Acupuncture Associates

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April 2007

In Tibetan Medicine, pulse diagnosis is an important examination

EXPECT ANOTHER FEW BILLIONS FOR THE FAT CATS

As another political season opens, the time is always right to funnel more money to those folks who provide no value for patients or physicians, but kick back a few percent to the legislative and executive branch criminals who set policy in this area.

Increasing numbers of sound bite solutions recommending that “everyone have insurance” fill the airwaves. Disguised under the rubric of “health care costs”, the majority of this money continues to flow to the robber barons of medicine. It is no wonder that we have the most expensive system in the world.

The most important question for patients, doctors, and the future of medicine is, "What is worth paying for?” Elected officials and members of the medical elite are not comfortable with this question because the answers might indicate that a great deal of money is spent ineffectually and, in addition, may actually contribute to increased suffering and death. (See Death by Medicine)

As long as public and political discussion only involves “Who is going to pay, and how do we maximize profits for the middlemen?”, the standards of medicine will continue to decline in the U.S.A.

Inasmuch as ordinary working people and small business have reached a point where they are strained to afford “health insurance” (actually fraudulent financing), it is long past time to question the assumption that third party for-profit financing of medical costs is an acceptable situation.

As purported funding for actual care is diverted to fat cats and the parasitic “insurance” industry, the result has also been third rate and dangerous care. Our medical system is, depending on whose studies are used, either the number one or number three cause of death in the United States.

Centralization and the “business” model of medicine are taking its toll in increased disease, higher mortality, and strong incentives for unnecessary testing, unnecessary surgery, and unnecessary drug treatment.

The Institute of Medicine estimates that adverse effects from prescription drugs occur 1.5 million times a year, 530,000 times a year for those 65 and older. The cost for treating these adverse effects in just the latter group is estimated at 887 million dollars. (Family Practice Management, February 2007, page 41).

In addition, it is estimated that a hundred thousand people die every year from adverse effects of prescription drugs that are properly prescribed. This is the equivalent of one jumbo jet airplane crashing every day, yet there is very little response from the medical establishment or their journalistic footpads, and hardly a squeak from our elected representatives.

For doctors who are increasingly expected to work by “quota”, or "pay for performance" prescribing drugs is the fastest way to get patients through the system. Discussion of adverse effects or analysis of drug-drug interactions takes time, and alternatives to drugs are never discussed by mainstream physicians.

Most physicians’ behavior indicates they are not aware that drugs are often not effective and always have some unwanted side effects. And, the probability of adverse interactions increases with each drug added to the regimen.

One lady that I saw last month was not responding to her 3 blood pressure medications, so her physician doubled the dose of all three! With “health care” such as this, we can expect astronomical levels of complications and expense. (LBG, March 2007)

SINGLE PAYER NOT A SOLUTION

Another false solution being promoted by the sound bite crowd is “universal health care”. For those who have not been paying attention to the ongoing failure of the Medicaid and Medicare systems, there is the example of the Veterans’ Hospital system. Recent news in this area highlighting the shortcomings of the military medical system should chasten those who believes that a central bureaucracy can lead to quality health care.

This is not a new situation and should not be a revelation to anyone in government. Even in the 1970’s when I was still a medical student, the inefficiencies and cruelty of this monolithic bureaucracy was well known to doctors and nurses who had dealings with the Veteran's Administration hospital system.

After the usual 10 days of "hearings" and bluster on the Walter Reed Hospital fiasco, our country's politicians will get back to the serious business of shifting responsibility, funneling money to fat cats, and grandstanding.

NATIONAL HEALTH SERVICE IN CRISIS

Proponents of national health care systems have also found that these centralized monstrosities cannot provide effective health care. Somehow, there is always enough money for the fat cats, but never enough for the actual workers who provide medical care.

Without sufficient nurses to carry out doctor's orders, provide increasingly complex therapy, and monitor patients, hospital and outpatient care will remain at abysmal levels and will even decline.

In Great Britain, nurses' salaries and working conditions have deteriorated to the point that nurses are forced to emigrate along with their skills. This is obviously to the the detriment of British patients.

The only solution to our present health care crisis is to return to the traditional roots of medicine, with practitioners and patients taking responsibility for individualized health care with no third party intervention. Only a decentralized system that is truly market driven can provide high quality medical care. Throughout all medical history and in every region of the World, this is the only model of health care that has worked. (L.B. Grotte, April 2007)

MORE THREAT TO THE HONEYBEE, MORE DANGER FOR US

In 1952, Ray Bradbury published a short story ("A Sound of Thunder") that suggested that a seemingly inconsequential event to an insect, long ago, would have vast consequences in the present for the human race.

That was science fiction. But when real disasters occur in the balance of the insect world, it impacts to a much greater degree, and much more quickly.

This is especially true of an insect which has an essential role in modern agriculture and medicine, the honeybee. A new and undefined threat to the balance of the natural world has been recognized as “Colony Collapse Disorder”. Entire hives of honeybees seem to be vanishing without a trace.

The immediate effect may be the loss of significant portions of the United States agricultural crop with subsequent loss of employment for farmers and increased costs for food. Honey, an unsurpassed food and medicine in itself, as well as a medicinal ingredient, will become more difficult and expensive to obtain. The availability of venom, used for arthritis and neuropathy, as well as desensitization, will decrease.

And, whatever is causing this, it cannot be only affecting the honeybee. More consequences in other areas of the ecosystem are certain to become apparent. (LBG, March 2007)

ACUPUNCTURE FOR HIP AND KNEE ARTHRITIS

A large German trial has found that acupuncture is of significant benefit in controlling the pain of osteoarthritis of the hip and knee.

Of 3633 patients, 357 were randomized to receive acupuncture (15 treatments over three months), 355 were randomized to a non-acupuncture control group, and 2921 did not accept randomization and opted for acupuncture treatment. All patients received usual medical care in addition to acupuncture.

The randomized acupuncture group showed significant improvement over controls at both three and six months in osteoarthritis severity (WOMAC scale) and quality of life. Improvements were comparable to those in the non randomized acupuncture group.

The authors report that "Physician characteristics, such as the level of formal acupuncture training or certification, did not influence treatment outcomes", although only 140 hours of certified training was a minimum requirement of participating physicians.

Partly as a result of this trial, the German Ministry of Health is considering a recommendation from a federal committee of doctors and health insurers that acupuncture should be covered by medical insurance. (Acupuncture in patients with osteoarthritis of the knee or hip: A randomized, controlled trial with an additional nonrandomized arm. Arthritis & Rheumatism, 54; 11: 3485 – 3493).

ACUPUNCTURE & RHEUMATOID ARTHRITIS

A small study has demonstrated that acupuncture, and particularly electro-acupuncture, appears to be effective in reducing joint pain, stiffness and swelling in rheumatoid arthritis (RA). 36 patients, average age 58, suffering from RA that was unresponsive to other therapies, were assigned to three groups and received either electro-acupuncture, traditional acupuncture or ‘placebo acupuncture’. All received twenty treatments over ten weeks.

The points used in the first two groups were Yangchi SJ-4, Waiguan SJ-5, Yangxi L.I.-5, Wangu SI-4, Dazhui DU-14 and Quchi L.I.-11. A total of 29 patients completed the study and most of the drop-outs (because of inefficacy) were in the placebo group.

In both the acupuncture groups the number of tender joints and physician’s global scores were significantly reduced. (Efficacy of Traditional Chinese Acupuncture in the Treatment of Rheumatoid Arthritis (RA): A Double-blind Controlled Pilot Study. American College of Rheumatology Annual Scientific Meeting, November 2006).

ACUPUNCTURE & HOT FLUSHES

In a study of 29 postmenopausal women who experienced at least seven moderate to severe hot flushes a day, active acupuncture was found to significantly decrease the severity of nocturnal flushes (by 28%) compared to 6% in women given sham acupuncture.

The frequency of flushes was reduced by more in the active treatment group compared to the sham but not significantly so. (A randomized controlled pilot study of acupuncture for postmenopausal hot flashes: effect on nocturnal hot flashes and sleep quality. Fertility and Sterility, September 2006; Vol. 86: pp. 700-710).

ACUPUNCTURE & ENDOMETRIAL PAIN

A study of 101 women (aged 20 to 40), of whom 83 completed the trial, with laparoscopic-proofed endometriosis, randomized them to one of two groups. The first received specific acupuncture for the condition while the other was treated at non-specific points (points with no relation to the diagnosis). Treatment was given twice weekly for ten weeks.

After a two month interval, the two groups changed. There was a highly significant decrease in pain levels in the specific group compared to the non-specific group where the pain remained nearly unchanged. (Is acupuncture in addition to conventional medicine effective as pain treatment for endometriosis? A randomized controlled crossover trial. Focus Altern Complement Ther 2006; 11: 42).

IT’S STILL NOT NICE TO FOOL WITH MOTHER NATURE

IVF babies have been found to have a 60% greater chance of having structural defects in the gastrointestinal tract, bone, muscle, and heart in a study of 61,208 babies born during 2005 in Ontario Canada. 1394 babies born via ART-IVF, ovulation induction, and intrauterine insemination were compared with babies conceived in the normal fashion.

Scientists presently have no explanation, but it is apparent that some factor in the manipulative process is affecting these babies. Of greater concern is that more subtle defects, ones that will not be as apparent as simple structural defects, may take years or decades longer to discover. By definition, these more subtle defects are occurring at unknown rates. This research was presented at the February 2007 meeting of the Society for Maternal-Fetal Medicine in San Francisco. (New Scientist, February 24 2007, page 18)

GREEN TEA & PROSTATE CANCER

A study on a mouse model of human prostate cancer has suggested that polyphenols in green tea are able to combat the disease on a number of different levels. The polyphenols change the insulin-like, growth factor- driven pathway present in prostate tumors, cause reduced expression of proteins known to cause the cancer to spread through the body and reduce the amount of vascular endothelial growth factor in the tumors, thus reducing the supply of blood and nutrients to the tumor. (Cancer Res. 2004 64: 8715-8722).

GREEN TEA & OVARIAN CANCER

Green tea consumption has been shown to increase the survival of patients diagnosed with epithelial ovarian cancer according to an Australian study of Chinese patients. Three years after diagnosis, 77.9% of 104 green tea drinking patients were still alive, compared to 47.9% of 140 non tea drinkers. (Int J Cancer2004;112(3):465-9).

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TEA & ALZHEIMER’S

Both black and green teas appear to counter brain enzymes linked to Alzheimer’s disease. Both teas inhibited the activity of  acetylcholinesterase (AchE) and butyrylcholinesterase (BuChE), but only green tea inhibited beta-secretase. Coffee did not show any significant effects on any of the enzymes. (Phytotherapy Research, Vol. 18, Issue 8: 624–27).

TOXIC WATER BOTTLE DANGER

Taking the subject of the March newsletter item on toxic water one step further, it is also unclear how the chemicals which leach out of the plastic of our ever-present water and food containers will affect present and future generations.

Bisphenol A is found in almost all polycarbonate plastics, and leaches into the food and water stored therein. Researchers at Case Western Reserve University have found that when pregnant mice are exposed to environmental doses of bisphenol A, their female fetuses develop abnormal egg cells. This means that toxic effects will not be seen until those fetuses grow up and try to have offspring themselves.

A similar trans-generational effect was seen in the 1970’s when it was discovered that exposure to the synthetic estrogen DES during pregnancy resulted in ovarian damage to daughters.  The significance of these mice studies in human beings may be unclear, but chemicals such as bisphenol A are already widespread in people’s bodies, unlike DES which was only prescribed for a relatively few women. (New Scientist Jan 20,2007 page 4)

COMMON PLASTICS MAY DAMAGE THE BRAIN

Research on rats exposed to bisphenol-A (BPA), a chemical found in many food storage plastics, indicates that it damages the brain and may lead to learning disabilities and age–related neurodegenerative diseases. BPA is used in baby feeding bottles, and high concentrations of BPA have been reported in the blood of some pregnant women.

About two billion pounds of BPA are produced annually in the United States and BPA derivatives are also used as flame–retardants in adhesives, paper and textiles. (Environmental Health Perspectives, 10. 1289, Online Feb. 24, 2005).

ORGANIC IS BEST

Organic tomato ketchup has been found to contain three times as much lycopene, the cancer-fighting chemical, than non-organic ketchup. (New Scientist, January 9th 2005). And organic milk has been found to have around 50% more vitamin E, 75% more beta carotene, and higher levels of antioxidants lutein and zeaxanthine and omega 3 essential fatty acids. (Soil Association Annual Conference, 2005).

FATHER’S AGE & SCHIZOPHRENIA RISK

According to a Swedish study which looked at hospital admissions for schizophrenia or non-schizophrenic, non-affective psychosis among over 750,000 people born between 1973 and 1980, greater paternal age at conception was associated with a greater risk of both disorders. Each 10-year increase in paternal age was associated with a 50% greater risk of schizophrenia in all except those with a family history of the disorder. (BMJ 2004;329:1070).

WALKING & THE BRAIN

In a study of over 2000 men aged between 71 and 93, it was found that those who walked less than a quarter of a mile a day were 1.8 times as likely to develop dementia as those who walked over two miles during daily activities. (JAMA. 2004;292:1447-1453).

In another study of 18,000 women aged 70 to 81 enrolled in the Nurses’ Health Study, walking at least two hours a week was associated with better cognitive performance. Those who walked for longer than two hours showed even greater benefits. (JAMA.2004;292:1454-1461).

CHRONIC BACK PAIN SHRINKS THE BRAIN

People suffering from chronic back pain showed 5 to 11% less neocortical grey matter than normal subjects, equivalent to the grey matter lost during 1-20 years of normal aging. The decreased volume was related to overall duration of pain, with 1.3 cubic centimeters lost for every year of pain. (J. Neurosci., Nov 2004; 24: 10410-10415).

PHYSIOTHERAPY & BACK PAIN

In a randomized trial of 286 patients with back pain of over six weeks duration, assigned either to routine physiotherapy or simple advice from a physiotherapist, there was no observable benefit from the physiotherapeutic intervention. (BMJ 2004;329:708).

MAGENTIC BRACELETS FOR OSTEOARTHRITIS

Wearing magnetic wrist bracelets significantly reduced osteoarthritic hip and knee pain compared to wearing dummy (placebo) bracelets, according to a British study of 194 men and women. (BMJ 2004;329:1450-1454).

SOCCER GOOD FOR BOYS

Boys aged ten to thirteen who played soccer for three hours a week over three years demonstrated a 7% increase in anaerobic capacity, 6% more total lean body mass and 33% greater total bone density than boys who did 45 minutes of other physical activity (e.g. running) a week. (Medicine & Science in Sports & Exercise. 36(10):1789-1795).

MIGRAINE AND STROKE

Having migraines appears to more than double the risk of suffering an ischemic stroke. The risk is greater in those who have migraine with aura, and is eight times greater in users of oral contraceptives. (BMJ 2005;330:63).

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"What Were They Thinking?" Department

NOT A SOLUTION: DISGUISING A PHONE CALL AS A DOCTOR VISIT

Why do we have so <p class=MsoNormal><span style='font-size:10.0pt'>Sometimes, when people seriously suggest expensive, nitwit ideas to solve medical problems, you wonder if they have any conception of what real medicine requires. It is sadly indicative of the state of medicine today that articles such as

This article, published on page one of the February 19th AMA News, details an idea so incredibly stupid that it deserves special attention. In summary, the idea is that a doctor can "see" a patient "from coffee shops, home, or elsewhere" through a video and audio link on a motorized platform, which is vaingloriously being termed a "robot".

According to the American Medical News, "the machines cut response times for intensivists and surgeons, allowing them to see patients more quickly."

Folks, I'm here to tell you that what people who are in places where "intensivists and surgeons" practice, what you need is quick evaluation and treatment, which requires someone to be right there, in the same place as the patient.

Yes, the doctor can look at a monitor and listen to the patient through the speakers on his laptop, but this is laughably inadequate to evaluate a seriously ill patient. Obviously, providing treatment is not an option for our "video doctor" who needs a qualified nurse or doctor on the spot to do the work. For the cost of this witless program, better to hire more registered nurses.

Although it seems the height of parody, some physicians think that they can do rounds effectively through a robotic avatar, such as this one being used at Hackensack University Medical Center in New Jersey. Connecting through a laptop through the internet to a hospital server presents many chances for these 'cyberdoctors' to miss out on what is going on with their 'cyberpatients'. When physicians finally figure out how to solve problems face to face, I will have a lot more confidence in exploring these wacky 'solutions'. This is one of many examples of money and technology wasted on an impractical and misguided program. And what happens when the robot rolls over this nurse's toe? Credit for this picture goes to 'InTouch Health', if that isn't ironic enough. Article is from JAMA, January 12, 2005; page 150. 'Physician Robot Makes the Rounds'

For the alert and comfortable patient pictured in the above photo a "visit" by the doctor with this gadget is of no more medical value than a phone call.

That there is anyone even remotely involved in medicine that thinks that having 100 of these expensive 220 pound machines wheeling around hospitals under remote control is a good idea is incredible in of itself.

But that otherwise presumably intelligent doctors and nurses would think that this is a substitute for a real hands-on interaction on any level is simply astounding science fiction.

"It's really easy to operate. We just need someone to push the elevator button because the robot doesn't have any arms", gushes Paul M. Vespa, M.D., director of neurocritical care and associate professor of neurosurgery and neurology at the David Geffen School of Medicine at UCLA.

Despite his title, I believe Dr. Vespa and the rest of the participants in this program could use a refresher course in critical thinking.

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