So what does Chinese medicine have to offer in the way of cold relief?  Well, it really is true that there is no cure for the common cold.  But the Chinese do have some tools up their sleeve in the way of shortening the duration if you get a cold.

Your cold has some characteristics that help us acupuncturist determine how best to treat it.  First, a common cold is considered an illness of the exterior of your body.  This means that it’s fairly superficial compared to a deep-seated disease of, say, your kidneys or heart.  Your cold is also external because you caught it from some outside funkiness, like someone sneezing into your coffee or driving past a daycare center.

In Chinese medicine, your cold is considered a kind of wind.  Pathogens, or stuff that makes you sick, is a little like bad weather in your body.  You can have heat, cold, damp, and in the case of your cold, you have wind.  Wind tends to affect your upper body, with changeable symptoms that come and go, and those symptoms tend to move around—all characteristics of your average common cold.

So your cold is considered external wind.  But there’s more.  Here’s where some diagnostic skills come into play.  Your cold can be associated with symptoms of warmth or cold.  Warm symptoms include running a fairly high temperature, more fever than chills, a really sore throat, thirst, yellow phlegm when you cough or blow your nose, and painful or red eyes.  Cold or cool symptoms include clear phlegm when coughing or blowing, more chills than fever, a mild sore throat, losing your voice, and achiness that tends to move around.

Whether your cold is one of wind plus heat or wind plus cold, here are some things you can do using Chinese medicine to speed up your recovery:

• Your first order of business is to sweat it out.  You can do this yourself on the first day or so if you catch it in time.  At home, make a broth of grated ginger and scallions (you can add chicken or vegetable broth), drink it down, bundle up, and go to bed and sweat. 
• If your cold is the wind plus cold variety, you will want to warm things up and disperse the cold pathogen.  Common household herbs like cinnamon, basil, cayenne pepper, fennel, mustard seed, as well as ginger and scallions are warming and help relieve your symptoms and speed the duration of your cold.
• In China, herbal formulas for wind and cold generally start with a combination of ephedra and cinnamon twig, plus other herbs depending on your symptoms.  However, in the United States, ephedra can no longer be used in herbal formulas, so your best bet is to talk to a practitioner who can prescribe the right formula for your symptoms.
• If you’re unlucky enough to have a wind plus heat type of cold, the path to feeling better is cooling the heat and dispersing the warm pathogen.  Some cooling herbs that you may have around the house that can help include mint and chrysanthemum (probably as a tea).  The classic herbal formula for a wind heat kind of cold is called Yin Qiao San. 
• You can also find teas or powders at your local Asian grocery store that contain the herb Ban Lan Gen (you may have to ask).  Ban Lan Gen has antibiotic and antiviral properties and also clears heat—a good choice, especially if you have a wind heat kind of cold (but it can be used for either).
• Beyond treating wind heat or wind cold, you may also need some help if you have a cough, sinus congestion, and wheezing or congested lungs.  There are herbal formulas for all of these situations, but you’ll need a little guidance from your acupuncturist or practitioner of Chinese medicine.
• Acupuncture can also be helpful in speeding a cold on its way.  Your practitioner would needle points to clear the pathogen from the exterior of your body, points to warm or cool as needed, and points to resolve your specific symptoms.

The reality is that some health insurance plans do cover acupuncture, but most do not.  Another reality is that many acupuncture practitioners have chosen not to accept health insurance payments for their services.  And for good reasons, too, such as wanting to get paid for their time, not spending their office hours mired in paperwork, and not wanting to participate in a “health care system” that fundamentally operates at a conflict of interest.  (It’s about money, not your health.)

Yesterday, I received an email from one of our professional organizations offering a whole host of continuing education seminars on insurance billing, coding, and the like.  I ask you, if you were my patient, would you rather I spent my professional development time studying how to bill insurance companies or how to better treat the people who come to me to improve their health? 

The article talked about what to do if your insurance doesn’t pay for acupuncture. Good question, but when you compare the cost of an acupuncture visit (generally $60-$120 a session) to that of a doctor’s visit, medical tests, and treatments (the $ky is the limit), we’re talking about peanuts.  Really, the cost of an acupuncture treatment in some cases is about that of the co-pay for your doctor’s visit.

Despite the fact that acupuncture is not regularly on the insurance radar, many people are still choosing to go the Chinese medicine route because it works, it’s cost effective, and many patients want to avoid drugs or surgery—or many have tried drugs or surgery and are still suffering.

So how, then do you afford regular acupuncture treatments?  I once had a chiropractor tell me, “If it’s important to you, you’ll find a way to pay for it”.  Sorry, I’m not on board with that attitude.  You shouldn’t go broke trying to afford your acupuncture treatments, and there are options.  Some thoughts (both from me and from the NY Times article) include: 

• Acupuncture is covered by Flexible Spending plans through your work and most Health Savings Accounts.  If you don’t have either, check them out.
• Most large cities have acupuncture schools, and every licensed acupuncturist must fulfill a number of hours in the teaching clinic.  The school teaching clinics generally offer acupuncture treatments for about half the price of those of licensed practitioners.
• Community-style acupuncture clinics have popped up in most large cities and now in smaller towns, too.  Community clinics treat patients in loungers in one large room, rather than on a table in a private room. Their prices are reduced or are on a sliding scale. I have had a former patient (very nicely) rave about the community clinic she now visits.
•  Ask your acupuncturist about treatment packages, in which you buy a number of treatments up front for a reduced price.  Also ask about family or senior discounts.
• If you own your own business, ask about bartering for services.  Some individual practitioners may be willing to trade acupuncture treatments for massages, carpentry, eggs, or whatever.  You won’t know if you don’t ask.

Personally, I have never turned down a patient who was unable to pay for my acupuncture treatments.  I believe that this ancient medicine offers so much to the future of health care—it should be available to all.

During his first appointment, Tony told me that he frequently felt like he was trying to fight his way out of a wet paper bag.  Wow!  In that one sentence, Tony divulged more about the underlying cause of his health problems than if I had interviewed him for an hour. 

Tony was struggling with something called dampness, which is the body’s inability to metabolize fluids very well.  The result is a feeling of heaviness, and can also be associated with problems like weight gain, poor digestion, edema, and moist skin problems like athletes foot.  Tony’s comment alluded to the moisture associated with dampness, as well as its constriction or heaviness.

Listening is something that practitioners of Chinese medicine do very well.  If I hadn’t given Tony the time to go beyond talking about his symptoms to share his story, he might never have made the comment which so quickly pointed me to his diagnosis.

If you visit a practitioner of Chinese medicine, you’ll find yourself discussing more than your symptoms.  A practitioner will likely ask you about when your illness or condition began, as well as things like how well you sleep, your appetite and digestion, the level of your energy, and your emotional health. 

In developing a diagnosis, a practitioner is also listening for non verbal clues.  For example, Tony had a loud voice that filled up my treatment room, which told me that his problem was excess in nature—he had too much of something—in his case it was dampness.  I have also had patients who are so difficult to hear because their voice is soft.  This tells me that their condition is likely one of depletion—their energy or some other vital substance is low, causing their symptoms. 

How a patient breathes can also tell me quite a bit about their health.  If they sound nasal, it’s obvious that they’re suffering from sinus issues.  The sound of a cough can be wet and productive, or dry and chronic, or accompanied by wheezing—each pointing to a different diagnosis.

In Chinese medicine, listening is the beginning of the healing process.  It goes beyond arriving at a diagnosis.  Being able to talk about a health condition and sharing concerns is therapeutic on many levels.  People who are suffering from chronic conditions need to be able to share their frustration or worries.  People who are isolated or living alone need to be able to talk to somebody.  People who are depressed need to describe what they’re going through.  And people who are worried about their health need to be heard and reassured.  Listening is an important par of the healing art of acupuncture.

You see, the school I attended also trains chiropractors.  This is not a problem.  The school trains chiropractors to perform acupuncture.  This is also not a problem.  However, the school trains chiropractors to perform “acupuncture” in 105 hours over seven weekends while at the same time they train acupuncturists in a three-year, 3,000 hour program.  This is a problem.

When I gave the fundraiser the short story, she assured me that she understood.  In fact, she had heard the same story several times already that day.  Really?  I asked her how many.  She shared, “Well, over the course of this morning alone I’ve heard it about 25 times.”

What this means, people, is that we acupuncturists mind that chiropractic schools are turning out Minnie Me acupuncturists in the equivalent of two months of weekends or less.  And we’re speaking with our wallets.

Let me spell out why we mind. 

First of all, this is a consumer issue.  Many chiropractors who perform acupuncture represent themselves as fully trained acupuncturists, which they are not and could not possibly be with the minimal training they have had.  When asked about their credentials, chiropractors call themselves Board Certified acupuncturists.  (At least in my state.) This simply means that they passed an exam held by their local board at the end of their seven weekends. (This is compared to licensed acupuncturists who must pass a national exam after 3,000 classroom and clinical hours of study. However, the consuming public is not aware of this fact.  And it shows.

During the first few years of my practice, I attended several health fairs and networking events.  I ended up talking to dozens of people who had been treated unsuccessfully by chiropractors with “chiropractic” acupuncture.  Not only does this give the acupuncture profession a black eye, but we also have to reeducate consumers and undo the negative effects of well meaning, but under trained chiropractors.

My second objection is purely selfish.  My school is cranking out chiropractors to perform acupuncture.  They compete head to head with the licensed acupuncturists who have spent considerable time and money to obtain their credentials.  Isn’t this a conflict of interest?

So, yes, we mind.  And while we may be a small profession, we’re growing fast.  And we’re letting you know in a language that is universally understood—financialese.  I am asked frequently by my patients for referrals to chiropractors, which I will do.  However, I won’t refer to one who’s doing abbreviated acupuncture.  And no, I will not support my school while they continue to train chiropractors in “acupuncture” in a weekend seminar format, or in any format, for that matter, less than the training in Chinese medicine demanded of licensed acupuncturists.

One of the best parts of what I do is that I learn a little something from each and every patient who comes in through my door. Some of those lessons are uneventful, but some are profound. Here is a short list of some of the incredible things I have learned from my patients:

-Aging is a state of mind. I have had people in my clinic in their 60′s who seemed very old. I have also had a number of 80 and 90-year olds who have appeared to be much younger and more vital than their age would indicate. The difference? Those people who are aging so well have a love for life. They get out of their house, they’re active, they have places to go and things to do. This is not to say they don’t have health problems; they do. However, they are somehow able to stay active, engaged, and upbeat despite their health issues.

-Your emotions are the key to your health. The Chinese have a saying that the emotions are the root of 100 illnesses. I have found this to be true in the clinic. Chinese medicine is all about treating the root of an illness, and in the majority of my patients, that root is emotional in nature. Strong emotions, such as anger, depression, fear, anxiety, grief, and intense longing have the ability to affect your health, causing symptoms as diverse as insomnia to digestive problems.

-Never make assumptions. That ass of u and me thing is so right! Whether it’s a patient’s ability to heal, their willingness to change unhealthy habits, or their ability to pay me for my services, more often than not when I have made an assumption, I have been wrong.

-Unless you change the behaviors that are making you sick, you will never heal completely. This may include a funky diet, an overwhelming lifestyle, working too hard, and stressful relationships, to name a few. Remember, Chinese medicine is effective because it gets at what’s really making you sick. If you’re unwilling to change, you’re going to stay…uh, sick.

-Shut up and listen. This has been a hard lesson for me. However, over time I have learned that if I just close my mouth and really hear what my patients are saying, they will tell me exactly what I and my patient need for them to heal. Part B of this lesson is that most people already know what’s making them sick. From the man who was “trying to fight his way out of a wet paper bag” (damp heat) to the woman who just needed a dark, quiet place (Yin deficiency), if I just open my ears, they will tell me what’s going on.

-There is no magic bullet to better health. Many years ago, a woman came to me for help with weight loss. She had tried every diet under the sun, but couldn’t lose the weight. I treated her and began talking about dietary therapy and some lifestyle tweaks. She came back for her second appointment and told me that she hadn’t lost any weight, and that she would not be coming back to me. People, Chinese medicine is an incredibly effective system of health and healing, however, you have to give it time and help it along. Geez…

-The best thing you can do to improve your health is to exercise regularly. Simple. Exercise improves your mood, reduces stress, improves the health of your heart, brings your blood pressure down, and keeps you young. I have seen patients completely turn their health around simply by adding exercise to their routine (plus the acupuncture, of course!)

-Learning is never complete. I will never know everything. Every patient that I see teaches me something, and I thank each and every one for their insight, lessons, and confidence in my ability to help them.

Earlier this month, Lindsey injured her shin, resulting in a painful bruise, right where her shin comes in contact with her ski boot. Lindsey, while being model-gorgeous and gracing the pages of the current Sports Illustrated Swimsuit Edition, is also hot on the slopes. She is a legitimate contender for five gold medals, so any whiff of an injury or weakness becomes international news.

When I see any kind of news story about celebrity illness or injury, my Chinese medicine mind clicks into gear. Every time an actor opens their mouth wide enough, I’m doing a TV tongue diagnosis. When some entertainer has an illness, I want details. As an acupuncturist, I want to diagnose these people. In Lindsey’s case, the diagnosis is pretty easy. According to Chinese medicine, she has something called blood stasis.

Good health in Chinese medicine is all about flow , whether it’s energy, blood, digestion, or emotions. When blood is not flowing smoothly, it stagnates and causes pain; usually the kind of pain that is fixed in one place and is stabbing in nature. Blood stagnation, or blood stasis is also associated with the color purple; not the book, but what happens when you get a bruise. Some examples of blood stasis include blood clots, varicose veins, some types of headaches, endometriosis, and in severe instances, heart attacks and pulmonary emboli (blood clots in the lungs). In the case of heart attacks and pulmonary emboli, the patient’s face, nails, and tongue will turn purple.

Chinese medicine has a lot to offer for someone with symptoms related to blood stasis. Acupuncture is all about flow, and for most patients, it would be the first line of defense. There are also dozens of Chinese herbs that get your blood moving. Some of them are recognizable, such as safflower flower, frankincense, myrrh, peach pit, salvia root, red peony root, and turmeric tuber and rhizome. Needless to say if you’re having a heart attack, are short of breath, or having severe chest or abdominal pain, get to a doctor–now.

So what should Lindsey do? Start out with compression (wrapping it) and ice to keep the bleeding and swelling to a minimum. Elevate the injury, as blood moves downhill. After a day or so, begin heating the injury so the blood will move out of the area, and take it easy. She should also be having regular acupuncture treatments to speed up the healing process, get the blood moving, and relieve the pain.

Go Lindsey!

First of all, let’s talk about…me.  The reality is that health insurance companies do not pay me or any other acupuncturist adequately for their time.  They typically will determine what they think is “appropriate and reasonable” and only reimburse that amount, which is often about half of my usual fee.  (My fees are in line with and often lower than other acupuncturists in my metro area.)

In addition, the insurance companies take months to get the check in the mail.  And they do it shamelessly.  I have had numerous letters from one insurer offering to send the check right away if I would take even less money than I’m entitled to! (The patient paid for the treatment, so they were barking up the wrong tree.) The inference is that if I don’t agree, they’ll take much longer to send the payment.  This begs two questions:  One, why can’t they just send the payment right away? And two, isn’t this blackmail?  Okay, three and four:  Who does business this way?  And, what would happen if you tried to pay your bills in this manner?

Furthermore, if I accepted health insurance, much of the time I now spend treating my patients would instead go to filling out documentation and paperwork to satisfy the insurance companies.  Or I would have to hire someone to do it.

So let me recap—I get paid less, they take forever to pay,  and it takes more of my time.  Where do I sign up?

How does my not taking health insurance benefit my patients?  I’ll answer that with a story:  Two weeks ago, I saw a new patient—a lovely, vital woman in her 90’s with some back pain.  She had been to another acupuncturist who accepted health insurance.  My patient’s experience with this provider is what brought her to me.  She complained that the other acupuncturist didn’t even talk to her to explain her condition or how the acupuncture would work.  He just plopped the needles in (her words), and left her.  His office assistant came take the needles out, and she never saw the acupuncturist again during that treatment.

This acupuncturist may be an excellent practitioner, but because he’s being paid less for each patient, he needs to see two, three, or four patients in an hour just to make a living.  One of the strengths of Chinese medicine is that listening to your patient is part of the diagnostic process.  However, if your practitioner is racing from patient to patient, that listening component is compromised.

My patients benefit from my non-participation in insurance reimbursements because I choose to see only one person at a time.  If I were dealing with health insurance companies, I couldn’t do that.  My patients get my full attention and intention, which enhances their treatment and the healing process. Isn’t that what it’s all about?

My patients who have insurance that covers acupuncture aren’t completely out of luck. I do offer my patients is a receipt that has been formatted with all my practitioner information, diagnosis and treatment codes, dates, amounts, etc., so they can submit it to their insurance for reimbursement. This type of receipt also works perfectly for patients who have Health Savings Accounts or Flex Plans.

Many would argue that acupuncture treatments should be accessible to everyone.  I agree.  However, MRI’s, doctor’s visits, and medications should also be within everyone’s financial reach, but they are not. Some acupuncturists have chosen to open community-style acupuncture clinics, with the cost of treatments determined by a sliding scale.  These clinics are a fabulous solution to working outside of the health insurance system.  However, many of my patients who are familiar with the community-style clinics still choose to come to me; to pay a little bit more and be seen one-to-one; a choice they should also have.

More and more providers of all kinds are opting out of the health insurance system.  Last month there was an article in our local paper about a family practice MD who opened his own fee for service clinic.  Many psychiatrists have also opted out of the system because the insurance companies want them only to prescribe medications and will not reimburse them adequately or at all for talk therapy.

To accept insurance payments or not is a personal and business choice for many practitioners, especially those who work with complementary therapies.  My personal choice is to practice in a way that most benefits both me and my patients, and to do so excludes intervention on the part of health insurers.

Comments?

According to the NY Times, last week a woman fell at the Metropolitan Museum of Art, and instead of breaking her wrist, she broke a painting, and an expensive one at that.  When the woman fell, she put a 6” tear into “The Actor”, a rare Picasso painted during the artist’s early rose Period around 1904-05.

The painting now lives in the Met’s conservation laboratory, while the experts figure out how best to restore the painting.  What’s interesting about this whole Picasso assault is that it’s happened before.  In 2006, Stephen Wynn, Las Vegas casino and hotel owner stuck his elbow through a Picasso, called “Le Reve” (the Dream), a painting that Wynn owned.  The painting has since been restored so expertly that apparently the tear is undetectable.

One of the tools the restorers used to put “Le Reve” back together was acupuncture needles to keep the tear flat.  This fact speaks both to the resourcefulness of really good art restorers, but also the nature of acupuncture needles.

Because they are not hollow, acupuncture needles can come in ridiculously tiny gauges (diameters) and the finer the gauge, the more pliable and unobtrusive the needle, which makes it useful for restoring art and for inserting into people painlessly. 

If you are one of those people who have thought about having acupuncture, but hesitate to do so because you think it’s painful; think again.  Acupuncture needles are fine enough to painlessly repair a Picasso, and they are also fine enough to repair your health.

During many of the most recent disasters, a group of acupuncturists who are part of Acupuncturists Without Borders (AWB) have arrived on the scene to treat both victims and relief workers suffering from exhaustion, stress, and anxiety. Volunteers from AWB were on hand near ground zero after 9/11 and were in Louisiana after Hurricane Katrina.

These acupuncturists use a protocol developed by the National Acupuncture Detox Association (NADA). The NADA protocol employs auricular, or ear, acupuncture, which is simple and can treat a large number of people quickly. Ear acupuncture works a little bit like foot reflexology, in which a map of the entire human body is found in the ear. A Western explanation is that each of the five ear acupuncture points used in this protocol are connected to nerve pathways that alter brain chemistry to calm anxiety.

The NADA protocol was originally developed for the treatment of addictions, and from time to time, I use it in my clinic to help patients who are recovering from chemical abuse and eating disorders. More recently, the NADA ear protocol has been used with good results for the treatment of Post Traumatic Stress Disorder (PTSD), not only with victims and relief workers after disasters, but with veterans returning from Iraq and Afghanistan. Researchers have found that ear acupuncture offered effective trauma relief in the form of reduced stress and anxiety, better sleep, and a decrease in the need for prescription drugs.

In the weeks and months to come, volunteer acupuncturists will play a small, but vital role in healing the rescue workers and survivors of this disaster.

This is a good question.  It’s a fair question, and you deserve an answer.  Unfortunately any practitioner who gives you a definitive answer in terms of an actual number of treatments is not being entirely truthful; they’re guessing.  For the truth is that there is no correct answer—everyone heals at their own pace.

In addition, a good practitioner should never tell you on the phone how many treatments they even think it will take for you to feel better.  I don’t have a problem with an acupuncturist estimating, or even recommending a number of sessions as a course of treatment, but they have no business doing so until they’ve at least seen you in their office.

The issue here is that there are a number of variables in the healing equation, including the following:

-How long you’ve had the condition.  If your elbow has been bothering you for twenty years, you most likely will take longer than the person who tweaked their elbow last week.

-The nature of your complaint or illness.   Many conditions are quickly resolved with Chinese medicine, including stress, anxiety, digestive issues, PMS, and many types of pain.  On the other hand, deep-seated chronic illnesses, such as autoimmune conditions may take much longer.

-Your general health.  I have seen many young and healthy patients seemingly heal right before my eyes in a single treatment.  However, older patients, those in really poor health, and those on numerous medications tend to need more treatments.

-Your commitment to getting better.  What you do at home in between treatments can make a huge difference in how quickly you heal.  If you implement your practitioner’s suggestions regarding dietary therapy, heating/cooling an injury, herbal formulas, and lifestyle changes, you can speed up your recovery dramatically.

So what do I tell prospective patients when they ask how many treatments they will need?  My best answer is that acupuncture is a therapy and while some people may heal very quickly—in a session or two, others will take longer.  I advise them to give acupuncture a fair try, say three or four treatments, to see how they’re improving.  At that point, I will have a better idea of how many treatments they will ultimately need to heal completely.