Archive for tag: acupuncture

Acupuncture Is Kind of a Big Deal

With at least two distinct "appreciation" events in the next two weeks, Acupuncture and oriental medicine seems to be powering its way into the integrative healthcare arena. Currently at NUHS, an acupuncture awareness campaign is giving AOM students, faculty, clinicians, and interns of all kinds of an excuse to sport an unmistakably fashionable bow tie. That's right, in addition to the pristine business professional wear and white coats, always part of our clinic attire, you can also catch us pinning on a snazzy white and black yin-yang bow tie from now through November 1st. It goes with everything.

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If gawking at odd bow ties isn't enough to grab your attention and get you thinking more about acupuncture and oriental medicine, then how about some free treatment? That's right. From October 27th to November 1st, all new patients to the NUHS AOM Clinic can receive a free treatment. This is a great opportunity for anyone who's been considering giving acupuncture a try, but hasn't been willing to shell out the usual $25. Just make sure to schedule ahead of time -- free generally means "busy" around the clinic!

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Why do we need to raise awareness about acupuncture (and all of oriental medicine)? In a 2014 National Health Interview Survey report, researchers revealed that 14 million Americans have tried acupuncture. That sounds like a lot, but it's really not. That's only 6% of Americans! What's holding back the other 94% of the American population? My guess is needle phobia. Who wants to be poked and pricked? Not even I like needles, and I use them every day.

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Neporent, Liz "A Close-Up Look at Acupuncture for Pain."
ABCNews.go.com. ABC News. April 22 2014. Web. April 25 2014

Thankfully, needlephobes like myself are not holding back the growth of acupuncture in the United States today. Lately we've been finding needles everywhere. The military is hiring acupuncturists, veterans' clinics are treating PTSD, and pain management and cancer treatment centers are flooded with requests for acupuncture services. Even research studies, in English, showing the efficacy and safety of acupuncture are appearing at a rapid clip. It seems like the west is doing a good job proving the east already knew what it was doing. Acupuncture can treat just about everything.

Ladies and gentlemen, the people have spoken. They want to be poked.

To find out more about these awareness events at NUHS, and to keep up with the happenings of our program on campus, check out the NUHS AOM Club Facebook page.

So What Is Chinese Medicine

With the start of a new trimester here at NUHS, and -- for many -- the start of a new school year, it's the perfect time to break it down. Just what is Traditional Chinese Medicine? How does acupuncture fit into the picture? Do you have to use herbs, too? What about tui na, qi gong, and tai chi? Let's not forget about my personal favorite -- dietary therapy!

Traditional Chinese Medicine (TCM) has arguably five branches, and I'm going to give it to you as I understand it. After two full years in the Acupuncture and Oriental Medicine Program, a first professional master of science degree program, I think I'm finally scratching the surface of what the ancient Chinese had to offer.

Acupuncture

photo of woman receiving acupunctureThis is the big guy, right? Acupuncture is the most well-known branch of TCM today in the U.S., involving the insertion of needles into specific points on the body. While some other fields offer an abbreviated, "stick it where it hurts" method, we TCM acupuncturists take the entire body, its functional organ systems, and each person's general constitution into consideration when deciding where to stick the needles. I know it's confusing when you say your back hurts and I put needles in your legs, ears, and hands, but just trust me. It's all connected through energy meridians. This is also why we ask you about your poop when you come in for knee pain.

Moxibustion

photo of Chinese herbYes, it smells just like marijuana, but it's actually a different herb called ai ye in Chinese pinyin, artemesia argyi in Latin, or Mugwort in plain old English. It does come in a tightly rolled stick form, we do light the end, but instead of smoking it we hold it near an acupoint on the body. After a few minutes of pecking the moxa stick close enough to provide penetrating heat but never burning you -- I promise -- you will reap the benefits of not only pain relief but tonification of certain organ systems and the freecoursing of energy through particular meridians. It feels great, but you will have to explain to people for the rest of the day why you smell like marijuana.

Herbs

photo of Chinese herbsLike many medical systems, from western naturopathy to Indian Ayurveda, TCM has a unique Materia Medica, or giant book of herbs, their properties, and their medicinal uses. While you don't have to "do herbs," most students at NUHS work towards the full MS of Oriental Medicine (which includes the herbal coursework in addition to the acupuncture work). Interesting fact: not all "Chinese herbs" are plant-derived. Many are actually minerals, such as salt or arsenic, or animal-derived, such as deer penis or flying squirrel feces. Just seeing if you're paying attention (but yes, those are really all in the Materia Medica).

TCM­

photo of garlic and onionsLumps dietary therapy, or food therapy, into the same branch as herbal therapy above. Because I love the application of common foods and nutritional principles so much, I'm awarding it half status as its own category. Some items that we'd call "food," such as garlic or onions, are also included in the Materia Medica as medicinal herbs. They're working together -- that's the point. Who doesn't love the ancient Greek saying, "Let food be thy medicine and medicine thy food?" Thanks, Hippocrates, thy father of western medicine. The Chinese happen to agree!

Tui Na

photo of woman receive a massageCan you pronounce it? Try this: twee nah. Good job. This is most easily compared to the practice of massage. Often called "Asian Body Work," these pushing and pulling movements applied by the TCM provider to the patient's body accomplishes many of the goals of general massage, such as relaxation and improved circulation of blood and energy.

Cupping

photo of cupping treatmentThis is also where we are going to mention the practice ofcupping. Stick a fire into a glass cup to create a vacuum that pulls toxins out of the blood and releases the exterior in a "wind-cold invasion" and you have a happy patient. In my admittedly limited clinical experience, everyone loves cupping, but mind your manners. The clinic is not an a la carte menu for your pleasure. Let the intern and the clinician decide which modalities are best for your condition each day.

Qi Gong

photo of qi gong practitionerAnother new phrase for the day. Practice: chee gong. Not so bad, is it? Qi gong offers the practitioner a chance to step back, relax, and renew his or her own energy and well being. Maybe you've seen images of elderly Chinese individuals at the park, wondering why they are punching the air in slow motion. That was a group of people cultivating their qi. As Dr. Yurasek tells us interns, "You can't give it if you don't have it!" Thus, practice your qi gong postures and movements before you head in for your clinic shift.

So, there it is--most of Traditional Chinese Medicine. We could also tie in tai chi or talk about gua sha, but I have to save something for next time! If you haven't tried TCM, now is a great time. Interns are fresh off a nice two-week break, white lab coats are pristine, and everybody's anxious to try out their skills. See you in clinic!

How a Clinic Internship Works

I get this question all of the time: "Do you acupuncture people yet?"

Yes, kind of, not really, I don't know what I'm supposed to say exactly. Do I put needles in people? Yes, of course. Should I? Well, that's where you've got me. Technically, I'm not a licensed acupuncturist yet, so I take that to mean that I can't charge people for acupuncture yet. Is it safe for me to needle people? Well, I do have my Clean Needle Technique certificate filed away somewhere....

2014-07-23_internDo I know what I'm doing? Can I help someone feel better? I don't want to be a pretentious jerk and assume the answers are "yes" here, but over the past year I've certainly had some good feedback. As a sometimes full-time and sometimes part-time student in the acupuncture program, I'm somewhere around Tri 5. I've completed a large chunk of the coursework, the whole observation phase in the clinic, and now I'm actively practicing on everyone who schedules an appointment with me in the AOM clinic on campus.

For the next year, I'll continue along in this internship, enjoying the opportunity to test out treatment strategies, hone my diagnosis skills, and figure out if "patient consents to treatment" actually belongs in the "A" or the "P" portion of the SOAP note. I'll do intakes; I'll form diagnostic impressions; I'll pow-wow with Dr. Cai, Dr. Stretch, and any other clinician I can find. I'll needle patients; I'll moxa their cold feet; and I'll do as much moving cupping as my forearm strength permits. If you're really special, I'll do tui na and I'll gua sha you afterward. Want some herbs? Sure, we have raw, granules, or patent pills. Right this way!

While the patient visits are the most important and most fun parts of the clinic internship experience, the clinic lottery is the part that causes the most anxiety among the interns. "Will I get my same shifts next tri?" "Which clinician will I work under?" "Which interns or observers will be on my shift?" All of these panic-stricken questions and many more can be heard all over campus right now -- the infamous Week 12 clinic sign-up and resulting lottery has arrived!

Photo of Stroger buildingSure, interns get to sign up for their preferred shifts and locations for clinic internships. We AOM students have the luxury of choosing the on-campus Lombard Whole Health Center clinic or driving to Stroger (Cook County Hospital) in Chicago for an off-site experience. My 45-minute commute is plenty, so I try to keep it simple and stick to the main campus. There we all are, fluttering around the sign-up sheet in the clinic lounge room, which is busting at the seams on a regular day, elbowing the interns who are actually trying to sit nicely and write SOAP notes that day.

If all goes well, there is a nice white empty slot shining and waiting just for you on the day and time that you've decided would be perfect for your upcoming trimester. In reality, someone else probably agreed and already signed up for that one. In the end, many interns are able to secure an acceptable shift and everyone survives the sign-up week. Some lucky individuals end up in the clinic lottery, where randomly drawn numbers allow devastated interns to play a sort of game-show rendition of "This will be your life next trimester."

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In my two years at NUHS, we haven't lost anyone yet! The sign-up process can be stressful for some, but by the time the next trimester rolls around, we're all just excited to start treating our patients and working with our clinicians to hone our skills. I have one more year of this endearing learning process, and then it's out into the real world for me (again). No more clinicians to ask questions of, no more easily accessible chiropractors down the hall to consult with on orthopedic issues (thanks, Dr. Anderson!), and no more half-days of work! Maybe this whole clinic deal is pretty great after all....

Why Are We So Wimpy?

2014-06-10_wimpYes, I said "we." I'm lumping you all in with me and almost everyone else I know. We're wimpy. My sister said it best several years ago in a comment about the "wussification of America." No, I'm not sure how to spell that. She was speaking about the general wussiness of people these days, and I'll see that new word and raise it to another contextual use.

I'm sure you know what I'm talking about. If you have had a baby in the past 10 years, you've certainly had to explain to a grandmother (your kid's or otherwise) why baby has to ride in the car seat for every little trip. "Yes, grandma, I know we're just riding up the street to the corner store. Yes, she still needs to be strapped into her car seat. Just because." Grandma undoubtedly replies, "I never strapped your father into a car seat, and he lived. He would ride all the way to Florida to visit Aunt Ida every year and nothing ever happened to him." Then simply to justify my own wussiness, I make up something about how I'll be arrested if the police see me with my kid riding on my lap.

2014-06-10_signSome of you might not be convinced about the car seats. They're important. Even I strap my kids into those things just to ride up the street, and I don't consider myself a huge wussy. Just start extrapolating this theory, though, and you'll surely jump onto the "wussification of America" bandwagon. We all drink light beer. Every kid gets a trophy. They cancel school when it snows. I'm so hot walking the 10 feet from my air-conditioned car to my air-conditioned office. I have to wait 3 whole seconds for my Facebook page to load on this old phone. Waaaah.

How does this relate to Acupuncture and Oriental Medicine? Well, the wimps don't leave their wimpiness at the door of the clinic. That is for sure. I can write this post without fear of offending anyone, because I, myself, am a needle wuss. That's right. I don't want to feel the needles. I'll needle you, but don't you try to needle me.

Clearly I am not alone. Sure, you have a few patients who never flinch when you insert a needle. They never complain that something hurts or feels weird. These are the lovely "exception" patients, and they are few and far between. Most of us recoil in pain -- pain that is really just an unfulfilled apprehension of pain -- with the insertion of each needle. At first, I liked seeing this reaction from patients, because it justified my own wimpiness. Now, though, I've evolved. As I become less wimpy about needling myself and letting others needle me, I think I subconsciously expect more of my patients, too.

2014-06-10_smokeThe people in Nicaragua never flinched. We would jab those needles right into the sore back or the tired feet, and the patient would hardly notice. Are Nicaraguans simply a stronger people than Americans? Probably, but I didn't stop there. No, what about the Chinese needling? So deep, so hard, so scary for most Americans. Are they inherently stronger than us, too? They want to feel that moxa until it burns a blackened memorial into ST36. I would move to Japan, home of "shallow needling," to avoid those 6-inch needles I've been told so much about from the Chinese professors and clinicians.

2014-06-10_needleNo, I don't think it's that Nicaraguans are freakishly strong or that Chinese people are particularly masochistic. I just think Americans are caught in the throes of the recent trends towards wussification. Be careful, don't get hurt; don't let the sunshine get you! I reject wussification insofar as I legally can, but I am still and will always be one of the wimpy ones in the clinic when I'm on the receiving end of that needle business. So, if you're afraid of needles and therefore have not yet tried acupuncture, this post is for you. If I can do it, you can do it.

Why There is No Such Thing as Sham Acupuncture

I get really annoyed when I'm reading the results of a scientific study about the effectiveness of acupuncture, and the author concludes that actual acupuncture was "not significantly more effective than sham acupuncture." What they seem to be saying is that acupuncture is not effective at treating X condition. What they are actual discovering is that needle insertion almost anywhere in the body will have an effect on the body's condition, often providing relief from X condition.

I like this part. As Dr. Kwon always told us in Point Location class, you can still help the patient even if you don't stick the needle in the exact acupoint. This realization saved my sanity on more than one occasion when trying to palpate and count thoracic vertebrae to locate the oh-so-important points of the Governing Vessel running up the spinal column. It's supposed to be located at T6, but T7 will be good enough? Awesome. Thank you for your flexibility, ancient wisdom.

So, back to the studies that drive me nuts. Here's how they commonly shake out:

Exactly 100 patients were studied for chronic knee pain, with 25 receiving no treatment, 50 receiving actual acupuncture (inserting needles at specifically proscribed points), and 25 receiving sham acupuncture (inserting needles randomly in the body). Guess what? The patients receiving no treatment did not experience improvement. The patients receiving actual acupuncture reported a 50% improvement, and those receiving sham acupuncture reported a 45% improvement.

I call that good news. The study concludes, instead, that actual acupuncture is not significantly more effective than sham acupuncture at treating knee pain. Wrong. What they actually did is prove Dr. Kwon right -- not that he needs any additional validation, seriously -- that even when needles are inserted at the "incorrect" location, acupuncture still has therapeutic benefits for the patient. Is the goal of an acupuncture treatment for knee pain simply to eliminate the knee pain? Not exactly.

Any time acupuncture happens, that patient's body experiences a shift in energy. We can usually feel a difference in the person's pulse after treatment, compared to before. The qi (energy) has moved, and in western terms, circulation usually improves. Sure, the knee pain is improved, but the patient might also sleep better than usual that night, awake with more energy than usual the next day, or even notice that a new head cold has resolved overnight.

Were these other effects coincidental? Maybe, but probably not. Any acupuncture is better than no acupuncture, and the results of studies comparing no treatment, sham acupuncture, and actual acupuncture will often reveal this truth. In fact, this little "secret" is why I'm not against other practitioners doing acupuncture on patients. We've all heard the buzzword "dry needling," which is when say, your physical therapist needles your arm when your elbow isn't healing as nicely as you'd like. I know several chiropractors who have completed the 100-hour certification in acupuncture, and they can often be seen sticking some needles into a sore back muscle.

Some acupuncturists are completely against this concept of non-acupuncturists needling patients, but I'm pretty much OK with it. I know the patient is probably receiving some benefit regardless of whether or not the needle goes in at an exact acupoints. What's important to me is that the patient is aware that dry needling or someone sticking some needles in where it hurts is not all that acupuncture has to offer. Those techniques have benefits, but not the full array of benefits that needling specific acupoints on specific meridians can produce.

So, if you know someone who's been needled before and didn't experience a great symptom reduction, it's still worth their time to try acupuncture from an acupuncturist. Crazy, I know. It's not that other providers are doing anything wrong; it's just that they aren't receiving the more complete system of treatment via acupuncture that we acupuncture students use.