5: Acupuncture and Swine Flu & Common Cold

May 25, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Swine Flu Guideline and Common Cold

Dear Friends and Patients:

Thank you for your continuously supporting my news letter.

As you may be aware, swine flu is spreading out in US. As per CDC ( Centers for Disease Control and Prevention), there are 5,764 cases and 9 deaths reported as of May 21, 2009.

The tri-state area is one of the most affected areas. Facing the new challenge of the swine flu, what should you do and how can you protect you and your family?

1. Please do not panic. What You Can Do to Stay Healthy:

  • Stay informed. This CDC website (http://www.cdc.gov/h1n1flu/)  will be updated regularly as information becomes available.
  • Influenza is thought to spread mainly person-to-person through coughing or sneezing of infected people.
  • Take everyday actions to stay healthy.
    • Cover your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it.
    • Wash your hands often with soap and water, especially after you cough or sneeze. Alcohol-based hands cleaners are also effective.
    • Avoid touching your eyes, nose or mouth. Germs spread that way.
    • Stay home if you get sick. CDC recommends that you stay home from work or school and limit contact with others to keep from infecting them.
  • Follow public health advice regarding school closures, avoiding crowds and other social distancing measures.
  • Find healthy ways to deal with stress and anxiety.

2. What is the symptom of swine flu, when will you see a physician if you think you have swine flu?

Swine influenza A virus infection (swine flu) can cause a wide range of symptoms, including fever, cough, sore throat, body aches, headache, chills and fatigue. Some people have reported diarrhea and vomiting associated with swine flu. Like seasonal flu, swine flu in humans can vary in severity from mild to severe. Severe disease with pneumonia, respiratory failure and even death is possible with swine flu infection. Certain groups might be more likely to develop a severe illness from swine flu infection, such as persons with chronic medical conditions. Sometimes bacterial infections may occur at the same time as or after infection with influenza viruses and lead to pneumonias, ear infections, or sinus infections.

The main way that influenza viruses are thought to spread is from person to person in respiratory droplets of coughs and sneezes. This can happen when droplets from a cough or sneeze of an infected person are propelled through the air and deposited on the mouth or nose of people nearby. Influenza viruses may also be spread when a person touches respiratory droplets on another person or an object and then touches their own mouth or nose (or someone else’s mouth or nose) before washing their hands.

Not all patients with suspected novel influenza (H1N1) infection need to be seen by a health care provider. Patients with severe illness and those at high risk for complications from influenza (see list below) should contact their medical provider or seek medical care.

Groups at higher risk for seasonal influenza complications include:

  • Children less than 5 years old;
  • Persons aged 65 years or older;
  • Children and adolescents (less than 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection;
  • Pregnant women;
  • Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders;
  • Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV);
  • Residents of nursing homes and other chronic-care facilities.

People with swine flu who are cared for at home should:

  • check with their health care provider about any special care they might need if they are pregnant or have a health condition such as diabetes, heart disease, asthma, or emphysema
  • check with their health care provider about whether they should take antiviral medications
  • stay home for 7 days after your symptoms begin or until you have been symptom-free for 24 hours, whichever is longer
  • get plenty of rest
  • drink clear fluids (such as water, broth, sports drinks, electrolyte beverages for infants) to keep from being dehydrated
  • cover coughs and sneezes. Clean hands with soap and water or an alcohol-based hand rub often and especially after using tissues and after coughing or sneezing into hands.
  • avoid close contact with others – do not go to work or school while ill
  • be watchful for emergency warning signs (see below) that might indicate you need to seek medical attention

3. Steps to Lessen the Spread of Flu in the Home

When providing care to a household member who is sick with influenza, the most important ways to protect yourself and others who are not sick are to:

  • keep the sick person away from other people as much as possible (see “placement of the sick person”)
  • remind the sick person to cover their coughs, and clean their hands with soap and water or an alcohol-based hand rub often, especially after coughing and/or sneezing.
  • have everyone in the household clean their hands often, using soap and water or an alcohol-based hand rub
  • ask your healthcare provider if household contacts of the sick person—particularly those contacts who may have chronic health conditions—should take antiviral medications such as oseltamivir (Tamiflu®) or zanamivir (Relenza®) to prevent the flu.

4. CDC Recommendation For Treatment of Swine Flu:

CDC recommends the use of oseltamivir or zanamivir for the treatment and/or prevention of infection with swine influenza viruses.

  • Oseltamivir (brand name Tamiflu ®) is approved to both treat and prevent influenza A and B virus infection in people one year of age and older.
  • Zanamivir (brand name Relenza ®) is approved to treat influenza A and B virus infection in people 7 years and older and to prevent influenza A and B virus infection in people 5 years and older.

Recommendations for using antiviral drugs for treatment or prevention of swine influenza will change as CDC learns more about this new virus. Clinicians should consider treating any person with confirmed or suspected swine influenza with an antiviral drug.

For more info about swine flu, please visit (http://www.cdc.gov/h1n1flu/)

5.  Is swine flu one of the common flu?

In my news letter 5, We will introduce Traditional Chinese Medicine treatment and concept for common cold. Please find the attached article for common flu, which might help you for your protection from swine flu.

Best wishes,

Jun Xu, M.D., L. Ac. And Hong Su Xu, CMD., L. Ac


News Letter, Vol. 1 (5), May, 2009, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

www.rmac.yourmd.com; www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Common cold



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Georgian S. is a 37-year-old female who works in office with an air conditioner right next to her desk.  One day she began sneezing and complained of a runny nose, nasal obstruction, and a sore and scratchy throat, as well as a cough with hoarseness.  She also had mild general symptoms like a headache, low grade fever, and chills. After not feeling well for about two days she called in sick, saying she was unable to go to work. She then called her primary care physician, who told her to drink fluids, take some Tylenol and stay at home for about two days, and afterwards she could probably go back to work.

The patient then visited me after she called her PCP. She complained of severe headache, aching in her entire body especially in all her joints, fatigue, poor appetite, difficulty concentrating, and sleeping. Her temperature was around 99.8 F, her lungs were clear, she had weak and floating pulses, and a smooth, white tongue coating.

This patient most likely had a common cold, an illness caused by a viral infection located in respiratory tracts such as the nose, sinuses, and bronchial tubes. A common cold may last an average of one week, a mild cold may last only two to three days, whereas a severe cold may last for up to two weeks. Oftentimes colds are mixed with influenza, which typically causes fever, muscle ache, and a more severe cough, so people can be very confused about the difference between the symptoms of colds and influenza.

Explanation of Illness

Adults usually experience an average of two to three colds per year and children six to ten, depending on their age and exposure.  Children’s noses are the major source of cold viruses. They usually contract colds at school.

There are over 100 different cold viruses.  Rhinoviruses are the most important as they cause at least one half of colds, swine flu might appear one of them also.

According to Chinese medicine (TCM), the common cold is exogenous and erroneous, with headache, nasal obstruction, aversion to wind, and fever.  The patient is very sensitive to wind and fever, and Chinese medicine believes it results from the decreased resistance of the body’s immune system and the invasion of the exogenous pathogenic factors.  The manifestations can be classified into two types

  1. Wind cold.
  2. Wind heat.

However, the main reason is that the human body’s immune system function has decreased.  We often see in the same office or same school, some people who always gets a cold,  fever and muscle aches three or four times a year, while other people never catch a cold.  While they both are exposed to same virus, one gets a cold and the other does not because of the difference of their immune function.

According to traditional Chinese medicine (TCM), there are two types of reasons and pathogenesis that cause the common cold:

  1. The main symptoms are chills, low fever, anihidrosis, headache, soreness, pain of the limbs, nasal obstruction, running nose, itching of the throat, cough, hoarse voice, profusely thin sputum, and thin white tongue coating, with a superficial and tense pulse.
  2. The main manifestation of wind heat is fever, sweating, slight sensitivity to wind, pain, a distending sensation of the head, cough with yellow thick sputum, congested sinus, sore throat, thirst, thin white or yellowish tongue coating, and a superficial and rapid pulse. Usually wind heat occurs in summer and autumn. The weather during summer and autumn is hot plus the wind is strong. However, human skin is always perspiratory, i.e. it contains numerous tiny holes for our skin to breath, making the body susceptible to the external pothogenesis. These external pothogeneses invade our body with wind and heat.

Treatment

Traditionally, western medicine treats the common cold using the following medications:

  1. This is the first choice to decrease running nose, sputum, etc.
    1. Non-steroidal anti-inflammatory drugs such as Tylenol, Advil, etc. lower the temperature and pain.
    2. Decongestants, which are vasoconstrictors and can decrease secretion.
    3. Cough suppressants like narcotics to decrease the cough.
    4. Anticholenergics might help to decrease the running nose, sputum, etc.

All of these treatments usually cannot cure the common cold because they are just symptomatic treatments. We cannot eradicate the cause of the common cold by western medicine; therefore, many patients suffering from common cold usually have cold symptoms for around one week.  However, by using traditional Chinese medicine, we may find some way to eradicate the infection and alleviate the symptom sooner.

The simplest formula of Chinese herbs for wind cold is as following,

Red sugar, scallion, fermented soy bean and ginger, boil for 20 min. Patient drinks it after the liquid become lukewarm. The patient should keep his or her body warm, i.e. lie in bed and cover himself with a comforter, waiting for perspiration over night. Usually overnight patient sweats profusely. Their symptom will be much less severe than before.  This simple concoction often alleviates the wind cold. .

For wind heat symptoms, we use onions, scallions, honeysuckle (金银花), and farsythio (连翘), plus sugar. These ingredients are boiled together and cooled. This mixture is often a sufficient treatment for wind heat.

As for acupuncture, we use the following points:

Wind Cold:

(If you can not see the pictures, please move your mouse inside the news letter, you will see these pictures.)

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Pic. 1- 1

pic1-2Pic. 1-2

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Table 1-1:

Points Meridan/Number Location Function/Indication
1 Feng Fu Du  point 16 Directly 1 inch above the mid point of the posterior hair line, directly below the external occipital protuberance, in the depression between m. trapezius of both sides Headache, neck rigidity, blurring of vision, epistaxis, sore throat, post-apoplexy aphasia, hemiplegia, mental disorders.
2 Feng Men Urinary Bladder Point 12 1.5 inch lateral to the Du meridian, at the level of the lower border of the spinous process of the second thoracic vertebra Common cold, cough, fever and headache, neck rigidity, backache
3 Feng Chi Gall Bladder Point  20 In the depression between the upper portion of m. sternocleidomastoideus and m. trapezius, on the same level with Fengfu (Du 16) Headche, vertigo, insomnia, pain and stiffness of the neck, blurred vision, glaucoma, red and painful eyes, tinnitus, convulsion, epilepsy, infantile convulsion, febrile diseases, common cold, nasal obstruction, rhinorrhea.
4 Lie Que Lung Point 7 Superior to the styloid process of the radius, 1.5 inch above the transverse crease of the wrist. Cough, pain in the chest, asthma, hemoptysis, sore throat, spasmodic pain of the elbow and arm
5 He Gu Large Intestine Point  4 On the dorsum of the hand between th e1st and 2nd metacarpal bones, approximately in the middle of the 2nd metacarpal bone on the radial side. Headache, pain in the neck, redness swelling and pain of the eye, epistaxis, nasal obstruction , rhinorrhea, toothache, deafness, swelling of the face, sore throat, arotitis, trismus, facial paralysis, febrile dieseases with anhidrosis, hidrosis, abdominal pain, dysentery, constipation, amenorrhea, delayed labour, infantile convulsion, pain, weakness and motor impairment of the upper limbs.

Du16 can be used to eliminate the wind cold and relieve the headaches.  Feng Men, UB12, one point of the Urinary Bladder meridian, dominates the surface of the whole body and could regulate the circulation of chi (energy) in the meridian to eliminate the wind cold and relieve chills and fever.  Lie Que Lung 7 is the lower point of the lung meridian. It is used to promote the functions of the lung and to help stop the coughing.  GB20 Feng Chi assists Feng Men, UB12 to eliminate the wind cold.  The rest points are powerful points to eliminate the pathogenetic factors of wind cold.

Acupressure tips for patients

  1. Press Du 16 and GB 20 with your thumb for about 5 min each, and then press LI 4 and Lung 7 for 5 min each. Alternate the points for about 2 sessions.
  2. Drink the wind cold formula immediately.
  3. Finish another session of pressing the points. You should feel better overnight.

Acupuncture tips for Acupuncture practitioners:

  1. Electrical stimulation at Du 16, GB 20, LI 4 and Lu 7 for 30 min will greatly reduce the symptoms.
  2. The above treatment should continue for one session of each day for two days.

Wind Heat: table 1-2

Points Meridan/Number Location Function/Indication
1 Da Zhui Du 14 Below the spinous process of the seventh cervical vertebra, approximately at the level of the shoulders Neck pain and rigidity, malaria, febrile diseases, epilepsy, afternoon fever, cough, asthma, common cold, back stiffness.
2 Qu Chi Large Intestine 11 Flex the elbow, the point is in the depression of the lateral end of the transverse cubital crease. Sore throat, toothache, redness and pain of the eye, scrofula, urticaria, motor impairment of the upper extremities,abdominal pain, vomiting, diarrhea, febrile disease.
3 Wai Guan San Jiao 5 2 inch above outer wrist transverse crease, midpoint between the radius and ulna Febrile diseases, headache, pain in the cheek, strained neck, deafness, tinnitus, pain in the hypochondriac region, motor impairment of the elbow and arm, pain of the fingers, hand tremor
4 He Gu LI 4 See  table 1-1 See table 1-1
5 Yu Ji Lung 10 On the radial aspect of the midpoint of the first metacarpal bone, on the junction of the red and white skin (i.e. the junction of the dorsum and palm of the hand) Cough, hemoptysis, sore throat, loss of voice, fever, feverish sensation in the palm.
6 Shao Shang Lung 11 On the radial side of the thumb, about 0.1 inch posterior to the corner of the nail Sore throat, cough, asthma, epistaxis, fever, loss of consciousness, mania, spasmodic pain of the thumb.

Da Zhui, Du14 and Qu Chi, LI11 are well known for lowering temperature, and Wai Guan,  SJ5, He Gu LI 4, Yu Ji L10, and Shao Shang L11 are coordinated to cure the pain all over the body and head.

Georgian was diagnosed with the wind cold.  The acupuncture points Du16, UB12, GB20, L7, and LI4 were given and the patient was also advised to drink ginger and sugar water.  She felt much better after two days and was able to return to work..

Acupuncture tips for Acupuncture practitioners:

  1. Electrical stimulation at Du 14, SJ 5, LI 4 and Lu 10 for 30 min which will greatly reduce the symptom.
  2. The above treatment should continue for one session of each day for two days.

Tips for Patients

Press Du 14 and SJ 5 with your thumb for about 5 min each, then press LI 4 and Lung 10 for 5 min each. Alternate above points for about 2 sessions.

  1. Drink the wind heat formula immediately.
  2. Finish another session of pressing the above points. You should feel better overnight.
  3. Eating a healthy balance diet, getting enough sleep, exercising regularly is essential for resisting and recovering from the a cold.
  4. In addition, taking proper nutritional supplements to support immune
    system. Supplements as needed to ensure you are receiving the recommended dietary allowances for vitamin A, the vitamin B complex
    (vitamins B-1, B-2, B-5, B-6, folic acid) and vitamin C, as well as the minerals zinc and copper. Both vitamin C and zinc are essential. For production of infection-fighting neutrophils; without adequate levels, you’re an easy mark for all types of infections.
  5. In addition, taking proper antioxidants and anti-inflammatory supplements help to
    support healthy immune systems.There are wide varieties of vitamin and mineral supplements on the market today, however most are in tablet form, which is difficult to absorb. Isotonic dietary supplements are delivered in a isotonic solution, which allows nutrients to pass directly into the small intestine and rapidly absorb into the bloodstream and delivering maximum results. Nutrametrix supplies high quality and efficiency of absorption in the body. You may visit http://www.nutrametrix.com/junxumd(1) nutraMetrix Multivitamin is an isotonic-capable supplement containing 100 percent or more of the daily value of essential vitamins and minerals. Only Isotonix Multivitamin contains a unique blend of complementary vitamins and minerals with the superior delivery of Isotonix.
    (2) nutraMetrix Vitamin C sets itself apart from other products on the market providing you with the maximum absorption of the nutrients within the product in the shortest amount of time.
    (3) nutraMetrix® Herbal Antioxidant™ is a combination of vitamins A, C and E, selenomethione, bilberry extract, green tea extract, ginkgo biloba and milk thistle in capsule form, that help protect the body from free radicals that can cause damage to cells., impairing the immune system and leading to various degenerative disease. nutraMetrix® Herbal Antioxidant™ provides strong antioxidant protection, supports a healthy liver, supports healthy immune functions.
    (4) nutraMetrix Immune Maximum Defense Formula is a great way to help maintain general health, help support our normal cellular defenses and promote healthy immune function.The compounds found in Immune Maximum
    Defense Formula promote healthy activity of interleukins, interferons and necrosis factor, all key components in a healthy immune system. Maitake Gold 404®, a highly studied extract of the maitake mushroom, is shown to be effective in supporting the body’s immune cells, including natural killer cells, macrophages, T cells and B cells
    (5) nutraMetrix OPC-3 (pycnogenol): nutraMetrix Isotonix OPC-3® is an isotonic-capable food supplement that is made from a combination of bilberry, grape seed, red wine and pine bark extracts, and citrus extract bioflavonoids, all found to be powerful antioxidants and anti-inflammatory. Studies have shown OPCs to be up to 20 times more powerful than vitamin C and 50 times more powerful than vitamin E in neutralizing free radicals. Isotonix OPC-3 contains the only isotonic form of Pycnogenol® in the world.

Jun Xu, M.D., L. Ac., and Hong Su Xu, CMD., L. Ac.

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