Monday, April 25

What is the Berkley Method?

The Berkley Method represents an integrative approach to the diagnosis and treatment of the infertile patient.

This is unique within the community of most acupuncturists treating infertility.

Most acupuncturists in the U.S. diagnose and treat strictly from the perspective of traditional Chinese medicine. While this method of treatment is rather romantic it does not represent an East meets West approach to care which is the standard currently used in China.

The East meets West approach is the more scientific approach; one which combines traditional Chinese medical applications such as acupuncture and herbal medicine along with scientific and medical approaches to care. For example, we are one of the few acupuncture centers that knows how to utilize herbal medicine in conjunction with clomid or gonadotropins and other medications such as dexamethasone, Lupron, Antigon, Tamoxofin, Letrazole, Naltrexone, etc. We also have extensive knowledge in treating disorders of pregnancy with herbal medicine such as sub chorionic hematoma and placenta previa. Most practitioners are not comfortable treating pregnant patients with herbal medicine because of their lack of clinical experience with herbs. We have saved many impending miscarriages with the use of herbs.

Integrative means that we combine both Western medical findings and traditional Chinese medicine findings when performing a diagnostic evaluation and creating a treatment plan. For example, a patient with endometriosis will be treated very differently than a patient with PCOS. A patient with high FSH will get very different treatment than one with high LH. A patient with low estrogen levels will get treated very differently than a patient with low FSH. These distinctions are very important when diagnosing and treating patients. You’ll want to know if your acupuncturist can make these distinctions and treat based upon them.

We are one of the few if not the only acupuncture center in NY that treats in this manner. We request and review the semen analysis, day 3 blood work, and thryroid findings. We also request testing for immunological factors and blood clotting (thrombophilic disorders) when necessary. We also request testing in some cases which may reveal a ‘hidden’ pathology of sperm which the typical semen analysis does not do.

We are probably the only acupuncture center that knows when to request certain tests and importantly how to interpret the results of these tests.

We are also the only fertility acupuncture center in Manhattan that has a Board of Advisors composed of some of the finest reproductive endocrinologists in NY State ( see our website to view our Board of Advisors).

The Berkley Center for Reproductive Wellness is the first acupuncture fertility center in New York City to specialize in infertility treatment. As the leader in our field we feel that we have learned to successfully integrate ancient and modern medicine. This gives our patients the best environment for care with the greatest chance of pregnancy and live births. We strongly believe that the best outcome for successful pregnancy and live birth is to be treated by a reproductive endocrinologist as well as an acupuncturist/herbalist who truly specializes in this field.

We are pleased to offer free mini consultations so that your questions may be answered and your concerns addressed. Bring in your reproductive medical findings and be prepared to have an active, interesting and informative conversation about your case. Hopefully, at the end of this lively dialogue you will have a lot more information than you had before you came in. This consultation in no way obligates you to be under our care. We offer this free mini consultation to help you make an informed decision when choosing your acupuncturist. In fact, you should have at least three FREE consultations with three separate practitioners – this way you can really have an informed opinion as to which practitioner is most suited to meet your needs.

We maintain relationships with many fantastic reproductive endocrinologists such as Drs. Alan Copperman, Tanmoy Mukherjee, Dan Stein, Dan Levine, Joel Batzofin, Glen Schattman, Robert Kiltz, Owen Davis, Sami David, Jonathan Scher, and many others.

These relationships make it easier for us to coordinate care with your reproductive endocrinologist providing you with a well rounded and highly coordinated patient centric-approach to care.

You should also know that we are available 24/7/365 for pre and post embryo transfer acupuncture treatment.

We are the first and the most experienced acupuncture clinic specializing in the field of oriental reproductive medicine in the United States.

Call us for excellence in care. 212-685-0985

Monday, April 18

Infertility, Endometriosis, Pain Management

Changes in my Acupuncture Protocol


After 13 years of study and clinical experience in treating infertility I have refined my approach to treating patients with acupuncture.
Previously I had always treated patients lying on their backs facing upwards.

Now I treat with three successive protocols: 1)Patient is on back facing upwards; 2) Next visit the patient is on his/her side and I needle the front and back simultaneously; 3) 3rd visit, I treat the patient face down and use acupuncture points on the back only.

This multi-faceted approach allows me to access many important acupuncture points on the body and potentially improve efficacy.

For those of you who are acupuncturists, I am using front mu points, back shu points and points of the 8 extra meridians as well as points which are appropriate for the pattern of disharmony being addressed.

I am starting to see good results with this new appropach.

Endometriosis

Recently, I have added endometriosis as a disease which I am treating.

Treatment is geared towards ameliorating pain AFTER a laparoscopy is performed; potentially slowing down it's re-growth after a laparoscopy by potentially regulating and stabilizing the immune function of the endometrium (for REI's: reduction of MMP's and aromatase IN THE uterine cavity. This is obviously experimental, but if success is manifest then many will be helped - if not, then I will strictly deal with pain management).

So, endometriosis patients are welcome!

Meditation & Pain Management

Lastly, we just completed our second Joanne Verkuilen, Fertility Meditation and everyone loved it! Thanks Joanne for a great job! Joanne is the Co-Founder of Circle+Bloom an incredible organization.

Oh...one more thing, I have hired two excellent acupuncturists whose expertise is in pain management. So, if you, a friend, or a loved one suffers with headache, back-pain, neck-pain, arthritis, etc., have them call Abbey Fromkin, L.Ac. or Jeff Wolf at The Berkley Center they will receive excellent care.

Ciao for now!

Thursday, March 31

Endometriosis

Endometriosis and pain


Pain in the endometriosis patient is caused by several factors which may function individually or concurrently.

1. Inflammation

2. Increased prostaglandins (pain substance)

3. Adhesions which cause distortion of the pelvic organs

4. Endometriotic adhesions on nerves (the woman with endometriosis who suffers with sciatica for example, as a result of endometriotic adhesions on the sciatic nerve)

Acupuncture and herbal medicine often facilitate the following effects.

1. A reduction of inflammation

2. An interruption of the prostaglandin cascade

3. Increase blood flow to areas with adhesions delivering appropriate biochemical products which increase healing; macrohphages for example, which serve to ‘eat’ foreign objects in the body of which an adhesion is but one. Acupuncture nor herbs can eradicate adhesions or endometriotic implants but may, as a result of increased delivery of mitigating biochemical substances, help reduce pain.

If you have pain pre and during menses, pain with deep penetration during intercourse, pain with ovulation, pain at mid cycle, and bowel changes with menses this is suggestive of endometriosis.

Before you get your laparoscopy (for example, if there is a 3 month waiting period because of your surgeons busy schedule), then use acupuncture and herbs to help reduce the pain.

In many cases pain is completely ameliorated after laparoscopy. There are occasions however, when pain persists. It is at this juncture that the use of acupuncture and herbs are very appropriate. Your ONLY alternatives are strong pain medication or medication which will prevent you from menstruating such as aromatase inhibitors or Lupron.

Though these medications will reduce pain, and prevent endometriosis re-growth you will not be able to get pregnant while on them. Even though these drugs can help reduce pain, they will also reduce your estrogen levels which, over time, can negatively affect your heart, brain function, and bone density. Acupuncture and herbs do not have these side-effects and permit pregnancy to occur.

The Berkley Center for Reproductive Wellness is pleased to announce that we are now treating endometriosis patients in addition to treating those couples who are trying to start or grow their families.


Endometriosis and infertility

Endometriosis causes infertility for several reasons.

1. Tubal damage which prevent egg fertilization.

2. Inflammatory proteins in the uterine cavity which prevent implantation

3. Implantation deficit as a result of endometrial pathology associated with endometriosis

4. Possible additional contributing autoimmune disorders which can contribute to infertility; activated natural killer cells, for example.

For the individual wishing to achieve pregnancy who has tubal damage, in-vitro-fertilization after laparoscopic excision surgery is the quickest means to a successful outcome in general. However, the endometrial lining itself is often pathologic and even after a laparoscopy, implantation failure is common. Even the best laparascopic surgeon cannot always excise all endometrial implants.

If, after a laparoscopy, if any endometriosis is still manifest, so too will be the inflammatory proteins associated with endometriosis which contribute to a hostile uterine environment preventing embryo implantation. One may think of this state as having a fever in the uterus. In essence, the uterus is sick. Acupuncture and specifically customized herbal medicine can, in some cases, as mentioned above, reduce these proteins, improve the uterine environment, and help increase pregnancy and live birth rates.

Wednesday, March 23

How does Acupuncture work?

For the Chinese and other like-minded individuals, it’s simple. Acupuncture works because it moves the Qi and blood within the body. One of the most important precepts of Chinese Medical theory states, “Where there is a free flow of Qi and Blood, there is no pain or dysfunction. Where there is no free flow of Qi and Blood, there is pain and dysfunction.”

If that’s the case, how do Qi and Blood become disordered?

Qi is the functional force that moves blood and “gets things done” within the Chinese body. It may become negatively affected in some of the following common ways:

*Repetitive strain disorder

*Trauma

*Climactic factors/wind, cold, damp, dryness, heat

*Nutritional insults/poor diet, drugs, alcohol, caffeine, etc..

*Disordered & imbalanced emotional states/anger and depression in particular

*Personal habits/overwork, overeating, too much sex (for men it’s a problem )

I’ve heard about Tai Qi and Qi Gong. What do these do for people?

They are “core level” practices within Chinese medicine related to the warming,

stretching and healing of the body. They help move the Qi and blood along their

meridian pathways, thus promoting a healthy body, mind and spirit. When practiced

along with acupuncture they enhance acupuncture’s beneficial effects thus helping

regulate normal body functions.


OK. I don’t necessarily believe that the movement of “Qi and Blood” are the reason acupuncture works. What is the western biomedical explanation for how acupuncture produces its effects?

*It inhibits the secretion of the neurotransmitter “Substance P” along ascending pain

sensory pathways to the brain, effectively “gating out” painful stimuli at the level of

the dorsal root ganglion in the spinal cord where the cell bodies of sensory neurons

are located. (The Melzak and Walls, MDs hypothesis)

*It facilitates the release of serotonin, dopamine, GABA and other inhibitory central

nervous system neuropeptides which translates into a happier, pain free affect.

*It affects the hypothalamic-pituitary-endocrine axis thus affecting hormonal and

metabolic functions within the body.

*It exerts its visceral effects on the tissues of the body via the glial cell – neuroendocrine

pathway hypothesis of Richard Gerber, MD.

*It stimulates the activity of certain immune system cells and supportive cells (fibroblasts

and fibrocytes) within connective tissue matrix.

*It produces muscle fasciculation which ultimately relaxes hypertonic muscle and connective tissue.


What is Chinese herbal medicine? And is it safe?

Chinese herbal medicine is a nearly five thousand year old practice of imbibing

special naturally derived medicinal substances as contained within the Chinese

Materia Medica, that when taken in combination with each other – most Chinese

herbal formulas contain at least four different medicinal agents – accentuate the

positive effects of each, while diminishing any unwanted side effects. When properly employed, it is the oldest, safest system of internal medicinals in the world. Western allopathic medicine cannot make that claim.

What is Chinese nutritional therapy?

Chinese nutrition therapy involves the inclusion or omission of certain food

items which are known to affect the state of Qi and Blood within the body,

down to the specificity of which internal organ(s) may be positively affected.

It is often used in conjunction with Chinese herbal formulas for the resolution

of internal disorders, as well as promoting overall maintenance of good health.


Does acupuncture hurt? Let’s get real here…

When an acupuncture needle pierces the surface of the skin, it typically inserts to

a moderate depth within the connective tissue. Most often, the patient experiences

an initial pricking sensation which gives way to a feeling of pressure and warmth.

The ancient Chinese texts called this “De Qi,” or “The arrival of Qi” to the point. Most

patients do not find this sensation painful or uncomfortable. The needles are made of surgical grade stainless steel, very thin in diameter, solid – thus not ripping of tissue like a hypodermic needle, presterilized and disposable. Counter-intuitively, a quicker,

faster, deeper insertion produces less of a “De Qi” sensation than one more superficially

applied.

What is moxibustion? How does it feel?


Moxibustion is the smoldering of a medicinal herb – artemesia vulgaris – on the handle of a needle, or on the protected skin of a patient to induce an even greater movement of Qi than would be produced by an acupuncture needle alone. It is often used for internal conditions and to tonify the overall Qi of the body. It warms the point and feels quite comfortable. Many patients report loving the feeling of moxibustion.


What is cupping? Why did Gwenyth Paltrow look like that?

Perhaps it was a publicity stunt? Cupping involves the application of

hollow glass spheres onto the protected skin of the patient, each cup creating a vacuum

which pulls skin, connective tissue and muscle up into the cup. The cup is then moved

around the skin, resulting in a greater flow of Qi and Blood to the local area, thus relieving pain and loosening up the tissues. It is often applied to muscular adhesions as well as areas of chronic stress and “stagnation,” within Oriental medical theory.


What is Gua Sha? Why on earth would I want to look like that?


When Qi and Blood get “stuck” in chronically tight muscle and connective tissue,

“Sha” results. Cupping is one way to relieve the “Sha”. Another method is to

“Gua” it away. A base of protective liniment is applied to the skin, and the practitioner

brushes the area with a porcelain soup spoon, or other suitable device. In western medical terms, the capillary beds are broken underneath the skin resulting in varying

degrees of ecchymosis or bruising. New blood and the Qi that carries it will slowly

repair the local tissues producing a healthier metabolic state than previously found, and relieve tightness and pain. It looks unusual, but feels great, especially starting a few days after its application.


What is a typical course of treatment like?

Many simple neuromuscular complaints of healthy individuals may resolve

within two to four visits, especially when combined with other proactive modalities

like Pilates, Yoga, Stretching, Qi Gong & Tai Qi. Internal disorders typically take

longer periods of time to shift into healthier patterns of organ functioning and thus usually require longer periods of treatment, along with Chinese herbal medicine, to successfully resolve.


Does insurance pay for treatment?

It may. Check with your health insurance carrier to determine if acupuncture is a covered benefit under your specific health plan. Some employers provide flex accounts that reimburse employees for out of pocket health care costs. As an independent self-employed practitioner, I am not a participating provider under any insurance plan and thus operate on a fee for service basis, with payment made at the time of treatment. I do offer “Superbill receipts” and gladly offer any other paperwork that may help patients obtain reimbursement for their expenses.

Why should I come to see you as opposed to another practitioner?


Because I’m good, with far more western biomedical knowledge than many other acupuncturists/herbalists. I truly care for you, taking the time to listen and treat, if desired, the totality of your complaints. When I don’t think I can help sufficiently, I refer out to a host of western medical specialists including many other complementary providers. That being said, the dynamics of the patient-practitioner relationship are
individual to every person I see. I strive to meet and exceed patients’ expectations of my care for them.

How would acupuncture support my goals for which I do Pilates, Feldenkrais, Alexander technique and Gyrotonic?

Great question! Whether on the “Reformer,” “Allegro” or simply doing mechanically unassisted Pilates work, the goals are typically to tone muscles, improve posture, repair and prevent injuries while engaging in a low impact, full body workout that also reduces mental and physical stress. In Pilates, the “tree can only bend as well as the trunk supports the whole tree”. In Chinese medicine the “trunk” of the body is not only its core structural center (abdominals and axial skeleton) but the energetic “Tan Dien” a point a thumb and a half width’s inferior to the umbilicus, or belly button. Furthermore, the energetic flow of Qi and Blood is found deepest and most significantly in the “Jing” level of the body – the Chinese “core” – with its extraordinary meridian pathways from which the regular organs in turn get their Qi and Blood. (i.e. Chong mo, Ren mo, Yin Wei mo, Dai mo support the Kidney, Liver and Spleen meridians that nourish the uterus, ovaries and vagina for women.) The “Ying level” of the Chinese body relates to the twelve organs found within, i.e. Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Urinary Bladder, Kidney, Pericardium, San Jiao, Gall Bladder and Liver. The “Wei Level” of the Chinese body relates to the muscles, tendons and surface energetics that prevent external pernicious influences from penetrating the body and causing illness and disease. Fasciculation type needling releases hypertonic muscle, providing healthier tone, flexibility and range-of-motion. Acupuncture needles, especially auricular (ear) needles, also release endorphins, enkephalins, and appear to raise serotonin levels in the central nervous system, resulting in a happier, more stress free affect. Acupuncture also acts as an analgesic at the source myofascial pain, simultaneously reducing inflammation and speeding up the repair of soft tissue that has been injured. Pilates’ emphasis on breathing, along with therapeutic movement, also reduces stress and helps injured soft tissue heal faster.