Browsing articles tagged with " Acupuncture"

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.

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