American Institute of Acupuncture

Top 9 Acupressure Points to Treat Premenstrual Syndrome (PMS)

acuherb — Tue, 30 Jan 2018 22:59:29 +0000

Acupressure and reflexology are alternative medicine techniques that are based on the theory of holistic self-healing using solely physical pressure. The pressure applied at specific points helps in increasing the flow of life energy through the meridians and clears the blockages. TheÂ history of acupressureÂ is centuries old and has been used effectively for treating various ailments such as muscle and joint pains, headache, indigestion and many more. PMS or premenstrual syndrome is a batch of symptoms that are linked with the menstrual cycle and although not life threatening, it can surely disrupt normal life of a woman for a few days. There are hardly any known remedies for this problem, but acupressure therapy can be used to treat the symptoms of PMS quite successfully.

Most Common Symptoms of PMS

PMS or premenstrual syndrome is an assemblage of symptoms that appear in women 2 weeks before the commencement of the periods each month, but the symptoms differ from person to person and is extremely difficult to categorize and analyze.

Physical Symptoms: Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â

Bloating
Breast Pain
Abdominal Cramps
Lower Back Pain
Muscle and Joint Pain
Headache

Psychological Symptoms:

Mood Swings
Anxiety
Irritability and crying
Tiredness
Restlessness
Appetite Changes
Confusion and Forgetfulness

9 Important Reflexology Points to Relieve PMS Symptoms

In this article we have listed some of the most important points ranging from various parts of the body that are useful for acupressure treatment of premenstrual syndrome.

Points on Abdomen

The most important acupressure treatment points for relieving PMS symptoms is located in the abdomen and stimulating these points by applying soft pressure using palms and fingers can help in relieving menstruation related discomfort.

Sea of Energyâ€“ This is one of the most important acupressure points for treating premenstrual syndrome. Located two fingers width below the navel, stimulation of this point helps in normalizing irregular periods, menstrual cramps, treats vaginal discharge and problems of constipation. Stimulating this point also helps inÂ relieving digestive disordersÂ such as gas, irritable bowel syndrome, headache and general weakness.

Gate OriginÂ â€“ This reflexology point is positioned four finger widths beneath the navel in the same line with the point â€œSea of Energyâ€. Stimulating this point helps in relieving PMS symptoms such as painful menstrual cramps, irregular menstrual periods, treating reproductive problems and incontinence. In addition, this point also helps in treating impotence in men.

Mansion CottageÂ â€“ This pair of points is located on the pelvic area, right at the center of the crease where the legs join the trunk of the body. Stimulating this point with the pressure of the palms helps in relieving painful abdominal cramps and discomfort related to menstruation. In addition, it also helps in treating infertility in women.

Rushing Doorâ€“ This acupressure point is located in the pelvic area, in the crease of the joint between the legs and the trunk of the body, exactly below the points â€œMansion Cottageâ€. Stimulating this point helps in relieving abdominal discomfort, bloating and cramps. In addition, this point can also help in treating hernia and dysuria.

Points on the Back

A few of the acupressure points related to PMS are located on the back of the body and stimulating these points not only helps in relieving abdominal cramps, but also soothes lower back pain.

Womb and VitalsÂ â€“ This pair of points areÂ located right outside the sacrum â€“ the bony area at the base of the spice, midway between the hipbone and the base of the buttocks. Stimulating this point with fingers helps in relieving menstrual cramps, pelvic pain,Â lower back painÂ and urinary problems. In addition, this point also helps in relieving hip pain, stiffness and promotes postpartum recovery.

Sacral PointsÂ â€“ Stimulating this group of points work effectively towards menstrual pain relief. These points are located in the sacrum, right at the base of the pelvis. Stimulating this point by applying gentle pressure with fingers helps in relieving menstrual cramps and relaxing the uterus. In addition, it also helps in relieving lower back and pelvic pain.

Points on Legs

The reflexology points present on the legs help in improving blood flow to the lower part of the body and helps in reducing bloating by driving out excess fluid from the body.

Three Yin CrossingÂ â€“ This point is located in the inner side of the leg, three finger widths above the ankle bone, close to the shinbone. Stimulating this point with the thumb and fingers helps in relieving water retention, bloating, genital pain, abdominal cramps and irregular vaginal discharge. In addition, it is also beneficial for treating sleeping disorders, insomnia, dizziness and vertigo. Stimulating this point is strictly prohibited during the later stages of pregnancy (8th and 9th months of pregnancy).

Grandfather Grandsonâ€“ Acupressure treatment for PMS must include this point. It is located in the arch of the inside of the foot, a thumb width from the ball of the foot.Â Stimulation of this point by pressing it with the fingers helps in relieving abdominal cramps. Stimulating this point also helps inÂ relieving stress and anxiety, digestive disorders and bloating.

Point on Arms

Last but not the least, comes one of the most important points of acupressure therapy â€“ the Union Valley point, the stimulation of which helps in treating a wide range of health problems.

Union Valley Pointâ€“ This acupressure point is located in the fleshy joint between the thumb and index finger on both hands. Stimulating this point by applying pressure on the fleshy region helps in normalizing delayed and irregular periods, calms the uterine muscles and treats infertility. In addition, stimulating this point also aids inÂ treating headache, shoulder pain, allergies, abdominal pain and constipation. This point should not be roused during pregnancy.

It is not even necessary to stimulate all these points in order to reap the benefits of reflexology and acupressure for PMS, applying pressure on only a few points for 3 to 5 minutes can do the trick. So, now that you know the most important acupressure points to relieve PMS apply it yourself and also try to provide comfort to your loved ones with this holistic way of healing.

Hormonal causes of irregular periods

acuherb — Tue, 30 Jan 2018 22:54:36 +0000

Â Â Â Our periods are orchestrated by natural, interdependent hormonal shifts, so itâ€s no wonder that often the first sign of hormonal imbalance is a change in the rhythm, timing or heaviness of our periods.

Â Â Â Irregular menstrual bleeding comes in many forms, and varies from woman to woman. You may experience spotting, mid-cycle bleeding or very heavy bleeding. The time between your periods may lengthen, shorten or become unpredictable. The way in which your cycle is â€œirregularâ€ is unique to you, but the underlying cause is often the same, and rooted in hormonal imbalance. And the good news is itâ€s possible to naturally restore your hormonal balance and so the regularity of your menstrual cycle.

Â Â Â Â Itâ€s common to have one or two irregular periods a year. But if you have more than that itâ€s a good idea to look at some possible causes and get your body back on track. Common causes of irregular bleeding are:

Perimenopause.Â If youâ€re over 35 you may be inÂ perimenopause, the months or years of hormonal transition that lead up to menopause. Technically, menopause occurs when it has been 12 consecutive months since your last period, but itâ€s rare for women to menstruate regularly until their periods suddenly stop. More commonly, women notice changes to their cycles five, ten or even fifteen years prior to reaching menopause.

PCOS.Â Women withÂ polycystic ovarian syndromeÂ (PCOS) usually do not ovulate regularly. Since regular periods depend on regular ovulation (unless you are on birth control pills, in which case your â€œperiodâ€ is actually a withdrawal bleed), one of the most common signs of PCOS is irregular bleeding. PCOS is commonly connected to insulin resistance, which is caused by diets heavy in sugar and refined carbohydrates.

Stress.Â Our adrenal glands are responsible for regulating cortisol levels, which have a direct impact on some of the hormones involved in menstruation such as estrogen and progesterone. The adrenals increase cortisol production in response to stress. Unfortunately, most women suffer from chronic stress that overburdens the adrenals and can lead toÂ adrenal dysfunction. The resulting cortisol imbalance leads to fluctuations in estrogen and progesterone. Healing your adrenals is essential for regaining the hormonal balance necessary for regular periods.

Hypothyroidism.Â Thyroid function is intimately connected with all your bodyâ€s hormones. When your thyroid hormones are off balance such as with hypothyroidism, it can result in a wide range of symptoms, including irregular periods, fatigue, weight gain, and depression. Many women with irregular periods have subclinicalÂ hypothyroidism.

All of these problems are rooted in hormonal imbalance, and fortunately there is a lot you can do to regain hormonal balance naturally. The basic approach is to give your body the support it needs to make and balance its hormones, while reducing the demands on your endocrine system.

Women can regain their natural menstrual cycles with a few healthy dietary modifications, pharmaceutical-grade nutritional supplements, stress management and relaxation techniques. Your cycles will normalize if you give your body the right support. And we know what a relief that can be!

Movements, Massage, and Pressure Points for Beautiful, Happy Breasts

acuherb — Tue, 30 Jan 2018 22:50:05 +0000

Though it is often thought of as a womenâ€s disease, men are also diagnosed with and die from breast cancer. Â Fortunately, breast cancer death rates have been falling since the late 1980s, especially among women under the age of 40.

This drop may be due to early detection, better treatments, and greater regard for factors such as some forms of hormone replacement therapy that were thought to increase the risk of cancer becoming more invasive. Luckily, there are many tools available to help professionals and their clients find happiness and beauty in their breasts.

There are four pillars of a healthy lifestyle: wholesome foods and good digestion, appropriate exercise, daily relaxation or meditation, and sufficient rest and sound sleep. In the Ayurvedic healing tradition, self-massage is considered passive exercise and is said to have many of the same benefits as that of an exercise class. Daily massage with oil, or self-abhyanga, is widely practiced in the Orient as one of the best paths to longevity and aging beautifully, but not so much in the West. But, just as massage is earning a reputation for being therapeutic rather than exotic, there is going to be acknowledgement that breast massage is one of the best things professionals can teach clients forÂ breast health.

Ayurvedic massage has two unique characteristics. First, there is a full recognition that the skin is an organ of digestion, fully able to act as a delivery system for herbal medicines. As such, the massage medium, usually herbal or aromatic oils, is considered to be at least 50 percent of the treatment benefit. The second characteristic is the use of specific pressure points in the marma system that are closely related to the chakras.

The two oils favored for the breasts are a blend of equal amounts of castor, flax, and corn oils and an herbal oil made with mustard seed oil, pomegranate rind, and an essential oil blend known as amber. If these oils are not available, untoasted sesame oil or any good-quality organic oil will work. Apply a small amount of oil to the front of the neck, dÃ©colletÃ©, and breasts before starting the massage.

TherapeuticÂ Â Breast Massage

1.Â With the head turned slightly to the left, use three fingers on the left hand to touch behind the right earlobe and massage the area in clockwise circles. This marma point, karnamula , is around the mastoid process, the little bump behind the ear lobe. Proceed to stroke down the side of the neck to the akshaka marma point , which is on the top surface of the right collar bone where it joins the breast bone, and apply light rotational pressure. Turn the head to the right and repeat the same stroke to the left side using the right hand. Repeat this process 15 times, alternating between the right and left sides of the neck. Perform 30 strokes in all.

The marma points that are touched by this stroke include:

1) Karnamula

2) Mantha â€“ improves lymphatic circulation

3) Siramantha

4) Akshaka â€“ stimulates lymphatic drainage.

2.Â With the head turned slightly to the left, use the left thumb or fingers to press down on the top surface of the right collar bone, from the breast bone out to the tip of the right shoulder. Turn the head to the right and repeat the same movement on the left side. If pregnant, apply this technique with very light pressure. Massage the skandadhara marma pointÂ in the hollow in front of the shoulder joint by using gentle, circular clockwise pressure or a press and release action.

The marma points that are touched by this stroke include:

4) Akshaka and

7) Skandadhara â€“ helps to ease tenderness in the breast and is particularly helpful for fibrocystic breasts.

3.Â Using rotational clockwise pressure, touch the hollow space behind the collar bone with the fingertips, starting again from the breast bone and moving up toward the top of the shoulders. Massaging under the collar bone can help reduce breast discomfort.

4.Â Starting under the right arm, press gently into the deep hollow of the armpit and apply rotational clockwise pressure into the kaksha marma point . Try pressing with the thumb, leaving the rest of the fingers on top of the shoulder. Do this movement three, five, or seven times and repeat it on theÂ left side.

The marma point that is touched by this stroke includes:

5) Kaksha â€“ helps with all breast problems including tenderness, mastitis, and fibrocystic conditions. It also activates the lymphatic system in the upper torso.

5.Â Touch the jatru marma point , which is at the top of the middle of the breast bone, and then touch hridayam , which is four finger widths below the top of the breastbone, approximately half an inch below the sternal angle. Press and release this point in a gentle, pumping action three, five, or seven times.

The marma point that is touched by this stroke includes:Â Jatru

6.Â Press and release apastambhaÂ in a gentle, pumping action three, five, or seven times. This point is between the ribs and the breast bone on both sides.

The marma point that is touched by this stroke includes:

8) Apastambha

7.Â Locate hridayam , which is midway between the top and bottom of the breast bone, roughly at the same level as the nipples. Apply gentle, rotational clockwise pressure to this marma and then proceed down the remainder of the breast bone and either side between the ribs with circularÂ massage strokes.

The marma points that are touched by this stroke include:

9) Hrid-1, 2, and 3 and Hridayam â€“ help relieve congestion in the breast tissue and enhance lymphatic circulation.

8.Â With the left hand on the right breast, stroke over the topside of the breast with the flat of the hand, moving from the breast bone towards the armpit and using the pressure that would be used to pet a cat. Using the right hand, repeat this movement over the left breast. Then, with the left hand, stroke the underside of the breast, starting at the breastbone and moving towards the armpit. Repeat this movement with the right hand on the left breast. Do these strokes in an alternating fashion; left hand over right breast and then right hand over left breast. Be sure to touch every part of the breast. Pay particular attention to the outer, upper quadrant of each breast, as this is the most common area for problems to arise. Be sure to end each stroke atÂ the armpit.

9.Â Do 100 circular strokes around both breasts simultaneously, keeping the shoulders relaxed and projecting positive thoughts towards the self and breasts. The circles should cover the outer portion of the breast and the tissues just slightly above, below, and to the side of each breast. The circles should gradually get smaller and move toward the nipples. Massaging the area directly below the breasts stimulates blood circulation. Massaging the portion of the breast below the nipple increases sensuousness and a sense of self-confidence. This step helps to maintain a pleasant shape to the breasts. If both hands are used, circling one way and then the other, the movement of the shoulders works theÂ lymphatic pumps.

The marma point that is touched by this stroke includes:

10) Stanya Mula â€“ helps to clear breast abscesses, cysts, and fibro cystic tissue; ease breast tenderness; and regulate lactation.

10.Â Pull the nipples, using gentle pressure between the thumb and index fingers. Nipple stimulation excites the finest capillaries and lymph tissue in this area of the breast.

11.Â Always end any breast massage by repeating the massage of the kaksha marma, which was performed in step four.

This massage can be done weekly, monthly, or anytime there is discomfort. If prior breast surgery has been done for any reason, please ask a physician before doing this massage.

The Benefits of Therapeutic Breast Massage

acuherb — Tue, 30 Jan 2018 22:40:13 +0000

Breast health is too often ignored until after a problem arises. Itâ€s an area of the body with powerful associations that sometimes makes women hesitant to seek care, despite the fact that the vast majority of them experience breast discomfort at some point. Whether itâ€s breast congestion, abnormalities such as lumps or cysts, diagnostic tests, or surgical procedures, any breast problem can create heightened anxiety and stress that can diminish overall health.

Although scientific studies are limited so far, anecdotal evidence suggests that these problems can be improved and possibly prevented with regular breast massage. Whether you massage yourself or seek out a certified therapist, breast massage can result in:

Increased circulation of blood and lymph
Reduced congestion in breast tissue
Relief from mastalgia (breast pain)
Improved posture
Restored range of motion in the upper body

These physical improvements may provide huge psychological and emotional benefits, especially for those recovering from breast disease and the aftermath of invasive treatments.

Getting the Lymph Moving

Breasts are often compressed with sports bras, constrained by underwire, or enhanced with padding. This can restrict the flow of lymph, a clear liquid derived from blood that contains disease-fighting cells called lymphocytes. According to Debra Curties, RMT, a renowned expert in breast massage, the lymphatic system â€œis considered the most important factor in breast tissue drainage. It is widely speculated that chronic impairment of lymph drainage may be implicated in many breast health problems, including cancer.â€ (1)

Unlike blood, which is pumped by the heart, lymph doesnâ€t have a pump of its own and must be moved by either muscle contractions or manual pressure. Curties points out that breasts have no musculature of their own, â€œso the primary physiological aims of breast massage relate to enhancing circulation and drainage.â€ (2) Gentle massage helps clear lymphatic channels, increases circulation, and reduces uncomfortable congestion.

Improving Posture and Range of Motion

Therapeutic breast massage also loosens the tissues of the chest, shoulders, and neck, using a combination of deep-tissue massage techniques, movement,Â breathing, and stretching. Whether your breasts are healthy or compromised, every woman can benefit from this work, and it can be a powerful aid to healing after surgery or radiation therapy.

These procedures can leave uncomfortable scar tissue, adhesions, and muscle imbalances. Restricted movement, altered posture, andÂ chronic painÂ often result. After medical clearance is given, a skilled therapist can release restrictions, which in turn can reduce or eliminate pain and improve range of motion.

What to Expect in a Treatment

Depending on local laws, you may need to get a doctorâ€s referral (even if you have healthy breasts) and sign a consent form before receiving breast massage treatments. Breast massage isÂ not advisable in certain circumstances, especially during treatments that make breast tissues more delicate, such as tissue expansion or radiation. It is also contraindicated in any case of infection or for direct contact on any undiagnosed lump. (3) For this reason, medical clearance is vital in the presence of any breast disease or trauma.

The therapist will take time to go over your health history and goals for the session, assess your posture and range of motion, and answer any questions you may have. If you are not comfortable being treated with your breasts exposed, you can opt to wear a loose T-shirt or be fully draped with a sheet.

Many women are surprised to find that therapeutic breast massage involves very little direct contact with breast tissue, and none at all with the nipple or areola. It requires active participation at times, as the therapist guides you through breathing and assisted stretching. Gentle pressure and movement are used to release tight connective tissue, adhesions, and contracted muscles in the chest and shoulder areas.

Techniques used may include myofascial release, trigger-point therapy, manual lymphatic drainage, and vacuum therapy (cupping), just to name a few. Some practitioners, such as those who provideÂ Â breast massage, may also complement the treatment with soothing energy modalities to restore balance and flow in the body, and counteractÂ anxiety.

Being comfortable with the process is vital to maximizing results, and clear, detailed communication with your therapist is necessary. Choose therapists who are experienced, have been certified or licensed within your state, and who have received specialized training in breast, oncology, and medical massage.

Taking Matters into Your Own Hands

Beyond professional breast massage treatments, you can take several preventive measures to maximize your breast health.

DailyÂ self-massageÂ keeps lymph flowing and is particularly good for those who suffer from general breast congestion and pain. There are many different techniques, but it doesnâ€t have to be complicated. Just gently massage your breasts in a circular motion using your favorite (preferably organic) body oil, 30 times in each direction with the intent of moving the lymph toward the armpit. Then, cup the breast in two hands, gently pulling away from the body, and then pushing back in. Repeat this pumping motion several times on each breast.
AddingÂ essential oilsÂ to your massage oil can make the process even more potent. Cinnamon, frankincense, thyme, citrus, roman chamomile, and turmeric are some of the oils recommended for breast health.
Use onlyÂ natural deodorants.Â Combinations of natural ingredients such as baking soda, magnesium hydroxide,Â coconut oil, and/or essential oils can give effective odor protection without questionable chemicals. A good rule of thumb is, if you donâ€t want itÂ inÂ your body, donâ€t put itÂ onÂ your body.
Avoid constrictive clothingÂ around the breasts as much as possible. If you are a smaller-breasted woman who can do without underwire, or perhaps without a bra at all, youâ€re in luck. For those who must wear bras, seek support designs that donâ€t use underwire, donâ€t wear them any more than is absolutely necessary, and massage your breasts well after removing them. While there is no definitive scientific link as of yet between bras and breast disease, it makes sense to keep that cleansing lymph moving.

The first step is to talk to your doctor and be sure you can receive breast massage. Assuming the answer is â€œyes,â€ then you can decide whether youâ€d prefer to work on yourself or look for a therapist to assist you.

*Editorâ€s Note:Â The information in this article is intended for your educational use only; does not necessarily reflect the opinions of the Chopra Center’s Mind-Body Medical Group; and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition and before undertaking any diet, supplement, fitness, or other health program.

The Flower Blooms: 7 Practices for Womenâ€™s Sexual and Reproductive Health

acuherb — Tue, 30 Jan 2018 22:18:41 +0000

Â Â Â Â Â When it comes to womenâ€s sexual and reproductive health, attitudes matter. Our culture shapes the way we feel about our bodies and more deeply, how our bodies respond.

Â Â Â Â â€œSafe sexâ€ in classical Chinese thought is sex that does not drain the body of needed energy and vitality, but increases it.

Chinese medical history is long and traverses time to places where cultural norms about womenâ€s sexual and reproductive health were quite different.

East Vs West â€“ Views on Womenâ€s Sexual and Reproductive Health

The Eastern wisdom traditions of both Dao andÂ Tantra say sexual energy is a possible pathway for awakening consciousness, divine enlightenment and healing.

That is what imbibes the language that they use to describe the body.

For example:

The Sanskrit word for the female organs is Yoni. Yoni means â€˜sacred space.â€

The Chinese equivalent is The Lotus Flower or Jade Gate.

There was a time when Jade was the most precious stone in China.Â Names including Jade indicated the most precious of all treasures.

The blooming of the lotus flower in Buddhism signifies enlightenment.

Letâ€s contrast that with the terminology in use presently in the West.

The pudendal nerve innervates the genitalia and pelvic floor. The term pudendal comes from LatinÂ pudenda, meaning external genitals,Â derived fromÂ pudendum, meaning â€œparts to be ashamed ofâ€.

That should give you a quick snapshot of the difference in cultural values regarding womenâ€s sexual and reproductive health.

Cultural Attitudes to Female Sexuality

Itâ€s my opinion that there haveÂ been strong, recent (last 100 years) cultural influences that have shaped our view, treatment and expectations of the female body.Â We also inherit a history of inherent sexism in the way anatomy and physiology has been investigated and presented.

I believe this has ledÂ to a distinct lack of natural curiosity and open, intelligent communication around these potent organs and glands and how to keep them healthy and vital.

In more ancient times in the East, the sexual dynamics of both female and male bodies were thoroughly explored and researched.

They saw arousal and the hormonal cascades it released and the circulation it cultivated as a potent force of generating vitality.Â They also understood that humansÂ neededÂ practice, technique and correct environmental conditionsÂ to fully harness the potential power of sexual arousal as a healing dynamic.

They researched and came to understand:

circulation
fluid movement
breath dynamics
ability to harness desire into the broader sensory experience of â€˜orgasmic energyâ€
focusing the mind
taming the ego.

All yielded significant holistic health outcomes.

They developed specific technologies for both women and men.

This article focuses on practices specifically for womenâ€s sexual and reproductive health. These practices can stand alone or can be incorporated into your existing yoga, Qi Gong, meditation or self-pleasure practice.

Before I outline the practices letâ€s take a closer look at the anatomy of what we are talking about.

Womenâ€s Sexual and Reproductive Health and the Female Anatomy

How the Chinese from the Tang dynasty described the female anatomy:

Vagina:Â The Jade Gate or The Lotus Flower

Vulva:Â The Golden Valley

Clitoris:Â Precious Pearl or Bright Pearl on the Jade Steps

Cervix:Â Inner Gate

Uterus:Â Jade Palace or The Cinnabar Field

Saliva:Â Sweet Wine Spring

Colostrum:Â White Snow

Vaginal Secretions:Â Moonflower

From a Chinese Medicine perspective, organs arenâ€t just the organs.Â They are networks, connected by channel pathways.

Traditional Chinese Medicine andÂ Womenâ€s Sexual and Reproductive Health

The two main sexual/reproductive channels in classical Chinese thought and therapeutic practice are:

TheÂ RenÂ (Sea of Yin/Nourishing Vessel)
TheÂ ChongÂ (Sea of Blood/most primordial channel connected to Source Qi, aka one of the first embryological fascia folds.)

These channels include:

connective tissue pathways
organs
glands
tissues
blood circulation
nerve pathways.

TheyÂ connect the:

pelvic floor
clitoris and clitoral body
vaginal canal
cervix
womb
ovaries
adrenal glands
thymus
emotional heart
throat
vocal chords
thyroid
pineal gland
brain.

Here is a simplified illustration of what the Ren channel looks like:

There isÂ lots of neural innervation to the female sexual and reproductive organs. MoreÂ research is surfacing about these unique tissues and glands, what they are connected to and what they have the potential for.

A new area of research is the vagina-brain connection.

This is a pic of the Vagus nerveÂ â€“ the curious nerve, the â€˜wanderingâ€ nerve. It gets a lot of attention when it comes to the gut-brain connection, but it wanders further, innervatingÂ the cervix.Â This looks a lot more meridian-ish.

To see more closely the functional relationship of the pathways of Ren and Chong, Iâ€d also suggest that you research recent images of:

the pelvic nerve andÂ pudendal nerve
pelvic floor musculature
MRI scans of the clitoris
the vascular supply to the cervix.

TheÂ basic premise of Chinese medicine is that if circulation is impeded then disharmony develops, leading to disease.

The Impact of Shame onÂ Womenâ€s Sexual and Reproductive Health

So, what happens when we haveÂ shame, judgement, ignorance, fear, trauma or lack of activityÂ in an area of the body?

Daoist and Tantric solo practices:

Encourage the flight andÂ fight response to switch off so that growth/repair/rest and digest canÂ switch on.
Increase circulation
Initiate relaxation
Encourage hormone and endorphin release
Increase self-awareness
Cultivate a loving and accepting attitude to self and others
Increase your capacity to feel pleasure
Align mind, breath, heart and sexual body.

They also go from external to internal in nature.

When there is a culture of shame focused onÂ the female anatomy and womenâ€s sexuality, these healing benefits are not attained. The good news is that we can useÂ sexual healing practicesÂ to turn this around.

*Here is where I stress that this article is just a messenger, an introduction.*

To start working with these practices please seek support from the resources list at the end.Â Some techniques are explained more fully than others, so please take the terminology and conduct your own searches. There is a world of books, videos, courses and online resources if youâ€d like to learn more about any of this. I highly encourage you to get curious.

7 Â Sexual & Reproductive Health Practices for Women

(A mix of classical and contemporary practices)

1. Meditation

These are usually guided practices until you get established in the technique.

The Micro-Cosmic Orbit
The Inner Smile
Womb Wisdom
Ovarian Temple
Heal Emotional Pain
Sexual Pathways Yoga Nidra Journey

2. Feminine Qi Gong

IncludesÂ breath, sound, movement or visualisation.

Kuan Yin Qi Gong
Ovarian Breathing
Shakti Flows
Finger Qi gong treatment

3. Breast Massage

There is so much benefit for this technique. Itâ€s also such a lovely practice to do. Boobies rock. They are a powerful dynamic place for women and so intimately connected to your heart and endocrine system.

Breasts are very important to take care of and are one of the easier areas of the female body to cultivate a relationship with.Â With regular massage you will start to notice how dynamic, intelligent and responsive breasts can be.

You can help flush the lymphatic system and your body can produce oxytocin this way.Â The upsurge in oxytocin helps us feel more connectedÂ â€“ to our body, to people and life. It cultivates the impulse to self-nurture and self-love and also helps prevent breast cancer by assisting with early detection.

4. The Female Deer

This isÂ a seated meditation practice in which you sit cross-legged with a heel pressed gently against the clitoris,Â or if you canâ€t reach you can place a ball in between your foot and clitoris. You can, if you have the flexibility, close of the opening of your vagina with your sole of your foot.

To start, youÂ gently encircle your boobs moving from the nipple outwards and then reverse out to in. You do this both ways about 36 times.Â Take your time.

You alternate between focusing your attention onÂ the feeling of your breasts in your hands and your hands on your breasts.

After the self-massage you sit andÂ observe the sensations occurring in your bodyâ€¦or you can proceed to the micro-cosmic orbit. (Which in a nutshell is visualising light or energy drawing up from your perineum/pelvic floor up your spine, over your skull, down the front line of your faceÂ and body, deep into your womb space/cervix and back to the perineum.)

5. The Yin and Yang of the Pelvic Floor

Lifelong pelvic floor functional integrity so much depends upon the interplay of good pelvic tone andÂ your capacity to release pelvic tension. YouÂ can include simple practices into your yoga, daily life, sexual practice or exercise to keep your pelvic floorÂ happy and able to do its essential work.

Did you know the Kegel exercises were designed by a male for men with urinary incontinence?Â They are not useful for women.

In France, a minimum of 10 sessions with a specialised pelvic floor therapist is offered to every woman, post-birth.

The pelvic floor isÂ such an integral part of our architecture. It contributes to core stabilityÂ and lower back support, holds the reproductive organs in place, is important for bladder and bowel function and connects to the genitalia.

For all things pelvic floor, including learning about the â€˜pelvic parfaitâ€, I highly recommend the amazing, practical and beautiful teachings ofÂ Nina IsabellaÂ akaÂ Mamashanti.

6. Jade Egg Practice

This is a self-love, awakening, honouring and devotional ritual to heal and nourish your sexual organs and glands.Â You utilise a crystal egg to massage your body, sexual organs and pelvic floor,Â first externally and then you can insert the egg inside the vagina. Internally itâ€s used to invigorate trigger points inside the vaginal canal and pelvic floor.

The jade eggÂ is a potent tool for release of stored emotion within the tissue and for connecting your mind and heart to your sexual organs.

In advanced practice there is also muscle strengthening and releasing work you can do with the egg known asÂ vaginal kung fu or vaginal weightlifting.

7. Stimulating the Cervix

This is a deeper practice in which youÂ create a safe sacred place to clear pain/trauma/numbness/emotions stored in the cervix, heart and sexual organs.You utilise a crystal or glass wand or fingers to gently stimulate the cervix. When you find an area of pain, tension or numbness, you soften and expand into the sensation.

This practice will also increase circulationÂ and increase hormone delivery to the cervix, awakening its capacity for pleasure and ultimately DMT release.

Acute Leukemia

acuherb — Thu, 17 Dec 2015 05:22:52 +0000

LeukemiaÂ Â is a type of cancer in which abnormal white blood cells grow in an uncontrolled manner. The white blood cells divide, multiply, and then spread out of control. This interferes with the production of normal blood cells.

Understanding how normal blood cells are formed offers greater insight into leukemia. Most blood cells are formed in the bone marrow and by the other organs in the lymph system. The marrow is the soft, sponge-like center of large bones. In the marrow of a healthy person marrow, very young cells called stem cells multiply and mature into three types of cells: white blood cells, red blood cells, and platelets. Each type has a specific job to do in the body.

White blood cellsÂ fight infection by destroying bacteria aÂ Leukemind viruses that invade the body.
Red blood cellsÂ carry oxygen from the lungs to all parts of the body.
PlateletsÂ help form blood clots, which control bleeding when a person is injured.

The lymph system consists of the bone marrow, lymph nodes, spleen, thymus, and tonsils. This system produces B-and T-lymphocytes (types of white blood cells). The B-lymphocytes fight infection by making substances called antibodies, which attack germs in the body. T-lymphocytes help to destroy invading organisms as well as cancer cells.

In leukemia, the marrow produces too many immature or abnormal white blood cells.Â As a result the leukemia cells crowd out the marrow and leave very little space for the normal blood cells to grow. Consequently, the number of healthy blood cells drops, and causes frequent infections, anemia, and bleeding problems.

This year about 31,500 Americans will be diagnosed with leukemia, including 28,800 adults and 2,700 children, and approximately 21,500 persons will die of leukemia. The chances of survival depend on the type of leukemia, the age and health of the person, and the medical treatment one receives. An average of 65% of people with leukemia survive for one year after diagnosis. This rate drops to about 44% five years after diagnosis.

Leukemia is grouped in two ways. One way is by the type of white blood cell that is affected. The other way is by how quickly the disease develops and worsens. This grouping is important because the speed with which leukemia progresses and the types of therapy that are given vary.

There are two main types of white blood cells: granulocytes and lymphocytes. Leukemia involving granulocytes is calledÂ myeloid or myelogenous leukemia. Leukemia involving lymphocytes is leukemia.

Leukemia can be eitherÂ acuteÂ orÂ chronic. Acute leukemia progresses quickly with many immature cells. Chronic leukemia progresses slowly with more mature, normal looking cells.

The two ways of grouping leukemia usually results in four main types of leukemia:

	Acute myelogenous leukemia (AML)Â is a common leukemia in adults from the ages of 50 to 70 years old. It is also called acute nonlymphocytic leukemia (ANLL). Acute promyelocytic leukemia, a subtype of leukemia, is associated with bleeding disorders.
	Acute lymphocytic leukemia (ALL)Â is the most commonly diagnosed in children under the age 10, but it also affects adults of ages 65 and older. Most ALL cases involve B-cell lymphocytes. The good news is that the 5-year survival rate of ALL has dramatically improved from 38% in the mid-1970s to 60% in the late-1990s. Survival rates for children with ALL have increased from 54% to 82% over the same period.
	Chronic myelogenous leukemia (CML)Â occurs mainly in adults from 50 to 70-year-old, but a small number of children may get CML. People with CML usually have a mutated gene called the “Philadelphia” chromosome where a part of one specific chromosome is attached to a different chromosome.
	Chronic lymphocytic leukemia (CLL)Â usually affects older adults and can run in families. Persons with CLL may feel well for years without treatment.

Acute leukemia is a malignant proliferative disease that originates from blood producing tissues in the body. It is characterized by symptoms that include anemia, bleeding, fever and infiltration symptoms such as enlargement of the spleen liver and lymph nodes.

Acute leukemia, also referred to by its common subtypes of acute lymphocytic leukemia (ALL) or acute myelogenous leukemia (AML), is a modern medical term that cannot be found in the ancient Chinese medical classics. However, its symptoms are similar to some TCM diseases. Acute leukemia symptoms fall under Traditional Chinese Medicine (TCM) disease categories of “pulmonary tuberculosis”, “hectic fever due to yin-deficiency”, “acute febrile diseases due to insidiousÂ pathogensÂ “, “blood disorders”, “saber”, “subcutaneous nodules” and ” abdominal masses”.

	Pulmonary Tuberculosis:Â This disease causes the same kind of fever and anemia symptoms as in acute leukemia, and is mentioned in the famous medical classic “Sheng Ji Zong Lu” written in 1118 A.D. The title means a collection of medical records.
	Hectic fever due to Yin-deficiency:This is a low-grade fever similar to those experienced in leukemia. It results from a yin deficiency and is mentioned in the medical classic“Treatise on the Causes and Symptoms of Diseases” written in 610 A.D.
	Acute febrile diseases due to insidious pathogens: These diseases cause similar high fever symptoms as in acute leukemia associated infections.
	Blood disorders:Â These conditions produce the same bleeding symptoms such as nose bleeds, gum bleeding and blood in the stool.
	Saber:Â Named after its shape, this is the inflammation of the axillary (armpit) and neck lymph nodes caused by tuberculosis bacteria.
	Subcutaneous nodules or abdominal masses:Â This TCM condition presents as infiltration symptoms such as enlargement of the lymph nodes, liver and spleen.

Causes

Western Medicine

Although there is no proven cause for leukemia, the disease is known to affect people of both sexes and all ages. It is also observed that leukemia affects more males than females, and is more often found in white people than in black people. On a positive note many people with one or more of known risk factors for leukemia never develop the disease, but most people who do develop the disease have no risk factors at all. Researchers have identified several possibilities for leukemia which are:

	Age
	Researchers believe that the chances of a normal gene changing into a cancerous gene increases with age. More than half of people who develop leukemia are over the age of 60.
	Smoking
	There have been reports of an increased risk of AML with cigarette smoking because it may trigger certain changes in a cell’s genes.
	Ionizing radiation
	A small percentage of leukemia cases are linked to exposure to high doses of radiation. For example, the survivors of the atomic bomb explosions at Nagasaki and Hiroshima in 1944 subsequently saw an increased incidence of leukemia. However, it has not been proven that exposure to large amounts of low-energy radiation from electric appliances, diagnostic imaging tests, or living near power lines will cause leukemia.
	Certain genetic conditions
	Scientists do know that most types of leukemias are associated with specific gene mutations. People who have rare genetic syndromes are at a higher risk of developing the disease. One example is Down’s Syndrome, in which there is a 20-fold risk of getting leukemia. Studies have shown that sex and ethnicity are factors in the disease as well. It is observed that leukemia occurs in males more often than in females, and in white people more often than in black people. The incidence of leukemia is high in Jewish people from Eastern Europe, but low in Asians.
	Chemical exposure
	Workers who have a long-term exposure to high levels of solvents such as benzene have a high rate of leukemia. Benzene is used in making medicines, dyes, and many other products.
	Drug therapy
	Certain drugs used to treat cancer called alkylating agents may also cause leukemia anywhere from two to nine years following treatment for various forms of cancer. The antibiotic chloramphenicol was associated with an increased risk of childhood ALL in mainland China.
	Rare viruses
	Human T-cell leukemia virus (HTLV-1) has been associated with the adult T-cell leukemia/lymphoma, which is often seen in geographical areas like the Caribbean and Japan.

Chinese Medicine

The major cause of leukemia is aÂ qiÂ deficiency andÂ pathogenÂ invasion that disturbs the harmony and balance of the body. The ways in which these conditions lead to leukemia symptoms are described below:

1.	When the vital qi (vital energy) is deficient,Â pathogensÂ can more easily invade the body and affect the normal functions of theÂ heart,liver, nutrient qi and blood. When this happens, TCM febrile disease symptoms such as high fever, bleeding, coma and convulsion can occur.
2.	If the body’s internal organs, especially theÂ spleenÂ andÂ kidney,Â yin and yang, qi and blood, become exhausted after a long period of months or years, the production of qi, blood, essence and bone marrow decline. This leads to leukemia related symptoms such as anemia and fatigue.
3.	A vital qi deficiency and pathogen invasion also affect qi and blood movement and the distribution of body fluid inside the body. Abnormal disturbances of these substances can cause blood and body fluids to leak out from theÂ TaiyinÂ (lung and spleen),Â ShaoyinÂ (heart and kidney) andÂ JueyinÂ (pericardium and liver) meridians, or the disturbance can cause them to accumulate and mix together. When this happens, they transform into a mass or nodule inside the body leading to infiltration symptoms such as liver, spleen or lymph node enlargement.

Symptoms

Western Medicine

With an acute onset of leukemia, symptoms appear and quickly worsen. However, the early symptoms of leukemia may be overlooked because they are similar to the flu or other common illnesses. In chronic leukemia, symptoms may not appear for a long time. In general, they are mild at first and gradually worsen. Chronic leukemia is often found during a routine medical check-up before there are any symptoms.

While signs and symptoms for each type of leukemia differ, common symptoms of leukemia include the following:

	Fever, chills, and other flu-like symptoms
	Frequent infections
	Slow healing of minor cuts
	Loss of appetite and/or weight loss
	Persistent weakness, fatigue, and pale complexion
	Swollen or tender lymph nodes, liver, or spleen (more common in ALL and CML)
	Unexplained and easy bleeding or bruising
	Tiny red spots (petechiae) under the skin
	Swollen or bleeding gums due to clumping of white blood cells
	Sweating, especially at night
	Bone or joint pain
	Headaches, nausea and vomiting, blurred vision, and seizures if the leukemia cells collect in the brain or spinal cord
	Swelling of testicles or soreness in the eyes or skin

Chinese Medicine

TCM practitioners will examine the individual, and categorize the symptoms under special syndrome groups known as “disharmony patterns.” Certain disharmony patterns are present during the different stages of the disease. Acute leukemia can be classified into following types:

I. Acute Attack Stage:Â This first phase of the disease is when abnormal white blood cells crowd the bone marrow and blood so that normal blood cells such as red blood cells, normal white blood cells, and platelets cannot be made in their normal amounts. There are four disharmony patterns under this stage.

1.	Damp and Heat Type
	Individuals have symptoms like a fever that cannot be relieved after sweating, and do not experience an aversion to cold temperatures. Dizziness, fatigue, a full feeling in the stomach and abdominal areas, and diarrhea are common. The urine appears dark yellow and comes in scanty amounts. In serious conditions, individuals will additionally suffer from severe joint pain.
2.	Noxious Heat Type
	Individuals suffer from a high fever, heavy sweating, and a pounding, throbbing pain in the head. Abnormal blood circulation symptoms such as bleeding from the nose, gums, or blood in the stool or urine can be present. The skin may also have a bruised appearance or haveÂ petechiae. The blood coagulation problems may cause life threatening symptoms in severe cases such as unconsciousness and bleeding into the brain.
3.	*Accumulated Mass Type*
	Masses or nodules appear beneath the skin of both sides of the neck, axilla (armpits) and inguinal regions (groin area). Individuals may experience severe and persistent bone pain, accompanied with restlessness and fever.
4.	*Interior Liver-Wind Stir- Up Type*
	Symptoms include severe pounding, throbbing pain in the head, impulsive vomiting, and a stiff neck. These can progress to more serious symptoms such as convulsions, spasms, and even paralysis of the face. In the most severe cases individuals experience an irregular and intermittent pulse, which leads to coma and finally death. The most severe cases occur when the leukemic cells enter the brain and impair its functioning.

II Remission Stage:Â The remission stage is when individuals are recovering from leukemia or are cured from it. This phase begins when the symptoms and signs of leukemia disappear, and the number of white blood cells and other blood cells in the blood or bone marrow return to normal. There are two disharmony patterns grouped under this stage.

1.	Deficiency of Qi and Yin Type
	Individuals have symptoms like heart palpitations, and shortness of breath. The complexion appears wan and sallow, and the body’s skin itself appears withered and pale. Additional symptoms that may be present include fatigue, poor appetite, chapped lips, dryness of the mouth and throat, restlessness, fever, spontaneous sweating or night sweats.
2.	Deficiency of Qi and Blood Type
	Individuals have pale lips, nails and a pale complexion. The skin may appear bruised in certain areas and the mucous membranes inside of the mouth can haveÂ petechiae. Dizziness, vertigo, distension and fullness in the abdomen, poor appetite, and heart palpitations that worsen with activity may also be present.

Diagnosis

Western Medicine

Medical history:Â Diagnosing leukemia involves several steps. Your doctor will want a detailed medical and family history to help decide if you are at risk for developing leukemia (for more information, refer to the section on the causes of leukemia). Other information includes the kind and duration of symptoms you are experiencing.

Physical exam:Â Your doctor will conduct a routine physical exam and will look for the swelling in the liver, the spleen, and lymph nodes.

Investigations:

If your doctor suspects you have leukemia, you will be referred to an oncologist. An oncologist is a doctor who specializes in diagnosing and treating cancer. He will request further blood tests and bone marrow examination. These procedures will help the doctor confirms the diagnosis, determine the type of leukemia, and to decide upon what kind of treatment is necessary.Â

Blood tests:Â A sample of blood is examined under a microscope to determine the number and the type of blood cells. Most people with leukemia have too many white blood cells and not enough red blood cells or platelets. If the results of the blood tests are not normal, your doctor may do a bone marrow biopsy.

Bone marrow aspirate and biopsy:Â A sample of bone and marrow cells is removed by inserting a long, hollow needle into the hipbone. These cells are stained and examined under a microscope. This test can confirm the diagnosis and reveal the type of leukemia.

Marrow is taken by syringe

Bone marrow aspiration and biopsy

Lumbar puncture:Â A small needle is inserted through the back to take out a sample of the fluid that surrounds the brain and spine. The fluid is then examined under a microscope to see if leukemia cells are present.

Imaging:Â One or more of the following tests are done to create a picture of the inside of the body and to see how far the leukemia has spread. These tests include X-rays, computed tomography (CT scan), magnetic resonance imaging (MRI), bone scan, and ultrasound.

Immunologic studies:Â This is an antibody-antigen reaction. An antibody is a protein made by lymphocytes, which is capable of interacting with a foreign substance (antigen), to inactivate it. This study will identify the antigens on the surface of cells. For example, the ALL may be either B-cell subtypes or T-cell subtypes.

Cellular and genetic analysis:Â The following new tests have improved the diagnosis of different types of leukemia and the measure of disease progression. Currently, these tests are not routinely done outside of the clinical trials.

	Flow cytometryÂ also uses the antibody-antigen reaction method. In this test, a sample of bone marrow, lymph node, or blood is treated with special antibodies attached to fluorescent molecules and passed in front of a laser beam. Each antibody sticks only to a certain type of leukemia cell and the laser causes leukemia cells to give off light.
	Cytogenetic studiesÂ are done to identify defects in the chromosome that may signal the presence of leukemia. The genetic association is especially higher in CLL. In CML, the Philadelphia chromosome is found in more than 90% of all cases.

Deciding on treatment:Â It is recommended to get a second opinion about the diagnosis and treatment plan. Doing this may help the person to confirm the diagnosis and review the proposed course of treatment. In many centers where leukemia is treated, the person may be asked to participate in clinical trials (treatment studies). Clinical studies help doctors find out whether a new treatment is safe and effective.

Â Chinese Medicine

Determining the circumstances and manifestations of a disease through inquiry, and by observing the individual’s symptoms are important in TCM. Diagnosis is based on the followingÂ four examination techniques.

Through these four techniques a variety of symptoms and signs will be used to identify the individual’s disharmony pattern. This is crucial because at the various stages of a disease, a variety of disharmony patterns are present which require different types of therapy. This is why individuals with the same disease are often treated very differently by their TCM practitioner.

A TCM practitioner will not diagnose an individual with acute leukemia. Instead, he or she will diagnose the individual with a disharmony pattern. Particular attention is paid to the following points for differentiation of the various disharmony patterns.

1.	Distinguishing the locations of the illness to find out which organs or systems are involved.
2.	Distinguishing the nature of illness to decide whether the syndrome is yin, yang, excess or deficiency type.
3.	Distinguishing the stage of illness to classify the disease in its acute or remission stages.

Acute leukemia commonly has the disharmony patterns described below:
I Acute Stage of Acute Leukemia

1.	Damp and Heat Type
	This often occurs in the early stage of leukemia, and is mainly caused by a mild deficiency ofÂ qi, and extreme excess of pathogenic heat. Dampness is produced when theÂ stomachÂ andÂ spleenÂ cannot function properly to transform and transport nutrients. As the dampness accumulates over time, it turns into a heat evil which can inflict damage to the body. Upon examination, the tongue is red and covered with yellow, greasy fur. The pulse is rapid.
2.	Noxious Heat Type
	This usually occurs at the time when normal blood cell production of white blood cells, red blood cells andÂ plateletsÂ is exhausted due to the overproduction of leukemic cells in the bone marrow and blood. At this stage, noxious heat is extremely excessive, and the remaining vital qi is sparse. Noxious heat and other toxic waste products are produced when the organs hyperfunction and an increase in metabolism is created that results in material consumption of substances such as nutrients and body fluids. As a result, the noxious heat damages theÂ meridiansÂ and blood and causes bleedingÂ symptoms. Upon examination, the tongue is red and dry and covered with yellow, dry fur. The pulse feels rolling and rapid.
3.	Accumulated Mass Type
	Noxious heat and phlegm evils transform into masses when they stagnate, and block theÂ collaterals(part of the meridian system) in the course of leukemia. Upon examination, the lips and tongue appear pale, and the tip and the margin of the tongue exhibitsÂ petechiae. The pulse feels deep and fluttery.
4.	Interior Liver-Wind Stir-Up Type
	This usually occurs at the terminal stage of acute leukemia, and develops from the stirring up of interior wind evils. In this stage, the body accumulates excessive noxious heat, which consumes body fluids and damages the blood and meridians. This triggers endogenous pathogenic wind that seriously disturbs the movement of qi and blood. Wind evils affect theÂ liver, which is responsible for helping with the flow of qi and blood. The wind evils are the result ofyin deficiency, hyperactivity of liver-yang or excess heat evils. This type can also be caused by phlegm evils blocking the clear orifices such as the mouth. Upon examination, the tongue appears red and dry is coated with little or no fur. The pulse is stringy and rapid.

II Remission Stage of Acute Leukemia

1.	Deficiency if Qi and Yin Type
	This occurs in a late stage of leukemia when the body is trying to recover from the damage the disease has inflicted. Qi and yin have been exhausted for a long period and the heart, spleen and body fluid distribution are no longer functioning normally. Upon examination, the tongue appears red and is covered with scanty or scaled fur. The pulse feels deep, thready and rapid.
2.	Deficiency of Qi and Blood Type
	This also occurs at the late stage of leukemia where the body is starting to recover. During this stage, vital qi begins to convalesce, and the heat, wind or damp evils start to disperse. The body is getting better from the illness, but the impaired organs, qi and blood are still very weak. Upon examination, the tongue is pale and swollen with indented margins, and covered with a thin, white fur. The pulse sign is deficient and heavy or soft and thready.

Click here to see the development of leukemia from a TCM perspective

III Differentiating acute leukemia from other illnesses

In the clinical diagnosis of TCM, acute leukemia should be differentiated from other similar diseases.Â

1.	Consumptive Disease
	This is a disease caused by insufficiency of vital qi and blood, or organ deficiency. When the individual experiences fever and anemia, it should be distinguished fromaplastic anemia, which comes under the category of consumptive disease. In the whole course of this type of disease, there are no nodules or abdominal mass, so it is easy to differentiate.
2.	Blood Disorders
	Blood disorders involve spontaneous bleeding diseases such as thrombocytopenia (not enoughÂ plateletsÂ to clot the blood), abnormal blood vessels and blood coagulation factor deficiencies. These specific blood disorders can be detected in leukemia patients through blood tests.
3.	Fever Caused by Exogenous (external) evils
	This type of fever is usually induced byseasonalÂ pathogens. It usually presents with persistent high fever and excessive interior heat. Interior heat is produced when there is a pathological disturbance in the physiological functions of the qi, blood, body fluids and organs. With this type of fever, the individual’s blood parameters are normal, and it is easy to recover from the fever. However, leukemia sufferers usually have a persistent low-grade fever, but when it is complicated by infections, the temperature will be high.

Note:Â If a TCM practitioner suspects there might be a serious problem that Chinese medicine alone cannot treat, he or she will recommend the individual see a western doctor for further follow up.

Treatment

Western Medicine

New and more effective ways of treating leukemia are being discovered annually. Many people with the disease can live for many fruitful years and be cured.

Doctors design a treatment plan to fit each individual’s needs. They consider the type of leukemia, how far it has spread, and whether the person has had other cancer before. The person’s age, symptoms, and general health are other factors of consideration.

Although acute leukemias show a more aggressive course, they are more often curable than chronic leukemias. The treatment of acute leukemia attempts to kill leukemia cells so they never grow back. Most doctors say that a person is cured if he or she shows no symptoms for five years after treatment. Chronic leukemias are less often curable. The treatment of chronic leukemia attempts to delay the leukemia from getting worse and to manage symptoms.

Treatment of acute leukemia usually involves three stages:Â 1) induction for remission, 2) post remission, and 3) therapy at the time of relapse. In addition, preventive therapy for leukemia in the brain is given to persons with ALL.

The standard treatments for adult leukemia are chemotherapy and bone marrow transplantation. Radiation and immunotherapy are used in specific types of leukemia. Since the leukemia cells spread throughout the body, surgery cannot cure this disease. However, surgery is done in some cases of lymphocytic leukemia. For example, if the spleen is swollen a doctor may take out the spleen.

RadiationÂ uses X-rays or other high-energy rays to destroy leukemic cells. It is administered either to the whole body or to only one area. Radiation is used for leukemia in the central nervous system (which includes the brain and spinal cord and in the testicles). It is also used for pain caused by spinal cord compression or expansion of bone marrow as a result of the leukemic cells crowding the bone marrow.

ImmunotherapyÂ tries to get the body to fight leukemia. It uses protein made by the body or created in a laboratory to boost, direct, or restore the body’s defenses against disease. Use of Interferon-alpha helps to strengthen the immune system and may delay the progression of the CML.

ChemotherapyÂ is the most common way to treat leukemia. Chemotherapy means drug therapy in which various drugs are used either in combination or as a single agent. Drugs taken by mouth or injected into a vein enter the bloodstream and kill leukemia cells in most part of the body. This is called systemic chemotherapy.

Rapidly multiplying cells often are more sensitive to the effects of chemotherapy. Most anti-leukemic drugs interact with DNA, the genetic material contained in all human cells. This interaction changes the DNA in such a way that the cancer cells are killed or are prevented from producing more cancer cells. Unfortunately, rapidly dividing normal cells in the body are also affected by these drugs, which can cause serious side effects.

Therapy for induction of remission.Induction refers to initial chemotherapy given to the person with leukemia to induce or produce a complete remission. Complete remission means there are no signs or symptoms of leukemia, and the number of white blood cells and blood cells in the blood and marrow is normal. The success of treatment depends on factors such as the ability to tolerate intensive treatment, the patient’s age, and the type of drug regimen.

In AML, the typical induction regimen consists of a combination of anti-cancer drug cytarabine and either one of the anthracyclines: daunorubicin, mitoxanthrone, or idarubicin. This regimen results in 60 to 80% of persons having complete remission.

One exception is the treatment of patients withÂ acute promyelocytic leukemia (APL), a subtype ofÂ AML. In APL, a defect in the retinoic acid receptor prevents the normal growth of promyelocytes (precursors to normal myeloid cells). The all-trans-retinoic acid (Tretinoin), a vitamin A derivative, causes leukemia cells to mature and die. This drug is used in addition to the chemotherapy. Another drug, arsenic trioxide, also is available to treat APL.

InÂ ALL, the most commonly used drugs are vincristine, cytarabine, cyclophosphamide, L-asparaginase, and prednisone.

InÂ CML, drugs like hydroxyurea or interferon have been used. A newly approved oral drug, imatinib mesylate (Gleevec) has been successful in promoting remission among the people enrolled in clinical trials. Its effect on long term survival still needs to be seen.

InÂ CLL, chlorambucil, fludarabine, and cyclophosphamide are commonly used in treatment. Chlorambucil produces a 5-year survival in 48% of people affected. With prolonged use, however, the disease becomes resistant to these drugs and progresses.

Post-remission therapy.Â Once the person with leukemia achieves a complete remission and recovers from the adverse effects of induction therapy, post-remission chemotherapy begins. This therapy tries to kill any remaining leukemia cells. Without further treatment, leukemia will recur in the majority of persons. The same drugs may be administered in a modified schedule or in doses.

In AML, high-dose cytarabine is used in persons less than 55 years old. This results in a long-term disease free survival of 5 years by 15 to 50%.

In ALL, the person continues to receive chemotherapy but in smaller doses. A typical maintenance regimen consists of low-dose oral methotrexate and 6-mercaptopurine. In order to stay in remission it may be continued up to several years.

Therapy at the time of relapse.Relapse refers to the return of leukemia cells, which were once absent, in the bone marrow. Response to further chemotherapy following relapse is usually poorer than the initial response after the induction therapy. For patients with an eligible donor, bone marrow transplantation (BMT) is an option and it may improve chances of survival.

Leukemia in the brain.Â Certain types of leukemia have a tendency to spread to the nervous system. To prevent or to treat this, doctors may inject a drug into the spinal fluid to destroy any cancer cells. This is known as an intrathecal method of administration. Radiation or high doses of systemic chemotherapy are given at the same time with intrathecal chemotherapy.

Bone marrow transplant (BMT). Bone marrow transplants offer some people with leukemia the best chance for a cure. It is usually performed when the leukemia is in remission but has high risk for relapse ; does not respond fully to the treatment, or relapses after treatment. In order to perform the transplant, higher doses of chemotherapy drugs are given. These high dose drugs effectively destroy the person’s leukemia cells. They also kill the normal infection-fighting cells of the bone marrow. To compensate for this destruction, healthy marrow cells are taken from the donor whose tissue type is the same as or almost the same as the person with leukemia. These are infused or transplanted into the person’s bloodstream through an intravenous (IV) catheter. It is hoped that the transplanted bone marrow will produce healthy white blood cells on its own.

There are two types of marrow transplants. In theÂ autologous marrow transplantation, the person’s own healthy bone marrow that has been saved and “cleansed” of leukemic cells are re-infused to replace marrow that was destroyed. In theÂ allogenic transplantation, marrow from a donor with a match of all six cell-markers, known as human leukocyte antigens (HLA), is used to replace the diseased marrow. The healthy marrow may be obtained from either identical twins (best match), or HLA-matched brother or sister, and more recently, from a person who is not related to the person with leukemia.

Based on most clinical studies, the overall survival rate among the different types of BMT was similar. BMT is successful about 50% of the time when measured two years after the treatment. There was a higher relapse rate in autologous BMT due to the failure of getting rid of all the leukemia cells. However, more persons died in the allogeneic BMT due to the complications.

Complications from treatment

Chemotherapy related complications

	The goal of chemotherapy is to destroy leukemia cells, but the drugs are not yet sophisticated enough to only target cancerous cells. In the process healthy cells, especially fast dividing cells such as the hair, skin, mouth, stomach, and intestines, may be destroyed. As a result, the person may lose hair, and suffer from dry skin, mouth sores, and an upset stomach. Fatigue is also a common side effect.
	Chemotherapy lowers patients’ normally functioning blood cells to very low levels. This results in an increased risk of infection and bleeding. The person must often take antibiotics to treat infections, and receive transfusions of red cells and platelets to restore the normal functions of these cells.
	Chemotherapy causes the rapid breakdown of leukemia cells, resulting in the release of cell-contents into the bloodstream. This can damage the person’s overall health and be especially damaging to the kidney. The condition is known as “tumor lysis syndrome” However, this problem can be prevented with special drugs (allopurinol and bicarbonate) and by drinking extra fluids.

Transplant related complications

After an allogenic bone marrow transplant, a person becomes at risk forÂ graft-versus-host disease (GVHD).Â This occurs when the donor’s marrow does not exactly match the person’s marrow. A battle between donor cells and host cells endangers the person’s health. Using drugs that suppresses the person’s immune function can reduce this problem.

New treatments:

Scientists and physicians are constantly searching for new and better ways to treat leukemia. Their effort focuses either on improving the efficacy of current drug therapy, reducing its side effects, or trying to attack leukemia cells in new ways.

Chinese Medicine

In TCM, the treatment of acute leukemia is based on the type of disharmony pattern.

ACUTE STAGE:

1. Damp and Heat Type:

Therapeutic aim:Â Due to an accumulation of damp-heat and toxic pathogens in the whole body, treatment focuses on clearing away heat and dampness evils, eliminatingÂ pathogens, and removing toxic substances.

Example of Prescription:Â Chaiqin Chenling decoction with modification

chai hu	chinese torowax root
huang qin	baical skullcap root
long dab cao	chinese gentian
zhi zi	cape jasmine fruit
chen pi	dried tangerine peel
fu ling	Indian bread
ban xia	pinellia tuber
ze xie	oriental water plantain rooti
zhu ling	chuling
bai zhi	large head atractylodes rhizome
lu gen	reed rhizome
she she cao	herba hedyotis diffusa
qing dai	natural indigo

2. Noxious Heat type

Therapeutic aim:Â This is caused by excessive noxious heat in the interior, and the disturbance of nutrientÂ qiÂ andÂ blood. Treatment includes clearing away heat evils, removing toxic substances, and clamping down on blood circulation to stop bleeding.
Example of Prescription: Shuiniujiao Dihuang decoction with modification

shui niu jiao	buffalo horn
sheng di	dried rehmannia root
dan pi	tree peony bark
chis hao	red peony root
yin hua	honeysuckle flower
lian qiao	weeping forsythia capsule
zhi zi	cape jasmine fruit
sheng shi gao	gypsum
bai hua she she cao	herba hedyotis diffusae

For delirium caused by intensive heat, Zixue pill, Zhibao pill or Angong Niuhuang pellet is helpful.

3. Accumulated Mass type

Therapeutic aim:Â This is caused by stagnant phlegm lingering in the interior and blocking theÂ collaterals (meridians). Therefore, treatment includes promoting blood circulation, removing obstruction in meridians, and softening and resolving hard masses.

Example of Prescription:Â Taohong Siwu decoction with modification

tao ren	peach kernel
hong hua	safflower
chuan xiong	szechwan lovage root
dang gui	chinese angelica
di huang	rehmannia root
chis hao	red peony root
hai zao	seaweed
bie jia	turtle shell
sheng mu li	fresh oyster shell
zhe bei	thunberg fritillary bulb
xia ku cao	spike of prunella

4. Internal Liver-Wind Stir Up Type

Therapeutic aim:Â Individuals with this type are in the most critical condition. Emergency treatment includes using aromatic drugs for resuscitation, and suppressing the hyperactiveÂ liverÂ to relieve theÂ wind syndrome.

Example of Prescription:Â Zhengan Xifeng decoction

huai niu xi	achyranthes root
sheng long ku	unprocessed fossil fragment
sheng bai shao	white peony root
tian dong	asparagus root
sheng mai ya	fresh germinated barley
dai zhe shi	ochre
sheng mu li	fresh oyster shell
xuan shen	figwort root
chuan lian zi	szechwan chinaberry fruit
yin chen hao	virgate wormwood herb
gui ban	tortoise shell
gan cao	liquorice root

Additionally, Zixue pill and Angong Niuhuang pellet can be taken with water.

REMISSION STAGE:

1. Deficiency of Qi and Yin Type

Therapeutic aim:Â The toxins and heat evils impair heart-qi, and burnÂ primordial yin. As a result, treatment benefits the qi, nourishes the heart, aids theÂ yinÂ and invigorates theÂ kidney.

Example of Prescription:Â Shenmai, Erzhi plus Dihuang decoction with modification

bei sha shen	coastal glehnia root
mai dong	dwarf lilyturf tuber
wu wi zi	chinese magnoliavine fruit
nu zhen zi	glossy privet fruit
han lian cao	ecliptai
gou qi chi	barbary wolfberry fruit
sheng di	dried rehmannia root
dan pi	tree peony bark
fu ling	indian bread
yi yi ren	coix seed
bai ji li	puncturevine caltrop fruit
gui ban	tortoise shell

For individuals with residual toxic substances:

she she cao	herba hedyotis diffusae
ban zhi lian	chinese lobelia herb

2. Deficiency of Qi and Blood Type:

Therapeutic aim:Â This type is caused by the deficiency of both qi and blood. In TCM, theÂ spleenÂ is responsible for the production of blood and qi. TheÂ kidneyÂ is responsible for storing the essence, which is the source for blood and qi. Therefore, treatment includes replenishing the qi, nourishing the blood, and invigorating the spleen and kidney.

Example of Prescription:Â Danggui Buxie decoction plus Sijun, Bazhen decoction with modification

huang qi	milkvetch root
dang shen	pilose asiabell root
dang gui	chinese angelica
bai zhi	large head atractylodes rhizome
fu ling	indian bread
shu di	processed rehmannia root
qi zi	barbary wolfberry fruit
nu zhen zi	glossy privet fruit
e jiao	donkey-hide gelatin

For individuals with residual toxic substances and hyperactivity of minute collaterals (meridians):

she she cao	herba hedyotis diffusae
xiao ji	field thistle herb

Prevention

Western Medicine

Prevention of leukemia is often difficult because the exact causes of leukemia are not understood.

	Do not smoke.


	Avoid exposure to various chemicals such as benzene. The degree of risk from these chemicals depends on the intensity and duration of exposure.


	Take safety precautions when working with hazardous chemicals or radiation exposures. Follow the environmental safety rules written to protect the workers in the industry.


	There are no special tests recommended for detecting the leukemia early. The best way to detect leukemia in initial stage is to report anyÂ symptomsÂ to the doctor right away. Persons with inherited genetic illnesses that are known to increase the risk of developing the disease should talk to their doctor about having regular checkups.

Chinese MedicineFrom TCM’s viewpoint, prevention includes two aspects:

1.	Preventing the onset of disease
2.	Preventing the progression of disease

Prevention of Disease Onset:

Stay away from evils such as wind and heat that invade the body and cause disease is important. Eat a proper diet, exercis regularly, maintain peace of mind by having an optimistic outlook on life. Get enough rest, and maintain a balanced lifestyle.

Prevention of Disease Progression:

Individuals who suffer from acute leukemia should maintain an optimistic attitude, and actively participate with doctors in deciding treatment options. Keeping up good personal hygiene, eating a moderate diet, avoiding smoking and alcohol and avoiding overstrain or mental excitement are also important ways to prevent disease progression.
Special attention should be paid to following conditions:

	When bleeding symptoms like the appearance of large body bruises, nose bleeding and gum bleeding occur, strict bed rest is recommended.
	Leukemia sufferers are more susceptible to exogenous (external) pathogens, so they should be kept in a warm, clean and ventilated room, which should be sterilized regularly to prevent infection.

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acuherb — Mon, 18 Aug 2014 22:02:36 +0000

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38 Natural Alternatives for HIV

acuherb — Thu, 10 Jul 2014 20:18:35 +0000

Fortunately, natural substances are being researched for their therapeutic value for our immune health. “Superbugs” develop due to repeated, frequent and multiple different antibiotic prescriptions. Plant products have historically been consumed and utilized for their anti-microbial and holistic benefits. Here are 38 natural substances which indicate potential benefit for people with HIV.

Whey proteinÂ concentrate supplementation canÂ stimulate glutathioneÂ synthesis and, possibly,Â decrease the occurence of associated co-infections.
CurcuminÂ is an effective treatment forÂ HIV-associated diarrhea.
A polyphenol and antioxidant richÂ fruit and vegetable concentrateÂ has therapeutic value in HIV patients due to enhanced proliferation, which could restore disturbances inÂ T-cell homeostasis.
Neem leafÂ extract safelyÂ increases CD4 cellÂ levels in patients with HIV/AIDS.
SeleniumÂ supplementation suppresses the progression of HIV-1 viral burden andÂ improves CD4 count.
Cinnamomum zeylanicumÂ has therapeutic activity in HIV-associatedÂ oral candidiasis.
Elderberry, green tea and cinnamonÂ extracts rich in certain flavonoid compounds were shown toÂ block HIV-1 entry and infection.
LicoriceÂ contains the compound glycyrrhizin which hasÂ significantly inhibits HIV replicationin the peripheral blood mononuclear cells from HIV-seropositive patients.
Sumac (Rhus chinensis)Â contains compounds withÂ anti-HIV activity.
LactoferrinÂ (from milk) mayÂ inhibit HIV virus infection in children.
The use ofÂ Alternanthera pungensÂ herb tea by HIV-infected patients may lead toÂ significant increase T lymphocytesÂ and decrease in biomarkers of oxidative stress, and might help in theprevention of the opportunist diseases.
Plasma antioxidant capacity can be increased by long-term ingestion of polyphenols fromÂ fruit juices or fruit-vegetable-concentrateÂ in HIV-seropositive patients.
American ginsengÂ reduces oxidative stress in patients taking the antiviral medication zidovudine without altering drug pharmacokinetics.
Korean ginsengÂ improves treatment outcomesÂ in HIV-infected patients on antiretroviral therapy.
Glycyrrhiza uralensis (TCM herb)Â improves immune function in HIV-infected patients.
Guduchi (Tinospora cordifolia)Â hasÂ therapeutic activity as an ajunctÂ to HIV/AIDS management.
Lemon juice and lemongrassÂ have therapeutic value in the treatment ofÂ oral thrushÂ in HIV/AIDS patients.
Tea treeÂ is an effective therapy for fluconazole-refractoryÂ oropharyngeal candidiasis.
St. John’s wort (H. perforatum)Â inhibits HIV-1 viral infection.
Lignans found withinÂ SchisandraÂ demonstratesÂ anti-HIV virus activity.
Seawead (S. fusiforme)Â inhibits HIV-1 infectionÂ in T cells, primary human macrophages, microglia, and astrocytes.
Black and green teaÂ contain compounds whichÂ inhibit HIV-1 entry.
Olive Leaf extractÂ exhibitsÂ anti-HIV activity.
Lentin, a novel and potent antifungal protein fromÂ shitake mushroomÂ exhibits inhibitory effects on activity of human immunodeficiency virus-1Â reverse transcriptase and proliferation of leukemia cells.
Chrysanthemum morifoliumÂ contains a flavonoid withÂ anti-HIV activity.
Croton tiglium, Cynomorium songaricum, Xanthoceras sorbifolia, and oleanolic acid derivates exhibitÂ anti-HIV activity.
Hyssop and Dittrichia viscosaÂ haveÂ anti-HIV-1 activity.
PomegranateÂ exhibitsÂ antiviral activity against HIV-1.
A polysaccharide fromÂ Rooibois leavesÂ has aÂ strong anti-HIV activity.
Rosa damascenaÂ contains compounds withÂ anti-HIV activity.
Rose flowersÂ contain compounds with with human immunodeficiency virus (HIV) type 1reverse transcriptase inhibitory activity.
Carnosic acid, a component found withinÂ Rosemary,Â inhibits HIV-1 protease.
Phyllanthus niruri (syn. P. amarus)Â inhibit wild-type HIV virus andÂ reverse transcriptase inhibitor-resistant variants.
CalophyllumÂ brasilienseÂ and Clusia quadrangulaÂ exhibitÂ HIV-1 inhibitory activity.
Melissa, Sweet Basil, Perilla, Prunella vulgaris and SavoryÂ hasÂ potent anti-HIV-1 activity.
Black cohoshÂ contains a compound Actein which exhibitsÂ potent anti-HIV activity.
Black and green teaÂ contain compounds whichÂ inhibit HIV-1 entry.
Blue-green algaeÂ extracts inhibitÂ reverse transcriptases activity, including that of HIV-1.

Is acupuncture covered by insurance?

acuherb — Mon, 28 Apr 2014 22:02:49 +0000

Is acupuncture covered by insurance?

The good news is that yes, many insurance companies now offer policies that cover acupuncture and related services performed by an acupuncturist.

Does my insurance cover acupuncture?

You can find out if your insurance provides acupuncture benefits by calling your insurance company’s patient information or benefits line. This number can be found on your insurance card.

If your insurance provider does cover acupuncture, here are a few questions that you can ask to determine your eligibility and coverage:

How many treatments do I get?
How much does the insurance company pay?
What is the normal co-pay for acupuncture from a preferred provider? (This is the amount you would pay out-of-pocket for each visit to a practitioner on their provider list.)
What percentage will I pay for out-of-network practitioners?Â (This is the amount you would pay out-of-pocket for each visit to a practitioner who is NOT on their provider list.)
Who must provide the acupuncture?
Will I need a referral from an MD to see the acupuncturist?
What is my deductible?
What conditions are covered for acupuncture? (Many plans only cover the treatment of pain)

What are Affinity Programs for acupuncture?

If you don’t have benefits, you may have what’s called an “affinity program”. This is an arrangement that the insurance company has with certain acupuncturists to offer their members treatments at a discounted price (usually 20% to 40% discount off regular price).

Do Medicaid and Medicare cover acupuncture?

At this time, Medicaid and Medicare do not provide coverage for acupuncture.

The California MediCal program offers limited coverage when you see an acupuncturist that is a MediCal provider.

Is acupuncture a treatment option after a car accident?

If you have suffered a personal injury in an auto or motor vehicle accident, your or the other parties car insurance will pay for acupuncture treatments.

How do I bill the insurance companies for acupuncture?

While more and more acupuncturists are signing up to become acupuncture providers for insurance companies and handle all the paper work involved in billing, it is common for practitioners to be paid in full and provide patients with the information they will need to file a claim for reimbursement themselves.

Coding for Acupuncturists

acuherb — Wed, 09 Apr 2014 18:36:52 +0000

Coding for Acupuncturists

By Kenneth Y. WangÂ The provision of acupuncture and oriental medicine within the third-party payer system of American healthcare necessitates the use of codes which designate what is being treated and what procedures are being utilized. The codes used that designate diagnoses are listed in the International classification of Disease, 9th Revision, commonly referred to as the ICD-9. Some state rules and regulations restrict licensed acupuncturists from diagnosis in medical terms. Still, the ICD-9 contains many codes that are sign and symptom oriented and well within those limits. If you have a referral with a diagnosis and treatment plan from the primary care physician, so much the better. But you must provide an ICD code when billing and that diagnosis should be clear in you chart notes as well. The codes that designate therapeutic procedures are listed in Current Procedural Terminology (CPT), updated and published yearly by the American Medical Association.Until 1997 there were no CPT codes for acupuncture. The advent in that year of the CPT codes for acupuncture (97780) and acupuncture with electrical stimulation (97781) was a milestone for integration. A new milestone was reached with the doubling of the acupuncture code set as of January 1, 2005 when 97780 and 97781 were retired. In their place we have:97810 Acupuncture, one or more needles, without electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient. 97811 Acupuncture, one or more needles, without electrical stimulation, each additional 15 minute increment of personal one- to-one contact with the patient, with reinsertion. (List separately in addition to code for primary procedure) 97813 Acupuncture, one or more needles, with electrical stimulation, initial 15 minutes of personal one-on-one contact with the patient. 97814 Acupuncture, one or more needles, with electrical stimulation, each additional 15 minute increment of personal one-on- one contact with the patient, with reinsertion. (List separately in addition to code for primary procedure) There cannot, of course, be milestones without obstacles and the path of development for these new codes was less than smooth. One glaring example of this is found in the definition of the codes, which includes the word .reinsertion.. This is not a word that has meaning within the acupuncture community since we do not reuse needles or points within a single treatment. This word was added by the AMA Reimbursement Update Committee (see below) to connote an additional set of points that would demand a greater amount of work. A .set. is undefined but according to the code definition it could be a single point. It must, for documentation purposes, be distinctly separate in some fashion and in the process of code development it was implied that a set would require repositioning of the patient. The CPT codes are the property of the AMA and they serve as a significant source of income for that organization. The CPT codes are used nationwide and have become not only the de facto standard but also the only HIPPA compliant code set. HIPPA, amongst many other things, mandated that there be a consistent code set across the country, no longer would there be regional codes, no longer would individual payors be able to use their own codes. The Centers for Medicare and Medicaid Services (CMS) is responsible for contracting with the AMA and establishing what is essentially a government mandated monopoly. In this process the CPT codes have come up against some criticism for being incomplete. An alternative code set, the Advanced Billing Concept (ABC) codes has been developed specifically with complementary and alternative medicine in mind. This was certainly not the focus of CPT. When HIPPA became the law of the land there existed a certain amount of pressure on the CPT to expand the code set. Acupuncture was one area ripe for expansion. The CPT Committee formed a workgroup comprised of representatives from the professional organizations that have acupuncture in their scopes of practice. These included the American Chiropractic Association (ACA), the American Academy of Medical Acupuncture (AAMA), the American Association of Oriental Medicine (AAOM) and the Acupuncture and Oriental Medicine Alliance (AOMAlliance). This group of practitioners met for over a year to develop a rational system that allowed for greater variability in coding an acupuncture treatment and still stood up under the scrutiny of, and was understandable to, the CPT Committee, few of whom had any knowledge of acupuncture. Time-based codes are something that has many precedents in the framework of the CPT code set and the conclusion of the workgroup was that this was the best strategy for additional acupuncture codes. These codes were indeed accepted by the CPT Committee and were then sent to the Reimbursement Update Committee (RUC) for valuation. The valuation process is one that all CPT codes go through and is, as they say, .where the rubber meets the road.. Valuation of a code means establishing a number called a Relative Value Unit (RVU) for that code. The number of .Units. expresses a .Value. which is .Relative. to that of other medical procedures, whether they be a colonoscopy or a cold pack. The RVU is made up of three separate component values. (The process of arriving at these values is beyond the scope of this article and to some extent proprietary to the AMA. Suffice it to say that it tries to be scientific, or at least systematic.) The .work value. denotes the training, effort and intensity of the practitioner.s effort. The .malpractice value. denotes the risk involved in the procedure. The .practice expense value. denotes the cost of the office and equipment needed to perform the procedure. These three values are added to arrive at the RVU for that particular code. The RVU is then multiplied by a .conversion factor. to arrive at a dollar value for each code. The conversion factor is a dollar amount that is established contractually by insurers or regionally by CMS regulations for Medicare and Medicaid services. So, RVU x Conversion Factor = Reimbursement. The Medicare conversion factor for 2007 is $37.8975, which is one reason your physician colleagues have very mixed feelings about being involved in it. Which begs the question: What is the RVU for acupuncture? When 97780 and 97781 were established there was disagreement among the practitioners consulted and since neither code was a Medicare/Medicaid reimbursable expense CMS did not feel it necessary to publish values. There do exist other RVU systems, which are published independently of CMS and the AMA. Relative Value Studies Inc. published values of 1.83 for 97780 and 1.96 for 97781. When CMS fist published the values for 97810-97814 they ranged from .53 to .68. This was due to, through error or omission, the cost of actually having an office (the practice expense portion) being left out of the code value. Any use of those code values is a clear under- valuation of acupuncture services but you may find an insurer still using these values. Fortunately this error was corrected by CMS and you will find the RVU as of 2007 at: 97810 .98 97811 .76 97813 1.05 97814 .85 The understanding of the workgroup was that the most common level of service would be 30 minutes of patient contact time, therefore, if there is no electrical stimulation, 97810 and one unit of 97811. If there is electrical stimulation one would use 97813 or 97814 or both as appropriate. The CPT initially mandated that one cannot mix the acupuncture without electrical stimulation codes and acupuncture with electrical stimulation codes but has since changed that to reflect the clinical reality. There are, of course, other nuances to code use. One of these is the aforementioned .reinsertion.. Another involves evaluation and management (E&M). E&M codes are divided into a new and a returning patient series of five levels of increasing complexity, time and charge. New patient codes are 99201 through 99205. Established patient codes are 99211 through 99215. The difference between a new patient and an established patient is three years. If the patient has not been seen by anyone in your clinic in that amount of time they can be considered .new.. Specific definitions of these codes can be found in the CPT manual. The 2007 E&M RVU are: 97201 .99 97202 1.73 97203 2.56 97204 3.92 97205 4.93 97211 .55 97212 1.02 97213 1.66 97214 2.52 97215 3.42 Typically within this model one patient encounter would entail the use of one E&M code and one or more procedure codes. The new codes for acupuncture do have a small amount of E&M included but it is minimal. The time element of the new codes are divided into three segments: . .Pre-service., greeting of the patient and a brief interval history. The code is based on this being 3 min. . .Intra-service., everything connected with doing the procedure â€“ washing your hands, positioning the patient, locating and cleaning the points, inserting and stimulating the needles, checking on the patient, removing the needles. The code is based on this being 15 minutes. This does not include needle retention time when you are not directly monitoring or communicating with the patient. . .Post-service., charting and any instructions to the patient. The code is based on this being three minutes. If your pre- and post- service time substantially exceeds 6 minutes and is clinically necessary you could charge for a suitable level of E&M, but it is essential that you document that you have fulfilled the requirements of that E&M code per the CPT manual and you must modify the E&M code with a -25 modifier to denote that this is a significant, separately identifiable level of service. Insurers will expect E&M to be billed with a new patient and on reevaluation or a new diagnosis of an established patient. It is inappropriate to bill an E&M for each visit. Everything you code for must be supported by your chart notes. Historically the profession of acupuncture has been based on a cash practice with little variation of charge from patient to patient. Moving towards integration into the reimbursement structure of American healthcare means adopting and adapting the standard practices of coding to what we do. Our professional responsibility is to charge with consistency a reasonable amount for our services. Insurance is not a cash cow to be milked by the sophisticated practitioner but an expression of the shared risk of human suffering.

American Institute of Acupuncture

Top 9 Acupressure Points to Treat Premenstrual Syndrome (PMS)

Most Common Symptoms of PMS

9 Important Reflexology Points to Relieve PMS Symptoms

Points on Abdomen

Points on the Back

Points on Legs

Point on Arms

Hormonal causes of irregular periods

Movements, Massage, and Pressure Points for Beautiful, Happy Breasts

The Benefits of Therapeutic Breast Massage

Getting the Lymph Moving

Improving Posture and Range of Motion

What to Expect in a Treatment

Taking Matters into Your Own Hands

The Flower Blooms: 7 Practices for Womenâ€™s Sexual and Reproductive Health

East Vs West â€“ Views on Womenâ€s Sexual and Reproductive Health

Cultural Attitudes to Female Sexuality

Womenâ€s Sexual and Reproductive Health and the Female Anatomy

How the Chinese from the Tang dynasty described the female anatomy:

Traditional Chinese Medicine andÂ Womenâ€s Sexual and Reproductive Health

The Impact of Shame onÂ Womenâ€s Sexual and Reproductive Health

7 Â Sexual & Reproductive Health Practices for Women

1. Meditation

2. Feminine Qi Gong

3. Breast Massage

5. The Yin and Yang of the Pelvic Floor

6. Jade Egg Practice

Acute Leukemia

åå››ç»ç»œæ­Œâ€”â€”é…ç»ç»œåŠ¨ç”»å›¾

38 Natural Alternatives for HIV

Is acupuncture covered by insurance?

Coding for Acupuncturists

Coding for Acupuncturists

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