Needling Me

Years ago, as a young woman in my twenties (Could that really be at least 50 years ago????), I was horrified to discover I needed surgery for bleeding hemorrhoids. It was embarrassing, my younger self thought. It was private, my younger self thought. So my younger self looked for an alternative and discovered acupuncture. Not only would I be spared someone – even though that someone would be a doctor – dealing with private parts of my body, but I would also be spared the insult to the body that surgery can be… and my insurance covered it.

Hmmm, I was fully clothed and the needles didn’t hurt although I had expected the process to be painful. Best? I did get relief from the bleeding hemorrhoids and avoided the surgery.

Remembering that incidence today for some unknown reason, I wondered what – if anything – acupuncture could do for those of us with Chronic Kidney Disease. So, I went searching for information.  But wait, I’m getting ahead of myself – as usual. Let’s go back to talking about what acupuncture is.

Acupuncture is a form of medical treatment that’s been used for hundreds — even thousands — of years. Acupuncture originated in Asian medical practices. That’s why many licensure and oversight boards use the term ‘Oriental Medicine’ to classify acupuncture.

Acupuncture is practiced by tens of thousands of licensed acupuncturists. Expert acupuncturists train for three to four years. The training includes both instruction in the use of needles and instruction in diagnosing conditions. Practitioners have direct supervision from another senior or expert practitioner.

In addition to this training, acupuncturists must undergo testing from a national board of examiners and continue to take instructional courses each year to maintain their license.

The American Medical Association accepts acupuncture as a medical treatment, and some insurance companies may cover the cost of treatment.”

Thank you, Healthline at https://www.healthline.com/health/dry-needling-vs-acupuncture for the above information.

The University of California, San Diego, School of Medicine, Center for Integrative Medicine in the Department of Family Medicine and Public Health at https://medschool.ucsd.edu/som/fmph/research/cim/clinicalcare/Pages/About-Acupuncture.aspx  had a succinct description of the process.

“First, your acupuncturist will ask about your health history. Then, he or she will examine your tongue’s shape, color, and coating, feel your pulse, and possibly perform some additional physical examinations depending on your individual health needs. Using these unique assessment tools, the acupuncturist will be able to recommend a proper treatment plan to address your particular condition. To begin the acupuncture treatment, you lay comfortably on a treatment table while precise acupoints are stimulated on various areas of your body. Most people feel no or minimal discomfort as the fine needles are gently placed. The needles are usually retained between five and 30 minutes. During and after treatments, people report that they feel very relaxed.”

PubMed, part of the US National Library of Medicine, National Institutes of Health at https://www.ncbi.nlm.nih.gov/pubmed/28422526 concluded via a small, fairly recent study:

“Acupuncture at bilateral Hegu, Zusanli, and Taixi for 12 weeks reduced creatinine levels and increased eGFR levels. The study only provided a feasibility method for the treatment of patients with CKD. However, the results of this preliminary study warrant further investigation.”

I think we all need a little help here to understand this conclusion. The three words we are not familiar with are all acupuncture points. The Acupuncture Massage College’s site at https://www.amcollege.edu/blog/commonly-used-acupuncture-points explained in language I could understand.

“Large Intestine Channel: LI4, Hegu
This point is located on the back side of the hand between the thumb and first finger. The primary use of this point is to relieve pain and treat inflammatory and feverish diseases.

Stomach Channel: ST36, Zusanli
This point is located on the front of the leg, just below the knee. It is helpful for digestive disorders. Research shows that using this point results in positive effects in treating anemia, immune deficiency, fatigue, and numerous diseases.

Kidney Channel: KI3, Taixi
This point is located just behind the inner ankle. It is used for disorders in several areas of the body, including sore throat, toothache, deafness, tinnitus, dizziness, asthma, thirst, insomnia, lower back pain and menstrual irregularities.”

Inflammatory? CKD. Anemia? CKD. Immune deficiencies? CKD.  Kidney? CKD. Now we know why acupuncture can help us. There seems to be a split among doctors as to whether it will or not, so you’ll have to be careful to talk to your nephrologist. Some will give you an emphatic, “YES!”  Others will give you a questioning look. And still others will ask you, “Why bother?” Be prepared with your answers. You don’t want to alienate the doctor in charge of your treatment and you want to keep the lines of communication open. Well, at least I do.

 

If you’re excited about the idea of acupuncture, you may be asking yourself how to find a good, safe practitioner. Sure you can look in the phone book, but – just as with any doctor – what would you know about how this particular acupuncturist functions? Before I had CKD, when I was plagued by another medical problem but had already moved to Arizona away from my NYC acupuncturist, I asked my stepdaughter about the acupuncturist she saw. If your nephrologist is onboard, you can ask for a referral. Sometimes, your primary care physician can be a good source here, too.

If you’re not excited about acupuncture, don’t push yourself. My husband tried it once to please me and swore never to do that again because he just didn’t like it. Okay, he has other ways of dealing with his back pain. While I am in favor of acupuncture and plan to incorporate this into my medical team once I’m done with surgery and rehab, I also like peace in the house.

Until next week,

Keep living your life!

Help When You Need It

One of the many people I met at the AAKP Conference who opened my eyes to things I’d never even though of before is Samantha Siegner from the Chronic Disease Coalition. We hit it off right away and I felt comfortable exposing my ignorance to her. Once she explained what the coalition does, I wanted all my readers to know about it. Happily for us, Samatha agreed to write a guest blog for us.

*****

Nearly half of all adults in the United States have one or more chronic health conditions, and the number continues to climb. By 2020, it is projected that over 157 million Americans will battle a chronic disease. While some chronic conditions can be prevented, others are inherited, or may develop as a result of numerous factors. Despite the prevalence of chronic disease, few organizations are specifically dedicated to addressing the needs of patients who battle all types of chronic conditions rather than a single disease.

The Chronic Disease Coalition (CDC) is national nonprofit organization that represents people battling a wide range of chronic conditions, including kidney disease, diabetes, arthritis, multiple sclerosis and more. As patients dealing with kidney disease or other chronic conditions know, it can be difficult to work, attend school or even get adequate health insurance coverage. Our organization works to not only raise awareness and educate the public about chronic conditions, but also to advocate for patients who need better access to care. Our mission is focused on exposing and addressing discriminatory practices and policies that are preventing patients from accessing necessary, often lifesaving care.

Discrimination based on a person having a chronic disease comes in various forms, but we most frequently see it occur in the school, workplace and with health insurance plans.

  1. School: For those looking to complete high school or even college, it can be difficult to regularly attend class or have the energy to complete assignments. For kidney patients, dialysis poses difficulty attending class, as you may be required to dialyze for several hours multiple times a week. It is important to educate yourself on the services offered by the school to ensure that you are receiving reasonable accommodation that support your effort to pursue education.

Our organization works with people to ensure that they are being treated fairly in the school system, read more in one patient’s story here.

  1. Workplace: Many people with chronic conditions may frequently visit the doctor’s office for treatment, response to a flare up or check-ups to ensure that their condition is being managed properly – these actions can require additional time off work. While it is not legal for an employer to ask about your medical history, some patients may disclose it. This can lead to a greater understanding and development of a process for how you miss work, but for others, it may lead to losing their job or being demoted.

The CDC helps patients by supporting legislation that protects the privacy of employee’s medical history and ensures that businesses and corporations cannot discriminate based on their health status. Additionally, we ensure that patients are educated on their rights within the workplace.

  1. Insurance: Unfortunately, insurance discrimination is all too common. Insurers institute a variety of practices to increase their bottom line at the expense of the patients, without consideration for the long-term health consequences. Some of the most common practices include, step-therapy or fail-first, lengthy prior authorization approval times, nonmedical switching and bans on charitable premium and copay assistance, which is a common way for insurers to target kidney patients.

Right now, insurers across the nation are targeting chronic disease patients who rely on charitable premium assistance to help afford the cost of their health care. By utilizing a loophole within a 2014 guideline issued by the Centers for Medicare and Medicaid Services, insurers are denying premium and copay payments made by charities, like the American Kidney Fund, on behalf of patients. As a result, patients are forced off their current health plan and left to find other options. This is a commonly used tactic to force patients off of private health plans and onto public plans, because the insurer doesn’t want to cover chronic disease patients that require expensive, regular treatment, like dialysis. While kidney patients are eligible for Medicare before the age of 65, a public plan may not meet their needs or cover services that can help a patient become eligible for a transplant.

The Chronic Disease Coalition is actively working to pass H.R. 3976, the Access to Marketplace Insurance Act to ensure that patients can access charitable premium assistance and choose the health plan that best meets their needs.

So how does the Chronic Disease Coalition work with kidney patients? In addition to advocating on behalf and beside kidney patients to ensure discriminatory policies don’t hinder their ability to access care, we work with patients in their communities to raise awareness and educate the public on kidney disease at an individual level and through our Ambassador Program.

After receiving an initial diagnosis, many people with kidney failure may not know what to expect from treatment, what questions they should ask their medical team and what changes may come to their daily life. Our Ambassador Program was developed on this understanding and is comprised of active advocates who battle chronic diseases and provide guidance, advice and advocate on issues that concern kidney patients. Ambassadors complete advocacy work that is relevant to their specific diseases and communities each month.

If you are interested in learning more about the CDC and how you may be able to become involved, please click here. Change happens when people speak out, share their stories and take action – the CDC is proud to provide a platform for kidney patients and all people with chronic conditions to do so.

*****

Did you click through on all the blue words? I did. I’d had inklings of what each of these meant, but the full explanation made my understanding so much better. All I can say is: Thank you!

SlowItDownCKD 2014 should be out on Amazon.com any day now. B & N takes a few weeks longer. This had formerly been the second half of the unwieldy, small print, indexless The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 2. I’d vowed to separate both this book and the equally unwieldy, small print, indexless The Book of Blogs: Moderate Stage Chronic Kidney Disease, Part 1 into two books each… and now I have. Of course, that leaves me with desk copies of each of the Book of Blogs which I no longer need. Want one? Let me know (but only if you haven’t received a free book from SlowItDownCKD before).

Until next week,

Keep living your life!