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Archive for the ‘TCM’ tag

Infertility and TCM Part 13: Why TCM Thrives in a Sick Western Society

By David Kreiner, MD

March 19th, 2015 at 12:41 pm

 

image courtesy of stuart miles/freedigitalphotos.net


Why is it that Traditional Chinese Medicine (TCM) has survived for some 2500 years and in fact remains a viable medical option for common health complaints in many contemporary societies?

Few other medical methodologies and treatments experience as much use as TCM even in the US which shares no common tradition, history or beliefs that may otherwise explain its popularity. Need I compare it to the history of Western Medicine, the bulk of which has been thankfully replaced by more contemporary scientific and technological advances?  These new innovations truly appear to be offering more good benefit than the dangerous, risky and unethical medicine popularly practiced in the West as recently as 85 years ago.

In fact, Western Medicine caused much iatrogenic illness until Dr. Ignaz Semmelweis introduced the importance of sterility in medical procedures and Dr. Joseph Lister did the same for surgery in the mid and late 1800’s respectively. It took until 1928 that Penicillin, the first antibiotic, was invented and it was not until 1953 that Jonas Salk invented the first vaccine to prevent polio.

Medical science has made great advances in immunizations which have been enormously successful in preventing disease.  These vaccinations have saved millions from life-threatening diseases.  So why is this not universally accepted as the medical panacea some of us perceive it to be?  The latest knock on this 20th century medical miracle thought by many to be worthy of the Nobel Prize in health and medicine is believable reports that autism is somehow related to these magic vaccines.  After all the experience and research, reasonably scientific folk are having difficulty completely ruling out a relationship.

Antibiotics and immunizations have saved more lives in the past 85 years than the compilation of all infectious deaths comprised from the beginning of time.  We have come a long way from the original discovery of the antibiotic benefits of some moldy bread transmuted to penicillin. However, a malady we face with modern medicine is that Western medical treatment has been developed in total disregard for our society, culture, traditions and environment.  A potential cure must be acceptable with not just proper use but strict disallowance of its improper use.

In the years that we have been blessed by the antibiotic revolution, we have seen commercial abuse in the form of common treatment on farm animals essentially creating antibiotic-resistant bacteria that destroys the effectiveness of that magic bullet that proved the savior against devastating disease making it oft times worthless.  Common overuse of antibiotics among physicians adds to this conundrum.

Environmental pathogens are making people ill including tobacco, stress, and recreational drugs as well as unhealthy diets rich in chemicals, medications, sugar, animal fats, and excess carbohydrates lacking nutritional value.  Food is over-processed and is often eaten to such excess that in combination with sedentary lifestyles in Western Medicine leads to obesity, diabetes and hypertension and in TCM to pathology related to stagnation of Qi, development of damp and other pathogens.

TCM is unique in that it works to improve these underlying factors responsible for making our society so sick.  This is why, though ancient, Traditional Chinese Medicine thrives in our modern albeit sick society.

Prior to the invention of the modern day antibiotic, TCM doctors discovered over the ages the “antibiotic” properties of certain herbs they discovered in their environment.  These ancient medicinals were derived from plants, animals, and minerals.  Other herbal decoctions were created to treat common complaints such as headache, pain, cough, cold, etc. as well as diseases such as gallstones, diabetes, hypertension, menstrual disorders and infertility. Dietary prescriptions are given by TCM practitioners and result in effective diminution of patient symptoms as well as acupuncture treatments aimed to eliminate pathology and correct unhealthy constitutions.

The goal of the TCM practitioner is to improve the individual’s health and well-being by focusing attention on the potential hazards of his/her environment such as stresses, emotions, bad habits, sleep, rest and activity, and diet.  An acupuncture treatment may help nourish deficiencies in the individual’s constitution that can put one at risk of contracting illness.  Herbal remedies can do same as well as eliminate pathologies before they turn into serious disease.

These TCM treatments are not only helping patients live healthier in their environment, the remedies themselves are actually coming from nature without artificial chemical contamination and are much less likely to have deleterious side effects.  It stands to reason that though the science behind TCM precedes the precision offered by the tools available with modern technology, the potential benefits are very much real today.

If you’d like to know more about TCM and how it may enhance your fertility, Long Island IVF is offering a free event on April 23, 2015, during National Infertility Awareness Week, entitled AN Evening of Alternative Medicine and Holistic Approaches to Enhancing Fertility.

All events during NIAW are FREE, but pre-registration is required. Events will fill up quickly. Attendance is limited. If you’ve been trying to conceive without success, please RSVP immediately to reserve your spot by contacting our Patient Services Coordinator, Lindsay Montello at 631-386-5509 or lmontello@liivf.com. You do not have to be a Long Island IVF patient to attend. Please feel free to bring your partner or a friend.

 

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Have you considered TCM for fertility enhancement or any other health issues?

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Infertility and TCM (Part 8): The Promise of Blending Western and Eastern Medicine

By David Kreiner MD

June 10th, 2014 at 6:34 pm

 

 

image courtesy of stuart miles/freedigital photos.net

As I approach the midway point of my second semester of studying Traditional Chinese Medicine (TCM) I realize that I believe much more strongly in the effectiveness of these ancient healing arts.  I have begun to work on recharging the Qi in my body by performing Qigong exercises and improving my abdominal breathing.  I stimulate my Qi meridians throughout my body daily to improve the flow of Qi in my body.  I even have performed some acupuncture on myself that I am convinced has helped relieve some minor arthritic pain as well as other symptoms that I have developed over the years.

I foresee a time when many physicians will utilize acupuncture to fill some voids that I have witnessed in Western Medicine.  Patients with aches and pains, chronic cough, urinary complaints and other common health issues often are either overlooked by Western physicians or inadequately treated.  TCM treatments of acupuncture, moxibustion, cupping and herbal therapies may offer an effective alternative to pharmaceuticals and surgery with less risk and fewer side effects.  I have seen benefit from these “manipulations of Qi” and believe that as the Western public becomes more aware of TCM it will become a commonplace mode of therapy.

Perhaps, even more exciting to me is the use of TCM as an adjuvant to Western Medicine.  We know that sophisticated Western laboratory and diagnostic testing is very effective in establishing Western diagnoses that are amenable to pharmaceutical and surgical therapeutics.  TCM, used as an adjuvant to these treatments offers a unique opportunityto improve the constitution of individuals thereby increasing their natural abilityto fight disease.  Also, by working through a different pathway TCM holds promise to increase the effectiveness of the Western Medicine treatment. 

This is the reason TCM/acupuncture combined with Western Medicine provided by high quality IVF centers offers patients their optimal chance for pregnancy success. 

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Have you, or has anyone you know, used TCM/acupuncture as an adjuvant to IVF or another assisted reproductive technology? Did you feel it made a difference?




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TCM and Infertility Part 6: TCM Pathogens of Wind, Cold, Heat, Dampness, Dryness, Phlegm and Emotion

By David Kreiner MD

April 18th, 2014 at 10:27 pm

 

credit: stuart miles/freedigitalphotos.net


Welcome, to my new world where I often feel like Robert A. Heinlein’s “Stranger in a Strange Land”.  

UnIike Heinlein’s protagonist, I am not accustomed to eating the bodies of the dead (though some natural holistic purists may consider this act the ultimate in sustainability.)  But to the previously unexposed who’ve been brought up from a Traditional Chinese Medicine (TCM) perspective, perhaps some of the Western Medical physicians’ practices may appear a bit barbaric.

In our recent Western Medical history such practices as lobotomy for psychological disorders, certain hard core diet therapies including high risk bowel resection surgery, and nearly routine hysterectomies for perimenopausal women would be considered potentially dangerous malpractice today.  However, if we thought drastic high-risk unnecessary medicine were a thing of the past, then consider the fact that excessive plastic surgery and some other unnecessary current Western therapies are more common now and have resulted in occasional deaths and disfigurement. 

Greed is a strong motivator and is one of the ills pervading our society… and the health care field has not been immune to its seduction.  Greed too often factors into determining the direction of treatment for individuals today.  Corporate greed is the reason insurance companies fail to cover many in need of health care and force physicians to see more patients than they have time to care for.  It is also a reason some providers order and perform some expensive and potentially risky tests and procedures.  

Western Medicine has had its share of iatrogenic disasters, yet I have seen many ill or infertile patients reap the benefits as a result of modern Western Medicine.  Even so, I as well as other physicians am left without answers all too often to explain or cure some of the complaints we hear from our patients.  For this reason I study TCM to learn its explanations and its treatments for some of these common ailments and complaints that elude the expertise of the Western physician.

I have been involved in the health care field for 37 years and I am quite comfortable communicating about pathogens such as bacteria and viruses and parasites and about pathophysiologic processes such as atherosclerotic heart disease, hypertension, diabetes mellitus, pelvic inflammatory disease and endometriosis to name a few.   Today, as I study Traditional Chinese Medicine, I now read and speak an additional language.  

The pathogens of TCM are Wind, Cold, Heat, Summer Heat, Dryness and Dampness, Phlegm and an individual’s emotions.  They may attack from outside the body such as wind cold (the equivalent to the common viral cold) or internally as a result of a disharmony among one or more of the organ systems.  Emotions such as Grief and sadness, anger, fear, worry and even joy according to TCM can be pathogenic when carried to an excess and lead to a disharmony of an organ system or to a blockage of the flow of Qi which can result in dampness and other pathologic events or pathogens. 

These pathogens are the “root” cause of the individual’s disharmony resulting in the manifestations or symptoms.  For example, complaints such as fever, cough, sore throat, vomiting, diarrhea, constipation, bloating, etc. ., are the result of these pathogens.  Interestingly, ancient Chinese texts refer to insects or bugs as being carried by the wind as a cause of some syndromes such as the Wind Cold referred to earlier.

There are also multiple ways to categorize and classify pathologic syndromes. They may be classified as cold or hot, internal or external, excessive or deficient or yin or yang conditions.  They may be identified as affecting one of the organ systems which are defined more based on their physiologic role from a traditional Chinese perspective rather than by their Western anatomic and physiologic identity that we learn in medical school.  There are four different layers of pathogenic attack from the most superficial to the deepest and most internal. There are even other theories of disease which may be used to classify pathology usually described as a disharmony affecting one or more organ systems.

The treatment prescription is based on the identified syndrome(s) and may be geared towards eliminating the root cause of the disease as well as the clinical manifestations and associated symptoms.  One may use acupuncture to tonify a particular weakened organ or Qi, yin or yang.  Acupuncture can eliminate heat or cold from one or more of the channels of Qi.  Or there may be excess body fluids in the form of edema, dampness or phlegm that needs to be eliminated.  Chinese herbal prescriptions are often given as an adjunct to the acupuncture to improve the efficacy of an individual’s treatment.

It does sound bizarre to this Western-trained physician, but I am impressed that the science of TCM has lasted thousands of years.  I imagine there must be something to this needling patients to modify the Qi in the body that has some benefit to the patients’ health and well-being.

I look forward to new adventures and greater understanding as I become more familiar navigating this strange land.

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Do you believe that TCM pathogens could be impacting your fertility?

 

 

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Infertility and TCM (Part 5) Channels and Points: TCM’s Gross Anatomy Equivalent

By David Kreiner MD

March 31st, 2014 at 2:05 pm

 

image courtesy of stuart miles/freedigital photos.net

 

As a new student in Traditional Chinese Medicine (TCM) and acupuncture one of the first and most important classes we must take is called “Channels and Points”. This to a former medical student is the TCM version of Gross Anatomy. Gross anatomy in medical school was my exciting introduction to the human body, essential to the study of medicine.  I owned the classic Gray’s Anatomy text which today is popularized by the TV show of the same name.  The course requires strict memorization of all the bones, nerves, ligaments, vessels and organs in the body.

Likewise, “Channels and Points” requires the memorization of the precise location of 365 points and the corresponding channels of Qi which course throughout the body and can be utilized in the practice of acupuncture.  How these channels and points relate to each other and to the different organs is important as that will also determine their usefulness in different clinical situations.  

It is believed that the location of the channels of Qi and their surface access points was discovered through centuries of observation of the existence of tender spots on the body during the course of disease.  Furthermore, it was observed that symptoms were alleviated when those points were stimulated by massage or heat.  

When a number of points became known, they were linked into groups with common characteristics and effects and hence a pathway for a channel was identified.  Knowledge accumulated over hundreds of generations documented in several ancient texts.  As information regarding the channels and points accumulated, theories evolved and often resulted in modifications of prior beliefs as more experience clarified more accurate placement and function of these channels and points.  

The first document that unequivocally described the channels and points in an organized system of diagnosis and treatment recognizable as acupuncture is The Yellow Emperor’s Inner Classic, dating from about 100 BCE. The information was presented in the form of questions posed by the Emperor, Huang Ti, and replies from his minister, Ch’i-Pai. The source of the text of his answers was likely a compilation of traditions handed down over centuries, presented in terms of the prevailing Taoist philosophy, and is still cited today in support of particular therapeutic techniques. There is evidence that acupuncture utilizing bronze, gold and silver needles was practiced around this time as well as moxibustion.  

A more contemporary view of the concepts of channels in which Qi flowed that was documented through the precise anatomical locations of acupuncture points developed later.  During the Ming Dynasty (1368–1644), The Great Compendium of Acupuncture and Moxibustion was published, which forms the basis of modern acupuncture. It includes descriptions of the full set of 365 points that represent superficial access to the channels through which needles could be inserted to modify the flow of Qi energy.

Unlike the bones, tendons, nerves and vessels of Gross Anatomy, the channels and points utilized in acupuncture do not have corresponding visible or palpable anatomic structures that may be identified in an effort to memorize.  These channels of Qi are not visible structures nor can they be felt through touching or palpation.  So how does the acupuncturist know where the surface access point is to direct his needle?  

The trained acupuncturist utilizes the surface anatomy such as bones, joints and ligaments to locate these acupoints.  The points typically are found between the ligaments, in bony crevices or between bones. Additionally, the body is divided into units of measure based on an individual’s own bone size.  The most basic unit, cun, is defined as the width of the individual patient’s thumb.  Two cun is the distance from second most distal or middle joint of the forefinger to the tip.  Three cun is the width of the forefinger to the pinky measured at the point of the middle joint of the fingers.  The arms are 9 cun from axilla to the transverse crease of the elbow and 12 cun from the elbow crease to the wrist crease.  The number of cun for every portion of the body is delineated so that the location of the acupoints is based on locating according to the distance by cun units from an identifiable spot on the surface anatomy of the patient and usually are found in between ligaments, bones or in the bony crevices which are palpated by the acupuncturist upon needle placement.  

There are also some points that are identifiable based on particular placement of the fingers and hands of either or both the acupuncturist and patient.  For example, if the acupuncturist places his finger on a patient’s styloid process then has the patient internally rotate his/her hand, the point is located where the acupuncturist’s finger ends up.  This point, currently my favorite, is Small Intestine (SI) 6 with the English name of Support for the Aged because it treats symptoms such as blurry vision, lumbar pain, neck pain and other aches and pains that affect individuals as they get older.  

Another critically important point and therefore given the distinction of being a Command Point for the head and nape of the neck is Large Intestine (LI) 7.  It is located when the acupuncturist places his/her index finger on the dorsal side of the patient’s hand and thumb on the ventral side in between the patient’s thumb and forefinger.  The acupuncturist will locate the point where the tip of his forefinger meets a groove in the anterior portion of the patient’s radius bone.  

How deep to place the needle and in what direction and angle are further issues to be learned another day.

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Are you finding this educational journey into TCM fascinating? Do you have any questions for Dr. Kreiner about this or any other TCM topic he has covered so far?

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Acupuncture: What’s the Point?

By David Kreiner MD

March 12th, 2014 at 3:29 am

 

image courtesy of stuartmiles/freedigitalphotos.net

I have previously mentioned the conundrum facing a Western-trained physician embarking on the study of Traditional Chinese Medicine (TCM).  It is part of our nature after a lifetime of scientific training to explain natural phenomena such as health and illness in ways that have been documented with physical evidence. 

The basic physiology on which TCM is constructed has no corresponding physical support that can be seen or measured…a requirement that scientific thinkers rely on to reassure ourselves about the validity and rationale of a proposed theory or treatment.

Instead, it feels to me as I study TCM that I am memorizing random “facts” with corresponding syndromes and treatments.  For now, I must push myself to continue my studies unconcerned that these basics I am committing to memory are not supported by any physical evidence other than the stories of successful therapies.  It is premature for me to pass judgment for as they say, “the proof is in the pudding”. 

In fact, as a practicing reproductive endocrinologist I have seen patients with poor ovarian function or previous failed pregnancies succeed in their child-building endeavors after acupuncture intervention is added as an adjunct to their fertility treatments. 

For this reason, I persevere to learn as much as possible because despite my own admission that TCM is difficult for me to accept as “scientific truths” I believe that it offers potential advantage to my patients as they go through their Western fertility therapies.

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How important to you is the science…or measurable physical evidence…behind an infertility therapy? Can you take a leap of faith and hope “the proof is in the pudding”?

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Traditional Chinese Medicine (TCM) – Perspectives from a Western-Trained Physician-Part 2

By David Kreiner MD

February 18th, 2014 at 4:44 pm

 

credit: stuartmilesfreedigitalphotos.net



I am now four tests deep into my TCM training and have experienced some of the typical Spleen disharmony that comes with anxiety over my performance on the exams.  It was not bad enough to cause a clinical spleen Qi deficiency but I did have some stomach upset from rebellious stomach Qi and occasional weak knees.

I wonder at times if I could explain TCM fundamentals in Western terms.  It would be very satisfying to put TCM physiology in a language and system that was consistent with the science that as a physician I have learned and lived with for the past 30 years.  I am used to a medical construct based on organs and structures I can see and feel and metabolic processes that I can measure. TCM affords us none of this.

Instead, the physiology of TCM to me is based on faith and experience.  Hmmm… if there is experience supporting successful therapeutics whether they be herbal medicines or acupuncture then why do I say that TCM is based on faith.  From a scientific perspective, we cannot explain TCM fundamentals such as Qi or Essence nor the channels they travel in.  There is nothing we are able to see or touch to prove to ourselves their actual existence.

I am not saying that it is necessary to have a blind faith in TCM in order to either practice it or submit oneself to its treatment.  Once again, there is the experience to justify its practice.  However, it does make a Western-trained physician perplexed.  Perhaps our science is not yet at a level to explain TCM.  Maybe…if we were able to measure extremely minute changes in electrical charges, or levels of energy radiated in the body at a frequency or amplitude that we are currently unable to document… then we might be able to witness and even measure TCM phenomena related to Qi deficiency and other clinical syndromes.

In the meantime, I study so that I may be able to someday offer the TCM as an adjunct to my fertility practice.

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Would you be open to combining TCM principles with Western medicine in your fertility treatment plan?

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