Symptoms of Stress
Stress, this is something that more and more of my patients are experiencing daily and finding that it is interfering with their health and happiness. Recently there have been several medical studies showing the relation between high stress levels and decreased health. In Chinese medicine stress affects the flow of qi and eventually blood flow within the body, causing stagnation.
Some common symptoms of stress
- anger, irritability, frustration
- stiffness in the muscles, commonly neck and shoulders
- trouble sleeping
- irregular menstrual cycle
- premenstrual symptoms, moodiness, breast distension, bloating
- migraine or tension headaches
- chest constriction, anxiety
- frequent sighing
- gastrointestinal disorders
- poor concentration
- Irritable Bowel Syndrome
What can you do to Manage Stress?
Acupuncture helps to move qi and blood and relieve stress. Acupuncture releases endorphins and serotonins within the brain and has a deep relaxing effect on the body, many people fall asleep while the needles are in. A medical study done at the University of California found that acupuncture decreases the sympathetic nerve activity during mental stress, lowering blood pressure and heart rate. Many people feel more energetic after as little as one treatment and have a marked improvement after 6-10.
Herbal Medicine is also effective to help manage stress and control the symptoms of stress within the body. Personalized herbal formulas in granule or capsule form can help with insomnia, digestive complaints, fatigue, headaches, menstruation, PMS symptoms, IBS, anxiety and muscle tension. Herbal medicine can be used alone or is most effective when combined with acupuncture treatments.
Acupressure is a treatment that can be performed by yourself or a partner at home. Stimulating certain acupuncture points on the body help to relieve stress and aid in circulation of energy.
LI4 – located between the thumb and second finger at the highest point of the web between the fingers. This point helps to release emotional mental and biological toxins from the body.
Liver 3 – located in the web between the first and second toe. This point in conjunction with LI4 is called the four gates, points used to open the channels and remove stagnation and toxicity.
P6 – located two inches up from the wrist crease on the palm side in the middle of the forearm between the two tendons. This point is used to help calm the mind.
Lifestyle Suggestions to Lower StressBreathing- Many of us are shallow breathers, breathing from the upper lungs, this can often be amplified with stress. Shallow breathing does not allow the qi to circulate properly within the body. I recommend spending 5-10 minutes a day focusing on our breath and bringing the inhalation down to the belly and expanding our diaphragm and on exhalation releasing air and contracting the diaphragm. Breathing exercises will have a profound effect to lower stress levels.
Meditation/ Visualization - Taking 15-30 minutes a day to meditate or use positive visualizations dramatically lower stress levels.
Exercise - Moderate exercise helps to reduce stress and effects endorphins released from the brain. Exercise also moves qi and blood.
Yoga Pilates, Qi gong – these exercises focus on the breath and help to move and build qi.
Friends and Family - having a support group is very important to help minimize stress. Allow time during the week to spend with friends and family.
Therapist - Someone who is trained to help you deal with stress and make positive changes in your life.
Do not eat late at night
- Eat small meals more frequently throughout the day
- Chew food well
- Do not overeat
- Do not drink too much fluids with meals
- Pay attention to eating, sit down to eat.
- Eat organically, locally and seasonally.
Foods to Eliminate/Reduce
- deep fried greasy foods
- sweets, pastries, simple carbohydrates
- alcohol, nicotine, caffeine, recreational drugs
- spicy foods
Foods to Add
- Spices to move qi- turmeric, caraway, rosemary, chive, mustard leaf, basil, thyme, mint.
- Cruciferous vegetables such as cabbage, broccoli, cauliflower, brussel sprouts
- Leafy green vegetables
- Organic lean meats and fish
Question of the Month:
Can stress affect my fertility?
Absolutely, stress has an effect on the hormones that are secreted from the brain which can alter the menstrual cycle and effect ovulation. Stress also effects blood flow to the reproductive organs which also will have an effect on fertility.
I would like to invite you to the third year anniversary celebration of Comox Valley Acupuncture and Traditional Chinese Medicine on Thursday September 27th from 5-8:00pm at 2311 Rosewall Crescent, Courtenay. Join Michelle for refreshments, appetizers, door prizes and meet her friends Leanne Zdebiak Eni form Island Pilates and Sarah Seads from Equilibrium Lifestyle Management. Bring a friend and I hope to see you there.
I am very excited to be attending an advanced course in Vancouver by Peter Deadman, a much respected practitioner of Chinese Medicine from the United States on male health. During this course I will expand my knowledge of male reproductive health to further help couples achieve their dream of a family.
Of the persons who seek out Chinese medicine interventions for painmanagement, the vast majority are for pain in the back and in particular pain in the lower back. In many cases, acupuncture is able to offer much-needed relief.
Many persons experiencing back pain complain of one or more of the following:
Shooting or stabbing pain.
Pain which radiates down the leg.
Muscular spasms and tightness which, if severe, may affect range of motion and the ability to stand straight.
Back pain may be caused by:
A strain of a muscle or ligament: this may be brought on by physical strain or injury.
Herniated discs: a bulging of the cushion between the bones of the spine (vertebrae).
Arthritis: this may cause narrowing of the space through which the spinal cord passes.
Skeletal abnormalities: such as scoliosis.
Osteoporosis: causes brittle bones, which, in turn, may lead to compression fractures of the bones of the spine.
In addressing any pain along the back, the location and trajectory of the pain is first clearly identified. Once this is done, it can be determined which meridian/pathway the pain falls on. Very thin acupuncture needles are then gently inserted at acupuncture points local to the area of pain.
Xi-Cleft points: Additionally points known as xi-cleft points on the identified meridian are needled. Xi-Cleft points occur on all the primary acupuncture meridians and are used for pain which occurs anywhere along the path of the meridian.
Du Mai and Hua To points: In the case of pain directly along the spine, points from the Du Mai meridian with points located between the spinal vertebrae are selected, often along with points which run immediately alongside the spine known as Hua To points.
Since the acupuncture needles are very thin, there is often minimal to no discomfort during the procedure.
In cases where there is muscular tightness or spasms, cupping may be done prior to the insertion of needles. Suction cups are placed in the area of discomfort and slide along the skin, lifting both the skin and muscle just below, allowing the relaxation of the muscles and enhancing the overall effectiveness of the treatment.
Electrical stimulation involves the application of a mild charge to the tips of an inserted acupuncture needle in order to increase the stimulation and pain-relieving effect of the acupuncture stimulation. It is not meant to be an exercise in how much one can bear as it is a means of gently stimulating the point.
Course of Treatment
The number of acupuncture treatments needed will depend on the severity of the condition. Improvement is usually noticed within the first two weeks of treatment, which may be done once or twice weekly, usually accompanying a prescription for rest.
Chinese herbal formulas
In addition to acupuncture, herbal prescriptions may be given. These herbs are used to relax the muscles, reduce swelling, and nourish the bones where degeneration or deficiencies exist. Several herbs are usually combined to create the ideal prescription.By Tracey-Ann Brown, Complementary & Oriental Medicine
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Both western medicine and Traditional Chinese Medicine recognize two categories of headaches: primary and secondary. A primary headache is a clinical condition, not a symptom of another disorder. Primary headaches include tension headaches, migraines and cluster headaches. Secondary headaches are caused by other medical conditions such as sinus disease, allergies, dental disorders, head injury or brain tumors. Acupuncture is used to effectively treat primary headaches, namely tension and migraine, which are the most common.
Types of HeadachesThere are a variety of different types of headaches, both primary and secondary. These include the following:Tension Headaches
Tension headaches, which occasionally affect most people, are the most common type of headache. They are recurrent headaches, and can last anywhere from minutes to days. These headaches are experienced as a dull pressure, mild or moderate in severity.
Migraine headaches are usually one-sided, pulsating or throbbing, and moderate or severe in intensity. They can be worsened with activity and may be associated with nausea and/or vomiting, as well as sensitivity to light or noise. Some patients also experience auras, a neurological symptom that develops gradually over 5-20 minutes. The patient may see brief flashes or waves of light, or changes in their vision. Other common features of auras include vertigo, imbalance, confusion and numbness.
Headaches occurring every day or almost every day are referred to as chronic daily headaches or rebound headaches. Sometimes they resemble tension headaches, and at other times, migraines. The overuse of pain medications can result in aggravating headache patterns.
Some headaches may be signs of a serious medical condition. These include headaches after trauma, headaches in the elderly, or headaches with any of the following symptoms:
Acupuncture involves the insertion of fine needles into specific points on the body, followed by gentle manual or electrical stimulation of the needles. Blood flow in the tissues increases when small vessels around the area of the needle dilate. While actions designed to increase circulation are generally an excellent treatment for pain, such a treatment is not beneficial in the treatment of migraines. Because the pain of a migraine may be associated with the dilation of blood vessels in the head, increasing circulation in this area can worsen the patient's symptoms. At New York AcuHealth, we utilize a unique approach to the treatment of migraine attacks. By avoiding points in the head, neck and upper body, and instead using points exclusively in the lower body, we avoid dilating the blood vessels of the head. The entire treatment is often performed with the patient in a recumbent position rather than in a prone position. This also minimizes dilation of the blood vessels during acupuncture.more >>>
- Vomiting without nausea
- Severe dizziness
- Extreme neck pain
- Sudden onset
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Read aboutAcupuncture Relieves Stress: New Understanding Of Why The Ancient Practice Eases AnxietyNeedle This: Study Hints at How Acupuncture Works to Relieve Stress
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Good news, acupuncture fans: It really does help relieve stress. And now, a new study is giving a closer look at why.
The new study explores the biological mechanisms involved in acupuncture's stress-relieving abilities, something science has yet to fully understand.
The researchers discovered that stress hormones were lower in rats that had received electronic acupuncture. Results were published in the Journal of Endocrinology.
"Many practitioners of acupuncture have observed that this ancient practice can reduce stress in their patients, but there is a lack of biological proof of how or why this happens. We're starting to understand what's going on at the molecular level that helps explain acupuncture's benefit,” study researcher Dr. Ladan Eshkevari, an associate professor of nursing at Georgetown University School of Nursing and Health Studies, said in a statement.
For the study, Eshkevari and colleagues designed a series of tests with electronic acupuncture to ensure that each rat received the exact same dose of pressure. Eshkevari targeted the spot below the knee, or the “Zusanli” point, with the needle. This area is the same in rats and humans and it is reported that stimulating it can alleviate stress and other conditions.
For the 10-day experiment, researchers split the rats into four groups. One group was a control group with no added stress and no acupuncture; one group was made to be stressed out for an hour each day but didn't receive acupuncture; one group was made to feel stressed for an hour each day but received "sham" acupuncture by their tails; and one group was made to feel stressed and received the genuine acupuncture treatment at the Zusanli area.
The body secretes an assortment of hormones into the bloodstream as a reaction to stress, which the researchers were then able to measure in the rats. They assessed blood hormone levels secreted by the hypothalamus, the pituitary gland and the adrenal gland -- together these are known as the hypothalamus pituitary adrenal (HPA) axis. They also measured a peptide involved in creatures' "fight or flight" responses, called NPY.
Researchers discovered that the "...electronic acupuncture blocks the chronic, stress-induced elevations of the HPA axis hormones and the sympathetic NPY pathway,” Eshkevari said in the statement.
Since stress has been linked with detrimental health effects includingheart disease and even brain shrinkage it’s important to study any measures to combat its detrimental nature.
Never gotten acupuncture, but interested in trying it? Click through the slideshow for some pointers on what to expect at your first appointment:
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Needles may not seem like the best tool for treating stress, but acupuncture could be tapping into basic biological systems that keep stress under control.
Reporting in the Journal of Endocrinology, researchers led by Ladan Eshkevari, assistant program director of the nurse anesthesia program at Georgetown University School of Nursing and Health Studies, mimicked chronic stress in a rat model and documented how stimulating certain body points with acupuncture can alter stress hormones.
The body’s stress response is triggered by two main pathways, one of which involves the HPA axis, or hypothalamus-pituitary-adrenal axis, in which these areas of the brain are activated to release peptides and proteins such as corticotropin-releasing hormone (CRH). They, in turn, launch the production of other hormones such as cortisol and norepinephrine that rev up the anxiety meter. Once activated, the system causes the heart to beat faster and the senses to go on alert. It also diverts the body’s energy away from background operations such as digestion to prime and fuel the muscles into a state of readiness.
MORE: The Two Faces of Anxiety
All of this is normal and necessary for protecting mammals, including us, from potential threats. But when stress becomes chronic, beating us down hour after hour and day after day, it’s no longer helpful and can become harmful. “People under chronic stress don’t handle acute stress very well,” says Eshkevari. “In chronic stress, the cortisol levels are elevated and never come back down to baseline, so people end up with insomnia or depressed or anxious because of the constant ramping up of this system.”
When Eshkevari, who is a nurse anesthetist, noticed that many of her patients who used acupuncture to treat pain reported sleeping better and feeling better able to cope with their pain, even if the needling did not relieve the pain itself, she wondered whether acupuncture might help to reduce stress.
MORE: Work Stress Linked to More Heart Attacks
There weren’t many studies documenting how acupuncture could affect physiologic stress pathways, however, so she designed one using rats to investigate how the relationship might work. To create chronic stress in the animals, she exposed them to an ice bath for one hour a day over 10 days. One group of animals was just exposed to the ice bath, while another was treated beforehand with four days of electroacupuncture in a known active site in the stomach. And another group of rats was treated with a sham version of the acupuncture in a non-essential point 5 mm away. Eshkevari used an electric-based acupuncture in order deliver standard amounts of stimulation to the animals and avoid any confounding effects of inconsistent activation of the stomach site.
To monitor levels of the stress hormones and their precursors, she and her colleagues also collected blood from the animals on the first day and again on day seven and 14 of the study. These levels were compared to those of control animals that were not treated to the ice bath.
MORE: Study: Acupuncture May Change the Way the Brain Perceives Pain
As expected, the animals that were only treated to the cold-stress showed higher levels of CRH and other stress hormones after their exposure. And the sham animals showed similar levels of activated stress hormones. But those that were pre-treated with acupuncture showed no such spike in these hormones. In fact, their CRH levels were similar to those of the controls who hadn’t been exposed to the ice bath at all.
“The acupuncture seemed to help recalibrate, or normalize the [stress] hormone levels, at least in this model using the rat,” says Eshkevari.
So instead of keeping the animals in a constant state of anxiety, the acupuncture seemed to dial down the heightened stress response and return it toward normal levels.
MORE: Is Acupuncture an Antidote for Allergies?
Whether that also occurs in people isn’t clear yet, but since the HPA axis works in similar ways among mammals, it’s possible the results could improve understanding of how to manage stress in people as well.
As far as why the needling at the stomach-point in the rat seemed to be so effective in tapping into the stress response, Eshkevari says there is evidence for a strong brain-gut connection, both in western and Chinese medicine. It may explain why, for example, we tend to eat when we feel stressed, or develop digestive disorders like constipation or diarrhea when we become especially anxious.
MORE: Acupuncture: A 2000-Year Tradition of Placebo Effect?
Eshkevari is currently repeating the experiment in animals who have already been stressed by the exposure to the ice bath. The goal is to determine if acupuncture can function not just as prevention but as a treatment as well. Even if acupuncture doesn’t prove to be a magic bullet, it may lead to better understanding of the HPA system and other ways to break the cycle of chronic stress.
Read more: http://healthland.time.com/2013/03/15/needle-this-study-hints-at-how-acupuncture-works-to-relieve-stress/#ixzz2RYFhtnfC
By Alice Park
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The Psychobiology of Pain
Isn't it interesting that the number one reason people visit a healthcare provider is because of pain. Chronic pain affects about 100 million American adults—more than the total affected by heart disease, cancer, and diabetes combined. Now consider this: the number one reason people avoid seeing an acupuncturist is because they are afraid of pain!
Even practitioners with the best needling skills have trouble attracting patients who are afraid of needles. Do you have options in your clinic for these patients? Fear of needles is very real and will often cause potential patients to reject even the idea of acupuncture treatment. Often you will hear many people say, "Acupuncture? Nobody's going to stick a bunch of needles in me!"
And yet, there are multiple ways to move qi and blood in the body, providing excellent results without needles. Modern research has provided new opportunities for acupuncture treatments that did not previously exist, including microcurrent, magnetic treatments and laser acupuncture.
Laser acupuncture is practiced widely throughout Europe and Asia and is quickly gaining popularity in the United States, though it still remains confusing to some practitioners. Deciding which type of laser to use and how to use it are the primary questions with which many practitioners struggle. To help you come up to speed and make the right decisions, here's a primer on laser acupuncture.
History of Laser Treatment
Scientists began lab experimentation with lasers in the 1950s, with availability outside the lab in the 1960s. Once the quest for laser knowledge began, it was unstoppable. Researchers wanted to know how this new kind of light could change the world of healthcare. Early laser experiments resulted in the realization that laser therapy minimized skin scarring, helped wounds heal faster, and affected cellular metabolism.
In the 1970s serious research began both in Russia and in the USA. By the 1980s, due to numerous positive reports, laser started to gain recognition as an effective method of stimulating acupuncture points without the use of needles.
Today, photobiology is the study of how light affects living things, and includes studies of single-celled organisms, plants, animals and humans. Laser acupuncture is an important field of study within photobiology.
Most lasers used in acupuncture are known as low-level lasers or "cold lasers," (because they don't produce heat.). These are not the same as lasers used for laser surgery, in which "hot lasers" are used as a scalpel to burn or cut. Studies show that low-level lasers can help regenerate cells, decrease pain, reduce inflammation, improve circulation, and stimulate hair growth, to name a few examples.
In 1991, a study was done in Novosibirsk, Russia that applied directly to the study of acupuncture. Researchers shined light on various parts of the body and found that light traveled under the skin to other acupuncture points, but it didn't travel to places that were not on acupuncture meridians. It appears that the body contains a sort of fiber optic network—where light enters an acupuncture point, travels through the meridian and can be detected at other places along the meridian with a sensitive photon detector. This is a fascinating study showing how light is actually received, used and transmitted throughout the body.
Recent studies on laser acupuncture have included advanced brain imaging, as well as several other modern protocols for measuring various physiological effects to the body. These studies show that laser acupuncture has physiological effects, not only locally, but also in the brain, similar to needle acupuncture. Laser on Urinary Bladder 67, for example, shows measurable effects in the brain. The effects were only detected when the laser was turned on. When the laser was turned off, no effects were detected.
Multiple published studies have shown good effects of laser acupuncture for the following conditions: hiccups, bed wetting, weight loss, post-operative nausea and vomiting, pain control, surgical anesthesia, dental anesthesia, carpal tunnel syndrome, dry eyes, and stroke-related paralysis. Obviously, as more studies are performed, more information will be found.
All this evidence is great news for us as acupuncturists.
Advantages to Using Lasers
Perhaps the greatest advantage of laser acupuncture is that it's completely painless. This is a great way to attract patients to your clinic who may have needle phobia.
Most patients feel nothing at all during laser acupuncture. Occasionally I hear of patients who feel something, but it isn't something they can describe really well. I believe they are feeling an energetic shift in their body. Some even describe an energetic sensation propagating along the meridian being treated.
You've already done the hard part by diagnosing and deciding which points to use. With laser treatment you simply light up the point for a number of seconds, depending upon the power and output of your laser, and then move on to the next point. It's fast and easy. We're talking seconds in comparison to needle retention time, which may be 20 to 30 minutes.
Because you are not breaking the skin—there is zero risk of infection. A couple of summers ago I volunteered my services at a summer camp for kids with cancer. The organization had concerns about the legal issues involved in treating kids with needles, so instead I used lasers and experienced great results.
Laser acupuncture is also effective and often shown to be as effective as needle acupuncture for a variety of problems. Effectiveness is enhanced because laser acupuncture allows you to treat points you otherwise might not be able to treat, due to patient age, sensitivity, or fear.
A number of practitioners (depending on the legality in their state) are actually training patients to self-treat during the interim between visits by sending them home with a diagram of recommended points and instructing/helping them to obtain a proper laser. This is especially effective for chronic-pain patients. Keeping movement in the channel between treatments helps chronic-pain patients to heal faster.
How to Perform Laser Acupuncture
The hardest part is deciding the correct points to treat and knowing the correct type of laser to use (which we will discuss further below). Any point on the body can be treated with laser except for those near the eyes. Even if your patient has a wound or an injury, you can shine laser light onto that area without contraindication.
Depending on the power and type of laser you are using, generally you are going to treat for approximately 15-60 seconds per point. Most practitioners report having good treatment effects in 10-15 seconds, depending on the type of laser used. Points that require deeper needling, like the legs and torso, may need longer treatment times. Ears, hands and feet require less treatment time.
Some lasers require the use of safety glasses. A lot of lasers used in acupuncture don't need glasses because they are Class IIIa lasers. These are considered eye safe because the blink reflex is fast enough to prevent any damage to the retina. Higher-powered lasers (Class IIIb) require safety glasses for both the practitioner and the patient.
Regardless of the type of laser you use, it should never be used around the eyes. Also, even with a Class IIIa laser, you should never stare directly at the beam or even the dot on the skin. In fact, if the skin is intact, it is a good idea to have the tip of the laser actually touching the skin to minimize light scatter or light reflection—which decreases the possibility of a reflective beam causing damage to the eye.
Because lasers have been shown to stimulate cell growth and repair, it's not a good idea to treat where you don't want cell growth. You obviously wouldn't want to laser someone's skin cancer, for example.
The Right Equipment
Lasers can range in price from under $100 to over $10,000. It's important to understand the equipment you are using so you get the best results.
What really matters is the output. It's the light that the laser produces that decides the outcome. Are you using the laser only to treat acupuncture points? Are you planning to treat broad areas or conditions (joints, inflammation, pain, etc.)? Each of these scenarios would require different laser capabilities.
I'm going to focus specifically on activating acupuncture points to move qi and blood in the channels. Here are some terms to be aware of:
Some laser manufacturers endorse a higher-power approach, while others endorse lower power. I think of the alternatives in terms of communication. Both shouting and whispering are effective forms of communication. The high-powered (Class IIIb) infrared lasers penetrate deeply and deposit lots of energy into the tissue. This is the shouting approach. The 5 mW laser is more like whispering, but because you are dealing with the power of the meridian system, all it needs is a little push, or a whisper, to do what needs to be done. In this instance you are working with the energy system of the body to help get the job done, so it doesn't take a sledgehammer to do it. Given then inherent safety of Class IIIa, I prefer the low-power approach.
- Wavelength: This refers to the color of the laser and is measured in nanometers (nm). At the high end of the color spectrum, we find violet and ultraviolet in the 400 nm range. At the low end of the spectrum, we find infrared light at 700 nm and above. Common acupuncture wavelengths are red, in the 635-650 nm range. Other colors you may find available are blue, ultraviolet and green. Different wavelengths have different applications.
- Output: This refers to the power or brightness of the beam, measured in milliwatts (mW). Most commonly you will find 5 mW lasers for acupuncture—which are classified as IIIa according to the FDA. Though these lasers have a lower-power output, they work well for acupuncture.
635 nM (Red) -The most common.
There are also reds in the 650 to 670 nm range, which are laser pointers that you buy at an office supply store for presentations. These are not particularly well suited to acupuncture and do not have the same biological effects as 635 nm lasers.
- The same wavelength produced inside the cells of the body, so it is biologically compatible with the body.
- Stimulatory effect: increases ATP production in the cell.
- TONIFYING effect on an acupuncture point.
450 nM (Blue) -NEW on the market.
700-1000 nM -Infrared Lasers.
- The previous so called blue was really an ultraviolet. The NEW 450 nM is pure sapphire blue.
- SEDATES or calms the channel.
- Don't confuse this with the 405 violet/ultraviolet sometimes sold as blue/purple.
532 nM (Green)
- Deep Penetrating.
- No visible beam.
- Produce heat.
- Deep wound healing and pain treatment.
- Not for typical acupuncture, although some studies have shown good results.
These systems are on the expensive end.
- Poor penetration of green wavelengths.
- Very little research to prove success rates.
It's hard enough bringing new patients into your clinic without the fear of needles compounding the problem. Patients who are in pain should not be afraid that you are going to cause more pain during treatment. Laser acupuncture is an excellent way to provide effective treatment without needles. The cost to incorporate it into your clinic will quickly pay for the investment. Check with your state board, and if laser acupuncture is legal in your state, I highly recommend you add it to your clinic.By Kimberly Thompson, LAcmore >>>
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Managing a Natural Healing Service Business
Microcurrent therapies consist of very low-intensity electro-therapeutic currents delivered to the body for pain relief, assisted rehabilitation and electronic, non-needle acupuncture. Microlight therapy is the combination of microcurrent and color light therapy.
Both microcurrent and Microlight can be considered to be part of the growing field of Energy Medicine – the use of energy frequencies and wavelengths to promote accelerated healing and well-being.
There is now wide recognition of the value of microcurrent therapies for pain relief. What is less understood are its valuable applications for treatment of neuropathies, neuro-muscular degenerative diseases and internal medicine. Special treatment protocols are required to address these conditions. Knowledge of appropriate acupuncture points is required for good results.
The focus of this article is the uses of Microlight therapy for treatment of diabetics. While there is much anecdotal evidence for the effectiveness of this approach no formal studies have been published to date. I will explain two ways Microlight can be used to treat diabetics.
It is beyond the scope of this article to fully explain the use of acupuncture and adjunctive therapies for diabetes. Good acupuncture treatment for this condition requires differential diagnosis and choice of appropriate acu-points. Major TCM diagnostic categories for evaluating diabetes include Spleen qi deficiency with possible dampness or damp heat, Liver qi stagnation with possible Liver Fire, or wasting disease of one of the three regions of the Triple Warmer. Once good differential diagnosis and acupuncture treatment planning has been accomplished the addition of vibrational medical methods can significantly improve outcomes. Therefore the treatments described in this article should be used as a complement to a good acupuncture treatment.
Microcurrent therapy has been shown to reduce or even fully eliminate the symptoms of peripheral neuropathy.No therapy for treatment of diabetes is likely to be effective without needed dietary and lifestyle changes being implemented. Such programs are called Therapeutic Lifestyle Change (TLC). The NIH has mandated that physicians first put their patients on TLC programs before starting them on long-term regimes of medications. It is likely that acupuncture and energy medical therapies could reduce the amount or duration of medication needed. The therapies for treating diabetes can also be helpful for weight loss and management. The Ideal Weight Program™ developed by Debi Weiss, R.N., L.Ac. is highly effective for weight loss and "diabesity", a complex condition encompassing both diabetes and obesity.
While a patient is making necessary dietary changes Microlight therapy can be useful for treating diabetes in the following ways:
1. Alleviation of peripheral neuropathy (PN)
Microcurrent therapy has been shown to reduce or even fully eliminate the symptoms of peripheral neuropathy. Positive results have been noted for treatment of neuropathy in diabetics and AIDS patients who were experiencing the side–effects of long-term medication regimes.
Treatment techniques include:
Richard Niemtzow is a retired Colonel in the U.S. Air Force who has introduced many acupuncture treatments, as well as microcurrent therapy, into the military. Dr. Niemtzow developed a protocol for treatment of PN that showed positive results for many military personnel. It called for 20-minute microcurrent treatments every other day for 1 – 3 weeks. I have personally experienced very positive results with my patients using a version of this therapy. His suggested microcurrent frequencies were 0.6 and 1 Hz.
- Application of pad electrodes to the legs, with special frequencies and polarity patterns being utilized.
- Treatment of acupuncture points on the legs and lower back with needle acupuncture and/or Microlight probe electrodes that strongly promote energy circulation and help "wake up" dysfunctional nerves.
I have found that the most effective form of pad electrode treatment for PN uses a sequence of Russian stimulation followed by microcurrent. Russian current is a modality devised by Kots in the 1970s for the Russian Olympic team. It consists of a complex milliamperage pattern and is applied to the body for muscle strength building. I have discovered, quite serendipitously, that this form of current can also be very effective for treatment of post-stroke, peripheral neuropathy and other neuro-muscular degenerative conditions. Further, I have observed that best results are produced by applying 5 – 15 minutes of Russian stimulation followed by 10 – 20 minutes of microcurrent through the same pad electrodes. This form of sequence therapy, plus Microlight probe stimulation, is available through the Acutron device.
The osteopath and naturopath H. Van Gelder discovered energy frequencies that can help heal a wide range of health disorders. Most of these frequencies can be applied through microcurrent stimulators to good effect. During the 10 – 20 minute period of microcurrent application through pad electrodes described above the following frequencies which could be supportive for treatment of diabetes could be applied:
In most neuropathy cases needle acupuncture can be used simultaneously with this pad electrode sequence. Useful needle points include the sacral Liao and Shang-Baxie points.
- 35 Hz: Diabetes, also Liver
- 3 and 6 Hz: Endocrine system
- 9 Hz: Pancreas
- 91 Hz: Pancreatic islets of Langerhans
- 23 Hz: Kidney
2. Organ / Autonomic Balancing Therapies
Organ functions are regulated by the autonomic nervous system through sympathetic and parasympathetic effectors. There are special acupuncture points on the front of the torso called Alarm or "Mu" points. These directly register the health of its associated organ, and can also be used therapeutically as acupuncture treatment sites. There are also acu-points that run along both sides of the spine on the back called Associated or "Shu" points. These are closely associated with nerve ganglia that connect with and regulate the organs. Mu-Shu technique is a simple method in which the front-Mu and back-Shu points are treated together with polarized microcurrent and appropriate colors of light.
There are Mu-Shu point combinations that help balance function of each of the major organs affected by diabetes. Organs should be selected that are found to be dysfunctional during differential diagnosis. It is best to just select two Organs for Mu-Shu treatment per treatment. Complete instructions for performing microcurrent and light Mu-Shu technique can be found in my article in Acupuncture Today February 2006, Vol 07, issue 2. (See my columnist link on acupuncturetoday.com.)
Color light selection is important for good results with Mu-Shu treatment of diabetes and other internal conditions. Dinshah, the great pioneer of color therapy in the USA taught that the colors of light particularly beneficial for treating diabetes mellitus include lemon, yellow and magenta. I suggest using kinesiology to confirm correct choice of color for each organ.
There is almost no risk to using this method and much potential for significant benefits. The few contraindications for microcurrent treatment include patients with a heart pacemaker, active cancer processes or those who are pregnant.
It will be of great value to set up clinical trials to further document these valuable effects of Microlight therapies for treatment of diabetics. This would fulfill a part of the NIH's mandate for Therapeutic Lifestyle Change programs that can treatment more patients at lower cost, and with less need for long-term drug use.
I believe that Microlight therapy can be a particularly valuable treatment in settings where there are large numbers of diabetic patients and limited resources, as exists in many Native American reservation and inner city health centers.
By Darren Starwynn, OMD, LAc
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The Psychobiology of Pain
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At its worst, acute pain can be unimaginably intense and stressful, and chronic pain can wreck havoc on a person's quality of life. Because pain is such a universal problem Traditional Chinese medical practitioners devote a considerable amount of time treating it.
Understanding the powerful psychology involved in the experience of pain, as well as its neurological and biochemical causes is therefore important.
It's sad but true that we need to have pain. Those who have worked in convalescent hospitals know about the bedsores that paraplegic patients who feel no pain often get on their hips or sacral region, or on their ankles. Some of these ulcers can go right down to the bone and can then infect the bone itself.
Patients with many neurological diseases who have diminished or absent pain sensation develop "Charcot joints" in their elbows, knees or ankles. Named after a French physician in the 1800s, these joints have been exposed to repetitive chronic trauma, with dislocations, infection, swelling and severe deformity. There is neurological abnormality known as "congenital absence of pain sensation." Those born with this condition do not feel pain at all. They grow up suffering from dental abscesses, infected joints and bedsores. They often die in their twenties. Some die from a ruptured appendix or a perforated duodenal ulcer they didn't know about until it was too late to save them.
The Elusive Nature of Pain
Observations of Howard Beecher, military surgeon in WWII, contrasted with his civilian surgical practice after the war was over. He noted that on the battlefield soldiers would continue fighting after they had suffered significant wounds. Many would report they had felt almost no pain while they were on the battlefield. Years later as a trauma surgeon in civilian life, Dr. Beecher noted a stunning contrast: he described the severe pain that accident victims complained of, beginning at the time of injury. Athletes in sporting events often continue on after spraining their ankle or falling on the race course and experiencing injuries, reporting later they hardly noticed any pain.
The other side of this coin is overreaction to pain. Physicians and nurses often report pain magnification in shut-in people such as those in nursing homes or other extended care facilities. These individuals focus on their pain and it seems to make it worse. We all know about how hypochondriacs react to pain, and it seems we are all on a spectrum in terms of how much pain we experience and how much or how little it affects us.
Some of this can be cultural. If we come from a society of over reactors we are likely to overreact. I worked as a surgeon in Saudi Arabia for several years, where the culture encourages those who are ill or injured to moan and complain about their physical discomfort. If they are in the hospital the entire village often comes there to sympathize with them, and they all moan and cry together. My experiences in this culture were in stunning contrast to those later on in Michigan, working with many Scandinavian patients. As a rule these patients seemed almost impervious to pain, and they rarely complained about their discomfort.
Amputee patients often develop phantom limb pain - severe discomfort in the hand or foot that is no longer actually there. They cannot rub it to provide comfort because it no longer exists. We must come to the conclusion that pain has a powerful psychological basis as well as a physical one.
The Psychophysiology of Pain Perception
The perception of pain has three aspects: physiological, affective and evaluative. The physiological aspects are based upon the stimulation of nocioceptive pain fibers distributed throughout the body. The actual amount of pain sensation depends on the extent of the injury or illness, and the particular body tissue that is involved. There are far more pain fibers per square centimeter on the cornea of the eye than on the skin of the chest or back, so a small ulcer on the cornea or a tiny grain of sand in the eye can be extremely painful. Partial ablation of pain sensation can often be achieved by ice packs, the application of local anesthetic agents such as oil of wintergreen or by acupuncture. The injection of xylocaine blocks all pain sensation because it blocks the firing of the nocioceptive pain fibers.
The affective aspects of pain perception are highly individualized, as the experience of pain varies widely in different individuals, whereas other sensory thresholds are more similar from one person to the next, such as position sense or touch. We are all on spectrum of how much pain we experience with a given injury or illness.
The evaluative aspects of pain perception refer to our learned, interpretive responses to pain. Some of these are broadly cultural, as I described above in my reference to Arab versus Scandinavian patients (I was speaking in general terms, of course). Beyond this we may have familial influences on how we perceive and interpret pain that go back to our early upbringing. These can be very powerful. Lastly, we carry with us our own Gestalt: the sum total of our personality, temperament, the amount of stress currently in our lives and the self-discipline we have developed over the years (or the lack of it).
Chemical aspects of pain
There are pain diminishing endogenous opioids that we all manufacture in our brain tissue. These are secreted by neurons in the central nervous system, and include beta endorphins, enkephalins and dynorphins. These opioids are 80 times more potent than morphine, molecule for molecule. Many of you are familiar with the studies that have been done in China and in this country indicating that acupuncture increases these pain-diminishing opioids in brain tissue. Some of us secrete more of these beneficial substances than others do, and there are many ways to enhance them, as we'll discuss in this article.
Conversely, there are pain enhancing endogenous substances in our nervous systems, including serotonin, substance P, bradykinins, prostaglandins and histamine. In addition, cytokines secreted by white blood cells when we are sick or injured can make our bodies more sensitive to pain. Our immune system seems to be signaling us to pay attention to what is wrong.
Neurological Aspects of Pain
The body has built-in mechanisms to control how much pain we experience, either reducing or increasing it, depending on what is going on in our lives at the moment. There is a gate-like mechanism in the dorsal horns of the spinal column, known as the substantia gelatinosa. This "gate" controls the flow of pain sensations that pass through on their way up to the thalamus and limbic system and then to the cerebral cortex where we actually experience pain.
When we are sick or injured, the initial pain sensations get through this gate in the spinal column and go through the thalamus, and on into the limbic system, the pre-conscious area deep in our brain where we process our feelings and the meaning of sensations we are experiencing. The limbic system communicates with the cortex. This system can stimulate a descending inhibitory signal. The descending signal goes from the limbic system and down the periaqueductal grey tissue to the dorsal horns of the spinal column, and into the substantia gelatinosa (gelatinous substance). These signals can then moderate pain, by closing the gate. Nerve cells in this area secrete endorphins that close the gate. With a closed gate: pain sensation is blocked. With an open gate, pain gets through to the thalamus and on to the sensory cortex.
Anxiety, worry, depression or focusing on an injury or illness open the gate and increase pain. Meditation, relaxation, or positive emotions close the gate and decrease or even block pain. We know acupuncture increases endorphin secretion in the cerebral cortex. Further research needs to be done to see if acupuncture also increases the secretion of endorphins in the substantia gelatinosa. This has been proposed as a mechanism of how acupuncture reduces pain, but it needs further study in the research laboratory. This research should also include an analysis of how the myelinated A delta pain fibers and the slower unmyelinated C fibers take part in this closure of the gate.
The actual experience of pain is influenced by many things: the person's activity at the time (running an Olympic marathon; fighting in battle), the level of attention versus distraction at the time, and circulating endorphins versus pain-inducing substances perfusing the brain at the time of the pain event. All of this is also influenced by our advance expectancy that we will experience pain. For example, what are our previous memories of going to the dentist? Was it a highly stressful, painful experience? If so, this primes us for a repeat performance the next time we drive to the dentist.
The meaning of the present event to the person is a strong contributor to how much pain he or she experiences. Our feelings of self-control or self-mastery, and our ability to minimize the pain experience are important contributors to how much pain we experience, and how it affects us.
Psychological treatment and support of patients with chronic pain
Techniques of psychological treatment include hypnosis, progressive muscle relaxation, meditation, guided imagery and biofeedback. Behavior modification with operant conditioning is often surprisingly effective. This psychotherapy reverses the usual rewards of being in pain: sympathy, attention, and relief from work/school responsibilities. The technique is for the therapist to increase the patient's activity level, ignore pain behaviors, and reinforce well behaviors. Cognitive therapy changes the interpretation of the pain, encouraging the patient to go towards the pain! The idea is that we do better if we control the pain, rather than letting the pain control us. This therapy attempts to increase self efficacy beliefs.
Mindfulness based stress reduction, created by Jon Kabat Zinn at the University of Massachusetts, is based on this approach. It includes deep inner self-focusing, muscle relaxation and an awareness of all body sensations. The patient is invited to go toward the pain, and to own it. Each person is bigger and more powerful than his or her pain. With this prevailing attitude, the person can gain control over the pain and place it in proper perspective. Curiously, the pain may then go away!By Bruce H. Robinson, MD, FACS, MSOM (Hon)
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The year of the Dragon is here. As fierce, mystical and wonderful as the dragon may be – 2011 was very exciting. Here is a recap, along with latest happenings in the profession.
Plenary Session A Success
In mid-November, I attended the third plenary session of the Quality and Safety TAG (Technical Advisory Group) under the auspices of the World Health Organization.
This tag is discussing surgical procedures, other medical procedures, and medication and the real and/or potential harm to the patients. The task undertaken of this meeting was to look at 1,600 codes in ICD-10 discuss add, change, delete or modify the code.
On the second day we had completed the section on surgical and moved into medical procedures. When we came to a certain area, I raised my hand and recommended that this would be the place to add acupuncture. To my overwhelming joy – every one of the members agreed. We also got manipulative therapies included – Tui-na being in this category.
In the next Category of medications – I had the honor of adding herbal medicine, homeopathy and traditional medicine.
I want to thank both Dr. John Chen of Evergreen Herbs and Bill Egloff of Crane Herbs for their help and support. This information went into the first drafts being sent to WHO. This is a great start for this medicine being able to take its place in the global health care system.
Earlier in the fall, both Dr. Kory Ward-Cook and I did a one day turn-around to Washington D.C. Our destination was the office of Dr. Josephine Briggs, head of NCCAM (National Center for Complementary Medicine, which is a part of NIH (National Institute of Health).
We went to meet and greet on behalf of the AOM community. As a result, the NCCOM web site references licensed acupuncture not just medical acupuncture.
Another step forward
In other news, the ISO-TAG-249 is the other international group discussing Quality and Safety. The Working Group for forming International Standard for acupuncture needles has met and the work is progressing. The Working Group of herbs met in Beijing with Christine Chang and Jason Wu attending from the US. I have been elected to the President's Advisory Group representing the U.S. representing the U.S.
The First Draft of ICTM to be included in ICD-11 has gone up for all to see. So, I encourage you to log on and take a look at http://apps.who.int/classifications/icd11/browse/f/en.
Attention AOM Students! The Trudy McAllister Scholarship is available. This is an annual scholarship which gives $2000 to students of Acupuncture and Oriental Medicine in ACAOM accredited or candidate schools working toward their degree in Acupuncture or degree in Oriental Medicine. For further details, please visit their web site www.trudymcalisterfoundation.org.
New Degree Program at PCOM
Pacific College of Oriental Medicine (PCOM) announced on November 30th that it will begin offering a unique holistic nursing Bachelor of Science Completion Program in Holistic Nursing through its New York Campus. This is the first bachelor degree nursing program within a CAM school in the country.
The program was developed in consultation with Carla Mariano, EdD, RN, AHN-BC, FAAIM, who also initiated the holistic nurse practitioner program at New York University and is past-president of the American Holistic Nurses Association. Mariano told the Integrator that the program is particularly timely as the nursing profession has a growing commitment to establish a bachelors' level as the basic educational standard for professional nursing. "BSN in 10" refers to the pending legislation requiring associate degree registered nurses to obtain the baccalaureate degree in nursing within 10 years of initial licensure. The states of New York and New Jersey each have legislation promoting this change. This direction for the nursing field was propelled by the October 2010 Future of Nursing report from the Institute of Medicine and Robert Wood Johnson Foundation.
Dr. Shi Xue Min
The CEU seminar on stroke rehabilitation acupuncture in Santa Monica, California, hosted by Emperor's College on November 19 and 20 was hailed a resounding success by attendees. The exclusive U.S. seminar featured the honorable Dr. Shi Xue Min, also known as the 'Father of Acupuncture'.
With over 200 practitioners and AOM students attending from all over the country, it was the largest class Dr. Shi Xue Min has ever held in the United States. Attendees included renowned acupuncturists as well as distinguished Emperor's College faculty members.
Dr. Shi lectured on Xing Nao Kai Qiao stroke rehabilitation and prevention therapy, an effective acupuncture protocol for stroke patients he developed in the early 1970s at Tianjin Hospital in China.
Make sure to check out an exclusive interview Acupuncture Today did with Dr. Shi Xue Min soon on www.acupuncturetoday.com this month.
By Marilyn Allen, Editor-at-Large
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There are lots of applications and devices out there for the acupuncturist-on-the-go. From general phone apps to help you get organized, to more specific apps made for acupuncturists and students of TCM, we'll take a look at some that can help make your job a little easier.
Please note: a lot of this information is about iPhone and iPad apps. I do not work for Apple; I just like their products. You can also find PC versions and Android apps.
Get organized and make money
When I got my iPhone a few years ago, I could answer patient phone calls and e-mails really quickly. It sometimes makes the difference between getting a new patient before they contact someone else for an appointment. I could even order herbs online while riding the bus to work. One of the best things about it is that I can now accept payment from patients on my phone. The iPhone has increased my efficiency while allowing me to have fun with a shiny new gadget.
I got an iPad this year and I was determined to get a lot of use out of it. The bigger screen and a wireless keyboard have enabled the iPad to become my portable computer when I don't want to carry around my heavier laptop. I can e-mail patients about appointments and send them attachments as PDFs, write notes, look up information on apps or the Internet, and makes posts to all of my Cicuto Acupuncture Facebook, Twitter and Google + accounts. The only thing I can't do with my iPad is use Quickbooks on it, yet.
Teresa Green, of Green AcuClinic in the Richmond, Virginia area, uses another kind of tablet, the Galaxy Tab, the Evernote app for organization and Dropbox to store files.
"I can save anything either with a few taps on the keyboard, choosing "share page" for web sites, or even take a picture of it! Then, I tag everything as many different ways as possible," Green said. "Since its saved online as well as on the app, it's backed up. I can then e-mail it, send it to Facebook, etc. It has become a major part of my "brain." I also love Dropbox as a way to have access to my important or often used files. Both are available as very functional free versions."
Green and I both use Square to process credit cards. Square was the first mobile credit card processing app I tried and, simply put, it works really well. You pay a percentage per transaction and that's it. There are no monthly fees and you don't have to buy a terminal. The Square card "swiper" itself is free and plugs into the headphone jack on your phone or tablet. Patients sign their name on your device using a stylus. You can e-mail a receipt or send it to a cell phone with a map square showing where the purchase was made. Money gets transferred directly to your bank account within a few days. You can download reports of transactions via the Square web site to use for accounting purposes. HSA cards can be processed by Square if the acupuncturist sets up their account with Square as a licensed health care provider. Flexible Spending Accounts (FSA) and other benefit cards are not supported by Square, but some acupuncturists have been able to process FSA cards.
ROAMpay is another credit card processing device. Like Square, it plugs into the headphone jack on your phone but you can't use it on a tablet. ROAMpay allows for Flexible Spending and Health Savings Account cards. When you apply for an account, you can list yourself as a health care provider and it enables you to take those cards.
ROAMpay is cheaper per transaction than Square. However, after using both devices for a while, I've found that the ROAMpay software just doesn't work as well as Square. I often have problems with it crashing or not recognizing cards when I swipe them. Most recently, I found out when I called customer service that this is because the swiper doesn't work with the latest iPhone operating system. They will be sending me the latest app as soon as it's available. I've only had the Square app crash a few times.
My advice is to use both Square and ROAMpay and figure out which works best for you. The convenience of being able to process credit card transactions on your phone or tablet is really worthwhile, plus there are fewer fees, which make them accessible for small businesses.
Patient Privacy and Technology
Another extremely important consideration when using handheld electronic devices is patient privacy. Both Square and ROAMpay apps use secure technology for making the patients' credit card information safe. The credit card information is not stored on your phone or tablet. If you choose to use your phone, tablet or computer to write patient records and information via cloud computing, you'll need to consider HIPAA compliance.
You can access practice management software on your computer such as Client Tracker, AcuBase and MacPractice via an iPad. Those programs are already set up to be HIPAA compliant. Steve Favarger is an IT consultant in the San Francisco Bay Area who specializes in setting up medical practices with iPads and practice management software programs like MacPractice. How does he ensure patient privacy with his work?
"The HIPAA compliance is already taken care of inside of the software," said Favarger. "What we then deal with is everything that is ancillary to the software. By that I mean: Is your backup solution HIPAA compliant? Is the way that you're communicating with your clients HIPAA compliant? Is the way that you're transferring patient data between yourself and your vendors HIPAA compliant? And that's what we focus on because the practice management software that they're going to purchase are, ipso facto, going to be HIPAA compliant and meet all federal regulations or they wouldn't be in business."
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There are versions of the huge textbooks I carried around in school on my phone. "A Manual of Acupuncture" by Deadman, Al-Khafaji and Baker is now available as an iPhone and iPad app - 675 pages now fit in the palm of your hand. The app is beautiful, elegant and extremely useful. It even has something that the book doesn't - videos with point location instructions.
I was just as excited to find BenCao a few years ago. It's an app for Chinese herbs and formulas. If the folks at exebeche hadn't come out with it, I was ready to find a friend who writes iPhone apps to collaborate with and make one myself. One of my favorite features of this app is a field where you can write and save your own notes. Also, the Chinese characters are listed for each herb and formula. I've found this handy in case I need to show a herb shopkeeper the name of a formula but I can't pronounce it. There are also photos of each of the herbs on BenCao, which can help students while studying.
Miridia Acupuncture Technology makes Auriculo, an ear acupuncture app, which has detailed picture of points and protocols for different conditions. It's a lot easier to use than an ear acupuncture chart. You can flip the picture by tapping on the screen to see a left or right ear and zoom in on the point. (Miridia also has a useful Points app, which I have mostly ignored since getting A Manual of Acupuncture.)
TCM Clinic Aid combines diagnosis, herbs and points and quizzes all in one app. This is one that acupuncture students told me about, and at just under $10, it's a great price for students and practitioners alike.
Tungz! is an app that's all about tongues. It's a great, affordable app for patients to learn what their tongues can tell them about their health. There are photos of tongues and health tips with diet and acupressure points. It can be a helpful tool for us to use when our patients ask "So what does my tongue tell you?" Tungz! is a great combination of a consumer level app that helps practitioners to explain our medicine.
There are many general medical applications that can be useful to acupuncturists as well. One of the most useful for insurance billing is Stat ICD-9 Coder. It contains over 14,000 diagnosis codes and is simple to navigate. The app will also be updated soon to reflect ICD-10. Epocrates has information, interactions and pill pictures for thousands of prescription drugs.
There are a lot of apps, programs and gadgets out there that can be overwhelming to choose from. It is extremely important to remember to ensure your technology means your patients' information is safe and secure. Spend some time exploring these options to help save you time and money now, and in the long run.
By Denise Cicuto, LAcmore >>>
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