CAM is defined as medicine used together with, or in place of, standard medical care. CAM considers mind, spirit and community as effecting health, advocates least-invasive interventions, and encourages physicians to be models of self-care. Several CAM practices, including acupuncture and stress management are already finding their places in medical centers.
 
Acupuncture has been a health profession in the U.S. since the 1980s and is accepted as safe. The NIH panel on CAM estimated that “acupuncture is used by millions of Americans,” and expressed hope that “where there are state health insurance plans, and for populations served by Medicare or Medicaid, expansion of coverage to include appropriate acupuncture services would also help remove financial barriers to access.”

Studies have reported efficacy of acupuncture for various conditions, including asthma, digestive symptoms, back pain, and osteoarthritis. Stress management techniques like yoga, meditation and biofeedback, have shown efficacy in the treatment of asthma, insomnia, depression, hypertension and immune functions. CAM treatments have shown to result in a “broad range of outcomes, from physical and emotional change to benefits involving lifestyle, outlook, and attitude towards health.”

Sixty-two percent of Americans from all income levels used CAM in 2003. In 1997, Americans spent $21.2 billion out-of-pocket for CAM services, and they used CAM providers almost 60% more often than primary-care physicians. Americans want their physicians to be more involved in CAM care, and 50% of physicians in North America agree that they should be knowledgeable about CAM. The Institute of Medicine has recommended that schools of medicine and health professions include CAM instructions for patient education and referrals.

In the light of these changes, boards of trustees must ask themselves the following questions: Would offering CAM in medical institutions make patient care more comprehensive? Safer? More dignified? More affordable? Would it promote patients’ autonomy and informed consent? If the answer is yes, the boards must act to exercise their leadership in promoting collaboration between physicians and CAM providers through education, fellowships and referral networks.

The extent to which boards will welcome CAM practitioners in their institutions will depend on the mission and the type of care provided. A hospital that focuses on orthopedic surgery will have different considerations than a center providing general care. A center in an affluent neighborhood may consider different CAM modalities than a center in the inner city. The Management and the Medical staff will determine CAM therapies most appropriate for the type of services the institution provides, in accordance with the board’s goals related to the quality of care and fiscal responsibility.

The following issues may be considered by the boards that look toward expanding their care to include CAM:

 Boards may look at the quality of care and patient safety in an expanded way, which will consider the amounts of drugs for pain management, reduction of stress levels, psychological outlook, or patients’ cultural and spiritual needs—markers not always considered by scientific medicine. The inconsistency of the CAM research outcomes may present some challenge, however, with the help from the experts, CAM safety can be determined in a clear and measurable way.

 Boards must not be tempted to micromanage the implementation of CAM therapies and leave the implementation of safety related to the CAM devices, sterilization or safety education for CAM practitioners to the clinical staff and the management.

 Boards need to distinguish between general beliefs and the facts about CAM therapies. They need to understand CAM efficacy, research methodologies and epistemological differences between CAM therapies and biomedicine. They must make sure that hospital privileges for CAM practitioners are not granted solely on the subjective judgments of medical staff.

 Boards must both remain true to the mission by providing quality care and ensure fiscal soundness and profitability for the developments and future investments. While it is the purview of the management to decide how the money will be spent for the implementation of CAM practices, it is the duty of boards to anticipate financial problems, monitor budgets and evaluate if CAM therapies are providing quality of care, as defined by boards.

Community, with its environment and natural resources, is one of the medical institution’s stakeholders. It is the board’s fiduciary duty to promote values of self-care and care for others. Boards must assess the cost of biomedical care to the environment, and they provide leadership in promoting environmentally friendly CAM therapies whenever safe and effective.

Clearly, the Boards of Trustees of medical institutions have fiduciary duties to provide health care that is effective, safe, least-invasive, and preventive. In order to fulfill this duty, Boards must provide vision and leadership to bring their institution toward expanded healthcare in a safe and fiscally responsible manner.
B. Basia Kielczynska
Acupuncturist
Integrative Medicine Department
Beth Israel Medical Center
New York

A traditional Chinese therapy practiced for over 5,000 years, acupuncture involves inserting needles on certain points on the body in order to promote the flow of vital energy. Acupuncture may also be helpful in the treatment of low back pain, arthritis, and certain side effects associated with cancer therapies.

By Cathy Wong, About.com Guide to Alternative Medicine

Drug addition did, too; barbiturates were his drug of choice, he said.

His family was the first to notice he was changed, he said. That was more than 40 years ago. The women in his life noticed, too.

As Hobbs headed for the brink, a group of friends realized he needed help. That was 25 years ago. Hobbs eventually spent 18 months in a stress unit at the North Chicago Veterans Administration hospital where he was treated for Post-Traumatic Stress Disorder.

He’s been on the road to recovery ever since, he said. It’s been a long road for Hobbs, who now lives at the VA Center in Dover, where he is trying to get his life back on track.

After years of therapy, a tiny needle has proven a boon to getting healthier, said Hobbs, who turned to acupuncture after seeing a flier at the veterans center.

Linda Stengel saw the value in using acupuncture to treat PTSD in veterans like Hobbs. Stengel, owner of Partners in Health in Caledonia, along with another local acupuncturist, started offering free treatments to veterans at their clinic on Douglas Avenue.

They’re trying to get the word out so younger veterans, returning from Afghanistan and Iraq, might seek treatment and hopefully avoid the struggles Hobbs encountered upon returning from war.

Stengel and Christie Kern, owner of Racine Community Acupuncture, trained with Acupuncturists without Borders, a program started as a response to Hurricane Katrina. The program proved successful in helping veterans relieve stress, according to Stengel.

“I think it would be so helpful if the military would offer reintegration. They spend so much time on training to prepare you to go to war,” Stengel said. “Then there’s seemingly no treatment to debrief you from all that you’ve done to learn how to be this killing machine … there’s no training on how to get rid of all that aggression.”

Hobbs agrees. At first, he wasn’t sure about the idea of having several tiny needles stuck anywhere on his body.

After a few months, he said, he and his friend, Gary, who also lives at the Veterans Venter, figured “Why not?”

The first thing Hobbs noticed, he said, was that he could sleep better. The second thing he said he noticed was that whenever he and Gary missed a week or two of treatment, he would start thinking “we need to go out and see Linda.”

Meeting Stengel has been the culmination of many years of therapy, Hobbs said.

“It happened at the right time in my life to kind of get me healthier than I’ve been, I think, ever,” Hobbs said.
PAUL SLOTH paul.sloth@journaltimes.com | Posted: Saturday, November 28, 2009 6:30 pm

I got a note from my friend Larry Berman last week. He wanted to let me know about a treatment that helped his wife control her migraine headaches. I thought her story might interest you. And even if you do not suffer from headaches, there is a good chance you could benefit.

Larry told me that Sophia has been suffering headaches for several years. She eats a diet that keeps her blood sugar stable. And she avoids processed foods with artificial ingredients. “That has helped,” Larry wrote, “But it didn’t make her headaches go away.”

Larry is the owner of a natural products company, called NatureCast. If there were something Sophia could take to address the cause of her headaches, he ought to know about it. However, nothing seemed to help.

Then a friend offered to teach Sophia the practice of acupressure. She said there were several techniques that might help to alleviate her problem. Sophia studied and applied the techniques. “The results were truly amazing,” Larry said. “Suddenly with the touch of a finger her headaches were gone.”

Larry told me that since she has been practicing acupressure, her headaches have subsided almost completely. The headaches she has had have been less intense and of shorter duration. And she now has a way to stimulate her own self-healing abilities whenever she needs it.

Press your thumb here… No more seasickness…

Sophia’s case is not the only success story I have heard about acupressure. In fact, a few months ago, I went deep-sea fishing with some friends and family. I noticed that my brother, Brad, had an elastic bracelet on his wrist. “What is that for,” I asked.

“See this hard plastic ball on the inside,” he said. “That presses down on a pressure point. It helps to relieve nausea and prevent motion sickness.” It seemed hard to believe that a little pressure on the wrist would have such an effect, but my brother swore by it.

Sure enough, he enjoyed the whole day, rough seas and all. He even drank a few beers. It was quite a different trip than the year before, when he spent nearly two hours hanging off the side of the boat.

Acupressure: How Does it Work?

Those who practice Chinese medicine believe the human body has up to 20 pathways of energy, called meridians. These channels course throughout the body, carrying energy in much the same way that our circulatory system carries blood to and from our organs.

However, these pathways can become blocked. When this flow of energy (or chi) is disrupted, poor health and specific conditions can result. Practitioners use electrical stimulation, needles, or firm pressure with the hand or a tool to stimulate specific pressure points along these meridians.

This can help release muscular tension and promote the circulation of blood. Practitioners also believe that it can remove the blockages, so that the body’s energy flows naturally, stimulating self-healing.

The Chinese are not the only culture to understand the body’s energy fields…

Most of us associate acupuncture and acupressure with Chinese medicine. After all, the Chinese have practiced these healing methods for thousands of years. But they are not alone.

Both the ancient Mayas and the Incas independently documented energy pathways in the body. The Mayans called this energy “wind in the blood.” The Incas talked about “rivers of light” flowing through the “luminous body.”

Sure enough, the pathways and pressure points these two cultures identified are almost identical to the ones that the Chinese have documented.

There is a lot more evidence for acupuncture and acupressure than anecdotes and a long history of use…

The most interesting evidence for this ancient practice comes from modern science – images of the brain itself.

For example, the journal Evidence-Based Complementary and Alternative Medicine, published by Oxford University, reported that, “Specific acupuncture points associated with hearing and vision stimulate the visual and auditory cerebral areas respectively.” Neuro-imaging showed that these areas “light up” when the pressure points were stimulated.

Researchers at U.C. Irvine stimulated a point on the foot, also associated with vision. Functional magnetic resonance imaging (fMRI) scans showed that this caused the visual cortex to immediately “light-up.” Researchers at Brigham and Women’s Hospital stimulated a specific point on the wrist, known to relieve nausea. This caused the part of the brain that affects balance and nausea to “light-up.”

These physical effects in the brain from stimulating these points on the body cannot be explained by our current knowledge of anatomy.

“Modern medicine” can’t explain how acupressure works. But we have proof that it does…

In my research for this article, I read numerous peer-reviewed studies on PubMed. Of course, some studies are not conclusive. However, there were dozens of well-controlled, peer-reviewed trials, published in major journals that prove the benefits of acupressure and acupuncture.

There is strong evidence that these healing arts can help to relieve muscle and joint pain and headaches. It can boost the feel-good neuro-chemical serotonin, thus helping with depression. It can help in the treatment of insomnia. It benefits those who suffer nausea from chemotherapy and anesthesia. There are dozens of conditions that have been shown to benefit.

In fact, in 1997, the National Institutes of Health (NIH) reviewed numerous studies, concluding that “there is sufficient evidence of acupuncture’s value to expand its use into conventional medicine and encourage further studies.”
But don’t wait for your family doctor to jump on board…

If you or someone you know has a condition you think might benefit from acupressure or acupuncture, look into it. It is perfectly safe. It is relaxing and therapeutic. In the case of acupressure, you can do it yourself. And for many conditions it has proven to be helpful.

But don’t expect to hear about it from your family doctor. Despite the growing evidence and scientific validation, most doctors in the U.S. still view these healing arts as pseudoscience. Dismiss that which you cannot explain.

My friend, Larry Berman, has written about his wife Sophia’s story. And he asked the practitioner who treated her to create a program highlighting the important pressure points on the body. Larry recorded it on DVD. It is an excellent introduction to this beneficial practice.

To Your Health,
Jon Herring
Editorial Director
Total Health Breakthroughs

As is the case with other organ systems, people are often confused when their acupuncturist or herbalist tells them they have a “kidney” problem. While perhaps more comforting than when my first Korean acupuncturist screamed out “brain problem!”, it raises an eye nonetheless.

As discussed in our first article, Chinese Medicine uses organ patterns to help describe processes and relationships within the body. As we now know, a “kidney” issue indicates a problem with the “kidney system” which rarely indicates a problem with the physical organ. The kidney system involves the physical kidneys, the adrenals, and the bladder which is the paired organ to the kidney system. The system also includes the kidney and bladder acupuncture meridians along with a host of imbalances from a Chinese Medicine perspective and western conditions such as nephritis.

About The Kidneys:

From a western perspective the kidneys perform very important processing and filtration functions in the body. Each day the kidneys process approximately 200 quarts of blood, taking out nearly 2 quarts of waste products and water. These waste products come from the normal breakdown of tissue in the body as well as from our food. The kidneys also release some very important hormones; Erythropoletin which stimulates the bone marrow to make red blood cells, Renin which regulates blood pressure, and Calcitrol (the active form of Vitamin D), which helps maintain calcium levels in the body.

We can live without one kidney, but without two we need to be on dialysis for the rest of our life or get a transplant. From a western perspective the kidneys are damaged by diabetes, high blood pressure, smoking, and a host of auto-immune and infection related conditions. Trauma and genetic conditions also play a role in kidney failure. General signs of kidney disease can be vague and include changes in urination (more or less often), fatigue, loss of appetite, swelling in the extremities, darkened skin, and/or muscle cramps.

From a Chinese Medicine perspective the kidney system has a very broad range of functions and is one of the most important systems in our body. Some of these functions are related to the physical functions of the kidneys, but others are related to connections made by the kidney meridian and other relationships from a TCM perspective.

The “kidneys” in Chinese Medicine perform the following functions:

“Stores” the “Jing” and controls development and reproduction:
  Jing, also called Essence, is a deep form of energy in our body. Some of it we are born with and other aspects we get from food and other activities. Jing is largely responsible for our mental and physical development and forms the basis of our ability to reproduce. Imbalances in this function can include infertility, sexual issues, and physical and/or mental developmental issues. (For more about Qi and Jing - see “What Is Qi?”)
 

“Controls” Water Metabolism:
  This is related to the western function of the kidneys. Imbalances in this function can lead to edema (body swelling) which can be very significant. Within this function there is also a relationship with the lungs that does not exist in western medicine. The control of water metabolism plays a role in moistening the lungs and aiding in their function - chronic dry cough can be signs of a kidney system imbalance.
 

“Receives” Energy or “Qi”:
  In TCM Theory the lungs and the kidneys work together to aid our ability to breath and circulate energy within our body. Weaknesses in the kidney aspect of this function can lead to issues such as shortness of breath, asthma, and/or fatigue.
 

“Controls” the bones, manufactures marrow to “fill the brain”, and “manifests” in the hair:
  This function relates to the kidney’s role in stimulating the production of bone marrow. From a Chinese Medicine perspective this involves both the bone marrow and the spinal marrow. Bone marrow is a crucial part of immunity, strong bones and teeth and spinal marrow is a crucial part of mental development, brain function, and hair growth. Dental problems are a sign of weak bone marrow function and hair loss is a sign of weak spinal marrow function. Imbalances in this role can lead to anything from loss of hair and minor dental issues to serious developmental disabilities.
 

“Opens” into the ear and “controls” the anterior and posterior orifices:
The Kidneys are said to “open in the ear.” Our ability to hear involves proper nourishment of the ears from the kidney system. Weak kidney energy can show up as poor hearing or other conditions such as tinnitus (ringing in the ears). The anterior orifices refer to the urethra and genitalia and imbalances here can result in urinary and/or reproductive issues. The posterior orifices refers to the anus and the role of elimination by the colon. Weakness in this role can lead to issues such as chronic diarrhea or constipation.

From a Chinese Medicine perspective the following list of signs and symptoms can arise from a kidney system imbalance:

Asthma, cold limbs, weak back and/or knees, incontinence, bedwetting, tinnitus, constipation, night sweats, insomnia, diarrhea, poor physical and/or mental development, weak bones, teeth, poor memory, poor libido and reproductive issues.

As you can see the role of the kidney system in Chinese Medicine goes far beyond the role of the physical kidneys as defined by western medicine. The kidney system provides the root of our overall energy and has a large influence over our development. This begins while we are still in the womb and continues to influence how well we age throughout our life.

Kidney System Patterns and Their Meanings:

As discussed previously, Chinese Medicine treats “patterns” not “conditions.” By examining the patient, their entire range of signs and symptoms, palpating points, looking at their tongue and their pulse, practitioners of Chinese Medicine will arrive at a pattern diagnosis. By choosing the appropriate pattern you can treat western conditions as well as offset any variety of more vague symptoms before they turn into full pledged “conditions.”

In the case of the kidney system, patterns generally fall into two categories: Yang deficiency (our heat, our movement, and our energy) and Yin deficiency (our ability to cool, our relaxation, and our fluids). A common pattern, particularly in modern western cultures, is known as Kidney Yin Deficiency.

Kidney Yin Deficiency contains the following signs - dizziness, tinnitus, vertigo, sore back, constipation, “empty heat” signs such as flushed face, nightsweats, hot palms, hot feet and/or hot chest, hot flashes, insomnia and/or chronic dry throat. Related conditions are insomnia, menopausal syndrome, and various anxiety disorders.

Kidney Yang Deficiency contains the following signs - sore and/or weak back/knees, sensation of cold, aversion to cold, weak lower limbs, fatigue, clear copious urine, poor appetite, loose stools, sexual issues, fertility problems and/or edema. Related conditions are chronic fatigue syndrome, chronic back pain, and infertility.

  For a full list of all of the kidney related patterns and their symptoms, you can see the “Kidney Related Disharmonies” page.

How Does My Lifestyle and Diet Effect These Patterns?

As the effect of the kidney system is broad, our ability to foster these imbalances is also quite broad. Generally if a chronic issue is anxiety and/or insomnia and you have that “go, go, go” mentality you are likely to be more yin deficient. If a chronic issue is fatigue and you are missing your “get up and go”, you are more than likely on the yang deficient side.

In modern western culture we see a tremendous amount of yin deficiency. The “work hard, play hard” mentality is a page from the “how to create yin deficiency” playbook. Our culture rewards hard work and we have a non-stop go, go, go culture - increasingly so. There is certainly nothing wrong with hard work, however, the kidney system above all other systems stresses to us the need for moderation and balance. Some people are at, or past, the point where relaxation becomes difficult and for some even stressful - this is yin deficiency. Yin deficiency is the equivalent of your body being locked in the “on” position. It stays on until you burn yourself out and crash which can be experienced in conditions such as hypothyroidism, cancer, auto-immune conditions, and depression to name a few.

For women this is a particularly acute issue as the yin of the body is an aspect of the blood. As we age we lose yin naturally - women lose more from menstruation. So this normal process coupled with a hard working lifestyle can lead to significant psychological and menstrual issues, fertility issues, and later problems at menopause. Issues at menopause are something many feel every women has to go through, yet in some cultures they may not even have a word for menopause. The menstrual cycle simply stops - no hot flashes, night sweats, mood changes, hormone replacement therapy - it just stops naturally and they experience no issues whatsoever. The concepts behind yin deficiency give us some clues as to why we see increasing problems in these areas.

The Yang deficient side is more straightforward - you run out of steam. This can come from working too hard, yin deficiency turning into yang deficiency, as a result of a significant illness, or perhaps starting life with a constitutional weakness (part of why some people seem to age faster than others even when lifestyle factors are taken into consideration).

So, what to do?

Moderation in all things appears to be very, very important. Respecting our energy levels and our normal fluctuations instead of always “pushing” through. When we need rest, rest - don’t just talk about resting, do it. All of the relaxation exercises such as qi gong, tai chi, meditation and yoga foster yin and help us to recharge and rebuild. As does a simple walk, reading a book, and relaxing with friends. We need our time and our space to regenerate and we will find that when we take this, not only do we feel better, but we are more productive. Part of allowing this to happen is the acknowledgement that the world will continue to revolve without us…