How Does Acupuncture Work? Part II

acupuncture meridiansIn Part I of How Does Acupuncture Work? we discovered how qi, blood, yin, and yang interact. Let’s take a deeper look at the way these forces merge to create the major organs of the body.

The Organs in Chinese Medicine

The primary organs in Chinese medicine include the Liver, Heart, Spleen, Lungs, and Kidneys. Each of these organs has a “sphere of influence,” meaning it impacts the function of other aspects of the body and can offer diagnostic clues leading to treatment possibilities based on deep-seated relationships.

Here are a few examples of internal imbalances leading to external signs and symptoms:

The Liver impacts the eyes in Chinese medicine. Virtually all eye symptoms can be traced back to Liver disharmonies. This may sound absurd in Western medicine, but we know that by treating the Liver in Chinese medicine, we can impact eye health.

The same is true for the Lungs. In Chinese medicine, the Lungs are responsible for the skin. Unlike the example of the Liver, the relationship between lung health and skin health is well-documented in allopathic medicine. For example, we know patients with asthma and allergies are more likely to develop eczema.

Through questioning patients about subjective symptoms, the acupuncturist is able to work backward to diagnose imbalances deeper in the body.

Investigating in this way yields many clinical benefits. For one, acupuncturists pay attention to signs and symptoms that may be overlooked by other practitioners. In fact, many acupuncture patients are surprised by the specificity of our diagnostic approach. We often ask questions other healthcare practitioners do not ask.

The next time your acupuncturist rattles off a list of strange questions, know they are gathering important information that will result in a customized treatment strategy designed specifically for your condition.

The relationship between all these disparate signs and symptoms can be confusing to Western patients. But rest assured, it’s the acupuncturist’s job to discover these relationships, not yours.

 

Seeing the Bigger Picture

Acupuncturists also gather objective information on a patient’s health by examining the body.

One of the primary ways we get information about what is happening internally is by feeling the radial pulse in your wrists.

Each wrist offers a window into your internal environment. I feel the pulse bilaterally at a superficial level and deeper, closer to the bone. This technique tells me about the state of each of the organ systems mentioned above, as well as the vitality of qi, blood, yin, and yang.

Acupuncturists also investigate the tongue. Believe it or not, your tongue tells a story about your inner climate. Do you run hot or cold? Do you have phlegm in your intestines or lungs? The tongue will often reveal these conditions. (If you are curious about tongue diagnosis, check out Why Does My Acupuncturist Look at My Tongue?)

We also physically examine the body. We may feel for changes in skin texture, how pain responds to pressure, or if the area is hot or cold. All of these signs and symptoms give us clues to what is happening internally. Once we decide on a diagnosis, we treat these imbalances by influencing the meridian system.

 

Qi and the Meridians

In Chinese medicine the human body is a connected system of relationships. Electrical and metabolic information is sent through the body via a network of invisible channels called meridians.

Meridians connect all parts of the body in a continuous network of impulses. This is why we can insert an acupuncture needle in the foot to affect the hip or one in the hand to halt sneezing. In fact, qi moving through the meridian system is the real “secret” to how acupuncture works. It is how information is conveyed.

When this system of communication is disrupted or blocked, we experience pain and dysfunction. Also, when the body is weak, the signals being sent through the meridians become weak. Acupuncture revives this signal by stimulating the qi and blood. It also directs the qi to correct the flow of these impulses so that the body functions in a healthy way.

Without the meridian system, and the theories of qi, blood, yin, yang, and the organs, there would be no Chinese medicine as we know it. If we ignore the idea of qi, throw out the theory of the organs, and simply stick a needle in a muscle, we will not be able to address truly complex health issues. Patients may experience temporary pain relief, and even a sense of relaxation, but to unravel deeper problems, such as asthma and heart arrhythmias, the ancient Chinese theories are indispensable.

As an acupuncturist and an acupuncture patient, the theoretical scaffolding beneath acupuncture has always made sense to me. It is what differentiates it from practices like dry needling or trigger point therapy, techniques that employ acupuncture needles but abandon Chinese medical theory.

As acupuncture treatment evolves in the United States, it is important that we not forget the importance of balancing qi, blood, yin, and yang, which are the basis of health. Acupuncture helps thousands of people every day all across the world because of its foundational theories, not in spite of them. Ancient Chinese doctors understood this.

We are lucky to have inherited such a profound vision of human health, one that is both applicable to modern illness and flexible enough to accommodate new knowledge. Even as we seek to explain how acupuncture works in contemporary language, we can appreciate its roots in the dynamic balance between yin and yang.

How Does Acupuncture Work? Part I

During graduate school I was part of an acupuncture education outreach effort. When I told our program director the topic of our presentation—how does acupuncture work—she laughed.

“Good luck figuring that out!”

She was right. Acupuncture is not easy to explain—and I watch it in action every day.

Despite this challenge, I’ve learned that educating people about how acupuncture works is important. We are curious beings, after all. Also, patients and practitioners, not to mention insurance providers and medical doctors, all want to understand how acupuncture provides relief.

In this post I hope to shed some light on this difficult question by giving you a short-and-sweet primer on the theory behind this powerful medicine.

 

The Roots of Acupuncture

The answer to “how does acupuncture work?” is embedded in a cultural perspective that is different from Western medical science. While Chinese medicine is based on observation of nature—with humans being an inextricable part of their environment—the ancient Chinese were not conducting double-blind placebo-controlled studies. Nor did they have the concept of germ theory or the endocrine system.

Even still, Chinese medicine is highly empirical, meaning it developed based on visible changes in wellbeing after implementing certain therapeutic techniques. Acupuncture and herbal medicine are not just theoretical—or superstitious—forms of medicine. In fact, Chinese medicine is the oldest and most contiguous body of textual medicine in the world, meaning what we use today has been refined through clinical practice and passed down in books over millennia.

Chinese medicine is also highly adaptable to modern illness, which is why it remains so clinically relevant and important to modern healthcare. Many theories and treatment methods used in the contemporary clinic were discovered over 2,000 years ago and are still applicable to patients with iPhones and Facebook accounts.

So just what was in these ancient texts?

The history of Chinese medicine began with the first herbal medicine text, the Shennong BencaoThe Divine Husbandman’s Classic of Materia Medica. This book was compiled 2,500 years ago and includes many well-known herbs that are still in use today, including ginseng and ginger.

The first acupuncture text was the Huang Di Nei JingThe Yellow Emperor’s Classic of Medicine, compiled 2,200 years ago during the Warring States Period in China. This manuscript introduced the ideas of yin and yang into medicine, concepts that could already by found in the religious philosophy of Taoism.

These ideas were flexible in that they could be applied to broad scenarios, such as weather and climate, or minute workings in the body, like growth and development, death and decay. The flexibility of Chinese medical theory is really what keeps it clinically effective even today.

 

Qi, Blood, Yin and Yang: Navigating the Inner Ecosystem

Much like an ecosystem, Chinese medicine is based on patterns and relationships that are visible in the natural environment.

We think of the outside world as a complex system of elemental interactions: water, soil, wind, sunlight. Similarly, the body is its own ecosystem. However, the primary relationships in your body occur between qi, blood, yin and yang.

Yin and yang are opposites, yin being dark, moist, heavy, cool, and receptive, and yang being light, warm, expansive, and generative. An important thing to remember about yin and yang is that these terms only have meaning in relationship to one another; they are inextricably connected. If we say a person who is cold lacks yang, we can only determine this by weighing it against the yin qualities present in their body.

Qi and blood have a similar relationship. Qi is life-force energy in Chinese medicine. It permeates and animates everything. I like to think of it as the electrical impulse that is always present in living organisms. Blood, like yin, is dense and nutritive. It moves all over the body, feeding the cells of the muscles, brain, and all the internal organs. The qi carries the blood around the body, pulling it forward with a magnetic force.

When qi, blood, yin and yang are in a state of balance, people feel good. When these forces are out of whack, disease comes about. The job of an acupuncturist is to determine what is imbalanced and adjust it through sending a corrective message through the needles.

 

Diagnosing Imbalances of Qi, Blood, Yin and Yang

But just how does an acupuncturist diagnose disease? First, we need to know how the yin, yang, blood and qi are interacting.

As an acupuncturist, I use many methods of investigation to determine what is out of balance in my patients. Some imbalances are temporary, acute, surface-level disease states, such as a cold, flu, or injury.

Other problems run deeper and become a part of a patient’s constitutional makeup. They grow from the little things we do, or that happen to us, over months or years. Sometimes they are even with us from childhood. I often think of these imbalances as “body habits.” They are harder to interrupt and often require maintenance support, including acupuncture treatment or herbal medicine, over a longer period of time.

Your body’s symptoms are subjective messages sent to alert you that something is off. My role is to question you about these symptoms so that a pattern emerges.

Through interpreting the relationship between symptoms (subjective) and signs (objective), I then reach a diagnosis designed to address the imbalances of qi, blood, yin and yang.

Next time, in How Does Acupuncture Work Part II, we’ll look at the role the internal organs play in diagnosing and treating disease. We’ll also learn the theory behind why acupuncture needles impact the health of qi, blood, yin, and yang.

The mystery continues…

The Healing Benefits of a Long Winter’s Nap

I just love winter in Colorado. Even though our snowy season has been quite mild this year, I adore the cozy comforts of winter. In my house, cold weather means lap blankets, doubled-up socks, never-ending mugs of tea, homemade soup, and, my favorite cold weather pastime, sleeping.

Over the last few years, sleep has become my primary medicine for everything from headaches to emotional distress to digestive issues. Although I rarely sleep late into the morning, I am happy to head to bed at 7:30 p.m. if I feel ready for a long winter’s nap.

I’ve learned that indulging my sleep habit makes my waking hours more productive and fulfilling. I need less caffeine to get my brain working, and my stress remains manageable when I get enough rest. My life feels noticeably easier when I’ve slept well. Like drinking plenty of water, sleep really is a miracle drug.

During the holiday season, I took two weeks off to rest and go within. As part of my time off, I incorporated a few of what I call Healing Naps. On the surface, these just look like plain old naps. (Maybe you’ve taken one of those already today.) To make my naps even more wonderful, I include a simple addition: before falling asleep, I imagine myself bathed in warm light as I lay in bed.

This loving, gentle blanket of light feels very similar to the way I feel when I receive an acupuncture treatment. I’ve even begun using this light-awareness technique before going to bed in the evening. I encourage you to try it, especially if you have insomnia or fitful sleep. The healing benefit of consciously directing warm, loving thoughts toward yourself before bed translates into a deeper sense of safety, which we need in order to let go into sleep. This safety resembles being “tucked in” as a child.

Sleep is a time of letting go, slowing down, and opening up. Why rush it? Give yourself an extra hour. Take a nap if you have the time on a Saturdayafternoon. Allow yourself to experience the regenerative peace of a temporary hibernation.

Like the sweet red fox pictured above, may you have the healing benefits of restful winter sleep. And if your sleep is not so restful, let’s talk about how acupuncture can help.

More Than Comfort: Therapeutic Presence in Alzheimer’s and Dementia Care

woman in grey jacket
This month I invited a dear friend, Heather Campbell Grimes, to guest blog for Boulder Acupuncture and Herbs. Heather writes about her experience working as a massage therapist in a memory care facility for patients with Alzheimer’s and dementia. Her insights on the importance of touch and the power of grounded presence in caring for this unique population are welcome inspiration for anyone working with elders. Thank you, Heather

Her real name is not Mary, but we’ll call her that for now. I knock on Mary’s door and then announce who I am before unlocking it with a key. The door leads directly into her bedroom. She’s where she always is: curled up and contorted in her bed, watching DVD re-runs of the TV show MASH.

She says, “Thank god it’s you. They’ve been coming in all morning, trying to get me to go to exercise.” Mary is in her early seventies, but a nasty fall about six months earlier—which resulted in a broken leg, a broken hip, and three major surgeries—left her looking frail and much older. I assume this, however, because I didn’t know her before she came to the Alzheimer’s and dementia residence where she lives now, where I work. From what her family tells me, her physical traumas—and a move cross-country to live in a place where she can receive constant care and that is closer to her daughter—exacerbated her dementia.

Propping herself up is a slow and painful process. Her shoulder-length gray hair is tied up in a little-girl ponytail, with at least a dozen bobby pins attempting to restrain the wispy side pieces. Mary has all-over body pain, as she describes it, and is prescribed legitimate pain-killers to take twice a day. They may or may not help the pain, but they do not free Mary enough —physically or emotionally—to want to leave her bed.

“Good morning, Mary,” I say and lug the massage table into her space. I set it up, loud and clunky, while she scoots herself to the edge of her bed, wincing from the pain. I roll her walker over to her and help her to stand before she shuffles herself to her bathroom. (Her home consists of a bedroom and a bathroom.) She voluntarily gets up for meals and that’s about it. And her weekly massage.

It’s a struggle for her to undress and climb onto the massage table, but she would have it no other way. I have tried to massage her fully clothed and in her recliner, half-clothed in her bed, but nothing is as satisfying to her as having her on the table for the full hour-long experience.

I’ve learned that she loves Frank Sinatra, so I bring my phone with me and we listen to the “Ultimate Sinatra Collection.” Mary is very inquisitive about Frank, so we’ve looked up quite a bit of his history on my phone—he was married four times and recorded over a thousand songs. She lights up when she talks about him, as if we had not had the very same conversation the week before, and the week before that.

Within minutes on the massage table, her body shifts from a tense assortment of stiff and rigid bones to feeling as though there is some space in there between the joints—some slight sense of buoyancy that I am pretty sure she doesn’t experience on a regular day. Her mood shifts from laser-focusing on her ailments to wanting to chat about music, my family, the words that go ‘on’ things. (Mary often talks about what words she would put ‘on’ things to describe them. She often says she’d put the word ‘ache’ on her leg, ‘sore’ on her foot, or ‘underwear’ on her Depends.)

The specific massage strokes are of no particular importance, though I know to work extra gently on most of her body, to focus on her shoulders and back, and to lay off her feet. What is most important, at least I believe, is the invitation for Mary to inhabit her body without resentment. Our one hour a week may be one of the few occasions where she can feel the sensations of her body without bracing herself against them. This increases her overall body awareness as well as palpably easing her anxiety.

And without all that struggle, she is able to relax and connect with me in a very human way. She doesn’t always remember my name (though I wear a nametag), and she repeats the same sentences over and over. But she always remembers that I have two daughters and am in the process of adopting the youngest. She asks about them every time.

Mary is one example of the numerous people with Alzheimer’s and dementia who I have had the good fortune to work with over the years. I’ve been a massage therapist for eleven years but have focused primarily on working with folks who have Alzheimer’s and dementia for the past six years. I work at a memory care facility that houses only this specific population.

Every one of my clients is supremely unique, with specific needs and thresholds. More often than not, I work with the residents for frequent, shorter chunks of time—fifteen minutes, twice a week is the most common—where they stay fully clothed and sit in a comfortable chair in a public area. It takes them such a long time to undress and re-dress, and the effort of climbing on and off of a standard massage table is just too much for most of them. But there are a few—Mary being one of them— who are agile enough to get on the massage table and who want only that.

Regardless of where the massage session is located, or how long it lasts, the connection is still there and is the pinnacle of our work. Every human has a basic need for caring touch, and although the staff where I work is exceptional, the fact is they have many people to look after. Often the residents’ experience touch primarily when they are getting dressed or toileted—the daily necessities.

The touch provided by a massage therapist is of a very different variety. It provides nurturance and attendance, sometimes helping a drowsy resident to grow more alert, sometimes aiding an agitated resident to calm down.

I also work as another set of eyes and ears to help provide the best care for these residents, letting the nurses and family know if a resident is more restless or confused than usual, or if they are complaining of pain in a certain area. This provides many of the families (as they are the ones who hire me) with a bit more peace of mind. It certainly does take a village.

One of the things I love most about working with this specific population is the genuineness of our interactions. There is nothing to ‘fix’, as it were, simply comfort and connection to offer. Most of my clients are not able to hold a typical conversation, so finding a way to relate with them requires a bit more curiosity and imagination. When I am attentive and grounded, my time with my residents feels incredibly valuable and satisfying. So when something is off, I can usually trace it back to where my mind and heart are at, how present I am being with them. This is a great service to me.

So when I am about to leave Mary in her room after her massage session, she may or may not want to come out to the common area with me. Likely not. But she does have a certain sparkle in her eye and a smile on her face as we hug and she says, thank you.

Heather Campbell Grimes is a blogger, freelance writer, and stage performer. Heather is also a massage therapist who specializes in working with elders who have Alzheimers and dementia. She is a devoted mother and foster-mother, and she lives with her husband and family outside Boulder, Colorado. You can find Heather at hcgrimes.org.

Acupuncture for Alzheimer’s and Dementia

senior in hat

Alzheimer’s disease and dementia impact over 5 million people in the United States. According to the Alzheimer’s Association, nearly 70,000 people in Colorado live with memory loss. With Alzheimer’s and dementia on the rise, complementary care options are critical for helping manage this widespread health crisis. Acupuncture can be an effective part of treating the many symptoms that occur with Alzheimer’s and other forms of dementia.

Alzheimer’s is a difficult condition to treat. Like many complex diseases, the causes are not well understood. Western medical intervention can help patients manage certain symptoms, but conventional treatment options have been ineffective in halting the progression of the disease. Given the increasing number of patients diagnosed with this illness, and the growth of our aging population, pharmaceutical companies and research institutions are scrambling to find a cure for this devastating disease.

Alzheimer’s and dementia primarily affect people over 65, though early-onset dementia does occur. There are currently 5.5 million people living with Alzheimer’s or dementia in the United States, and that number is expected to rise as our population ages. The widespread prevalence of these conditions has shot up dramatically over the last 17 years; since 2000, deaths from Alzheimer’s disease have gone up 89%. Alzheimer’s is now the sixth leading cause of death in Colorado and the United States as a whole.

The course of cognitive diseases like these can be long. Some patients live a decade with progressively complicating symptoms. There are currently no known cures or preventative methods to stop Alzheimer’s disease. This means the full burden of the disease usually comes in old age when one’s health may already be compromised. It is not uncommon for older adults living with Alzheimer’s or dementia to have diabetes, heart disease, or other chronic illnesses.

Even in elders who do not exhibit memory loss, old age brings a host of physical and mental difficulties. Acupuncture excels in treating many conditions that show up in our later years, including arthritis, digestive issues, insomnia, hypertension, depression, and anxiety. It is important to remember that although Alzheimer’s and dementia are memory disorders, patients may suffer from physical illnesses that are manageable through complementary medicine, such as massage and acupuncture.

We know that the personality changes that accompany dementia can be challenging, both for patients and caregivers. Recent research in the U.S. on the efficacy of acupuncture in treating depression and anxiety in Alzheimer’s patients has been promising. These diseases can instigate profound feelings of despair and cause an increase in social isolation. Acupuncture, different from talk therapy, offers a body-mind treatment that can calm feelings of anxiety and lift the mood. Treatment offers patients the chance to interact with someone outside their normal sphere of care, which can stimulate social connection.

Acupuncture also excels in treating pain of all kinds. Many seniors report living with pain, which can lead to a decrease in physical activity and changes in sleep patterns. Movement is critical for maintaining health and inspiring participation in activities that bring us joy. Many dementia patients are still capable of physical exercise and should be encouraged to stay active as a way of promoting their overall health. Acupuncture keeps seniors moving by alleviating back, knee, neck, and foot pain.

Expanded research on using acupuncture and Chinese herbs in treating Alzheimer’s is being explored in China and Japan where prevalence of the disease is also on the rise. While we cannot claim that East Asian medicine currently offers a strong method for halting or reversing this disease, we can provide supportive care in the realm of helping to manage co-existing symptoms. Hopefully, as research on Alzheimer’s and dementia increases, comprehensive approaches to treatment will become available to patients at all stages of the disease. Ideally, we will discover ways of preventing these conditions as well.

At Boulder Acupuncture and Herbs, we treat patients in the early and middle stages of Alzheimer’s and dementia. We use both acupuncture and Shiatsu to help manage pain, depression, fatigue, and anxiety in patients with cognitive disorders. Our approach to each patient is dependent on the client’s comfort level, receptivity, and physical condition. Some patients may be seen privately, while others need a care partner present. We can also visit patients in their homes or in memory care facilities in Boulder.

The challenges of living with dementia can be overwhelming for many patients, especially during the early stages of the disease when rapidly changing capabilities can cause intense distress. Similarly, caring for a loved one diagnosed with dementia is also incredibly challenging. Managing this disease is a group effort, and we want to be of service. Call us to discuss how acupuncture might help ease the discomfort of living with dementia.

Prescription Opioid Abuse in Elders

brain

The prescription opioid epidemic in the Unites States has reached unprecedented numbers. The Department of Health and Human Services states that nearly 80 people die from opioid-related overdose in the Unites States every day. These deaths come from both recreational drugs, like heroin, and prescription painkillers. Seniors are particularly at a risk because they are often prescribed these medications for pain. Luckily, acupuncture can offer immediate help with prescription opioid abuse in elders.

But first, how does opioid abuse develop? Prescription painkillers are best used to manage acute pain, meaning post-surgical discomfort or after sustaining an injury or fall. Chronic pain, such as that associated with arthritis or old injuries, is less responsive to opioid intervention and can actually create a cycle of tolerance and dependence.

How did we reach this point of widespread addiction to pain medication?

A contributing factor was the medical community’s shift to treating pain as the “fifth vital sign” starting in the 1990s. This meant that after heart and respiratory rates, blood pressure, and body temperature, doctors screened patients about pain. For patients living with pain, this was a blessing. As many chronic pain sufferers will attest, intractable pain can lead to depression, loss of income, and strained personal relationships. There is no doubt that chronic pain changes the landscape of life.

Despite their efforts to alleviate pain, the medical community’s move to prescribe high-powered medications to help millions of patients has resulted in a complex public health problem.

Although the face of the opioid epidemic is not typically portrayed as a senior aging at home, we know elders are impacted by this trend. Kaiser Health News reported that in 2011, 15% of Medicare patients were prescribed opioids after a hospital visit. Ninety days after being discharged, 42% of those patients were still taking those medications. Clearly opioid abuse is becoming a concern for elderly patients.

The Dangers of Opioid Abuse in Elders

Painkillers change pain perception by activating opioid receptors in the brain. The relationship between a pain site and the way the brain recognizes pain are altered by the addition of prescription medication. As the brain becomes accustomed to the flood of introduced opioids, its receptor sites multiply. This is why opioid drugs are so highly addictive. The body becomes chemically dependent on receiving this additional influx of opioid to function comfortably.

The side effects of opioid use in seniors are especially worrisome, including changes in cognition and poor motor control leading to falls. When taken in high amounts, these medications are particularly dangerous. For elders with memory impairment, accidentally doubling up on doses can be deadly.

Unlike younger adults seniors do not metabolize opiates at the same rate, meaning more of the drug is likely to stay in the body for a longer period of time. Family members or friends who sympathetically offer painkillers should be aware that elders carry a greater risk of overdose due to decreased liver and kidney capacity. Never share opioids with a senior.

Even when elders are appropriately prescribed opiates, these medications can bring unwanted negative symptoms, including:

  • nausea
  • constipation
  • urinary retention
  • sedation
  • skin rashes
  • compromised respiration
  • cardiac symptoms
  • lowered libido
  • heightened pain perception
  • decrease in bone density

For some patients multiple doses of opioids per day can lead to physical dependence in less than one week. It is important that elders have a recovery plan in place to transition off of these drugs as soon as possible.

This is where acupuncture can help.

Acupuncture Helps Prescription Opioid Abuse in Elders

 Pain creates neural pathways in the brain that stimulate the body to release its own naturally occurring opioids, including endorphins. When pain thresholds are exceeded, such as after surgery, the body cannot control the sense of discomfort. Prescription opioids are particularly useful in helping the body manage this type of severe pain.

Over time, as the trauma from surgery or a fall heals, communication between the pain site and the brain relaxes. In an ideal scenario, painkillers—natural and introduced—are no longer needed. When the body does not heal effectively, pain can linger, continuing to send alarm messages to the brain. Chronic pain creates a particularly insidious cycle of depletion in the body, requiring higher and higher doses of medication to provide relief.

The insertion of acupuncture needles naturally stimulates the release of endorphins, assisting the body in repairing itself. Acupuncture also combats inflammation, which reduces feelings of pain and stiffness. It increases blood flow, helping tissues flush out stagnant blood and encouraging the lymphatic system to repair compromised areas. And, most importantly, it interferes with the distressed messages ricocheting between the brain and distal pain sites, leading to a real change in pain perception.

All of this occurs over repeated acupuncture treatments. Patients suffering from chronic pain, and especially those on opioids, should expect to receive multiple acupuncture treatments to change underlying dysfunction. In some cases, acupuncture is incapable of resolving the pain entirely, especially if the trauma happened years—or decades—ago. Our goal is to help patients feel as comfortable as possible given their personal health history and constitution.

It is important to remember that acupuncture does not work like a pill. Once a patient has become accustomed to taking medication, especially an opiate, the expectation that acupuncture will bring substantial relief right away is misplaced. A course of treatment can last anywhere from two to six months, and sometimes longer, depending on the severity of the condition.

Chronic pain is a complicated problem. It requires clients, and practitioners, to be patient with the body as it repairs itself. Additionally, if a patient is addicted to opioid medications, the process of reducing prescription dependence is particularly challenging. It requires a team approach, which can include medical care, physical therapy, massage, and acupuncture. Get help when it’s needed, and don’t give up too quickly.

Alta Mira recovery center in California says that drug dependence in elders can be overlooked or dismissed because of a perceived lack of urgency. This attitude is often motivated by our cultural beliefs about the limits of old age. At Boulder Acupuncture and Herbs, we are committed to offering seniors access to drug-free alternatives that do not erode quality of life, no matter your age.

If you or a loved one is caught in the cycle of chronic pain, call us today. If you’ve sustained a recent injury, get in to see our acupuncturist right away. Acupuncture will speed up the recovery process and lower your risk of developing drug reliance. And if opioid abuse is already a concern, talk with us about how we can work with you and your doctor to break the cycle of dependence.

For more information on chronic pain in elders, see our article Pain Management in Older Adults.

 

Works Referenced

Chau, Diane, et al. Opiates and Elderly: Use and Side Effects. Clinical Interventions in Aging. 2008. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2546472/.

Esposito, Jenny. Silent Epidemic: Seniors and Addiction. U.S. News and World Report online. December 2, 2015. http://health.usnews.com/health-news/patient-advice/articles/2015/12/02/silent-epidemic-seniors-and-addiction.

Gold, Jenny. Opioids Can Derail the Lives of Older People, Too. http://www.npr.org/sections/health-shots/2016/12/20/502470255/opioids-can-derail-the-lives-of-older-people-too.

Prescription Opioid Abuse In The Elderly An Urgent Concern. Narcanon website. http://www.narconon.org/blog/narconon/prescription-opioid-abuse-in-the-elderly-an-urgent-concern/.

Sphar, Brittany. Opioid Considerations in the Elderly. Presentation at University of Colorado Internal Medicine Department of Geriatrics Grand Rounds. March 17, 2016. http://www.ucdenver.edu/academics/colleges/medicalschool/departments/medicine/geriatrics/grandrounds/Documents/15-16/GeriatricGrandRounds-Sphar-031716.pdf.

The Opioid Epidemic: By the Numbers. U.S. Department of Health and Human Services. Updated June 2016. https://www.hhs.gov/sites/default/files/Factsheet-opioids-061516.pdf.

Why Opioid Addiction in Seniors Remains a Hidden Epidemic. Alta Mira website. Posted September 2016. https://www.altamirarecovery.com/blog/opioid-addiction-seniors-remains-hidden-epidemic/.

 

Acupuncture for Urinary Tract Infections

women

Urinary tract infections, also called UTIs, are a common occurrence in older adults, especially women. In Western medicine UTIs are caused by the presence of bacteria, often E. coli, in the bladder. These bacteria travel up the urethra, and if left untreated, can also affect the kidneys. Managing a urinary tract infection quickly is important. If left untreated, these infections may spread, causing damage to the bladder, kidney, urethra, and genital tissue.

The symptoms of a UTI include burning on urination, the sensation of needing to urinate and being unable to void, itching in the genitals, or pain in the lower abdomen. Patients may also have an overall feeling of being unwell, including fever, irritability, or insomnia.

Healthy urine should pass easily, be straw-colored and free of cloudiness. In the case of a UTI, the urine may be dark in color, cloudy, milky, or even streaked with blood. The presence of blood in the urine indicates the infection is severely irritating the lining of the kidneys, bladder, or urethra.

Women are more likely to contract UTIs because of the short length of their urethras, or the passage between the bladder and the outside. Many women who suffer from UTIs show a chronic recurrence of these symptoms. For women who wear padded protection against accidents, a lack of breathability in the vaginal area can create an environment for bacteria. Also, patients who are unable to bathe regularly present a higher risk for developing a urinary tract infection.

Western medicine treats UTIs with antibiotics. Depending on the severity of the infection, the duration, and the patient’s history of naturally managing UTIs, alternative treatments are available.

We will focus on acupuncture, Chinese herbs, and dietary medicines, though there are other resources for UTIs in Western herbalism and homeopathy. My experience is that women often discover the best combination of alternative treatments for their particular body; no “one way” is right for every patient.

Chinese medicine treats the cause of UTI in many different ways, depending on the patient’s age, constitution, symptoms, and overall health picture. UTIs come about due to a variety of factors, including environmental, biological, and emotional. Certain types of UTIs are initiated by psychological upset and can be traced back to stress or anxiety. In Chinese medicine these infections are treated differently than UTIs caused by tight-fitting clothing, hygiene issues, or eating the wrong foods.

UTI symptoms fall on a spectrum. Some women experience intense burning with urination. Other women feel bloated and swollen, as if their urine cannot pass through the urethra because the passage is narrower than usual. Still others may feel no pain at all but notice their urine is cloudy. I have also known of women who simply felt like they had the flu but could not point to the bladder being the cause of their discomfort.

Once I have determined the cause of the problem, I develop an acupuncture plan and may prescribe a Chinese herbal formula designed to address the infection. Most UTIs can be cleared up with a few treatments and a week of herbs. If your symptoms are recurring though, we need to determine what is triggering the infection and eliminate the irritant.

The vagina and opening of the urethra are sensitive to changes in temperature and the presence of chemicals. I recommend all women wear cotton underwear, which is the most breathable fabric available, to keep the vaginal area cool and dry. If you wear pads or panty liners to manage incontinence, choose products that are made of organic cotton and a minimal amount of plastic. Organic cotton cloth diapers are a good solution for patients who need round-the-clock protection. Currently, there are no organic cotton disposable adult diapers on the market. I am hopeful these become available soon. Above all, make sure the underwear, pads, or diapers are changed regularly to minimize the risk of bacteria from the colon entering the urethra.

Drinking plenty of water will help your body flush the bacteria out of the bladder. You may also add 100% cranberry juice to your diet. Just make sure your juice does not contain any added sugar or high-fructose corn syrup. All bacterial infections are “fed” by the simple sugars found in sweet fruits and refined sweeteners. The best dietary change you can make to make the body inhospitable to bacterial infections is to cut refined sugars and alcohol.

A simple, effective home remedy for UTI is drinking corn silk tea. Corn silk is the “hair” that grows around the corn ear and is sloughed off before eating the kernels. This “silk” is soothing to the urinary tract and also has a mild taste. You can make a tea from the silk or buy encapsulated corn silk to be taken as a pill. This remedy is not for patients who are taking blood thinners (Coumadin, Plavix, etc.) or diuretics for high blood pressure or edema. If you are not taking these contraindicated medications and are experiencing recurring UTIs, consider buying a bottle of corn silk pills to keep on hand for future infections.

It is critical to remember that some urinary tract infections are best managed with antibiotics. Longstanding infections, or infections in patients who have compromised immune systems, should be addressed through Western medicine. If you are unsure whether your symptoms should be treated with antibiotics, make an appointment with your doctor. For mild infections, acupuncture, herbs, and dietary therapy may offer relief.

We are happy to talk with you about your symptoms and your health history to determine if Chinese medicine is the right choice for you.

Acupuncture and Surgical Recovery

According to the article “Common Surgical Procedures in the Elderly”[*] published by the American Geriatrics Society, older adults receive 20% of all surgeries conducted in the United States. Comprising only 13% of the population, the patient-to-procedure ratio for older adults undergoing surgery is quite high.

Surgery is an important part of modern healthcare. Many life-threatening and painful conditions are helped by surgical intervention, including cardiac events and broken bones. Older adults may undergo many surgeries to address a variety of health problems as they age.

Whether you have a procedure planned or are recouping from surgery, consider adding acupuncture to your rehabilitation program to shorten and ease your recovery time.

Acupuncture works by stimulating the body to initiate its own healing capabilities. Inserting needles in the skin at specific points reduces inflammation, releases endorphins, stimulates the immune system, and promotes blood flow to compromised areas. Recovering from surgery stresses the body’s natural repair and defense systems, especially in older patients with weakened immune and metabolic responses. Acupuncture provides gentle, supportive treatment during those vulnerable weeks after surgery when the body is asked to do significant self-healing. It stimulates the appetite, promotes elimination, and can reduce dependence on pain medication, all of which speed recovery and improve quality of life through the rehabilitation process.

Post-surgical acupuncture can be done in a variety of settings. Patients may be treated in bed, in a wheelchair, on a massage table, or in a recliner. Our clinic specializes in elder care, which means we can treat older adults with mobility restrictions and special needs, including hip, knee, and back surgeries. 

A series of acupuncture treatments can also help you prepare before receiving a medical procedure. Acupuncture boosts your immunity, calms your nervous system, and helps you sleep, which are important to recovery. Plan to see your acupuncturist once a week for three weeks before your surgery, and aim to schedule your last appointment a day or two before your procedure. Once you’ve had your surgery, schedule a series of follow-up appointments to help you through rehabilitation.

After surgery, it is important to closely manage your post-surgical pain. As pain levels rise, so do instances of insomnia, high blood pressure, and anxiety. By combining acupuncture with traditional pain management, many patients find they are able to reduce their pain medications, helping them feel more alert and avoiding side effects like constipation. Remember, pain is best managed through treatment before it becomes unbearable. Schedule appointments with your acupuncturist prior to going in for surgery to insure you are able to get in after your procedure.

Surgery can be worrisome, especially in older patients, and particularly if the recovery process is long. At Boulder Acupuncture and Herbs, we see patients in their homes or in rehabilitation facilities, like Frasier Meadows Healthcare Center, so that you can start treatment right away. If you have a surgery planned, call us to schedule a series of appointments aimed at helping you recovery quickly, safely, and with fewer complications.

[*] http://www.americangeriatrics.org/gsr/anesthesiology/common_surgical_procedures.pdf

Going on an Elimination Diet? Give Yourself a Month

woman holding ice cream

Dietary adjustments are hard. When I recommend dietary changes to patients, I ask them if they can commit to one month of effort. The annoying truth is that elimination diets, such as gluten- and dairy-free diets, can take time to show results. Often patients abandon an elimination diet too early to effectively evaluate its impact. Other elimination diets, like sugar, caffeine, and alcohol, show almost immediate results, leaving little room for doubt. I have never heard anyone say they felt better, physically, eating more candy and doughnuts.

The “costs” of an elimination diet can be surprisingly high. Not only can it be more expensive to buy items that substitute for foods you are accustomed to having, there is a time cost to learning to cook new foods or find restaurants that meet your needs. Maybe you are the only person in your house launching this diet, which is a challenge in itself. There can be mental costs to starting a diet as well, such as saying no to your mom’s chocolate cake. It’s important to factor these costs into your plan.

Giving a diet less than four weeks to prove itself is usually a formula for failure, setting you up to ping pong between deprivation and bingeing. Drastic changes are hard on your body, your mind, and in some cases, your wallet, so don’t shortchange your ability to honestly evaluate your results by giving up too early.

Once you see real results—increased energy, better digestion, fewer headaches—you will be inspired to keep going. The costs no longer feel so high, and the payoffs more than make up for your efforts. This takes time, though. Pick a four-week period, plan in advance, and get help if you need it.

Acupuncture offers wonderful support during elimination diets. It curbs cravings, optimizes your digestion, and helps your body flush out residual toxins and metabolic wastes. Together, we can come up with a plan that will enable you to get the most out of your diet so that you see lasting results.

Why Does My Acupuncturist Look at My Tongue?

dog tongue

Something you may not know about your acupuncturist is that she is used to seeing some very challenging cases. As a practitioner of Chinese medicine, I have the privilege of working with clients who may be coming to my office after seeing many other practitioners. Because our medicine is not well understood in the United States, it is often used later in the disease process. One of my goals as an acupuncturist and herbalist is to change this dynamic.

That being said, I have had the opportunity to work on difficult cases and witnessed powerful changes in my patients’ wellbeing. One of the tools I use in the diagnostic process is looking at the color, texture, moisture level, and overall vitality of the tongue. Believe it or not, everyone’s tongue is different. Your tongue tells me a lot about your internal health and can offer clues to very stubborn illnesses.

The tongue illustrates the state of the organs, most specifically, the stomach. Different regions of the tongue correspond to different organ systems and can reveal heat, cold, stagnation, and phlegm in parts of the body I can’t see from the outside. I may be able to discern phlegm in the lungs or intestines from observing the tongue, or your tongue may show the cause of your anxiety or insomnia. The tongue even reveals abstract symptoms like fatigue and irritability.

The #1 thing to remember about tongue diagnosis? Don’t brush your tongue! The coating, texture, and moisture level are all key indicators of your body’s internal climate. And don’t worry. If you’ve had coffee, a Jolly Rancher, or a breakfast burrito, I am usually able to look through all of that to discern the real state of the organs. And rest assured, yours will not be the first blue tongue that has shown up in my exam room.