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Science

My First Patient

By | Acupuncture, Addiction, Chinese Medicine Theory, Evolve Health + Wellness, Food Is Medicine, Science | No Comments

In Chinese Medical School one of the first things we’re taught is to not needle without the supervision of a licensed practitioner, and one of the first things we learn is almost everyone needles without the supervision of a licensed practitioner.

First of all, it’s fun. Once you realize you can insert painless needles into particular points on the body to “magically” elicit healing responses of varying degrees it becomes as tempting as driving a car with only a learner’s permit. Secondly, I’ve never met anyone who doesn’t have loved ones suffering as a result of medication falling short of the job. People need help. There’s no time and usually less money, and this is how Dad became my first regular “guinea pig” (his words).

80 year-old man – Chief complaint: Back pain

Dad had been a great athlete, better than I was I’m pretty sure, though he’d never admit so. He played soccer and tennis through college (a whole school’s more than I) and first impressed Mom on a date by leapfrogging a parking meter in his early 40’s. I’m presently 39 and the only thing I can imagine leapfrogging is my pillow into bed.

Somewhere around 70 his body broke down and it seemed with every year his walking stamina was reduced by a full city block. Hip and low back pain, swollen arthritic hands, and macular degeneration in his only functional eye was what scared him most. Understandably, this coincided with a perpetual frustration, the prequel to Depression, and I felt helpless watching my once engaging, charismatic pops transform before my eyes into Cycloid B, sad old man: One word answers, conversations cut shorter, and a subtle but palpable withdrawal from most social cyphers. This is hard to see in a parent – even harder to change in one.

For two years our weekly appointments were malleable around my schedule. Dad had turned from once successful, Manhattan ad executive to struggling, suburban real estate agent, and his schedule was pretty open. Every week I would await his arrival, which was usually a few minutes early, and every week he (inadvertently) tried to make me into a better acupuncturist via his own agenda of relief.

I’d treat him on my bed, face down, sometimes face up, probably attempting whatever “point protocols” I’d just learned that week, always ending with some “Tui-na” massage on his aching back. Results ran the gamut as they tend to, especially with new practitioners and less compliant patients, and I began to “suspect” that he was coming to see me each week just to see me.

On days that I had the bandwidth I would sit and explain to him why it was important to eat healthier, to drink more water and less wine, and even counseled him on how to better manage the pathological patterns that had developed in his dynamic with Mom. Dad was smart, and I’d watch him nod his head in accord with my logic, then come back the next week and shake his head at himself, ashamed, staring at the floor: “I know, son. I gotta do better. I gotta do better.”

I would hear those same four words in all of our conversations for the rest of his life.

It was the first time I observed the little boy inside my father’s eyes. I could see in his gaze the fatherless child he once was, somehow presently in need of my guidance. My once omniscient, hilarious patriarch looked so unknowing and sad, which in turn made me sad, and on my tougher weeks I secretly hoped he would cancel our appointment. I was going through my own personal struggles at the time and couldn’t always fend off the black cloud that seemed to follow him into my tiny Manhattan apartment, hence disallowing of much dilution of said energy.

I’d kiss him on the cheek: “How ya doin’, Pop?”

“Ohhh, I’m alright I guess.”

American male translation: I’m awful, but don’t know how to communicate so.

It seemed like every lead he’d get or hope he had for the sale of a house would fall through, and every week was a new marital conflict with Mom. My once very supportive father barely had two dollars to rub together and it broke his heart that Mom had to work so hard in battle of their reverse mortgage. It broke my heart that it broke his, and I only wished that I’d been unaware enough to not see the parallel between his professional disappointments and my own (comedy) career. Eventually Dad gave up on real estate, mostly because he wasn’t making money, but also his waning energy and visual acuity made driving around town quite difficult. His third and final career would be planning dinner each day for when Mom came home from work. That, crossword puzzles and cheap wine kept him busy for his final years.

In one of our last father/son talks (I as the father, he as son) I encouraged him, as tactfully as possible, to attend Alcoholics Anonymous. The only thing more difficult than convincing a functional alcoholic that they’re an alcoholic is doing so to a parent who’s been drinking his entire life. For some reason we are only able to grasp the concept of the tipped scale when it comes to cigarette smoking. Every other suggested cause and effect is met with: “But I’ve been doin’ this my whole life!”

Exactly.

I gently explained to him for the hundredth time the physiological mechanism by which daily alcohol (and poor diet) might exacerbate his symptoms, also how his consistent intoxication might be contributing to the distance between he and Mom. I never had the strength to add “between he and I” as well.

To my pleasant surprise Dad actually attended the meetings, but never considered quitting drinking, instead naively questioning the rest of the world’s most famous organizational source of sobriety.

“You mean to tell me,” he once confided, “that these people never have a drink? I can’t believe that. I’m gonna ask one of them after a meeting.”

“No! Dad, don’t do that. You don’t have to do that. Trust me. With the exception of the occasional member who might be lying, none of them drink at all.”

“Wow. I can’t believe that.”

He really couldn’t. He kept attending, but much like our acupuncture visits I think he just liked the company and the something to do. In his final years I never saw him drink a glass of water or eat a real breakfast, nor skip his glasses of wine. Although the doctors never assigned him any formal diagnosis, it came as no surprise to me when last month he passed away from heart failure.

Thirty years prior, as a six-year old I’d gotten him to quit smoking with one simple utterance: “Daddy, if you don’t quit smoking you’re gonna die,” and he never lit up again. Apparently logic and supportive evidence persistently delivered by a grown-up doesn’t carry the weight of the wanting look of a child.

I’m not mad, nor do I entirely blame Dad for his condition. I believe there is some karmic assignment to our states of being, but equally that we are active participants in it. We’re all “getting old,” though it’s evident we’re all doing it differently. I guess I can understand skepticism about acupuncture, as we can’t see the “chi” or channels, and some people require tangible evidence detectable by the human senses. However, there is no longer any mystery about the toxicity of sugar, and I think we’re past the generation that fails to recognize functional alcoholism as alcoholism.

My opinion is that the moment sensational pleasures take the place of interpersonal and creative ones we’re in danger of becoming perpetually more dependent upon them. “Let me enjoy my life!” Dad would bark back at Mom when she’d nag about his vices. He’d shuffle off into the living room, full glass in hand. I never saw the joy.

It’s quite simple and scientific, and if only the concept were as drilled into our collective conscious in the same way “smoking kills” has been since my generation: All vices, whether tobacco, alcohol, sugar or sexual overindulgence, serve the same purpose as do anti-depressants. A faux surge of dopamine, which must by the laws of physics “rob Peter to pay Paul,” which means not only fails to address the root of said depression but also contributes to new branches of symptomology. I realize it is easier said than done, but sadness, albeit uncomfortable, is a part of the human experience to be embraced, not muffled and avoided in a psycho-spiritual equivalent to Advil for headaches. It requires courage and patience, which frankly sucks, but is apparently the only way. I’ve now had hundreds of patients since Dad, and request of them all the time: Don’t try to do better. Just do better, as “trying” suggests a mere desire to transform so long as no adversity is involved (which really is paradoxical). It’s not so you can live to be 104, but so the years between 70-85 aren’t so sad.

Love you, Dad.

Research Supports Acupuncture in Cancer Survivorship

By | Acupuncture, Chinese Herbs, Evidence-Based Medicine, Evolve Health + Wellness, Integrative Medicine, Internal Medicine, Oncology, Post-Graduate Education, Research Studies, Science | No Comments

In a systematic review of surveys completed by cancer patients in the journal Hematology/oncology Clinics of North America, use of TCM therapies during treatment ranged from 2.6-100% in every one of the observed studies. Since many oncology centers do not have their own Chinese medicine departments, we can surmise from this information that cancer survivors are seeking care privately. It is paramount that the modern TCM provider understand cancer patients and their needs, from treatment to survivorship.

Research in the American Cancer Society journal suggests that adjunctive TCM therapy may lower the risk of death in patients with advanced breast cancer. A special issue on cancer survivorship in Evidence-Based Complementary and Alternative Medicine shows the usefulness of TCM for assisting patients living with and beyond cancer. Other research in Medical Acupuncture by de Valois et al demonstrates that acupuncture may support prostate cancer survivors in managing unfavorable symptoms and side-effects of pharmacological treatment.

In addition to integrative care during treatment, Chinese medicine can play an important role in health recovery and maintenance after conventional cancer therapies. In our upcoming Cancer Survivorship: Treatment Strategies for the TCM Provider seminar, we will focus on strategies, challenges and special considerations in treating cancer survivors.

Opioid Addiction: Natural Pain Relief through Acupuncture

By | Acupuncture, Addiction, Evidence-Based Medicine, Evolve Health + Wellness, Integrative Medicine, Internal Medicine, Orthopedics, Pain Management, Psychology, Research Studies, Science, Stress Reduction, Trauma | No Comments
800px-Flickr_-_Official_U.S._Navy_Imagery_-_Cmdr._Yevsey_Goldberg_conducts_an_acupuncture_procedure.

Acupuncture for Pain Relief by the U.S. Navy Cmdr. Yevsey Goldberg

This year, the Centers for Disease Control and Prevention (CDC) has revised its guidelines for prescribing opioid pain relief. In the US, opioid addiction has resulted in hundreds of thousands of people overdosing on prescription medication. The CDC has reported that deaths from prescription opioids quadrupled since 1999, resulting in 78 American deaths due to opioid overdose a day. The new guidelines from CDC seek to improve patient safety and address opioid misuse, which all too frequently leads to addiction and overdose-related deaths.

Responsibly reducing the distribution and administration of these potent and highly addictive medicines is one way to address the opioid addiction epidemic in our society. The problem, however, is that people who are most vulnerable to developing an addiction to prescription pain killers end up on that road because they are in pain. Revisions made to prescription guidelines may limit the potential for abuse or misuse, but the need for a different method of pain relief is absolutely necessary.

Acupuncture has been shown to be enormously effective for natural pain relief. This makes acupuncture an attractive alternative to opiate-based drug prescriptions, with no risk of addiction and other major adverse side effects such as those from opioids. The integration of acupuncture into treatment plans of those suffering from chronic or acute pain can significantly diminish the need for addictive medications, and ultimately promote a better quality of life.

A research study that was published in the journal Archives of Internal Medicine looked at nearly 18,000 people who were treated with acupuncture for chronic pain. The results of 29 different Randomized Control Trials were analyzed, and the researchers concluded that acupuncture is in fact an effective treatment for chronic pain and is a viable treatment option across different pain conditions.

Acupuncture for natural pain relief is so effective that the US military has explored the use of acupuncture in the battlefield. Based upon the effectiveness of acupuncture in treating acute pain in soldiers and veterans, a $5.4 million dollar project was started in 2013 by the Department of Defense and Department of Veteran Affairs. The joint incentive fund, “Acupuncture Training Across Clinical Settings (ATACS)” was implemented to examine acupuncture’s impact on pain and reduction in opioid abuse.

Besides natural pain relief, acupuncture has been shown to effectively treat many different medical conditions. A comprehensive review published by the World Health Organization lists dozens of indications in which acupuncture is an effective method of treatment. Because acupuncture and Chinese medicine is a holistic system of medicine, the treatment of pain would include treating the whole body and the whole person. It is common for people under care with acupuncture and Chinese medicine to experience relief of symptoms related to other health concerns besides pain.

What about alternatives for those who may already be reliant on pain medication?  In 2011, researchers conducted a study showing that acupuncture is effective in the treatment of opioid addiction. While they concluded that the lack of Randomized Control Trial studies means that work still needs to be done in order to concretize acupuncture’s efficacy for treating opiate addiction, the studies did prove that acupuncture is helpful in symptoms of withdrawal and caused relaxation in the patients.

The opioid addiction epidemic is widespread and devastating in its impact on communities across the United States. The Centers for Disease Control has recognized the need for raising awareness of the problem on all levels of healthcare and has responded with guidelines for injury prevention, encouraging providers to recommend nonpharmacologic therapies for pain. Acupuncture is an effective treatment method with little to no side effects that can provide natural pain relief, as well as helping to improve quality of life by reducing need for medication and increase relaxation.

If you have any questions about how acupuncture can help you or someone you love, please don’t hesitate to contact us at Evolve Health + Wellness, Chinese medicine and acupuncture clinic in NYC.

A Model for Integrating Acupuncture into Supportive Care in Oncology

By | Acupuncture, Evidence-Based Medicine, Integrative Medicine, Internal Medicine, Oncology, Pediatrics, Research Studies, Science | No Comments

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Last month, we hosted – for the first time ever – a seminar in Chinese Medicine and Oncology at the Columbia Medical Center/New York Presbyterian Hospital. This two-day course, led by the esteemed Drs. Katherine Taromina and Frank Butler, examined treatment strategies and the role of Chinese Medicine in supportive care for cancer patients. In addition to invaluable clinical insight and cutting-edge research shared by our lecturers, participants were offered an exclusive tour of the infusion center and cancer care facilities at the hospital.

As Acupuncture and Chinese medicine is increasingly becoming a standard method of treatment in the US, it is important to examine how best to integrate it into conventional practices and treatment protocols. One of the articles reviewed at the seminar was co-authored by Dr. Taromina herself: ‘A Model for Integrating Acupuncture into Supportive Care in Oncology’. This article is the first of its kind to explore the practical application of Chinese medicine in a hospital setting when treating cancer patients.

According to the article, there have been over 800 scientific studies published over the last 10 years on the role of acupuncture in cancer care. Many of them demonstrate the effectiveness of acupuncture in the treatment of cancer symptoms as well as adverse reactions to chemotherapy. Symptoms such as nausea, pain, xerostomia, anxiety, hot flashes, lymphedema, and insomnia can be effectively treated with acupuncture.

Dr. Taromina’s work in this field is pioneering, and we hope you gain as much from reading her article as we have. We’d love to hear your thoughts on the topic, too!

If you missed out on the seminar, don’t worry. If you are a licensed provider, you are eligible to attend our Grand Rounds: Oncology and Cancer Care Support. For more information, don’t hesitate to Contact Us, or sign up for our Professionals Newsletter to stay up-to-date with our course offerings and events.