treated all together in one large room. However, there are two very important difference as to how these clinics operate in China that is notably different from how community acupuncture is practiced here. First, in China there is not as much embarrassment about being naked so, if necessary, patients may completely disrobe in front of each other to allow access to certain acupuncture points or parts of the body that need to be treated. In American society this would be impossible so community acupuncture here is limited to treating only those parts of the body that can be reached while fully clothed. Second, in China clinics use regular examination tables for treatments while here it is usually done with patients sitting in armchairs. This means that in America, community acupuncture is also limited by the inability to access to all of the points on the back of the body. So in community acupuncture, as it is practiced here in America, over half of the total acupuncture points are inaccessible.

 2. “For acupuncture to be most effective, patients need to receive it frequently and regularly.”

In Chinese medicine there is no frequency of treatment that is considered to be ideal for all people and all conditions. The frequency and regularity of treatments is determined in many ways, particularly by how long you have had your condition. For example, the longer you have had something, the less often you will need treatments. This is because chronic conditions are more ingrained with deep roots, and they generally tend to shift slowly and gradually over time. On the other hand, conditions like colds will definitely respond faster so frequent treatments would be ideal. Other factors that can influence frequency and regularity of treatment include your general state of health, your age, the severity of your symptoms, and your compliance with taking herbs and making dietary and lifestyle changes. So, for some conditions daily treatments may be idea, while for others treatments every other week would be better. If the patient’s goal is to utilize acupuncture for preventive medicine or to maintain wellness, they may come in even less often, say once per month to once per season.

3. “As acupuncture has moved toward the mainstream, it has been forced into a paradigm of one-on-one treatments and high prices, which has decreased not only patient access but treatment efficacy.”

There is no form of health care for which the efficacy of a treatment is dependant on the number of individuals in the room or the amount charged for the service. In Chinese medicine efficacy depends much more on the skill of the practitioner to make an appropriate diagnosis and select the appropriate course of treatment. On the contrary, I would argue that the limitations of community acupuncture have a greater potential to decrease treatment efficacy. First is the limitation of time, which makes it especially hard to make an accurate diagnosis. While most acupuncturists see about one patient per hour, community acupuncturists will see up to four. This does allow them to split their costs and do cheaper treatments but it restricts the time available for each patient. A high quality session with an acupuncturists can include questions about all bodily systems and functions, especially in the case of chronic and/or complicated cases, and this alone can take 30 to 45 minutes. In addition to this there may be a physical exam, dietary and lifestyle counseling, and discussion of a treatment plan. There should also be time allowed to answer patient questions and, especially in the case of pain, to do some of the hands-on therapies acupuncturists are trained to do like tui na (Chinese medical massage), cupping (glass orbs suctioned to the skin), moxibustion (smoldering herbs used to warm acupuncture points), or acupressure (applying manual pressure to the acupuncture points). There is simply no way to complete all of this in just 15 minutes. The second limitation in community-style acupuncture is on access to the acupuncture points. Because all of the points on the back of the body and any point that requires disrobing are off-limits, the appropriate treatment may not even be possible. For example, the most common reason that patients come in is for pain and the most common area of pain is the lower back. In a community-style clinic not only would the practitioner be unable to treat the lower back directly, they would also be unable to do tui na or any other hands-on treatments in that area.

4. “Community acupuncture clinics represent a return to tradition.”

Actually, this medicine is practiced in many different cultures in many different ways and there are literally hundreds of different traditions. In India there is a traditional form of acupuncture that is part of Ayurvedic medicine that is based upon the Suchi Veda, a 3,000 year old text that predates the written record of Chinese medicine. In this tradition the needles were dipped in herbal liquids. In Japan traditional acupuncturists use needles that are much thinner than those used by the Chinese and there is one particular style in which only one point is needled per treatment. The Japanese also developed shoni-shin, a type of pediatric treatment in which various metal objects are used to poke, prod, or scrape (but not pierce) the acupuncture channel system. They even have a 400-year old tradition of blind acupuncturists and currently about a third of all acupuncturists in that country are blind. In Korea there is a focus on needling the hands only. This is a kind of “microsystem” acupuncture in which the different areas on the hands are said to have a one-to-one correspondence with other specific areas of the body. Another microsystem form is auricular (ear) acupuncture, which is used extensively in America by members of the National Acupuncture Detoxification Association to help patients break drug addictions. There are also separate traditions in other countries like Vietnam and Tibet. Even in China there are multiple branches of this ancient medicine, with hundreds of guarded family tradition. In truth, there are many different traditions in this field and community acupuncture represents a new way in which this medicine is being practiced.

The Amazing Ginkgo Tree

August 6th, 2010

There are many reasons why ginkgo is a popular symbol. Ginkgo trees are not only beautiful, they are an important medicinal plant with a fascinating story. The ginkgo is considered to be a living fossil and is the only remaining representative of the Ginkgoales order, which had 19 original varieties. Fossils from these plants date back 270 million years, putting the ginkgoes on the planet before the dinosaurs. At one time they were common and widespread in Asia, Europe, and North America. If you look closely at a ginkgo leaf you will notice how the veins are all the same in width, beginning at the stem and fanning out, and there are at most two lobes. This is quite different from more modern tree species which have multiple lobes and a central vein that branches out into smaller and even smaller veins. Also, like redwoods, ginkgoes have very long life spans, with some individuals estimated to be more than 3,000 years old. 

Ginkgoes were first discovered by Europeans in the 17th century in Japan by the German botanist Englebert Kaempfer. Up until then the plant was considered to be extinct, as it was known only through fossil records. The tree, however, had survived in Asia in Buddhists monasteries and Shinto shrines, where they had been revered and cultivated since around 1100 AD. These monasteries and shrines offered protection for the trees, conserving the natural landscape around them, acting as ancient nature preserves. The tree is thought to originate in eastern China in the Xuangcheng province, spreading first to Japan, around the same time that Zen Buddhism was introduced there. 

Ginkgo biloba is used as a medicinal plant in both eastern and western herbal traditions. In the west the leaves are taken to enhance blood circulation and oxygenate the heart. They are also known to increase the supply of oxygen to the brain, making them applicable for conditions marked by memory loss, such as Alzheimer’s. They are anti-oxidant, reduce blood pressure, and inhibit clotting. They are also used for tinnitus, vertigo, hearing loss, impotence, and Raynaud’s disease. In the east the seed is favored over the leaf. It is prescribe for chronic coughs with wheezing and copious sputum. It is also taken for vaginal discharge and cloudy urine. The seeds are first mentioned in Chinese herbals published a long time ago, way back in the Yuan Dynasty (1280-1368). 

Toady ginkgoes are widely cultivated and propagated in both the east and the west, primarily as ornamental landscape trees. They are very hardy and are not easily susceptible to environmental pollutants. They thrive in places where the air quality is poor, such as in New York City, where they line the streets of Greenwich Village. There are even some ginkgoes in Japan that survived the 1945 atomic blast at Hiroshima in an area where all other life was obliterated. All are all still alive today, located in temples or public gardens. Because of this the Japanese consider the ginkgo tree to be the bearer of hope. Though the seeds of the ginkgo are edible and considered a delicacy in Asia, they are covered in a fleshy coating which some consider to be untidy for landscaping. Because of this, the seedless male tree is preferred to the female as an ornamental. This, unfortunately, has made it difficult for the tree to propagate itself naturally, and ginkgoes are still considered to be an endangered plant. Still, for a tree that was almost extinct not too long ago, the ginkgo is doing quite well.

The ginkgo is an important symbol for many reasons. First, it is an amazingly ancient tree. Surely there is an inherent wisdom in a plant that has survived for 270 million years. Second, this is a tree of great beauty. Who hasn’t appreciated the ginkgo in the fall, with its beautiful golden leaves? Third, the ginkgo is a powerful medicinal plant. It has been used in many healing traditions and over many centuries. Even today in America it is one of the top ten herbal supplements. And finally, the ginkgo is an example of how humans can consciously choose to help save a rare and endangered plant. This began almost 1,000 years ago with the Chinese Buddhist monks and continues today all over the world where this plant is appreciated and revered.

Chinese Herbal Pain Relieving Oils

August 2nd, 2010

I use liniments, or medicated oils, a lot in my practice and find that they really help my patients with their pain issues.  In Chinese medicine pain is seen as a blockage of the normal flow of energy and fluids so these oils contain herbs that move chi and invigorate blood. I apply them after acupuncture, coupling them with points that move qi and blood.  I can tell you for sure that the acupuncture and oils definitely enhance the effects of each other!  These oils typically include herbs like wintergreen, camphor and/or menthol, all natural pain relievers.  Below are some of the most popular varieties of oils that I use.

White Flower Analgesic Balm

  • ingredients: camphor, menthol, wintergreen, eucalyptus, lavender and peppermint in an oil base
  • for the temporary relief of minor aches and pains like backache, arthritis, sprains, bruises, or strains. Apply to the temples for headaches or to the sides of the nostrils for sinus congestion.

Zheng Gu Shui

  • ingredients: menthol, camphor, angelica, ginseng and other herbs in a rubbing alcohol base
  • very cooling and strengthening so excellent for torn or inflamed ligaments. Also used for acute bruising and swelling due to traumatic sprain and to heal bone fractures. Analgesic for pains of muscles, joints, bruises, and strains.

Po Sum On

  • ingredients: menthol, skullcap, licorice, cinnamon oil, dragon’s blood resin, and peppermint in a base of camellia oil
  • for the temporary relief of minor aches and pains like backache, arthritis, sprains, bruises, or strains. Apply to the chest as a vapor rub for congestion or use on insect bites to stop the itch.

Yintang: The Most Requested Acupuncture Point

July 19th, 2010

Yintang is the most requested acupuncture point and is found in the middle of the forehead. It is an “extra point,” a class of points that are mapped but do not fall on a specific acupuncture channel. This point has a few different indications but the most common reason it is requested is because it calms shen. Shen is a term used in Chinese medicine that doesn’t really have an exact translation in English. Basically it refers to the aspect of us that is not physical, like consciousness and thought, and our emotional and spiritual being. There are many points that calm shen and they are used in a wide variety of conditions like anxiety, depression, and insomnia, even pain and shock.

 Most acupuncture points have more than one indication and yintang is no exception. Like all acupuncture points it is valuable for treating local conditions such as frontal headaches. It also benefits the nose and can help when there is nasal congestion and discharge or sinus pain. I use it a lot in my practice, especially for stress and sinus allergies and infections.

The location of this acupuncture point corresponds to the third eye, a metaphoric eye in Hinduism and Buddhism that opens as our consciousness expands and we become enlightened. It is the location of the brow chakra, the 6th of 7 major energy vortexes that exist in our bodies, which has to do with inner guidance, mental clarity, and intuition. Even in western medicine this is an anatomically important location, where light enters the skull to activate the pineal gland. As darkness increases in the evening, the pineal gland is stimulated to secrete the hormone melatonin, which makes us sleepy. As the sun comes up and light increases, the pineal gland stops producing this hormone and we wake up.

My Health Care Philosophy

July 14th, 2010

I strive to offer my patients high quality Acupuncture treatments at the most affordable rates possible. Below is an explanation of some of my ideas about health care and my philosophy towards my practice.

I spend quality time with my patients.
One of the most common complaints I hear from my patients is that they feel like they never get to spend enough time with their health care providers. When they go to their appointments they aren’t able to explain what all of their symptoms are or ask their questions, and there is little time, if any, allotted for physical examination. Intuitively they understand that a proper diagnosis takes time. As it is today, most health care providers spend approximately five or ten minutes with each patient and they see dozens of individuals per day. In contrast to that I usually spend between an hour and an hour-and-a-half with you and usually see just five or six individuals per day. One of my most important jobs is to conduct a thorough intake so that I can understand not only the kinds of symptoms that you have, but also the underlying root cause, and that just takes time.

I give you my undivided attention.
I have a single treatment room and work with only one patient at a time. Because I don’t overlap appointments, I can give you my full attention. Plus, I intentionally allot plenty of time for each appointment, allowing me to work in an unhurried manner so that I can focus on you, my patient. This gives me time to conduct a thorough intake and examination and make a proper diagnosis. I also have time to answer all of your questions, explain your diagnosis and treatment plan, discuss your health care goals, and give you advice about dietary and lifestyle changes that you can do to help facilitate healing. If needed, I even have time to do all of the other things I do besides acupuncture, such as tui na, cupping, and moxibustion (see below). These are traditional hands-on treatments that practitioners of Chinese medicine are trained to do and I find that they greatly improve my patient’s results.

I do more than just acupuncture.
When you see an Acupuncturist you are really seeing a practitioner of Chinese medicine. Like physicians, our education is very extensive, requiring pre-medical studies and years of graduate school,  plus clinical practice, national licensing examinations, and continuing education. While in school we learn so much more than just acupuncture and I feel I owe it to my patients to utilize all the tools I have available to help them feel better. Plus, I find that my patients get better results if I combine acupuncture with these other therapies, especially in the case of pain, which is the most common reason people come in. Some of the many traditional techniques that I do include tui na (Chinese medical massage), cupping (glass orbs suctioned to the skin), moxibustion (smoldering herbs used to warm acupuncture points), and acupressure (applying manual pressure to the acupuncture points), plus the application of plasters (medicated herbal patches) and liniments (medicated herbal oils applied topically). We are also trained to offer dietary and lifestyle advice and in herbal formulation. I find custom herbal formulas to be more targeted and effective than pre-made herbal pills so I prescribe them quite often.

I work hard to keep my rates affordable.
The average price for Acupuncture in Asheville is $95 for an initial appointment and $75 for a follow-up. At the upper end some even charge $135 for an initial and $85 for a follow-up. In contrast to that I charge just $70 and $55. Many patients come in for chronic conditions that require a series of treatments so I also offer package discounts, and I even have special rates for children and seniors. Though I must cover all of the expenses of running an office, I work hard to keep my rates affordable without sacrificing the quality of what I do. I could charge less if I saw more patients per day and spent less time and effort with them. However, I really prefer to do fewer, higher quality treatments because I find that my patients get better results in a shorter amount of time. Another important part of my work is donating my time as a practitioner for free to local non-profit organizations like Project Access. I strongly believe in giving back to my community and keeping my rates balanced allows me to do this important community service.

I maintain your privacy and confidentiality.
The patient-practitioner relationship is built on trust so I conduct all of my appointments in totally private, soundproofed rooms, on a strict one-on-one basis. All treatment notes and files are kept in confidentiality in accordance with federal regulations and I will never give out your health care information without your express permission. This is not just a legal issue. I believe that privacy is an unbelievably important aspect of my work. It allows my patients to voice their true concerns and openly talk about what is really going on with them, both physically and emotionally. It also allows them to fully express their thoughts and feelings in a safe and private space, which gives me a deeper understanding about what is really going on. I find that for my patients this freedom of expression is often very healing in itself. The acupuncture treatments themselves often require privacy as well, especially if disrobing is necessary for access to the area of the body that needs to be treated, so working in a private room is actually essential to what I do.

I believe in practicing with compassion and intention.
My ultimate intention is to treat you with compassion and respect. Many people hesitate to seek treatment for their conditions because they fear that they will be judged or criticized by their health care providers. Some have even been dismissed or trivialized with damaging results. I understand that my role is not to judge you, but to care for you and help you achieve your goals. I want to work with you no matter who you are and no matter what your current health status is. I firmly believe that it is never too late to improve your level of wellness. Compassion is a very powerful concept and is the heart of my work, one that I think is essential to true heath care. As the famous Dr. Francis Peabody said in his final lecture, “The secret in the care of the patient is to care for the patient.”

Protect Yourself from Summer-heat

July 12th, 2010

Summer-heat is a condition that is caused by exposure to the excessive heat and humidity of summer. In western medicine this condition is called heat exhaustion or, if more severe, heat stroke. Exposure to the elements is a common contributing factor in illness and imbalance, but isn’t one we often think about because we tend to spend so much time indoors. Many of us are outside just minutes per day in little spurts as we move between our car and various buildings with controlled environments. Air conditioning, central heating, and devices that control humidity help us modify our interior spaces, significantly neutralizing extremes in temperature and moisture, and protecting us from wind and precipitation. During earlier times in human history, however, we spent a significant part of our day outdoors, and protecting ourselves from exposure was a daily concern. It is under these conditions that Chinese medicine was developed, so there is an emphasis in this field on how environmental factors can contribute to illness and disease.

Summer-heat is probably one of the most common ways we are affected by exposure in modern times. One reason is that we spend so much time in controlled environments that we are actually less acclimated to the outdoors. Our bodies just aren’t as practiced at neutralizing the effects of the elements. This is sort of like how over-protecting ourselves from germs can make us more susceptible to microbial infections. Another reason is that we don’t prepare. For our ancestors, exposure was a real concern and they were faced with life-threatening situations on a much more frequent basis. We, on the other hand, have become spoiled by easy access to artificial environments. Thinking about exposure is outside the scope of our day-to-day consciousness so we are less likely to do the things we need to do to protect ourselves from the elements. I also think that we have lost the general collective knowledge and awareness of what the early symptoms of exposure are. Unless you are were in the scouts or are trained in first aid, odds are you have no clue.

Summer-heat affects our bodies by causing them to overheat and dry out. The first signs of overheating are sweating and clammy, pale skin as our bodies attempt to release excess heat to help regulate our internal temperature. The drying effect of the heat makes our mouths dry and increases our thirst, causing us to crave the cooling fluids that we need. As our bodies dehydrate our blood volume actually decreases, leading to low blood pressure. Low blood pressure plus low blood volume means headaches and dizziness because we literally lack enough blood to nourish the uppermost reaches of our bodies. The effort to eliminate extreme amounts of heat through copious sweating saps our energy, causing fatigue and physical weakness. If a person with these symptoms does not rest, drink fluids, and remove themselves from the sun and heat, the condition may progress to the next level, leading to poor appetite, nausea, vomiting, diarrhea, and dark urine. Though rare, this condition can progress even further and become so extreme that it is life-threatening.

The best treatment for summer-heat is prevention: dress lightly when it is hot out, don’t exercise in the late afternoon when the temperature peaks, avoid extremes of heat and sun, and and stay hydrated. If you or someone you know starts to have early symptoms of summer-heat, get them out of the sun and heat to a cool and dark place and give them plenty of fluids. If things progress to the next level, they may need medical attention. In western medicine the most common treatment would be re-hydration with fluids and electrolytes through an IV drip. In Chinese medicine acupuncture and herbs are used to reduce internal heat, promote moisture in the body, and give relief from symptoms like nausea, vomiting, and diarrhea. Traditional southern remedies like iced honeysuckle flower tea re-hydrate us and cool us from the inside out. Watermelon is an excellent remedy as well. The sugars in this fruit boost energy and the juiciness replenishes fluids. Watermelon is also loaded with electrolytes and promotes urination. This combination stimulates the urinary system to eliminate heat from the interior of the body out via the kidneys and bladder. Stay cool!

Garlic is Not Good for You

June 23rd, 2010

I often hear people say, “But I thought garlic was good for you.”  While it is true that garlic is good for some, it is important to understand that it is definitely not good for others.  For example, garlic is a blood thinner.  This means that it is excellent for individuals who eat a rich and heavy diet or have high cholesterol.  However, this also means that it is not good to take if you are on a prescription blood thinner or if you have a clotting disorder or bruise easily.  For these people, garlic will actually aggravate their condition.  Because it is such a powerful blood thinner it is even suggested that you don’t take garlic for the two weeks leading up to any major surgery! 

By nature garlic is very oily, pungent and warming so it can lead to heartburn, belching, acid reflux, and intestinal gas, even in individuals who don’t normally suffer from these digestive issues.  For those who already have these conditions, they should avoid garlic because it will definitely make the symptoms worse.  And so it is with pretty much every medicinal herb that you know.  There is a general misunderstanding that because herbs are natural substances, they will have no side effects.  This is actually not the case.  Basically, you can assume that if something is strong enough to have a medicinal effect, it will probably have side effects and contraindications, and be good for some conditions and individuals but harmful for others.

The Nature of Things

June 16th, 2010

Knowing the properties of foods and herbs is essential when utilizing them for health enhancement. In modern times we attribute the benefits of these things to the vitamins, minerals, essential oils, fatty acids, and other chemical constituents that they contain. Our ability to know of these ingredients is given to us by modern chemistry. With chemistry we can break things down to their smallest parts, analyze their molecules, and measure quantitatively just how much any particular thing any particular substance has. But what if you lived before the advent of modern chemistry? How then would you understand and categorize foods and herbs and their healing properties? Well, Chinese medicine was developed way before modern chemistry and, because of that, Chinese practitioners were inspired to come up with some pretty innovative ways to categorizing things. What they did was to look at the nature of things.

In Chinese medicine herbs are classified not by their chemical constituents but according to certain properties that they have such as taste and temperature. As it turns out, the taste of an herb is a very rudimentary way to determine what types of chemicals it contains. For example, carbohydrates will give an herb a sweet taste, while minerals will make it salty. The temperature of an herb is not its actual temperature when taken with a thermometer but is its energetic temperature. An herb like peppermint, for example, is energetically cold, while an herb like cayenne pepper would be energetically hot. This is how Chinese medicine explains the fact that peppermint can cool a fever but should never be used to treat a cold when a person has severe chills. Or how cayenne can warm the cold hands and feet of an individual with poor circulation, but should be avoided in menopausal women with hot flashes. Each herb will have a different nature that makes it more applicable for treating some conditions over others. In other words, things are not inherently good or bad, they just have different properties.

IBM Partners with Traditional Chinese Medicine Hospital to Improve Treatment of Kidney Disease

June 3rd, 2010

IBM will be collaborating with South China’s largest hospital, Guang Dong Hospital of Traditional Chinese Medicine, to help doctors compile and understand disease treatments from thousands of existing Electronic Medical Records (EMR’s). The purpose of the project is to enable doctors to conduct empirical studies on the efficacy of Traditional Chinese Medicine treatments for Chronic Kidney Disease. IBM’s new analytical system makes it easier to extract and compile relevant information and detect patterns in data. Hospital President Lu Yu Bo said “As more and more medical data becomes available through electronic medical records and interoperable systems, there is a real opportunity for doctors and clinicians to use the information in new ways for improved patient care.”

IBM’s has been involved in medical research before, collaborating with healthcare professionals since the 1950’s. Past projects include work on understanding how influenza viruses mutate, development of better HIV antiretroviral therapy methods and projects on cancer, AIDS, and dengue fever. To read more about this interesting topic click here.

Céline Dion Expecting Twins with the Help of Acupuncture

June 3rd, 2010

Celine Dion recently announced that she is pregnant with twins through a combination of in-vitro fertilization(IVF) and acupuncture.  Five previous attempts utilizing IVF alone were unsuccessful.  The singer is currently 14 weeks along in her pregnancy.  He husband says, “We’re ecstatic! Céline was just hoping for a healthy pregnancy. She was hoping for one baby, and the news that we are having two is a double blessing.”  In IVF an egg and sperm are combined in a laboratory dish.  The resulting embryo is then transferred into the uterus.  The Mayo clinic and numerous studies have shown that IVF with acupuncture is 65% more successful than IVF alone.  Click here to read the source article.