Slip and Fall Injury: How Acupuncture can help

Slip and Fall injury in Older Adults: An overview and how Acupuncture can help.[1]

Every year in the US, millions of adults slip and fall, causing moderate to severe injuries, such as hip fractures and head traumas, and can increase the risk of early death 1 . Fortunately, falls are largely preventable. Acupuncture and traditional Chinese medicine can help strengthen the body in a holistic fashion and decrease the likelihood of severe injury. A snapshot of the 2013 statistics shows how dramatic slip and fall problems are in America:1

Statistics:

· One out of three older adults (those aged 65 or older) falls each year1 but less than half talk to their healthcare providers about it.2
· Among older adults, falls are the leading cause of both fatal and nonfatal injuries.3
· In 2013, 2.5 million nonfatal falls among older adults were treated in emergency departments and more than 734,000 of these patients were hospitalized.3
· In 2012, the direct medical costs of falls, adjusted for inflation, were $30 billion.4
· Twenty to thirty percent of people who fall suffer moderate to severe injuries such as lacerations, hip fractures, and head traumas.5,6 These injuries can make it hard to get around or live independently, and increase the risk of early death.
· Falls are the most common cause of traumatic brain injuries (TBI).5
· In 2000, 46% of fatal falls among older adults were due to TBI.7
· Most fractures among older adults are caused by falls.8 The most common are fractures of the spine, hip, forearm, leg, ankle, pelvis, upper arm, and hand.9
· Many people who fall, even if they are not injured, develop a fear of falling.10 This fear may cause them to limit their activities, which leads to reduced mobility and loss of physical fitness, and in turn increases their actual risk of falling.11

Fall Injuries

· People age 75 and older who fall are four to five times more likely than those age 65 to 74 to be admitted to a long-term care facility for a year or longer.13
· Rates of fall-related fractures among older women are more than twice those for men.14
· Over 95% of hip fractures are caused by falls.15 In 2010, there were 258,000 hip fractures and the rate for women was almost twice the rate for men.17
· White women have significantly higher hip fracture rates than black women.17

What can you do to prevent injuries?

Adults can stay healthy and independent to reduce their chances of falling.18,19 Specifically, you can:

· Exercise regularly. Exercise focuses on increasing leg strength and improving balance, aspects that can get more challenging over time. Chinese Medicine Movement Therapies such as Tai Chi and medical Qi Gong programs are especially good for promoting balance and core strength.1
· Get acupuncture regularly. Acupuncture therapy stimulates the body’s natural muscle response in a gentle way and leads to greater body awareness and improved muscle tone and stability.
· Take Tonic Herbs on daily basis. Tonic herbs boost the immune system and calm the nervous system without the side effects of pharmaceutical drugs. A calm and balanced nervous system is the first step towards stability and preventing falls.
· Ask your acupuncturist to review your medicines—both prescription and over-the counter—to identify medicines that might cause side effects or interactions such as dizziness or drowsiness.1
· Have your eyes checked by an eye doctor at least once a year and update your eyeglasses, if needed. Consider getting a pair with single vision distance lenses for some activities such as walking outside.1
· Improve home safety by reducing tripping hazards. Install grab bars inside and outside the tub or shower and next to the toilet, or add railings on both sides of stairways, and improve the lighting in your house.1

To lower their hip fracture risk, you can:

· Get adequate calcium and vitamin D—from food and/or from supplements.1
· Do stability, balance and weight bearing exercise, such as Tai Chi, Qi Gong and Movement Therapy.1
· Get screened and, if needed, treated for osteoporosis.1

References

[1] Article adapted from CDC.Gov website: http://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html. Retrieved 31DEC14.

1. Tromp AM, Pluijm SMF, Smit JH, et al. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol 2001;54(8):837–844.

2. Stevens JA, Ballesteros MF, Mack KA, Rudd RA, DeCaro E, Adler G. Gender differences in seeking care for falls in the aged Medicare Population. American Journal of Preventive Medicine 2012;43:59–62.

3. Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web–based Injury Statistics Query and Reporting System (WISQARS) [online]. Accessed August 15, 2013.

4. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and nonfatal falls among older adults. Injury Prevention 2006a;12:290–5.

5. Sterling DA, O'Connor JA, Bonadies J. Geriatric falls: injury severity is high and disproportionate to mechanism. Journal of Trauma–Injury, Infection and Critical Care 2001;50(1):116–9.

6. Alexander BH, Rivara FP, Wolf ME. The cost and frequency of hospitalization for fall–related injuries in older adults. American Journal of Public Health 1992;82(7):1020–3.

7. Stevens JA. Fatalities and injuries from falls among older adults – United States, 1993–2003 and 2001–2005. MMWR 2006b;55.45:1222–24.

8. Jager TE, Weiss HB, Coben JH, Pepe PE. Traumatic brain injuries evaluated in U.S. emergency departments, 1992–1994. Academic Emergency Medicine 2000;7(2):134–40.

9. Scheffer AC, Schuurmans MJ, Van Dijk N, Van Der Hoof T. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age and Ageing 2008;37:19–24.

10. Bell AJ, Talbot-Stern JK, Hennessy A. Characteristics and outcomes of older patients presenting to the emergency department after a fall: a retrospective analysis. Medical Journal of Australia 2000;173(4):176–7.

11. Vellas BJ, Wayne SJ, Romero LJ, Baumgartner RN, Garry PJ. Fear of falling and restriction of mobility in elderly fallers. Age and Ageing 1997;26:189–193.

12. Stevens JA, Dellinger AM. Motor vehicle and fall related deaths among older Americans 1990–98: sex, race, and ethnic disparities. Injury Prevention 2002;8:272–5.

13. Scott JC. Osteoporosis and hip fractures. Rheumatic Diseases Clinics of North America 1990;16(3):717–40.

14. Donald IP, Bulpitt CJ. The prognosis of falls in elderly people living at home. Age and Ageing 1999;28:121–5.

15. Hayes WC, Myers ER, Morris JN, et al. Impact near the hip dominates fracture risk in elderly nursing home residents who fall. Calcified Tissue International 1993; 52:192–198.

16. Stevens JA, Sogolow ED. Gender differences for non-fatal unintentional fall related injuries among older adults. Injury Prevention 2005b;11:115–9.

17. National Hospital Discharge Survey (NHDS), National Center for Health Statistics. Available at:www.cdc.gov/nchs/hdi.htm. Assessed September 14, 2011.

18. Gillespie, LD, Robertson, MC, Gillespie, WH, Sherrington C, Gates S, Clemson LM, Lamb SE. Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews 2012, Issue 9. Art. No.: CD007146. DOI: 10.1002/14651858.CD007146.pub3.

19. Moyer VA. Prevention of Falls in Community-Dwelling Older Adults: U.S. Preventive Services Task Force Recommendation Statement. Annals of Internal Medicine 2012;157(3):197–204.

ABOUT THE AUTHOR:

Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and President of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional East-Asian medical techniques. Mr. Heide is a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.

Menopausal Syndrome (Climacteric Syndrome): How Chinese Medicine Can Help

Menopause is a transition that all women eventually pass through on their way from reproductive age to the non-reproductive stage in their life. Technically speaking, ‘menopause’ is the complete cessation of menstruation.[1] Menopause usually starts somewhere around the age of 48 and proceeds through age 55, with an average age of 51. According to Chinese medicine in the Simple Questions—a foundational text for Chinese medicine—the average age at which a woman starts her menopause transition is 49.[1]

In the clinical setting, most women will experience some combination of basic symptoms that include:

· Hot flushing and night sweating
· Mood swings: anxiety, depression, insomnia
· Drying hair, skin, nails, vaginal tissue
· Back pain and osteoporosis
· Fatigue and headaches
· Poor memory and concentration

From a biomedical perspective, the main cause of menopause symptoms is ovarian changes that lead to a decrease in estrogen (in the form of estradiol) production. Nearly 85% of women suffer from hot flushes and nearly 45% continue to experience them for up to 10 years after menopause.[1]

Normal biomedical treatment for menopausal symptoms is usually based on hormone replacement therapy (HRT or ERT): native estrogens, conjugated equine estrogens or synthetic estrogens in a dose that is approximately 1/7th of the dose used for the contraceptive pill.[1]

Different from a biomedical approach, the Chinese medicine perspective on menopause focuses on the declining state of the Kidney Essence (the foundational energies that provide substance and function to the body). Menopausal symptoms are, on a basic level, due to the natural decline of Kidney Essence, which can be broken down into two aspects: declining Kidney Yin (substance) and declining Kidney Yang (function). Depending on the symptoms a patient presents with in the clinic, Chinese medicine will determine which deficiency (Yin or Yang) is most affected and treat according to the pattern. Often, both Kidney Yin and Yang are affected and need to be addressed.

Treatment according to Chinese medicine patterns for menopause is essential. While acupuncture is an excellent choice for initial symptom management, it is important to incorporate herbal remedies into the treatment strategy for a more complete therapy. Because both Kidney Yin and Yang are often deficient, common formulas such as Zuo Gui Wan (Restore the Left [Kidney]) and You Gui Wan (Restore the Right [Kidney]) are incorporated into the herbal strategy. While the Kidneys are the principle Chinese medicine organs associated with decline in menopause cases, other factors can often complicate the patient’s case such as the presence of Phlegm and Dampness (pathogenic disease causing factors) and Qi Stagnation and Blood Stasis (lack of proper energy and blood movement).[1] Often, if secondary factors such as Phlegm and Blood Stasis are not addressed, simply treating the Kidney deficiency will not resolve the condition.

The expected prognosis for menopause symptom management is good, and most patients begin to see results within 2-3 months of regular acupuncture and herbal treatments.

Recently, I had a 53-year-old female patient visit my clinic in Eugene requesting treatment for hot flashes (flushes) and insomnia. After a detailed patient history and intake, I decided that her Kidneys were deficient and need to be strengthened, but she also had a Phlegm/Damp condition that would likely make the treatment challenging. I chose to place her on twin formulas from the Classical Pearl line: Guanyin Pearls and Earth Pearls at dose of 3 capsules each in the morning and 3 capsules in the evening. Additionally, I recommended a tonic formula of Eucommia Bark, which is known in Chinese Herbal medicine to strongly tonify Kidney Essence. After 2 months of weekly acupuncture treatments and compliancy with her herbal medicine, my patient happily shared that she had noticed a significant change in her ability to fall asleep at night and also a decrease in her hot flashes. As of this blog write-up, she continues to use herbs and acupuncture to manage her symptoms, and feels much better now than when she first arrived in my clinic—and does not need to use HRT at this moment.

The take away from this discussion on menopause is: acupuncture and Chinese herbal medicine are excellent choices for patients who are suffering from menopause symptoms and are interested in other treatment options beyond biomedical HRT treatment.



ABOUT THE AUTHOR:

Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and President of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional Chinese medicine therapies. Mr. Heide is a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.






[1] Maciocia, G. Obstetrics and Gynecology in Chinese Medicine. 2nd Ed. (2011). Pps: 735-738; 753-754.

Community Style Acupuncture (Acupuncture Group Therapy): Why it’s a great treatment option for fixed income patients.

Many patients suffer from chronic pain that will not resolve in the typical insurance timeframe of 6-10 treatments. Community style acupuncture is wonderful bridge between full priced, private treatments, and nothing at all.

Recently, I had a patient come into my office in Eugene and inquire about acupuncture and herbal medicine for a chronic pain condition. After a detailed review of systems, I concluded that his condition would require 6-12 months of regular care—specifically meaning—acupuncture at least once per week with supplemental herbal formulas. This patient had been in multiple car accidents resulting in multiple spinal fusions to help correct herniated lumbar and thoracic discs. After having had surgery, steroid shots, and used oral pain killers for nearly a decade, he was desperate to find another pain management solution because his life—as he describes it—was slowly slipping into a endless cycle of pain medication, surgery, and relapse.

Upon hearing that he would need nearly a year of acupuncture therapy to help resolve his condition, he disappointedly shared with me that he was on a fixed income and could not afford regular treatments of $75 per week. I ask him what his budget was for therapy and he indicated that he was on a fixed income that was limited and small—only about $30/week. He was preparing to leave my office, when I asked to him stay, and indicated there was another option available: community style acupuncture, or Acupuncture Group Therapy.

Community style (Acupuncture Group Therapy) is a model of treatment that uses a sliding scale from $20-40 per treatment. The patient selects which price they feel is best suited to their budget, and they pay for a one-hour community style acupuncture treatment. Community treatments are group treatments (5-10 people seated in comfortable, reclining zero-gravity chairs) in a large room. During this time, the attending acupuncturist will seat the patient and conduct a brief medical intake. Acupuncture points will then be selected and treatment administered. Seat time is approximately one hour, on a first-come, first-served basis. After approximately one hour of needle retention time, needles will be removed and the patient is free to leave.

The benefits of Acupuncture Group Therapy are many, but the therapy is specifically indicated for those people who suffer from chronic, long-standing conditions that benefit from regular (one or more times per week) treatment. Additionally, the sliding-scale makes treatments affordable to those on a fixed income, or have limited resources for their healthcare.

Another wonderful benefit of Acupuncture Group Therapy is the group itself. Many patients report that when they are treated in a group setting, they feel much more calm and have a sense of stronger healing from each treatment. Feeling the augmented benefits of group treatments is a common phenomenon in the medical world, and Acupuncture Group Therapy uses this spectacular healing response to help optimize care for all patients.

Anjuna Medicine is pleased to announce that we have started two Acupuncture Group Therapy time slots: Wednesdays from 3pm-8pm, and Saturdays from 3pm-8pm.

If you know of a friend or family member who could benefit from Community Style Acupuncture Group Therapy, please have them contact Nathan at Anjuna Medicine: by phone 619-240-6497 or by email at ‘Nathan@AnjunaMedicine.com’



ABOUT THE AUTHOR:

Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and President of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional East-Asian medical techniques. Mr. Heide is a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.

Frozen Shoulder (Adhesive Capsulitis) Pain: Treatment options with Acupuncture and Chinese Herbal Medicine.

Frozen shoulder pain is one of the most common conditions treated in my clinic. The typical patient who seeks treatment is often between the ages of 40 and 65; more common in women than men; and is especially perimenopausal women or in patients with endocrine disorders, such as diabetes mellitus or thyroid disease.[1] [2] [3]

The key symptoms for diagnosis include:
· Very painful shoulder triggered by minimal or no trauma.
· Pain disproportional to movement.
· Especially painful when externally rotation the elbow by the side of the trunk
· Alternation of stiffness and freezing periods of pain.

Generally speaking, there are three phases to a frozen shoulder pathology: the inflammatory phase (4-6 months duration), the freezing phase (4-6 months duration) and the thawing phase (up to a year or more).1 2 3 The total time for idiopathic frozen shoulder, in the absence of other complications, is 24 months. However, patients with shoulder trauma, or active endocrinopathy conditions can last much longer.

From the perspective of Chinese Medicine, Dr. Subhuti Dharmananda, Ph.D., Director, Institute for Traditional Medicine in Portland, Oregon has the following commentary on Frozen Shoulder treatments (excerpt):

“COMMENTARY ON ACUPUNCTURE THERAPY
As is often noted for treatment of acupuncture therapy, the methods used for frozen shoulder involves diverse ideas about selection of points. There are two main strategies: involving either local or distal treatments. Many of the local points chosen are ones at the shoulder and then some others on the affected meridian (mainly small intestine and large intestine meridians) along the arms and hands. Distal points may be used instead (as in the case of several below the knee points, and also for scalp acupuncture). In some cases, contralateral treatment is relied upon; other times, both local and distal points are on the affected side. Less often, both local and distal points are used. In terms of the points most frequently selected, the local points jianyu (LI-15), bianao (LI-14), and quchi (LI-11) of the large intestine meridian and jianzhen (SI-9), bingfeng (SI-12), and houxi (SI-3) of the small intestine meridian are emphasized. The commonly used distal points are yanglingquan (GB-34) and tiaokou (ST-38) plus several extra points between or to either side of these points were each mentioned. Acupuncture therapy was supplemented by massage and/or the patient's own exercises in virtually every case. Sometimes physician-managed manipulations would be used.

HERB THERAPY
Pain in the upper body is often deemed a disorder related to invasion of wind, and a condition with stiffness is often associated with coldness, so frozen shoulder fits the ancient category of wind-cold invasion. Modern thinking on the subject of persisting pain at a fixed site suggests that blood stasis may also be involved.

A typical traditional formula considered suitable for "50-years shoulder" is Juanbi Tang, which has the wind dispelling herbs chiang-huo and siler and the blood vitalizing herbs turmeric, tang-kuei, and peony. These herbs are used in a base of tonification therapy that is suited especially to those who are elderly and suffer from a disorder in which there is easy invasion of wind and development of stagnation due to qi and blood deficiency. Hence, in addition to the blood nourishing herbs tang-kuei and peony, the qi tonic and center strengthening combination of astragalus, fresh ginger, jujube, and licorice is included.

An herbal preparation described as a successful remedy for frozen shoulder has the following main herbs: chiang-huo, siler, tu-huo, cinnamon twig, chin-chiu, vitex, cnidium, millettia, and salvia. Here, cnidium, millettia, and salvia serve to vitalize blood and nourish blood, while the other herbs dispel wind and warm the meridians.”[4]

Acupuncture and herbal therapy is an excellent choice for the patient who wishes to make significant progress in the treatment of frozen shoulder and, hopefully, avoid future surgical procedures.



ABOUT THE AUTHOR:

Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and President of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional East-Asian medical techniques. Mr. Heide is a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.








[1] Neviaser AS et al. Adhesive capsulitis: a review of current treatment. Am J Sports Med. 2010 Nov;38(11):2346-56.
[2] Rill BK et al. Predictors of outcome after nonoperative and operative treatment of adhesive capsulitis. Am J Sports Med. 2011 Mar;39(3):567-74.
[3] Robinson CM et al. Frozen shoulder. J Bone Joint Surg Br. 2012 Jan;94(1):1-9.
[4] http://www.itmonline.org/arts/frozenshoulder.htm

The Low Back Pain Injury: Treatment and financial considerations with acupuncture and herbal therapy

Low back pain is the second most common cause of missed workdays due to illness and the most common cause of disability in the US. Most episodes of back pain are self-limited, but 5%-10% of cases become chronic. Chronic conditions account for 90% of healthcare expenditures for back pain and amount to approximately $50 to $80 billion dollars annually.[4] Acupuncture and herbal therapy has an extensive history of successfully managing low back pain and reducing overall costs associated with chronic cases, and should be considered as an initial treatment option.

Lumbar disk herniation usually occurs from degenerative disk disease (dessication of the annulus fibrosis) in patients between 30- and 50-year-olds. The L5/S1 disk is affected in 90% of the cases. Compression of neural structures, such as sciatic nerve, causes radicular pain. The most common activity leading to herniation is usually bending or heavy loading (such as lifting) with back in flexion, which leads to a herniation or extrusion of the disk contents.[1] [2] [3]

The key symptoms for diagnosis include:

 
· Pain with back flexion or prolonged sitting.
· Radicular pain with compression of spinal structures.
· Lower leg numbness.
· Lower leg weakness.

Many patients mistakenly attribute the onset of their back pain to a specific injury, however, the actual injury from activity such as bending over, twisting, or lifting, is often trivial. Much of the time, low back pain is from the culmination of chronic injury and cumulative trauma relative to the person’s general health. Physically active and energetically healthy people have a lower incidence of back pain than those who lead an imbalanced and sedentary lifestyle.[4]

From the perspective of East Asian Medicine, Kidney Qi manages the strength of the low back. When the Kidney Qi is strong, the low back is strong; when Kidney Qi is weak, the low back is weak. The poor posture plus the following factors can lead to low back pain: Weak Kidney Qi combined with invasion of Cold and Dampness, plus Stagnation of Qi and Blood.[4]

Treatment methods vary between East and West. From the Western allopathic perspective, bed rest for up to 48 hours is appropriate for acute exacerbation of symptoms followed by first-line treatments of: activity modification; NSAIDS, physical therapy, core stabilization exercises and McKenzie exercises.[1] [2] [3] The incidence of low back pain recurrence after one year of nonsurgical treatments is at least 40%.[1] [2] [3] Corticosteroid injections can be beneficial, especially when used to relieve acute pain, but the results tend to only last three months. Surgery is usually suggested after all other conservative measures have failed. [1] [2] [3]

From the Eastern perspective, a combination of acupuncture, herbs, TuiNa (medical massage) and QiGong (movement exercises) can help the body reduce pain, improve flexibility, increase mobility and enable the patient return to their activities of daily living. Patients in my private practice regularly report that within 6-8 weeks of weekly acupuncture treatments and herbs, they are 90% recovered with very few—if any—pain recurrences. The benefits of using an acupuncture and herbal approach is that often the pain levels can be reduced to the point where the patient rarely requires surgery or additional drug therapies (corticosteroid injections) that have long-lasting, adverse side effects.

The cost effectiveness of non-operative treatments, such as acupuncture, is an important consideration point:
· Surgical discectomy w/ fusion (no complications/with comp.)  $41,363/$55,575
· Repeat surgical procedure (often required multiple times):       $28,019
· Lost productivity (work, caregiver, housework):                      $59.71/hour
                                                                                            _______________
Surgical and lost productivity total:                                         $69,441.71[5]

An average acupuncture treatment costs $75/session. A conservative treatment plan would require weekly treatments for six months. Herbs cost an average of $85/month for six months. The total cost for treatment with acupuncture and herbs for six months is approximately: $2,310.00. Most modest insurance plans have high deductibles between $2500 and $5000. Therefore, a patient must often spend between $2500 and $5000 before surgery is covered. While acupuncture and herbal therapies are not always the correct solution for patients with low back pain, it is clear that an initial expenditure of $2,310.00 in an effort to potentially save $69,44.71 in surgical expenses makes good financial sense. The added benefit of acupuncture therapy is that complications from surgery can often be averted if acupuncture and herbal therapy is effective, which also helps reduce overall costs.

Acupuncture and herbal therapy is an excellent choice for the patient who wishes to save money, prevent surgical complications and is interested in a holistic approach to healing.


ABOUT THE AUTHOR:

Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and CEO of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional East-Asian medical techniques. Mr. Heide is a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.


[1] Jacobs W et al. Total Disc replacement for chronic back pain in the presence of disc degeneration. Cochrane Database Syst Rev. 2012 Sep 12;9:CD008326
[2] Rihn JA et al. Duration of symptoms resulting from lumbar disc herniation: effect on treatment outcomes: analysis of Spine Patient Outcomes Research Trial (SPORT). J Bone Joint Surg Am. 2011 Oct 19;93(20):1906-14.
[3] Suri P et al. Recurrence of radicular pain or back pain after nonsurgical treatment of symptomatic lumbar disk herniation. Arch Phys Med Rehabil. 2012 Apr;93(4);690-5.
[4] Callison M. Treatment of Orthopedic Disorders: A Class Manual. 2nd Ed. 2007 AcuSport Seminar Series LLC:114-157.
[5] Tosteson AN et al. The Cost Effectiveness of Surgical Versus Nonoperative
Treatment for Lumbar Disc Herniation Over Two Years Evidence From the Spine Patient Outcomes Research Trial (SPORT) SPINE. 2008 33;19: pp 2108–2115

9 Things Successful Patients Won’t Do

Recently, Dr. Travis Bradberry, Ph.D., wrote a great blog on LinkedIn called, “9 Things Successful People Won't Do” and in it he featured tips that can be directly applied to health management.

When patients first enter my clinic in Eugene, many arrive because they are suffering from some form of pain or medical condition that has not previously responded well to allopathic medicine and/or conventional medical therapies. Many patients are frustrated and upset by their condition, and are—understandably—nearing the end of their patience with medical professionals. Often the initial conversation between a patient and myself is one that revolves around frustrations of previous, often unsuccessful, medical care and the disenchantment around the lack of results produced by current healthcare system at large. While these are all important topics to discuss and I would like to continue to provide my office as a safe space to explore such conversations, it is helpful to enlist Dr. Bradberry’s tips to help improve acupuncture therapy. Successful patients—patients who achieve their healing goals with their healthcare practitioner— do the following:

They Won’t Let Anyone Limit Their Joy

Therapy satisfaction and healing are derived from many different areas: the body’s current health state, the medications one is on, nature and history of the illness, genetics, and most importantly the mental state of a patient. A success patient knows that their healing is primarily derived from the way in which they view their disease and the current situation—that is to say, they stay positive about the direction of their therapy, even if it seems to be taking longer than expected. Successful patients don’t compare themselves to other people, or to other times in their lives. Healing is a unique process that is always tied to the unique circumstances of that particular day and injury. While it is often initially satisfying to ask others how their treatments went and what results they received, the successful patient knows that only opinions that really matter are their own and the feelings associated with it. The joy of a successful treatment is a powerful healing tool and should not be limited by any other outside entity.

They Won’t Forget

Successful patients are quick to forgive themselves (and their bodies) of past injuries. Dr. Bradberry states, “Forgiveness requires letting go of what’s happened so that you can move on.” This process of forgiving and moving onward releases the emotional shackles that often prevent patients from truly healing. Successful patients are unwilling to be controlled by their own feelings of mistakes that might have lead to an illness. Rather, the successful patient lets mistakes go quickly, learns from those mistakes, and becomes assertive in protecting themselves from future harm.

They Won’t Die in the Fight

Successful patients know how important it is to live to fight another day. In the progress of illness, unchecked emotion makes you dig your heels in and fight the kind of battle that can leave you severely damaged. Unchecked emotions place unnecessary stress on the immune system and prevent the deeper healing that often needs to take place when working with chronic, recalcitrant conditions. The successful patient manages their emotions in such a way that they are able to choose healthcare battles wisely and only fight when the time is right. This is not to say that successful patients do not fight for the healing process—they do, in fact, fight very hard to heal. However, by being selective and aware of when to exert maximum fighting energy and when to calm down and allow the body to heal without emotional stress is the critical difference which often makes the largest difference between those patients who have profound healing responses and those who become stuck and don’t heal.

They Won’t Prioritize Perfection

Successful patients won’t set perfection as their target goal because they know it doesn’t exist. All patients are fallible, and when perfection is the goal, one is always left with a nagging sense of failure; Patients end up spending time lamenting what healing failed to accomplish instead of enjoying what healing did occur. Taking a step back from the larger goal of ‘complete, painless recover’ and breaking down the process into smaller steps to complete recovery will often reveal just how much healing is actually happening. The successful patient knows how to observe the small progress waypoints, rather than becoming fixated on the end result and being disappointed when they don’t arrive at the end immediately. 

They Won’t Live in the Past

Past medical conditions erodes self-confidence and makes it hard to believe a better outcome is possible in the future. In most cases, perceived therapy failure results from taking risks and trying to achieve something that isn’t easy. However, successful patients know that success lies in their ability to rise in the face of failure, and they can’t do this when they’re living in the shadows of their past medical history. Any significant medical milestone worth achieving is going to require one to take some risks, and one can’t allow failure to stop a person from believing in the ability to heal. When a patient lives in the shadows of their medical past, that is exactly what happens; the past medical history becomes the present, preventing future healing The successful patient does not allow the shadows of past medical conditions to prevent future healing successes.

They Won’t Dwell on Problems

The focal point of attention determines emotional state. When a patient fixates on the problems, this creates prolonged, negative emotions and stress, which inhibits the healing process. Successful patients know that when focus is placed on actions to better the circumstances, they create a sense of personal power that produces positive emotions and improves the healing response. Successful patients won’t dwell on problems because they know the most powerful healing response comes from a focal point on solutions and positivity instead of negativity and problems.

They Won’t Hang Around Negative People

Complainers are bad for the healing process because they wallow in their conditions and fail to focus on healthcare solutions. Unsuccessful patients want people to join their melancholic mental so that they can feel better about themselves and lack of progress. Dr. Bradberry states, “people often feel pressure to listen to complainers because they don’t want to be seen as callous or rude, but there’s a fine line between lending a sympathetic ear and getting sucked into their negative emotional spiral. You can avoid getting drawn in only by setting limits and distancing yourself when necessary. Think of it this way: if a person were smoking, would you sit there all afternoon inhaling the second-hand smoke? You’d distance yourself, and you should do the same with complainers. A great way to set limits is to ask complainers how they intend to fix a problem. The complainer will then either quiet down or redirect the conversation in a productive direction.” Successful patients are determined to surround themselves with individuals that are positive and engaged in the healing process.

They Won’t Hold Grudges

Successful patients learn that holding grudges against themselves or their healthcare providers only compounds the challenging healing situation. Again from Dr. Bradberry, “the negative emotions that come with holding onto a grudge are actually a stress response. Just thinking about the event involved sends your body into fight-or-flight mode. When a threat is imminent, this reaction is essential to your survival, but when a threat is ancient history, holding onto that stress wreaks havoc on your body and can have devastating health consequences over time. In fact, researchers at Emory University have shown that holding onto stress contributes to high blood pressure and heart disease. Holding onto a grudge means you’re holding onto stress, and [successful patients] know to avoid this at all costs. Learning to let go of a grudge will not only make you feel better now but can also improve your health.” 

They Won’t Say Yes Unless They Really Want To

According Dr. Bradberry, “research conducted at the University of California in San Francisco shows that the more difficulty that you have saying no, the more likely you are to experience stress, burnout, and even depression. Saying no is indeed a major challenge for most people. ‘No’ is a powerful word that you should not be afraid to wield.” Successful patients are very much engaged with their own healthcare, and the ability to have a positive conversation with a healthcare provider about the wishes and desires of treatment empowers successful patients and establishes a pathway for repeated future healing and healthcare successes. Saying ‘No’ to healthcare recommendations, when the recommendations do not seem appropriate to the patient, can be an avenue for gaining personal power that will lead to a greater sense of direction in the healing process.

ABOUT THE AUTHOR: Nathan J. Heide, M.S., L.Ac.

Mr. Heide is founder and CEO of Anjuna Medicine, LLC in Eugene, Oregon. Anjuna Medicine (www.AnjunaMedicine.com) is a private practice, focusing on integrative pain management solutions for chronic and recalcitrant diseases by using traditional East-Asian medical techniques. Mr. Heide is currently a graduate of Pacific College of Oriental Medicine (San Diego) and a current doctoral fellow at Oregon College of Oriental Medicine in Portland, Oregon.

Reference: 9 Things Successful People Won’t Do. Travis Bradberry, Ph.D. Retrieved from www.LinkedIn.com, 18AUG14.

Handwashing for Better Health

Anjuna Medicine Blog, August 13, 2014. Nathan J. Heide, M.S., L.Ac.

“Antimicrobial chemicals are so ubiquitous that a recent study found them in pregnant mothers' urine and newborns' cord blood. Research shows that their risks may outweigh their benefits.” The Atlantic Online. Julie Beck, Aug 12, 2014.

Recently, many scientists have discussed the potential benefits and risks of reducing the volume of antibiotic material used in the US and around the globe. As more antibiotic resistant bacteria develop and challenge the growing global population, it is important to find ways to maintain proper sanitation and hygiene without relying exclusively upon chemical solutions. One solution is to recall the basic principles of handwashing with regular soap and warm water.

According to the Centers for Disease Control, “Handwashing is like a "do-it-yourself" vaccine—it involves five simple and effective steps (think Wet, Lather, Scrub, Rinse, Dry) you can take to reduce the spread of diarrheal and respiratory illness so you can stay healthy. Regular handwashing, particularly before and after certain activities, is one of the best ways to remove germs, avoid getting sick, and prevent the spread of germs to others.”

When is the best time to wash hands? Follow these easy guidelines to help prevent the spread of germs:*

·       Before, during, and after preparing food

·       Before eating food

·       Before and after caring for someone who is sick

·       Before and after treating a cut or wound

·       After using the toilet

·       After changing diapers or cleaning up a child who has used the toilet

·       After blowing your nose, coughing, or sneezing

·       After touching an animal, animal feed, or animal waste

·       After handling pet food or pet treats

·       After touching garbage

How should you wash your hands? Follow these easy directions for the best results:*

      ·       Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.

        ·       Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.

        ·       Scrub your hands for at least 20 seconds. Need a timer? Hum the "Happy Birthday" song from beginning to end twice.

        ·       Rinse your hands well under clean, running water.

        ·       Dry your hands using a clean towel or air dry them.

*http://www.cdc.gov/handwashing/when-how-handwashing.html, Retrieved 13AUG14.