Dr. Darshan S. Khalsa's Blog

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BATTLEFIELD ACUPUNCTURE AND THE ARC OF ACCEPTANCE September 5, 2010

My previous blog post was about a pain reduction technique  called Battlefield Acupuncture.  At Khalsa Integrative Medicine we utilize both the beginning and the advanced Battlefield Acupuncture techniques and the pain reduction results have been outstanding! I believe that this technique will move much closer to mainstream acceptance within the next few years.

New ideas or medical therapies typically go through a three-step process as they move into mainstream acceptance.

The first step is to be ignored; the second step is strong opposition from mainstream medicine, and the third step is acceptance.

In the first step, therapies are often ignored when they don’t fit into the mainstream ways of thinking (It couldn’t possibly work, so why bother investigating?)

In the second step, there is some acceptance or success with the new idea, so the entrenched way of thinking begins to strongly oppose the idea. (The idea couldn’t possibly work and here are all the reasons why it couldn’t possibly work, the results must be phony, etc…, etc…)

The third step begins when there is enough success with the new idea or therapy that people many people want to use it regardless of whether it fits into mainstream medical thought. (We know it works, even if we don’t yet understand all the reasons why it works.)

An article last week in the military newspaper Stars and Stripes about Battlefield Acupuncture illustrates this three-step process very well.

Here’s the link:  http://www.stripes.com/military-turns-to-acupuncture-as-alternative-to-prescription-painkillers-1.116167

Here’s some of the article:

“As the number of prescriptions for opiate painkillers skyrockets — and more troops admit abusing those drugs — the military has been forced to look beyond conventional ways to treat pain.

“This is a nationwide problem,” said Brig. Gen. Richard Thomas, assistant Army surgeon general. “We’ve got a culture of a pill for every ill.”

In June, the Army surgeon general released a report addressing the lack of a comprehensive pain-management strategy, suggesting alternative treatments including meditation and yoga.

Even though some in the medical field maintain that acupuncture has never been proved effective, the Air Force sees it as one of the more promising alternatives to combat pain.”

The article goes on to quote many patients and doctors saying what great results they are getting with alternative techniques in general and Battlefield Acupuncture in particular, and other doctors saying it can’t possibly work and therefore it doesn’t work.

It looks like we are somewhere between steps two and three in the arc of acceptance—the technique has had enough success that it is no longer ignored, and it is now accepted by some and strongly rejected by others.

Over the years, I have seen the same arc occur with acupuncture in general, organic foods, yoga, meditation, herbal medicine, energetic medicine, kinesiology, and many other modalities.  This gradual acceptance is part of the process we go through individually and collectively when we are exposed to new ideas.

I am very gratified to see such a conservative and traditional institution as the military begin to embrace alternative therapies.  In this the military is beginning to exemplify the highest form of conservatism:  a practical examination of what works and what doesn’t work.  Then, if it works let’s use it more, if it doesn’t work let’s try something else.

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To Vaccinate or Not Vaccinate? October 16, 2009

Patients have been asking me lately about whether or not they should get the flu vaccinations, both regular seasonal flu vaccination and the H1N1 swine flu vaccination.

I think the short answer for most of my patients is no.  However, this is not a simple question, so I’m going to take a round about way of answering it, and first discuss vaccinations in general.

Even if every bad thing you have ever heard about the effect of vaccinations on individuals is true: (vaccinations contribute to autism in children, they can cause auto-immune disorders, people often get sick immediately after getting vaccinated, some of the additives in vaccines can contribute to cancer or neurological diseases); even then, from a public health perspective, vaccinations are still often beneficial. The benefits to the general public of not getting epidemics outweigh the individual negatives. Over the course of the 20th century vaccinations have apparently helped reduce the incidence of infectious diseases such as smallpox, whooping cough, and polio. At the same time, for most individuals there seems to be very little immediate negative effects from getting vaccinated.

So what we have to do is find a reasonable balance between the severity of the epidemic threat, the effectiveness of the vaccine against the epidemic threat, and the potential harm to the individual from getting vaccinated.

At this time, for the regular seasonal flu vaccine, there is little or no evidence that the flu shot is even effective at reducing the incidence of flu. You can see a very interesting article in this month’s Atlantic magazine, titled “Does the Vaccine Matter?” (Available online at: http://www.theatlantic.com/doc/200911/brownlee-h1n1 ).  The years that the flu vaccine has been a good match for the seasonal flu have no difference in outcomes from the years in which the flu vaccine has been a poor match. No large scale double blind testing has ever been done. There is a widespread belief that flu shots reduce the incidence of flu, but very little evidence that this is true.

For the H1N1 swine flu vaccination (now just starting to be available) here is the situation: While the virus spreads easily, the sickness itself is so far relatively mild and most people have developed no lasting problems. At the same time, the effectiveness of the vaccine is unknown and the risk of potential harm from a new, relatively untested vaccine is higher than normal.

So it seems that for both seasonal flu and H1N1 swine flu, there is very little benefit from getting the vaccinations and very little risk incurred from not getting the vaccinations.  This is why I have been recommending that patients not get flu shots and that patients instead take other steps to build their immune systems naturally.

Aside from the lack of benefits, there are potential downsides to getting the flu vaccinations. These downsides apply to most other vaccinations as well, and that is why vaccinations should be individually evaluated for benefits and risks.  There is no effective treatment that doesn’t potentially cause some problems.

Here is a partial listing of some of the potential downsides of vaccinations:

Mercury in the form of Thimeresol is used as a preservative in many vaccines. Mercury is a known neurotoxin and can combine with other factors to induce neurological and auto-immune disorders.

If you are already sick, getting a vaccination may throw your immune system further out of balance and cause long lasting problems. Never get a vaccination when you are feeling sick. This is a particular problem with young children since their immune systems are not fully developed. Likewise, receiving multiple vaccinations at once is not a good idea. Children in this country receive far more vaccinations than in other countries with some evidence that their overall health is worse.

Introducing an infectious agent directly into the blood stream means that it is not mediated by the normal immune protections. In addition, some vaccines contain aluminum, formaldehyde and other toxic substances. These substances can cause allergic reactions that can lead to auto immune disorders in those who already have compromised health. Even non-toxic vaccine additives such as squalene or egg whites can induce allergic reactions when introduced directly into the blood.

There are many more potential downsides. Some people will develop either immediate or long term problems after getting vaccinated. Of course, most relatively healthy people will have no problems whatsoever with the vaccines.

In the case of the seasonal flu or H1N1 flu vaccinations, the risks of getting the vaccine are not balanced by the potential rewards.

The answer for other diseases or for future pandemic diseases could be different.

 

Preventive measures for H1N1 Swine Flu August 25, 2009

Yesterday the President’s Council of Advisors on Science and Technology issued their estimate of the possible impact of H1N1 swine flu on the American population:  Up to half the population infected and up to 1.8 million hospitalizations required!  This is much more than a normal flu season—we’ll find out in the next few months how accurate their estimate is.  This H1N1 flu variety is relatively new and people have built up less immunity.  Unlike most influenzas, predictions are that older people will have more immunity and that this flu will disproportionately infect younger school age people. 

Here’s a link to the Center For Disease Control’s H1N1 Swine Flu site with lots of good information:  http://www.cdc.gov/H1N1Flu/

I’m certain the mainstream media will be sufficiently alarmist so the real issue becomes what should we do to prepare for the impending flu season.  Disease is always an interaction between the strength of the pathogen and the strength of our immune system.   How can we strengthen our immune systems to better resist these new pathogens?

The vaccine which may help prevent infections won’t be ready until the flu season is well underway.  Vaccines have their own problems as well, and I’ll discuss these in a future blog post.

 The basic recommendations for strengthening the immune system are still primary:     stress reduction,   regular acupuncture,    good diet along with steps to improve digestion,   good hygiene (frequent hand washing, etc…)

I also teach patients various acupressure techniques that are effective for immune building and disease prevention.  In addition, I’ve been dispensing two different supplements to patients to help build their immunity and one supplement to keep in reserve at home in case a cold or flu starts.  We dispense only to current patients since no formula is indicated for everyone.

Two supplements that we often give to patients to boost the immune system:

The first supplement is a Chinese Herbal Formula called Yu Ping Feng Wan, “Jade Wind-Screen Pills”.  This is a very old formula in continuous use at least for the last 700 years in China.  It contains Huang Qi (Astragalus), Fang Feng (Siler), and Bai Zhu (Atractylodes).  The action of this formula is to build up your immunity, hence the name:  create a precious (Jade) Screen around your body to shield you from pathogenic influences (Wind).  Yu Ping Feng San is a good formula for almost everyone to take as we enter cold and flu season. 

We also sometimes give patients another good modern formula that combines enzymes, Chinese Herbs and Western Herbs called ProSol™ Immune.  Here are some of the ingredients of this formula:  PHysioProtease™ is an enzyme blend that activates the immune system to promote healing and seeks out areas of inflammation and tissue damage.  Astragalus root extract – An antioxidant that helps protect the liver, has many known immune stimulating properties.  Goldenseal root – Contains several alkaloids shown to have anti-microbial and antibacterial properties. Echinacea angustifolia root – Has antiviral, anti-fungal and immune-stimulating effects

What do we do when our immune boosting preventive measures are not adequate and we feel ourselves starting to get a cold or flu? 

I’ve been recommending to patients a Chinese Herbal Formula called Gan Mao Ling to keep on hand for just that time.  This formula has antibacterial and antiviral properties and can be very effective at helping the body overcome an initial disease onset.  This formula is not as effective at building the basic protections as Yu Ping Feng Wan or ProSol™ Immune, but is more effective for initial disease onset.  Here are the ingredients of Gan Mao Ling Wan: Ge Gen (Pueraria Root); Da Qing Ye (Baphicacanthus Leaf); Bo He (Mint); Ju Hua (Chrysanthemum); Jie Geng (Platycodon); Xing Ren (Apricot Seed); Lian Qiao (Forsythia) Gan Cao (Licorice).  Gan Mao Ling Wan, if taken at the onset of a cold or flu, can often help your immune system throw the disease off quickly.

Be prepared for flu season!   If you wish to maintain optimal health through this coming flu season, please schedule an appointment.  We dispense only to our patient base, so if you are not already a patient, you will need to make an initial appointment.  Our best wishes for your good health this flu season!

 

Healthcare Policy from a Practitioner Standpoint August 16, 2009

Healthcare legislation is presently being considered by Congress and the White House and some policy reforms are expected within the next few months.  I expect that the details will be highly complex and the final thousand page proposals will probably contain many surprises.  We are all familiar with the unsustainable growth in the cost of health care and health insurance, so some changes are necessary.  In addition, the present system produces a lot of unnecessary anxiety which drives up overall health care costs.  Our present per capita health care costs are higher than any other country, and our average outcomes put us well behind most other advanced countries.

I am by no means an expert but I’ll give my simple take on the basic problem:  There are no major institutional parties in this country that have a real interest in health.   Treating acute or chronic disease is the focus of our healthcare system.  Indeed it would better be called a sick-care system than a health care system.   Western medicine is wonderful at treating acutely ill cases and trauma, but not particularly effective at preserving and expanding health.

Individual people are of course interested in promoting their own health, but the major institutions involved in health care are not interested in promoting good health.   The private insurance companies pass on all their costs and make extra profits by denying claims and cherry picking only healthy customers; the hospitals make their money doing acute care; individual MD’s generally mean well but are not reimbursed for time spent on educating patients and are themselves focused on acute care; and the pharmaceutical companies main interest is to have people take their drugs for long periods—healthy people are not good pharmaceutical customers.

I am hoping that the final legislation will include a strong “public option” and that this will eventually lead to outcome based standards determining which medical procedures are cost effective.  These outcome based standards could in turn create a motivation to do more preventive medicine:  “ A stitch in time saves nine” and “an ounce of prevention is worth a pound of cure” are two common proverbs for good reason:  with more preventive care, the country could achieve much better health outcomes at a lower cost.  If true outcome based standards are put into place, the utilization of alternative and integrative healthcare will increase, and overall health care costs will decrease.  Right now the institutional incentives are all working the other way.  There was an interesting article in the New Yorker recently discussing local health care differences and some of the institutional pressures driving up health care costs. http://www.newyorker.com/reporting/2009/06/01/090601fa_fact_gawande 

Of course, the real change that needs to happen is in the overall consciousness and understanding of people regarding wellness.  For now, there are many individuals interested in health and wellness, but many Americans are still looking for the quick fix, the magic pill that will fix everything.  After a few years, they come in to see us because they are taking six or seven pharmaceutical medications and feeling terrible.  It would be far less costly to change behaviors and avoid the problems in the first place.

On a public policy level, most people want unlimited acute health care for a limited cost, and this is barely being addressed in the current proposals.  It will be interesting to see what comes out of the legislative process with all the competing interest groups contending.  I’m hoping for some improvements, even if the improvements are minor.

We definitely do need to transition from our present sick care system to a true health care system.