Kevin Coughlin MD Blog

We had an interesting week as we closed out February 2010. 2 Positive IVF pregnancy results - I will be supporting them weekly until the pregnancies are established. Another treatment course was to turn a 34 week baby from breech to head down - results are pending. Still another treatment was induction of labor for baby number 7! Spleen 4 and Spleen 6 were particularly effective and she left the office with hard steady contractions - waiting to hear how long it took to deliver. But, not every treatment was Baby related. Recent patients include a gentleman with ALS and arm weakness, and a lady from far West Nebraska with a neurological degenerative disease too new to have an insurance code! Her hearing and blinking are affected but mostly we are working on strength in her arms too. Monday will be her second visit. Other new patients this week have Fibromyalgia, Bipolar disorder, Chronic migraines, withdrawal symptoms from anti-depressants and pain medication. And on it goes - of course with low back pain, neck and shoulder pain holding their good share of appointment slots.  I am still fascinated and encouraged by responses we see. On we go.

The web talk was well-received last week. I covered the applications for acupuncture during cancer treatment, and recovery phase. Sources included the research from such prestigious sites as MD Anderson, Johns Hopkins, Mayo Clinic, and Sloan Kettering.  I cited the work of Keith Block, MD from Chicago, a leader in integrative oncology. But during the Q/A at the end “Frank” a “retired MD” took issue with acupuncture stating that “nothing has changed in 50 years” and this is “all hocus pocus” (I sensed that he wanted to use a stronger phrase) and no better than hypnosis. I replied that I respected his opinion, but knew of hundreds of colleagues around the country who practiced acupuncture every day and saw clinical results. “Well, maybe one in 200 would fall for this, but most doctors are TOO HONEST!” after which he hung up.  The moderator apologized, but I felt and stated that it was educational to hear first hand that such opinions do exist, and may be all too common among Western physicians. The rest of the questions were thoughtful and sincere. Several came from cancer patients, and some from nurses and caregivers. So heckle away, those who protest. You will not dissuade the advance of Integrative Medicine.

Next Week - I will be presenting a talk for the Catholic Health Initiatives network titled “The Healing Power of Acupuncture”. This is part of the Strong & Smart - Living Well with Cancer series. I will address the growing field of Integrative Oncology (Conventional + Alternative) and the applications of acupuncture within that setting. The details are:

Tuesday, February 9, 2010

10AM PST - 11AM MST - Noon CST - 1PM EST

45 minutes of Presentation + 15 minutes Q/A

Register and receive log in information at 800-278-7837

There is no charge.

You will be able to watch on your computer screen and listen on your phone. For yourself, friends, and family this is an opportunity to hear how acupuncture can enhance cancer treatment and recovery. It will also be recorded for later access. We would love to have you join the audience.

2010 finds Medical Acupuncture in steady demand. The balance remains at 60% pain management; 40% energy work but some dynamics are changing. I find MORE fellow physicians are suggesting that patients consider acupuncture - and then referring for treatment. This is very encouraging. So often in American Medicine the sequence only includes medication, then surgery. Sometimes it includes some physical medicine such as physical therapy - or injections of medications before surgery. But in the last 6-12 months I find more of my colleagues are inserting acupuncture (no pun intended) into their sequence of management. And really, why not try a series of $90 acupuncture treatments for a knee or low back before commiting to a $50, 75 or 100K surgery bill + the risks of anesthesia, hospital-borne infections, etc. It just makes sense.

Headache (HA) patients are a significant % or my practice. The last 2 weeks I have seen a NUMBER of new HA patients ranging in age from 11-85 y/o. Acupuncture offers a whole host of approaches. Some very direct and logical. Some very complex and steeped in the most traditional understandings of Chinses Medicine, Yin/Yang, Qi and the 5 Elements of Wood, Fire, Earth, Metal, Water. A recent patient saw immediate relief from HA she has had for years [holding now for 3 weeks; her co-workers can’t believe it; she is happy]. 2 new patients are over 50 with new onset of nagging HA with in the last 12 months [CT and MRI have ruled out tumors, thank goodness]. Overall, HA patients have had some of the most dramatic responses in my practice. I look forward to the challenge of a new HA patient - especially those who have “tried everything”. If you are in that category consider a series of acupuncture treatments. Perhaps life can be better. A lot better.

We continue to  have positive pregnancies. Some are IVF with assistance by acupuncture. Several have been spontaneous (although) some couples do use IUI. In reviewing the acupuncture literature there continue to be a number of thoughts on which are the best meridians. I individualize, but favor Chong Mo and Ren Mo for their deep energy connections and influence on reproductive energy.

I have several patients following recommendations of Randine Lewis, PhD. She has written The Infertility Cure (Traditional Chinese Medicine based) and host The Fertile Soul retreats (search online).

I recently became aware of the Sher Institue at haveababy.com. They have a partial refund policy if IVF is not successful. There are other clinics with similar policies around the country.

I also continue to see a LOT of different drugs used by the Reproductive Endocrinologists and I try to strike a balance with my patients to not be OVERLY dependent on external hormone manipulation. Many patients are also told “gain weight” and “don’t exercise at all”. I understand the theory of hormone suppression if one is TOO lean, but I think it is unwise to eat excessively just to gain weight. And exercise, in balance, is very beneficial for the mind and spirit - so I chafe at stopping it completely. Again, balance is the key. A colleague recently said “Keep your focus on your partner and his or her needs. Don’t always focus your love and energy on the baby you want to have.”  I like that. To all of you trying - I wish you success. Call or email if we can help.

If you or someone you know is dealing with Cancer, these are 2 NEW books just out.

First, “Life Over Cancer” by Keith Block, MD. Dr. Block is a conventional oncologist (cancer doctor) who is leading the movement in the US to combine chemo / radiation / surgery WITH complementary treatments like acupuncture and sound nutrition advice to support people before, during and after their cancer treatments. This book is designed for the PATIENT at whatever point they are. I HIGHLY recommend it. Check online to get a copy.

Second is “Integrative Oncology” Donald Abrams, MD / Andrew Weil, MD. This book is more for the DOCTOR but is one you might share with your oncologist. It addresses a host of supportive treatments for patients during cancer therapy (including acupuncture). You can also find it online.

Share this information - and use it yourself. Dr. Block’s chapters on eating for cancer prevention are for ALL of us. Cheers!

1) For couples who want assistance without technology or drugs: I review medical history, GYN history, menstrual cycle history, and ask about sperm counts and openness of the fallopian tubes. Thyroid levels, and history of endometriosis are also important. I do treatments usually twice per month to balance the cycle, help deal with stress, encourage ovulation and encourage implantation and growth of the fertilized egg. We talk about herbs and nutrients as well as diet advice that may be helpful.

2) For couples who are using Clomid and doing IUI (Intra-uterine insemination) I work with all of the factors above and time more specifically around the IUI. I generally do not use herbs if Clomid is being used, but diet and some supplements still apply.

3)For couples who are doing Advanced hormones (see the prior post) and / or doing IVF (invitro fertilization) with a Reproductive Endocriniologist (RE) some of the basics still apply – like dealing with the stress involved – but the acupuncture treatments are more targeted to the Calendar established by the RE and adjusted according to how the eggs are developing and when the IUI or IVF transfer will take place. Typically, there will always be a treatment before and after the IUI or IVF. The goal of Medical Acupuncture is to focus on the Person / Couple and not just Reproduction (although that will get a lot of attention). The first visit involves the most discussion, history and planning of strategy and timing. But, as the process goes along adjustments will be made.Many insurance companies do not cover “Infertility”. Many do not cover Acupuncture per se.  But because I am an MD there can be some coverage for medical diagnoses such as endometriosis or PCOS. Also some treatments are done for Fatigue, Stress, Insomnia and other medical diagnoses. We will be happy to work with you and your policy. In general, you would pay $90 per treatment if you paid all out of pocket. This amount would reduce if insurance did cover. The first consultation / treatment is $125.

There are a number of studies on line regarding the benefits of acupuncture for infertile couples. My personal experience includes 6 positive pregnancies so far during 2009. This is very encouraging. For some couples the issue is PCOS (PolyCystic Ovary Syndrome) for others it is irregular periods, low sperm counts, recurring miscarriage after conception, endometriosis, or inconsistent ovulation. In my practice I provide acupuncture as a single treatment approach or as a complementary approach for couples who are working with Reproductive Endocrinologists for IUI or IVF. These couples are often using fertility drugs such as Clomid, Pergonal, Repronex, Follistim and others. A knowledge of Chinese Medicine, acupuncture, Chinese Herbs AND reproductive physiology allows for specific treatment plans catered to the individual patient and their circumstances. It is a fascinating area of acupuncture practice and one that I hope will benefit many other couples.

Medical acupuncture demand continues to grow.  As of 1/1/08 my practice had become exclusively acupuncture. 60% is pain management for low back, neck, HA, etc. Some practitioners will not treat pregnant patients - I do so with caution and commom sense. Ear points for nausea for instance are very benign - and often effective. But as far as pain - I am treating a patient who is 6 months pregnant with a low back strain - meds are not the best option so she sought out acupuncture. Today she tells me after one treatment she is “75% better”. Great!

The other 40% of my practice is Energy work for irritable bowel, sinus and allergy, fibromyalgia, fatigue, hormone issues including menopause symptoms, and just general maintenance of vitality and balance. Several people have told me that with their regular once per month treatments they no longer have their mid-day slump.

This is very gratifying. Having a positive energy input in a society that tends to drain us is, to me, a significant tool. Stay tuned. Thanks.