Wednesday, December 8, 2010

Does Acupuncture Work: Symptom Relief vs. Correction


Symptom Relief vs. Correction:
In Chinese Medicine, the goal is to give the patient relief from their symptoms, as well as to address the underlying cause of the symptoms. Symptoms are the last piece of the puzzle to appear. In general, the conditions that created the symptoms were in place years before the symptoms actually appeared. These conditions often are multi-factorial and often go unnoticed by the patient.
Take for example, a leaky roof. Every time it rains, water starts to drip in to the house, making the floor and carpets wet. After some time, the roof and the carpets begin to mold and the wood and ceiling begin to rot. Symptom relief would involve putting a bucket under the leak, catching the water, so that the floor stays dry. However, over time, the ceiling continues to rot and mold and sometimes, if the outside stressors (in this case, the rain storm) are strong (eg. Heavy rainstorm), the bucket isn’t big enough to hold all the water and overflows on to the carpet and floor. Over time, the temporary, symptom relief approach becomes inadequate, and doesn’t actually solve the problem (the mold and rotting), because we didn’t actually address the cause.
Now, let’s say the home owner is still unwilling to spend the time and money to fix the cause of the problem, so instead, they tape a piece of plastic over the leak in the roof. This seems to be effective for a while, however, the roof continues to rot and mold, and eventually the plastic breaks. You get the point. Sure, you could continue to cover the leak with plastic over and over, or use the bucket approach each time it rains, however, eventually, the mold and rotting will cause further problems. People in the house start to develop allergies to the mold that is growing, and after awhile, the rotting causes structural damage to the house, and the roof begins to buckle. You now have more and more symptoms developing from the same root cause. It no longer is safe to leave it as it is. The amount of time and money that is now needed to replace the roof is significantly more than it would have been to fix the original small leak.
Symptom Relief = the bucket and the taped plastic
Correction = fixing the roof
An additional step to making sure that symptoms do not return is maintenance. In the case of the leaky roof, maintenance would entail inspecting the house and treating minor damage BEFORE it becomes a bigger problem.
With Acupuncture and Chinese Medicine, treatment that includes all three phases is the most effective and durable approach. The duration of each phase depends on a few factors, including how long the person’s had the symptoms/condition, age, lifestyle, diet, overall health, consistency of treatment, etc.

Tuesday, July 13, 2010

Laugh Everyday

In the last post, I discussed the role of sleep in appetite control and metabolism-- specifically the release of the hormones leptin and ghrelin. There are two other activities that have a positive affect on these hormones. The first is an obvious one-- Exercise. Getting regular exercise helps to balance blood sugar and insulin levels, and help to maintain a healthy weight. The second activity is Laughing. A recent study shows that laughing may reduce cholesterol, blood pressure and improve immune activity.

Laughter affects the body like exercise


Results of the study, from Loma Linda University's Schools of Allied Health (SAHP) and Medicine, showed that laughing not only enhances a positive mood, but lowers stress hormones, increases immune activity, and lowers cholesterol and blood pressure, similar to moderate exercise.

In the study, 14 healthy volunteers were recruited to a three-week study to examine the effects that eustress (mirthful laughter) and distress have on modulating the key hormones that control appetite.

During the study, each subject was required to watch one 20-minute video at random that was either upsetting (distress) or humorous (eustress) in nature.

During the study, the researchers measured each subject's blood pressure and took blood samples immediately before and after watching the respective videos.

Each blood sample was separated out into its components and the liquid serum was examined for the levels of two hormones involved in appetite, leptin and ghrelin, for each time point used in the study.

When the researchers compared the hormone levels pre- and post-viewing, they found that the volunteers who watched the distressing video showed no statistically significant change in their appetite hormone levels during the 20-minutes they spent watching the video.

In contrast, the subjects who watched the humorous video had changes in blood pressure and also changes in the leptin and ghrelin levels.

Specifically, the level of leptin decreased as the level of ghrelin increased, much like the acute effect of moderate physical exercise that is often associated with increased appetite.

Dr. Lee S. Berk, a preventive care specialist and psychoneuroimmunology researcher at Loma Linda University's Schools of Allied Health (SAHP) and Medicine, said that this research does not conclude that humour increases appetite.

"The ultimate reality of this research is that laughter causes a wide variety of modulation and that the body's response to repetitive laughter is similar to the effect of repetitive exercise,” he said.

“The value of the research is that it may provide for those who are health care providers with new insights and understandings, and thus further potential options for patients who cannot use physical activity to normalize or enhance their appetite," he added.

The study is being presented at the 2010 Experimental Biology conference.

Tuesday, July 6, 2010

Easy Weight Loss? -- Sleep to support your weight loss efforts

Sleep your way skinny?

Ok, so it may not replace good diet and exercise, but based on recent studies, getting adequate and good quality sleep can improve your metabolism and curb your appetite. In fact, the study showed that getting less than 8 hours of sleep and/or poor quality sleep (disturbed sleep) can disrupt your metabolism and increase your appetite by affecting the release of leptin and ghrelin in the body-- two hormones that are involved in appetite regulation. On top of that, the energy deficit that results from lack of sleep then causes the person to be less active, expend fewer calories, and consume more calories. The study showed that "shorter sleep times were associated with increased circulating ghrelin and decreased leptin, a hormonal pattern that is consistent with decreased energy expenditure and increased appetite and obesity"(PLos Med. 2004 December; 1(3): e61).

Acupuncture and Chinese Medicine offer an effective, drug-free approach to addressing sleep issues and enhancing sleep quality. A healthy diet and regular sleep schedule is also important in maintaining optimal sleep and for general well-being.

link to the study: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC535424/

also see article below:

Sleep - A Good Way to Manage Your Appetite and Weight?

April 27, 2010

Did you know that losing sleep may increase your appetite and as a result your weight? Several studies have been published in recent years have looked at the relationship between sleep loss, weight and appetite and should serve as a guide for how we value sleep.

According to one study published in The American Journal of Clinical Nutrition this year, one night of reduced sleep subsequently increased food intake and, to a lesser extent, estimated physical activity-related energy expenditure in healthy men. These experimental results, if confirmed by long-term energy balance measurements, suggest that sleep restriction could be a factor that promotes obesity. The study observed two groups of men - half of which slept for 8 hours, while the other half got 4 hours of sleep, and found that the men who got less sleep consumed 22 percent more calories than those who slept for 8 hours. A University of Chicago study last year also arrived at similar conclusions when they included women in the study. Such sleep restriction may have been a bit extreme, but it is also not altogether uncommon in our society and is a pattern deemed the "royal route to obesity" by Eve Van Cauter, PhD, who conducted the Chicago study.

Some researchers have found that hormone function is to be blamed for how short sleep duration affects our appetite and weight. Another study published by the National Center for Biotechnology Information found that feelings of hunger as well as plasma ghrelin levels are already elevated after one night of sleep deprivation, whereas morning serum leptin concentrations remain unaffected. The researchers explained that their results provide further evidence for a disturbing influence of sleep loss on endocrine regulation of energy homeostasis, which on the long run may result in weight gain and obesity.

Monday, June 28, 2010

Can thoughts & emotions change our body chemistry?

Biocognition Podcast, Mario Martinez:
http://www.soundstrue.com/podcast/?p=1027

I just came across a great podcast by clinical neuropsychologist, Mario Martinez called "The Mind-Body Code". Martinez expands on the field of psychoimmunology-- the concept that mind and body are inseparable and that our thoughts and emotions can influence our immune and nervous system, and coins the term, "Biocognition". Biocognition factors in our cultural environment, as well as mystical theology.

Martinez states that based on his cross-cultural research, people can only be wounded in 3 ways:
1. Shame
2. Abandonment
3. Betrayal

He says that we all walk around every day carrying the psychoimmunology of one of these processes. I take it to be like a psychological imprint that is learned very early on in life, usually taught to us by people that are very important to us (parent, loved one, etc). This imprint colors our reality, and influences how we perceive and act in this world. For example: Your significant other leaves for a long weekend vacation with his/her friends without you. In a healthy relationship, this event should be neutral. Yes, the partner will be missed for a week, but you should be able to continue functioning normally and welcome the partner home when they return. If you have a history of abandonment, this event becomes more drastic than it should. You may feel as if your partner has left for good, and feel inappropriately sad or overwhelmed with loss. Martinez says that this is you dumping your history on to the moment.

Biocognition theory and recent research studies have shown that these imprints/emotions not only affect our relationships and perceptions of the world, but also directly influence our immune system and nervous system, thereby contributing to development of illness and disease. Based on research summarized in Martinez' podcast, each of the 3 wounds create different and specific biochemical reactions in our bodies:

1. Shame & Betrayal: release inflammatory products just like the body would in response to a physical wound to heal and protect itself. However, chronic over-production of inflammatory products lead to disease (particularly cardiovascular disease and certain cancers, also arthritic conditions). Inflammation is now being studied as a common underlying factor in many chronic diseases.
2. Abandonment: fight or flight response. Tends to release cortisol = stress hormone.

The good news is, that we can also use the power of our minds to reverse and heal this maladaptive pattern and skewed perception of the world. He talks about embodying or feeling the physical reaction when these emotions are triggered and then re-empowering the self using relaxation and meditative techniques. HONOR to treat shame, COMMITMENT to treat abandonment, and LOYALTY to treat betrayal. He recommends doing this work with a trained professional (therapist, etc) who understands this work.

The chemistry of our bodies can change with healing thoughts. We must first learn to recognize our diseased thoughts, and then prescribe ourselves healthy, healing thoughts. He also stresses that it is more than just thought and intentions. These must be followed actions and cleaning of wounds.

Listen to the podcast: http://www.soundstrue.com/podcast/?p=1027

Increase Midwifery Care in Hospitals to decrease Caesarean Rates and Save Money




Timothy R. B. Johnson and Judy Norsigian

The high cost of caesareans

FOR A symbol of what ails the US health system, look no further than hospital delivery rooms, where costly caesareans, many for non-medical reasons, are inching closer to a majority of all births.

Even though caesareans are associated with higher rates of complications than vaginal births, they are becomingly increasingly common. Problems range from infections, including the more serious antibiotic-resistant ones, to blood clots, prematurity, respiratory problems for the baby, and more complications with subsequent pregnancies. There is even a small but measurably higher risk of death for the mother.

Between 2000 and 2006, while the Massachusetts caesarean rate climbed from 16th to 10th highest among all states, the state’s ranking on neonatal mortality has slipped from 4th best to a tie for 9th. Six hospitals in the state have caesarean rates greater than 40 percent for first time mothers, yet none of these hospitals is designated as a high-risk center. So much for the argument that high-risk pregnancies are the reason for these rates.

There are also cost consequences for taxpayers — the caesarean rate for Massachusetts mothers on Medicaid is increasing at a faster pace than among privately insured mothers. Nationally, in 2008, average hospital charges for an uncomplicated caesarean section were $14,894, while such charges for an uncomplicated vaginal birth were $8,919.

What can we do to lower the caesarean rate? Considerable media attention has focused on how extreme obesity can raise the risk of having a caesarean, but more emphasis is needed on these system-based approaches:

■More hospitals need to institute policies that restrict the induction of labor, unless there is a good medical reason. Unfortunately, labor is now sometimes induced solely for the convenience of the physician or the mother, and labor induction increases the likelihood of a caesarean section in many women. Almost all the recent increase in late preterm (34 to 36 weeks) births was related to planned caesareans carried out too soon, and the rise in premature and low-birth-weight babies has required more expensive hospital-based care to address the medical problems of these infants.

■Obstetricians and hospitals should follow the new National Institute of Health recommendations to offer the option of vaginal birth after a caesarean for those women who want to avoid repeat surgery. As noted in a recent NIH press release, “Although as many as 60 percent of hospitals in some states routinely prohibit vaginal delivery by women who have had a caesarean section, that practice is out of step with current medical research.’’

Expanding this option would require that the American Congress of Obstetricians and Gynecologists amend a recommendation that hospitals have 24/7 presence of an anesthesiologist if they choose to offer vaginal births after a caesarean. Because of this recommendation, many hospitals concerned about liability refuse to allow them. Yet those same hospitals find it acceptable to call in an off-site anesthesiologist when mothers need an emergency caesarean for any other reason.

■Hospitals could expand access to nurse-midwifery care. In Boston, statistics for hospitals that care for women facing the same risk of complications show that hospitals with nurse-midwifery services tend to have lower caesarean rates than those without a significant midwifery presence.

In 2008, the two Boston-based hospitals without midwifery services (Tufts Medical Center and Beth-Israel Deaconess Medical Center) had overall caesarean rates of 37.7 percent and 42 percent respectively, while hospitals offering significant midwifery care averaged between 27 percent (Mt. Auburn Hospital) and 35 percent (Brigham and Women’s Hospital). Notably, Boston Medical Center — a hospital with both a large midwifery service and an at-risk population — had a caesarean rate of 30.1 percent.

Enhancing access to midwifery care might well be the most effective approach to safely reducing the overall caesarean rate — and could lead to significant cost savings and improvement in other priority areas such as breastfeeding. It would also address the impending shortage of obstetric providers. The Legislature should pass a bill to expand access to midwifery care in Massachusetts. We must finally make midwives more central in maternity care — as do all other countries whose birth outcomes are superior to ours.

Timothy R. B. Johnson, MD, is Bates professor and chair of the Department of Obstetrics and Gynecology at the University of Michigan. Judy Norsigian is executive director of Our Bodies Ourselves.

Friday, April 9, 2010

What can our Economy Learn from Acupuncture?

An Economy in Need of Holistic Medicine


By ANAND GIRIDHARADAS
Published: October 23, 2009

CAMBRIDGE, MASSACHUSETTS — The American economy is having what doctors call an acute episode.

Employment won’t throb. The circulation of capital remains weak. Industry is breathing, but barely. And if we can agree on anything one year into this mess, it is that there is little we can do when the patient arrives already this bad.

That is why the talk now is so often of prevention. Prevent the next crisis through health insurance and a green-energy sector, the American president says. Prevent it by cutting spending and nurturing personal responsibility, American conservatives retort.

But the truth is that politicians, and not just in the United States, are rarely willing to invest in a problem that hasn’t occurred. Consensus and action are easier to come by after a 9/11 or a Lehman Brothers than before. Problems in the embryonic, soluble phase don’t interest us; and those that do interest us are often too big to solve.

Which is where acupuncture comes in.

Western medical practices have attracted similar criticisms in recent years, for an emphasis on intervening in disease rather than preventing it beforehand and promoting quotidian well-being. But in health, unlike politics, an alternative approach called wellness has emerged, focused on investing in health before it breaks down.

What can wellness tell us about our present economic malady? As it moves from fringe to mainstream — with wellness programs in the health care reform proposals now in Congress, wellness manifestos on the best-seller lists and a U.S. Army wellness program that asks soldiers to introspect and meditate — I asked experts about the approach’s core tenets and how they might be applied to the body politic.

Nip it in the bud. Wellness argues for cultivating health a little every day, not just restoring it during calamities. We increasingly accept that it is better to monitor a diabetic’s blood sugar with regular clinic visits than to amputate her limbs. We accept that businesses can avoid costly cancer treatments by encouraging workers to stop smoking. But in our political life, we prefer to wait until things reach the emergency room.

We barely regulate financial markets for years, thinking regulation oppressive, until we are compelled to nationalize private firms. We avoid expensive investments and controversial new methods in public education, then pay the price in lower social mobility and vast prison populations. We neglect building roads and bridges and Internet highways, fearing the cost, and then reap the much greater costs of whole regions falling off the economic grid.

“With a lot of social problems, we’re not sure how to prevent it, and therefore we don’t spend money on it, because we always have a lot of other priorities,” said David Cutler, a Harvard economist who has advised both the Clinton and Obama White Houses on health care.

Go to the roots. Western medicine tends to fight symptoms, whether suppressing coughs or flooding the brains of the depressed with serotonin. Wellness is interested in underlying causes. It is inclined to see an infertile woman, for example, as a stressed woman rather than a woman with defunct ovaries, and may suggest that she eat and work differently rather than take ovary-manipulating pills.

In public policy, a symptom bias rules. A housing crisis? Enact a tax credit! Bank failures? Bail them out!

There is nothing wrong with such steps — except for what they leave out, as most economists will tell you.

Even amid all this action, we have virtually ignored the complex weave of issues beneath the issues: meager savings, a debt addiction, a congenitally spendthrift political system, an almost pathological craving for stuff. And, with our topical cures, we should not be surprised to see new symptoms of the old maladies appearing: insurance again being packaged into derivatives, bonuses again soaring on Wall Street.

“We treat symptoms, and we do not look at the causes of the symptoms,” Deepak Chopra, the famed alternative-medicine and wellness guru, said when asked to extend the wellness metaphor to the economy. “We are totally at this moment looking at it in a reductionist manner. The reductionist manner is a bailout. And somehow that’s supposed to solve the problem, whereas the problem occurred because we were thinking reductively.”

Look within. Wellness sees the causes of and remedies for ailments as lying within us. Avoid infection by building immunity. Defeat disease by eating foods that help the body heal itself.

With the economy, we look everywhere but within. It’s the fault of greedy Wall Street bankers. It’s Washington’s fault. Bush’s fault. Obama’s fault. Greenspan’s fault. Somebody fix it!

But what about us? Why can’t we acknowledge that it was us who bought all those unaffordable houses, us who listened to that zero-gravity financial “advice,” us who bought and bought and never kept a rainy-day fund? And why, in solving the problem, do we expect the state to create substitute dynamism instead of renewing the culture of decentralized dynamism that made the U.S. economy so vital to begin with?

“Conventional medicine is very unbalanced in placing all its emphasis on external interventions rather than looking to advance that internal capacity to maintain healing,” said Andrew Weil, founder of the Arizona Center for Integrative Medicine and the author of several books on wellness. Likewise with the economy, he said: “Instead of simply identifying external threats and developing weapons and strategies against them, we should instead identify and strengthen immunity and resistance.”

A politics of wellness would transcend party. It would emphasize the up-front investments that Democrats like in order to achieve the long-run fiscal solvency on which Republicans insist. It would fulfill the liberal belief in a positive role for government in maintaining well-being but would honor the conservative conviction that government’s chief role is to help the social organism heal itself. It would acknowledge, with the left, the complex lattice of cultural and institutional influences that govern a society’s well-being, while emphasizing, with the right, the limits of what any external healer can do.

Think wellness in these hard times. The most urgent problems, after all, may be the ones we haven’t had yet.