Archive for tag: auricular acupuncture

Should a Veteran be Homeless?

I think not. Yet, there are around 50,000 homeless veterans in the U.S. on any given night -- despite a 33% drop since 2010! "The U.S. Department of Veterans Affairs (VA) states that the nation's homeless veterans are predominantly male, with roughly 8% being female. The majority are single; live in urban areas; and suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders."

This is where acupuncture comes in, friends. The National Acupuncture Detoxification Association (NADA) protocol, specifically, is helping veterans with PTSD manage stress, addictions, difficulty sleeping, and other behavioral and mental health conditions. NADA uses a standard set of ear points -- Sympathetic, Shen Men, Kidney, Liver, and Lung -- stimulated either with needles or with ear seeds.

Since it was established in the Bronx in 1974, the NADA protocol has brought relief not only to veterans, but also others in need of assistance with addictions, from food to illegal drugs. How does it work? The acupuncturist -- or one of over 10,000 health care professionals trained specifically in NADA protocol -- inserts the five sterile, stainless steel, one-time use needles into the ear and lets them remain for up to 45 minutes. Then, we take them out. It's simple. It's fast. It's cheap. It's effective.

2015-07-10_nadaWhat are patients saying about the NADA protocol? "...improved program retention, a more optimistic and cooperative attitude toward the process of recovery, as well as reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals." 

On Friday, June 26, NUHS Chief AOM Clinician Dr. Hyundo Kim and a group of acupuncture and oriental medicine interns headed downtown to the Chicago National Guard Armory to offer free PTSD ear seed treatments to homeless veterans. That's right -- NADA can get even easier! When needles aren't appropriate or convenient, we can still stimulate the ear points of the NADA protocol with stick-on ear seeds. The added bonus is that the patient can essentially take the treatment "to go," and can squeeze the seeds, reactivating the points, for the next few days.

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At that Chicago Stand-Down event, held in June, homeless veterans are brought together in a single location to access community resources and supplies needed to begin addressing their individual problems and rebuilding their lives. Our group of volunteers provided ear seed treatments while other groups provided everything from a hot meal to a bag of clothing to an eye exam. I saw booths for flu shots, HIV tests, dental services, and Reiki. That day -- that one day -- those homeless veterans had a full-service experience.

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Representatives were on-site to match them with shelters, jobs, and the benefits they earned for their service to the United States of America. They were welcomed, they were appreciated, and they were valued.

Ear-icular Egg-corns

This weekend I saw an article about the word "eggcorn" being added to the dictionary. Perfect, I thought. Someone has finally justified my mispronunciation of the word "acorn." After all these years, I've been vindicated.

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No. That's not what happened. Apparently, a word has been created, tested, and formalized for these types of circumstances. When enough people say a word incorrectly enough times, it can become a legitimized word. You can't just be totally crazy and wrong, though, mind you. You have to misuse a word and have it be somewhat close to making sense. Then you can be legitimized.

2015-06-05_dic"For all intensive purposes," "a mute point," "an averse reaction," "old timer's disease," and "soup chef." All wrong. Look again -- it should read "for all intents and purposes," "a moot point," "an adverse reaction," Alzheimer's disease," and "sous chef." Notice how the words commonly used are technically wrong, but still actually kind of correct? Now there's a word for that, and that word is, appropriately, an "eggcorn."

What do eggcorns have to do with TCM? Well, thanks for asking. Some of my favorite intentional misspeaks just happen to be related to auricular acupuncture, or, as I call it, "earcupuncture." Closely related is the way that I call the ear apex the "earpex." Sometimes, I just can't help myself. It's like the words are out there just calling me to stick them together. Maybe I'm not even misspeaking; I'm just making new contractions. You're welcome.

Today, on this new day, just one week after Merriam-Webster added "eggcorn" to the dictionary, I feel confident in using my slightly off the beaten Daoist path terminology. I'm using earcupuncture, or earicular acupuncture, I'm bleeding the earpex point to lower blood pressure, and I'm not apologizing. Words that are wrong but self-explanatory enough to be right are OK in my book.

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Also, ear acupuncture is important. It's powerful, it's fast, it's easy, and it's cheap to perform. People need to become more familiar with this modality of Traditional Chinese Medicine, but the sterile statement, "I'm going to insert needles into your ear now," doesn't always go over well with patients. Can an eggcorn or two lighten the mood? Can a spoonful of humor make the needle slide in more smoothly?

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Why does auricular acupuncture work so well that I'm willing to mispronounce it to help new patients accept it? The theory of auricular acupuncture is that the ear is a microsystem, where every body part is represented and connected to a particular point on the ear. Red spot on the antihelix? Maybe it's revealing your knee pain. Really sore when I squeeze your lobe? Could be your tooth infection screaming for help.

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Say it how you like. Whether it's ear acupuncture, ear-icular acupuncture, or earcupuncture, just try it out. I won't judge you on your pronunciation. Will it hurt? Maybe. Here's a secret tip. Sometimes we don't even use needles on the ear points. We have these things called "ear seeds," and they definitely don't hurt. If you could handle the feel of a Band-Aid with a piece of dirt stuck to it, then you'd be fine with ear seeds. Just squeeze and enjoy the pain relieving benefits. It's easier than sticking an acorn to your earlobe.

Giving a Brazilian at Stroger

"Give her a Brazilian in Room 1!" This is the new catchphrase around Stroger. That's right, we're giving Brazilians at the pain clinic in Cook County Hospital. I occasionally worry that a passing doctor thinks I'm waxing ladies in the treatment room, but the concern quickly fades as I get down to business. This Brazilian is all in the ears, and the only intimate part is the bleeding. I always think bleeding is sort of a personal interaction.

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According to a successful acupuncturist in Brazil, the best treatment for relieving joint pain with heat signs is to tonify the energy of the major internal organs, direct it towards the affected joints, and then bleed it out of the body. How do we do this exactly? Here's a sample case: inflammatory knee pain, let's say on the left knee. It's painful, the area is red, swollen, and warm to the touch. The patient often reports feeling warm, the pulse is slightly rapid, and the tongue is often red.

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The Brazilian technique is essentially a three-step process. First, we needle the following points on the ear of the non-affected side: Shen Men, Sympathetic, Liver, Kidney, Heart, and Lung. Six needles so far, if you're counting. Then, we needle the corresponding painful body parts on the ear of the affected side of the body: Knee. OK, we're up to 7 needles so far. Totally doable. Now we let those needles rest for a while while we enter the SOAP note in the lovely electronic medical records system at Stroger.

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After about 10 or 15 minutes, we take those needles all out. Next step, we get intimate. It's time to bleed the Ear Apex on the affected side. I like to give it a few hard squeezes to ensure I'm stealing as much hot blood out of this person's body as possible. Don't worry -- it's usually just a drop or two.

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What happens next? Well, it varies. Often times, though, it goes like this. The patient stands up, wiggles around to "test" for any perceptible changes in pain level and range of motion, and starts to smile. "I feel better!" Pain levels are dropping from 10/10's to 4/10's in that 15-minute treatment time. Is it unorthodox? Somewhat. Is it effective? Seems to be. Will we keep giving Brazilians at Stroger? You bet.

This One Time, at Stroger

Dr. Yurasek and I scrubbed into the isolation unit, donned our masks, and needled an in-patient right in her hospital bed. I knew that shift would be different. It was only my third day, but it just felt different when I punched in that morning...and I was right!

2015-02-05_1Between our usual out-patient pain clinic cases at Cook County Hospital, Dr. Yurasek, the other morning interns, and I were discussing some of the more remarkable results achieved with auricular acupuncture. That's putting needles on ears, for the laypeople reading today. He told us about a patient in a wheelchair who rolled in with several bullet wounds and walked out the same day after the acupuncture treatment. We told him about patients whose pain level went from 10/10 to 0/10 after their acupuncture treatment. It was basically "one time at band camp" day at Stroger.

Dr. Yurasek was explaining that these types of staggeringly effective results are the reason that acupuncture has been making its way into the world of western medicine. Specifically, he said it was the "portal to acupuncture ecstasy." That's actually the start of an entirely different "one time at Stroger" story from last week... but we aren't talking about that one here.

The point was that with the obvious decrease in patient pain after a 10-minute needling and tui na treatment, it's hard to shut the door in the face of the acupuncturist who wants to treat the people. Let us into your hospitals! Share your space with us, MDs! We were all on board... but how would we get the administration to give us the time of day?

2015-02-05_2Then, the call came. The sixth floor had an in-patient in acute abdominal pain, and her doctor wanted the acupuncturist to come up and lend a hand -- a hand with a needle at the end of it. And, since they called Dr. Yurasek, it would be a big hand with a really, really big needle on the end of it. We all know he likes those 6-inch needles. I don't even near-faint anymore when he whips them out and drives them into a patient's leg. I still look at the other side, though, expecting to see the needle sticking out back there... I do still do that.

I had just hooked up my patient to the E-Stim machine and dimmed the lights in her treatment room, when Dr. Yurasek peeked his head in my room and said, "Let's go." Where were we going? I didn't know yet. He calmly said, "There's an inpatient on the 6thfloor in acute abdominal pain, and we're going up to needle her." Alrighty. If you say so, sir. I walk next to him, fumbling through the pockets in my white coat, knowing I probably needed to be bringing supplies or something.

Halfway upstairs he, very casually, mentions that the patient is actually in an isolation unit, and we'll need to take extra precautions. OK, ummm, is it too late to go back downstairs? What? Thoughts of bringing home some exotic virus (other than the ones I've already had) to my kids were flying through my mind.

2015-02-05_3Well, now I'm so nervous that I don't even know where I am. Where are we heading? East wing? West wing? Where's the lake? Finally, we make it to her unit. The nurses glance up at us like, hey, no big deal, go on in. She's through that set of doors, and then through that next set of doors... the ones with those red signs taped to the window. OMG. "Droplet isolation"! I don't even know what that means, but I'm nervous. Very nervous. We scrub in, the nurse finally steps in and helps us with our facemasks before we tied them on backwards, and basically pushed us through the next set of doors.

Well, too late to back out now. Here we go. Luckily I had needles in my pocket. Or he did, I can't even remember. The next 30 minutes were a blur, mostly because I was nearly passing out from the recirculating carbon dioxide in my facemask. How do people wear those for extended amounts of time? Clearly I was doing it wrong. First timers, right here.

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"Where's your worst pain right now," Dr. Yurasek asks the patient, who I definitely thought was unconscious when we first walked in, splayed out in her bed with the usual useless hospital gown covering her nothing. "My back, and my leg, all the way down to my foot," she says. Well, she's conscious. Great news for my burgeoning anxiety. Abdominal pain, back pain, she's got it all, but her back hurts the most right now. So, we treat her back pain. Cue the 6-inch needles into the ancient secret lock-and-key points now called "Gall Bladder 30" and Gall Bladder 34." Sciatic pain relief on the way!

The patient is in less pain and is visibly more relaxed in her body tension. She was in the middle of telling us a story, but then she suddenly passed out asleep. OK. As long as she's not dead, I'm going to make it. I run around like a crazy person in a crazy mask looking for a gauze pad so we could take the needles out, and finally, our job is done here. We walk back downstairs to the outpatient pain clinic and resume our day.

"How's your internship at Stroger going," people keep asking me. Awesome. It's freaking awesome. If you have the opportunity to intern at Stroger, and you're not doing it, you're missing out.

A Needle in the Ear or a Cigarette in the Hand

Can acupuncture help you stop smoking? Maybe. Like most smoking cessation plans, the most important part will be whether or not you firmly desire to quit using tobacco. If you have the will, then acupuncture might just have the way.

2014-03-05_cigActually, smoking cessation is one of the more long-standing mainstream applications of acupuncture in the United States. My husband recently asked me for ideas about the effectiveness for his co-worker who has been trying to quit, and my mind has been making the connections ever since. How does it work? Will it work? Which points should be used? How often will he need treatment? Can he do some of the work at home between acupuncture sessions?

Naturally, being just a student, I didn't know the answers to these questions without looking into them myself. Now that I feel like I have a handle on some of these factors, I'll go ahead and give you lowdown. Of course, I'm not telling anyone to try this at home, but this is what your acupuncturist might do if you walk into the clinic and ask for help in your journey to drop the cigarettes for good.

First, let's talk about the mechanisms. Why does a needle going through your skin make you want to stop smoking? Actually, there are multiple methods to this madness. On one hand (literally, on the side of your hand, via an acupoint called Tim Mee) a needle can actually make your cigarette taste bad. Personally, I think they already taste bad, but apparently people who smoke tend to like the taste. Moving on, if changing the taste of a cigarette from lightly ashy to repulsively garbagy isn't strong enough magic for you, there are other things that might still work for your stubborn self.

2014-03-05_ear 200Next, auricular acupuncture can help control your cravings, addiction, and withdrawal symptoms while trying to quit. Think ear piercing with a purpose! While ear acupuncture can sound even scarier than regular body acupuncture to the faint-at-heart-newbies, rest assured that the needles are hair-thin and barely felt. I should tell you that electro-stimulation of these auricular points is also commonplace. Some commonly used ear points for smoking cessation include the following: Shen Men, Sympathetic Autonomic, Point Zero, Endocrine, etc. Your acupuncturist will add additional points depending on your individualized condition. Nope, auricular acupuncture for smoking cessation is NOT necessarily a one-size-fits-all treatment.

Now, what can the patient do at home to keep these positive no-smoking juices flowing between acupuncture sessions? Luckily, we have a plan for that, too. If you've never heard of ear seeds, you will if you seek help to quit smoking from an acupuncturist! Small seeds or magnets (fancy name--auricular pellets) with clear tape backing are stuck on the above mentioned ear points, and then the patient is instructed to squeeze them several times a day until they eventually fall off. If you shower regularly, this is generally in around three days. If you're looser with your bathing schedule, you might keep your home care going for a whole week I suppose. But, let's just pretend everyone showers more than once per week.

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Back to the main event: Can acupuncture help you quit smoking? It really is UP TO YOU. Unless your acupuncturists steals your cigs, robs you of any available currency, and prevents you from bartering in the streets for your next nicotine fix, it really is in your hands. Studies show a variety of outcomes; some are very positive indeed. If you're ready, call the clinic!

References:

Effect of Acupuncture on Smoking Cessation or Reduction: An 8-Month and 5-Year Follow-up Study. Preventive Medicine, Volume 33, Issue 5, Pages 364-372. Dong He, Jon I. Medbø, Arne T. Høstmark

Acupuncture to Stop Smoking - Yin Yang House