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By: Billy Shonez Singh, MS, L.Ac. 

©2009

 

                  It is a disease that is defined as a metabolic disorder that is characterized by either abnormally low or high blood sugar levels that lead to a variety of metabolic derangements.  It is commonly characterized by fatigue, excessive urination, excessive thirst, and excessive hunger.  In this country, it is the biggest cause of death or disability.  In developed countries, the incidence of diabetes has doubled in the last 15 years and its going to double in the next 15 years.  The worst part of this situation is that one out of three people do not know they have diabetes.  For those that are diagnosed have had it for much longer amount of time and wind up with complications such as neuropathies.  According to Clinton J. Choate's article "Diabetes Mellitus (Part One)", it is estimated that 60% to 70% of diabetics have mild to severe forms of nervous system damage.

The symptoms range from:

• Pain in the feet and legs.
• Cramping, tenderness, and muscle weakness.  They can occur in the legs and feet along with the arms and hands.
• Paraesthesias- pricking, tingling, or numbness along the skin.
• Blurred vision.
• Impotence

 
In allopathic medicine, the treatment for diabetic neuropathies involve physical therapy, medications and in severe circumstances, surgical intervention.  The some of the medications used to treat paraesthetic pain and other neuropathies are tricyclic antidepressants and selective serotonin reuptake inhibitors.  Even though these specific medications are used in the treatment of depression, they are also used in treating peripheral neuropathies.  However the side-effects are numerous and seem counterintuitive when one looks at them.  For example, the antidepressant Imiprine (Tofronil) treats peripheral neuropathies by releasing norepinephrine in the central pain modulating pathways located in the brainstem and spinal cord.  However a side-effect of Imiprine is impairment of mental or physical abilities and cardiovascular disease.  When you look at those side-effects and compare them to the risk that diabetics have with cardiovascular disease, it seems rather counterproductive.
According to Subhuti Dharmanada, "Acupuncture therapy is a common approach to treating diabetes in China.  Many Americans assume that acupuncture is only suitable for treating pain, perhaps because the initial introduction of acupuncture was mainly for this application.  Increasingly, people with pain and other health problems for which acupuncture is selected also have diabetes."  Acupuncture can treat neuropathies by bringing blood flow and nerve conduction to the skin to treat numbness and tingling in the extremities.  Another point to mention is that blood flow and nerve restoration can also be accomplished in regards to the treatment of blurred vision and impotence.  Unlike the medications mentioned, acupuncture has no side-effects.  
 
 

 

Bibliography
Dharmanda Ph.D., Subhuti "Treatment of Diabetes with Chinese Herbs and Acupuncture" web posting date: January 2005 www.itmonline.org pg.14
 
Choate, Clinton J. "Modern Medicine and Traditional Chinese Medicine: Diabetes Mellitus (Part One)" Journal of Chinese Medicine Number 58 September 1998 pg.4
 
Echeverry, MD, MPH, Diana M. "Diabetic Neuropathy: Treatment and Medication" updated April 4th, 2007 http://emedicine.medscape.com/article/315434-treatment

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

                                          www.zenohs.com  ©2010

 

A 69 year old woman came into my office in October 2009.  Her main complaint for the past eight years has been multiple joint pains in her body due to Rheumatoid Arthritis.  Since her diagnosis, she was placed on thirteen different medications.  Four of them were for treating joint and muscle pain associated with her main complaint.  The other four of the medications were used in lowering her cholesterol and her blood pressure.  The side-effects of the medications were headache, bone pain, jaw pain, muscle weakness, swelling of the ankles and feet, and joint pain- among other things.  The last five of her medications were unrelated to her main complaint but were used in treating the side-effects.  She described her joint pain as severely sharp and stabbing variety located in her neck, lower back, knees, feet, shoulders, wrists, and fingers.  The pain would get exacerbated by damp, cold, and rainy environments as well as walking up a flight of stairs.  In addition to this, I noticed that she had swelling along the fingers and toes.  The swelling was due to the inflammation in the joints and had fluid build-up (edema) in both her ankles.  In her previous history she mentioned that she was a pack-a-day smoker but quit smoking fifteen years ago.  Lastly, she consumed two to three cups of coffee a day.  After treating her with acupuncture for seven months at once a week intervals, we both noticed dramatic improvements in the signs and symptoms.  The swelling in her fingers and toes had decreased.  Her ability to walk with more fluidity and speed was noted as well without any stiffness and debility in her knees and ankles.  It was also indicated that her handwriting appeared less rugged and more fluid after the swelling was alleviated in her fingers and hands.  In any case she now visits me every other week for maintenance-style treatments.  After all the progress we had witnessed together, here is what she had to say:

 

                         "I have been suffering with severe Rheumatoid Arthritis for about eight years.  After researching alternative methods of pain management I came across Billy Singh's web site and was impressed by his credentials.  I have been seeing him for acupuncture treatments for several months with excellent results.  The treatments have given me great relief from the inflammation in my knees, feet, and shoulders. 

            I am thrilled with the results I am getting from the treatments and would highly recommend them as a compliment to conventional medicine."

-          Janet M.

 

In my humble opinion, after getting a testimonial like this, all I can say is that I am sorry but decrease in severity of signs and symptoms of a disease is one of side-effects of East Asian Medicine.

 

 

 

Billy Shonez Singh is a licensed acupuncturist and a board certified Chinese herbalist by the NCCAOM.  He is currently practicing in Commack, NY.  His primary focus with East Asian medicine is stress, pain management, diabetic complications, and treating chemotherapy side-effects. 

Basic TCM Knowledge regarding Osteoarthritis of the Knee In Traditional Chinese Medicine

Osteoarthritis (Degenerative Joint Disease) is mostly related to Fixed Bi and Painful Bi.

Fixed Bi Syndrome: The chief manifestations include pain and heavy sensation in the relatively fixed areas of body limbs or joints, numbness of the muscles, aggravation of the condition in rainy days, white greasy tongue coating, and soft slow pulse.

Painful Bi Syndrome: The chief manifestations include severe pain in the limbs and joints as if being stabbed or pricked. In the worst cases, there is fixed pain that is alleviated by warmth but aggravated by cold, better in the daytime but worse at night, limited movements of the joints, no local redness nor feverish sensation, cold sensation in the affected parts, thin white tongue coating, wiry tense pulse.

Pathogenesis

Wind, cold and dampness invasion causes the blockage of the Qi and blood in the meridian. In modern medicine, it is related to aging, endocrine disorder as well as trauma and improper posture.

Clinical manifestations
 
The onset of osteoarthritis of the knee is insidious. Initially, there is articular stiffness, seldom lasting more than 15 minutes; this develops later into pain on motion of the affected joint(s) and is made worse by activity or weight bearing and relieved by rest. Deformity may be absent or minimal; however, varus deformity of the knee is not unusual.

Imaging

Radiographs may reveal narrowing of the joint space, sharpened articular margin, osteophyte formation and lipping of the marginal bone, and thickened, dense subchondral bone. Bone cysts may also be present.

Major pattern differentiation

Fixed Bi:
Pain fixed in the knee joint accompanied by heaviness, stiffness and numbness, sometimes slight swelling.

Painful Bi:
Severe pain in the knee joint, aggravated by cold and alleviated by heat.

Treatment Principle:
Expel wind, Cold and dampness, improve the meridian circulation and regulate Qi and blood.

Major Acupuncture points and needle techniques

Acupuncture points for knee:
Xiyan (Ex.), Dubi (ST35), Zusanli (ST 36), Yanglingquan (GB 34)

Alternative Therapies:

Auricular therapy
Corresponding area (Knee), Sympathetic, Shenmen


Subcutaneous needling therapy
Select local point or tender points
Seven-star needle tapping and cupping

Read paper on Osteoarthritis of the Knee for Rachel Peterman's Clinical Acupuncture Practice II class at New York College of Traditional Chinese Medicine in Mineola, NY.

She gives an overview of Osteoarthritis of the knee, and Western and TCM treatment approaches.

Rachel H. Peterman, M.S., DHEd(c), J.D.

Osteoarthritis of the Knee.pdf

"Psoriasis is a systemic disease and should be treated as such, a fact that Chinese medicine has identified for hundreds of years. A recent article published in the British Journal of Dermatology stated that people with psoriasis have an increased risk of heart disease. The authors stated that traditionally western dermatologists mainly focused on psoriasis in the skin and joint level, but failed to view any correlation to other organ systems.

Because psoriasis is an immunoinflammatory disease, affecting the body as whole, it makes sense that the same inflammation causing the skin manifestations could also aggravate other diseases known to be induced by inflammation, particularly cardiovascular disease. See research here.

Chinese medicine's view of psoriasis as a systemic inflammatory disease is seen in the main traditional patterns attributed to it, mainly fire toxins and heat in the blood with stasis. It has always held that psoriasis is a disease of the blood, hence any part of the body influenced by the blood can be affected, particularly the heart.

It is interesting to see that many of the herbs used to treat psoriasis in Chinese medicine also have cardiac protective properties. Dan Shen, Salvia miltiorrhiza, is one of them. I use the herb a lot in my prescriptions to treat psoriasis, as it's main functions are to cool and invigorate the bloods flow. Dan Shen has been used both traditionally and in modern times to protect and repair heart tissue. Many studies have been done on this herb and I recommend you look at my research section to view one of them.

The more western research that comes out showing that the body is an integrated whole, that problems in one area (like the skin) influence other body areas, the more impressed I am with the observations of the ancient Chinese. By treating the roots of a disease pathoglogy, then not only is the disease itself healed, but so is a multitude of other associated problems. This is wholistic medicine."

Trevor Erikson, March 25, 2009 ;The Chinese Medical Dermatology Website

Mr. Erikson's Skin Disease Photo Gallery shows Before and After pictures of skin diseases treated with TCM.

Trevor Erikson's article is apt because of this April 8, 2009 article in the New York Times "Genentech announced on Wednesday a phased voluntary withdrawal of the psoriasis drug Raptiva from the United States because of a link to a brain infection.

Raptiva has been associated with an increased risk of progressive multifocal leukoencephalopathy, a rare and usually fatal disease of the central nervous system."

NEJM amicus brief supports failure-to-warn claims against Wyeth Laboratories.

A group of current and former editors of The New England Journal of Medicine, along with several well-known NEJM contributors, recently filed an amicus brief in U.S. Supreme Court, charging pharmaceutical companies with deliberately withholding relevant adverse-reaction data when their profits are at stake. The brief was filed in conjunction with the Wyeth v. Levine case, in which drug giant Wyeth Laboratories is appealing a Vermont Supreme Court decision awarding $6.8 million to Diana Levine, who had to have her arm amputated after improper administration of the Wyeth anti-nausea drug Phenargan.

Levine's lawsuit charges that the drug contained inadequate warnings and instructions for use. Wyeth, in turn, is claiming that FDA authority to approve drug labeling preempts state failure-to-warn litigation regarding prescription medication. In the summary of its argument supporting Levine, the amicus brief stated:

"The argument of Petitioner [Wyeth] and its amici ('Petitioner/Amici') that federal preemption of state law failure-to-warn claims involving prescription drugs will actually make the world a safer place is riddled with factual fallacies. First, contrary to Petitioner's/Amici's necessary premise, the FDA is in no position to ensure the safety of prescription drugs. Not only is the FDA seriously hampered in its ability to determine the risks of drugs before they are approved for sale, but it has proven inadequate to the task of addressing hazards that only become apparent after a drug has been widely marketed to an unsuspecting public. Post-approval dangers posed by drugs placed into the market are unfortunately quite common. However, the FDA's ability to either anticipate these risks or react expeditiously once they have been revealed has been limited by serious information-gathering constraints in both pre- and post-approval settings."

Part of the difficulty the FDA has in addressing drug risks, according to the brief, stems from the fact that it is forced to rely on the manufacturers themselves for outcome data upon which to base its decision to either approve or disapprove a drug. The brief went on to use the examples of three different drugs - Pondimin/Redux, Vioxx and Trasylol - in which the manufacturers allegedly withheld key information from the FDA and strongly argued against stricter label warnings, all the while continuing to market these drugs to an unsuspecting public. In all cases, the companies allegedly manufactured data, ghostwrote articles for medical journals and/or withheld negative findings from the FDA.

The worst of these offenders in terms of estimated patient deaths was the anticoagulant Trasylol, marketed by Bayer. The drug was found to cause kidney failure. According to the amicus brief: "Between 1999 and 2005, Bayer generated over $935 million in revenue from sales of Trasylol with over $353 million in 2005. Bayer forecast that Trasylol would some day generate upwards of $600 million annually." Although exact numbers may never be released, an estimated 242,000 deaths were likely attributable to Trasylol between its release in 1993 and its eventual withdrawal from the market in May 2008.

In light of these examples and others, the brief argues strongly in favor of the FDA and the legal system working together to enhance consumer protection:

"Product liability lawsuits and the FDA have peacefully coexisted for seventy years for one simple reason: they have complementary, rather than conflicting, goals. The tort system complements the federal regulatory structure by providing a mechanism for compensating victims of hazardous drugs. Product liability litigation provides the FDA with key information unearthed in litigation that the agency can use to better protect the public from unsafe and inadequately labeled drugs. At the same time, the tort system and the FDA are similarly constrained.

"Whereas the FDA, as a regulatory body, weighs the risks against the benefits of a drug, in 'failure-to-warn' litigation most state courts require a similar balancing between the cost of care owed to a patient versus the prospective harm."

The brief went on to conclude:

"[G]iven that pharmaceutical companies have been known to equate increased warnings with a loss of sales, they would have an incentive to delay warnings as long as possible. As has been shown, certain pharmaceutical companies have already proven themselves unwilling to prioritize safety over profits, even when faced with the threat of civil liability. It is chilling to imagine how such companies might conduct themselves if the threat of tort liability for dangerous drugs were eliminated entirely by virtue of federal preemption."

The full text of the amicus brief, along with all other briefs filed in the lawsuit, is available online at www.abanet.org/publiced/preview/briefs/nov08.shtml#wyeth.

This article was published in Acupuncture Today, The Acupuncture and Oriental Medicine News Source