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11: Acupuncture and Drug Abuse

Nov 27, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dear Patients and Friends:

I assume that all of  you are having a wonderful holiday season. Please find the following News Letter 11. We will discuss about drug abuse. It might give you some idea to help others.

I wish you continue to have a wonderful holiday season.

Best,

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


News Letter, Vol. 1 (11), November, 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

 

 

 

 

Drug Abuse

 

Peter W. is a 53 year old man who has been extremely successful in business. During his career, he built up a huge company which he sold for 20 million dollars in 2000.  Afterward, he felt depressed and realized he had nothing to do which made him sluggish and without motivation, as he had no goal to pursue.  He started using drugs, including heroin, which soon became a daily habit.  When he was no longer to procure drugs easily in the United States, he turned to the internet and started ordering drugs by E-mail, which were sent to him from Africa.  Though he had no real idea what he was using, he continued with his habit, which made him feel empty, depressed, anxious, restless and gave him insomnia, all of which caused a poor relationship with his wife and family.  On some occasions he used so heavily he was unable to rise from his bed for a couple of days, on other occasions his family had to rush him to the emergency room.  He felt occasional euphoria, followed by the deepest depression, and cloudy mental functioning.

He knew this was not way to live, so he tried to find work that would engross him.  For example, he took a charity job and helped the company build up cheap laptop computers for distribution to third world countries to help the young people there.  In spite of this worthwhile work, he still felt empty.  He took another job as V.P. and a seat on the Board of Directors in one of the biggest computer companies.  He worked very hard at this new job, however, as soon as he stopped working or had leisure time he found himself reverting to drug use.

Finally, he came to me for help, saying he wanted to quite drugs altogether.

Heroin is a highly addictive, illegal drug, the most abused and most rapidly acting of the opiods.  It is processed from morphine and naturally occurring substance extracted from the seeds of certain varieties of poppy plants.   It usually appears as white or brown powder, and sometimes is mixed with sugar and other substances to cut its strength.

Heroin has both long and short term effects.  The short term effects include: depression, bad respiration, clouded mental functions, nausea, vomiting, spontaneous abortion.  It is used medicinally for the suppression of pain, though under controlled conditions. In addition, heroin can cause temporary feelings of euphoria.  Long term effects include addiction and infectious diseases such as HIV, AIDS, hepatitis B and C, collapsed veins, bacterial infection, abscesses,  arthritis and pneumatic problems.

In Western medicine there are many types of detoxification programs.

  1. The methadone is the most popular.  Methadone is a synthetic opioid that blocks the effects of the heroin and eliminates withdrawal symptoms; this method has a proven record of success for heroin addicts.
  2. A pharmaceutical approach is the use of buprenorphine as another behavioral therapy.  Buprenorphine offers less risk than methadone and can be prescribed in the doctor’s office.  Bupherorphine and Suboxone is a combination drug product formulated to minimize abuse.

Chinese medicine and acupuncture have a long history of treating drug abuse.  The two types of treatments are:

  1. Auricular acupuncture
  2. Body acupuncture.

The main functions of the acupuncture treatment are to decrease the withdrawal symptoms and improve the patient’s depression and brain function.  There are many studies supporting these treatments and the most well known is that acupuncture can directly increase the level of endogenous endorphin, which makes the patient feel calm, relaxed and cheerful.  Acupuncture can also directly stimulate the central nervous system to make the patient feel less depressed and lessen the craving for drugs.

For auricular acupuncture, I use the lung, endocrine, liver, spleen and large intestine points corresponding to these organs. .  The lung has an opening through the nose and when people abuse heroin, the lung point will protect the lung function and strengthen the immune system.   The endocrine points increase endorphin secretion and increase people’s immune function to protect the entire body.  Liver and spleen points improve circulation and also improve the taste in the mouth because the spleen and stomach have openings in mouth and large intestine points; the intestine and the lung have direct meridian connection, so if we improve the function of the large intestine, this in turn will directly improve the lung function.

Pic 6-1

For the body acupuncture points, the most important ones are on the head. I use Baihui DU20 plus shi sheng chong Exn1, total five points, which can directly stimulate the central nervous system when I add electrical stimulation to the needles.  They send current directly to the cortex of the brain, which greatly improves the patient’s mood and decreases the depression.  Shuaigu GB8, which is on the head 1.5 inches above the tip of the auricular is directly connected to the sensory cortex, which will improve the body’s sensation and make it dislike the taste of heroin.  Hegu L14 is a point that can largely increase endorphin secretion and Qu Chi L111 will give a better functioning effect.  Neiguan Pc6 is a point of the pericardium meridian, which also helps improve mental functions.  Lu7 is the point from the lung meridian which protects the lung from attacks of heroin and improves the immune function of the lung.

Pic 6-2

After treatment of two weeks, the patient started to feel decreased withdrawal symptoms and had more energy.  However, he sometimes still feels cravings for heroin, and he has some physical weakness, with muscle spasms in his arms and legs.  He also experienced restlessness and agitation, often accompanied by insomnia.  I continued the acupuncture treatments three to four times a week for eight weeks, while also discussing the short and long term effects of heroin use and what organs would be effected and harmed by continued use.  He told me that, in spite of the withdrawal symptoms, he still felt much better with the treatments and he is happy to treat his addiction in this fashion, rather than go into a methadone program, at which point his drug use would become generally known.  By coming to me, he can be treated in private for his addiction.

Peter W. was also advised to make lifestyle adjustments and I encouraged him to work more for the charity.  He traveled to Africa and Asia to actually see and meet the people using the inexpensive computers, and what it could do to improve their lifestyles.  This experience touched him a great deal and after about 3 months of treatment he stopped using heroin entirely and is now completely clean.  His insomnia, depression, anxiety and other symptoms are much improved and he is leading a normal life again.

9: Acupuncture and Smoking

Sep 29, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 1 (9), September, 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

 

 

 

 

Smoking Cessation

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Jackson W, a 56 year old male, is president and CEO of a large company.  When he consulted me it was due to his habit of smoking 2 packs of cigarettes a day for the past 45 years.  Now he has shortness of breath and heart palpitations and he is afraid he may have lung cancer.  He came to me hoping I could help him quit.

He is a heavy-set man who comes down hard on his feet and legs while walking, he has yellowish facial skin and smells of cigarettes, especially on his breath.  He says he feels energetic and, by listening to his lungs, I ascertained there was no wheeze, no cloud sound from the lung and his heartbeat was normal.  In giving his history, Jackson told me he had been in the army, and after his tour of duty returned to the United States where he started to work.  Since he never went to college, he knew he had to work extremely hard to beat his competitors, and he roused both himself and his son, by telephone as he worked in a different city, at six .am., at which time he went to work, often not returning home until 10 p.m.  He worked like this seven days a week which, in the beginning was doable.  However, recently, he felt he did not have the stamina to keep up this schedule, and he was afraid he might die of smoking and working so hard, to he came to me for help.

I discussed with Jackson the absolute necessity to stop smoking, because cigarettes contain the drug nicotine, which is as highly addictive as heroin or cocaine.  Over time, the smoker becomes physically and emotionally to it and totally dependent on nicotine.  Many men think nicotine gives them the energy to support their lives, while many women believe cigarettes make and keep them thin.  Studies have shown that smokers must deal with both physical and psychological dependence to be successful at quitting and staying quit.

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When a smoker inhales, nicotine is carried deep into the lungs where it is absorbed quickly into the bloodstream and carried throughout the body.  Nicotine affects many parts of the body, including the heart and blood vessels, hormonal system, metabolism and brain.  Nicotine can be found in breast milk and even in cervix mucus secretions of smokers.  Nicotine can freely enter the placenta during pregnancy and affect newborn infants.

Nicotine produces pleasant feelings that makes the smoker want to smoke more and more, and after awhile the smoker develops a tolerance to it, which brings an increase in smoking over time.  The smoker reaches a certain nicotine lever and then smokes to maintain this level.

Currently all medical research indicates that many severe diseases are caused by smoking.  These include bronchitis, emphysema and even lung cancer, which makes many smokers try to cut back or quit altogether.  However, as soon as the smoker actually does quit  – for a few hours or a few days – withdrawal symptoms occur, including dizziness, depression, feelings of frustration, impatience, anger, irritability, sleep disturbance, increased appetite, trouble concentrating, headache, tiredness and restlessness.  All these symptoms can lead to the smoker starting again in order to boost blood levels of cigarettes back to the level where there are none of these symptoms.

I discussed all these issues about health with Jackson in an effort to make him understand why he must quit.

1.  Almost everyone understands that smoking can cause lung cancer, however, many other cancers can be introduced through smoking: cancer of the mouth, vocal cord, affecting the larynx, throat, pharynx, esophagus, bladder, kidneys, pancreas, cervix, stomach and leukemia.

2. Lung disease can lead to pneumonia, chronic obstructive pulmonary disease (COPD) and chronic bronchitis.

3.  Smoking can also lead to heart attack, stroke, blood vessel disease and blindness.

Chinese medicine believes that cigarette smoking falls into three major types:

  1. Type 1 is Energy deficiency of the heart and lung, which includes bronchitis, emphysema, coronary artery disease and insomnia.  The main symptoms are cough, asthmatic attacks, chest pain, sore throat, shortness of breath, agitation, anxiety, poor sleep, insomnia and dreaming.
  2. The second type is Yin deficiency of the liver and kidney, which includes high blood pressure and insomnia.  The main symptoms include dizziness, faintness, tinnitus, impotence, early ejaculation or night ejaculation, dysmenorrheal and infertility.
  3. The third type is Weakness and deficiency of the spleen and stomach, which includes chronic gastritis and peptic ulcer.  The main symptoms include stomach ache, bloating, poor appetite, loose diarrhea, heaviness of the body, drowsiness and headache.

4. Treatment

(1) Auricular acupuncture treatment, i.e. Ear embedding needles.  First we find the most painful points on the ear, those usually corresponding to the heart and sympathetic system. I regularly use Sheng Meng, Heart, Lung, Endocrine and Large Intestine. I insert the needles at the auricular points.  These needles stay in  the ear for seven days and every day the patient presses the needles for 4 to 5 minutes per hour, which lessens the craving for the nicotine in a cigarette.  He also presses the needles anytime he gets the urge to smoke.  It is possible to bathe or shower with the needles imbedded in the ear, but the patient must be on the alert for any signs of inflammation or infection.

(2) Laser treatment. Laser needles can also be used on the auricular acupuncture points. aiming directly at the ear for usually 2 to 3 mm.  For each treatment, four pints are used for 15 minutes each time, with the total treatment about 25 to 30 minute.  This is done 3 times a week for 4 to 8 weeks.

  1. Auricular acupuncture point injections. 0.5% sodium chloride can be injected for each day one or two points, always changing the points after each injection. Endocrine, sheng meng, stomach, liver and lung points are often used.
  2. Electrical stimulation for the ear. I usually select sheng meng, lung and endocrine, and use a 1 inch needle in both ears and do six points, then employ electrical stimulation for about 30 minutes and continue this treatment every other day for a total of  four weeks.
  3. Body acupuncture. Emotional burden, such as stress, anxiety, poor sleep and depression can force many people to smoke, therefore, body acupuncture can help to reduce emotional problem.

1, Type 1: Energy deficiency of the heart and lung,  auricular points are heart, sympathetic, sheng meng, body points are Zhong Fu, Ju Que, Nei Guan, Fei Shu, Xin Shu, San Yin Jiao, Chi Zhe.

Pic 5-1

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large_pic2, Type 2: Yin deficiency of the liver and kidney Auricular points are Liver, Kidney, Sheng Mend, Endocrine, body points are Jing Meng, Xing Jian, Tai Xi, Gan Shu, Bai Hui, Shui Quan.

table_2Jackson was treated with both ear and body acupuncture.  He had three treatments a week for eight weeks, and after the first week he reduced his intake to one pack of cigarettes a day and the second week he stopped smoking. After the total time of eight weeks he was completely off cigarettes.

In my experience, the first two weeks are the most crucial time for the patient, because the nicotine withdrawal syndrome is the most severe and the patient is depressed, agitated, sometimes anxious and suffering from insomnia, and any of these can cause a return to smoking.  If I treat the patient with ear acupuncture, he can constantly press the needles embedded in the ear, which will decrease his craving for a cigarette and will enforce the psychological support. If the patient knows all the consequences of smoking, and desires to quit, he usually can do so with acupuncture.  Most succeed with the right attitude toward the consequences of continuing to smoke.

Tips for acupuncturists:

  1. Education, education! This is the most important part. If the patient is not willing to quit, there is no way to force the patient to quit.
  2. Encouragement: You have to encourage the patient to stick to the program.
  3. Support: you have to get support from the patient’s family and friends.

Tips for patients:

  1. Be determined and stick to the program: the first 2 weeks are the most difficult time. If you can stick to it, you will win the war.
  2. Think about your future and your family’s future, you do not want to set up a wrong role model for your children and family members.

8: Acupuncture and Allergy and Sinusitis

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

Dear Friends:

I assume you have had a wonderful summer. Now it is the time for our news letter 8 – allergy and sinusitis. If you think any of your friends or family members might be interested, feel free to forward this to them.  I hope your friends and you will enjoy it.

Best regards,

Jun Xu, M.D and Hong Su Xu, C.M.D.


News Letter, Vol. 1 (8), August, 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

Case Discussion: Allergy and Sinusitis

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From: www.eyuyu.com/…/0618/20090618011745378.jpg

Dan J was a 16-year-old boy who came to me complaining of itchy and pinky eyes, difficulty breathing, headaches, and a runny nose which exuded yellow and green sputum for two weeks.  The patient had experienced these symptoms on and off for more than five years and they got worse  during the spring and autumn and better in the summer.   He was diagnosed with allergies which sometimes developed into sinusitis. He was given Allegra, benadral and other antihistamine medication.  At the beginning, this treatment helped, however, after about a week or two the medication stopped working. The patient was also given allergy shot with multiple antigens for more than one year. However, it seems not working too. His symptoms are very often developed to severe sinusitis headache, poor sleep and difficulty in concentration. His physician often has to prescribe antibiotics to prevent the infection further development. His mother is very concerned about the frequent usage of antibiotics, therefore today, he is brought to me. He reported he has all the symptoms listed above, with the addition of a minor outbreak of hives on his face and body.

Explanation of Illness

Allergies are an abnormal reaction to an ordinary, harmless substance called allergen.  They are many different allergens, such as pollen, dust, fur and mold.  When the allergens are absorbed into the body through inspiration or skin contact,  people’s immune system will have a chain reaction, and the white blood cells will produce IgE antibodies.  These antibodies attach themselves to mast cells which will cause the release of histamine and other potent chemicals.  This histamine will cause a spasm of smooth muscle on the respiratory tract, sinus, skin, ear and other body parts and then leading to runny nose, watery eyes, itching, and sneeze. If the sinus is infected with virus and bacteria, sinusitis occur and patients will feel sinus headache and fever.

There are three major sinus: 1. Frontal, 2. Ethnoid and 3. Maxillary sinuses, which are easily infected or irritated with allergens.

pic2There are five types of allergic reactions according to western medicine:

  1. Seasonal allergic rhinitis.
  2. Allergic rhinitis.
  3. Eczema (atopic dermatitis)
  4. Contact dermatitis.
  5. Urtcaria (hives).

Symptoms can be from mild to severe and are usually treated with antihistamines, decongestants, cortisone products (which might produce long ranging side effects), local chain modifiers which will block the effects of inflammatory chemicals and mast cell stabilizers.

 

Traditional Chinese Medicine (TCM) believes allergies and sinusitis are one disease with two different manifestations and stages.  In the first stage, the patient’s immune system is weakened.  When the weather changes, antigens, such as dust and mould increase and  invade the human body through the skin, mouth and nose, casing symptoms of the lung and the liver.   The symptoms of lung show shortness of breath and secretion from the sinus, the nose is the opening for the lung.  If there is allergen invasion from outside,  and  the patient’s body is not strong enough to combat it – especially if the immune system is in a weak state – the weak immune system will make the  lung symptoms worse.  This is why different people face the same allergen invasion and have different responses.  Most people are not allergic to dust, mould and the like.  They have no problem with allergens.  However, some people suffer from this condition because their immune system is weakened and their body energy is low, especially in the lung.  The liver function corresponds to the eye, i.e. the opening outlet of liver is eye. Therefore, if the lever function is low and weak, the eye symptoms such as itchy, pinky and tearing eye are more prominent.

Treatment Through Acupuncture:

Type 1:

  1. Allergic sinusitis.  We use LI 20 (Ying Xiang), which corresponding to maxillary sinus,  LI11 (Qu Chi), LI 4(He Gu) and GB 20 (Feng Chi).

Frontal sinusitis: add UB 2 (Zan Zhu)

Ethmoid sinusitis: add SI 18 (Quan Liao)

Pic 4-1

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Table 4-1

chart4Notes: Please see news letter 5 for table 1 and Pic 1 series, news letter 6 for table 2 and Pic 2 series Newsletter 7 for table 3 and Pic 3 series  from www.drxuacupuncture.co for the location and photos of the acupuncture points.

Pic 4-2

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Acupressure Tips for patients:

  1. The key acupressure points are LI 20, UB2 and GB14. You will feel your sinus opening by pressing the above points in both sides for 5 min of each and 2 to 3 sessions.
  2. Irrigating your sinuses with normal saline or some Chinese herbs solution might give you a significant improvement.

Acupuncture Tips for Practitioners:

  1. By electrical stimulation the points of LI 20 (Ying Xiang), UB 2 (Zan Zhu)  and GB 14 (Yang Bai), you may give patients a surprise that their sinusitis and headache might go away within one to two sessions, because the above points may increase the opening of the sinus and drain the sinus. The patients will feel “the pressure over the sinus” are much less after the treatment.
  2. LI 20 (Ying Xiang) is the outlet of the large intestine meridian and is adjacent to the nose, thus LI 20 connects the nose to the sinus after stimulation of the point. By stimulation of points of LI 20, UB 2 and GB 14, the treatment desensitizes the mucus membrane and decreases the amount of secretion. Hu Gu is the original location of the large intestine point, which can make the invasion of the allergen decrease and also will expel the allergen from the body. GB 20 (Feng Chi) will  enhance LI 4 (He Gu) of the  function to expel the invasion of the allergen.

Type II

For allergic eye symptoms we use GB20 (Feng  Chi ), LI11 (Qu Chi), LI 4(He Gu) plus the followings, St 1 (Cheng Qi),  St 2 (Si Bai), SJ 23 (Si Zu Kong) GB 14 (Yang Bai), GB 1 (Tong Zi Liao), UB 2 (Zan Zhu), UB 1 (Qing Ming), ST 8 (Tou Wei) and Ex-HN5 (Tai Yang).

For itching in the ear, add SJ 21 (Er Meng) and SI 19 (Ting Gong), GB 2 (Ting Hui).

See Table 4-2,  Pic 4-1 and Pic 4-2

chart6pic7Acupressure Tips for patients:

  1. For patient with itching ear and tinnitus, SI 19, SJ 21 and GB 2 are the best choice. You may press the above points for 3 to 5 min, 2 to 3 sessions per day for  2 weeks, you will realize the beauty of the points.
  2. For tearing and itching eye, GB 1, UB1 and St 1 are good choice.

Acupuncture Tips for practitioners:

  1. Electrical stimulations for SI 19, SJ 21 and GB 2 will greatly improve hearing, tinnitus and decrease the ear itching. You have to further differentiate the symptoms based on the patient’s body types,  there are two subtypes:
    1. Kidney Yang deficiency accompanied with symptom of cold in all 4 extremities, fatigue, and clean and long urine: add UB 23 (Sheng Shu) see Pic 3-1 and table 3-4.
    2. Gall Bladder fire excess accompanied with symptom of thirty, bitter in the mouth, inflamed eye, add GB 34 (Yang Ling Quan)  and Li 3 (Tai Chong).

Pic 4-3

chart8

  1. GB 20 (Feng Chi) ( See Pic 1-1 and table 1-1)  protects the patient from the allergen invasion and strengthens the immune function of the human body.  St 8 (Tou Wei) and Ex-HN5 (Tai Yang) are around the scalp, and will decrease headaches.

chart9Pic 4-4

pic10Initially Dan J underwent my treatment for four visits.   On his first visit, after about 20 minutes, his eyes were dry and his sinuses had stopped running, which made him happy and much more comfortable.   With three more treatments, his symptoms were almost gone. After discussing the case with his mother, Dan J came back for continued treatment, for a total of ten visits.  His problem was mainly due to a weakened immune system with deficiency of Kidney and Lung.  he needed acupuncture to help him improve these systems, thus casting off the effects of allergens on his body.

After subsiding his symptom, Dan was advised to return to my office during summer for about 12 visits, even then he did not have any symptom. After these treatments, Dan’s immune system was much strengthened, he only needed to come to me at the beginning of the next few  allergy seasons for five to six visits. Recently, however, his symptoms are so much improved, that he no longer needs to consult me, even at the beginning of new allergy season.

Tips for everybody:

“Strengthening your Yang in the summer, nourishing your Ying in the winter” is the wisdom of Traditional Chinese Medicine, which guides TCM practitioners for more than two thousand years. It means that the patients of allergy, sinusitis and asthma should be treated during summer for strengthening their Yang, i.e. immune system. The acupuncture points are UB 13 (Lung, Fei Shu), UB 15 (Heart, Xin Shu), UB 20 (Spleen, Pi Shu) and UB 23 (Kidney, Shen Shu). This is the reason  I requested Dan J came to my office during summer for 12 visits.

7: Acupuncture and Asthma

Jul 29, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dear Friends and Patients:

Have a nice summer!

Now, it is the time for our News Letter 7. We will describe the bronchitis and its medical and acupuncture treatments in the News Letter 7. Please enjoy the info we provide, it might help you for your family members or friends. You may call our office at 203-637-7720 for further info.

Best wishes,

Jun Xu, M.D and Hong Su Xu, C.M.D.


News Letter, Vol. 1 (7), July, 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

Case Discussion: Asthma

 

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Jimmy S is a 12-year-old boy who came to my office after a sudden onset of   shortness of breath and tightness in the chest.  In addition he said he had occasional pain and trouble in sleeping and, by listening to his lungs, I heard audible wheezing.  He sometimes had coughs as well, and his mother reported he first developed these symptoms when he was 2 years old.  The incidents happened mostly in cold weather, and sometimes when he ran or participated in sports.  At these times he had difficulty in breathing, often coughed or wheezed and all this together brought about a diagnosis of asthma.  His doctor prescribed an inhaler and other medication, which, for a while, made his asthma better.  However, for the past decade, though he used these asthma-aids, he still had frequent attacks.  These made him miss classes which bothered him, as he wanted to keep up with his schoolmates.  His primary care physician could give him no further help, at which time he consulted me.

What causes asthma?

 

Asthma is an inflammation and constriction of the lungs and airways, including brachial tubes. Asthma is usually triggered by cold, allergens, including dust, mould, perfume, fur, etc, respiratory infection such as the common cold and physical activity such as exercise, cold air and irritants such as smoke.  Certain medications also can trigger asthma, such as aspirin and non-steroid anti-inflammatory drugs, as well as strong emotion, stress, gastroesophageal reflux disease, menstrual cycles and allergic reactions to certain foods.  After exposure to these irritants, the airways produce extra mucus that blocks them and makes the brachial wall muscle tighten and constrict, which causes all the symptoms of asthma such as cough, shortness of breath and wheezing.  If symptoms become worse, some patients will get an infection which will produce yellowish sputum and this infection will cause more severe symptoms.  Asthma is usually worse in the morning and late at night.  In between asthmatic episodes, symptoms have been known to disappear or improve, but this does not mean the asthma has gone away, which is why Jimmy S has had these symptoms for more than ten years.

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Resource: http://www.rainbowskill.com/wp-content/uploads/2009/03/asthma1.jpg

There are four types of asthma:

  1. Allergic asthma, caused by the airway inflammation when exposed to allergens, such as dust, mould, smoking, fur, perfume, food, etc.
  2. Exercise-induced asthma, which is triggered by vigorous activity.
  3. Cough-variant asthma, which produces a chronic and persistent cough, sometimes called a habitual cough, without shortness of breath.
  4. Occupational asthma, caused by exposure to certain stimulants, such as certain chemicals, oils, gas, etc.  in the workplace.

 

From the Western point of view, the treatment of asthma includes two types of medication:

  1. Bronchodilators such as beta-agonist, albuterol and salmeterol and also anticholinergics such as ipatropium.  These two types of medications can dilate the respiratory tubes and open the lungs to air.
  2. Corticosteroid.  The inhaled corticosteroid is recommended for most patients and is most effective for the respiratory tract and with minimal effect on the rest of the body at normal doses.  These are good for short-term relief if inhaled or given by injection to speed up the resolution of airway inflammation.

It is strongly recommended for people with asthma to carry their inhalers with them, in case any emergency happens to them. The above precaution sometimes plays a role of life or death. However, for a long term treatment, the Chinese medicine might help more.

Chinese Medicine Diagnosis and Treatment

Asthma is characterized by repeated attacks of paroxysmal dyspnea with wheezing.  It can be divided into two types, deficiency and excess.

Type I:  Excess

1.       Wind-cold type.  This kind of asthma attack is due to the invasion of wind-cold pathogen from environment which impairs the smooth flow of the lung qi (energy), injures the skin and hair and makes the lung respiratory tract, especially the bronchial tract, closed or restricted.    Since the lung and the body surface  defense system are weakened, the lung qi fails to disperse and descend which leads to a cough.

2.       Phlegm-heat type.  This type asthma is due to the failure of the spleen in transformation and transportation resulting in the production of phlegm from accumulated dampness, finally ending in retention of phlegm which turns into heat or excessive fire of the lung which evaporates the fluids which caused the  accumulation of phlegm.  The phlegm stays in the lungs with hotness, causing the lung energy to stagnate, which causes the impairment of the lung’s proper function, then causes asthma.

Type II:  Deficiency

  1. Lung deficiency.  A prolonged and protracted cough usually weakens and injures the lung energy, and strain of an internal lung and respiratory muscle can also bring about deficiency of the lung energy.  In either case, shortness of breath and dyspnea may occur.
  2. Kidney deficiency.  Since the kidney is the energy resource of the human body, longstanding asthma, overwork and other factors will affect the kidney function, therefore, if kidney deficiency is present, its energy cannot support lung functions, which will induce weakness of the kidney and make an asthma attack that much more severe.

Treatment:

  1. For wind-cold type the principal is to eliminate the exogenous pathogens as well as improve the lung’s function and enrich the lung’s energy.

Prescription:  UB13 Fei Shu, UB12 Feng Men, Du14 Da Zhui, Lu 7 Lie Que, LI 4 He Gu.

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Acupressure tips for patients:

  1. The most important points are UB 12, UB 13 and Du 14.
  2. Press UB 13 for 5 min with both your knuckles, then UB 12 for another 5 min, alternate for about 3 times might help you to reduce the asthmatic symptom and the patient might feel relief from the acupressure self treatment.

Acupuncture tips for practitioners:

  1. Electrical stimulation on UB 12, UB 13 and Du 14.
  2. Ultra Red Heating Lamp on UB 12, UB 13 and Du 14 for 20 to 30 min.

3. UB13 and UB12 are located in the vicinity of the lung, which will greatly improve the lung’s function and energy and will protect the lung from the exogenous pathogens attacking.  They will clear the lung and eliminate the wind.  DU14, Lu 7 and LI4 function to eliminate the wind-cold and clear the lung, therefore soothing the asthma.

  1. Phlegm heat:  Because phlegm heat shows signs of mild infection of the lung, there are more points to choose from for eliminating the exogenous pathogens such as wind heat.

Prescription:  UB13  Fei Shu, EX-B1 Ding Chuan,   Ren 22 Tian Tu, and Lu 5 Chi Ze , St 40  Feng Long.

Table 3-24

upperlimbs

Acupressure tips for patients:

  1. Press hard on bilateral EX-B1 Ding Chuan for 5 min, then UB 13 Fei Shu for 5 min, alternate for 2 sessions.
  2. Ren 22 Tian Tu may also help to decrease the asthma after pressing for about 5 min.

Acupuncture tips for practitioners:

  1. No heating lamp.
  2. Use all above 5 points and electrical stimulation for 20 to 30 min. If they are pairs, you should use the paired points also.

3.  Lu 5 Chi Ze is very important to reduce the phlegm heat and soothe the brachial smooth muscle.  Fenlong S40 is a point of strengthening the spleen function which resolves the problem of phlegm.

4. UB13 Fei Shu is applied to clear the lung and regulate the flow of energy.  Ren 22 Tian Tu causes the energy to subside and resolves the problem of phlegm, as well as eliminating excessive heat.  Dingchaun is the point which causes a cessation of wheezing and makes breathing much easier.

Type II:  Deficiency Type:

Lung deficiency: The lung is the vital internal organ to regulate respiration. Lung energy deficiency leads to the easy entry of the pathogens, and causes asthma. The goal is to improve the lung energy and efficiency and decrease the chance of the body being attacked by exogenous pathogens.

Prescription:  UB13 Fei Shu, Lu 9 Tai Yuan, St 36 Zu San Li and Sp 3 Tai Bai.

Table 3-3

10

11

Acupressure Tips for patients:

  1. For long term health care, always press St 36 and UB 13, even you do not have any illness; these two points will protect you from the attack of external pathogenesis.
  2. Lu 9 and Sp 3 for acute attack.

Acupuncture Tips for practitioners:

  1. Heating Lam should be used for St 36 and UB13.
  2. Electrical stimulation for LU 9 and Sp 3.
  3. Lu 9 Tai Yuan is the beginning point of the lung meridian and is able to reinforce the lung energy.  UB13 Fei Shu, used in both acupuncture and moxibustion, can strengthen the lung energy,  and St 36 Zu san li S36 is the key point of the stomach meridian, which can greatly improve the immune system and energy of the entire human body.
  4. Sp 3 Tai Bai  is the first point of the spleen meridian.   The spleen can greatly improve the lung’s breathing function, therefore, Sp 3 can both clean out the phlegm and relax the smooth muscle of the brachial tract.  St 36 and SP 3 combined will strengthen the lung and improve the function of the spleen and stomach.

Kidney Deficiency:

The kidney is the energy manufacturer of the entire human body. Any lessening of its function will cause a decrease of the immune function and energy flow of daily activity.  For this reason it is necessary to strengthen the kidney.  UB13 Fei Shu, REN17 Tan Zhong,  K3 Tai Xi  and UB23 Shen Shu, and REN 6 Qi Hai are selected.

Table 3-4

12

Acupressure Tips for patients:

  1. UB 23 is the key point to press.
  2. UB 13 and Ren 17 will greatly help in  strengthening the kidney function.

Acupuncture Tips for practitioners:

  1. Heating Lamp should be used for UB 23 and UB 13.
  2. Electrical stimulation for UB23, Ren 17 and Ren 6.
  3. Ki 3 Tai Xi strengthens the primary energy of the kidney and, when combined with UB23 Shen Shu, the original point adjacent to the kidney, it will greatly enhance the Ki 3 functions.  REN17 Tan Zhong  is one of the most important energy points in the eight influential points and UB13 Fei Shu is the back-shu point of the lung which reinforces energy and smoothes out ragged breathing.  Ren 6 Qi Hai is an important point to reinforce lung energy and recreate energy in the lower lung respiratory track and also strengthens the kidney and primary energy.

Tips for patients and practitioners:

Asthma attacks usually happen in fall, winter and spring, and only occasionally in the summer. Based on traditional Chinese medicine, summer is the most important season to reinforce the kidney and spleen Yang energy.  I insist patients having treatments during the summer. I use not only acupuncture but also moxibustion, i.e. Moxa during summer.  One treatment in summer is probably the equivalent of four or five treatments at any other season.  Utilizing the previously cited points in acupuncture, it is possible to alleviate chronic asthmatic symptoms by strengthening the energy and improving function of spleen, as well as that of the stomach and kidneys.  In this way it is possible to relieve, or even eradicate future attacks.

Jimmy S received a dozen treatments from me during the first summer.  During the school year, he worked very hard at his studies. His summer treatments helped him so much that he only needed to consult me each summer for a few visits.

6: Acupuncture and Bronchitis

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

Dear Friends and Patients:

Time flies! Now it is the time for our news letter 6, bronchitis. You may find some useful info for your reference. So far, we have sent out total 6 news letters in this year. If you or your friends would like to read previous news letters, please visit: www.drxuacupuncture.co. You are welcome to forward our news letters to your friends. Here are the titles of all of the previous case discussions:

1. Unexplained infertility

2. Headaches

3. Weight control

4. Osteoporosis

5. Common cold

Thank you very much and have a wonderful July 4th!

Best wishes,

Jun Xu, M.D., & Hong Su Xu, C.M.D.


News Letter, Vol. 1 (6), June, 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

Case Discussion: Bronchitis

main_pic1

 

 

 

Susan W., a 45-year-old female. came to my office complaining of a severe cough which had lasted for about three or four weeks.  It caused her tremendous pain on her chest and abdominal muscle and she also coughed out yellowish greenish phlegm and sometimes experienced wheezing and shortness of breath; she also was running a low fever and had chills and  muscle aches.  She also suffered nasal congestion and sore throat and had difficulty swallowing  food.  Her ears were blocked, making it  difficult to hear, and she was extremely uncomfortable in many areas when she came to me for evaluation and treatment.

This patient most likely had bronchitis, an irritation and inflammation of the airways.  It is often triggered by the upper respiratory tract infection such as the common cold or influenza, and can also be caused by sinus infection, as well as exposure to irritating fume or dust or fur of cats or dogs or tobacco smoke.  According to Western medicine, there are five types of bronchitis based on western medicine:

1.         Acute bronchitis.  It will last about several days to weeks and usually it will clear up on its own.

2.         Viral bronchitis.  This is triggered by viral infection such as common cold.

3.         Occupational bronchitis.  Patients are exposed to lung irritants in one’s home or work place and the treatment usually is withdraw from the place.

4.         Chronic bronchitis.  The above symptoms will last for longer than three months or recur at a frequency over period of years so this chronic bronchitis usually is not caused by infection but is very often associated with chronic obstructive pulmonary disorder.

5.         Asthmatic bronchitis refers to the same symptoms but the underlying cause is asthma.

Traditional Chinese medicine believes bronchitis is a lung disease which results either from attack of the exogenous pathogenic factors or from disorders of the lung itself.

For the invasion of the exogenous pathogenic factors, there are two types:

1.  Wind cold: The main manifestations are cough, itching in the throat, thick white sputum, and the patient is easily susceptible to cold, with symptoms such as fever,  anihidrosis, headache, nasal obstruction and discharge with thin white tongue coating, and superficial pulse.

2. Wind heat:  The main manifestations are choking cough with yellowish thick sputum, thirst, sore throat, fever, headache, and  the patients are aversion to wind and with symptom of sweating, with thin yellow tongue coating and superficial and rapid pulse.

For the internal organ injury of the lung, there are two types.

1. Blockage of the lung by  phlegm.  The main manifestation is cough with profuse, thick white sputum and stuffiness and congestion of the chest, loss of appetite, white sticky tongue coating, and rolling pulse.

2. Dryness of the lung with deficiency of yin.  This is manifested  by dry cough without sputum or with scanty sputum, dryness of the nose and throat, sore throat, spitting – or even – coughing of blood, afternoon fever, malar flash, red tongue, with thick tongue coating, and rapid pulse.

 

Treatment:Western medicine.

By far the majority of bronchial cases are originally from viral infections, this means that most cases of bronchitis are short term and require nothing more than symptomatic treatment.  Since antibiotics do not cure a viral illness, overuse of antibiotics  will make the bacteria habituated in the respiratory tract resistant to the antibiotics currently available.  Many doctors  prescribe antibiotics because they feel pressure from the patients. If they do not prescribe certain antibody, then the patient will think the doctor did nothing to help.

We can use acetaminophen to control the fever, such as,  Tylenol, aspirin, or ibuprofen.  Also the patient should drink as much  fluid as possible in order to clear the body, dilute the virus and to make the virus dissipate in the body’s  fluid.  A humidifier might also help and over-the-counter cough suppressants such as the Robitussin  and Mucinex might also assist in loosening the secretions.

Bronchodilator inhalers will help open airways and decrease the wheezing. If there is bacterial infection, then antibiotics should be prescribed.

Traditional Chinese medicine and acupuncture treatments:

1.         For wind cold.  You may choose acupuncture points such as Lu 7 Lie Que, LI 4 He Gu, and UB13 Fei Shu (Lung Shu), and with supplementary points for pain and swelling of the throat, Lu11 Shao Shang, and for fever and aversion to cold Du14 Da Zhui and SJ 5 Wai Guan.

Pic 2-1

back_pic2

Table 2-1chart3

2.         For wind heat: UB 13 Fei Shu, Lu 5 Chi Ze, Du 14 Da Zhui, LI 11 Qu Chi.

Pic 2-2

arm_pic4

chart5

3.         For the internal lung injury with the blockage of the lung by phlegm, so we select back-shu points and other lung points: like UB13 Fei Shu, Ren 12 Zhong Wan, Lu 5 Chi Ze, St 36 Zu San Li, St 40 Feng Long.

Pic 2-3                                                                                             Pic 2-4

pic6 pic7

pic9

Acupressure tips for patients:

1.      The most important points are Fei Shu, UB 13. Ask your friend or family member press the points on both side for 5 min each, alternately press until you feel energy flow go through your lung.

2.      If you have fever or feel very cold, press Da Zhui, Du 14 for 10 min, then press Fei Shu. UB 13, which will greatly improve  your immune ability and quickly decrease your cough and respiratory symptom, such as cough, sneeze, etc.

Acupuncture tips for acupuncture practitioners:

1.      Always electrically stimulate Fei Shu , UB 13. If the patient has wind cold, Lie Que, Lu 7 and Da Zhui, Du 14; for wind heat, Qu Chi, LI 11 and Da Zhui, Du 14.

2.      Combined Fei Shu, UB 13 with Zu Sanli St36 and Feng Long, St 40, you may greatly improve your patient’s immune function.

The above patient was diagnosed to have wind cold so after the treatment for about one week and her symptoms disappeared and she returned to work.

4: Acupuncture and Osteoporosis

Apr 27, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

 



News Letter, Vol. 1 (4), April, 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

Case Discussion 4 – Osteoporosis


骨质疏松

Patient Name:  Emily M.

Emily M. is 59 years old female.
About one week ago, when she opened her garage and tried to take her garbage can out of her house, she had a fall and she immediately felt  severe pain in the right hip and she had difficulty to getting up from the ground. Her husband immediately called 911 and Emily was taken to the hospital.  In the ER an x-ray was done which showed a fracture (Fx)  of the right hip.  The patient had an immediate operation for a total hip replacement because she had severe osteoporosis and her bone age is more than -2.5 SD as shown by a bone scan. After the operation, she came to my office for rehabilitation, and she asked me why it is so easy to have a fracture. Her friends sometimes had falls without any problems.  She wanted acupuncture treatments and also a nutritional consultation about her osteoporosis.

I asked her past medical history.  When she was young Emily was an athlete.  She ran about five miles a day five days a week for about 10 years, so she was very thin and skinny during this period.   When she was between 16 and 26 she rarely menstruated.    After she stopped her marathon training she gradually recovered her menstruation. Then, she got pregnant.  She has two children and  she told me her mother also had a fall at age 55  and also had a Lumbar 4 and 5 veterbrate compression fracture.  She asked me if there was any connection between her mom’s fall and her own.

Emily has osteoporosis, which is often seen in women of postmenopausal age and men above age of 75.  Osteoporosis usually does not show any symptoms until one day a fracture occurs.  Women and men with osteoporosis most often break bones in the hip, spine, and  wrist.  The fracture of the bone in an old person could be a warning sign that the bone is weaker than optimal.  A fracture of the long bone such as hip and wrist are acute impaired mobility, and they require surgery. The symptoms of vertebral collapse, usually exhibit sudden back pain often with radicular pain shooting down to the legs with numbness and tingling sensation. This fracture usually is called a compression fracture and by x-ray, you can see the vertebral collapse. If there are multiple vertebral fractures (Fx), you will see the patient has a stooped posture, loss of height, and chronic pain with reduction of mobility.

Risk Factors For Osteoporosis:

All post menopausal women and men age 50 and older should be evaluated clinically for osteoporosis risk factors in order to determine the need for bone mineral density testing. Osteoporosis is preventable if we identify the risk factors for the patients and therefore a fall causing the fracture of a bone can be avoid.

The most identifiable risk factors are as following:

1.

Genetic factors:  There are many genetic factors that will cause osteoporosis such as parental history of hip fracture, cystic fibrosis, hypophosphatasia, idiopathic hypercalcinuria, etc.

2.

Lifestyle factors such as low calcium intake, vitamin D insufficiency, excessive vitamin A intake, high caffeine intake, high salt intake, alcohol: three or more drinks a day, immobilization, inadequate physical activity, smoking, tennis, and excessive physical activity. There are numerous examples of marathon runners who develop severe osteoporosis late in life.  In women, heavy exercise can lead to decreased estrogen levels, which inhibit the calcium absorption and produce osteoporosis.  In addition, intensive training without proper calcium and vitamin D and nutrition compensation will increases the risk of osteoporosis and fracture. Soft drinks, which contains phosphoric acid may increase the risk of osteoporosis because the phosphoric acid will displace calcium contained in the bone.

3.

Medications:  Many medications are associated with osteoporosis and fracture.

1).        Glucocorticoids i.e. steroid.  If you take more than 5 mg per day of prednisone or equivalent for more than three months, usually it will cause osteoporosis.

2).        Anticoagulants such as heparin.

3).        Chemotherapeutic drugs.

4).        Anticonvulsant.

5).        Barbiturate.

6).        Cyclosporin A, tacrolimus, lithium, etc.

4.

Diseases and disorders.  There are many diseases associated with osteoporosis:

1).        Endocrine disorders such as Cushing’s syndrome, hyperparathyroidism, thyrotoxicosis, diabetes mellitus, adrenal insufficiency, etc.

2).        Malnutrition, parenteral nutrition, and malabsorption such as Crohn’s disease, ulcerative colitis, lactose intolerance, gastrectomy surgery, intestinal bypass surgery or bowel resection, vitamin K and vitamin B12 deficiency, etc.

3).        Renal insufficiency.

4).
Hematological disorders such as multiple myeloma, leukemia, lymphoma, sickle cell disease, etc.

5).
Hypogonadal disease such as Turner syndrome, Klinefelter syndrome, Kallmann syndrome, anorexia nervosa, etc.

Who gets osteoporosis?

Osteoporosis is more common in elder individuals and Caucasian woman, but osteoporosis can occur at any age in men as well as in women and in all ethnic groups.

About 10 million Americans have osteoporosis, 80% of them are women.  One in two women has a fracture related to osteoporosis in her lifetime.  Thus, women over the age of 50 are at greatest risk of developing osteoporosis and suffering related  fractures.

Osteoporosis can begin at a young age if a person does not get enough calcium and vitamin D.  After reaching maximum bone density and strength between the ages of 25 and 30, a person loses about 0.4% of bone strength each year.  At this rate and with good nutrition, people should experience bone loss without developing osteoporosis.

However, after menopause, women lose bone mass at a higher rate as high as 3% per year.  After menopause, a women’s body makes much less estrogen.  Estrogen is a hormone substance that flows in the blood to control body functions.  It helps to prevent osteoporosis.  In fact, osteoporosis is secondary to the body that cannot make enough new bone and to compensate the body’s  loss of the old bone.

How to diagnose osteoporosis?

The dual-energy absorptiometry DXA measures the hip and the spine bone density to establish or confirm the diagnosis of osteoporosis, predict future fracture risk, and to monitor patients by performing serial assessments.  WHO, the World Health Organization has established the following definition based on BMD (Bone Mineral Density) measurements at spine, hip, or forearm by DXA devices.

Normal BMD is within 1 SD of a young normal adult, T-score at 1.0 and above.

Low bone mass osteopenia, BMD is between 1.0 and 2.5 SD (Standard Deviation)  below that of a young normal adult, i.e.  T-score between -1.0 and –2.5.

Osteoporosis, BMD is 2.5 SD or more below that of a young normal adult, T-score at or below –2.5.  Patients in this group who have already experienced one or more fractures are deemed to have severe or established osteoporosis.

Who should be tested for BMD?

Based on National Osteoporosis Foundation conditions’ guide, the following people should be tested for BMD.

1.         In women age 65 and older and men age 70 and older, recommend BMD test.

2.         In postmenopausal women and the men age 50 to 69 recommend BMD testing when the doctor has concerns based on their  risk factor profile.

3.
Recommend BMD testing to those who have had a fracture to determine degree of disease’s severity.

How is osteoporosis treated?

1.         The most important treatment is prevention.

1).
Calcium 1000 mg per day should be taken for women before menopause and a 1200 mg per day for women who are postmenopausal.

2).
Vitamin D 800 IU for women before menopause and 1000 IU vitamin D for postmenopausal women.  Men up to age of 50  should increase vitamin D and calcium intake to 800 IU of vitamin D and 1000 mg of calcium per day.

There are numerous calcium products in the market. Most of them are in tablet form, which  is difficult for your body to absorb, because the calcium supplement is not blended with vitamin D and magnesium; these are necessary to aid in the absorption and use of calcium.

Even if the calcium tablet is blended correctly, it may be difficult for the body to utilize or break down the calcium. One explanation may be that many calcium brands use calcium from eggshell or oyster shell. These may not be well absorbed by the body. Another reason calcium may not be absorbed from a tablet is because of DCP, which is a binding agent used to hold the tablet together. DCP does not break down in the body.

In addition to binders, some calcium supplements may have additives such as chlorine and other chemicals. Even assuming no binders are used in the calcium tablet, the body must still break down a hard-pressed tablet into a usable form. If the tablet cannot be broken down sufficiently in the stomach, then the calcium will not be absorbed. If you can’t break down the calcium your body is robbed of the calcium needed to support bodily functions.

Based on the above analysis, I strongly urge you not take the tablet form of calcium. After careful study, I believe that Nutrametrix supplies the best calcium, i.e. blended with Vitamin D3 and magnisium, isotonic form.

2.         Regular weightbearing exercise. Increased walking, jogging, tai chi, stair climbing, dancing, and tennis. Muscle strengthening exercises include weight training and other resistive exercise.  Weightbearing exercise programs not only increase bone density but also improve both heart and lung functional ability and muscle strength.

3.         For prevention, you should take all preventative procedures such as checking and correcting vision and hearing, evaluating any neurological problems, reviewing any prescription medications for side effects that may affect balance, and providing a check list for improving safety at home.  Wearing undergarments with hip pad protectors may protect an individual from injuring the hip in the event of a fall.  Hip protectors may be considered for patients who have significant risk factors for falling or for patients who have a previously fractured hip.

4.         Avoidance of tobacco use and excessive alcohol intake.  Alcohol and cigarettes inhibit osteoblast cell activities and improve osteoclast cell functioning.  Osteoclast cells usually destroy the bone density and osteoblast cell build up the bone density.

Medical treatment for osteoporosis:

1.         For the patient who has vertebral or hip fracture.

2.         DXA hip or spine T-score is less or equivalent to –2.5.

3.         Low bone mass and US adopted WHO 10-year probability of hip fractures more or equivalent to 3% or 10 years probability of any major osteoporosis related fractures more than 20%.

The following are the FDA approved medications for treatment of osteoporosis:

1.         Bisphosphonates.

a.
Alendronate, brand name, Fosamax.  Alendronate reduces the incidence of spine and hip fractures by about 50% over three years in patients with prior vertebral fracture.  It reduces the incidence of vertebral fractures by about 48% over three years in patients without prior vertebral fracture.

b.
Ibandronate, brand name, Boniva.  Boniva reduces the incidence of vertebral fractures by about 50% over three years.

c.
Risedronate, brand name, Actonel with calcium.  Risedronate reduces the incidence of vertebral fractures by about 41& to 49% and the nonvertebral fractures by about 36% over three years with significant risk reduction occurring after one year of treatment in patients with a prior vertebral fracture.

d.
Zoledronic acid, brand name, Reclast.  Zoledronic acid is approved by FDA 5 mg/IV infusion over at least 50 minutes once yearly for osteoporosis in postmenopausal women.  Reclast reduces the incidence of vertebral fractures by about 70% with significant reduction at one year, hip fractures by about 41%, and nonvertebral fractures by about 25% over three years.

There are many side effects for bisphosphonates, such as GI problems, difficulty swallowing, inflammation of esophagus, and gastric ulcer.  All these medications must be taken on an empty stomach first thing in the morning with at least 8 ounces of plain water.

There are also other treatments for osteoporosis.

1.         Calcitonin: the brand name is Miacalcin or Fortical.  Oral salmon calcitonin is FDA approved.

2.         Estrogen hormone therapy.  For estrogen hormone therapy, the Women’s Health Initiative reported increased risks of myocardial infarctions, stroke, invasive breast cancer, pulmonary emboli, and deep vein phlebitis during five years of treatment with conjugated equine estrogen and medroxyprogesterone, however, subsequent analysis of those data showed no increase in cardiovascular disease, therefore, the use of the estrogen hormone treatment is recommended for only shortest duration and the lowest effective doses.  All the clinicians must evaluate the risks before considering giving patient this hormonal treatment.

3.         Parathyroid hormone PTH, brand name, Forteo, is approved by FDA for treatment of osteoporosis in postmenopausal women at high risk for fracture, however, there is increased incidence of osteosarcoma in rats.  The usage of parathyroid hormone is cautious.

How acupuncture helps osteoporosis:

Traditional Chinese Medicine thinks osteoporosis mainly is caused by kidney deficiency, therefore, the most important thingin TCM is to protect kidney function and acupuncture usually cannot treat the fractured bone, however, acupuncture can help by improving and

adjusting the stomach and large intestine natural absorption for calcium, phosphate, magnesium, etc., to prevent mineral loss.

The following acupuncture points usually are selected to treat and help the prevention of osteoporosis.

Dazhui Du14 and Ming Men Du4 and also Pi Shu UB20, Wei Shu UB21, Shen Shu UB23, and Qi Hai Shu UB24.

Pic 43-1

See graph below for explanation of picture above:

table

tips

3: Acupuncture and Weight Control

Mar 27, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

 


News Letter, Vol. 1 (3), March, 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


Case Discussion 3 : Weight Control

Fat ChildSusan W, a 45 year old female, came to me complaining of knee pain which she had been experiencing for more than seven years, but which has become much worse in the last two months.  I noted that, at about 5’6,” she weighed in excess of 210 lbs. and walked in an awkward position.  She told me she liked to walk for exercise, and even run, but, because she was getting bigger and bigger, her knee pain was getting worse.  She said she ate “very little” but was unable to get her weight down, and even walking caused  pain as well as heart palpitations.  She had high blood pressure and cholesterol.  She claimed to have tried everything including calorie control, exercise and diet pills, but nothing had worked.  Her clothes no longer fit and she was embarrassed to go to the gym and expose herself in exercise clothes.

Obesity is a chronic condition defined as an excess amount of body fat.  The normal amount of body fat is between 25-30% in women and 18-24% in men.  Anything over those percentages is considered obese.  Overweight is different from obesity. Overweight is having extra body weight from muscle, bone fat and/or water. Obesity is having a high amount of extra body fat.  The most useful measure of overweight and obesity is body mass index, which is based on height and weight, used for children, adults and teens.  There are many reasons for overweight and obesity.

1.
Unbalanced energy in and out.  In developed countries, the main cause of obesity is overeating; people ingest too many calories for their height and level of activity, so weight gain happens over time.

2.
Physical inactivity.  Many Americans are not very physically active.  One of the biggest causes is spending too much time in front of computers and the television.  A study finds that more than two hours of regular TV viewing per day has been linked to overweight and obesity.  Other reasons include the dependence on cars instead of walking and light physical demands at work and home.  The people who are inactive are more likely to gain weight because they do not burn up the calories they take in from food and drink.

3.
Environment .  Our environment prevents a healthy lifestyle since there are not enough sidewalks for people to walk on and, as many people spend two hours or more commuting to their jobs with cars or train, they do not have time for physical exercise.

4.
Poor nutritional information or lack of access to healthy foods.

5.
Genes and family history.  Many people are obese because their parents were, due to genes and bad habits relating to food and physical activity.   There is definitely a link between genes and the environment, as children adopt the habits of their parents.

6.
Medical conditions.  Some diseases can cause overweight, such as hypothyroidism, Cushing syndrome and polycystic ovary syndrome.

7.
Medicines.  Certain medicines such as cortcosteroids, prednisone and antidepressants such as Elavil and Neurontin may cause weight gain.

8.
Emotional factors such as depression, anger and stress can make people overeat.

9.
Age. As people age, they tend to lost muscle, especially if they become less active. Muscle loss slows down the rate at which the body  burns calories. After age 50, it is wise to reduce the number of calories consumed daily, otherwise it is easy to gain weight.

10.
Pregnancy. While it is normal to gain weight during pregnancy, many women retain this weight even after the baby is born due to lack of activity and increased calorie intake.

11.
Lack of sleep.  Studies have found that the less sleep people have, the more likely they are to be overweight or obese.

Overweight can also induce  the following medical risks or diseases:

1.
Heart disease, heart attacks and congestive heart failure.  Many people have coronary artery diseases and other heart related illness, they are afraid of physical activities and stressed, therefore, they do not perform physical exercise and very often eat junk food to reduce their stress. Because of increased body weight, the heart has to pump more blood to the body, which increases the heart load, and in turn, can lead to a heart attack and congestive failure.

2.
High blood pressure.  Obesity can induce high blood pressure, forcing the heart to pump more blood to the extremities, which increases the intensity of the arteries and make the blood pressure go higher.

3.
Stroke.  Fatty tissue deposits in the blood vessels, subsequently narrows the blood vessel and makes the blood supply decrease to all the important organs. If the blood supply is blocked to the brain, this will cause a stroke.

4.
Type 2 diabetes.  Overweight and obesity  increase the resistance to the insulin contained in the body tissue, which will increase the pancreatic function,  in the long run, means the pancreas cannot secrete enough insulin. Lack of insulin causes  type 2 diabetes.

5.
Increased cholesterol level.  Because high fat tissue supplies a high amount of triglycerides and low-density lipoprotein, which is bad cholesterol, they will cause heart attacks, hypertension and the like.

6.
Cancer.  Being obese raises the risk of colon, breast, endometrial and gallbladder cancers.

7.
Osteoarthritis.  Being overweight puts tremendous pressure on knee and hip joints and low back, which causes pain just as in Susan W’s case.

8.
Sleep apnea.

9.
Reproductive problems such as infertility in women.

10.
Gallstones.  Cholesterol can form gallstones, which cause  abdominal or back pain.

Overweight and obesity can be diagnoses by body mass index (BMI).  Take your
height and weight. You can calculate  your BMI with the following formula or
check the following tables. The BMI 18.5 – 24.9 is normal, below 18.5 is under
normal weight, 25 -29.9 is overweight, 30-39.9 is obese and anything over 40 is morbidly obese.

 

 

 

BMI Categories:

  • Underweight = <18.5
  • Normal weight = 18.5-24.9
  • Overweight = 25-29.9
  • Obesity = BMI of 30 or greater

Please see the following tables
from National Heart Lung and Blood Institute for your reference:

http://www.nhlbi.nih.gov/guidelines/obesity/bmi_tbl.htm

Table for MBI greater than 35, as provided by National Heart Long and Blood Institute.

Many people seek medical advice for weight loss.  In traditional western medicine, the patient is sometimes prescribed anti-obesity medication to try to help with weight loss.  The two medicines approved by the FDA for weight loss are Meridia, which sends signals to the brain to curb the  appetite.  There are, however, side effects of  raising blood pressure and pulse.  Another medication is  Xenical, which reduces the absorption of fat and calories, also vitamins A, D and K, which could cause mild side effects such as  loose stools.

Surgical Procedures:

The American Society for Bariatric Surgery describes two basic approaches thatweight loss surgery takes to achieve change:

1.
Restrictive procedures that decrease food intake:

Gastric Restrictive Procedure –
Vertical Banded Gastroplasty (VBG)

Vertical Banded Gastroplasty
(VBG) is a purely restrictive procedure. In this procedure the upper stomach near the esophagus is stapled vertically for about 2-1/2 inches (6 cm) to create a smaller stomach pouch. The outlet from the pouch is restricted by a band or ring that slows the emptying of the food and thus creates the feeling of fullness.

2.
Malabsorptive procedures that alter digestion, thus causing the food to be poorly digested and incompletely absorbed so that it is eliminated in the stool, which include the following:

(A)    Biliopancreatic Diversion (BPD )

(B)     Extended (Distal) Roux-en-Y Gastric Bypass (RYGBP-E )

(C)     Biliopancreatic Diversion with “Duodenal Switch”

3.
Combined Restrictive & Malabsorptive Procedure – Gastric Bypass Roux-en-Y.

For non surgical treatment, I usually use the following six programs together:

1.
I first ruled out any medical illness which might have caused her obesity.   She was screened for polycystic ovary syndrome and checked for hypothyroidism and/or Cushing’s syndrome.  All tests came back normal.

2.
Acupuncture.  I combined body acupuncture with auricular acupuncture points. For the body, the most important points are ST-34,  Liang Qiu points and SP-4, Gong Sun.  Liang Qiu points belong to the stomach meridian and can inhibit stomach activity and make the food absorption slower and decrease the appetite.  Gong Sun SP-4 is a point of the spleen, which can increase the body’s metabolism and decrease the appetite, too.  Ren 12 (Zhong Wan) and Ren 3 (Guang Yuan) are local points adjacent to the stomach and intestine, they directly affect and facilitate the bowel movement, therefore, inhibit the absorption of the food in the GI system.

Pic 10-1 and 10-2:

Table 10-1

Auricular needles are the most important part for weight loss program. I chose the points of spleen,  stomach, liver, small intestine and Sheng Meng.  These points can inhibit stomach activity, slow the absorption of nutrition from food in the stomach and small intestine, also improve energy of human body and decrease the stress and depression.  The patients should press the ear needles to lessen their craving for food while she or he feels hungry.  The points on the liver, endocrine and Sheng Meng may reduce the stress and anxiety, in  adjunction with the points of spleen, stomach and small intestine, to decrease the craving sensation.  It is possible to  substitute vegetable or plastic seeds in place of the needles, for those who fear needles, and generally speaking, they will have
the same effect.

3.
Diet program.  Diet is the most important and the most difficult part for entire weight loss program. The principal is “You must eat less than the calories you burn”.

The following points are must to follow:

1.
Eat healthy and good breakfast.  You may eat healthy food as much as you like for breakfast. I do not suggest skipping breakfast because we need  breakfast to supply entire day’s energy.

2.
Have a moderate meal as lunch to maintain necessary energy for afternoon.

3.
Eat minimum dinner or no dinner. Most American are doing the opposite, i.e. they do not eat breakfast, eat moderate lunch and huge dinner. Because they think they deserve the banquet after all day’s hard work. However, they do not understand that they can burn the calories we take during the day time due to their work.  Most people watch television after dinner or engage in some other activity which burns few if any calories, and the foods eaten at dinner which have all night to be digested  mostly turn to fat.  Turning around the way we eat can cause significant weight loss, with breakfast now being the largest meal and dinner, small or non-existent.

4.
Chinese herbal program.  I usually also prescribe herbs to  improve the
bowel movement and loosen the bowel, which hasten the food through the system faster than usual, thus not being able to be absorbed as fat.

5.
Nutrition supplements. There are thousands of nutrition supplements in the market.

After careful selection, I chose 3 nutrition supplements for our patients.

1.
Transitions Carbohydrate Absorption Inhibitor (CAI)

CAI  inhibits the enzymes that normally breakdown starch into glucose in the small intestine.   As a result, the absorption of glucose from carbohydrate-rich foods, such as bread, potatoes, rice and pasta is limited. The active ingredient, wheat amylase inhibitor, delivers the advantage of maximum effectiveness in small amounts.

2.
Transitions CLA (Conjugated Linoleic Acid (CLA)

Transitions Conjugated Linoleic Acid (CLA) Caffeine Free is ideal for those who have lost weight or are losing weight and want the extra support to keep it off.  TransitionsTM CLA Caffeine Free contains natural ingredients that can help redistribute fat to fat burning muscles tissue to  assist in promoting lean muscle mass and decreasing the amount of fat stored in your body.

3.
Transitions Fat Conversion Inhibitor
(FCI)

Transitions Fat Conversion Inhibitor (FCI) helps reduce the number of calories being converted to fat, assist in maintaining normal blood sugar levels, and can decrease appetite. It contains the natural ingredient, Garcinia cambogia, that inhibits the fat conversion process in your body’s cells and promote more effective burning of  calories.  Garcinia cambogia also increases serotonin levels which controls your appetite putting you in control. Transitions FCI also contains other natural ingredients that effectively promote weight loss: Gymnema sylvestre is a natural herb that can help maintain blood sugar levels and reduce cravings for sweets. Chromium is an essential trace mineral that promotes normal glucose uptake by the cells. This process aids in the maintenance of blood sugar levels and ultimately helps maintain your energy level and decrease your cravings.

6.
Physical activity. I encouraged Susan to do physical exercise 45 minutes to an hour six days a week.  If she did not exercise she still would be
unable to burn the calories she eats.  Susan liked to run, I advised her to give up running and she was in encouraged to have swim and stationary bicycle, as swimming and station bicycling do not have an impact on the knee and hip joints.   It is also very good exercise for the entire body, especially all other joints.  Susan now swims and bicycles around one hour a day six days a week.

After two months of sticking to her program, Susan lost about 14 pounds. Her auricular needles were changed once a week, to prevent infection.  She also continued to take Chinese herbs and nutritional supplement and kept up her diet and physical activity program.  After six months she had lost almost 40 pounds and no longer needed the auricular needles.  Her knee pain was much improved after she lost weight.

Tips for Patients:

1.The key is the dinner. If you eat very little dinner or no dinner, you will lose weight very soon.

2.The acupuncture and nutritional supplement will greatly decrease your appetite.

3.Exercise will help you burn more calories. The following idea will help you do more exercise without spending more time:

A.Always park your car far away from the shopping center or any place you go.

B.Try to walk upstairs and downstairs without taking elevator.

C.Always hold your abdomen while you sitting in  your chair.

D.Always walk to somewhere if you do not have to drive.

Tips for acupuncture practitioners:

  1. The most important issue is to encourage your patient to stick to the program for al least 3 to 6 months.
  2. Auricular needles might be useful without combining with body acupuncture to suppress the appetite.
  3. Diet program alone might be enough for some patients to loose weight.

4. Prevention are always more important than the treatment.

If  you like to lose weight , please call my office to make an appointment.

For more info, please visit:

http://www.win.niddk.nih.gov/publications/myths.htm

2: Acupuncture and Intolerable Headache

Feb 22, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  1 Comment

News Letter, Vol. 1 (2)

February, 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

 


Case Discussion 2: Intolerable Headache

September 28, 2008

Patient Name: Joan T.

學起來!5大穴道治頭痛,一分鐘立即舒緩

Joan T., a 16-year-old schoolgirl, was brought to me by her mother, because the girl had been suffering from headaches since she was 12 and first had her period. Her headaches were so severe that four or five days of the week during her period she was often not able to go to school. These headaches manifested themselves on both sides of the temporal area and also caused severe pain to the left eye. Because of the severity of the pain, Joan called her mother several days a week to pick her up from school, and the headaches were interfering with her school work. This made it necessary for her mother to quite her job and to begin to home school Joan, which she did for several years. However, at 16, Joan returned to high school as a junior in order to start preparing for the college entrance exams as well as apply to colleges. Her headache pain had become so severe that Joan was sleeping poorly, was extremely stressed, which often resulted in tears and depression, which made her eat too much, causing a large weight gain. Her mother had taken her to all kinds of doctors in hopes of alleviating her condition, but nothing helped, especially the drugs prescribed for Joan’s headaches. Her SAT exams were commencing in two months, at which point the mother finally brought her to me for evaluation.

By physical examination, Joan was a slightly obese young girl, very depressed and stressed. She spoke in a low tone; she did not like  light, felt pain by touching her temporal area and back of the scalp, i.e. the occipital area.

The patient might have one of the following three types of primary headache, i.e., tension, cluster, or migraine geadaches. She might as well have a mix of the two or three of the following headaches.

Tension headache: Tension headache is the most common type of chronic and frequent headache. The symptoms include steady pain on both side of the head and or back of the scalp with the feeling of pressure and tightness around head and as if a band was put tightly around it. The pain usually increased over period of hours when the pain gets worse, and might develop pulsating quality. The pain radiates from neck, back, eyes or other body parts.

Cluster headache: Cluster headache is often described as a sharp, penetrating or burning sensation on the one eye. The patients feel as if somebody punched the eye and this pain is of sudden onset without warning; within a few minutes excruciating pain develops and people with cluster headaches appear restless The pain is so severe, some patients report it is even worse than childbirth. The cluster headache usually lasts about 2 to 12 weeks, though some chronic cluster headaches may continue for more than a year. These sometimes go with seasonal change.


Migrai
ne Headache: A migraine headache is a throbbing or pulsating headache that is often one side and associated with nausea and vomiting, and sensitive to light, sound, and smell with sleep disruption and depression. These attacks are very often recurrent and do not change with age, sometimes develop a chronic migraine headache.

There are two subtypes of migraine headache, migraine with aura and migraine without aura. Most auras are visual and are described as bright shining light around objects or at the edges of field of vision or zig‑zag lines with wave image or hallucinations, some may experience temporary vision loss and motor weakness, speech, or language abnormalities, dizziness, vertigo, tingling, or numbness.

A MRI of migraine patient

The causes of headaches are usually different.

The causes of tension headaches are usually caused by stress, muscular tension, and gouty arthritis on the neck or spine,

postural changes, vascular dilatation, protracted coughing or sneezing and fever and depression and temporal mandibular joint disorder etc.

The cause of the cluster headaches is unknown, however, cluster headache also well known to be triggered by alcohol, nitroglycerin, or similar drugs.

The cause of migraine headaches is unknown either. It is very often. There is a family history of disorder and migraine headache can be triggered with many stimulants for example alcohol, weather,

altitude, exertion, food, and color and contrasting pattern, hormonal change, hunger, lack of sleep, medicine, perfume and stress etc.

From the western medicine point of view, there is many different kind or medications to treat headaches. For example, Topamax, Imitrex are using for migraine headaches with some successful cases. However, beta blockers, antiseizure medication, calcium channel blockers, tricyclic antidepressants, and analgesics such as aspirin, ibuprofen, acetaminophen etc are tried to treat migraine, cluster, and tension headaches. However, most of these drugs can not provide significant improvement for above headaches. Therefore, more and more patients are starting to look for alternative treatments. Acupuncture is one of the best therapies for the headaches.

Chinese medicine classifies headaches into two categories:

1.

External wind attack headaches: the headaches are caused by external factors, such as wind cold and wind heat. The headaches usually have a character of acute onset and very severe and constant attack.

Wind Cold: it shows periodic attack, the pain always is connected with neck and upper back and aversion to wind and cold, the head feels heavy, likes to have a band to tight around the head. The patient does not feel thirsty, and have thin and white coating on the tongue with floating pulse.

Wind Heat: feels expending headache from inside of the head, accompanied with fever and aversion to heat and wind, reddish face and eye, feels thirsty, constipation, yellowish urine, red tongue body with yellow coating on the tongue and floating pulse.

2.

Internal organ dysfunction headaches: internal headaches usually are slowly onset and the pain is mild and sometimes feels emptiness within the head. When patients are on stress and overwork, the pain will be worse. The pain is on and off and usually last for long time.

According to traditional Chinese medicine, head is the collection of all the Yang Meridians. The six Yang Meridians all distribute to the head and face and also liver Meridians go up to the top of the head, therefore, headaches can be diagnosed based on the meridian distribution. If we know the Meridians distribution, so then we will be easier to make clear diagnosis and treatment.

1,

Tai Yang (Urinary Bladder) meridian headache usually located at top of the head and back of the head and connected to the neck.

2,

Yang Ming (Large Intestine) meridian headache usually is on front of the head, i.e. the forehead including upper portion of the eye.

3,

Shao Yang (Gall Bladder) meridian headache usually is on the bilateral temporal area and radiates to the ear.

4,

Jue Ying (Liver) meridian headache usually is on the top of the head sometimes connecting to the eyes and frontal head. (Large Intestine) meridian headache

Acupuncture treatment for headaches:

First ask the patient the location of the headache and the severity of the headache, i.e. find out which internal organ shows dysfunction.

Second ask the patient about their accompanied symptom, differentiate the wind cold from the wind heat.

  1. For Tai Yang (Urinary Bladder) meridian headache, i.e. the headache locates on top of the head and back of neck. We choose the following, GB20 Feng Chi and DU16 Feng Fu and DU19 Hou Ding and BL9 Yu Zhen and BL60 Kun Run and SI3 Hou Xi.

  1. For Yang Ming ((Large Intestine) meridian headache, i.e. the headache locates on the front of the head, i.e. the forehead including upper portion of the eye. The acupuncture points are Yin Tang and Tai Yang (Extraordinary Points), Lu 7 Lie Que, LI 4 He Gu, GB 14 Yang Bai

  1. For Shao Yang (Gall Bladder) meridian headache, i.e. the headache usually is on the bilateral temporal area and radiates to the ear. The following points are chosen, GB 20 Feng Chi, Extra Point 1 Tai Yang, SJ 5 Wai Guan, ST 8 Tao Wei, GB 38 Yang Fu, GB 39 Jue Gu.

  1. For Jue Ying (Liver) meridian headache usually the pain is on the top of the headand many time it connects to theeyes and frontal head. Du 20 Bai Hui, Liv 3 Tai Chong, Lung 7 Lie Que.

If the patient with above symptoms accompanied with the wind cold or wind heat signs, we will add the following points:

  1. Wind Cold: GB 20 Feng Chi, Extra Point Tai Yang , ST 8 Tou Wei, GB 8 Shuai Gu, UB 12 Feng Meng, UB 60 Kun Lun.

  1. Wind Heat: GB 20 Feng Chi, Tai Yang, St 8 Tou Wei, GB 8 Shuai Gu, Du 14 Da Zhui, SJ 5 Wai Guan,

Personal tips for clinical use:

Acupressure tips for patients:

  1. If you have headache, please differentiate the site of the headache, i.e. identify if you have Tai Yang, Yang Ming, Shao Yang, or Jue Ying headache.
  2. After you identify the site of the headache, then try to locate the points by following the above tables and pictures.
  3. Acupressure the points with your knuckle, press with the comfortable pressure on the points, count 20 counts then change to another points. You should use the symmetric points at the same time.
  4. Your acupressure points mainly locate on the head, use the head points as the major acupressure points. You may ask your friends or family members to help you with moderate acupressure.

Acupuncture Tips for Practitioners:

  1. The most important is to identify which meridian headache your patient belongs to, i.e. Tai Yang, Yang Ming, Shao Yang, or Jue Ying.
  2. Identify the external type, i.e. wind cold or wind heat. If you could combine the meridian with the external type, your acupuncture effects will be much more than the average acupuncturists.
  3. The distal points, i.e. on the hands and feet, are very important for your treatment. Please do not ignore the distal points.
  4. Please put your patients in a quite and low illuminated room, with electrical stimulation for 30 min.

5. Many headaches may be triggered by occipital neuralgia, trigeminal neuralgia, common cold, sinusitis and allergy etc. For those headaches secondary to the above, we have to treat the original trigger. We should treat the sinusitis, occipital neuralgia, trigeminal neuralgia, common cold, allergy, etc. If we can effectively treat the original trigger of the primary headache, our patient’s recovery rate will be much higher the average of acupuncturists. For many years, 99% of my patients felt much improved after my treatment because I notonly treat the symptom of headache, but I also treat the trigger factors.

Joan’s headache is very complicated. From the western medicine point of view, her headache belongs to migraine headache. However, her headache always triggered by occipital neuralgia and worsen with her hormone and menstruation. Every time when she has hormonal change and also sometimes occipital nerve pain, her headache symptom would get worse. Therefore, she has four to five attacks per week.

After I made a clear diagnosis, first I used GB20, DU16, and Bai Hui and also Tai Yang, and LI4. The patient underwent my treatment three times a week for about two months and she also was injected with cortisone to block her left and right occipital nerve pain, her headache is much-much better. After my treatment, the patient took her SAT test and applied for college, she was accepted into the Boston College and after two years follow up, her mother reported that Joan is great and she has no any major headache attack. She survived her college study. Her mother is very-very thankful to me.

1: Acupuncture and Unexplained Infertility

Jan 21, 2009   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 1 (1)

January, 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

Case Discussion 1:

Unexplained Infertility

Amy S., a 36-year-old woman, is an OB-GYN at a Connecticut hospital, who delivers babies every day. When she finished her residency two years ago, she and her husband wanted to have a baby and tried for a pregnancy for a year to no avail. As a doctor, Amy is well aware of the workings of her body. She consulted the best endocrinologist and infertility specialist in the area, who checked her hormone levels, including the thyroid, pituitary gland, adrenal gland, ovaries, etc., only to find nothing was wrong. She was careful about nutrition, was at her ideal weight of 120 pounds and neither drank nor smoked. She also had an ultrasound study which showed no problem in her tubes, uterus or ovaries. Amy’s husband was also examined and shown to have a normal quantity and quality of sperm with no antisperm antibodies; the delivery of his sperm was also normal. He showed no retrograde ejaculation and no blockage in the ejaculatory duct.


Amy came to me for consultation and evaluation. She is an open-minded physician, devoted to her job, and works between 55 and 60 hours a week. Her husband is an emergency physician who works in the same hospital and he, too, works hard. Amy and her husband are often on call, causing much stress. They both keep irregular hours and often do not see much of each other. From her history, I could tell she was very stressed, unhelpful to her pregnancy situation.


Amy told me she had read an article which indicated that acupuncture plus IVF (in vitro fertilization) could help the patient increase the success rate for pregnancy. She tried it once without success.


Based on the above information, Amy has unexplained infertility. Unexplained infertility is, by definition, when a couple has not conceived after 12 months of contraceptive free intercourse.


There are many causes of infertility, including the following:

For the male:

1.
Impaired production and function of sperm, low sperm concentration. Normal sperm concentration is greater than or equal to 20 million sperm per milliliter of semen. A count of 10 million or fewer sperm per milliliter of semen indicates low sperm concentration, and the chances of conception lessen. A count of 40 million sperm or higher per milliliter of semen indicates increased fertility; also, if a sperm changes its shape and mobility or is slow, the sperm may not be able to reach or penetrate the egg.

2.
The malfunction of the Hypothalamic-Pituitary-Gonadal Axis: if the axis is not working properly, the male hormone level will be disturbed and the sperm will be both low in count and slow in activity.

3.
The testes system, including transportation and maturation.

For the female:

1.
Fallopian tube damage or blockage.

2.
Endometriosis.

3.
Ovulation disorders.

4.
Early menopause.

5.
Polycystic ovary syndrome.

6.
Fibroid in the uterine.


Even though there are many women who cannot conceive because of the above reasons, there are also 15 % of couples who cannot conceive due to unexplained reasons, and Amy falls into this category.


Amy was encouraged to have IVF treatment and, beforehand, get acupuncture treatments. She was scheduled to have hormone regulation (hormone treatment) for a month before trying to become pregnant again, and to have acupuncture treatments with me three times a week during that month.


Two groups of key acupuncture points were selected for Amy:

Stomach


Zhong Ji (Ren # 3), Guan Yuan (Ren # 4), Gui Lai (Stomach # 29), Chong Men (Spleen # 12), and Fushe (Spleen # 13). This group of acupuncture points adjusts the hormonal level of the entire body. Zhong Ji and Guan Yuan (Ren # 3 and Ren # 4) directly stimulate the uterus, which makes the uterus muscle very relaxed, and will increase the chance of contraception and easy implantation. Stimulation of the point Fushe (Spleen 12), and Chongmen (Spleen 13)—both points bilateral and adjacent to the ovary and uterus—will directly adjust the ovary’s hormonal secretion cycle, in turn increasing the activity of the pituitary, adrenal and ovary axis and increasing the chance of contraception. Gui Lai (Stomach 29) is also adjacent to the ovary and uterus, which assists the first four points in adjusting the entire female hormone system.


The second group is on the back eight-liao points.


Picture
Eight-liao points (eight points on both sides of the sacral area) directly stimulate the pudendal nerve and the pelvic splanchnic nerve. These nerves will stimulate the uterus and ovaries and help increase the chance of contraception, as well as adjust the entire hormonal system of the female reproductive system.


The two groups above of key acupuncture points will be alternatively treated during each day’s visit, in addition to the Hegu Large Intestine # 4, Quchi Large Intestine # 11, San Yin Jiao Spleen # 6, Xue Hai Spleen # 10 and Tai Chong Liver # 3 – all of which will help adjust the hormone environment in the entire body and thus aid contraception.


After four weeks of treatment, Amy underwent the IVF procedure and was kept on the acupuncture treatment twice a week. Amy reported to me that she had eight eggs mature, an improvement from the first IVF treatment which had produced only three mature eggs.


After a 48 to 72 hour culture, six of her eggs were fertilized and Amy’s doctor implanted four into the uterus. The doctor told her she should have bed rest overnight and that she could return to work the next day; however, I told her to have bed rest for two days, because Amy’s job is more stressful than most people’s, and she has to bend forward in her work to deliver babies.


A month after insemination Amy told me she was pregnant. She was very excited about her condition and eight months later delivered twins, a boy and a girl. She was thrilled with the results, as was her husband.


In my personal experience:

1.
In unexplained infertility, most of the cases are stress related. As an OB-GYN doctor, Amy worked very hard, as did her husband, and they had little time to be together. They are both under constant stress, their bodies always tight, in particular Amy’s uterus muscles. These factors made it very difficult for the fertilized eggs to attach themselves to the uterus. Some patients may be lucky enough to be pregnant; however, they may not retain their baby in the uterus because of the stress and tightness of their uteruses. They may have frequent miscarriages. My treatment is mainly for stress-reduction.

2.
Many unexplained infertility patients have irregular hormone environments in their bodies because of their high stress levels. These will affect the patient’s entire reproductive system, such as Oocyte maturation, delivery, fertilization, implantation, etc. My acupuncture points are selected to adjust the hormone environment and make the different hormones harmony.

3.
Each patient should have about one month of acupuncture treatment before starting the IVF procedure to prepare the patient’s hormonal system and to have her relax psychologically.

4.
It is extremely important for the patient to have 48 hours of bed rest after insemination before taking up normal activities, because at this time the fertilized eggs are very weakly bound to the uterus. Any inappropriate movement during these first 48 hours might cause an early miscarriage.

5.
For the key acupuncture points, you may do the acupressure by yourself as indicated above.

According to studies from Germany and Australia, the IVF treatment without acupuncture has a 29% success rate for pregnancy. However, the combination of acupuncture with IVF increases the success rate to 49%–almost a third higher than IVF alone. Therefore, it would seem advisable to combine the two treatments.

For more questions, please visit www.rmac.yourmd.com refer to the icon of fertility.

Dr. Xu has been voted as the best acupuncturist in Fairfield County

Jan 20, 2009   //   by drxuacupuncture   //   Uncategorized  //  No Comments

Original article available here.
Fairfield Country Weekly; May 2009

Professional Services

Acupuncturist

Dr. Jun Xu

Rehabilitation Medicine and Acupuncture Center

1171 E. Putnam Ave.

Greenwich, CT

(203) 637-7720

Dr. Jun Xu of Rehabilitation Medicine and Acupuncture Center is what you’d call a three-in-one doctor. He’s an MD, a certified acupuncturist and a certified Chinese herbologist. Living in China during the Great Cultural Revolution in the ’60s, Xu knew he wanted to “heal people’s minds and hearts,” but when the college he was attending closed, he could not continue. He soon switched to healing people’s bodies. He’s since received schooling in the East and West. He says western medicine is too focused on detail and diagnosis. He focuses on the whole person, starting with the body structure and spiritual strength. “I will teach you to keep your posture correct,” he says, “and if you have neck pain I’ll put needles in your neck, but also your hands and feet to increase blood flow, wash away inflammation and decrease muscle spasms.” He explains there are “channels in the hands and feet that go to your brain and help to release endorphins so you feel relaxed, calm and in less pain.” He says that the body has a natural ability to combat illness and that acupuncture facilitates this ability. It’s smart, he says, to turn to acupuncture for infertility problems, asthma, peptic ulcers, hormonal imbalances, anxiety, arthritis and many other ailments. “Our goal is to cure the patient,” he says, “not to make acupuncture famous.” Watch for Xu’s new book later this year, Magic Needles: How Acupuncture Can Help You.
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