Posts Tagged ‘Health’

The Small Annoyance of Sheng Jiang

Oscar Sierra Posted in Chinese Medicine, Herbs,Tags: , , , , , , ,
1

Photographer: Frank C. Müller
Image via Wikipedia

Recently, I wrote a custom herbal formula for a patient of mine. This particular formula called for the herb, sheng jiang. For those of you unfamiliar with this pinyin translation, you probably know it as rhizoma Zingiberis recens.  No? Ok, this is actually just everyday fresh ginger, a relatively common ingredient in the Chinese herbal pharmacopoeia.

On this particular day, the person who painstakingly decocts our custom herbal formulas for our patients from bulk raw herbs only had dried ginger, gan jiang, at his disposal. Although the medicinal properties of gan jiang and sheng jiang are similar and I could have gotten away with substituting gan jiang, sheng jiang was much better suited for this particular individual’s condition or pattern (diagnosis). However, if I was going to go with sheng jiang, I would have to ask the patient to add it himself every time he was to drink the custom formula (twice/day). This particular patient was not only relatively new to me, but also new to Chinese Medicine. Custom Chinese herbal formulas are strong individualized medicine; we are big fans of this ancient healing modality. As we always warn our patients though, these can range in taste from “earthy” and “healthy,” to bitter, to sometimes, “God awful tree bark flavored!” It’s already hard enough to get people to drink this stuff for weeks at a time. I worried that asking this relatively novice patient to also find and add fresh ginger to it would be too overwhelming. In the end, I banked on how enthusiastic he seemed in our initial consults and went with the semi-Do-It-Yourself option of making the formula without the gan jiang and asking him to add it himself knowing that it would be a better formula and hoping that it might also increase the palatability and maybe even spark an interest in Chinese herbs.

It was only that evening, when I got got home, that I really came to appreciate the therapeutic properties of sheng jiang in this scenario. I was excited because I had been soaking some beautiful, top-grade Japanese dried Donko Shitake mushrooms in water all day. I had all the ingredients for a fabulously simple miso soup and I had been looking forward to it all day: fresh green onions, 2yr old aged miso, aged shoyu (soy sauce), dried wakame seaweed, dried daikon. I got home, laid out all the ingredients in my kitchen, and realized, ironically, that I was missing fresh ginger—yes, sheng jiang. Again faced with the ginger dilemma, I could either make the soup as-is with all the other makings of a great soup, or find some way to secure the fresh ginger and make the perfect miso soup. I had just gone grocery shopping the day before, and I was in no mood to get in my car again, so I knocked on the door of the new neighbors next door whom I had yet to meet.


Did I end up savoring the perfect miso soup with sheng jiang? No, they didn’t have the ginger. I did get to meet my
neighbors though.

What does this have to do with Chinese Medicine and/or appreciating the therapeutic properties of sheng jiang?  It was only after I went to the trouble of at least trying to get the ginger that I realized that sometimes, maybe even always, the greatest therapeutic value of something isn’t so much in the inherent properties, active ingredients, biochemical mechanism of action, or even energetic qualities of something (ie in TCM: warming, cooling, bitter, raises the Qi, clears Heat, etc.), RATHER—

The greatest therapeutic value in a remedy lies in the time and energy one puts into it with the purpose and intent of achieving and receiving health and healing.

Yes, for the patient with the gingerless formula, the fresh ginger was slightly better suited for him. However, every time he goes out of his way—maybe way out of his way—to fix his formula with the final touch of fresh ginger, he’ll hopefully be reminded that all this work is for a good and noble cause—his well-being. Will he one day appreciate this and even want to start cooking his own herbal formulas from scratch so he can truly appreciate the look, texture, smell, and taste of each individual herb? I don’t know, probably not, but hopefully his
formula will at least taste good.

As for me, I enjoyed my soup—gingerless as it may have been—knowing my neighbors are good kind people who offered every other spice in their fridge and spice rack. I’m glad I went to the trouble of knocking on their door, introducing myself, and asking for ginger. I feel a little more integrated in my community and now know they too will knock on my door if they ever need anything.

Cross-section of a relatively young ginger root

Sheng Jiang / Fresh Ginger

Ginger, heaven forbid you do something for your health right?

Any comments are appreciated, we’d love to hear back from you.

Oscar Sierra, L.Ac.

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Ten Questions: #1. Do you accept insurance?

Mark Schwartz Posted in Acupuncture,Tags: , , , , , , , ,
0
Acupuncture chart from the Ming Dynasty.
Image via Wikipedia

We’ll focus on  some frequently asked questions that I receive from potential new patients. Do you accept insurance?

Currently in the state of Georgia it is not possible for an acupuncturist to get in network with an insurance company. In many other states acupuncture is routinely covered by insurance policies. Georgia is a little behind on certain things. However that is not the whole story.

Currently we receive payment at the time of treatment. My experience is that certain insurance companies are more likely to cover acupuncture than others. Best case scenario, if you have United Health or Cigna, it is well worthwhile for you to make the call to inquire. We ask that you look into this on your side as we are a small family owned and operated business and do not maintain a staff for billing as most medical doctors do. Other companies do have coverage but United Health and Cigna are most likely too. Some policies may cover 30-70%.

Tricks of the Trade:
We all know that the insurance companies job is to process your monthly payments (your fee for having the privilege of carrying their card in your wallet) and stamp “No” on as many as your submissions as possible. I realize it is not politically correct to say so, but this is the general consensus on the matter. If you are bold enough to make the phone call, you should know there will be “trials & tribulations”. So some useful information, that they would prefer you not have:

1. Call your insurance company and ask them if the cover acupuncture on your policy. If you get the “no” answer, try calling them back and ask if they accept claims for 97811 and 97810, low and behold, you may be quite surprised to get the “Yes” answer. These are the codes for acupuncture.
2. Ask them what you can  use the acupuncture for. Let them answer the question.  Most common is nausea and vomiting from chemo radiation therapy, nausea and vomiting from pregnancy, back pain, neck pain, and migraine headaches, etc. We have seen patients told that yes they have coverage, only to find out that after coming several times, they are told AFTER submitting your claims… “Oh sorry, your policy only covers “acupuncture in lieu of anesthesia” . Yes acupuncture is that good at treating pain!!!. Some folks may have religious reasons why they might not want to take anesthesia or be allergic to the medication and may opt for acupuncture during the surgery….that’s right completely awake, while your surgeon takes care of business.
3.  We are out of network, and so they will want to reimburse you at out of network levels.
Now, we know its not your fault that there is no in network person for you to choose here in Georgia. There is something called “a Gap exception”, and each company calls it something different, its part of “the secret”. So what’s Gap all about? Its a means that you may petition your insurance company to reimburse you at the in network levels, when there is not a in network provider within a so many mile radius. Petition, as in they may say yes or no, but its worth the effort.

The Trials and Tribulations: Reality, if you have asked the right questions, and are told you will get reimbursed…then you will get reimbursed …you will have to work for it though….There is some inefficiency going on here whether intentional or otherwise. It may take you a month or two to get reimbursed and you may have to call several times. We have heard all the stories…, “Why Mrs. Smith its right here on my desk, I’m so sorry, I just don’t  know why it hasn’t been processed.”

smiley face stickers

Image by South Carolina's Northern Kingdom via Flickr

For patients who who seek reimbursement, we will provide  you with “superbills” for your insurance company. Each week we get many exciting letters and phone calls from insurance companies…we immediately respond to them. Another tip, before you ask for a superbill receipt from us, ask your insurance company exactly what they want to see….this will save a lot of time…go figure there is no standard. Anything left out WILL delay your reimbursement.

What a Country! I love America and our glorious health-care system.

Call us with any additional questions you may have.

In good humor,
Mark Schwartz, L.Ac., FABORM, Dipl. O.M.

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Leaky Gut Syndrome, Chinese Medicine & Functional Medicine: the Optimal Solution

Oscar Sierra Posted in Functional Medicine,Tags: , , , , , , , , ,
2

The subject of this blog is entirely too complex and interesting to cover in 1 blog, however, know that I’ll be writing more about this in blogs to come so you can properly digest it.

As most of my patients know, I often light up upon the mention of food. As a feinschmecker equally passionate about Acupuncture & Chinese Herbs, this subject is particularly palatable as a specialty and well-suited for my background in Western Nutrition Science and my background in eating all kinds of stuff.

diagram of a human digestive system

Image via Wikipedia

Everyone knows vibrant health is contingent upon several factors: healthy exercise, diet, positive outlook, social interaction, and spiritual connectedness.  We can go for days, weeks, and unfortunately, even months without exercising or having meaningful community and spiritual connections.  We can be grumpy for years.  The eating piece though, most of us can’t go more than 4 hours before thinking about what is for lunch or dinner.  Starting here is convenient and can have a great impact.

Largely influenced by dietary habits, Leaky Gut Syndrome (LGS) is both common and complex.  Its manifestations and etiology cannot be limited to the simply the gastrointestinal (GI) system.  Like any syndrome or pattern in Chinese Medicine, it requires a more global understanding and system thinking (see previous blog, Chinese Med. 101…).  Besides the usual GI dysbiosis, gas, bloating, diarrhea, constipation and fatigue, symptoms can be neurological, dermatological, and even auto-immune in nature such as arthritis affecting the joints.

Jake Fratkin, O.M.D., L.Ac., has a number of great presentations and articles on this subject and on how to integrate TCM and functional medicine into treatment (see links below).  He states that about 50% of all chronic disease conditions are rooted in a Leaky Gut scenario.  This is a lot of people.

So what is Leaky Gut Syndrome?

Well to put it bluntly, it’s when your gut is out of whack and it starts leading to problems elsewhere in your body.  There could be dysbiosis.  Again, crudely, this means that the flora in your GI are out of balance.  There could be either too many of the bad bacteria, too few of the good bacteria, some combination of the 2, pathogenic parasites, yeast, etc. Repeated antibiotic use can often wreak this kind of intestinal havoc.   Maybe some uninvited parasite

Bugs

Image via Wikipedia

(candida albicans, cryptosporidium, giardia, etc.) is camping out in your breadbasket.  There could be insufficient enzymes to break down your food (lactase, proteases, etc.).  There could be a pH imbalance.  There could be inflammation (markers include CRP, WBC’s, Lactoferrin, etc.)  There could be food allergies (IgG4, S-IgA, IgE, Celiac’s, etc.).  There could be some nasty combination of all of the above where one causes and/or aggravates the other factor causing a chain reaction.  LGS could lead to anything from dermatitis, allergies, asthma, fatigue, eczema, to rheumatoid arthritis and that catch-all, one-size-fits-all Western diagnosis of “Irritable Bowel Syndrome.”  No matter exactly what type of symptoms and dysbiosis, one hallmark of LGS is impaired intestinal permeability.  This means that things that are not supposed to pass through into the body from the gut end up passing through.  This also means that things–nutrients– that are supposed to pass through from the gut, sometimes don’t.  Gone unchecked, this can lead to toxicities and deficiencies in the body.

What is Functional Medicine?

Functional Medicine embraces the holistic, Mind/Body, system-thinking approaches of CAM modalities, but approaches health and disease from a scientific, evidence-based perspective.  To quote Lord and Bralley in Laboratory Evaluations for Integrative and Functional Medicine, 2nd Ed., “with its science-based emphasis, functional medicine relies heavily on laboratory tests for identifying nutritional, biochemical, and metabolic imbalances underlying patient symptoms.”
In short, the Functional Medicine practitioner isn’t satisfied with treating symptoms, but rather seeks to correct the
underlying imbalance causing the symptom and/or set of symptoms (pattern).  This underlying imbalance may, at first glance, seem unrelated to the chief complaint.

Treatments?

Li Dong Yuan

Ever since Li Dong-Yuan wrote the Treatise on Spleen & Stomach (Pi Wei Lun) in 1249 CE (Yuan Dynasty), Chinese Medicine has had a pretty good handle on the gut, its global influence, and its therapeutic interventions: herbal formulas, acupuncture, and dietary therapy.

In the last 10-15yrs or so, Functional Medicine has also been adept at zeroing in on specific gut imbalances and analyzing what may be driving those imbalances.  Specific interventions could include probiotic, prebiotic, and enzymatic supplements.  They could also include recommendations to simply chew food more.

A combination of Ancient Chinese Wisdom and Modern Functional Science-Based Medicine is, in my opinion, is the optimal solution.

I’ll give concrete examples in coming blogs.

In the meantime, occupy yourselves checking these out:

http://www.drjakefratkin.com/pdf/LeakyGutHandout.pdf

www.ei-resource.org/articles/leaky-gut-syndrome-articles/leaky-gut-syndrome:-a-modern-epidemic-part-ii/

Oscar Sierra, L.Ac.

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Talking with Your Oncologist about Integrating Acupuncture/Herbs into your
 Treatment Plan

Mark Schwartz Posted in Chinese Medicine, Oncology,Tags: , , , , , , , , ,
0

Acupuncture Atlanta

Patients continue to report an increased use of Complimentary & Alternative Medicine in their fight against Cancer. Chinese Medicine is the oldest literate continually practiced form of medicine in the world with a history that spans 3000 years. Though Western medicine advances have made considerable leaps in their ability to treat Cancer, they still have not managed to develop an adequate means of helping their patients cope with the very serious side effects experienced during Chemo & Radiation therapies and post-surgically.

Chinese medicine has much to offer here and its treatment methodology is both time-tested and backed by much research. Unfortunately many physicians may be unaware of the benefits of Chinese Medicine for cancer patients. Many oncologists may be reluctant to refer to an Acupuncturist and Chinese herbalist because they don’t understand how they work.

If you are interested in utilizing Acupuncture and Chinese herbs to help you during your treatment and the recovery period, I suggest you share these links of valuable research and information with him or her.

Research is the language of communication that your doctor will be most comfortable with.

If you have any questions before or after speaking with your physician please give us a call. We would welcome the opportunity to discuss your case both with you and your doctor.

  • Its benefits for cancer patients can be summarized:
    • Lessens side effects: nausea/vomiting, weight loss, night sweats, dry mouth, anxiety, depression, dizziness, fatigue, hot flashes, etc.
    • Alleviates pain
    • Strengthens Body & Immune Function
  • Let your oncologist know that Acupuncture is recognized by the World Health Organization (WHO) as an effective form of Treatment for over 40 common disorders
  • Make your oncologist aware that several elite healthcare facilities offer Acupuncture to their patients, including:
    • Cancer Treatment Centers of America
    • Moffet Cancer Center
    • Naval Medical Center
    • Enloe Regional Cancer Center, California
  • 1.Video: http://www.youtube.com/watch?v=s9x1Sz9z-zc
    Atlanta OB/GYN Kevin Windom speaks about the advantages of integrating Western Medicine with Chinese Medicine and Acupuncture. Dr. Windom tells us why it is that many physicians may have reservations about referring their patients to a Chinese medical practitioner.

    2. National Cancer Institute – Human/Clinical Studies
    http://www.cancer.gov/cancertopics/pdq/cam/acupuncture/HealthProfessional/page6

    3.Improved Outcomes When Combining TCM With Western Interventions for Cancer: http://www.AcupunctureToday.com/archives2005/sep/09fratkin.html

    4. Information about Chinese medicine and Cancer Care

    http://www.chinese-medicine-works.com/pdfs/cancercmbeinfieldkorngold.pdf

    5. Please phone or email us for this comprehensive journal article:

    Acupuncture: Role in Comprehensive Cancer Care—A Primer for the Oncologist and Review of the Literature by Andrea J. Cohen, MD

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Chinese Medicine 101: the deskness of your PC and your Gut-Brain

Oscar Sierra Posted in Chinese Medicine,Tags: , , , , , , ,
0
PIII-900 Guts (about to be transplanted)

Image by frigante via Flickr

I’m in the process of grading papers for a 6 wk., 36 hr. course on Chinese Medicine (CM).  The students are a cross section of ages all training to be massage therapists.  Every time I teach this course, I’m reminded of the drastic difference in Western and Eastern thinking.  We cover the basics of CM: The main Channels/Meridians, Qi, Yin, Yang, Blood, the organs, Shen, 5 Elements/Phases, etc.  They also have to learn a small handful of points on the body and their indications.  In this sense, this class is just like their anatomy and physiology, just a different system of medicine.  However, the most difficult lesson and perhaps the most important, is simply the difference in thinking.  Long after they forget the exact location of Stomach 40 or Lung 5, they’ll (hopefully) remember that there’s a different way to make sense of the world and come to conclusions.  In this paradigm, there are few, if any absolutes.  Definitions are contingent upon interrelationships.

Traditionally in Western thinking, thing A–let’s say the desk on which your computer is probably sitting, is different than thing B–your computer on which you’re reading this blog.  Within the paradigm used in CM, the characteristics of thing A, your desk, are less important than the way thing A interacts with thing B, your computer, and maybe thing C–you.  In this sense, the RAM, processor speed, and brand of your computer are taken into account, but it is just as important, if not more important, to understand the way the computer sits on the desk and interacts with you.  In fact, the very nature of thing A is somewhat contingent on the relationships it has with things B and C.  There is a computerness to your desk, and there’s a deskness to your computer.  Yin has its own set of characteristics one can list and memorize, but it is really only useful if taken into context with Yang.  Your desk is Yin because it’s solid and your computer is Yang because it lights up.  However, your desk could also be considered Yang because it’s up off the floor and holds your computer up. Your computer could also be considered Yin because it’s black, stationary, and accepts your input.
For the student accustomed to rigid definitions of what is and what isn’t, this is very difficult to grasp.  In anatomy and physiology they learn about the stomach and the brain in two distinct chapters.  The brain is not your stomach and your stomach is not your brain.  You go to the podiatrist if you have foot problems and the neurologist if you have chronic migraines.  In CM, your leg bone is connected to your …. hip boneMusic-sixteenthnote.png, your hip bone’s connected to your… back boneMusic-sixteenthnote.png… The Stomach is intimately connected to the Spleen, and the Spleen is intimately connected to mental clarity and focus.  To treat migraine headaches, it’s sometimes useful to treat a point on the foot.

Interestingly, this paradigm of interrelatedness is slowly making headway into mainstream Western Biomedicine by means of recent advances in what people call Mind-Body Medicine, Functional Medicine, or Holistic Medicine.  “Attention Deficit Disorder,” “ADD,” or what can easily be considered a mental thing, is often successfully managed with diet–a gut thing.  Chronic physical pain (body) is often managed with meditation (mind).  Menopause and hypothyroid conditions are no longer just seen as inadequacies in estrogen, progesterone, or thyroid hormone, they are seen as imbalances in complex interactions between estrogen, progesterone, thyroid hormone, TSH, iodine, cortisol, epinephrine, norepinephrine, testosterone, stress, diet, exercise, etc.  The whole of our organs, hormones, and Meridians is greater than the sum of its parts.

For a simple & funny bit on Steven Colbert’s take on the Dr. Michael Gershon, MD gut-brain connection, check this out: http://wikiality.wikia.

Brain, computer art

Image via Wikipedia

com/Dr._Michael_Gershon

Oscar Sierra, L.Ac.

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Why the Move Towards Infertility Specialization?

Mark Schwartz Posted in Acupuncture, Fertility,Tags: , , , , , , ,
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As early as my student clinic days at the Academy of Oriental Medicine at Austin, I decided that I wanted to specialize in the treatment of gynecological disease. I was passionate about my interest in Chinese medicinal herbs and had an opportunity to work at our school’s herbal pharmacy for 2.5 years while a student. In China, Chinese Medical Gynecology is almost exclusively herbal based. I prescribed raw herbal formulas to most of my patients and asked friends who worked in the student clinic to send me patients who were interested in taking raw herbs. This request brought me many female patients who were trying to conceive, overcome painful periods or PMS, and deal with perimenopause. I was very impressed with how effective Chinese herbs and Acupuncture were to treat these conditions.

Lotus flower at West Lake, Hangzhou

Image by Pedronet via Flickr

After Graduation, I decided I did not fully have the all tools necessary to help my GYN patients, so my family and I decided to move to China where I continued my studies by following senior Chinese medical doctors in the hospital in Hangzhou. About 80% of that first year was spent in the gynecology department, and the remaining time in Internal Medicine. I was very fortunate to have the opportunity to study with Doctors Fu Ping, Wang  Mingde, He Jialing, and Wu Boping.  During my 2 years I continued to study Chineseand improve my ability to read medical Chinese.

There is a growing trend among acupuncturists to specialize, just as our western medical colleagues do. In Chinese medical hospitals in China, everyone specializes in one department:

Gynecology
Dermatology
Oncology
Auto-immune disease
Gastro-intestinal
Pediatrics
Acupuncture
Etc……

We are all very very good at treating pain, and with my experience treating patients at the Anxiety & Stress Management Institute I am excellent at treating various psychological conditions. However, as time goes on, I am accepting very few new patients who are not looking to work on infertility. I am extremely grateful to my current and previous patients as well as local physicians who continue to support my move towards specialization by referring patients to me

Mark Schwartz, FABORM, L.Ac.

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Mark Schwartz:
Fellow of the American Board of Oriental Reproductive Medicine!

Mark Schwartz Posted in Fertility,Tags: , , , , , ,
1
Guanyin and child, similar to a Madonna and Ch...

Image via Wikipedia

I am very pleased to announce becoming a Fellow of the American Board of Oriental Reproductive Medicine (FABORM).

The ABORM has been formed by leading professionals in Oriental
Reproductive Medicine who have come together voluntarily with a resolve
to meet the patient and physician demand for a demonstration of

knowledge of care in this field. We have recognized the need for a
certification to maintain that practitioners who are treating patients
with Oriental Medicine in the field of Reproductive Health are doing so
with an advanced knowledge and experience, and to allow practitioners to
demonstrate their knowledge through the process of voluntary examination.

The ABORM is a non-profit 501(C)6 corporation devoted to
teaching, research, and the practice of Oriental Medicine as it relates
to the treatment of reproductive disorders. The ABORM respects the
training and lineage of all practitioners who work with reproductive
disorders. Our medicine is holistic in nature, and that holism must be
retained as we choose to gain advanced knowledge in the treatment of
fertility with Acupuncture and Oriental Medicine. In the interest of the
health of all our patients, and the advancement of the AOM profession,
ABORM asserts the right of any practitioner to gain advanced knowledge
in any area he or she chooses to study.

For me this accomplishment conveys to local OB-GYN‘s, Reproductive Endocrinologists from Atlanta‘s four infertility centers, and my patients that infertility is truly my specialty and not just something I occasionally treat. Every acupuncturist can treat pain, but not all can help you realize your dreams of becoming a parent. If you are having trouble conceiving, you will not go to a neurologist/orthopaedist, rather you will seek out a specialist who treats infertility. Likewise when you are seeking an acupuncturist you should select one who is a specialist.
I welcome  your comments and questions here on our new blog about how we can help  you conceive naturally or in conjunction with your physician and maintain a healthy pregnancy.

Best Wishes,

Mark Schwartz, FABORM, L.Ac., Dipl. O.M.

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