I had a phone inquiry the other day when I got into the office.  The message said “I want to know more information, please call me back at 818.xxx.xxxx”.  No name, no other info.  So I returned the call and, after some explanations, got through to the person with the question.

 She wanted to know what services I offer.  I explained to her that I practice Traditional Oriental Medicine, which means I combine needles, herbs, dietary advice, exercise and other treatments, as appropriate, on a case-by-case basis.  I then told her that, in general, my patients all receive acupuncture and most of them opt for herbal formulae as an adjunct.

 She asked me about fees, and I countered by asking if she was coming in as a cash or insurance patient.  She said her insurance wouldn’t cover acupuncture, so I told her that acupuncture was $190 for the first visit, $85 thereafter and the herbs were usually between $5 and $10 per bottle and that a bottle tends to last for two weeks to a month.  I also explained that if she needed acupuncture with electrical stimulation the fees are $200 for the first visit and $95 thereafter.  I also explained that additional therapies might be needed depending on her individual case.  I said we would discuss those fees and treatments as the need arose.

 She had started sputtering whilst I was speaking, and she burst out “$85?  For that you only get acupuncture?”  I said, yes, acupuncture treatments cost $85, and she countered with “and that’s all, for $85?””  Her voice was rising, and in the background I heard someone asking if she was okay. She got herself under control and managed not to hang up on me, but it was a near thing and I MAY have been imagining the good-bye.

 I hung up, shaking my head, and went about my day.  But the whole thing has been bothering me.  I live in a large city, where people regularly go to Whole Foods for their lunch and Starbucks for their lattes.  They drive their large SUVs or their import cars through miles of miserable traffic, getting the worst possible mileage and pay some of the highest petrol prices in the country.  They have housekeepers.  They think nothing of going to Burke Williams for a massage and spending upwards of $150.  They regularly buy new clothes, eat out, buy music, and go to movies or the theatre.  The spend money like it’s Monopoly money, until it comes to their health.  Then, they want the most health care for the lowest price.

 Now, I’m not talking about the folks on a strict budget.  From those folks, I tend to get “Money’s really tight right now . . .” to which I say “As you probably saw on my website, I offer a hardship discount.” And they make an appointment, come in, and get their health back together.

 So what do really get for the price of a treatment in my clinic?  You get a health care practitioner who has spent more than 3000 hours in her initial training, as well as extensive, and on-going, post-graduate studies.  A practitioner who applies her knowledge of herbs, human physiology, diet, the five elements, Daoist study, theology and human nature to every treatment.  A practitioner who takes the time to talk, and more than that, to listen, with every patient.  To really hear what the underlying issue is.  A practitioner who won’t dismiss your health concerns, and who is part of a larger referral community so you are referred to other practitioners if that’s the most appropriate for your case.

 Not to sound like a greeting card, but your health really is the most important thing you “own”.  You really don’t have anything if you don’t have your health.  It’s important to find the right practitioner to become a partner in maintaining your health, not the cheapest.

 Think about it at least, and then go find the right health care practitioners to be on YOUR health care team.

What does that mean?

Does health mean physical vitality, mental acuity or emotional stability?  Or does health mean reducing the number of prescriptions in the medicine cabinet or the number of missed days at work?  For each person, health means something different, and is something we must each define for ourselves.

What would health look like to you and your family?

Would there be more time with your significant other or children?  Or would there be more money for vacations or special purchases?  Would it mean better sleep, and so, better days?  Would it mean gaining or losing weight and then being more active, physically or socially?  How would your family benefit if you were healthy?

What would it feel like to have health?

What would it feel like to wake up each morning without the lingering effects of disease (dis-ease) in your system?  What would it feel like to be able to function during the whole month?  Or plan for something three, six or nine months away?

For many people, this is a concept that is so far removed from their reality they refuse to entertain the notion.

For some, they’ve been told absolutely they CANNOT have health.  Perhaps this is true, but what if it isn’t?  What if the diabetic or hypertensive in your family could get treatments and actually “get health”?  What would that be worth to your family?  If you no longer had debilitating headaches or menstrual cramps?  If your back/neck/arms/legs/joints no longer ached/burned/throbbed?

And what holds people back from exploring their options?  Is it fear of failure or fear of success?

There are any number of terrible “invisible diseases” (Chronic Fatigue Syndrome / Myalgic Encephalomyelitis, Fibromyalgia, Lyme, Primary Immunodeficiency Disease and Dysautonomias to name a few) which it would be inappropriate to baldly state could be “cured” but what if the debilitating symptoms could be reduced.  And what is that worth?

A leap of faith?

Three or four visits to a health care provider who treats the whole body to see if you get any relief?

What if it worked?  What if it didn’t?

When counselling adult students returning to school after years in the workforce, I often had to field versions of this question. “What if, after going to school full-time for four years, I don’t go into practice as an acupuncturist?”  And I would answer them “What if you don’t.  At the end of those four years, you’ll have gained a Master’s degree, a whole new way of approaching health – yours and your family’s at least.  And you’ll be four years older.  If you don’t go to school, at the end of four years, you’ll have four years more experience in the world, that’s true, and you’ll be four years older, but you won’t have been exposed to the richness of experience you’ll get returning to school.  If you’re not sure this curriculum is the right one, go talk to other schools.  Maybe you’d rather study mental health, or education, or get a Masters in your current field.  Go take some time, listen to the voice inside you that’s telling you to return to school.  And remember, it’s only four years after all.”

They didn’t always come to our school, some went away and stayed in their jobs and some went to schools in other fields.  But each one of them let me know that they appreciated the reminder.  It’s easy to forget, but time is only time.

So what if you did go to, say, an acupuncturist, for a few visits?  What would you lose?  What might you gain?

What is your health really worth?

Upon receiving her (first – she’s a new patient) billing statement, one patient looked at the adjustments column and said “What’s this?” 

I told her that they are the contractual adjustments I make because I am an in-network provider with her insurance.  She was incensed – not at me, at the tiny tiny amount the insurance companies feel acupuncture is worth.  She asked some other questions, like why I didn’t change my rates.  I pointed out that even if I did change my fees, all that would happen is that I would have to write off larger amounts. 

It really did my heart good to have a patient get so upset on my behalf.

 I love what I do & I have the BEST patients!  Thanks to all of you.

Happy Rosh Hashanah!

For those of us who only know Rosh Hashanah as a holiday in our Outlook calendars, here’s a brief intro:

Rosh Hashanah, literally “Head of the year,” is a Jewish holiday and the first of the High Holidays which are days specifically set aside to focus on repentance that conclude with the holiday of Yom Kippur.  It is observed as a day of rest.  During the afternoon of the first day of Rosh Hashanah, or the second if the first falls on Shabbat, it is customary to observe the practice of tashlikh in which prayers are recited near natural flowing water, and one’s sins are symbolically cast into the water. Many also have the custom to throw bread or pebbles into the water, to symbolize the “casting off” of sins.

The traditional Hebrew greeting on Rosh Hashanah is shana tova for “[a] good year”, or shana tova umetukah for “[a] good and sweet year.” Because Jews and the world are being judged by God for the coming year, a longer greeting translates as “may you be written and sealed for a good year” (ketiva ve-chatima tovah).

Shana Tova  to all my Jewish patients and their families, friends and wider communities.  Let us all join together in the prayer that this new year will be a good and sweet one.

Everyone suffers from irritability and moodiness from time to time, but if you find that a short temper and frustration are becoming a constant issue for you, then acupuncture may be able to help.

Often irritability and moodiness are the consequence of chronic stress in your life. Over time these emotions can progress into more serious emotional conditions such as anxiety and depression as well as other health conditions such as digestive problems, trouble sleeping and the tendency to get sick more frequently.

Within Oriental medicine emotional disorders can be associated with a number of different patterns of disharmony; however, anger, irritability, and frustration are all signs that our qi is not flowing smoothly. The liver is responsible for the smooth flow of qi (life force) throughout the body and for smoothing our emotions. When the liver’s function of moving qi is disrupted, qi can become stuck. This is referred to as liver qi stagnation.

Liver qi stagnation is one of the most common patterns of disharmony seen in today’s patients. In addition to irritability and moodiness, signs and symptoms may include distending pain in the area below the ribs, stuffiness of the chest, sighing, abdominal distention, nausea, sour regurgitation, belching, diarrhea or constipation, feeling of a lump in the throat, irregular periods, painful periods and distention of the breasts prior to periods.  Liver qi stagnation is commonly associated with PMS.

Acupuncture is excellent at relieving liver qi stagnation. Treatment for irritability and moodiness associated with liver qi stagnation focuses on moving qi and supporting the liver and spleen organ systems with acupuncture, lifestyle and dietary recommendations and perhaps an herbal formula.

The liver is responsible for the smooth flowing of Qi (life force) throughout the body. When the liver functions smoothly, physical and emotional activity throughout the body also runs smoothly. So, for optimum health, move your Qi.

• Stretch – The liver controls the tendons. According to Oriental medicine, the liver stores blood during periods of rest and then releases it to the tendons in times of activity, maintaining tendon health and flexibility. Incorporate a morning stretch into your routine. Try yoga or Tai Chi.
• Eye Exercises – The liver opens into the eyes. Although all the organs have some connection to the health of the eyes, the liver is connected to proper eye function. Remember to take breaks when looking at a computer monitor for extended periods of time and do eye exercises.
• Eat Green – Green is the color of the liver. Eating young plants – fresh, leafy greens, sprouts, and immature cereal grasses – can improve the liver’s overall functions and aid in the movement of qi.
• Try Something Sour – Foods and drinks with sour tastes are thought to stimulate the liver’s qi. Put lemon slices in your drinking water, use vinegar and olive oil for your salad dressing and garnish your sandwich with a slice of dill pickle.
• Do More Outdoor Activities – Outside air helps liver qi flow. If you have been feeling irritable, find an outdoor activity to smooth out that liver qi stagnation. Try hiking or take up golf.
• Enjoy Milk Thistle Tea - Milk thistle helps protect liver cells from incoming toxins and encourages the liver to cleanse itself of damaging substances, such as alcohol, medications, pesticides, environmental toxins, and even heavy metals such as mercury.
• Get Acupuncture Treatments – Acupuncture and Oriental medicine can help improve the overall health of your liver as well as treat stress, anger and frustration, which are often associated with liver qi disharmony.

Periodic acupuncture treatments can serve to tonify the inner organ systems and can correct minor annoyances before they become serious problems.

Not all acupuncture points have a name and specific location. Some of the most effective points to use in acupuncture are local points of tenderness. These points are referred to as Ah Shi points which in Chinese literally means “That’s the point!”

Ah Shi points were first mentioned during the Tang Dynasty (founded in 618 AD) classic Thousand Ducat Prescriptions.  These points become spontaneously tender when disease or injury occurs, or in locations where Qi has become congested but which are not among the regular acupuncture points on a specific meridian or pathway.

Their locations are not fixed; they are the points that, upon palpation, are the most sensitive.  In many cases a small knot or pea sized nodule can be felt under the skin at these points of tenderness.

Ah Shi points are especially effective in the treatment of pain and are often used in conjunction with local and distal meridian acupuncture points, as seen in the study cited in my last blog.

Fibromyalgia Syndrome (FMS) affects an estimated 2 percent of the population. Conventional therapies are limited in the success of treating this complex and unexplained condition. Current treatment is largely comprised of prescribing different medications for the varying symptoms in a trial and error approach. Research shows that as many as 90 percent of people with fibromyalgia have turned to complementary and alternative medicine to manage their symptoms. Acupuncture, in particular, has become a popular treatment choice and has shown to be an effective treatment for FMS, surpassing even warm water exercise and second only to tri-cyclic antidepressant therapy.

What is Fibromyalgia Syndrome?

Fibromyalgia is a medically unexplained syndrome characterized by chronic widespread pain, a heightened and painful response to pressure, insomnia, fatigue, and depression. While not all affected persons experience all associated symptoms, the following symptoms commonly occur together:

• chronic pain
• debilitating fatigue
• difficulty sleeping
• anxiety and depression
• joint stiffness
• chronic headaches and jaw pain
• difficulty swallowing
• dryness in mouth, nose, and eyes
• hypersensitivity to odors, bright lights, and loud noises
• inability to concentrate (called “fibro fog”)
• incontinence
• irritable bowel syndrome
• numbness or tingling in the fingers and feet
• painful menstrual cramps
• poor circulation in hands and feet (called Raynaud’s phenomenon)
• restless legs syndrome

Fibromyalgia is diagnosed when there is a history of widespread pain in all four quadrants of the body for a minimum duration of three months and pain when pressure is applied to at least 11 of 18 designated tender points on the body, This condition does not result in any physical damage to the body or its tissues and there are no laboratory tests which can confirm this diagnosis.

Symptoms often begin after a physical or emotional trauma, but in many cases there appears to be no triggering event. Women account for a disproportionate number of FMS cases although some researchers believe this is due to the willingness of women to seek treatment.  The risk of fibromyalgia increases with age.

Oriental Medicine does not recognize fibromyalgia as one particular disease pattern. Instead, it aims to treat the specific symptoms that are unique to each individual depending on their constitution, emotional state, intensity and location of their pain, digestive health, sleeping patterns and an array of other signs and symptoms. Therefore, if 10 people are treated with Oriental medicine for fibromyalgia, each of these 10 people will receive a unique, customized treatment with different acupuncture points, different herbs and different lifestyle and dietary recommendations.

Because the symptoms of fibromyalgia are highly variable form one person to another, a wide array of traditional and alternative treatments has been shown to be the most effective way of treating this difficult     syndrome.  A treatment program may include a combination of psychological or behavioral therapies, medications, exercise, acupuncture, herbal medicine and bodywork.

Research

A recent study from the Mayo Clinic found acupuncture helpful in treating the fatigue and anxiety commonly experienced by fibromyalgia patients. In the trial, patients who received acupuncture to counter their fibromyalgia symptoms reported improvement in fatigue and anxiety, among other symptoms. Acupuncture was well tolerated, with minimal side effects.

In the double-blind study, Mayo Clinic doctors gave 25 fibromyalgia patients acupuncture, and 25 “sham” acupuncture treatments. Patients received six treatments during the two- to three-week study. Those who received acupuncture treatments reported less fatigue and anxiety one month following after treatment than did “sham” group.

“The results of the study convince me there is something more than the placebo effect to acupuncture,” says and David Martin. M.D., Ph.D., lead author of the acupuncture article and a Mayo Clinic anesthesiologist. “It affirms a lot of clinical impressions that this complementary medical technique is helpful for patients.”

Dr. Martin performed the study at Mayo Clinic Rochester with co-authors Ines Berger, M.D.; Christopher Sletten, Ph.D.; and Brent Williams. The study used only two acupuncturists and examined only patients who reported more severe symptoms, offering better experimental control. Still, the Mayo Clinic doctors urged more study to see how acupuncture can best be used in treating fibromyalgia patients.

Source: Mayo Clinic (2006, June 13). Acupuncture Relieves Symptoms Of Fibromyalgia, Mayo Clinic Study Finds.

There have been many advances in the early detection and treatment of cancer.  While the standard medical care for cancer is effective, the treatments are aggressive and cause numerous unwanted side effects as well as a lowered immune system. Acupuncture has received much attention as an adjunctive therapy in cancer treatments for its use in pain relief, reducing side effects, accelerating recovery and improving quality of life.

Acupuncture provides a total approach to health care for people with cancer. It can be used to address many of the concerns that come up during and after chemotherapy, radiation, biological therapy and surgery.

According to the National Cancer Institute, acupuncture may cause physical responses in nerve cells, the pituitary gland, and parts of the brain. These responses can cause the body to release proteins, hormones, and brain chemicals that control a number of body functions. It is proposed that, by these actions, acupuncture affects blood pressure and body temperature, boosts immune system activity, and causes the body’s natural painkillers, such as endorphins, to be released.

Areas that acupuncture has shown the most promise include:

• Nausea and Vomiting
• Dry Mouth, Night Sweats and Hot Flashes
• Stress, Anxiety and Fatigue
• Pain Management
• Increasing White Blood Cell Count

The strongest evidence of the effect of acupuncture has come from clinical trials on the use of acupuncture to relieve nausea and vomiting. Several types of clinical trials using different acupuncture methods showed acupuncture reduced nausea and vomiting caused by chemotherapy, surgery, and morning sickness. It appears to be more effective in preventing vomiting than in reducing nausea.

Other symptoms caused by cancer treatment

Clinical trials are studying the effects of acupuncture on cancer and symptoms caused by cancer treatment, including weight loss, cough, chest pain, fever, anxiety, depression, night sweats, hot flashes, dry mouth, speech problems, and fluid in the arms or legs. Studies have shown that, for many patients, treatment with acupuncture either relieves symptoms or keeps them from getting worse.

Boosting the Immune System

Human studies on the effect of acupuncture on the immune system of cancer patients showed that it improved immune system response, including increasing the number of white blood cells.

Pain Management

In clinical studies, acupuncture reduced the amount of pain in some cancer patients. In one study, most of the patients treated with acupuncture were able to stop taking drugs for pain relief or to take smaller doses.

Acupuncture is also very useful for support if you are undergoing chemotherapy, radiation, or hormonal therapy. Because chemotherapy and radiation therapy weaken the body’s immune system, a strict clean needle method must be used when acupuncture treatment is given to cancer patients.

New Lung Cancer Guidelines Include Acupuncture

Acupuncture is now officially recommended for lung cancer patients experiencing fatigue, dyspnea, chemotherapy-Induced neuropathy, pain, nausea and vomiting.

The new edition of these standard guidelines represents the first time complementary and integrative medicine has been addressed in the prevention and treatment of lung cancer. Lung cancer is the leading cause of cancer death in the United States, causing more fatalities than the next four most common types of cancer combined.

The new guidelines were developed and reviewed by 100 multidisciplinary panel members and have been endorsed by the American Association for Bronchology. American Association for Thoracic Surgery, American College of Surgeons Oncology Group, American Society for Therapeutic Radiology and Oncology, Asian Pacific Society of Respirology, Oncology Nurses Society, Society of Thoracic Surgeons, and the World Association of Bronchology.

For more and more patients, insurance coverage for acupuncture is the make or break deciding factor.  I am pleased to announce that, through OptumHealth Physical Health of California, I will be a participating acupuncture provider for the following companies beginning 16th January 2010.

Great-West Healthcare
Health Allies
Medical Resource LLC
Secure Horizons
PacifiCare Health Systems
United Healthcare
Premera Blue Cross
Spring Hill School
Easy Choice Health Plan

I remain an in-network provider for Blue Shield of California.

If your health care coverage is with any of these plans, or any other, I encourage you to make 2010 the year you take control of your health.  Call to make an appointment and let acupuncture/traditional oriental medicine assist you toward radiant good health.

The Centers for Disease Control and Prevention issued the following update.  It has more to do with Public Health than Acupuncture, but I post it here as a public service since there may be a water frog or two being gifted this holiday season. 

Investigation Update: Outbreak of Human Salmonella Typhimurium Infections Associated with Contact with Water Frogs

CDC is collaborating with public health officials in many states to investigate a multistate outbreak of human Salmonella serotype Typhimurium infections due to contact with water frogs including African Dwarf Frogs. Water frogs commonly live in aquariums or fish tanks. Amphibians such as frogs and reptiles such as turtles, are recognized as a source of human Salmonella infections.  In the course of routine assessment, a number of cases with the same strain have been identified over many months. As of 11:59pm EST on December 9, 2009, 50 individuals infected with the outbreak strain of Salmonella Typhimurium have been reported from 25 states.

ADVICE TO CONSUMERS

• Always wash hands thoroughly with soap and water after touching any amphibian (e.g., frog) or reptile (e.g, turtle), their housing, or anything (for example, food) that comes in contact with them or their housing.   Adults should assist young children with hand washing.  
• Watch for symptoms of Salmonella infection, such as diarrhea, fever, and abdominal cramps.  Call your health care provider if you or a family member have any of these symptoms.

Persons who should avoid contact with amphibians and reptiles and their habitats (e.g., aquarium, fish tank, or terrarium)

• Persons at increased risk for serious infection from salmonellosis are children < 5 years old, elderly persons, and persons with weakened immune systems.
• These persons should avoid contact with amphibians (e.g., frogs) and reptiles (e.g., turtles) and anything that comes in contact with them (e.g., aquarium, habitat, and water).
• Keep amphibians and reptiles out of homes with children < 5 years old or people with weakened immune systems.

Placement and maintenance of habitats

• Amphibians (e.g., frogs) and reptiles (e.g., turtles) should not be kept in child-care centers.
• Habitats containing amphibians or reptiles should not be kept in a child’s bedroom, especially children aged < 5 years.
• Do not allow amphibians or reptiles to roam freely through the house, especially in food preparation areas.
• Keep amphibians and reptiles out of kitchens and other areas where food and drink is prepared or served to prevent contamination.
• Habitats and their contents should be carefully cleaned outside of the home. Use disposable gloves when cleaning and do not dispose of water in sinks used for food preparation or for obtaining drinking water.
• Do not bathe animals or their habitats in your kitchen sink. If bathtubs are used for these purposes, they should be thoroughly cleaned afterward. Use bleach to disinfect a tub or other place where reptile or amphibian habitats are cleaned.
• Children aged <5 years should not clean habitats.

• Always wash hands thoroughly with soap and water after cleaning habitats.

LEARN MORE

To learn more about the outbreak, read the complete update on the CDC Salmonella website. To learn about other recent outbreaks and incidents, visit the CDC Recent Outbreaks and Incidents page.

 Centers for Disease Control and Prevention (CDC) · 1600 Clifton Rd · Atlanta GA 30333 · 800-CDC-INFO (800-232-4636)