Monday, July 27, 2009

What is Reflexology?

Reflexology is believed to have been used in China, India and Egypt as long ago as 5000 years. It was brought to the US by Dr. William Fitzgerald during the 1920s, and has continued to flourish as a treatment option to this day.

Reflexology theory holds that your entire body is mapped out onto your feet. When certain points are massaged, corresponding areas of your body will be effected. All treatments involve a Chinese Medical diagnosis so that appropriate areas can be massaged for each individual patient. Much like other forms of Chinese medicine, Reflexology is a system that treats the body as a whole, not just the symptoms of a biomedical complaint.

Reflexology has been shown to be an effective treatment for digestive disorders, headaches, various body pains and more!

If you receive a reflexology treatment, always make sure to drink plenty of water following treatment as uric acid that has settled into your feet due to gravity will be released during your treatment! Much like after a massage, if these chemicals are not diluted by water you consume, you may experience feelings of nausea or muscle aches.

Monday, July 13, 2009

Problems with Chinese medicine scientific studies

We've all seen the contradicting studies: acupuncture does work for this condition. Acupuncture doesn't work for the same condition. What's going on?

The problem with these scientific studies is that many of them are not being designed properly to match how the medicine works. Science is FABULOUS for pulling things apart to understand how every little cog works. However, Chinese medicine is about the whole machine. You can't remove one piece and study it alone.

In many studies I see have a conclusion that sounds something like this: "Acupuncture shown to be ineffective for treating X, Y or Z." Then, when I read farther into the study, it's because they used a single acupuncture point in all of their study participants. I always have to giggle at this. Acupuncture is not a system where all people with X biomedical disease end up having the same Chinese medical diagnosis. For example, knee pain isn't just knee pain. It could be due to Kidney Qi Deficiency, Kidney Yang Deficiency, Kidney Yin Deficiency, Cold Bi Syndrome, Hot Bi Syndrome, Qi and Blood Stagnation among the basic few. What one needle may work great for Kidney Qi Deficiency knee pain may actually exacerbate knee pain due to Qi and Blood Stagnation! So of course, when all of these patients with knee pain are grouped together and treated like they have the same disease, the researchers get poor/mixed results! Not to mention that most styles of acupuncture do not use a single-needle approach (there is a Japanese style in which a single needle is used - the PERFECT needle for that patient on that day at that moment).

I'm not saying get rid of the science. We need the science in order to validate our medicine in this society. We need the science to validate our medicine so that insurance companies will be willing to cover services that could greatly benefit a huge number of Americans suffering from debilitating disease processes. But what we need most of all is studies that are designed with the idea of how Chinese medicine works in mind, otherwise we're just wasting time and money on studies that aren't actually testing the medicine as it is used.

Researchers out there who may stumble upon this blog (okay, so I may be dreaming big here ;) ), please make sure you have an acupuncturist help you design your study. And I'm not talking about a biomedical doctor who has gone through "medical acupuncture" training, because that's not the same thing as an acupuncturist. An acupuncturist will be able to help point out when you're missing an aspect of how Chinese medicine works so that you can get the most true-to-life results possible!

Lastly, I want to point out that if/when a drug is shown to be ineffective, it isn't concluded that pharmacology, as a whole, doesn't work. Why, then, do we say that acupuncture, as a whole, doesn't work, when one point is found to be ineffective for a single diagnosis?

Tuesday, July 7, 2009

Preventive Medicine

I was reading an article today about biomedical health care and its outrageous costs. This isn't what I'm going to talk about today, however. In this article it mentioned that if people would use preventive medicine, it could greatly decrease the cost of health care overall by preventing the BIG health care costs such as bypass surgery, diabetes, etc. I agreed with this statement UNTIL it qualified what it meant by "preventive medicine."

Preventive medicine, according to this author, was the use of medications to prevent further disease. The example that was given was this: If a patient with high cholesterol would simply take statin-drugs to lower their cholesterol, they could likely prevent heart disease which can lead to further complications and further costs.

I sighed when I read this. While the above statement is true, it's missing the point. We, as a society, still haven't seemed to have figured out what preventive medicine is. It doesn't mean taking a pill for the rest of our lives to cover up a symptom. While this can be a valid step in making sure irreparable damage isn't done, it isn't preventive medicine.

Now, don't get me wrong. It is often necessary for someone to take a pill while their body learns to take over the function that the pill is meant to mimic. In the above case, it is extremely important to get high cholesterol under control, and a drug may be necessary to achieve this quickly to avoid damage to the vascular system. However, there are further steps that are required! Diet and exercise changes among the basic of these.

The end goal of ANY branch of medicine should not be to merely get bloodwork numbers within an acceptable range, but for the patient to be able to sustain those numbers on their own at some point.

(Disclaimer: I'm not saying that all people should live medication-free. Some health concerns are uncontrollable without chemical intervention. However, in an ideal world, these patients are still keeping their medication doses as low as possible by using preventive medicine.)

Preventive medicine should be seen as medicine that teaches and allows the body to function properly without chemical intervention on a permanent basis.

Friday, July 3, 2009

What is Qi?

Ooooh, this is a fun question! Biomedicine has been wondering this FOREVER! (Or, at least since they learned of Chinese Medicine and Qi.)

I like to tell my patients when they ask, that Qi is what makes the difference between being alive and being dead.

Biomedicine doesn't know what makes us alive vs. dead, and they don't know what Qi is. Coincidence? I think not!

One textbook definition of Qi is "The fundamental substance of which all matter in the natural world are composed. All matters in the natural world are formed by the change and movement of Qi." (Advanced Textbook on Traditional Chinese Medicine and Pharmacology, Vol. 1. New World Press, Beijing, China, 2002.)

Another textbook similarly describes it as "The fundamental substance constituting the universe, and all phenomena are produced by the changes and movement of Qi. Qi is both the essential substances of the human body which maintain its vital activities, and the functional activities of the organs and tissues." (Chinese Acupuncture and Moxibustion. Foreign Languages Press, Beijing, China, 2003.)

Free, smooth movement of sufficient amounts of Qi is essential to health and vitality. When this is not the case, we begin to experience unhealth. Acupuncture is certainly not the only way to achieve free and plentiful Qi. Health CAN be retained and regained through healthful living, but Chinese medicine can speed the process back to health. In addition, Chinese medicine can PREVENT disease by ensuring that the amount of Qi that one has is always in adequate supply and moving properly throughout the body.

So what does Qi feel like? To me, as a practitioner, when I needle a patient and I'm aiming for the Qi, it often will feel like the tip of my needle is bouncing on the surface of a balloon. When I "get the Qi" it feels as though this balloon has let the needle in. I've heard other practitioners describe it as a gentle tugging sensation on the tip of the needle.

My patients often say that Qi feels like someone pressing on their skin at the site of the needle. Some patients will feel this same sensation of pressure run along the channel after the needle has been inserted. Some people will feel the Qi as a mild warm or cool sensation at the needle.

Perhaps it's this inability to even describe the sensation of Qi that has led so many to be skeptical of its existence? Okay, maybe it's due to the fact that there are no biomedical tests that can prove that it exists.

Regardless, Chinese medical practitioners can feel the Qi in your pulse, can see it reflected on your tongue and in your face, and can feel it through the needles. Thousands of years of patients and practitioners and positive results can't ALL be wrong.

Thursday, July 2, 2009

One of my biggest pet peeves

We hear it all the time. "It couldn't hurt." It sounds innocent enough, and REALLY it is a sign that things are changing in the biomedical field. Doctors are starting to accept the fact that even though acupuncture and Chinese herbal medicine don't test well under "standard double-blind, placebo-controlled studies" (watch for a future post on the problems with this style of testing of Chinese medicine), they are seeing that their patients often get relief from non-biomedical medicine.

Here is my problem with hearing the words, "It couldn't hurt:" It COULD hurt if done improperly, and may not do any good. A licensed acupuncturist and Chinese herbalist goes through a 4-year program of learning in GREAT depth all of the intricacies of this style of medicine. In many states, doctors are allowed to practice acupuncture without ANY training because it is considered a "medical procedure" and thus falls under their scope of practice. Luckily, the doctors who practice acupuncture without ANY knowledge of the system are few in numbers. However, the "training" that many doctors receive should not be considered training, but a brief introduction. 100-300 hours of instruction just isn't enough to learn the ins and the outs of such an intricate system of medicine. Kudos to those doctors who have the conscience to get at least SOME knowledge, but this doesn't make you an acupuncturist.

Unfortunately, through programs to teach "medical acupuncture" there isn't enough hands-on training, and this is where the problems lie, in my opinion. There are proper angles and depths at which needles are inserted at each of the acupuncture points (of which there are over 500 commonly-used points). If needles are inserted improperly, such injuries can occur as tendonitis, neuritis, pneumothorax, peritonitis and more. An acupuncturist spends an entire YEAR learning just proper needle insertion, let alone the other aspects of the medicine.

"Medical acupucnturists" aren't given enough training in the art of Chinese medical diagnosis. For example, back pain, in Chinese medicine can have one of several different diagnoses that is leading to the patient experiencing pain in their back. Many medical acupucnturists use a standard set of acupuncture points (kind of like following a recipe to bake a cake) to treat back pain, regardless of the Chinese medical diagnosis. Doing so may lead them to use a point that, at best will have no effect, or at worst, exacerbate the complaint.

Another downfall to a lack of hands-on training is a lack of the concept and perception of Qi. Now, I know this may sound like a silly thing to be concerned with, but I assure you, it's not. (I will note here, that not believing in, or being able to feel Qi, at least isn't DIRECTLY harmful, just a waste of a patient's time, money and trust in the medicine). Medical practitioners who learn "medical acupuncture" are not taught to feel Qi. To me this is missing the entire point of the medicine! If you can't feel the Qi, or don't believe that it exists, how can you manipulate it in order to get the healing response that is desired?

Again, I applaud doctors for opening their minds to the possibilities that other styles of medicine can work. However, unless you're willing to dedicate your time to getting full training, please refer your patients to a specialist. Let's all stick to what we're good at, and refer our patients to each other. They will be the major benefactors, which is what should have gotten us into medicine in the first place.