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Patient Information - First Visit
First Visit   |   Healing Process   |   Asian Medicine Modalities - Treatment Types  

                  "The good physician treats the disease;
                                    the great physician treats the patient who has the disease"
                                                                            - William Osler

Activities Before and After an Acupuncture Session

Because acupuncture mobilizes the body’s different kinds of energy (Qi), it is advisable to have a healthy, but not a heavy meal, a couple hours prior to each treatment.  Acupuncture received on an empty stomach may, in some patients who are new to acupuncture, produce a slight lightheadedness or mild nausea for a few hours.  After an acupuncture treatment, it is best to wait a few hours before eating a meal that is moderately light.  And, to prolong the calming and therapeutic effects afterwards, the best activity to engage in is simply to relax, if possible.



Consultation and First Visit
Our consultations are comprehensive and detailed.  Depending upon the nature and complexity of the patient’s condition(s), 90 minutes or in some cases 2 hours may be spent with the patient.  The consultation may be completed at the first session or divided between two sessions, or more. 
During the consultation a detailed health history is taken and a physical exam is performed. A comprehensive range of questions will be asked covering the areas of the patient's mind, body and spirit, in addition to symptom-related experiences concerning his/her chief complaints. This is an important time for us to get to know the patient and his/her health concerns, as well as allow the patient to ask questions and address any concerns. It is this initial consultation which establishes the baseline by which a diagnosis is made, a treatment plan is developed, and progress is measured.

Depending on the conditions to be treated, the physical exam may consist of palpating the regions affected such as the head, neck, abdomen, back, limbs, and joints. Functional testing may be employed to check for range of motion and/or movement deficits. Certain diagnostics measurements may be taken such as weight, blood pressure, oral temperature and respiration. In all cases and for each visit, the tongue will be examined and the pulse palpated for their conditions and diagnostics information.

Upon completing the consultation, an Asian medical diagnosis is made and the treatment plan discussed with the patient. If the patient is on prescription medications or undergoing other forms of medical therapy, their effects, side effects and any possible drug-herb or therapy-herb interactions are researched and evaluated prior to prescribing medicinal herbs.

For patients who are taking supplements and/or medications, it will be helpful to bring either the entire bottle/package or an itemized list of each item and the daily dosages taken.  

Acupuncture Needle Retention

Acupuncture needles are generally retained for 20-40 minutes after insertion of the last needle.  However, certain conditions may require either shorter or longer retention.  For children, needle retention is generally about 10 to 15 minutes.  This retention period is an important time for the body’s innate healing mechanisms to be activated and distributed.  It is also an important time for the patient to relax and quiet his/her mind to allow the healing activities of the needling to occur unimpeded.


Follow-up Sessions

Follow-up sessions generally are scheduled for 60 minutes.  For certain conditions and disorders, up to 90 minutes may be necessary

Frequency of follow-up sessions depend on numerous factors specific to each individual.  Please see the paragraph entitled Frequency of Treatments and Duration of Care further down on this page.



Treatment Plan

Treatment strategy depends on factors such as the condition being treated, progression of the disease, intensity of the symptoms, the patient's constitution, age, pharmaceutical drugs being taken, and more. Generally, the following strategy types may be employed:
  • Treat the symptoms (Manifestations) first and then address the underlying causes (Root) later. This approach is taken when the symptoms are severe and/or the condition is acute.
  • Treat both the Manifestation and Root simultaneously. This approach is taken when the symptoms are less severe and the underlying causes are chronic and conducive to concurrent treatment.
  • Treat the Root only. This approach is taken when treating the underlying causes will effectively eliminate the outward manifested symptoms. In most cases, this approach applies to very chronic conditions which have existed for a long time.

Treatment Modalities
A variety of treatment modalities are available. Depending on the symptoms presented at each session, the condition being treated, and the stage of the therapy, different modalities may be employed at different times. These modalities may include acupuncture, electro-acupuncture (e-stim), moxibustion (moxa), cupping, gua sha, plum blossom needling, intradermal needle retention, ear seeds, medicinal herbs, and therapeutic body work.

Please see the section on Asian Medicine Modalities for additional information.


Treatment Effects

Treatment effects depend on many factors. These factors may include one's unique attributes, age, constitution, his/her physiological and mental-emotional states, the nature and complexity of the condition, the stage and progression of the disorder, whether or not drugs or prescription medications are taken, and more.

For some conditions and some patients, the effect of acupuncture is almost immediate. For others, the effect is felt a few hours later. And for some, the healing effect is noticed a day or two later. Sometimes, noticeable improvement may not be attained until a few sessions have passed.

The quality of the effect may vary also. In most cases the initial effect from any of the treatment modalities is a reduction in the primary and related symptoms and a state of relief. Sometimes, however, certain symptoms may seem to be aggravated initially before reduction/elimination occurs as the body's energetics seeks to adjust itself. For example, in chronic bronchitis where the lungs are congested by "dry and difficult" phlegm-mucus, more frequent coughing may occur initially and temporarily as the phlegm is loosened through therapy and the body responds by coughing as a way to discharge it.


Duration of Effects
Generally, each treatment session builds upon the prior treatments. Therefore, the effects of each treatment tend to last longer as treatments progress. This is an important reason why the patient should try not to miss scheduled appointments.

Until a satisfactory level of relief is obtained, the duration of the effect of each treatment session will vary by the various factors identified above.  


Frequency of Treatments and Duration of Care
The frequency and duration of care are very specific to each patient and depends on any number of factors identified above, and those explained in the section on Healing Process. This is also affected by whether or not the patient elects to take herbs.  Certain symptoms/conditions, especially those of recent onset and acute nature, may be treatable in a few sessions. Others may require months of therapy. Conditions like HIV may require a lifetime of complement care, in alternating phases of treatments and no-treatments, as a way to increase the quality of life, reduce the side effects of HIV medications, and help prevent the disease from progressing to AIDS.

In most cases, frequency of treatments at the onset of therapy is extremely important. In Asia for example, conditions such as musculoskeletal, neurological, and acute disorders are treated daily during a course with a five-day interval between courses. A course may involve 10 sessions or more.  If the condition/symptoms are alleviated before the end of a course, treatments may be suspended at that time or the patient placed on a maintenance schedule.  For certain disorders, completing a full course may be advised irrespective of resolution of symptoms prior to the end of the course. This applies to conditions that are prone to relapsing or becoming chronic. 

Elsewhere, including in America, few individuals are likely to be able to adhere to a daily treatment plan. To the extent possible, undertaking two or three acupuncture treatments per week for the first few weeks of therapy will greatly facilitate the healing process and promote a faster and more positive outcome.



Women

Unless women are being treated specifically for uterine/menstrual disorders, reproductive and/or fertility matters, it is generally not advisable to get acupuncture during the first few days of the menstrual flow. This is because acupuncture may affect the natural downward flow of the body's energies (Qi) during this time.   



Pregnancy

Traditional Asian medicine is generally a safe medical modality for pregnant women.  However, a handful of acupuncture points, certain procedures and techniques, and some herbs may be inappropriate during pregnancy as they may have disruptive effects on the fetus or may affect milk production in nursing mothers.  With careful and prudent application, there are wide ranging benefits to the pregnant mother and during the post-partum period.  This is particularly the case in women who have had bouts of infertility, previously suffered miscarriages, or are prone to post-partum depression. 


Maintenance
Even after one's symptoms are resolved, traditional Asian medicine can help sustain a healthy life and prevent future imbalances. At this stage, treatments received either monthly or on alternating weeks may be sufficient to help preserve continuing balance and wellness.

In general, acupuncture and herbs taken for 3 to 4 weeks prior to the change of each season is an important strategy to help the body adjust to the specific elements of the coming season. Often, infectious diseases like the common cold, flu and other bacterial and viral infections afflict those whose immune systems are unable to quickly and adequately adjust to the change in seasonal elements and pathogens. Acupuncture and herbs can help boost the immunity and help ward off the different types of pathogenic factors associated with each season.

Numerous researches have shown that the more one incorporates traditional Asian medicine into one's life, the more it can help nurture the mind and body while promoting health, wellness and longevity.


Herbal Medicine - General Guidelines


The following guidelines apply to all herbs, whether they are taken in water decoction (cooked) form, in powder or pill forms.  

1/ Dosage:
-If instructed to gradually increase dosage of herbs over time, start at lowest dose and increase each day or every other day by a small amount, such as one (1) pill or half (1/2) gram increase per dose.
-At any dosage, if there are suspected side effects, contact your acupuncturist for further instructions.  The simple solution in most cases is to reduce dosages to the prior level at which no side effects were experienced.   In any case, it is important to discuss this with your acupuncturist before taking any action
 
2/ Possible Side Effects:
-While herbs are mild and gentle in their effects, some individuals may lack the digestive enzymes and friendly bacteria specific for digesting certain ingredients and substances. 
    -In this case, symptoms such as gas or indigestion or nausea or diarrhea may occur.
-Individuals who have allergies to certain substances may experience allergic reactions to certain ingredients/substances in the herbal formula. 
    -In cases of allergy, symptoms such as itching or a rash may occur.
 
3/ Timing:
-Unless otherwise instructed, herbs should be taken about 30 minutes before or 60 minutes after food.  The important thing is to not take them with food as their effects may be greatly reduced.
 
-Unless otherwise instructed, first dose should not be taken before 8 am in the morning, and last dose should not be taken less than 3 hours before bedtime.  This is because your digestive system is not yet fully awake before 8am, and the moving/dispersing nature of some herbs may disturb sleep if taken too close to bedtime.
     -However, if taking calming herbs to help with insomnia, those may be taken close to bedtime.
-If patient is taking medication of any kind and in any form, there should be a wait time of not less than one hour after the drug intake, before taking herbs.  Please follow the recommended wait time appropriate for each medication you are taking. 
 
4/ Stop taking herbs in the following situations:
-Certain conditions may, but not always, require stopping herbs intake until the condition has been resolved. 
-These conditions include but are not limited to:
   -when an infection occurs such as a cold or flu
   -when physical trauma/accidents occur that would cause internal or external bleeding   
   -when new drugs/medications are being introduced
   -when undergoing any kind of medical procedure, such as surgery
   -when suspected of pregnancy
-In all such cases, please stop taking the herbs and inform your acupuncturist as soon as possible.


First Visit   |   Healing Process   |   Asian Medicine Modalities - Treatment Types
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