Monday, November 30, 2009

Autism, Acupuncture, and the Denver Model

Autism is not just a challenge for the autistic child, but also for the entire family. In my practice I focus on treating the family -- the parents and siblings, particularly the primary caregiver -- because family support is so vital for good quality of life and social progress for the autistic child.

Here is some good news from: The Denver Model: An Integrated Approach to Intervention for Young Children with Autism. A recent study shows that an autistic child can make significant progress towards a normal life with strong social intervention from an early age. Here are a couple of their core principles:

Families should be at the helm of their children’s treatment.
Children with autism are capable of becoming intentional, effective, symbolic communicators and most children with autism can have useful, communicative speech when provided with appropriate interventions of sufficient intensity during the preschool years.
Successful intervention for young children with autism requires that most of their waking hours are spent in socially oriented activities. Providing more than 20 hours per week of structured intervention is necessary for optimum progress.

"When done in this fashion, many children are able to learn and make remarkable progress," said Geraldine Dawson, lead author of the study, published online Nov. 30 in Pediatrics, and chief science officer of Autism Speaks. "Some of the kids at the end of the study were going into regular preschool and had developed language and friendships with their peers." USNews

Keeping the family unit strong and in good mental and physical health becomes key to this type of social intervention training. Stress reduction and health-supportive techniques like acupuncture and meditation can be very helpful.

As for the treatment of autism with Traditional Chinese Medicine (TCM), in my practice, I have found the combination of acupuncture and herbal medicine with psychotherapy to be profoundly helpful. TCM does not distinguish between the mind and the body, but believes the clearing energetic disorders in the body can help relieve psychological problems. And, many of my patients have found it so. I suspect that adding acupuncture treatments to the Denver Model protocol would show increased benefits.

Of course, the prospect of getting any child to sit still for half an hour with acupuncture needles is unpromising. Adding ADHD or autism to the mix makes it much more difficult. However, pediatric acupuncture offers alternatives to the traditional form used for adults and older children. Quick insertion and removal of the needles is nearly as effective as retaining the needles for 20 minutes to an hour. Another option is scalp acupuncture. In this technique needles are inserted along the scalp -- a technique particularly effective for autism treatment -- and can be left in while the child plays normally with occasional stimulation.

Autism does not exist as a concept in TCM, but behavioral and social disorders do, and they usually relate to a strong imbalance in Yin and Yang, and deficiencies of constitutional Qi. The goal of the acupuncture treatment thus is to balance Yin and Yang, to normalize qi and blood flow in the brain, and to support the essential constitution. Of course, every child is different and an experienced TCM practitioner devises a treatment protocol specific to each child treated.

Byron Russell

Tuesday, November 24, 2009

Get Ready for 2010 -- End of Year Accounting

Beside the beginning of the holiday season, this is also the time for choosing insurance plans for 2010 and for final filings for Flex Spending Accounts, Health Savings Accounts and Insurance.

A couple of things to remember:

If you have an open enrollment period at your company, please check to see if your plan for next year affects coverage for Alternative Medicine options (like acupuncture), and sign up for the coverage that best suits you. Plans tend to change on a yearly basis; so, it is important to check the details.

Many of my patients use a Flex Spending Account (or HSA) to cover their medical charges. Acupuncture, Herbs and Supplements can all be charged against these accounts. Please let me know as early as possible if you will need a Superbill for your FSA filing. For those with excess funds in an account, this is a good time to stock up on herbs and supplements (like multi-vitamins, Calcium and Fish Oil) for the coming year.

If you haven't yet filed for insurance reimbursement for your treatments, this is a good time to do it. Don't worry, you usually have at least a year from the date of treatment to get the papers in.

Herbs for Acetaminophen Overdose

Did you know that Acetaminophen toxicity is the most common cause for Liver Transplant in this country?

Acetaminophen is a pain reliever present in many over-the-counter cold and flu medicines. It is broken down, or metabolized, in the body into byproducts - one of which can be very toxic to the liver. At normal, therapeutic levels, this byproduct is easily deactivated when it binds to a naturally occurring, protective molecule called glutathione. But the body's glutathione stores are finite, and are quickly depleted when the recommended doses of acetaminophen are exceeded.

Unfortunately, the prevalence of acetaminophen makes it easy to accidentally exceed the recommended levels, which can occur by dosing more frequently than indicated or by combining two or more acetaminophen-containing products. However, severe liver damage can occur at even two to three times the recommended dose (the maximum adult dose is 4 grams per day; toxic daily levels range from 7 to 10 grams). Medical News Today

A study from Stanford University School of Medicine shows results for an herbal derivative S-methylmethionine in preventing this liver damage. S-methylmethionine is found in many herbs and flowering plants.

The best known of the herbs for protecting the liver is Milk Thistle. Many studies have shown it as an antidote for chemical poisoning and even that from Amanita phalloides Death Cap mushrooms. It is also very effective in reducing the side-effects of alcohol indulgence. This is a supplement I include in my daily herb regimen at a low dose. It is good preventative medicine.

Byron Russell

Wednesday, November 18, 2009

Acupuncture at UCSF Mt. Zion Hospital

I had a great experience a few days ago -- doing an acupuncture treatment for a patient in the UCSF Women's Health Center at Mt. Zion Hospital. My office is across the street from the UCSF Mt. Zion center; so, I believe I am the closest acupuncturist to their very busy Women's Reproductive Health Center. It is a big office with some of the best fertility experts in the Bay Area, including Dr. Marcelle I. Cedars. She is the Director of the Division of Reproductive Endocrinology and many of my patients have gone to her for help with fertility problems and IUI and IVF procedures, and all speak very highly of her.

The surprise for me was that the Center now keeps a room reserved for use by acupuncturists. Though they don't have their own acupuncturists on staff, they keep space free for patients who want to bring an acupuncturist with them for treatment immediately preceding their IUI and IVF procedures. I got a call from a patient whom I had not seen in a few years who now lives out of the area, but was coming in to San Francisco for her fertility procedures. She asked me to meet her there for a treatment. It was too far away for her current acupuncturist to travel, but very convenient for me to accompany her.

The staff at the center is very friendly and accommodating. My patient was in great spirits and very excited about the procedure. It was interesting to note that her excitement translated into a very wiry (read: STRESSED) pulse. Stress -- even the excited kind -- is not helpful in achieving good fertility results. A forty-five minute electro-acupuncture treatment calmed her pulse and put her in a sleepy, mellow mood for the procedure.

The research on the benefit of acupuncture at the time of fertility procedures is very strong and I'm glad to see fertility centers like UCSF's making space for this in their program. Pacific Fertility does the same thing, and I will be doing an on-site treatment for another of my patients there next month.

Byron Russell

Monday, November 16, 2009

Athletes and Acupuncture

Here is a post from my Sports and Acupuncture blog -- What can TCM (Traditional Chinese Medicine) -- that is mainly Acupuncture and Chinese Herbs -- do for an athlete? If you are an athlete, what can it do for you? I like this question because it brings up the topic of sports injuries, but also the bigger topic of living a healthier life, rather than just treating illness.

So, acupuncture and sports medicine: let's start with a couple of prominent examples. Health care is (and should be) private -- so, I never discuss my patients without specific permission. Fortunately, a number of famous athletes have discussed using TCM in the press.

A great example is Kerri Walsh (Olympic Gold Medalist in Volleyball). She used acupuncture to resolve pain and speed healing after Rotator Cuff Surgery. This is something I see a lot in my practice -- and it isn't just for athletes. Once of the benefits of acupuncture and herbs is that it helps to reduce swelling, inflammation and pain, and speeds healing. I also think it works well for reducing the formation of scar tissue. For a high performance athlete, this is particularly important in reducing time out from training, and in regaining the full use of the injured part of the body.

Another is Yao Ming (Houston Rockets Basketball All-Star), who suffered a stress fracture in his left foot and had surgery to install a screw to stabilize the bone, again with acupuncture and Chinese herbs as part of his aggressive rehabilitation program -- to speed his recovery. This is a type of injury I've seen a number of times in my practice -- recently with a couple of triathletes and skiers. It can be a tough surgery to recover from, but I've seen great results - a good surgeon is the first step, then acupuncture and herbs to reduce the swelling, pain, and scar tissue. I also use Electric Acupuncture (Microcurrent Electric Stim) and infrasound treatments. This type of surgery and rehabilitation also helps people with severe bunions and foot pain.

So, one answer I will suggest is that TCM helps with post-surgery rehabilitation, with the goal of reducing swelling, pain, inflammation and restoring full function as quickly as possible. Next is a discussion with more specifics of what the treatment entails.

Byron Russell

Tuesday, November 10, 2009

Osteoporosis and Vitamin D, Calcium, Diet

Osteoporosis is a thinning and weakening of the bones that can result in bone fractures and disabling breaks. It is a health problem for 44 million Americans (more than half of those over 50).

Here is a link to an interesting summary on the current research on osteoporosis by Dr. Sciabbarrassi. What You Don't Know About Osteoporosis. A quick summary:

Calcium -- either dietary or supplement sources - by itself does not offer any clear or consistent benefit in preventing osteoporosis or reducing fracture risk in anyone.

He also notes that increased dairy intake doesn't help! And that Vitamin D deficiency is a world-wide epidemic. However, the combination of Vitamin D and Calicium is recommended -- at least 1000 IU Vitamin D and 1200 mg Calcium in an easily absorbed form.

I recommend the liquid Calcium/Magnesium combination to my patients. Along with weight-bearing exercise and a multi-vitamin that includes Vitamin D, minerals and herbs. There are several Chinese Medicine formulas to strengthen bones and prevent premature aging. These are primarily herbs that support the Kidneys and hormone system. Drynaria and Epimedium are two of the most important herbs for this problem.