Wednesday, May 5, 2010

Portland Acupuncture Project - Urban Needles

The Portland Acupuncture Project, a 6 month long installation, explores the interface between art, regional planning, traditional Chinese medicine and the health of a city. This project is being sponsored by the OAAOM (Oregon Association of Acupuncture an Oriental Medicine) in concert with the Department of Planning and Stability, METRO, the Regional Arts and Culture Council, the Oregon Arts Commission and the Northwest Health Foundation.

The artist, Adam Kuby, explains that he uses “…the body as a metaphor for the entire city…hop[ing] to identify those places in the landscape that are important to us as a community, drawing attention not only to the significance of each focal point but also to the interconnectedness of them to each other as well as to ourselves.” The 4 goals of the 35 foot tall needles are to:

create visual links to the “The Portland Plan,” the city's 25 year strategic planning effort happening now
help people connect their own individual bodies and individual health to the health of their city
spotlight the acupuncture profession and generate local & national press coverage
offer acupuncture demonstrations and treatments at various sculpture sites during the installation

City planners hope this instillation will stimulate public discourse about the Portland Plan, a guide for the city’s growth over the next 25 years. The Portland Plan ( HYPERLINK "" examines the challenges we face around education, affordable housing, livability, and environmental sustainability and sets lofty goals to ensure that all these issues are addressed in future planning. The needles will be placed in areas that bring attention to the some of the city's most challenging problems, greatest assets, and enormous potential.

The first 5 needles, made out of super strong, high-tensile steel that is still light enough to be lifted manually, will be placed along the Willamette and the Columbia Rivers. The initial instillations draw attention to these ancient waterways as the reason for Portland's existence, while also pointing to specific challenges and opportunities they are facing today. You can learn more about the artist, the project and the location of all the needle installations at

Friday, March 5, 2010

C-Sections: Not Something To Take Lightly

A recent article in Lancet, a leading medical journal out of England, cites a spike in cesarean sections (c-section) over the last decade. The greatest rise was seen in China, where this surgery was performed in 46% of all deliveries. In Chinese culture, this spike is tied to an increase in wealth, a perception of modernity, and even a desire to have your child born on a “lucky” birthday. However, this rise in c-sections can be seen across the entire globe and over every socioeconomic class. Even in the United States the rate of c-sections has risen from 4.5% back in 1965 to 33% in 2007.

There are many reasons why this rise is happening. Research suggests that the natural contractions of the uterus are disrupted by the continual electronic monitoring of the baby as well as by the administration of epidurals early in the delivery. Women are rarely being advised of all their birthing options, perhaps because as medicine becomes more advanced a more casual attitude towards major surgeries is taking hold. It is easier to “go in” and get the baby then invest the time and energy in having a doula or other trained professional present to assist in a natural birth. One is also left to wonder whether insurance compensation practices pressure doctors to deliver in an efficient manner, as a long, drawn out delivery is still reimbursed as just “a delivery”.

It is important to realize that c-sections pose a great deal of risk to both the mother and the child. Mothers will have uterine scarring after the c-section that increases the future chances of infertility, ectopic pregnancies and placenta previa, a condition where the placenta develops across the cervix, increasing the risk of miscarriage. A higher rate of unexplainable fetal demise happens after week 34, late in the 3rd trimester, in women who have scarred uteruses. And the one proposed benefit of a c-section, protecting the pelvic floor and reducing future incontinence, seems over emphasized. Minimal differences exist 6 months postpartum and by age 50 no noticeable difference in the strength and function of the pelvic floor is detectable. Furthermore, this concern can be offset by regularly practicing simple pelvic floor exercises.

Babies, too, are put at risk when a c-section is performed. A recent study has shown that the normal infant mortality rate in the United States, 0.62 deaths per 1000 vaginal births, jumps 3 fold to 1.77 deaths per 1000 when a c-section is performed. While this is still considerably low, it is cause for concern. These deaths can be the result of something as simple as being cut during the procedure or as complicated as developing dyspnea, a breathing disorder, after they are born. Dyspnea can develop in weaker children who are unable to clear out the amniotic fluid in their lungs that would normally be pushed out by the natural physical compression of the lungs during vaginal birth. Children delivered via c-section have high levels of pain medicines in their systems, leaving them sleepy and uninterested in breastfeeding. These children often lose interest in breast-feeding and again if already weakened, can fail to thrive.

Cesarean sections are one example of the great strides modern medicine has made to save lives and avert emergencies. However, this is a major surgery that does come with serious risks, and anyone planning a family should evaluate the pros and cons prior to their delivery date.

Thursday, January 14, 2010

Largest Drop In Health Care Spending in 50 Years

Spending on health care slowed in 2008, according to a government report released Tuesday. In fact, health spending grew more slowly than at any time in at least a half-century.

However, the annual health spending statistics published by the Department of Health and Human Services are a classic case of good news and bad news.

The good news: Health spending slowed down. Way down, said Anne Martin, one of the authors of the study published in the current issue of the policy journal Health Affairs.

"National health spending growth slowed in 2008 to 4.4 percent, the slowest rate of growth in the National Health Expenditure Accounts."

In other words, the slowest growth since the government has kept records.

The bad news: Health care still totaled $2.3 trillion in 2008. That's more than $7,600 per man, woman and child. Plus it still grew faster than the rest of the economy.

There's still more bad news, says Rick Foster, the chief actuary at HHS. A major reason health spending slowed is that with the bad economy, many people simply couldn't afford medical care.

"In many cases they lost their employee-sponsored health benefits at the same time they lost their jobs. So that meant that the cost of care was much much higher because they had to pay it out of pocket. So some people presumably scaled back on their purchases."

Analysts say that given the depth of the recession, the problems with health spending probably didn't get any better in 2009.

Monday, December 7, 2009

Antacids inhibit Probiotic efficacy

Patients are often prescribed probiotics to replenish their system with healthy bacteria in order to improved their digestion and prevent the overgrowth of yeast. Probiotics encapsulated in enteric coating have a better chance of passing undisturbed through the stomach and reaching the intestines. We have recently learned that when taken with prescription antacids, the effectiveness of the enteric coating is neutralized. These antacids change the environment of the stomach, increasing the breakdown of the protective coating.

We regularly prescribe probiotics for patients with gastro-intestinal disorders. It is our experience that when taken 30 minutes prior to an antacid, the above complications are eliminated.

High Marks for Inner Gate Acupuncture

Inner Gate Acupuncture would like to thank those of you who took the time to fill out the Kaiser CHP Practitioner Satisfactory Survey earlier this fall. Oliver and Erik were evaluated and you gave them very high marks, 98% and 96% respectively. Your feedback not only helped Kaiser realize how effective acupuncture is, but also how appreciative you are to be able to access acupuncture. It also helped Inner Gate Acupuncture learn how to better serve and treat our patient.

Below are the remarkable scores that you gave us:

  • 99% of those surveyed reported that our treatments helped
  • 88% of those surveyed reported that our treatments helped reduce prescription drug intake
  • 92 % of those surveyed reported that our treatments helped reduce the use of other medical care for the same problem

Better than the above marks were the comments you chose to share with Kaiser. Erik “has relieved nerve pain that many MD’s couldn’t”. He was described as “compassionate, caring, well-informed” and “awesome”. One patient enjoyed seeing Erik because “he really makes me feel comfortable to discuss anything…which is the most valued thing as a patient”. Oliver was described as “awesome !”, “very attentive, very helpful”, “extremely nice and caring and easy to talk to” and as someone who is a great teacher. However, the award winning description is that Oliver “is the bomb diggity of acupuncture.”

Good job guys. Keep up the good work.

The Merchants of Hongcun


Anhui, a landlocked, mountainous province, is today one of the poorest areas in China. But this was not always the case. Because there was such limited land on which to grow rice and raise livestock, the people of Anhui turned to commerce for their livelihood. Harvesting bamboo, silk and tea locally, they used a complex system of river ways to bring their products to market in Hangzhou, some 200 miles away. They also made a lot of money in trading salt (very much like stock traders buying and selling pork bellies in today’s market) and in running pawnshops.

As they gained wealth they invested it in their homes. Traditionally, merchants were very low in the social hierarchy, below government officials, the literati and even farmers. Therefore, they built the outside of their homes with simple brick and plaster, so as not to upset the established social order by suggesting that they had more wealth or power than government official, even if they truly did. The outside also lacks windows (though there are numerous sky lights) and the walls are built taller than the roofs, to prevent robberies while away on business. However, once inside it is evident that the homes were anything but simple. Rooms are built with the finest teak wood. Every room is decorated with ornate carvings depicting the wishes of the owner—100 boys in the bedroom, the character for “longevity” in the in-laws quarters, famous quotes by great scholars in the study. Lavish courtyards are spread throughout the compound offering areas of leisure for the families.

The city of Hongcun, depicted in these pictures and used as the site of the opening scene of “Crouching Tiger, Hidden Dragon”, is 900 years old. It was moved to this location after a fire destroyed the previous city. Shortly after the move 2 more fires plagued the city. The city people decided to set up a system of canals that run through the city, so that fires can be easily extinguished. The houses are built in close proximity and the fact that they a made out of brick on the outside also helps prevent a fire spreading from one house to another. This small town is a reflection of the great wealth and prosperity that inhabited the valleys of Anhui in previous times.

Efficiency in Chinese Hospitals

I came down with a cold a few days ago and it quickly dropped into my chest. Each time I coughed I was rocked with intense pain in my left lung, like someone was cutting me with a knife. I was left stooped over in pain, catching my breathe for a minute, dreading the next cough. Having just spent a week helping a student recover from pneumonia, I wanted to rule out any possibility that she had passed it on to me. I was hyper-paranoid because I was about to visit my 4-year-old daughter and my 4-month-old nephew and I wanted to make sure that I wasn’t going to put their health at risk.

To rule out pneumonia you need to get a chest x-ray. The speed at which the whole process unfolded was astounding. I walked into the emergency room and walked right over to a doctor. Within 2 minutes I had an order for a chest x-ray. After paying $12 (for the doctor’s time and the x-ray) I went directly to the radiology department where I was the 10th person in line, and yet, 10 minutes later my name was called. The nurse closed the lead doors behind us, showed me where to stand, hit a few buttons, and sent me on my way. The longest part of the process was waiting for my results, a whole 15 minutes, about the time it took me to write this document.

When the process was all said and done, I spent 45 minutes and $12 dollars ruling out pneumonia. I am fortunate to have a GOOD insurance plan, and yet I would have paid hundreds of dollars and spent numerous hours going through the same process in the U.S. While we all understand how troubled our medical system is, what most people don’t understand is just how cost effective and efficient other countries medical systems are. While China numerous challenges as it moves towards a 1st world country, her is one area where they are far more advanced than the U.S.