Posts Tagged ‘Herbal Medicine’

Ten Questions #2: Acupuncture, Does it Hurt?

Mark Schwartz Posted in Uncategorized,Tags: , ,
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Many are concerned about this question: Acupuncture, does it hurt?

Often you will see acupuncture needles described as hair-thin. That is actually not very accurate. The needles are very thin indeed though. If you have a friend who is a doctor or nurse, you can ask them about our needle size. Our needles are generally either 32 or 36 gauge, and we do have thinner needles available. I promise if you ask your doctor what they think about this size needle, she is going to smile…they are really really thin.

So what is it supposed to feel like? I usually tell my new patients the following joke:

If you go for acupuncture in Japan, they think if it hurts at all, that the doctor is no good. However if you go for acupuncture in China, they think if it doesn’t hurt at least a little bit, not only is the doctor no good, but he’s just taking your money!

Point here, that among many Japanese acupuncturists it is thought that you put the needle in and let it be. They think your body knows what to do with it. Chinese acupuncturists, however, think putting the needle in and then gently manipulate it is the preferred methodology. The thought here is we move the needle and this causes a response in the body which calls upon the function of this acupuncture point. When we move the needles we are seeking what we refer to as De Qi or “the arrival of Qi.”  Qi is the body’s natural electrical life force. If you are not ready to believe in Qi, that is alright…you can think of the body’s naturally occurring positively and negatively charged ions, another kind of Qi. This De Qi or Qi sensation feels like a dull ache, distension, soreness, pressure, or tingling. We experience the world through our hands and feet, so some points here may be a little more sensitive. You may occasionally experience a “Zing,” where a strong sensation is felt and travels down a finger or toe or from one place to another. Stronger Qi sensation, it is not a mistake. This Zing usually passes instantly in a second or two. If a point is uncomfortable let us know immediately, and we will adjust or remove the needle immediately.

So what do I do? Generally, if a patient is coming in for pain, I may elect to use a slightly thicker needle and manipulate the needle more strongly than say, if they were coming in for infertility or stress or anxiety. Why? Because I have found that a stronger Qi sensation is going to relieve your pain more quickly. For folks coming in for pain, the degree of discomfort experienced from the acupuncture treatment is still relatively mild compared to the pain they want to get rid of.

Nearly everyone can receive acupuncture. Even if you are afraid of needles, we can nearly always select the best needle size and manipulation style to suit your needs and make you comfortable. We do not always manipulate the needles and if you find the sensation unpleasant we can avoid the manipulation all together. Great results are gotten using acupuncture in both China and Japan, so there is always more than one way to give you an effective treatment.

In general, most people leave acupuncture treatments feeling extremely calm and centered. The experience is similar to the feeling you have after a wonderful massage, but uniquely different….the only way to know what I mean is to give it a try! Believe it or not some of our patients even fall asleep on the table.

Keep an eye out for Liz’s video as she talks about how well she has done with Oscar’s gentle acupuncture treatments despite her phobia of needles.       

Acupuncture is like a day at the Beach!

Mr Smiley Man

Image by Mr Dodgy via Flickr

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Ten Questions: #1. Do you accept insurance?

Mark Schwartz Posted in Acupuncture,Tags: , , , , , , , ,
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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: , , , , , , , , ,
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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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