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.

High Brow Culture in China

While you come in a rush, when you leave please flush

There has been a big push in the last decade in China to get people to make simple adjustments in their day to day life that will greatly improve public health. Don't spit in public. Don't litter. Wash your hands. The fun thing about these campaigns is that the Chinese like to play on homonyms. The image above, stuck to the wall in the back of a bathroom stall, reads:

"Lai Ye Chongchong, Qu Qing Chongchong"

In this case, the focus is on the word "chong", which here means "to be in a rush" and "to flush the toilet". (This campaign is brought to you by "Comfortable Rectum, healing hemorroids with a patch you stick on your belly button.")

In chinese, the number of sounds are far more limited than in English. In order to have a rich and articulate language, they relay on 4 tones so that the sound "chong" for instance, can be pronounce with 1 of 4 tones. However, even within the same sounds with the same tone, there are numerous meanings which can only be clarified by reading the character. It all makes for a very challenging language for an American to study, but a fun and subtle language with numerous levels that the Chinese enjoy.

Cat Guts Used To Treat Obesity


As China’s unparalleled and sustained economic growth enters its 4th decade a burgeoning middle class is gaining modern apartments, flat screen televisions, SUVs, and potbellies. That’s right, China is get fat, though they still have a long way to go to reach the size of their American Idols. With the widening waist lines comes a staggering spike in fatty livers, high blood pressure, high cholesterol and diabetes. While China is a communist country, it does have self-proclaimed “special characteristics”, meaning capitalism. Where there is a disease, there is a dollar to be made on a treatment. And when it comes to obesity there are numerous treatments being promoted, most interesting, and shocking, of which is the “Cat Guts Treatment”.

In a nut shell, people are having “cat guts” inserted at acupuncture points so that they can lose weight. What?!?

The Chinese name for this treatment, Yang Chang Xian, literally translates as “Lamb Intestine Sutures”. So which one is it? Lamb intestines or cat guts? Neither. In actuality, it is a very thin suture that has been soaked in Chinese herbs (no one knows which ones because the company closely guards its trade secrets) and polarized with powerful magnets. The suture is placed in to a hollow point, 18 gauge needle (the size and type that is used to draw blood) and then the needle is jammed (literally) into an acupuncture point and/or “fat area” of the body that the patient wants reduced. The practitioner wiggles the needle around, trying to stimulate the acupuncture point, and then press a button at the top of the needle that release the suture into the skin. A band-aid is placed over the insertion point to prevent any bleeding. While this sounds terribly uncomfortable, the patients swear that 90% of the time it does not hurt, and their calm demeanor on the table suggests the same.

The “Cat Guts” are placed in about 10-15 points in the body, concentrating mostly in the abdomen, love handles, hips and upper thigh. The patient is then sent home for 2 weeks, at which point they come back for another treatment. Patients report losing 4-6 lbs of weight over a two week period. The weight loss results from continuous stimulation at acupuncture points that promote GI function, from a decrease in appetite and from extra metabolic energy being used by the body to absorb the suture.

Women are seeking this treatment in droves and by any standard BMI (Body Mass Index) are far from obese. The most common reasons voiced for getting this treatment are:

  • Young women who are trying to find jobs and feel that if they are thin it will be easier
  • People who are not interested in working out but still want to lose weight
  • People who are not interested in changing their diets but still want to lose weight

This treatment can cost anywhere from 200-1000 yuan (28-140 USD) per treatment, depending on whether the procedure is done in a subsidized, government run hospital or in a private clinic. This is 5-25 times more expensive than a standard acupuncture treatment, which runs about 40 yuan, but unlike the acupuncture, which is administered daily for a course of 10 treatments, this procedure is only done twice a month.

Cat guts anyone?

H1N1 in China

The moment you get on a plane to China the search for H1N1, the swine flu, is on. You are peppered with questions before landing, you walk through a metal detector that has been jerry rigged to measure your temperature, and health officials coral you into a room marked “quarantine” if you look tired. This happened to one of our students who was tired because she had been traveling for over 24 hours.

The hysteria amped up when I brought a student to the hospital with nausea and a fever a day later After testing her blood and taking her temperature they told us that she had to stay in the hospital that night until a throat swab could be done and an H1N1 test came back negative. I protested because I had 12 other students back at the hotel waiting for me and I could not leave this one in the hospital without a translator. However, we had set a chain of events into motion that was now being monitored by provincial officials.

Over the next 24 hours the student was quarantined, or “jailed” as she put it, in one of the most sparsely furnished rooms. She slept on a bed with many-day old sheets in a room that was painted white but had the stains of years of dirt and disease on the walls. The windows were barred, keeping her in but not keeping the mosquitoes out. The walls of every room were covered with charts screaming “H1N1”, reminding you to wash your hands, showings images of Caucasian women coughing clouds of disease, and telling doctors and patients alike the chain of care and command as the disease progresses.

24 hours later, 3 IV drips later, 15 phone calls later and 4 doctor changes later, the H1N1 diagnosis came back negative and we were allowed to go home.

Erik goes to China - 2009

Erik is returning to China for 5 week, taking alumni and recent graduates from the Oregon College of Oriental Medicine to Nanjing, China where the students willl spend 4 weeks training in a local hospitals. This is his third year leading the trip. While it is a burden to Inner Gate to have him gone, each year he brings back new and exciting treatment protocols which enhances the care our patients receive. This year Erik will study with a famous fertility doctor and two pain specialists. He will also spend 5 days in Wenzhou, China celebrating the marriages of both his brother-in-law and his cousin

While Erik is away his patients will continue to receive care from Oliver and Casey. Inner Gate Acupuncture is also excited to introduce Lindsay Matthews, L.Ac, who will be spending 3 days a week treating patient. Lindsay is an OCOM alumni and a past student of Erik’s in China. She enjoys working with athletes and sports related injuries, as well as educating patients in preventative care techniques. She is also developing a practice in the field of Integrative Oncology, offering acupuncture and herbal medicine to those going through Western cancer therapies.


Lindsay Matthews, L.Ac

Birth of Ollie's new daughter - Opal Mae

Birth of Ollie's new daughter - Opal Mae


Oliver and his wife Anne are excited to announce the birth of their second baby, Opal Mae Leonetti, on August 15th, 2009.

Vital Stats:

6lbs, 11 oz

20.5 inches long

Oliver has just returned from a 2 week paternity leave and reports that "Opal is growing, pooping, and generally happy." While Opal is spending most of her time with mom, Oliver is enjoying extended time with his oldest daughter, Sophia, who is very excited to be a big sister.