Random Ruminations of an Acupuncture Doctor

Occasionally, I have aha moments. In these moments I am inspired to share with others. Bits and pieces of stuff I've learned along the way down my path. Please enjoy!

Wednesday, October 27, 2010

The Science of Acupuncture, Part 2


Acupuncture, Chinese herbal medicine and Oriental medicine, in general, have received countless criticism from naysayers when it started to become more popular with patients in the west. Why has an 8000 year-old medicine received so much criticism? The answer is multifaceted.
It begins with the fact that both western and eastern medicines are rooted in different paradigms. Western medicine is based in microbiology and biochemistry (i.e.: bacterial and viral infections, hormonal imbalances). For just over 200 years western medicine has been the primary source of healthcare in the west. Few patients realize that prior to that western medicine had its origin in northern Europe where, for over 500 years, the primary focus of physicians was trying to keep people alive after being infected from the plague. Preventive medicine wasn’t a concern during this period and doesn’t seem to be of much concern today. 

Preventive medicine uses treatment strategies and education to keep patients healthy. As a result they are less likely to need medical intervention, whether it is for the common cold, allergies or cancer. As a result of being in a constant diseased state, patients are more likely to seek out ways to pay for healthcare through insurance policies that cover the procedures and medications their physicians prescribe. As a result, healthcare and health insurance policies have experienced exponentially increasing costs to patients. Economically, this doesn’t make a lot of sense, but somehow the majority of the population has jumped on-board with this “sick” model of medicine.


Historically, western medicine has justified treatments through expensive or dangerous laboratory tests (i.e.: blood and urine tests, x-rays, MRI’s, CAT scan, colonoscopies, etc.). Unfortunately, for many patients, these tests result in inconclusive results, which does not help explain why they remain in a diseased state. It can be very frustrating for patients. Consequently, patients, often times, end up having more doctor visits, more medications, more surgeries or other procedures, all of which increases costs to patient and their insurance companies. Does this make sense?

Oriental medicine isn’t based on bacterial and viral infections or chemical imbalances as the primary cause of disease. Because of this, patients and western physicians argue that it isn’t a scientifically based medicine. As if the only valid science is bacteria, viruses and chemicals. 
Unlike many of my colleagues, I was fortunate enough to study and work in a true science-based field: engineering. The various engineering disciplines are, all, rooted in natural laws that govern all matter, no matter what it is: sub-atomic particles, complex machinery, aerospace vehicles or the human body. All matter in the universe is subject to natural laws. Most doctors fail to realize this, yet scientists in every field agree that natural laws are the catalyst for change in the state of all things, large and small, living and inorganic. This the primary cause of disease in Oriental medicine.

Engineering is all about using natural laws to design structures and mechanisms so that they will function flawlessly in various environmental states. The human body is comparable to an extremely complex structure or mechanism. It is, constantly, being subjected to various environmental states and is required to function flawlessly in all of them. It breaks down when its owner neglects to learn about and respect the natural laws that govern the body and forces it to operate outside what would be considered a safe envelope. Engineers, in their designs will, typically, plan on their mechanisms or structures to operate within a safety-of-factor of at least two. This means that the engineer will design the product to withstand twice the strain or load it is subject to.

Unfortunately, most patients are unaware of the “safe envelope” their bodies are designed to operate in. Consequently, when this envelope is repeatedly violated their bodies become less able to withstand the constant abuse. What would be considered a safe envelope for one person may not be for someone else. So, in essence, each person is different and should be treated accordingly. To believe that the entire population is the same and will respond the same to a specific treatment strategy is a fallacy of certain medical models. Chinese medicine has always asserted that various patients presenting with the same signs and symptoms, most likely, will have different underlying pathologies. It would be insane to treat them all the same, but that is, exactly, what’s happening in most traditional medical models.
There are several fields of western science that govern Oriental medicine and it’s various patterns of diseases and pathologies. What’s amazing is the ancient Chinese discovered these sciences thousands of years ago and identified their affects on the human body and how to appropriately treat them. The science of Oriental medicine encompasses the following scientific fields: thermodynamics, fluid mechanics, holography, quantum physics, electromagnetism, static and dynamic physics, wave theory and particle physics. Granted, these are difficult sciences to wrap your head around and because of that, prevent most doctors of oriental medicine from adequately explaining the science of acupuncture to patients and western trained doctors. In a follow-up, I'll discuss a few of these sciences and the mechanisms of how they affect changes in the body that lead to the disease process. Th ancient doctors of Chinese medicine had extensive knowledge of these sciences and how to apply them to physical, mental and spiritual health.



Friday, October 1, 2010

Really! Is this Modern Medicine at it's Best?

I see all kinds of patients in my clinic. Young, old, men, women, the works! We get referrals from several different types of doctors: other acupuncturists, MD's, DO's, chiropractors, naturopaths, etc. There is a group of patients that, in my opinion, western medicine has swept under the rug, to hopefully not resurface. Which group, you ask? The elderly, the senior citizens, the folks that are supposed to be living the "Golden Years".

Case in point. A chiropractor recently referred an elderly gentleman (73 years old) to me for low back pain following a spinal fusion in the lumbar spine.


Come to find out, the chiropractor had done a multiple number of therapies, several times a week, for several weeks without any success: spinal adjustments, cold laser therapy, ultrasound. All he was able to do was successfully run through the patients insurance money. At what point does a doctor with integrity tell a patient that there is nothing else they can do for them? Granted, every patient is different. They all respond differently to each therapeutic modality. Each patient has their own unique history that can inhibit their body's healing processes. Some of a patients history is due to their own lack of attention to proper diet, lifestyle, exercise, etc. The other problem with a patients history is due to poor or incorrect treatment strategies by their doctors. I believe in doing all I can to help educate patients so that they will have the necessary tools to make good choices in order to enhance their health and well being. Unfortunately, most medical professionals are so over-worked, just to keep their doors open, that they don't make time to empower patients to help themselves. The end result is that it becomes easier, not better, to simply prescribe more medications or perform more surgeries.


Getting back to my new patient, he brought in his list of medications and significant medical procedures.

And people wonder why they're not feeling well or not getting better.

Significant medical procedures or events from 1987 to 2009:

3 heart attacks
Triple by-pass heart surgery
Polyps removed during colonoscopy, 3 times
Gallbladder removed
Double knee replacement
Congestive heart failure, 3 times
Prostate Cancer surgery
Spinal fusion in lumbar spine
Heart catheterization
Defibrillator/Pacemaker installed


Current list of medications:
    * carvedilol
    * Celebrex
    * Diovan
    * dipyridamole
    * furosemide
    * Klor-Con M
    * Levoxyl
    * Lovaza
    * metformin
    * Niaspan
    * Novolin 70/ 30
    * pantoprazole


Whenever a patient is taking more than 2 or 3 medications, I like to run a report of any possible interactions to see if there is anything to be concerned about. The report for this patient is listed below:

Avoid/Use Alternative

1. carvedilol <-> Celebrex
monitor BP, use alternative: combo may cause sodium/water retention, decreased antihypertensive efficacy (antagonistic effects)

2. carvedilol <-> Novolin 70/ 30
use alternative: combo may alter glucose metababolism, prolong hypoglycemia, mask hypoglycemic sx (adrenergic antagonism)

Monitor/Modify Tx

3. carvedilol <-> metformin
monitor glucose: combo may alter glucose metab., prolong hypoglycemia, mask hypoglycemic sx (adrenergic antagonism)

4. Celebrex <-> Diovan
monitor BP, renal fxn: combo may decr. antihypertensive efficacy, incr. risk of nephrotoxicity (antagonistic effects, additive effects)

5. Diovan <-> furosemide
monitor BP, use for therapeutic advantage: combo may incr. risk of hypotension (synergistic effects)

6. Diovan <-> Klor-Con M
monitor potassium, check potassium content of supplement: combo may incr. risk of hyperkalemia (additive effects)

7. furosemide <-> metformin
monitor glucose: combo may decr. hypoglycemic agent efficacy; loop diuretics may cause hyperglycemia (antagonistic effects)

8. furosemide <-> Novolin 70/ 30
monitor glucose: combo may incr. insulin requirement, loop diuretics may cause hyperglycemia (antagonistic effects)

9. Levoxyl <-> metformin
monitor glucose: combo may decr. hypoglycemic agent efficacy; high dose thyroid hormone may cause hyperglycemia (antagonistic effects)

10. Levoxyl <-> Novolin 70/ 30
monitor glucose: combo may incr. insulin requirement, high dose thyroid hormone may cause hyperglycemia (antagonistic effects)

11. metformin <-> Niaspan
monitor glucose: combo may decr. hypoglycemic agent efficacy; niacin may cause hyperglycemia (antagonistic effects)

12. metformin <-> Novolin 70/ 30
monitor glucose, use for therapeutic advantage: combo may incr. risk of hypoglycemia (synergistic effects)

13. Niaspan <-> Novolin 70/ 30
monitor glucose: combo may incr. insulin requirement, niacin may cause hyperglycemia (antagonistic effects)

Caution Advised

14. carvedilol <-> Lovaza
caution advised: combo may antagonize antihyperlipidemic effect of omega-3-acid (antagonistic effects)

15. carvedilol <-> Niaspan
caution advised: combo may incr. risk of orthostatic hypotension (additive effects)

16. Celebrex <-> furosemide
caution advised: combo may decr. diuretic, natriuretic, antihypertensive effects of loop diuretics, incr. risk of nephrotoxicity (antagonistic effects, additive effects)

17. dipyridamole <-> Lovaza
caution advised: combo may incr. risk of bleeding (additive antiplatelet effects)

Really?! I'm positive this patient was never informed of the interactions or the side affects of all these medications. It's very sad to see what is happening to our "senior citizens". They were raised in an age where you could put all your trust in the medical profession. That trust has failed this patient and I'm sure it has failed many others.

I can't help but think that western medicine has, somehow, gotten off-track. Whatever happened to "doing no harm"? There seems to be a real lack of connection of medical doctors with their patients. Actually, I hear complaints about this, quite often, from my own patients. Unfortunately, most of the population in Western society are convinced that western medicine has all the answers. This case illustrates how off-base this system has become. Just the other day, another one of my patients asked me how to file a complaint with my state's medical board. I asked her why, was she going to file a complaint about me? She assured me that she wasn't but related her own horror story and experience with "one" of her many other physicians. It seems to be a rampant problem in main-stream medicine.

The medical profession, in general, is broken. The focus needs to be put back on the patient, not the bottom line.