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This case is about cirrhosis 4th stage. The patient was on the waiting list for a liver transplant when he came to my clinic. Here is the story.

Back ground history

He attended a wedding ceremony. While he ate food, he felt nausea and vomiting. He rushed to the toilet bowl and vomited lots of blood, seeing only red blood, but no food at all. He went to an M.D. right away. The M.D. examined him with an endoscope and found all veins in the stomach and esophagus were like large varicose veins (esophageal varicose) with a purple color. According to the test he received later, he threw up 1.5 liter of blood.

He was sent to a large hospital Emergency Room immediately. After all examinations and tests, he was diagnosed with cirrhosis 4th stage, meaning he needed liver transplant surgery. The hospital requested that he be put on the waiting list at the liver donation center and now he is on the waiting list. Being on the waiting list means you have to wait about three years in most cases, however if his family or relatives are willing to donate part of their liver and they match well, this period may be shortened. There is no good match from his family.

During my diagnostic interview, he stated he didn't take alcohol or smoke. After diagnosing him, I told the patient that the blood vomited might come from lung, not from stomach, based on no foods in the vomit and the red blood color of the blood. The patient was surprised a bit and admitted that he had a few experiences of vomiting before. Each and every time he observed some food, acid taste and sticky saliva from the mouth, but this time strange enough only red blood. I also noticed his lung function was weak.

I recommended him to take acupuncture treatments. Liver transplant surgery just replaces a diseased liver with other person's liver. If the patient has a problem with the blood stream in and out through liver, there is a good chance for a new replaced liver to become bad due to improper blood circulation through the liver. We explain this function in Traditional Korean Medicine as 'the meridian may be blocked'. As long as this was a possibility, it is better to help proper blood circulation with acupuncture and Oriental medicine, and also have the transplant surgery. Acupuncture treatment doesn't exclude the planned transplant surgery. He understood the concept and the treatments began.

Acupuncture treatments

His anxiety began to disappear after 2 treatments. His tiredness also diminished. He used to become tired after one hour of driving and had to take a rest. He could work at his normal daily job without much difficulty. This was big progress for him.

When I suggested taking oriental herbs, he preferred not to take herbs as his M.D. told him not to take any herbs and asked him to write down all foods he takes.

I explained the progression of liver disease to him using TCM theory. Normal liver condition changes into hepatitis, inflammation of liver. This means liver produces heat. The heat consumes moisture, and then liver becomes hardened causing cirrhosis. If this continues without treatment, this turns into cancer. He used to feel fever, lassitude, and loss of appetite. He even he walked to one side instead of walking forward sometimes. I suspect he might suffer chronic hepatitis. He didn't have proper treatment for this matter, and is hoping he recovers soon.

I told him he lost lots of blood when vomiting. I also asked him how he will make up all the lost blood. This is the first reason he needs herbs. Taking just iron is not enough to make new blood. We are able to use herbs to make new blood. I removed all unnecessary heat from liver already, and your liver needs more moisture and blood, since liver stores blood, according to acupuncture theory. He told me that he prays for more wisdom as his M.D. and I suggested differently. He decided to take herbs one week later and told me that my advice is more convincing and understandable. He also told me that I made his health better.

Unusual experience

After seven treatments, he experienced very unusual things. He awakened about 2 o'clock in the morning. Suddenly he felt that all the energies around him were being sucked into him. His expression was that 'it was like vacuum cleaner sucking up dirt.' His mind became calm, all worries disappeared and he became very peaceful. He experienced the same thing again 6 o'clock in the morning. This one happened slowly and for a longer period.

Regular check up by his M.D. 

He got treatments three times a week from me. After 12 treatments, I told him that his condition was improved and treatments just two times a week may be alright. After 14 sessions he had a regular check up from his M.D. There were 2 surgeons and 10 interns around the table waiting for him. They checked him by listening with a stethoscope, took his blood pressure and number of pulses per minute, etc. They looked around at each other and wondered what happened.

They expected he would be suffering from ascites (ascites is excess fluid in the space between the tissues lining the abdomen and abdominal organs) on his abdominal area or would have become emaciated by now. What they saw was a perfect healthy man sitting there instead of a sick person. They asked him what happened. He told them he got acupuncture treatments. One surgeon nodded and said "I don't have any objection to acupuncture." However the patient didn't tell them he took herbs, as he believed they may be disapproving. His M.D.'s decided no more surgery was required, but the application for a liver donation will not be cancelled just in case. 

The patient is going to take acupuncture treatments once a week or every two weeks until his next regular check up from his M.D.

Lesson about second opinions and integration of Eastern and Western medicine

1. All hepatitis or cirrhosis may be caused due to poor blood circulation into and out of the liver. Obviously this is one of causes. We call this meridian obstruction. If the problem was begun due to poor blood circulation, surgery alone may be not enough. Any transplant must consider acupuncture, too. This idea should apply to kidney transplants, too.

2. Patients need a second opinion. This opinion should include not only Western doctors, but also acupuncturists. Western medicine may not tell about meridian theory (proper blood circulation) in my opinion. Eastern medicine can't do the surgery. Eastern and western medicine combined may provide the best service to patients.

Visit my website, Answers with Acupuncture in Flushing, NY

Chan Hur, L. Ac.

Chan Hur, L.Ac. 

"The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM^®), ... has just released the results of its recent milestone national Job Task Analysis (JTA) survey,the 2008 Job Task Analysis: A Report to the Acupuncture and Oriental Medicine (AOM) Profession which is available via the NCCAOM website, www.nccaom.org. 

The primary purpose of the JTA is to provide a blueprint for the development of the NCCAOM certification examinations, which serve as gateway and prerequisite for entry-level practice of AOM in 43 states, plus the District of Columbia. The JTA survey identifies the importance and frequency of tasks performed by NCCAOM Diplomates from various regions of the country, in different practice settings, as well as at different points in their AOM career. These results serve to validate the knowledge, skills and abilities, i.e., competencies, performed by an entry-level AOM practitioner in the United States.  

The AOM profession is evolving all the time; therefore, it is extremely important to continually review and update the content of the NCCAOM certification examinations. Best practices in validation of examination content is to perform a JTA a minimum of every five years. This report serves to provide the examination content validity verification for the years 2009 though 2013."

The study showed that 57.9% of the respondents were certified in Acupuncture, and 23% were certified in Oriental Medicine. A massage therapy license was also held by 7.3% of the respondents, and 5.2% are Registered Nurses. Women hold 69.7% of NCCAOM certifications, and men hold 30%.  

The primary style of practice taught is Traditional Chinese Medicine (TCM) at 83.9%. The mean student loan debt of Diplomates who responded was $45,891, and 70% of the Diplomate respondents said they earned less than $60,000 a year, while 21% earned between $60,000 and $121,000 a year. Their earnings depended on hours worked and years of experience, with higher earnings reported from Diplomates who received their certification in the last 11-15 years. 

91% of the respondents were self-employed, and 30% are both self-employed and working for someone else. 58% of the Diplomates who are not eclusively self-employed in solo practice work in a multidisciplinary group practice with other health care providers or with other AOM practitioners. 

A holistic practice, acupuncture seeks to re-establish the body's healthy equilibrium and function, as opposed to forcing healing using surgery or pharmaceuticals. Interestingly, Chinese practitioners were not the only (and may not have been the first) to identify these energy pathways in the body. The frozen body of a man recovered well-preserved from the Alps features tattoos that correspond to Chinese acupuncture's qi meridians."

"Some folks, including older Western M.D.s, still talk about whether or not they "believe" in acupuncture. Such thinking is ill-informed and outdated. One might as well speculate about whether to believe in aspirin, morphine, insulin, surgery or an MRI. The question is not whether acupuncture works, but how it works, and whether it is the appropriate therapy for a particular syndrome, problem, symptom, disease or patient. In a clinical setting and performed by a licensed professional (licensure is by state) acupuncture is effective for a variety of complaints."

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The National Acupuncture Detoxification Association (NADA) is a nonprofit association that conducts training and provides public education about the use of acupuncture as an adjunctive treatment for addictions and mental disorders.

Understanding the principles of both Chinese medicine and chemical dependency can lead to significant benefit in recovery from all forms of drug addiction as well as alcoholism and a variety of mental disorders.

The National Acupuncture Detoxification Association has specific protocols for this type of treatment, which have been carefully developed and extensively tested. Experienced clinicians provide training in a variety of locations nationwide and in coordination with an annual conference.

More than 1500 clinical sites in the US, Europe, Australia and the Caribbean currently use these protocols.

While adapted to Western attitudes and conditions, the NADA method derives directly from the Chinese medicine theory of detoxification. Our best hope for success is unified application of these protocols, which NADA promotes through:

1. Public education about acupuncture as a recovery tool
2. Training of professionals in use of the protocol
3. Consultation with local organizations in setting up treatment sites
4. Distribution of reference materials about acupuncture as an adjunctive treatment technique

Training

For qualified persons, access to continuous training sessions for Acupuncture Detoxification Specialist (ADS) is available in two locations: at Lincoln Recovery Center in The Bronx, NY, and Homeward Bound, Inc, Dallas, Texas.

To determine your eligibility and timing, call Ms. Rosa Reyes at (718) 993 3100, Ext. 131, and in Dallas, Texas, call Dr. Susana E. Mendez at (214) 941-3500 Ext 283. Training requires 70 hours. There is no charge for the training in The Bronx, but you have to maintain yourself in terms of room and board while in the city. In Dallas, call Dr. Susana E. Mendez at (214) 941-3500 Ext 283, for details about training fees and accommodations.

Periodic training sessions are also scheduled at other locations in the USA and Canada.

Arthritis is one of the most pervasive diseases in the United States and is the leading cause of disability. According to the Centers for Disease Control and Prevention one out of every three Americans (an estimated 70 million people) is affected.

For most people arthritis pain and inflammation cannot be avoided as the body ages. In fact, most people over the age of 50 show some signs of arthritis. Joints naturally degenerate over time. Fortunately, arthritis can often be managed Acupuncture and Oriental Medicine.

What is Arthritis?

Arthritis isn't just 1 disease; it's a complex disorder that comprises more than 100 distinct conditions and can affect people at any stage of life. Two of the most common forms are osteoarthritis and rheumatoid arthritis. While these 2 forms of arthritis have very different causes, risk factors, and effects on the body, they often share a common symptom--persistent joint pain.

Osteoarthritis (OA) is the most common form of arthritis in the United States, affecting an estimated 21 million adults. OA begins with the breakdown of joint cartilage, resulting in pain and stiffness.
OA commonly affects the joints of the fingers, knees, hips, and spine. Other joints affected less frequently include the wrists, elbows, shoulders, and ankles. When OA is found in a less frequently affected joint, there is usually a history of injury or unusual stress to that joint. Work-related repetitive injury and physical trauma may contribute to the development of OA. If you have a strenuous job that requires repetitive bending, kneeling, or squatting, for example, you may be at high risk for OA of the knee.

Rheumatoid arthritis (RA) can affect many different joints and, in some people, other parts of the body as well, including the blood, the lungs, and the heart. Inflammation of the joint lining, called the synovium, can cause pain, stiffness, swelling, warmth, and redness. The affected joint may also lose its shape, resulting in loss of normal movement. RA can last a long time and can be a disease of flares (active symptoms) and remissions (few to no symptoms).

Diagnosis and Treatment of Arthritis with Acupuncture and Oriental Medicine

According to Chinese medical theory, arthritis arises when the cyclical flow of Qi in the meridians becomes blocked. This blockage is called, "bi" type pain and is widely studies and successfully treated using a combination of acupuncture and/or Chinese herbs.

Acupuncture and Oriental Medicine have been found to be extremely effective at treating the pain and inflammation associated with all types of arthritis. The acupuncture points and herbs that are used depend on if the blockage of Qi (arthritis) is caused by the pathogen wind, cold, damp or damp-heat.

Traditional Chinese Medicine does not recognize arthritis as one particular syndrome. Instead, it aims to treat the specific symptoms that are unique to each individual using a variety of techniques such as acupuncture, Chinese herbs, bodywork, lifestyle/dietary recommendations and energetic exercises to restore imbalances found in the body. Therefore, if 10 patients are treated with Oriental medicine for joint pain, each of these 10 patients will receive a unique, customized treatment with different acupuncture points, different herbs and different lifestyle and diet recommendations.

Your acupuncturist will examine you, take a look at the onset of your condition and learn your signs and symptoms to determine your Chinese diagnosis and choose the appropriate acupuncture points and treatment plan.

The Acupuncture Treatment

Acupuncture points to treat Arthritis are located all over the body, not just directly over the affected area. During the acupuncture treatment, tiny needles could be placed along your legs, arms, shoulders, and perhaps even your little toe!

There seems to be little sensitivity to the insertion of acupuncture needles. They are so thin that several acupuncture needles can go into the middle of a hypodermic needle. Occasionally, there is a brief moment of discomfort as the needle penetrates the skin, but once the needles are in place, most people relax and even fall asleep for the duration of the treatment.

The length, number and frequency of treatments will vary. Typical treatments last from five to 30 minutes, with the patient being treated one or two times a week. Some symptoms are relieved after the first treatment, while more severe or chronic ailments often require multiple treatments.

Chinese Herbs for Arthritis

There are many Chinese Herbal formulas that are prescribed for arthritis. Your acupuncturist will examine you, take a look at the onset of your condition and learn your signs and symptoms to determine which herbs are best for you.

Here are some commonly prescribed Chinese herbal formulas for arthritis:

• Remove Painful Obstruction Decoction (juan bi tang)- For joint pain that increases with cold and is possibly accompanied by heaviness and numbness in the limbs.
• Cinnamon Twig, Peony, and Anamerrhena Decoction (gui zhi shoa you zhi mu tang)- For swollen and painful joints that are warm to the touch and worse at night.
• Angelica Pubescens and Sangjisheng Decoction (du huo ji sheng tang)- For heavy and painful sensations at fixed locations in the lower back and lower extremities accompanied by weakness and stiffness.

Studies on Acupuncture and Arthritis

Several studies have shown that acupuncture can help people with arthritis and related auto-immune diseases.

In one Scandinavian study 25 percent of arthritis patients who had been scheduled for knee surgery cancelled their operations after acupuncture treatment. In the study, researchers compared acupuncture with advice and exercise for the treatment of osteoarthritis of the hip. Thirty-two patients awaiting a total hip replacement were separated into 2 groups. One group received one 10-minute and five 25-minute sessions of acupuncture, and the other group received advice and hip exercises over a 6-week period.

Patients were assessed for pain and functional ability: Patients in the acupuncture group showed significant improvements, while no significant changes were reported in the group that received advice and exercise therapy. The results of this study indicate that acupuncture is more effective than advice and exercise for the treatment of osteoarthritis of the hip.

Another study at the University of Maryland showed that elderly arthritis patients with knee pain due to arthritis improved significantly when acupuncture was added to their treatment.

The randomized clinical trial, performed at the University of Maryland School of Medicine, determined whether acupuncture was a clinically safe and effective adjunctive therapy for older patients with osteoarthritis of the knee.

The study addressed these questions:

1. Would the addition of acupuncture to conventional therapy produce an added measure of pain relief?
2. Would the effects of acupuncture last for 4 weeks following the end of treatment?
3. Would acupuncture have any side effects?

Seventy-three patients were randomly divided into 2 groups. One group received twice-weekly acupuncture treatments and conventional therapy for 8 weeks, and the other group received conventional therapy only. Patients who received acupuncture had significant pain relief and showed improvement in function. Those who did not receive acupuncture showed no significant change. No patients reported side effects from any acupuncture therapy session.

Safe Alternative to Medication

Even without the studies, the popularity of acupuncture for arthritis continues to grow because more and more people have found significant relief from Oriental Medicine without the negative side effects that come from Western pharmaceuticals.

Lifestyle and Dietary Instructions

Your diet plays a crucial role in helping you avoid or control arthritis. The first objective of a healthy diet is to help you lose weight if you are overweight. Being overweight can cause additional stress to your joints.

The second way a balanced, varied diet can help ease the pain of arthritis is by providing vitamins and minerals that keep your joints healthy and avoiding "damp" foods such as dairy products and greasy or spicy foods.

If you have arthritis or knee or hip pain, vitamin C and vitamin D can help prevent bone and cartilage destruction. And a multivitamin can help ensure that you always get the nutrition you need.

Here are some other healthy (and delicious) choices to include in your diet.

• Ginger - A natural anti-inflammatory, available as powdered extracts in capsules as well as alcohol-based extracts. Follow the dosing directions on the label. Or make tea by combining one-half teaspoon of grated ginger root with eight ounces of boiling water. Cover and steep for 10 to 15 minutes, then strain and add honey to taste.
• Fresh pineapple - Bromelain, an enzyme in pineapple, reduces inflammation. Be sure the pineapple is fresh, not canned or frozen.
• Cherries - Recent research has shown that tart cherries are an excellent source of nutrients that may help to reduce joint pain and inflammation related to arthritis.
• Fish - Cold-water fish such as salmon and mackerel contain omega-3 fatty acids, which help keep joints healthy as well as reduce pain and swelling. If you don't care for fish, consider supplementing your diet with fish oil capsules.
• Turmeric - Another natural anti-inflammatory. Look for an extract of whole turmeric, in health-food stores; follow the dosage directions on the label.

Find an Acupuncturist

Today, acupuncture is an acknowledged and respected field of medicine which requires formal training and certification in order to practice. In most States, provinces and countries, acupuncture is legislated in order to assure quality of treatment.

Acupuncture and Oriental medicine is an art and a science that takes years to master. Look for an acupuncturist with formal training and experience in the treatment of Arthritis on www.Acufinder.com or at the NYCTCM Find an Acupuncturist page.

Community Healthcare at NYCTCM's Teaching Clinic

New York College of Traditional Chinese Medicine (NYCTCM)'s Teaching Clinic offers Acupuncture and Chinese Healing Arts to the community while providing our advanced students with a clinical internship.

Our interns are senior-level students at the acupuncture school in New York who have passed a series of qualifying exams that allow them to diagnose and prescribe therapies for the patients who come to our clinic. Licensed Acupuncturists and Traditional Chinese Medicine practitioners supervise our interns. Many of our supervisors have M.D. degrees from China, and all have considerable clinical and teaching experience.

Acupuncture Treatments in NYC and Mineola

Clinic at NYCTCM's school in Mineola, Long Island, New York

Initial visit -- $35; Subsequent visits -- $25. Phone: 516-739-1545

Clinic at NYCTCM's school in Manhattan, New York

Initial visit -- $35; Subsequent visits -- $25. Phone: (212) 685-0888.

References:

Rheumatology in Chinese Medicine, 2002. By G. Guillaume & M. Chieu
Chinese Herbal Medicine: Formulas and Strategies, 1990. By Dan Bensky & Randall Barolet
Acupuncture: A Comprehensive Text By Shanghai College of Traditional Chinese Medicine, 1981

This article is reproduced from Acufinder.com - Acupuncture for Arthritis

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By Billy Shonez Singh, M.S., L.Ac., Dipl.Ac., Dipl. C.H. (NCCAOM)

                                                ©2010

            Recently my father became a vegetarian a couple of months ago.  Since then, he has lost weight, his psorasis has cleared up, and he is much calmer and reserved than before.  On the other hand, a 44 year old woman comes to my clinic with insomnia and irregular menstruation with blood clots and PMS and feels very cold especially during the summer.  When I asked her about her diet, she says that she has been a vegetarian when she first came to this country from India.  Now, these two highly different cases are related to being a vegetarian.  Some people become vegetarian for political reasons as is the case in a few PETA members I have met.  Other reasons are because of religious issues as in the case of Hindus and Buddhists.  Whatever your reason is for getting into vegetarianism, you should know that there are a few pros and cons to becoming one.  The pros of becoming a vegetarian are weight loss, lowered intake of chemicals and toxins that are associated with eating meat, and a much calmer disposition than non-vegetarians.  According to history, Buddhist monks and those from the Brahmin caste in Hinduism would adopt a strict vegetarian diet not just for spiritual reasons, but the cooling nature of vegetarian foods helped them with their focus during meditation.  However, based on my experience of what I have seen in my clinic, vegetarians present themselves with a disease pattern in Chinese medicine known as blood deficiency.  In blood deficiency, the signs and symptoms are not typically related to Anemia; putting it simply, the quantity of blood has not been compromised; it's the quality of the blood.  Therefore, a person with blood deficiency pattern associated with a vegetarian diet will have the following signs and symptoms:

• Chills
• Cold limbs
• Pale complexion
• Insomnia
• Irregular menstruation
• Intolerance to cold
• Small and pale tongue
• Thin pulse

Therefore, the only solution to all of this is either to start incorporating meat into their diet.  If that is not an option for Hindus and Buddhists, then herbal medicine is a good solution to taking care of blood deficiency based signs and symptoms listed above.  However I find that herbal medicine and dietary changes (such as eating meat) will produce better results together.  For Hindus that cannot eat meat, there is a justifiable way you can get around that rule.  The only caste within the caste system that can eat meat are the Kshatriyas (the warrior caste).  "Vegetarianism is prescribed only for the Brahmin priests among the Hindus.  This is not the original Vedic tradition, because if you go to the source texts in Ayurveda, they all contain tonic recipes and prescriptions for meat, including beef.  Hindu fundamentalists have tried to resurrect Ayurveda in a vegetarian form after independence there in 1948, and this form is the dominant one in the US.  But the actual source texts recognize the tonic qualities of meat (pg.2, Bergner)."

            In conclusion, vegetarianism has its benefits while at the same time it has its downsides.  After all according to Paul Bergner, "...in the vegetarian south India, there is a higher rate of heart disease, hypertension, and type II diabetes than in the US and Canada (pg2.)."  In my experience, a balanced diet blending both vegetarian and non-vegetarian foods ultimately ends up being the stand-alone preventative to the signs and symptoms associated with a long-term vegetarian diet.  If having a vegetarian diet is nearly impossible to give up because of religious restrictions, at least make sure that all foods are cooked before eaten as opposed to having them raw.  In Chinese medicine, raw food that has been eaten has a tendency to disturb the normal functioning of the digestive system resulting in the above mentioned signs and symptoms along with stomach cramps, nausea, and vomiting.  A good solution when eating vegetables is to incorporate spices such as ginger, garlic, fenugreek, and cinnamon.  The properties of those particular spices are very warming and allow for proper digestion of raw vegetables in the stomach without any ill effects. 

 The Tao of Food: Diet in Taoist Practice states, "If you are a young healthy person, with no sickness, than a vegetarian diet is possible.  But if you have lack of energy or some other deficiency, then meat broth should be consumed from time to time."  It further states that, '...the diet should be composed of 30% leafy vegetables, 20% meat and 50% grain."  Take care everyone and eat well.

 

 

Bibliography

Bergner, Paul Thinking Critically About Diet, http://chineseherbacademy.org/articles/critical_diet.html, April 4^th, 2006. 

 

Hon, Sat Chuen, Tao of Food: Diet in Taoist practice. http://www.qigongtherapy.com/dec.html, December 18^th, 2006