Licensed acupuncturist Helen Ye, LAc, presents this guide to the ancient and complete system of health care commonly called Chinese medicine. Learn about the guiding philosophies, variety of therapies, data on efficacy, and broad range of common conditions it can address – from asthma to headaches to menstrual irregularities to gastritis. Ye demonstrates how patients are assessed, describes how treatment is individualized, and shares studies on such topics as acupuncture for addiction recovery and herbs for chemotherapy-induced nausea.
Thank you so much for having me here. I am Helen Yee. I'm a licensed acupuncturist. Um I am a Chinese woman and been practicing Chinese medicine for 20 years and have been in the health care field for almost 30. Um Don't want to date myself too much. Uh My family of origin is from the Pacific Islands and from China. So I want to share a little bit today about acupuncture and Chinese medicine. I will be using the Chin Chinese medicine, East Asian medicine interchangeably just because the history of East Asian medicine and Chinese medicine are so intertwined. Um It is more commonly known definitely as Chinese medicine, but it's more inclusive to use the term East Asian medicine. All right. And for those who are interested in placing questions in the chat, please place that in the chat. I'll be addressing questions at the end of my presentation in case I do end up um answering your question in the process of my presentation. All right. So what is Chinese and East Asian medicine? So you will see just some images here where there's cupping, which is uh also known as myofascial decompression. Um A number of PTS are using those uh that practice. From Chinese medicine. You have acupuncture. There's a picture of an individual with acupuncture on the ear. And we have Mount Sebastian, which is a dried herb that is burnt over a region of the body can used, can be used with acupuncture needles. And we also have a smokeless version of some of these things, I'm going to that to hold some of these things out. So, and let me know if you can't see this. So this is a cup here, just a very small cup. Um And then here we would, this is glass. We do have plastic ones that we would normally use in our clinic at U CS F. That's more of a hand pump and this would require of course, um a little bit of a flame to create a vacuum. This is the traditional style of OK. This is a silicone version that we would stick on small portions of the body and that would suction the skin a little bit and the smokeless versions of the mock Seussian. So the Moxa we would use for either very gentle uh sense of patience, Children, adults as well too. We have a dried mug work here that you could see. This is the smokeless version that we will use in our clinics here at U CS L. And down below here, you will see some pictures of herbs that is put into a tea and a picture of an herb shell and gua shell, which is a scraping technique. And this particular technique has been around since the paleolithic age, which is at least 10,000 years ago, if not much longer than that, which is the use of pressing your hands or a skin sing technique with stones against the skin to really benefit the the body and health. Here, I also have an image of several images of electro acupuncture. So you will see different small devices. These are run by batteries. Um typically non volt batteries with electrodes and alligator clips attached to acupuncture point. You'll see on the back of this individual can be done on a number of different extremities and things of that nature. And this takes the place of an individual standing there manually stimulating the needles and this is really wonderful for a lot of neurological conditions. So individuals with nerve conduction issues, um people with paralysis, post strokes. Um this is uh a common technique used in neurology. They've done a lot of studies using one acupuncture point that is really helpful for overactive bladder and urinary incontinence and urgency. So what is Chinese medicine in East Asian medicine? It is a complete system of health care. So it is the same kind of conditions you would see your primary care. Doctor acupuncture and East Asian medicine has been around for 3 to 5000 years, not including Guia, which has a much longer tradition. And you could see that there's a lot of tools that we use in our toolkit as East Asian medicine practitioners. It's a complete system of health care. It addresses all kinds of conditions that you would see and it withstood the test of time. No internet, no iphones, no computers. Um And even during times when there was really very little exchange in roads except for the Silk Trade ro um where lots of information and sharing of knowledge and uh traditions were used and spread to Greece, for instance, with the four humors and to India, with Ayurvedic medicine and the elements that are used in those respective countries. So Chinese medicine has its own unique theories of anatomy, health and treatment. We'll get into a little bit of that and its emphasis is on wellness and preventive care, regardless of what part of the continuum of illness or wellness you might be, for instance, uh back in the village days, people would go to the village doctors and say I caught a cold. I sprained my ankle. I've got an infection. I feel I don't feel good. What can I do? Or also my child is not feeling good. What can I do to keep them well? And so learning how to eat with seasons, different lifestyles uh that you would do seasonally different environments and uh climate conditions. I really want to keep people as optimized as possible. Nowadays, we would be looking at this as how do we keep people well? And how do we keep people from progressing from whatever conditions they may already have been diagnosed with or have pre disposition in their families. For instance, the focus is supporting and stimulating the body's own natural ability to cure itself. So, strengthening our internal systems, learning how to manage and navigate and regulate our emotions, its effects on our bodies. And what happens in our individual systems is something that as an acupuncturist and Chinese medicine practitioner, I can help support my patients learn these different ways of knowing their bodies and how to support them with the many tools that I have at my disposal. And the goal is to achieve a level of harmony and balance. And we'll get into a little bit of the concept of gene, a little bit individualized medicine. I know nowadays we've got the terminology of position, physician medicine, Chinese medicine and East Asian medicine has always been personalized medicine. It is individualized. Each time I see each of my patients adjusted and adapt to what I'm seeing at that time. Even if I'm working over a course of treatment on a particular one or two conditions such as rheumatoid arthritis, someone's got diabetes and they've got neuropathy or nerve uh numbness and pain, tingling in their extremities. They'll be looking at how does that work in concert of everyday life. So what does the practice include acupuncture of medicine? We do talk a lot about diet and nutrition from an East Asian medicine standpoint self care. There's a lot that we do in self care including breath work, stretching and exercise and movement. Tai Chi and Qi Gong for instance, um or regular exercise as well to including the ability of the exercises, lifestyle changes. Um hydration, looking at some of the foundational things that we do need to ensure um including sleep um including with the body work that we do do includes massage, acupressure, for instance. And Chinese rehabilitated massage, which is not relaxing but extremely helpful. So what are the differences between Western medicine and East Asian medicine? Western medicine predominantly compartmentalize the body. It individualizes different portions of the body such as the respiratory system of lungs. You've got the pulmonologist, you've got the cardiologist to work on the heart. You've got your G I specialist who works on the digestive system and you've got the hepatologist and so on and so forth in East Asian medicine. We're looking at functions in relationships. How is the function of a said organ working? How is that working in relationship with other organs? Are they being impacted by that? What's impacting the whole system? What's impacting which system more than another in Chinese medicine we are using in English, the same words as in Western medicine for the anatomy with the organs. But we are not referencing the same concepts of what they actually do functionally in Western medicine. So we may use the terms, stomach spleen, liver, kidney so on and so forth. But they do not mean the same things functionally. When we're using that. In Chinese medicine, the mind and body are separate. In Western medicine. And in East Asian medicine, the mind and body are seen as one fluid connection with each other, they're not separate, the mind has a significant effect on the body stress, for instance, anxiety, what is that affecting in the organs in this individual as you're presenting in front of me? And that's going to be different from each person to each person. Even if they're diagnosed or not diagnosed with anxiety. Treatment is compartmentalized in western medicine. So again, we're looking at, you're seeing a cardiologist, you've got hypertension, you've got high cholesterol, you're given particular medications for that condition. There may be side effects over a long duration of time for some patients. Some patients may notice those side effects sooner than others and then medications are sometimes added to manage those side effects. And in East Asian medicine, we're looking at balancing those different organs. How do we support an organ if it's a little bit weaker, how do we calm another organ system if it's a little bit um excessive if you will, and it's in hindering the regulation and harmony of those organs working together. And how do we work on balancing the system if there are emotional issues that is causing this regulation in the body and imbalances? So, the term Qi, which is one of the fundamental concepts of Chinese Mexican East Asian medicine. People tend to translate this as energy. It's a very poor translation. Unfortunately, a better translation I would find is vitality. It is more encompassing, it includes not only physical energy but one's vibrancy in terms of the clarity of your mind, your emotional ability to ground yourself, to speak clearly, to take an information, to um look at your body's skin and texture. And really how do you move through your time and space in the course of your day? It is not purely pure energy that's in a fiscal standpoint. It is your immune system. How is your overall system looked at the top portion of this? Just to give you an idea of what this character when we break it into parts means this top portion with the three lines. And um uh is it represents air. Actually, it's a shortcut version of the character air in Chinese and the bottom portion inside kind of the hat looking area is me which is referencing rice or a staple for food together. After one is born, excuse me. After one is born through your air and the food that we eat. How is the condition of your digestion? Do you eat quickly? Do you not? Do you hold your breath? How's the quality of the air that you breathe? All of these come into context when we're talking about cheap here, we have an image of excuse me of an acu puncture model. I have one here as well. And there are pathways that are often referred to as meridians. There are 40 main meridians throughout the body in school. There are approximately 350 points that are taught. There are 2000 plus points, acupuncture points on the whole body. So these just show kind of the primary meridians or pathways which you can liken them to uh rivers and lakes and oceans. Kind of how pathways and streams. There are small pathways that connect to larger streams. Uh not unlike uh roadways as well. You have smaller streets that connect to other next larger streets to main highways and then freeways that you can think of as the main meridians of the body that course both internally and externally on the body, connecting the organs and all parts of the body to the central nervous system through the spine and to the brain. So what is acupuncture good for the NIH here in America National Institute for Health has found the following conditions to be treated effectively by acupuncture. This statement that was published by them in 1997. So quite a few years ago, you could see here, it is listed here to be very helpful for addictions for asthma for a number of pain conditions such as headaches or back pain, carpal tunnel, dental pain, fibromyalgia, menstrual issues and all types of nausea, vomiting after surgery uh for chemotherapy and certainly for morning sickness, inclusive of that for those who are pregnant. And with the World Health Organization, they listed the acupuncture benefits in 1979 I have two slides here that is from the who that lists all the different conditions that they find acupuncture is really beneficial for. So you see a lot of different things here including bed wetting, uh acute tonsillitis. This is primarily affecting mostly younger Children. If you will, you do have a lot of different vision issues, cataracts, central retinitis, conjunctivitis. Uh There's a number of G I conditions listed here, diarrhea, duodenal ulcers, dysentery, esophageal spasms and a number of other G I conditions listed below. Mm On the next slide here. Again, we have some paralysis issues. So, neurological issues, there's issues with coughs and colds that we saw in the prior slide including sinusitis. A lot other neuropathies. Again here, some other neurological conditions like trigeminal neuralgia, which is kind of facial paralysis of this particular trigeminal nerve on the face. And some issues with uh dizziness if you will. I was informed before I um scheduled this presentation on my calendar that we would have some physicians um that may be interested in some research. So I've included a few research uh highlights here for those who are interested in this type of work. Excuse me, I just want to have a sip of water here. Just a few uh research highlights for acupuncture and herbs here. And I'll go into a little detail um for one of these particular studies. So the first one identified Vicars at all has acupuncture for chronic pain. So this study looked at all types of chronic pain studies and in 2012, uh published this and what they found was they were comparing sham or fake acupuncture with a fake looking needle that would tap on top of its surface compared to no acupuncture group. So that's the control group where they just receive regular conventional therapies or no therapies depending. And an acupuncture flip for all types of chronic pain. And what they found was that uh the acupuncture group by far has much more significant improvements for chronic pain than either the big acupuncture group or the control group. And that acupuncture is effective and superior to both the sham or the pig acupuncture and the control group. The mcpherson study, I will go into a little bit more detail in just a bit here. And the Jackson study, which is a comparative effectiveness study for migraine sufferers. It was an interesting study because they actually had a placebo group that were given a sugar pill and also received regular conventional medicine as well as an acupuncture group that also received conventional therapies in Western medicine between the two. What they found was the placebo group and the acupuncture group both had benefits. Actually, there was a reduction of migraine headaches. But what they found was the placebo group had only short term benefits and those who had received acupuncture had a sustained effect. And the conclusion of this particular study stated that acupuncture is not a placebo treatment because compared to placebo, it had a longer term effect and a positive effect to help them with migraine headaches. The second study, I was referencing the mcpherson study is a really amazing study. So this study was a meta analysis which essentially is a study of multiple trials and other research studies that are looking at the same, the same question. So this study included 29 trials and almost 18,000 individual patients. It is a huge study and a huge undertaking. So this data actually showed for a lot of chronic pain conditions that after one course of acupuncture. So the one course of acupuncture would vary from 12 to 20 treatments, generally speaking once or twice a week. But that after the course of treatment, there was a very sustained effect of improved chronic pain by those suffering from the chronic pain compared to a baseline. So when they, before they started acupuncture of several months, at at the very least. And in some cases, some patients, 50% of them noticed still benefits 12 months later, which was really interesting. So even if you do not receive acupuncture, but if you complete the course or the dosing of having acupuncture once or twice a week for 12 to 20 sessions for chronic pain, you will have an improvement of managing that chronic pain condition regardless of what it is. Now, you're hearing a lot about me talk about chronic pain acupuncture studies, especially in the US in America. The predominance of research studies have focused on pain. Some have focused on nausea and vomiting and chemotherapy, cancer therapy um issues. But acupuncture research has really been around for only about 50 or so years internationally. Um and in China, Taiwan, Hong Kong and other East Asian countries, they have been, there's thousands of studies on herbs and acupuncture. They are not all focused on chronic pain, not all of them are translated into English. Um but they are studying best practices. They're not asking the question whether or not does acupuncture work, but they're asking what is the best practice for a set condition or pattern as they might understand it in Western medicine and a pattern as you might understand it in Chinese medicine that's differentiated from Western medicine. This next acupuncture study that I want to highlight that's done by Rick Harris is actually focused on fibromyalgia patients. These were all female patients and they were looking at um opioid juice particularly and looking at the new opioid receptors. And what they found with patients who received acupuncture was that they decreased their use of opioids because their pain levels were decreased. What they found, what the acupuncture did was that it increased and improved the new opioid receptor binding, which may be the reason why these patients were reducing their use of uh of acu uh of opioids. Um And they were differentiating it with sham acupuncture, which is the big acupuncture needle that gets tapped in on the surface of the skin but doesn't penetrate it but still provides a stimulation of the point itself. But there are some herbal research highlights I want to just um include here and this is the first one is about fatigue, which many people suffer from for, for many, many reasons from medical conditions to those who are not diagnosed with medical conditions. And this used both Chinese ginseng and American ginseng and found that either one of these types of ginseng was very helpful for improving fatigue and there were no contraindications for any of the patients um or their um medic medicines that they were using. The second one is an interesting study. It is a four or formula. Um That's been around for thousands of years actually. And this study was actually used as an adjunct to cancer therapy. So patients receiving chemotherapy and they were also receiving this formula, four herbs. What did they find? They found that it actually enhanced the anticancer agents for colorectal liver and pancreatic cancers. So there's no issues with thinking that it was going to contradict it. It reduced chemotherapy toxicities such as diarrhea, nausea, vomiting, and syndromes, et cetera. It did not affect the pharmacokinetics of the chemotherapy use. So the um so what does that mean? So essentially means that the use of these poor herbs in this one formula in conjunction with chemotherapy with this population did not affect the um the target and goals of using the chemotherapy. There was no contraindications, side effects or interactions that people often um consider about the drug herb attractions if you will. And I know a lot of people when they're talking about acupuncture and wondering what happens in an acupuncture session, I'll, I'll kind of get into what that might look like in a little bit. But what happens in my diagnosis or my assessments of a patient when I do see them? So I am doing a an intake, I'm asking questions, they may fill out an intake form if they've had enough time to complete all of it. Um And at OSHA, we do have a fairly comprehensive intake form that is about eight or nine pages um which is a few pages less than it was even a few years ago. I'll definitely be reviewing their charts if the chart is successful in our electronic medical record system. If their chart isn't very readily available, I'll just take a look at the intake forms and ask the questions that I need. But if their labs and things like that, MRI S x-rays, other doctors, notes and allied health professionals are available. I will review that before seeing the patient the first time I'll take a look at them. So observations is a very big key in Chinese medicine. It's not going to say I'm going to observe you as you come in. I'm going to take a look at your skin, the how your voice is sounding to me, skin tone. How do you walk? What's your gait looking like? What does your mental clarity look like and sound like? Um the shin and the eyes doesn't translate very well in English. But it is kind of the, the brightness, the looseness that one can see in terms of vibrancy or c coming through someone's expressions and behaviors. And also observation wise as we're going through the intakes and any physical exam, we'll be looking at any co discolorations, redness, um moisture, dampness, hot, cold sensations that will be observing as well too. For those who have seen an acupuncturist or East Asian Med medicine practitioner will be somewhat familiar with the fact that we do look at tongues. Um So we'll ask our patients to stick their tongues out. I do have some patients who laugh every time they opened up their tongues and stick out their tongues so I could look at it and um to look at the pulses. So there are pulses on both wrists. I'm just gonna stand up here. So we're feeling on the radial artery. There are three fingers on each wrist that we feel for on both sides and we are feeling for three levels. 123, so top middle deep levels and three positions. So three levels of three positions, 123, 123, that three positions on each wrist, they correspond to different organs and different levels of the body. It gives us information about how the individual is doing emotionally, physically, the interaction of how the emotions are affected or not. And it may just be a purely internal organ issue. And of course, we're also including palpation and physical exams. So well. So you've got shoulder issues and we take to look the shoulder, look at the neck muscles and palpate on the back and the front of the shoulders and see what else is going on. Um We may do some range of motion um exams, some neurological exams. So there is some overlap with some things we might do with, one might see their primary care doctor do or some of their specialists. Again, each practitioner in East Asian medicine and acupuncture may do different tests based on what they're seeing and how they, you know how they uh what their style is as a practitioner. So what I'd like to do is do a short demonstration and Eric, I would need your help with this if people put things in the chat, but I would love people to maybe just unmute themselves. So I have Elsa, she is my daughter's doll and she has trusted me to borrow her um as um as a help for demonstrating how acupuncture is used and the flow of the work that I might do. So, let's say Elsa is an intermittent patient that I've seen off and on this last year, she's 32 years old. She has P MS and menstrual cramps. Her periods are a little bit irregular. Um But today she comes in again, she intermittently, I had told her I would love to see her regularly to help with the menstrual cramps and irregularity. Uh because having her menstrual cramps means she would be taking at least maybe half a day off, whether she's taking a PTO or working at home or lying in bed with a heating pad because she's not really very functional for half a day once a month when she does get her period. If she does get her period, her periods are anywhere from every 1 to 4 months. Um So she's coming in today. The last time I saw her was perhaps two months ago and again, intimately seeing her perhaps once a month or every two months at her own discretion. Uh, she did not follow treatment plan. Uh, although I think part of it had to do with time taking off and, uh I think insurance coverage, which we could talk very briefly about them a little bit. So tell me if you can, what else is she coming in with today? Does she have a cough or cold? Did she sprain an ankle? Um, does she have a little bit of regret of stress injury. Is she having more stress? So, I'd love participants to come off, um, audio if you can or put things in the chat and Erica, if you could just holler out certain things that, um, people would like for me to treat Elsa for today. Um, I'd love to incorporate what that might look like and the acupuncture treatment. Mm. Neck pain, neck pain. Mhm. Chronic migraine. OK. Calf strain, calf strain. Yeah. Feeling tired. All right. So we'll go with that. So neck pain, feeling tired. She strained her calf maybe when she was exercising and she may have chronic migraine because she's been working hard um at a computer and she's stressed. So as I said, she does suffer from stress and all right, Elsa. So let's go ahead and I'm feeling her pulses here. I'm going to get the p here. Oh, so can you stick your tongue out for me? OK. So it doesn't take me very long to take a look at someone's tongue. Some of my colleagues might take a little longer. Um I studied with both um quite a few different Chinese uh practitioners and some the Japanese Suni as well, which is a very different style of acupuncture. All right. So Elsa, I'm going to go ahead and clean your points. So I'm just gonna look up up as you can see, I've got an alcohol swab in hand. Thank you a little bit down here. She has a skirt on. So I'm just gonna pull this up, just know in acupuncture. Although I might be doing some local points to help with some of her condition. I'm also doing some additional points that are not completely local to where the problem is. We can treat all kinds of conditions both locally and our way but not at the local area. So I have some acupuncture needles here. These are one time use. They're disposable. I'm going to pull one out just to have it closer to the camera. For those who are interested and curious, I've never seen an acute before. So this one happens to have a red handle. I'm gonna put it a little bit closer here. No, looks like people need. Let me stop sharing here. Thank you for letting me know. Is that better? All right. So here we have ma your needle and I'm just going to take this out. So this plastic part is called the guide tube. Some people will tap their needles in and I will do that in a little bit. So this red handle is the handle. That's what we call it. The needle handle and the body of the needle is this portion here. We do not put the whole thing in the body. We only put a portion of the tip in the body. The needles themselves are really tiny. They're as fine as a hair on your head and I'm looking at a little bit to see if you can see that a little bit more easily. It is a very flexible needle. It is a solid needle, which means there's nothing inside. Um, hi. Um, someone just walked into the room. Um, and this is a solid needle. So there's no hole in the middle. So we're not putting anything in the body. We're not extracting anything from the body. It's very comfortable. So let me go ahead and put that away here. All right. So I'm going to put a needle in here. So I'm tapping this in the forehead point. This point is called yin tongues. Very soothing and common point. Putting a couple of points on the back of Elsa's head and neck. Usually patients are very comfortable when they receive acupuncture. Most patients are lying down one of the side tables and I know it makes people will wonder, does that hurt? What I would say is it doesn't hurt. But the first time you do receive acupuncture, if you're anxious and tense, which is normal, the first time, you will likely because of having a little bit of more anxiety, of not knowing what to expect or anticipate, you will likely feel it a little bit more. So what does it feel like? It feels like a little pinch or a little bug bite at the moment of the insertion? That's really, it, it will really feel it just literally for one second. Or half a second with the insertion of the needle. There might be just a little bit of gentle stimulation. So I'm doing a little bit of gentle stimulation once I put the needle in. So Elsa, as I'm putting these needles in, have you been doing some cardio to help you with releasing tension in the body and helping some of the epinephrine and stress hormones are strictly out of your system and have a place for the stressful hormones to cycle out and really help the body improve its circulation and do a little bit of stretching afterwards. And are you taking breaks from looking at your screen that we talked about some time ago, once an hour, five minutes at a time and setting your outlook calendar or your smartphone calendar for an hourly reminder to get up. Well, have a sip of water, use the bathroom or even if you were on a Zoom call to see if you can stand up a part of that. All right. So this is what I'll see what like I'm going to kind of bring her head to toe. So you'll see on the frontal view here that there are points on the feet on her shins, which will also help with some of the calf calf muscle. These points are also helped with poor fatigue or her stress or her um menstrual cycle and with her migraines and neck pain, I'm going to go ahead and put these in the shops container and usually when the needles are set in place, they are, they are left in place and that the patient will rest in the room. It's usually quiet with or without music for about 20 to 30 minutes. Typically some patients might rest for a little bit longer with the needles for 40 minutes, um, or a little bit more depending on what the treatment is. So, acupuncture has been used, um both for disasters in disaster zones by acupuncturists without borders. Um Both those who fly in and those who um maybe local, for instance, at Ukraine, when we had the wildfires up in Napa Sonoma up in paradise, we had deployed some acupuncturists there, some were volunteers, some were from the local region. We traveled there to really provide um ear acupuncture points that can be done seated as I'm seated and I'm going to bring um ear. I don't know if you can see some of this. This is a one that has English words on here. Um that denotes different areas of the ear that can be used for the whole body and the ear is but one of many microsystems of the body that can be used for both diagnosis and assessment and treatment. So a microsystems essentially a part of the body that can be used to help the whole body. So the face is one, the scalp, the hands, the feet. So reflexology uses the hands and feet quite a bit, abdomen, the back, other areas of the body, um the tongue, we don't do needles for the tongue. Um But it is a microsystems that can give us information about what is going on in the whole body. Uh So these areas are microsystems of the whole body. All right. So I just want to stop there and see if there's any particular questions. Um Erica, can you read through some of the questions in the chat? Sure. Um The first one is why is it recommended to have something to eat prior to an acupuncture session? Also, why is it that I am exhausted and tired after a back acupuncture session? Is that normal? Ok. So, um let me address the first question. What is it important to eat? It is important to have something in your stomach before you go in for an acupuncture treatment to reduce the likelihood of fainting or feeling lightheaded. Because um depending on the individual, some people may feel more easily, faint or lightheaded, faint, um uh lightheaded. If you will, we wanna reduce that risk. And when we are putting acupuncture needles in the body, we are stimulating the body to do some work. It is not um just a nap. If you will with acupuncture needles in the body, it is a therapeutic treatment. Needles are stimulating your body to do some work if your body does not have quite enough energy. And if the acupuncture needles are a little too strong for what your body's ability to provide the energy to move those things and do what the needles are meant to do. You can feel very lightheaded and not feel very good. Um Eric, can you repeat the second question again? Oh, sure. Yeah. Uh Why is it that I am exhausted and tired after a back acupuncture session? Is that normal after a back acupuncture session? So I don't know what your condition is, um or the acupuncturist or if it's just the fact that you may be getting um back, only acupuncture and feeling tired. Um So it may be that they added the electro stimulation to it that may be causing more movement and more fatigue or that there are a lot more needles being used. So it may be a stronger treatment for your, for your system. Um If you're feeling really tired for a long time. So what's a long time? I would say if you feel tired every single time after receiving uh you know, a back acupuncture treatment for back pain, you need to let your practitioner know um in a long time would be if it's more than three days, if you feel really, really tired or completely exhausted, even for a couple of days, you do need to let your acupuncturist know that should not be the case on an ongoing basis. Great. And the next question is, how well does it work for post stroke patients? So, the outcomes will be much better for somebody who has had their stroke more recently. So, if a person suffered their stroke five years ago, and they've just started to do acupuncture and they've started to work with me, our ability to get the outcomes, the best outcomes we can garner will be greatly reduced. So the best outcomes to help with a poststroke um paralysis, patient is to start after the patient is, you know, considered stable. There's no bleeds going on in the body and they are cleared to receive acupuncture usually within a few months, if not, you know, like three or four months, if not sooner, if there are no bleeds in the body to really help recover some of the faculties. OK. Is there a maximum number of needles that should be used during treatment uh to avoid any adverse reaction? A cut? And that's going to be, yeah, it really. So for acupuncture needles, I'll um address those separately. Uh it will really depend on the individual patient. Each person's body is going to be really variable with how they respond to treatment. I have some patients who are extremely sensitive, they get the outcomes and results I need by just placing ear needles uh for their body. I had patients who I need to use electro stimulation for their needles to get the best outcome for their body and they tolerate it really well. And if I use electro acupuncture for some other patients, it becomes way too strong for the bodies. So it is really dependent on the clinicians, ability to gauge what is too much for that individual's body to get the results that we're looking for. And I know the studies, I've shared the research when we're looking at research from a Western medical standpoint, it is not truly individualized so we can learn um kind of fundamental knowledge of what's working. What's not. This is the question that some of the, you know, research I've shared with you about um around chronic pain, what's working, what's not, how does, how can we make broad statements and conclusions or inferences from what we've learned in the research? But every time my colleagues and I work with patients, it is really individualized for each person and each session for cupping um cupping. Again, it's going to be dependent if it's used with acupuncture or not. Depends on the patient, depends on how strong of the cupping um uh experience or technique we're using as well too. So again, that's going to be contingent on the on the patient's body. Um If you as a patient have questions, your concerns or you want to just find out why please ask your practitioner. I think I think many of my colleagues would be more than happy to address your question. Hey, uh may you share more information on insurance coverage for acupuncture? Absolutely. So not everybody has coverage for, for acupuncture, but because we are in California. Um More than many other states and we have about a third of the acupuncturists in the country practicing in the state of California, which is really fortunate for all of us. Um But I would still say we can still have more to really provide uh service for our wonderful communities. Um So I would say first call your insurance company, the number on the back of your card, ask them if you have acupuncture coverage. I don't know. Um if your hr folks might be able to provide a little bit of uh support there. But certainly if you have different insurance types that are offered to all of you, your insurance coverage will vary from staff person to staff person. So the best bet is to call your insurance company and inquire if there's acupuncture coverage. If it is part of an in-network provider, then you need to know who those providers are. What are the limits if there's number of uh visits per year? Uh Is it limited to certain conditions such as pain only versus, you know, chemotherapy, nausea, vomiting or can you see someone for pretty much anything? Um And if you do not have acupuncture coverage through your insurance company, if you have a health care flexible spending account, you can save your receipts from your acupuncturist in order to get reimbursed for those acupuncture visits through your health spending account. Ok, next question. Thank you. Um When would electro acupuncture be used over traditional acupuncture. Um Again, that will really depend on the condition. So, depending on the patient's body's uh response to treatments, depending if um also on the clinician, I have some colleagues of mine who rarely use electro acupuncture. Um I myself, depending of on my patient population, I do see a lot of cancer patients. Historically, I work with a lot of women's health. I've shifted to working with a lot more medically complex patients with um a lot of needs and um might have food uh scarcity as well too and insecurity. So working with a lot of high needs patients with medical complexity. Uh if their bodies do not, if they respond well enough to acupuncture, then I may not need to use electro acupuncture. But if they are not responding enough to the degree I would like for us to improve, I may try electro acupuncture for the conditions that we're treating and see if their bodies respond well to it or not. And electro acupuncture itself can really be dialed up and dialed down. No pun intended there. But um it can be really gauged based on to the patient's comfort level of doing that to a degree that's comfortable versus a super strong stimulation. And have you seen covered with Tricare Triwest uh Military insurance? Oh, the va um yes, I have seen there's definitely Triwest does cover acupuncture. We unfortunately do not accept Triwest at U CS F there are select providers who are in the Triwest um network. So I would definitely recommend that you do contact Triwest and see, uh you know what your region is coverage, who's in the network. I do know certain VA S in the Bay Area do have acupuncturists there. Um I know San Francisco VA has one acupuncturist who is a colleague of mine. Um I know other acupuncture down at the San Mateo one. Again, it depends on the va itself. Some VA s do not have acupuncturists uh like myself, but they may have other providers like a nurse or nurse practitioner or physician's assistant who may practice acupuncture or not. So you need to ask and find out I would really, really encourage all of you just to really seek out acupuncture and Chinese medicine because it really helps to support you at any stage in life. We do treat pets or, or young Children and, and um infants, we do see infants in the hospital. Um They usually don't need acupuncture needles unless they're super sick like they are in the hospital here. Um Oftentimes, um just hands on work is really all we need. Um And nowadays, of course, there's acupuncture for all animals as well too such as this um this uh uh display I have here. Any other questions or comments? I just want to be mindful of everyone's time. I don't see anyone in the chat right now. I'm curious how many people have had acupuncture. It sounds like there's at least one or two people um, in the chat who have had acupuncture, you could just raise your hand up, um, or unmute yourself folks. Oh, wonderful. Ok. So there was a question that came up, what is the treatment plan and time for chronic migraine and outcomes? So, for chronic migraine, it depends on what else is going on. You know, there, there's all kinds of things. I would always work with my physician partners to rule anything out. So if you've been, you know, assessed by physicians, you might be working with a neurologist that specialize in, in migraines. I would definitely want to be looking at diet and lifestyle, stress management, sleep hydration and diet. Um, you know, taking a look at supplements and your fundamental, you know, uh fluid and hydration exercises, um, and things of that nature and really be able to look at, um, what else can we do like physical therapy? Um And the treatment outcomes are quite helpful. Again, it would be dependent on how bad are your migraines, the intensity of the pain level, the frequency of them. Um, what are the symptoms and really being able to do a log of those different symptoms over time? And see, I would probably for someone with migraines once or twice a week would be the treatment plan to start with probably for at least 12 to 20 sessions. And then during that time frame, looking at the diet, the lifestyle and all the other things that I talked about and then starting to fold those recommendations in because just using acupuncture by itself is just one tool I'm always looking for. How else can we maximize and optimize for a sustained period of time, the best outcomes we can possibly get for chronic migraine or whatever the conditions might be. And oftentimes people come in with multiple conditions and then we need to kind of figure out which number one, that's number two, it's number three and priorities and really to take it from there, um The outcomes are generally really good. Uh You know, some of the research that I've shared with you, some specifically for chronic migraine. Any other comments, questions? I just have like a few moments in my chat right now. I hope this has been helpful for everybody. Yes, it has Helen. Thank you so very much. I've never had acupuncture before myself. So you sparked my curiosity. It's been around a very long time and it really benefits all kinds of conditions. And for those who don't have a condition, as I stated earlier in my presentation, it is wonderful to be evaluated when you don't have anything diagnosable because you do. We all want to stay well, especially as we get older. So aging gracefully, we're all living longer. And also during the time of COVID, we want to make sure that we're staying as well as possible. Uh, we're going into the cold and flu season also. How do we strengthen our immune systems as we go into the season? And what measures can we do to strengthen our bodies? So we don't get sick and if we do get sick that it's relatively mild. Thanks, sir. And I appreciate your, uh your comments in the chat. Yes, it was. Thank you, Helen. Um If there's any more questions for Helen, this is no more questions. We really appreciate you joining. Um It was, it was very informative, so very well done. Thank you so much. We enjoyed it. So, um is there if there's other questions Helen? Like after this or something, I can maybe gather the questions. Um You guys can send your questions to me, Erica Van. Um Just send it to my email and I can forward it to Helen. Um Thank you very much, you guys. Yeah, absolutely. I appreciate it. Thank you so much. All right, everyone. That's it for today. Thank you. Thank you for having me. I appreciate it.
