Medicine and bias

A prominent former Harvard researcher has admitted to cooking the books on his studies to prove his hypothesis that there's a direct correlation between obesity and sleep apnea.

Personally, I'm not against the scientific method. Like any tool, it must be used with awareness of its limitations. This story is an extreme example of the major flaw with the scientific method: observer bias. Researchers take many steps to try and weed out bias in their studies and findings (obviously falsifying your data is a whole other level!), but I feel it remains a flaw of even the most well crafted studies. Bias determines what questions are even asked in the first place, as well as how the results are interpreted.

Before I was an acupuncturist, I studied feminist and anti-oppression theory. One of the things I learned is that bias cannot be eliminated. Our perspective and who we are informs everything we do and the conclusions we come to. It's the nature of human existence. The best thing we can do is to know who we are, and where we are coming from, so that the limitations of our perspective do not overwhelm our judgments, or close off the possibilities of other truths.

In Chinese medicine, we learn to see people and their dis-eases in terms of patterns. Patterns of behaviour, patterns of imbalance, patterns of disfunction. Each symptom exists in concert with the whole, and together they create a picture of where the person is and how they are developing.

A key philosophy guiding the practioner of TCM is tong yi bing zhi, yi bing tong zhi: "Same disease, different treatments; different disease, same treatments." In other words, we break with the Western medical style of treating symptoms, rather than a whole person. Two people with sleep apnea, are two different people - how we help them return to health and balance with Chinese medicine will be very different.

The case of the Harvard researcher brings up a current contentious issue of bias in medicine and health: 'obesity' and its health impact. I practice "body-positive" medicine. I feel strongly that health is not something that can be measured and weighed. Simply looking at a person and making judgments about their health is fraught with peril. Humans come in many shapes and sizes, and appreciating and accepting that diversity is a strength of holistic medicine. Mental health and self-love are vital parts of a full, balanced life. Prescribing a certain body size as 'normal' or necessary for health is akin to prescribing certain heights, ages or races as optimal.

Jing shen bu jin, zhi yi bu zhi, bing nai bu yu. "If the psyche is not taken into account, and the mind not treated, disease cannot be cured." This is as true for those of us who heal, as for those of us healing.

Be well!
Kirsten

Health, Stress, Acupuncture... and you!

A new study shows that acupuncture is as effective as cognitive-behavioural therapy in the treatment of Post Traumatic Stress Disorder (PTSD).

PTSD is usually seen in survivors of accidents, violence, or natural disasters and reflects the person's attempt to cope with a sudden, traumatic event or experience. Recently it has received coverage in the news as returning veterans from Iraq are experiencing the sometimes devastating effects of this disorder. (Source)

The study using acupuncture found that acupuncture provided significant relief, and kept symptoms at bay for 3 months even after treatment was stopped.

Of course, this isn't news to those of us in the field. Acupuncturists Without Borders, a great organization, has been using squads of acupuncturists to treat survivors of natural disasters as well as veterans for several years. And I see in the clinic everyday the immediate effect of acupuncture on anxiety, depression and plain old stressed-out Angelenos!

There is no health problem that is not exacerbated by stress. Pain, digestive troubles, hormonal imbalances... all are made worse by the constant toll of major and minor worries. Our bodies were not designed for the constant, unrelenting strain we now subject them to. Chronic stress depresses the immune system, increases risk of cancer and heart disease, and even shrinks the part of the brain responsible for memory. (Source) Add to that the fact that so few of us make time for the activities that still the mind, that allow the adrenal and other stress-hormone producing glands to rest, and you have a recipe for disaster. Stressed out yet?!

I jokingly call my acupuncture treatments "meditation for cheaters." A few needles can push you into deep relaxation, no lotus position required! Western medicine is still undecided as to the mechanism by which acupuncture so effectively calms the body and mind, but of course, we don't have to wait for them to find out. Make time in your day for calm and quiet, and time in your life for the healing benefits of acupuncture.

Read an earlier article about self-care for stress

Fatty Acids, Not Cholesterol Drugs, Reduce Heart Failure Mortality

The Lancet online has published the results of a large Italian study aimed at weighing the effects of Omega 3 Fatty Acid supplementation versus statin (a class of cholesterol lowering drugs) therapy for patients with heart failure. Surprise. The drugs lower cholesterol... but don't prevent recurrence of heart attacks or death. (Omega 3 Fatty Acid supplementation has a modest but statistically significant effect in reducing illness and mortality)

"Tognoni said that the prescription of rosuvastatin or any statin to patients with heart failure should not be considered because the use of the cholesterol-lowering drugs does not translate into any clinically meaningful benefit for heart-failure patients." Source

I've long been suspicious of 'numbers drugs'. Those are the ones like cholesterol lowering, blood pressure lowering etc., that treat the numbers in a lab test, not real symptoms. As research progresses, we often find that things thought to be simple equations, like high cholesterol=heart failure, therefore low cholesterol=less heart failure turn out to be far more complex than that. High cholesterol is a created disease. It has no symptoms, can only be detected in a lab, and no one is actually certain of what it leads to. Except that it leads to taking expensive and side effect laden drugs. I am gratified by the results of this study, and reaffirmed in my respect for my profession: TCM sees the person as a whole, and disease and wellness as processes, not a mathematical equation.

Where have I been?

The answer to that question is: studying for the boards!

I will be flying to Sacramento in 3 weeks to write my licensing exam along with a thousand or so other would-be acupuncturists.

Hopefully I will pass (positive vibes happily accepted!) and will get my license to practice acupuncture in California sometime in September. I'll be back writing then, I promise!

be well!
Kirsten

British Columbia to cover Acupuncture for Low-Income Residents.

Or is it?

The supplementary coverage for low-income residents of British Columbia (where everyone is covered for basic health care by government health insurance) adds acupuncture to the type of alternative medicine that participants can be reimbursed for:

"MSP reimburses premium assistance recipients $23 for each supplementary benefit - for example either physiotherapy, naturopathy or acupuncture - for a combined maximum of 10 visits per year." Read the complete article from the Victoria Times-Colonist

On the one hand, it's great to see the BC government recognizing the benefits of acupuncture - and the importance of helping people access low-tech preventative care like it and other 'alternative' medicine. (Apparently the BC Health Minister used acupuncture to treat his injuries from running - always good to have a patient in government: apparently Arnold Schwarzenegger and Maria Schriver both get acupuncture, which has been good for helping kibosh legislation in California that would be damaging to the profession). On the other hand, 10 treatments total for all three of these modalities, chiropractic, acupuncture and naturopathy, is so very little. I think there is still resistance to seeing the way that our medicine works - not in dramatic bursts like surgery, a cortisone shot, or a course of antibiotics.. It's more like eating well or regular exercise - sustained change is a result of consistent visits. Not that people don't have amazing results from a single treatment - I've seen it myself. But for most people, especially if you have chronic or longstanding problems, acupuncture needs to be a regular thing, not a sporadic one.

All this brings me to the Community Acupuncture model, which attempts to close the gap between how often people need to receive acupuncture for the maximum health benefits, and how much most people (even not technically 'low-income') people can afford. I am taking a roadtrip in a few weeks to Northern California and I will be visiting a few Community Acupuncture clinics to see how this style of treatment works - I'll report back on my findings, but I am optimistic about a model that sees more people getting more treatments, more often!

L'khaim, to your health.

Kirsten

Spring time is the right time... for controlling your allergies!

Seasonal allergies are the bane of springtime for many people. As the rest of us feel light as clouds, floating on the euphoria of longer days and warmth as winter wanes, the allergic among us are locked inside, fearful of the clouds of pollen waiting to attack them. They sneeze and sniff their way through the beauty of spring, peering about through watering eyes, waiting for it all to go away.

Despite the miraculous transformations that the actors in the commercials go through, over the counter treatments for allergies are often as bad as the disease, leaving you with a dry nose, but either comatose from antihistamines, or with a pounding heart and shaking hands from 'non-drowsy' formulations.

So, what can Chinese medicine do for you, poor woeful allergy sufferer?

Lots, according to studies. A controlled 2004 study using acupuncture and herbs, concluded:

"We could show that this treatment was efficacious in improving global severity rating and in affecting disease-related quality of life parameters after 6 weeks of treatment when compared with sham needling plus a non-specific herbal formulation" (Source)

What exactly does that mean? It means after 6 weeks, people getting real acupuncture and herbs felt better than those getting the placebo versions. There are dozens of other studies showing the same things. Other findings involve testing the nasal secretions of allergy sufferers (great job!) . That study revealed that the secretions of patients after receiving acupuncture treatment had no or lower quantities of eosinophils, a blood cell related to allergic response that is high in those suffering from allergies. (Source)

So come in for acupuncture treatment and herbs! The best results occur if you come in BEFORE allergy season, preferably at least 6 weeks. But of course, symptom relief can still be had if you missed the window. Once your symptoms abate, your practitioner will use acupuncture and herbs (and diet and lifestyle changes) to build up your system so that next season you'll feel great, pollen or no pollen.

There are some things you can do at home to reduce your allergy woes. Remember where I mentioned 'diet and lifestyle' up above? Like other holistic modalities, Chinese medicine feels great and works because you, the patient,are a participant in your own treatment and healing. Of course, to be a participant, you have to participate!

1. Diet
Common stimulants of allergic symptoms include dairy, sugar and wheat, especially white flour products like pastries, bread and pasta. Cutting down or eliminating these items will usually make you feel better right away. I tell patients to just try a week without one of them. If you notice a difference, then you know what you have to do!

2. Sleep
Are you getting enough sleep? Most people don't. Cutting corners on sleep sends your system into emergency mode, and that stimulates your already hyperactive immune system. Our society trains us to think of sleep as a waste of time, but we literally can't live without it. If you are getting less than 6 hours a night, something has to give.

3. Air quality
Definitely be active in your community to advocate for clean air laws, greater public transportation options and slashing industrial emissions. All these things contribute greatly to rates of respiratory disease of all kinds, including allergies. On the home front, trade in your chemical cleaners, detergents and sprays for nontoxic, fragrance free versions. Or make your own! Nothing cleans as well and safely as baking soda and vinegar (and elbow grease, but then you'll get some exercise too!)

Breathe easy with Chinese medicine and you'll be able to enjoy those spring flowers!

Hawthorn for the heart

A new study indicates that the popular herb hawthorn may have measurable benefits for heart disease patients (complete study here: warning medical-ese ahead!). Hawthorn is called shan zha in chinese. It's indicated for 'food stagnation', conditions where improperly or incompletely digested food hangs around and causes trouble. Shan zha is specifically recommended for meats and fats. In modern times this has translated into its use for atherosclerosis: fatty plaque deposits in the arteries impeding blood flow. Shan zha also promotes blood flow, another indicator of its modern use as a heart health herb.

Shan zha is a component of various formulas a chinese herbalist might prescribe, but it is also considered a 'food herb' - safe to take for long periods. A delicious tea can be made by steeping the dried berries in hot water. You may wish to sweeten the brew with a little honey, as the berries can be tart. Enjoy February, 'heart health month' with a warm red glass of hawthorn berry tea!