Midwest Medical Acupuncture

Practice UPDATE

2010-12-12T13:23:00.004-06:00

Due to time constraints which now make it impossible for me to make guaranteed appointments, I have decided to close Midwest Medical Acupuncture in its current model at the end of 2010. I want to thank all of MMA's past and current patients for their business. Feel free to email me with any acupuncture questions you may have.

I know firsthand

2010-01-15T12:41:00.002-06:00

I recently had a patient ask me if I knew what semipermanent ear needles feel like. The answer is of course. All treatments that I do in my practice are ones that I have personally experienced myself. In the Helms Medical Institute course, there is a specific checklist (dubbed affectionately as the "dance card") of treatments that every student must perform AND receive before s/he can complete the course. There were some treatments on that list that I found extremely uncomfortable that I subsequently choose not to use in my practice. After all, I am supposed to make you feel better, not give you pain and anxiety.

So, rest assured, everything I do for my patients has been test-driven first by myself. Isn't that the Golden Rule?

What element are you?

2009-11-02T17:15:00.001-06:00

In Five Element theory, people can be described in terms of five different elements. These are: Water-Wood-Fire-Earth-Metal. A quick and easy way to use 3 of your senses to determine your element(s) works as follows. Keep in mind this is highly abbreviated. For further information, I refer you to Joseph Helms' book Getting to Know You, and Charles Moss' website.

First sense you will use is vision. Notice the color you love to wear, surround yourself with, and carry as accessories.

Black-Greenish blue-Red-Earth tones-White

Second sense is taste. Note which flavor of food you would choose if you could only take one flavor with you on a desert island.

Salty-Citrus-Coffee-Sweet-Spicy

Third sense is auditory. This may be tricky to do with your own voice, and you may need to seek assistance. Notice how your voice sounds in normal conversation.

Groaning-Shouting-Singing-Laughing-Weeping

Determine your element(s):

Water: Black-Salty-Groaning

Wood: Greenish blue-Citrus-Shouting

Fire: Red-Coffee-Singing

Earth: Earth tones-Sweet-Laughing

Metal: White-Spicy-Weeping

What's it all mean?

Water perseveres, has the will to go on. When stressed, Water becomes fearful, and physically may have urinary, bone, and back issues.

Wood gets things done, likes to be second-in-command (all the action, less administrative hassle). When stressed, Wood becomes angry, and physically may have joint/tendon pains, especially in the neck and shoulder areas.

Fire is the creative force, the one in-charge. When stressed, Fire becomes over-exuberant or hyper, and physically may have blood pressure and heart issues.

Earth is the caring nurturer, sometimes ignoring his/her own wellbeing for the sake of others. When stressed, Earth becomes a worrier, and physically may have sinus headaches, GI problems, bleeding issues, and hernias or prolapsed organs.

Metal is rigid and organized, giving great attention to details. When stressed, Metal can become depressed, and physically may have breathing problems or skin issues.

Remember, my list is very brief compared to detailed Five Elements Theory and is only meant as an introduction. You will find that knowing these basic principles will aid you in "reading" people you encounter everyday. And of course, yourself.

Whose time is it anyway?

2009-08-29T15:06:00.002-05:00

I recently spent almost 2 hours in an exam room waiting for my doctor to show up for the first appointment of the day (me). Unfortunately, I had no AT&T bars on my cell phone - leaving me with 2 hours of nonproductive wasted time. To the doctor's credit, I was informed about every 1/2 hour or so that he would be with me shortly.

When I opened Midwest Medical Acupuncture a year ago, I set up my schedule to incorporate extra time for new patients to have their questions completely and thoroughly answered, and for returning patients to discuss results of the previous treatment and any new stressors in their lives. I hate to wait, and assume that everbody else does as well. When you show up for your appointment, that time should be yours - not the person before you.

The significance of waking up at 3A

2009-07-08T15:05:00.002-05:00

Almost everyone I know has had the experience of waking up at 3AM in the morning for no good reason. Usually people blame that late-night latte, going to sleep earlier than usual, car headlights shining in the window, or mulling about a stressful situation at work. In the context of acupuncture, the latter is the most likely cause.

However, it's not because our subconscious has been working overtime trying to solve our problems while we sleep. It's because Qi energy circulates on a 24-hour cycle, and the end of a day's energy cycle occurs at 3AM. The new day's energy begins it's circulation around the body at 3AM (ok, 3:01 AM). If the previous day has been stressful and energy sapping, then the start of the new day's energy cycle isn't always going to occur smoothly. How does this manifest? Sudden wakefulness at around 3AM, as our Qi energy tries to "jump start" into the next day.

What to do? Other than avoiding stress, and acupuncture to replete energy levels, we can do things like tai chi, yoga, meditation, picking up a new relaxing hobby, or even reading a book while listening to "chill" music. When energy levels improve, 3AM wakefulness should be a thing of the past.

Acupuncture is not a religon

2009-05-18T15:35:00.003-05:00

I have recently encountered several people who all had the same essential question for me: "Is acupuncture a religon?" The answer is NO. Acupuncture is a 2000+ year old method of treating and preventing physical and psychological ailments using carefully placed needles. It can be looked at as a type of medicine that uses needles instead of pharmacological therapies. Practitioners of Chinese Medicine (which I AM NOT), will also prescribe herbal therapies in addition to acupuncture.

In my practice, I only use acupuncture and do not prescribe medications or herbal therapy. I encourage all patients and potential patients to discuss their acupuncture treatments with their primary care physicians. In some cases, the patient may know more about acupuncture than their primary care physicians. Then it becomes important to let your primary care doc know about your experiences and results - that information may help another patient in the future.

I believe the future of healthcare will include cooperation between traditional Western medicine and alternative medicine. The patient is then the winner, receiving the best of both worlds. For more on combining Western and alternative medicine, please read any of the fine books by Andrew Weil, MD.

"A" is for April and Allergies

2009-04-26T19:34:00.002-05:00

Acupuncture can be effective in preventing or decreasing the effects of all the lovely pollen floating in the St Louis springtime air. If your eyes have already started to itch, your nose is congested, and you are sneezing it may take more than one acupuncture treatment to get definite improvement. However, a treatment before the symptoms start can be very effective. It may be too late for the 2009 spring season, but a good thing to keep in mind for the future.

Remember, as always, if you have ACUTE difficulties breathing for any reason acupuncture is not the first line of treatment. Contact your physician and/or dial 911.

Search the archives

2009-04-02T13:17:00.003-05:00

Just a reminder that you can use the "blog search" function to find entries of interest to you. It's located at the top left-hand corner of your browser page in the blue border. Enter the keyword(s) of your topic (e.g.,"asthma"), and the relevant blog entries will be displayed. This is probably easier than looking through the archives for a specific topic. However, if you have time to do that, please browse my older blog postings.

Happy First Blog-anniversary

2009-04-01T00:19:00.002-05:00

It's hard to believe that I have been publishing this blog for an entire year now. I want to thank all of you who follow my blog, recommend my blog to others, and anyone who has ever clicked onto this site.

When I started this site I wanted to provide patients, friends, and the curious with a starting point from which to approach acupuncture. I was getting the same questions from so many different people (e.g., are needles reusable, does it hurt, does it work if I don't believe?) that I needed to create a place to address these frequently asked questions. But it's not my style to write "dry" paragraphs of informational material, so I created this blog. I pick interesting topics related to medical acupuncture and provide answers in a way that I would if having a conversation with a friend or patient. So, if you're reading this now, thanks for joining my conversations and come back when you have time.

"A journey of a thousand miles begins with one step"

What your tongue says about you

2009-03-27T10:51:00.003-05:00

In Western medicine, the doctor will ask you to open your mouth, stick out your tongue, and say "aaaahhhh". The doctor in this setting is looking at the structures in your mouth and throat (e.g., tonsils, uvula, tongue), the range of motion of your jaw, and the condition of your teeth/dental work.

In Eastern medicine, the exam is focused on your tongue itself. Why? Because the tongue is a "microsystem", which means that different parts of the the tongue represent the condition of various parts of the body. Simply, this means the tip of the tongue corresponds to the heart and lungs, the middle part of the tongue corresponds to the stomach/spleen, the sides of the tongue corresponds to the liver/gallbladder, and the base of the tongue corresponds to the kidneys and digestive tract. The qualities examined in the tongue include: shape, size, color, coating, moisture, and blood vessels underneath.

A little experiment to try on yourself is to look at the tip of your tongue (the heart area) when you have been sleep deprived. It will appear to be redder than the rest of your tongue when you are exhausted. When you think you are caught up with your sleep, check the tip of your tongue again. The redness will have disappeared if you are indeed well-rested.

The study of tongue diagnosis is fascinating, yet sometimes difficult to accept in a Western sense. A good place to explore if you are interested in reading more about tongue diagnosis is tradition chinese medicine text book author, Giovanni Maciocia's website.

Spring forward!

2009-03-06T19:31:00.002-06:00

With spring around the corner (fingers crossed), it's time to think about moving exercise to the great outdoors. Warmer weather is easier on the joints and the lungs, and the days are longer. If you jump too enthusiastically into a new exercise regimen, you may find yourself with new aches and pains. These can be treated with rest, ice (acutely) and heat (after the initial insult subsides).

Which joints or areas of your body that are susceptible to injury can be related to your biopsychotype. When treating an ache with acupuncture, it is common to combine a local treatment (ie, where it hurts) with an energy movement (ie, points in the arms and legs that help move energy/chi through the body). The condition being treated may get temporarily worse before improving, may not improve, or may improve immediately. Usually a good response is obtained within 4 treatments over 2-4 weeks, but this is not written in stone. Conversely, if no improvement is seen in this time period, it may be time to try another modality.

Enjoy the warm weather and remember to turn your clocks forward tomorrow night.

Can I get my breath "back"?

2009-03-01T13:45:00.000-06:00

Acupuncture is not the treatment of choice for acute asthma attacks. However, placing acupuncture needles in specific points the upper back may help prevent future attacks. These points are located bilaterally alongside the upper spine and influence the lungs. And as with many ailments, decreasing stress levels is also an important factor in decreasing acute attacks.

Other acupuncture treatments that can help with asthma attack prevention can involve "distant-from-the-lung" acupuncture points in both the arms and legs. These points are good energy movers that get energy flowing smoothly through the body, allowing stress-related blockages to ease up. In fact, this type of treatment has been helpful for non-asthmatic patients who like to engage in atheletic activities (eg running, biking, walking) during the allergen-ridden St Louis summers.

Remember, when having an acute asthma attack or any type of shortness of breath, your personal physician and/or 911 is the immediate treatment indicated, along with your rescue inhaler.

The other thing that is important when dealing with breathing issues: Quit Smoking. Enough said.

Chemotherapy, Nausea, and Acupuncture

2009-02-11T21:42:00.003-06:00

One of my relatives recently finished a course of cancer chemotherapy. Her greatest fear BEFORE starting the chemo? Nausea and vomitting. Since I was planning to do some pre-chemo acupuncture treatments to give her an energy boost (tonifying the Yin), I added a few anti-nausea points to her treatments. She also told her oncologist that she was afraid of nausea/vomitting, and he assured her that the anti-nausea drug ondansetron (aka "Zofran") was a standard part of the premeds she would receive for chemotherapy. I'm glad to report that she did not experience any episodes of nausea during her 4 month course of chemotherapy.

I cannot say that it was the acupuncture alone that prevented the nausea, since she also received the very effective anti-nausea drug ondansetron. However, there are reports in the scientific literature that suggest that acupuncture may increase the effectiveness of anti-nausea drug therapy in children with cancer, adults with cancer, and adults receiving chemo for arthritic conditions. Because of space constraints (and to keep from boring readers), I have only included a few references. More can be found at Pub Med if you are so inclined to explore. Some of the earlier papers on acupuncture tend to be less scientific (and more anecdotal reports) than more recent ones. Since the establishment of the NCCAM by the NIH, more stringently designed prospective studies are being published.

Skin and lungs

2009-01-31T16:05:00.003-06:00

In acupuncture anatomy, the skin is counted as the "third lung". When treating skin conditions, the lungs are also taken into consideration. In this acupuncture context, it makes sense that people who have respiratory problems like asthma, emphysema, or those who smoke often have skin problems and vice-versa.

From a "western" point-of-view, asthma and certain skin conditions like hives can both be the result of histamine release. It is interesting that the acupuncturists of olden times discovered the connection between lungs and skin, although not necessarily know how these two organ systems were "scientifically" related.

Acupuncture treatment should not be substituted for pharmacological therapy for lung and skin conditions, but used as a supplementary treatment. By balancing the energy of the lung, acupuncture can decrease symptoms of lung disease (eg, wheezing, cough) and of skin diseases (eg, itching, dryness, redness).

NB: The first line treatment of cancer and suspected cancer is always to consult with a physician who specializes in internal medicine or oncology.

Happy (Belated) New Year!

2009-01-11T18:04:00.003-06:00

As the first post of the new year, I thought about resolutions. But, too cliche. So I'm just going to wish all visitors to this blog a happy, stress-free, and blessed 2009. I'll be posting more on acupuncture later this month, as I'm starting to review for the written Medical Acupuncture Board Exam. What's a new year without academic challenge?

Ouch! My back!

2008-12-18T17:38:00.002-06:00

If you throw out your back while lifting a box or falling down, you have an acute or "yang" pain. This type of pain feels worse with heat and movement, but feels better with cold and immobilization. There are a couple of acupuncture points, interestingly located on the head, which can be used for acute back pain. The energy along the middle of the back flows from the sacral to lumbar to thoracic to cervical spine areas. Therefore, acupuncture points along this pathway in the head pull the energy through the back and neck areas. Usually a treatment or two can ease acute back pain.

Chronic back pain is a whole other condition. Chronic back pain is "yin" pain. This type of pain feels better with heat and movement, and feels worse with cold and immobilization (think: morning stiffness commonly present in rheumatoid arthritis and other chronic pain conditions). Treatment of chronic back pain takes more than a treatment or two. Remember, it is a chronic condition - it didn't develop in a day or a week or even a month. It will take more than a day or week or a month to make things better. Chronic back pain, and indeed chronic pain of any type, is not only sapping physically, but mentally as well. Treatment of chronic back pain may include: local treatment to induce the body's own production of endorphins ("natural pain killers") as well as overall treatment to increase the body's yin energy which becomes depleted by the stress of chronic pain. Oftentimes, it is the energy treatment that is more powerful in producing good results, than local treatment alone.

In addition to the body treatments, semipermanent ear needles are sometimes included in the treatment to give you a little extra stimulation. As with any acupuncture treatments, those for back pain are tailored to your specific situation: biopsychotype, current stressors, what type of treatment/needles you are comfortable with, etc.

What to do for CRAMPSssssssssssss

2008-12-11T18:29:00.006-06:00

This is an entry geared toward women, but men who live with women may find this information helpful. As explained in previous entries, men are YANG (sky, outside, strength) and women are YIN (earth, inside, nourishing). The three YIN channels of energy cross at one specific point in the leg called Spleen 6. This spot is four finger-widths above the ankle bone on the innerside of the leg. This spot is often sensitive to even light pressure.

A treatment for menstrual cramps is to locate the point on either leg and press until the spot is no longer tender. It is not surprising to have one leg more sensitive than the other. Of course, this treatment is more effective and longer-acting as a prophylaxis using acupuncture needles BEFORE the crampsssssss start, but almost instantaneous relief can result from mere pressure. For added stimulation, digging a fingernail into the spot may be helpful.

WARNING: Spleen 6 is one of the FORBIDDEN POINTS in PREGNANCY. Do not try this technique if you ARE or THINK YOU ARE pregnant.

DISCLAIMER: This blog entry is for informational purposes only and not intended to take the place of medical help. If you are having severe pelvic cramping and/or bleeding, please contact 911 or your personal physician immediately.

Help! I need to QUIT!

2008-12-07T16:13:00.003-06:00

Since beginning my acupuncture practice, and even while I was still completing my studies I was frequently asked about acupuncture as a "quit smoking" or "lose weight" treatment. The simple answer is "yes and no." As in "yes, acupuncture can ASSIST with both problems" and "no, it is not a one-needle cure."

If we think about addictive habits, there are two things that come to mind. First, they develop over time. Second, we feel some sort of "gain" doing this activity, or it would not be a problem quitting. This means that any plan to quit smoking or eating will have to take some time - there is no such thing as an INSTANT cure/solution. And more importantly, you must be willing to put in the work and effort of quitting the habit. Without this mental motivation, acupuncture will not, in and of itself, cause a change in behavior. No work, no payoff in effect.

Meh! How do acupuncture needles help in changing addictive behavior? Assuming that you have accepted that this is a change-over-reasonable-amount-of-time process, and have mentally committed to "wanting" to make changes/quit, acupuncture needles in the ear may affect things like appetite and cravings**. The ear needles also can improve overall energy and decrease stress levels, which are two big culprits when it comes to binge eating and smoking. Tiny semi-permanent needles (see below) are placed in several sites in the ear and retained for several days. As the ear generates new epithelial/skin cells, the needles will fall out on their own. Most people will need weekly treatments for the first month or so, at which time the unwanted behavior should become easier to avoid. Again, the important take-home message is you can quit, but you must WANT to quit. Needles do not cure without your help.

Semipermanent ear needles enlarged for detail purposes. Unlike regular acupuncture needles, these tiny needles can be worn almost unnoticeably in the ear for several days.

**Aside: Cravings for specific types of food (eg, salt, milk chocolate, spices) may also be related to your biopsychotype and stresses on your system. Check out the quiz, if you haven't already.

Nitty gritty on teeth grinding

2008-11-25T19:06:00.002-06:00

I don't believe in coincidences. I think everything happens exactly how it is supposed to happen. A few weeks ago I went to a birthday party of one of my most vibrant friends. She's a people person, and everybody loves to be around her. She makes a good living as a dentist, and many many of the invited guests were dentists. When conversation made it's way around to the subject of acupuncture, several dentists asked about using acupuncture for "teeth grinding" (technically known as "bruxism" from the Greek brugmos "to gnash teeth").

Interestingly, I had recently treated a patient in the office successfully for jaw-clenching and teeth-grinding. Of course, these are signs of stress - and as anyone who has read my blog knows - stress is usually the big culprit in blocking energy. Unblocking the energy circuits that run through the jaw-area, along with a general tonification of yin energy will usually do the trick. Remember that yin energy can be thought of as "nourishing", "mother", and "earth". This is the energy that is depleted in most people in the US over the age of 30, especially in the current economic climate. Treating the energy block will decrease the need to clench the jaw and grind teeth.

And to bring this post full-circle (not unlike an episode of Seinfeld), the patient with the teeth-grinding reminds me a lot of my dentist friend both physically and personality-wise.

An added note courtesy of my own dentist: if you are using a bite-guard as a treatment for teeth-grinding and jaw-clenching, make sure it is not a soft guard. A soft guard is like chewing gum 0r gummy bears, and has too much "give" to prevent the tired, aching jaw in the morning.

Another winterizing treatment

2008-11-17T17:49:00.002-06:00

If the thought of electricity makes you squeamish, or you feel more relaxed laying on your stomach, there is another combination of needles that can give you a "boost" for the the long dark days of winter. It involves 3 - 5 needles placed in the lumbar (lower) area of your back and about 20 minutes under a nice soothing heat lamp. You will feel relaxed during the treatment and energized later on. Of course, as with any acupuncture treatment, you may feel like taking a nap afterwards. Or you might feel like cleaning your house. Go ahead. Listen to your body. It's always telling you things you should know already, but are sometimes too busy to acknowledge.

Acupuncture for people who do too much

2008-11-04T20:00:00.002-06:00

There is a combination of acupuncture points which can be thought of as a "winterizing" treatment. As the holiday season, end of the year, and winter approach many of us will feel particularly stressed out. The shortened hours of daylight along with the falling temperatures can combine to make you feel sluggish. This is the time that a boost to your "chi" can make a marked difference in your day-to-day energy levels.

The treatment involves strong energy points in the arms and legs, coupled with a little electricity or heat lamp. One caveat, this treatment cannot be done if you are pregnant as it uses several points that can induce labor. If you are pregnant, a modified treatment can be done which avoids the "labor" points.

In between acupuncture treatments or can't get in for one? Consider curling up with a hot cup of tea and a good book, and embrace winter's changes in daylight and temperature. Sometimes resistance is futile, in a good way.

Youngest patient(s)

2008-10-22T20:05:00.003-05:00

I have mentioned acupuncture treatments for children in past entries. As I have written before, I do everything to avoid a NEGATIVE association between needles (of any kind) and children. What happens in childhood affects adulthood attitudes toward medical treatment.

Recently, my nephew and nieces (ages 4 - 7) have been hitting me up for acupuncture treatments whenever I'm over for a visit. It has both an immediate energizing effect which they like, and a soothing calming effect at bedtime which their parents like. They have become such experts that they know which needles are more comfortable than others. I have been told that they discuss getting acupuncture with their little friends at school. It's interesting to me that acupuncture has become a treat for them.

The youngest patient that I have treated is a 4 year old with severe eczema. She has watched me acupuncture her parents on numerous occasions, and even allowed me to use the electro-stimulation pen on a couple of her leg points. The last time I saw her, she agreed to take 2 needles in legs, so I chose a powerful point which affects the skin. After they were in, and she realized that they were not painful, she asked for 1 more needle. I let her pull them out herself under my supervision, as I think self-help can start at any age. Last I heard, she still has eczema, but was itching less after the acupuncture and a skin cream regimen.

It's exciting to think that these kids are the next generation of acupuncture.

What's your stressor?

2008-10-17T19:11:00.000-05:00

A lot of physical symptoms and pain problems can appear when you are stressed. Depending on your physical and psychological makeup, stress can result in headache, sleep disorder, digestive problems, neck or low back pain, etc. Of course, if these symptoms are not going away or are recurring and interfering with daily activities, you need to start with a visit to your internist to rule out serious problems.

If serious treatable causes have been ruled out, and that knee isn't getting better or the headache seems better but is still in the background, it may be time to look carefully at the situation to identify your stressor. This can be a "not-seeing-the-forest-for-the-trees" kind of thing if you are trying to evaluate things on your own. Sometimes it takes an outside observer to figure out that your migraine headache is related to your final exam schedule, or that your bum knee is better when you go home to visit your sick mom. In these cases, acupuncture can help alleviate your symptoms, but you need to identify your stressor in order to prevent recurrence of your symptoms in the long run.

Acupuncture can help replenish your energy level when you have been suffering from chronic stress. It is also a good preventative treatment when you have unavoidable stress like a mandatory final exam, a retirement fund in the stock market, or an ill family member.

How are the needles placed?

2008-10-07T08:18:00.002-05:00

Acupuncture points are found in two ways: classical anatomical landmarks and by feel. Both factors are important in locating the proper site for needles. Before I place my single-use disposable sterile needles, I wash my hands with soap and water followed by a wash of bactericidal foam cleanser. I use an alcohol prep on the acupuncture points themselves. The needle remains sterile as it pierces the skin, since I use single-use sterile guide tubes (instead of my fingers on the needle) to hold the needle in place on the skin. The picture below shows the guide tube and the needle. Notice that the guide tube is shorter than the needle. With the needle in the guide tube, a small portion of the needle handle extends above the tube. A gentle tap-tap on the needle handle pops the needle through the skin. The guide tube is then removed and the needle advanced to the proper place. My hands never touch the point of the needle or the portions that enter the skin.

Electricity!

2008-10-04T17:13:00.001-05:00

Electricity can be added to an acupuncture treatment for tonification of energy. This means that small alligator clips are attached to the needles and a low frequency stimulation (2-6Hz) is run through the needles. The electricity source is a small unit that runs on a 9V battery. The sensation is pulsating rather than electrical shocks. It can be felt in one or both needles attached to the source. When I use electricity for this reason, the treatment time can be decreased from 20 minutes without to 10 minutes with electricity. For people who don't want to try electricity, or have a condition that should not be subjected to electricity (eg, pacemaker, defibrillators, metal hardware), a similar tonification can be effected with a heat lamp or more vigorous manipulation of the needles.

Electricity can be used at a higher frequency (>6Hz) to stimulate endorphin release. In this situation, it is usually done with needles either locally (eg at the elbow) or at the affected spinal levels (eg, lower back pain = lumbar level needles). The body adapts quickly to the pulsating sensation, and during a treatment the intensity level may need to be increased once or twice.

I have had electrical stimulation in all of the above situations, and I admit I was apprehensive for the first treatment (on my elbow, see picture here). But the treatment was paradoxically relaxing, and my elbow felt sort of numb immediately afterward and didn't bother me for about 3 days. Of course, it's always important not to overdo things just because you feel better. Remember a former Cardinal 3rd baseman (who did not get acupuncture as far as I know), but did get a cortisone injection in his shoulder. He played immediately after that and in my opinion he's never been the same. Time is an important and overlooked factor in any treatment.

Go Blue!

2008-09-29T14:47:00.002-05:00

I just got back from Ann Arbor Michigan where I got to see my medical school classmates, 20 years later. The highlight of the weekend was the Michigan - Wisconsin game which honored the UM Olympians from the Beijing Summer Olympics. Including, of course, Michael Phelps (above). It was a sorry first half, with Michigan behind 0-19 and only a single first down. The second half made up for the first, finishing in a nailbiting 27-25 win for the unranked Wolverines. It was a historical 500th game in the Big House, and a proud Wolverine moment. Next entry on acupuncture after I recover from the excitement.

Macular degeneration

2008-09-27T22:33:00.000-05:00

There is some evidence that macular degeneration may be treated with acupuncture. I am not trained in this type of acupuncture. You can get further information from the website of Dr. Alston Lundgren who is the pioneer of this treatment. This is not a stand-alone treatment for macular degeneration and your ophthalmologist must be involved in your care.

One-needle acupuncture

2008-09-20T11:40:00.000-05:00

The primary acupuncture technique taught at HMI is called "N/N+1" and requires at a minimum 6 needles. It is very effective and not too daunting to new patients. At a recent talk on acupuncture, one of the questions I was asked was, "Why can't you use just one needle?"

The answer is, "I can, but I don't." Here's the reason: The N/N+1 technique uses needles inserted in acupuncture points and "getting chi" which is a dull achy sensation, but not painful since nerves are not the target. The One-Needle technique uses just that, one needle, but the target is the nerve that "supervises" the area of interest. The needle is used to "caress" the nerve and is more of a local treatment. The N/N+1 technique is a more global treatment for the pain PLUS for general state of well being which is why I like using it. Choice of techniques vary by practitioner.

Oooh my aching head

2008-09-16T16:08:00.001-05:00

The first acupuncture treatment I gave to somebody other than a classmate was to my massage therapist. When I showed up for my massage appointment she was sitting in her treatment room looking exhausted. She told me she had been suffering all day from a migraine headache aura, and at some point in the day it would turn into a full blown headache. I could tell that her energy level was low during my massage, and offered to do a quick acupuncture treatment before her next client. After 20 minutes, she literally jumped off the table energized and reported that the aura was gone. She called a couple of days later to tell me her migraine had never materialized.

Headaches, like any other aches and pains can be the result of stress-induced energy blockage. Oftentimes, patients who suffer from headaches are aware of a certain time of year, certain time of day, or certain type of situation which will trigger the pain. When organic causes of headache have been ruled out, the pain is usually treated symptomatically with a variety of drugs, lifestyle changes (e.g., yoga, meditation), and sometimes surgical procedures.

Acupuncture can be effective for headaches that have been determined to have no treatable cause. The location of the acupuncture needles used to treat a headache depends on the area affected (e.g., top of the head, behind one eye, back of the head and neck, etc), the time of day the headache usually begins, associated factors like caffeine, and the overall physical/emotional state at time of onset. Most people will feel an improvement after one treatment, but some will require periodic maintenance treatments to keep headaches in check. It is always better to be proactive and preventative when it comes to health.

Acupuncture and golf

2008-09-14T17:51:00.002-05:00

At my old job, I was working with a surgeon who was suffering from the sniffles during the last case of his work day. After finishing up the last stitch, I offered him an acupuncture treatment to clear the congestion and hopefully ward off a full-blown cold. While the needles were in his nasal congestion increased, and then drained out after the needles were removed. I noticed an immediate improvement in his energy level and his complexion changed from pasty to rosy.

The next day he reported that not only was he completely symptom-free, but that he had won the longest drive award at his golf tourney. I like to think that both were the result of the acupuncture.

You say "placebo", I say "it works"

2008-09-09T18:00:00.002-05:00

I've had several friends who were kind enough to let me give them acupuncture treatments last year when I needed volunteers. I noticed a certain type of person (overachiever, successful, professional, scientific man) who would receive a treatment for either "dwindly-pre-flu sniffles-coming-on-but-I-have-stuff-to-do", or for lower back pain would report great results to me the next day. And then would add the P.S., "Of course, it's probably placebo effect." To which my reply always is, "But it worked, didn't it?"

The irony is that my medical specialty is anesthesiology. Although much research is continuously being done to discern the mechanism of anesthetics, when we discuss the "how" of anesthesia it is in terms of plausible theories.

The question is: if it works, does it really matter how? If you are curious about science, see my earlier blog entry here.

Quote of the Day

2008-09-07T19:28:00.003-05:00

One of my DVD acupuncture lecturers used this quote by Aldous Huxley the author of Brave New World at the end of a talk:

"The notion that a needle which is introduced into the foot can somehow improve liver function appears absurd in the light of commonly accepted physiological theories. How are we to react when we find ourselves faced with events which, by the rigor of logic, should not take place and yet do? We have two alternatives: either we close our eyes to this embarrassing occurrence in the hope that if we do not consider it, it will either vanish or leave us in peace, or we accept it, at least for the moment, as an inexplicable anomaly. Anomalous phenomena, like Chinese acupuncture have often been ignored precisely by those whose duty it is to study them."

I like to see a man of letters writing about science. It's much more interesting to read prose than journal articles.

Got the Gustav blahs

2008-09-04T19:02:00.002-05:00

We've had an extraordinary number of Thursdays this year that have been rainy. At least it seems that way. Today...no exception. Due to the stormy weather blahs caused by the hurricane formerly known as Gustav, I'm going to take it easy and pass on a real blog entry today. Instead, I'm having some hot tea and a baked potato. Yum

Nausea and acupuncture

2008-09-02T18:43:00.004-05:00

In acupuncture lingo, nausea is caused by "rebellious stomach chi." In Western lingo, nausea is a major annoyance associated with motion sickness, post anesthesia recovery, and chemotherapy.

As an anesthesiologist, I deal with the 2 former situations - motion sickness of a patient rolling down the hall in a gurney or wheelchair, and post anesthesia in the recovery room. There are numerous pharmacological treatments for nausea in the perioperative setting, which work to some degree, but sometimes with other unwanted side effects (eg, drowsiness, confusion).

I have started using two acupuncture points to decrease and/or supplement the use of antinausea drug therapy. One point is on the inside of the wrist. Some of you may be familiar with the sea-bands that are on the market for sea-sickness. These bands have a small ball embedded into a tennis wristband which theoretically places continuous pressure on the wrist antinausea point. The other point is located on the lower leg, just below the knee. In the operative setting, I use only pressure (or sometimes I teach the patients to use their own fingers/fingernails) in these two points with good result.

I had a fellow at a previous hospital who had a hip replacement with spinal anesthesia. Usually postoperative nausea is associated with general anesthesia. However, it can occur with spinal and epidural anesthesia. My first treatment was to use the wrist acupuncture points. To my surprise, one of his wrists had a huge bruise across the point from a previous IV placement attempt. The other wrist had a huge welt/hive from administration of a pain medication via his IV. Since I was unable to comfortably put pressure on the wrist points, I went to the point just below his knee on the non-operative side and pressed hard. About 30 seconds later he said, "Hey what did you just do to me? My nausea is gone!" I was glad to hear through the grape-vine that the postop nurse who took care of this patient with me now uses acupressure points for acute nausea. Of course, she still sends somebody to get the antinausea drug, but doesn't always have to use it.

My mother (who has given permission for use of this story) had her first chemotherapy treatment last week. Having heard all the horror stories about chemo nausea, we planned to do several things ahead of time trying to prevent the nausea. The first thing we did was go to Trader Joes and buy the Triple Ginger Cookies and a bag of candied ginger. Mom liked the former better than the latter. "Too spicy!" she said about the candied ginger. Ginger is known for it's antinausea qualities, usually calming a rebellious stomach within minutes of use. The second thing we did was acupuncture (with needles) at the wrist, leg, and a lesser known foot point, specifically for nausea. I also put some needles in to improve her overall energy level, as worry about the diagnosis and treatment over the past month had been quite stressful.

The next day, at her chemotherapy appointment, we had a wonderful pharmacist who suggested to Mom's doctor that she be prescribed some dissolvable zofran (gold-standard antinausea drug) to take for the first 3 days following chemotherapy. She felt so well following her treatment that she asked if she had really gotten any chemo medications. I can't say for sure what specific treatment or combination of treatments worked, but something did. I'm hoping it can last for the next 6 weeks of her 1st round.

I'm trying to get ginger ale for the surgery center, which is a more palatable form of ginger, although those Triple Ginger Cookies were extremely tasty. I think my Dad ate most of them while Mom was napping.

One caveat: ginger can thin the blood, so be careful if you are already on blood thinners.

Four needles for relaxation

2008-08-31T08:32:00.002-05:00

There is a combination of four needles which is placed in the hands and feet called "the Four Gates." It is incredibly relaxing and also has the added benefit of easing headache and sore throat. I have used acupressure on these points to calm excited children, and sometimes if the child is willing, needles can be used with even more effectiveness. Above is an experienced 7 year old, who asked for "acupuncture to help me sleep better." And he did.

These four points can be used for anybody, except in pregnancy (the hand point is not recommended for use in pregnancy it may induce contractions).

What to expect during your first visit

2008-08-23T15:41:00.008-05:00

When you arrive for your new patient appointment, you will first fill out a brief medical history, including current medications, surgeries, and allergies. Also included in the paperwork is consent for treatment, financial agreement, and the HIPAA privacy notice.

During your first visit to the office, I will take an acupuncture directed history. This means that I will ask you questions related to your physical and emotional state as well as specific questions regarding whatever it is that ails you at the moment. For the acupuncture exam, I will examine the area of interest, as well as your tongue and pulse.

Remembering that physical and emotional/psychological makeup of each individual may predispose that person to specific ailments, I may ask you questions that don't seem to be relevant in a Western sense (eg, What flavors of food are you fond of?). I suggest taking the Biopsychotype quiz (link at the upper right of this blog page) if you are interested in learning more about your own physical and emotional/pyschological makeup.

The entire visit will take approximately 60 - 90 minutes depending on your specific problem and treatment plan. I rarely use more than 10 needles for the first treatment, especially if you are new to acupuncture. As you get more comfortable with acupuncture needles and treatment effects, I may increase the number of needles as needed.

As always, please ask questions at any time. If you are informed, you will feel more at ease with acupuncture treatments.

When your body says "NO!", listen.

2008-08-21T17:58:00.002-05:00

Today I had planned to do my ACLS (Advanced Cardiac Life Support) recertification, bring some supplies to the office, finalize brochures for my colleagues to use for referrals, and log in 2 - 4 hours of Medical Acupuncture CME time. It's always good to set goals to gauge productivity, but sometimes it's more important to be realistic.

In my case today, I had barely recuperated from a high-volume patient load yesterday at the anesthesia job, and really needed to clock in some zzzzs first. After finishing up my work at the anesthesia job this morning, I had a cup of coffee to perk me up. Despite the caffeine load, the warmth of the coffee lulled me into a 2 hour nap. When I woke up I was disappointed to have fallen behind on my ambitious schedule. However, I felt more energized after the nap, and proceeded to knock off half the to-dos on my list.

The moral of the story: Your body knows best, when your mind is being unrealistic.

Mei Zen Facial Acupuncture

2008-08-19T18:17:00.000-05:00

I got an excited call from one of my Mei Zen cosmetic acupuncture patients early on a Sunday morning. She had just come back from her class reunion, and some of her friends asked her if she had "work done" on her face. She said, "Noooooo, but I did have cosmetic acupuncture."

Josie before (above) and after (below) 10 treatments of Mei Zen Cosmetic Acupuncture over 5 weeks, focusing on the puffy undereye areas. She reported sleeping more soundly, feeling more energetic, and a marked decrease in chronic low back pain after the first Mei Zen treatment. This state of wellbeing has been ongoing, although I think retirement has been good to her in addition to the acupuncture treatments.

What is Mei Zen cosmetic acupuncture? It is a system developed by Martha Lucas and Denise Ellinger in 2003 using shallow needling techniques that can increase collagen in the face, soften lines and wrinkles, improve complexion, and at the same time increase overall wellbeing of the patient. A course of Mei Zen consists of 10 treatment over 5 weeks. Each treatment takes about 60 minutes, which includes needles placed in face and body acupuncture points. The acupuncture points are chosen specifically for each patient, depending on the desired focus of the treatment (eg, eyes, lips, forehead, etc) and the patient's biopsychotype and general state of health.

Who should NOT receive Mei Zen cosmetic acupuncture? People who suffer from seizures, uncontrolled hypertension, migraine headaches, are pregnant, taking blood thinners, or smoke heavily. Notice that for the most part, these are dynamic states and most can be remedied. For example, it is best to treat migraine headaches first and then proceed with the Mei Zen protocol.

I was given a treatment during my Mei Zen seminar, and found that my skin felt firmer even after a single treatment. I slept extremely well that night, and woke up completely refreshed. And as anyone who has been to 7-8 hour "working" seminars knows, it's unusual to feel very energetic on the second day. Unfortunately, the number and position of the needles for the protocol make it very difficult to give myself a treatment. I'm currently looking for a local acupuncturist trained in Mei Zen to give me the full protocol.

If you would like to know more about Mei Zen cosmetic acupuncture, please email me (machengmd@gmail.com) or call me (314-249-6101).

Opening Day at MMA

2008-08-17T14:00:00.004-05:00

Yesterday was Opening Day at Midwest Medical Acupuncture, with patient visits beginning at 10AM. The office, which is located in the J3 Studio, is in full work mode but it's still an evolving process. I need a workspace to do my paperwork (consents, HIPAA etc) and have yet to decide exactly where to hang my artwork. The feng shui has to be just right for me before I commit to a picture hanger in the wall.

I had some beautiful Opening Day flowers sent to the office by Brock and Leanne Ridenour of Ridenour Plastic Surgery, which was a pleasant surprise.

The J3 Studio is hopping, with proprietress Judith Southard's appointment book practically full to the brim. She offers facials, waxing, and makeup application by appointment

(314)621-6060. Click here for more information.

And don't forget to check out the cool interior design of the restroom when you visit us. It was all designed by FOJ3 (Friend-of-J3Studio) Kory Waschick.

How many visits do I need?

2008-08-09T17:17:00.000-05:00

I get asked this question a lot, and the answer is simple. You will know when a treatment is working, and you will also know when you need another treatment. I realize that this sounds nebulous, but I prefer this answer to a "set schedule". Not that there is anything wrong with a set treatment plan, but I think we all need to have some say and therefore some responsibility in the maintenance of our health status.

At the start of a treatment for a new patient, I may suggest a frequency of visits (eg weekly, once-a-month) but it is exactly that - a suggestion. I will help you with health and wellness, but you need to help me with feedback on how specific treatments affect you. Similar to all things in life, the same treatment can affect people differently.

The exception to the rule is the Mei Zen Cosmetic Acupuncture, which I will describe in a later entry. In the case of cosmetic acupuncture, the skin/collagen require at the least 10 treatments over the course of 5 weeks for optimum results.

Thinking about Mind-Body

2008-08-06T20:23:00.003-05:00

I gave a short medical acupuncture talk and demo earlier this week at REI on Brentwood. Thanks to Sally Drake from Training Bible Coaching for arranging the time and space with Mari from REI, and my co-presenters Maury Jackson (Yoga) and Jared Van Anne (Logan Chiropractic).

I'm not going to rehash the details of my talk, because honestly, I based the talk on these blog entries.

It was nice to see that more people are getting interested in mind-body therapies. In my experience as an anesthesiologist, I see many patients everyday who are on a staggering list of medications. My own parents are in this group. Having had occasion myself to be on multiple pills at one time, I know the difficulties in managing a medication "schedule".

Now, I don't want people to quit taking their medications cold turkey. NEVER ADJUST YOUR MEDICATIONS WITHOUT THE SUPERVISION OF YOUR PRIMARY CARE PROVIDER. Some people may have to be on multiple medications for very good reasons. However, I want people to think about making themselves feel better from a mind and body perspective. Doing things like yoga, relaxation techniques, exercise, reading a book can be a treat for your mind. And when your mind is at ease, often times the body will be in a better state to heal. For more information from an expert I respect and admire (but haven't met, yet), check out Dr. Andrew Weil's book Healthy Aging as a start. It's an easy read, and you don't have to be "aging" to benefit from the information. In fact, it'll make aging easier if you start preparing for it when you are young.

And if you have a bit of cash to spare, you might want to visit the Canyon Ranch in Tuscon, AZ. I haven't made it there yet, but I hope get there at some point. In the meantime, I'm doing yoga at the South City or Chesterfield Y with Maury.

Appointments now available

2008-08-05T18:43:00.003-05:00

I am glad to announce that appointments are available for new patient consultations on Saturdays in August and September beginning on Saturday, August 16th, 2008. Please send me an email (machengmd@gmail.com) with your evening contact number, and I will call you to book your appointment, give you directions to the office, and tell you what to bring. I promise to post some more informative entries in the upcoming weeks, but right now I am busy putting the finishing touches on the treatment room.

If you have contacted me in the past few months, thank you for your patience. I will be in touch by the end of this week by phone or email.

Please note that I will not be working Saturday August 29th or September 27th.

Office Opening in August

2008-07-30T14:34:00.002-05:00

Almost all the supplies for the treatment room have arrived, and I am busy unpacking and arranging things. If you are on my waiting list already, I will be contacting you in the next 2 weeks. The only caveat is I have a possible family crisis brewing which may require me to be out-of-state for a short period of time. I will have more details after the beginning of next week. Fingers crossed that the crisis will be averted.

Doctor, are you BOARD CERTIFIED?

2008-07-26T00:42:00.000-05:00

I've been Board-certified in Anesthesiology since 1993. To become Board-certified I had to pass a written exam, and an oral exam. I was able to take the written test as soon as I finished residency. Passing the written test was the requirement for taking the oral boards the next calendar year. I was pleased to pass both tests on my first try at each.

Unfortunately for a person like myself, who likes to get tests and certifications accomplished at the earliest possible opportunity, Medical Acupuncture Board-certification has a minimum clinical experience time and a treatment number requirement. So, the answer to the question, "Are you Board-certified in Medical Acupuncture?" is "Not yet, but I soon will be." I am currently reviewing the more obscure acupuncture facts, theories, and points that I anticipate will show up on the written exam to "make the curve". I will take the written exam in April, 2009. There is at this time, no oral exam for medical acupuncture. Assuming I pass the written exam in April, the earliest I can become Board-certified is after 2 years of clinical acupuncture experience (not including the year I spent in the basic course). I'm planning the big party for 2010.

In the meantime, I have logged over 200+ acupuncture treatments, and just as many hours of independent bookwork since completing my basic training. I really wish there had been Starbucks when I was an anesthesiology resident, wi-fi and carmel macchiatos certainly make studying these days much easier. Unfortunately, the nearest one is on Starbuck's list on upcoming closings.

Acupuncture needles and the Olympics in Beijing?

2008-07-22T06:36:00.000-05:00

I got this link from a friend who has received acupuncture treatments from me. In celebration of the upcoming Beijing Summer Olympics, check out these acupuncture needles. I'm a fan of less-is-more, so don't ever expect that my treatments would use that many needles. At least not the first one I give to any new patient.

REI Talk NEW DATE

2008-07-21T08:50:00.000-05:00

Breaking news: The Acupuncture and Yoga for Athletes presentation by me and Maury Jackson has been rescheduled for Monday, August 4th starting at 630pm at REI in Brentwood. Check the REI website for the specifics. See you then.

Hints if you are new to this blog

2008-07-20T14:21:00.003-05:00

For anyone new to this blog, here are a few hints. First, check the archives and look at the topics that may interest you the most. I have straightforward titles for most entries. People have found the "How does acupuncture work?", and "What biopsychotype are you?" good starting points. I especially recommend the biopsychotype entry, as it links to the website of my acupuncture teacher Joseph Helms, MD. It describes a lot of the interaction between acupuncture treatment and you as a unique personality (biopsychotype). Timewise, it is worthwhile to sit down and do the online quiz on Dr Helms' website. I've conveniently put a link on this page for you to click entitled "Take the Biopsychotype Quiz." See it up in the right-hand corner under the green banner?

Other good basic entries are "Does it work if I don't believe?" and my nephew's personal fave "Children and acupuncture."

I have information on the progress of my office setup, which is really a way for you to get an idea of what I am like and how the office will run. As always, if you have questions or comments please post them, or email me. And I'm planning to start taking patients ASAP.

Office Update MID July

2008-07-16T17:07:00.000-05:00

The space looks absolutely wonderful. I am currently moving in supplies, but the piece d' resistance has not yet arrived (the treatment table). I am raring to go, but I must have a comfy place to do the treatments. Although I am anxious to get everybody on the book, I want to make sure that I do not have to do any rescheduling in the hectic summer months. I have a continuously updated email list and everybody on the list will be emailed or called when I open the appointment book.

My first observation of acupuncture, in China

2008-07-08T23:03:00.002-05:00

All this talk about the Beijing Olympics and the heat wave we've had in St Louis this week reminds me of the first time I ever observed an acupuncture treatment. In 1988, I was lucky enough to garner a spot in a group of residents and med students from the University of Michigan Medical School going to visit the Friendship Hospital in Beijing. Our mentor and leader of the group was Dr Richard Judge, an amazing teacher and cardiologist who is still at the University of Michigan.

I graduated from Medical School one day in May 1988, and was on a plane to Beijing the next. Each of us was paired with our Beijing counterpart, shadowing them on rounds, conferences, and sightseeing trips. Our days were full from sun up to sundown. I remember the day we walked into an OR in the hospital and observed a doctor placing acupuncture needles in a patient for some sort of abdominal surgery. Although we did not stay for the entire procedure, it was strange for me to see a patient who seemed awake to be having surgery and appearing comfortable. At the time I wrote in my notebook something about being skeptical that nothing else was being given to this patient for anesthesia.

Having done some studying about acupuncture in the OR setting, I'm still not sure I would even want to try it...as patient or doctor. Anesthesia as we know it in the US is made up of three things: analgesia, amnesia, muscle relaxation. With acupuncture, the patient receives only analgesia and maybe a bit of secondary muscle relaxation. But without amnesia, the patient has to be prepared for the length of surgery, being awake, and not moving. Because of these things, I would only ever consider using acupuncture as an adjunctive treatment for pain.

It was a cool sight to see acupuncture performed in China. But nothing beat the Great Wall, even in 110 degree June heat.

Great American Malady

2008-07-05T15:16:00.001-05:00

On this great National Holiday Weekend, we should all relax and take things easy. This Great American Life can be both a blessing and distressing. Things are geared toward faster, stronger, smarter. Which isn't all bad, unless you're the one that has to deliver the faster, stronger, smarter product. To stay on top of things, take time out for yourself. You can't be the fastest or the strongest if you aren't smart about maintaining your physical and psychological health.

In acupuncture class, we learned about a combination of acupuncture points that was fondly called a treatment for GAM. " What is GAM?" we all asked each other. GAM stands for "Great American Malady." Without more explanation than that, we all nodded in understanding. We all suffer from GAM in one form or other. It's the situation I described in the first paragraph: the stress of keeping up as the fastest, strongest, and smartest. It can manifest as that pounding headache on the morning of a big presentation, as a stiff and achy neck after a long day at the computer, or that queasy stomach when you're trying to wrap up the big project by Friday afternoon. How can we prevent GAM? Or at the least, recognize it and alleviate the discomfort?

Common sense tells us, we need to relax and take time for ourselves. We need to breathe. We need to read a book, do something we really enjoy, spend time with those we love. Do yoga, go for a run, swim some laps. You know all this already. So, stop reading my blog (which I wrote ahead of time, I'm actually at the Cardinals-Cubs game right now) and go relax.

FYI: There is an acupuncture treatment for GAM. It can be given after the fact, when you are stressed and depleted in energy. Or better, it can be given prior to a known or suspected stressor. As all old wives will tell you: an ounce of prevention is worth a pound of cure. Or something like that. Go relax now.

Office Update Early July

2008-07-03T05:29:00.000-05:00

First, for all of you waiting for my office to open, thank you for your patience. Secondly, I am planning to move new office furniture and equipment into the space within the next week (allowing for the holiday weekend). Fingers-crossed, I will be able to begin seeing patients at mid-month. I hope I'm vague enough so as not to jinx things. I will be contacting everyone who has expressed interest in Midwest Medical Acupuncture to schedule appointments as soon as it is possible. Please send me an email if you wish to be on the list. My email address is: machengmd@gmail.com. You may also send questions and comments to the same address.

Single use needles

2008-07-02T17:05:00.004-05:00

After my 7 year old nephew received his first acupuncture treatment from me, he thought to ask, "Aunt Mary Ann, are you using clean needles on me?" This was a surprising question from one so young, but also points out the importance of cleanliness and sterility in this day and age. I suppose his question may have been triggered by his close observation of my prepping of his skin with alcohol, cleaning my own hands with antibacterial gel, and then his failing to see the clean new needles because he didn't want to watch the needling part. What he missed was the opening of each individually-wrapped, brand-new, sterile needle (see above).

Working in the sterile setting of the operating room on a daily basis since the late 1980's, I have become a product of my environment. I don't reuse ANYTHING. I like new disposable EVERYTHING. I use alcohol swabs on EVERYTHING. I am the same way in my acupuncture practice. I won't even use the same needle twice on the same patient. So, rest assured that all the acupuncture needles I use are very thin, very brand-new, and very one-time-use.

How BIG are the needles and do they hurt?

2008-06-29T18:22:00.000-05:00

When people ask me if acupuncture needles hurt, I tell them "I'm an anesthesiologist, I've spent the last 22 years of my life taking away pain."

The next thing I tell them is the difference between cutting needles (used to draw blood, place IV catheters, spinal anesthesia, inject medicine) and acupuncture needles. Cutting needles (see above) are exactly what they sound like. They have a sharp beveled edge and are made to cut through the skin and blood vessels. They are hollow in order to draw blood out, or inject medicine. A larger diameter hollow needle allows easier blood drawing and quicker drug injection.

On the other hand, acupuncture needles (see below) are made to "puncture" through skin, but they do not have a sharp beveled cutting edge. Acupuncture needles have a point which will not penetrate your skin unless they are pushed through. Unlike cutting needles, nothing gets drawn out of or injected through the acupuncture needle so they are very thin. For comparison sake, acupuncture needles for the most part are thinner than the cutting needles that dentists use. I place pressure on the skin, and then insert the needle in the acupuncture point with a gentle tap on the end of the needle.

As you may already suspect from previous posts, I choose my acupuncture needles by testing them on myself. (Okay, I used some close friends and family members to reach a consensus opinion, but I never use anything on them that I myself have not tried first.) I think it is extremely important for doctors to know what it feels like to be a patient. This works for acupuncture, but unfortunately not for anesthesia. I have had general anesthesia once, and I don't remember it at all.

Speaking of self-help

2008-06-24T17:01:00.003-05:00

I have been nursing a bum ankle for the past 3 weeks or so. I had it "popped" back into place soon after the onset of pain, and had relief for about 1 day. Then it returned, but in a rather quirky way. Some days it would ache in the morning and get better by noon, others it would be in the background all day only to worsen in the evening so that I couldn't walk on it. It was stabbing some of the time, and aching more of the time. There was some relationship to work days. I had a first weekend reprieve, but over the past 2 weekends the ache was relentless and I might have uttered a scream of frustation or two.

What was I thinking? For some reason, I wanted to "walk it off" without resorting to acupuncture. However, yesterday afternoon I decided that three weeks of ankle pain resistant to my trusty Adidas running shoes, Nike air sandals, Jolly gardening clogs, aleve, enbrel (my rheumatoid arthritis drug), yoga, Xango juice, and Bolthouse Farms Berry Boost smoothies, was enough. I needed acupuncture. I have been studying Joe Wang's One Needle Technique aka Neuro-anatomical Acupuncture (ie, less-is-more) and putting some of his ideas to use, inserted three (one needle is too spartan for me!) needles into the involved meridians. 20 minutes later my ankle was feeling better, but I still treated it gingerly all night. This morning I had only a single, brief, faint twinge of pain. I stood on my feet all day at work and I am wearing flat archless sandals without even a hint of the pain I had over the last 3 weeks.

Like I mentioned in an older post, I always seem to get a patient appropriate for treatment that I am studying at the time. This time it was me. Nothing like acupuncture in the first person.

I believe in self-help

2008-06-23T18:18:00.001-05:00

My brother-in-law got a treatment from me for his aching elbow on my last visit to Chicago. I've treated him in the past for acute lower back pain as well. When I was finished with his elbow treatment this time he asked me if I ever put needles in myself. "Of course," I answered. To which he commented, "Boy, if I could do acupuncture on myself I would do it every day!"

When I do treatments, I let the patient be the judge of when s/he needs the next one. After all, who knows your body better than you? However, there are times when a little "reinforcing" acupressure may be all you need to get over a minor set-back. I like to teach my patients at the surgicenter a relaxation point on their hands. It's a large area, about the size of a quarter and located between the index finger and the thumb. Massaging the muscle in this web between the index finger and thumb induces a nice sense of relaxation. It's best when both hands can be massaged at the same time, but if you don't have a friend handy (no pun intended) just alternating one hand then the other works just as well. The area can initially be tender or achy, especially in the dominant hand, and certainly if you are feeling anxious.

I had a row of anxious patients one day, and I went from bedside to bedside teaching this particular acupressure point, along with the breathing exercise I wrote about in an earlier post. When I checked on the patients about five minutes later, all three had fallen asleep while massaging the relaxation point. They all required lower doses of sedatives when it was their turn in the operating room.

N.B. This technique works on rowdy children (but you have to catch them first), for anxiety at the dentist (first-hand knowledge), for insomnia, and fear of flying.

Mid-June Office Update

2008-06-18T20:16:00.003-05:00

I stopped by the J3 Studio last night with owner Judith Southard to take a look at the progress of my office space. Lot's of work has been done since my last visit - walls painted, soffits and doors in place, and I can finally get a visual idea of the finished space. Here is a shot of my future treatment room. I especially like the window. Of course, I will have some sort of window treatment for privacy, but will definitely keep the natural light. The holdup at the moment is the electrician and plumber who are apparently not feeling very urgent about this project! The prognosis for opening for patients remains July. I will be contacting everyone who has called, emailed, or talked to me about medical acupuncture treatments as soon as this date is set in stone. If you are interested in being added to my list, please send me an email (machengmd@gmail.com) with your contact information. I welcome any questions or comments you may have as well.

Ladies and Gentlemen, we are in a HOLDING pattern

2008-06-14T16:04:00.005-05:00

Anybody who has heard the pilot make the statement that is the title of this blog entry knows that the typical reaction is a groan, followed by a stiffening of the body as it prepares to sit in an uncomfortable upright position for even longer. Ironically, this stiffening is in itself a "holding pattern." We can all think of things that force our bodies in holding patterns: computer keyboards, telephone use while driving, golf/tennis swings, high-heeled shoes, baseball bleachers, and the list goes on. If you've had a massage or have even rubbed your own neck at the end of a stress-filled week, you know there are lots of tight spots or even lumpy nodules along the muscles in the areas causing you achy problems.

In Western medicine, these tight spots are known as trigger points. Pain clinic doctors will commonly inject these points, and massage therapists will often apply manual pressure to these points to effect a "release." The scientific research and clinical work on trigger points was done by Janet Travell and published in her 2-volume definitive work entitled, Travell & Simons' Myofascial Pain and Dysfunction: The Trigger Point Manual. What is fascinating about her work is that her mapping of (Western) Trigger Points coincides well with the meridians along which (Eastern) Acupuncture Points are located. Since Travell did not have acupuncture training, her work could be considered a modern Western corroboration of an older Eastern concept. However, it is also important to keep in mind that acupuncture treatment should not be confused with trigger point injections. Acupuncture treatment addresses the flow of energy within the entire body, while trigger point injections are a local therapy.

"Life is a repetitive strain injury." - Janet Travell, when asked if she was familiar with a disorder called "repetitive strain injury."

REI Talk To Be Rescheduled!

2008-06-12T13:14:00.004-05:00

The REI event entitled "Acupuncture and Yoga for Athletes" originally planned for Monday, June 16th, 2008 is in the process of being rescheduled. The "yoga" part of the lecture/demo (Maury Jackson) was not able to make it on that particular day. Not to worry, I will post the new time and date as soon as it is determined!

In the meantime, try a child's pose at the end of your busy day, and enjoy a little quiet time. Namaste.

West meets East: a great summer read

2008-06-08T12:34:00.002-05:00

I just finished an enjoyable memoir of a Princeton college student who takes time off from school to train with the Shaolin Monks in China. Matthew Polly is not a typical dilettante who runs off for a month and comes back with an embellished account of his adventures. No, this is a guy who took things so seriously that he stayed in Shaolin for two years, competed in an international tournament, defended the honor of his Shaolin school, and showed the monks who were his teachers that he, too, could "eat bitter." What especially impressed me was that he spoke the language, learned the customs, and honored the traditions of his host country. His prose is clear, well-written, and infused with his dry humor. I highly recommend American Shaolin by Matthew Polly. Reading his book made me want to study (acupuncture, NOT martial arts) in China as well. However, the chinese language is easier to speak than to read which might be a problem for me when textbooks are involved.

Does it work if I don't BELIEVE?

2008-06-07T12:18:00.000-05:00

My siblings, Mom, and assorted close relatives all were willing volunteers for my acupuncture treatments even before I started my training. All of them had one thing in common, they BELIEVED that acupuncture works. They had no doubt that I would give them treatments that work, and they all had good results from their treatments. As one of my brothers said, "Either this acupuncture really works, or we're a weak-minded family." I don't mind if people I treat chalk up their good outcome to the placebo effect, because I know that acupuncture works.

How? Firstly, my young nephew sat at an all-you-can-eat Sunday Brunch Buffet completely pale and lethargic picking at his food. He had been under the weather the entire weekend and missed a couple days of school before that. I asked if he would let me stick a needle or two in his legs. He thought about it, but wasn't thrilled. "How about a dollar a needle?" I asked. He let me do this, and I placed a needle in each of his legs, and then one near left knee that he said was sore. His only expectation at the time was that he was going to get 3 dollars. After 10 minutes, I removed the needles, and he literally jumped off the sofa and was off running around the house as if he had never been ill. He was back in school the next day.

Secondly, my father has been the sole hold-out from the entire family. This isn't surprising since he's an engineer by training and very logical. After watching everyone else in the family get acupuncture from me, he finally let me do a very basic treatment on him for his "watery eyes." He wanted to know exactly "how this acupuncture works" and didn't seem totally satisfied with the Eastern explanations of chi blockage or the Western explanation of endorphin release. He slept well after the treatment (he's an insomniac), reported his eyes felt better the next morning, and over the next week had great improvements in his morning blood sugars. I'm still not sure he believes it was the acupuncture, but he did get good results.

Thirdly, acupuncture works on horses. I haven't seen this firsthand, but I have a friend that rides competitively and she swears by it for her horses. She wants me to learn the points for horses, but since I'm scared of them I don't think horse acupuncture is in my future.

No electronic records for me...yet

2008-06-06T14:00:00.000-05:00

I went to my doctor yesterday, and he has to input all my information these days into a computer. It seems to me that our patient-doctor relationship is a little different with a computer as a "third party." I see this as well in hospitals who rely on computers for charting everything. There are advantages, I know. But for my practice, I'm going to stick with good old pen and paper, so I can talk with my patients without having to tap on a keyboard. Call me old-fashioned. Plus Mom really made sure I had good penmanship, so I have no trouble deciphering my own notes from one day to the next. It's just my signature that is a little bit of a mess.

Children and acupuncture

2008-06-05T19:43:00.000-05:00

Parents have asked me if acupuncture works on children. The answer is yes! However, the child must be willing to receive the treatment, and acupuncture needles are not always used. Alternatives I use include applying direct pressure to points, electrostimulation without needles, and tiny super-fine acupuncture needles.

My first experience with children was really unplanned. I made a "housecall" to demonstrate an acupuncture treatment to a friend, but was greeted by two children bouncing off the walls. I used gentle pressure on a single hand point used for sedation (web of skin between the index finger and the thumb) for a few minutes to show them what acupuncture was like "without needles." In a few minutes, we found one child dozing in front of the TV and the other asleep on the kitchen floor!

I have used pressure on the same hand point to help my 3 year-old niece get over her fear of merry-go-round horses. Two 7 year-olds I know have allowed me to put a single small gauge acupuncture needle into the sedation point in the hand, or the analagous point in the foot (see above, check out how his posture is relaxed...his mother reported that he slept quite soundly through the night).

A fellow acupuncture classmate of mine called me right after I had returned from the ear acupuncture course in Chicago. Her son was complaining about an earache and she wanted to know if there was an ear point that she could use to treat this. After a theory-based discussion that I won't bore you with, we decided she should electrically stimulate two points on his ear: one for pain in general, and one for the ear specifically. She reported later that day that he was playing happily without complaints.

Being an anesthesiologist however, I am ALWAYS wary about using needles in children for any reason because I don't want to create an association between doctors, hospitals, needles and FEAR. Children who fear doctors grow up to be adults who fear doctors, and that should be avoided at all cost.

June Office Update

2008-06-03T16:28:00.000-05:00

I went down to the new J3 Studio in Lafayette Park last night to check out the progress. The rooms are marked out, no drywall yet, but I could still get a good feel for the overall space. The interior designer is working on colors for the treatment rooms and reception area. It's looking more like an early July (crossed fingers!) opening. I'll keep you posted.

Slow down, take a deeeeep breath

2008-05-29T18:13:00.000-05:00

I'm posting a little less this week, because I'm on vacation. Rest and relaxation is great during a week off, but what to do when it's time to go back to work? The answer to prolonging that peaceful easy vacation feeling is taking a deep breath...literally. What happens in our crazy work lives is that we forget to breathe. When we are stressed by things like deadlines, public speaking, paperwork, or the price of gas, we start to take short quick breaths, or even to hold our breath. When we hyperventilate and/or hold our breath, our bodies then think there's some sort of DANGER. Then our fight-or-flight adrenaline kicks in, we breathe even faster and our pulse rate goes higher, and it becomes a vicious cycle.

As an anesthesiologist, I see this breathing pattern all the time in patients who are stressed about having surgery. I help them break the vicious cycle by having them change the way they breathe: Deep inhalation for 2 seconds through the nose, then a long exhalation for 4 seconds through the mouth. Think "in through the nose, out through the mouth", with breath moving in a circular way. I have them imagine oxygen filling every part of their lungs when they inhale, and bad air leaving the lungs during the longer exhale. This pattern slows down the breaths, and relaxes the entire body. (Isn't taking a great big refreshing breath of fresh air the first thing most of us do when we get to the ocean or the great outdoors?) I have been using this technique for the past 20 years in the operating room setting. When I started taking yoga classes about 8 years ago, I was surprised and pleased to find a similar practice of breathing being taught to us aspiring yogis!

So, when I get back to work on Monday, I'm going to take nice slow deep breaths and prolong that relaxed vacation feeling. I highly recommend it.

Ooh my aching... seasonal allergies?

2008-05-26T16:00:00.000-05:00

As an anesthesiologist, I planned on approaching acupuncture from a pain management perspective. I figured I could use acupuncture to take care of pain postoperatively, perhaps preemptively if given before incision, and of course for sprains, trick knees, and low back pains. I never dreamt it could be used for something as commonplace in the Midwest as seasonal allergies.

To most of us who suffer from seasonal allergies, they can be considered a "pain" but not in the same sense as a sprained ankle or tennis elbow. In an acupuncture sense, however, seasonal allergies are the result of...you got it, blocked chi. Just like with pain, unblocking of blocked chi can lessen the "stuffy nose, scratchy eyes" feeling that accompanies the ragweed pollen at this time of year.

Seasonal allergies can be treated after the fact, or preventative measures can be taken prior to "allergy" season. The length of time between required between treatments vary from person to person. Some people can remain symptom-free the entire summer after one or two acupuncture treatments in the spring, while others may need more frequent acupuncture treatments and/or still require antihistimines (although usually in smaller doses than before the acupuncture).

Luckily for me, the acupuncture points for treating seasonal allergies are easily reachable on myself. If I know I'm going to be outdoors for an extended period of time (eg, The CRIM, Lewis and Clark Half Marathon or San Jose Rock and Roll Half Marathon), I will give myself a treatment a day or two before. I do this in advance, as the treatment can sometimes cause a relaxed, sedated feeling on the day of treatment. Which is okay for a walk in the park, but not for a run!

What Biopsychotype are you?

2008-05-22T17:55:00.000-05:00

Acupuncture explains pain as an obstruction of chi in the body. Other manifestations of obstructed chi include insomnia, anxiety, digestive, breathing and sinus problems. This is by no means a complete list, but a starting point. All of us can probably name a friend or family member that always seems to have problems with digestion or allergies or migraine headaches or a bad back. Have you ever wondered why this person is susceptible to this specific problem?

Acupuncture explains this by the concept of "Biopsychotypes". A biopsychotype uses both physical attributes and personality traits to describe any given individual. Joseph Helms, MD who is considered the Father of Medical Acupuncture in the US describes the three biopsychotypes as Will/Spirit, Vision/Action, and Nurture/Duty. Each of us manifest all three biopsychotypes in varying proportions. The balance (or imbalance) of biopsychotypes influences what kind of problems we will have when we experience stress on our systems (eg, get a pounding migraine, neck stiffness, lots of gas, etc).

To get a clearer idea of the concept of Biopsychotypes and to figure out your balance of the three types, check out Dr Helms' website and take the self-scoring quiz. For even more information written in clear lingo-free language, read his book "Getting to Know You". New Midwest Medical Acupuncture patients are given the quiz prior to/at the first consultation along with a "standard Western" medical history.

It's sometimes helpful to take the quiz once by yourself, and then to let somebody who knows you well to take it for you. It's interesting how our self-perception can vary from how others perceive us. Somewhere in the middle probably lies an unbiased truth!

For the record, my Biopsychotype is predominantly Vision/Action, with Will/Spirit a close second and Nurture/Duty a distant third.

My letter in Arthritis Today!

2008-05-20T19:49:00.000-05:00

I have been a subscriber to the Arthritis Foundation's magazine Arthritis Today for the past decade. I recommend it to people with newly-diagnosed arthritis, friends of people with arthritis, and anyone who wants a healthy lifestyle (even if they don't have arthritis).

Arthritis Today is currently running an excellent three-part series on how to prepare for and recover from joint replacement surgery.

While flipping through the current May-June issue, I was pleased to find my letter to the editor on page 10. I am including an excerpt, because I am always an anesthesiologist at heart!

"...Patients have a choice between a general anesthetic and a regional anesthetic (including a spinal, epidural, or nerve block). Oftentimes co-existing conditions, such as chronic back pain, sleep apnea, hiatal hernia and obesity, as well as the patient's personal preference, need to be considered.

I spend time with my patients preoperatively to answer all their questions, so that the day of surgery will be as stress-free as possible. It's important that patients know they have a say in the type of anesthesia they receive..."

Gotta run to the post office and send a copy to my mom!

Office Update

2008-05-19T19:16:00.000-05:00

Just an entry to update everybody on the office status. The lease was signed last week, the build-out about to begin, and I'm ordering supplies and forms. I'll have a treatment room in J3 Studio in the Lafayette Park area (which includes free parking!), leasing space from J3 Studio owner Judith Southard, one of the best aestheticians in St Louis. My opening date depends ultimately upon when the office is ready, but I'm shooting for mid-June or so. Initial office hours will be on Saturdays by appointment only. More news to follow as it develops.

Scars tell a story

2008-05-16T16:21:00.000-05:00

There are 12 principle meridians and each meridian runs through specific points on the body. Surgical incisions or even regional anesthesia needles (eg, spinals or epidurals) inevitably disrupt the integrity of acupuncture points in the surrounding area. It makes sense that the resulting scar tissue can cause energy blockages and even result in pain syndromes. The pain may remain local to the scar, or may be referred to an area seemingly distant to the scar. It is important pay attention to the time relationship between the onset of pain (after) and the surgery (before).

A simple method of dealing with a troublemaker scar using acupuncture is to surround the scar with superficial needles. The area around the scar will usually turn red, and needles are left in place until the redness is gone. Deactivation of the scar can also be done with injection of the common local anesthetic lidocaine into the scar. If energy blockage (ie, the PAIN) is still present, electrostimulation to the needles can be added.

Two cases of pain related to scars stick out in my mind. The first is a friend who had a posterior spinal fusion and a scar extending from his lower thorax to top of his sacrum (tailbone). Portions of the scar were thick, red, and raised. He was having sharp lower back pain around the scar that felt different than his pain before surgery. I surrounded his scar with 20 shallow needles and left them in until the redness cleared in approximately 20 minutes. He reported improving relief over the next few days.

Another friend asked me to treat her lower back pain. On a previous occasion I gave her a quick, energy moving treatment for neck pain without taking a full history. This time, after asking about scars and surgical history, she reported that her lower back pain had begun shortly after abdominal surgery. Her scars from two surgeries formed a cross just below the belly button. I surrounded her scars with many many shallow needles, leaving them in long enough to clear the redness (about 25 minutes). Her scars were so extensive, and crossed so many meridians that I thought she might needle lidocaine and/or electrostimulation. She felt worse that night, but felt much better in a couple of days. If her pain comes back, I'll try lidocaine. But to me, less is more. It's much more "thoughtful" on so many levels.

Battlefield acupuncture, part deux

2008-05-15T15:47:00.000-05:00

Lately, I've noticed that things are happening to me exactly when they need to happen. I was putting the finishing touches on the last entry when a friend with a swollen painful right tennis elbow showed up for an acupuncture treatment. I had taken care of his elbow in the past with an energy moving treatment, but this time offered the option of the semipermanent ear needles.

I put the five needles in, checking for improvement after each needle like we learned in class. He didn't notice much until I put in the one in near the top of the ear, and then reported that the pain was gone. The swelling and point tenderness were markedly improved as well.

Locally, I did a two-needle electroacupuncture treatment at the elbow for 10 minutes. ( I've had this done twice myself with relief lasting for a couple of days).

In this picture, I did put in the needles. I use steel needles instead of gold. It's just what I had on hand at the time. Not as "bling-bling" as gold, but still effective.

Now, I promise, no more ear stuff for a while.

"Battlefield" acupuncture

2008-05-15T14:19:00.001-05:00

One more post about the ear, and I'll move on to other topics. I was introduced to the concept of "Battlefield Acupuncture" for pain management during my HMI Medical Acupuncture course last year. The protocol is usually taught to HMI students by Colonel Dr Richard Niemtzow who developed this method of treating pain using 5 ear points. Unfortunately, he wasn't available to teach our class session last December.

I was lucky to find his name, along with his colleague Colonel Dr Stephen Burns on my list of fellow attendees at the AAMA Ear Acupuncture course I wrote about in an earlier entry. Both were kept busy fielding questions about Battlefield Acupuncture during the two day session, even though they weren't teaching the class.

In a nutshell, Battlefield Acupuncture is done with special semipermanent ear needles. These are left in the ear for up to 3-4 days, and will fall out on their own as skin grows back into the "hole" the needles make. The landmarks for proper placement of the needles are straightforward, and according to Drs. Niemtzow and Burns the techniques is being taught to US Air Force doctors going into warzones. I could write more, but it's already written up nicely by an observer of a teaching session in Germany here, and by Dr Niemtzow himself here and here. You don't have to read more, but they are easy, interesting reads, and how much easier can it be? I already put the links in. Go ahead, point and click!

Note: The "Battlefield Acupuncture" needles in the picture were put in by the man in charge of HMI Medical Acupuncture for Physicians, Joseph Helms, MD.

Yin without Yang

2008-05-11T12:04:00.000-05:00

As an acupuncturist and a person with rheumatoid arthritis AND most importantly a "recovering academic researcher", I often use acupuncture treatments on myself before using them on patients. This way, I can note the progression of effects and have first hand knowledge of treatments. A classmate of mine of similar mindset told me about a treatment she gave herself using only Yin needles. In class, we had been repeatedly told that Yin needles must be used with Yang needles in order to form "a circuit". After treating herself with only Yin needles, she developed low back pain bilaterally. This makes perfect sense, as pain is a sign of energy obstruction. By failing to use Yang needles to "pull the energy" through her body, the energy got stuck at the level of her lower back.

Last night I was feeling beat and had foot pains from a session of bootcamp. I decided to put in an energizing circuit, but for some reason or other I only put the full Yin-Yang circuit on the left side of my body. On the right side, I lazily put in only the Yin needles. I felt great afterwards and slept like a baby. This morning, however, I had an achy right-sided lower back pain. Palpating points on my ears revealed a tenderness on the right ear in the area corresponding to the sacro-iliac joint (SI joint). I put in the Yang body needle on my right side, waited about 10 minutes, and the right-sided back pain is now gone. I would have gone straight for the ear point if not for the technical difficulty of putting an ear point in oneself !

Take home message: Yin must be balanced with Yang!

Needles in the ear?!

2008-05-08T09:23:00.001-05:00

As promised, a brief introduction to ear acupuncture. In the HMI medical acupuncture course, I learned about using the ear "microsystem" points to reinforce the use of body points. That is, if I had a patient with knee pain, I would first put in the body points for the main treatment followed by a needle in an ear point corresponding to the knee. The ear is a "microsystem" in that it contains a precise upside down map of the body, with the head located at the ear lobe, the spine stretching along the cartilage, and the hands and feet at the top of the ear. It's hard to imagine without a picture. There is a complicated history of ear acupuncture which goes between France, Europe, and China but suffice it to say it's used in all those places and more.

In Beate Strittmatter's Ear Acupuncture: An Easy Approach to the Body course, I learned how to use the ear as the main acupuncture treatment, with the body points used to reinforce the ear points! Her argument in favor of this approach is that results may be seen very quickly in some cases, less needles are used, and the "ear does not lie" (meaning a problem in the body can be found as a point in the corresponding point in the ear). The disadvantage to this technique is that the points on the ear need to be located precisely, usually requiring special pointfinders. Luckily, I have several already!

Bridging East and West

2008-05-05T10:36:00.000-05:00

I just got back from a fantastic AAMA sponsored ear acupuncture course in Chicago this weekend. The travel left much to be desired, but then...that's O'Hare. My next post will cover some interesting ear acupuncture information, but for now here's a nice little tidbit from the instructor Beate Strittmatter, MD to think about:

The Soul says to The Body, "I can't seem to get The Person to notice what is going on with Me." The Body replies to The Soul, "Don't worry, I'll make The Person pay attention to You."

This is a simple explanation of how stress, worry, and anxiety can manifest as neck stiffness, knee pain, back pain, migraine headache, and sleep disturbances, to name a few of the body's "attention-getters". When we have a physical symptom, sometimes it is important to search for underlying causes that are not necessarily physical. Which probably explains why I get a backache the week before my acupuncture courses, and which promptly resolves when the course actually begins! See? I'm living proof.

Treating pain problems with acupuncture

2008-04-28T18:04:00.000-05:00

As an Asian board-certified anesthesiologist with arthritis, I have been interested in acupuncture for the last 10 years or so. While I was still in academic practice at Washington University I looked into taking the Helms Medical Institute's Medical Acupuncture for Physicians (HMI) course with the intent of doing research (publish, publish, publish!) on acupuncture for postoperative pain management. Unfortunately, the time commitment for the HMI course was too much for me to handle on top of a unpredictable workload at that time.

I kept an eye on the latest news in alternative medicine and read books by Andrew Weil, and Bill Moyers, not only for future research ideas but for ways to possibly control my own rheumatoid arthritis. In 2007, with some control over the vacation and on-call schedules at work, I was able to complete the HMI course successfully. I currently have been relatively flare-free for the past 8 years by combining one prescription medication with supplements, exercise, and of course I do acupuncture on myself if I can reach the points! But enough about me.

Pain management with acupuncture can be thought of on different levels:

Local treatment: This is probably what most people think of when they think of acupuncture needles and pain control. Local treatment is exactly what it sounds like, placement of needles in the area causing a problem (eg, shallow surface needles or deeper trigger points in the back, "woody" muscles in the upper back). Electrostimulation can be applied, or the needles simply left in place for a period of time.
Neuroanatomical treatment: This approach involves electrostimulation of needles placed in the particular spinal segments involved in the area of pain. Theoretically, this works by causing the release of neurotransmitters that modify pain or the perception of pain.
Energetic treatment: This is usually the hardest treatment to explain because the needles involved are frequently DISTANT to the site that is painful. The acupuncture theory is that ALL PAIN states are caused by "blocked Qi" and needles placed along the affected pathways help unblock Qi.
Microsystem treatment: This usually involves needling points on the ear that correspond to points on the body itself. I will cover this in more detail when I return from a 2-day course on treating pain with ear acupuncture in Chicago this weekend.

Again, this information is incredibly simplified and I plan to go into greater detail in future entries. I'm off to yogalates class for meditating and relaxation.

How does acupuncture work?

2008-04-19T14:17:00.000-05:00

A lot of people ask me "how does acupuncture work?" In addressing this question, I always tell people that I was a skeptic going into the Helms Institute's Medical Acupuncture for Physicians course. I had a "biphasic" aha-moment early during the first in-residence session of the course: 1. I had an electroacupuncture treatment done on my elbow as a class demonstration (which gave me 3 days of relief from tennis elbow pain) AND 2. I watched an incredibly obnoxious classmate with neck pain and stiffness get immediate relief and a concurrent instant calming effect from a simple acupuncture treatment. So, when you ask me about acupuncture, rest assured that I always keep an open mind balanced with a scientifically-driven need to know how things work. PLUS I never give a treatment that I haven't tried myself.

With that background, I can tell you that acupuncture works in at least two ways:

1. Traditionally, energy (aka "Qi" or "Chi") travels through the body along meridians not unlike blood traveling through blood vessels. When energy encounters an obstruction, physical and emotional symptoms can result. Acupuncture needles unblock these obstructions and allow the Qi to flow smoothly through and along the body.

2. Scientifically, the insertion of acupuncture needles and/or placement of surface electrodes with/without electrical stimulation, and application of pressure at acupuncture points have been demonstrated to stimulate the release of endorphins which in turn decrease pain.

Both of these explanations are simplified, and in a future entry I will include scientific basis and references (I can't seem to deny my academic background, even years later!).

For some basic information from the NIH, please check the Concensus Statement on Acupuncture from 1997, and the 10 year Anniversary Conference.