Integration- MEDS

[Guest guest]

 

Actually I am specifically interested in legal issues when a physician is not willing to work on reducing, and it’s the patients choice and you assist. I am also not talking about a cold-turkey approach, but a tapering. And not just giving a supporting general Rx, but something specifidcally designed to reduce the side-effects of the withdraw, and replace the drug on some level.. Example and real case below:

Jason, have you personally talked with the MD, about why and how you would plan to tapper the patient off Western Drugs? Perhaps, if you are talking with him and sharing your stratgey and why it is in the patients best interest... maybe he will be more willing to work with you? If he is the primary care physician and you do it anyway <even if it is the patients choice> I would make sure you have a good lawyer, as well as lots of insurance!

 

Recently I attended Dr. Chen workshop... The most common prescribed drugs and their Herbal alternatives. It was certainly insightful.

 

I am working with a Western MD, and all the patients I see are on approximately 10 different meds. In addition, many are getting Trigger shot therapy. One day he challenged me to see if I could get one of the patients off of all the Western drugs. Quite frankly, it would take so much energy... not to mention the patient more then likely would not be complaint with the herbs... not to mention the time in withdrawing her from each and every drug, while replacing the drugs with herbs. Besides in her case she is on State disability because of pain, therefore cannot afford the out of pocket cost of herbal remedies. I do love the challenge... and think, I will ask him if he will cover the cost?!

 

 

In Health,

Teresa

 

[Guest guest]

Reality seems that integration is somewhat forced: I.e. Most

patients with chronic diseases will be on multiple meds.

 

I don’t know if this has been addressed much in the

past, if so please direct me to the subject and I will search the archives:

 

I would like

to start a thread discussing procedures in reducing and eliminating medications

through herbal medicinals and issues surrounding this. Although I would like to hear people's

general theoretical considerations, also important would be actual case

studies/histories and/or research/outcome studies.

Something

curious to me is the following scenario: a patient comes in on five or six

meds, wants help, but the practitioner will not prescribe herbs out of fear

(and possibly rightfully so) or just lack of knowledge. I have heard we cannot treat until the

patient is completely off the meds.

This seems extreme… Or a practitioner will just give them a patents

or tinctures of six gentlemen, linking etc – treating the overall

pattern- knowing know real harm will be done, but also no real gain. Integration to me is

understanding the pharmaceuticals and herbs from a biomedical

perspective, as well as a TCM perspective, and if the patient desires getting

them off the meds having the knowledge to use the tools we have to do so.

For example,

using modern research that shows that a given herb or formula, can greatly

assist in getting someone off medication by increasing the half-life of the

drug or a body substance etc. This

herb might not be pattern based, and in actuality with some of these patients

on 6-10 meds there is no clear pattern anyway.

The question

becomes, do any of you actively assist in getting patients off medication. This is assuming that the patient wants

to and has asked your help. What

are the legal issues surrounding this?

This is also assuming that the doctor does not want to assist in the

process. What is the group's

experience on this one?

 

Is this type

of administering of herbs, beyond our scope? If we start helping patients get off

serious medications are we only setting ourselves up for attack by the AMA?

 

On a side

note, pertaining to my last post, if you or going to choose a

herb/formula that modern research in China shows that

with administration via decoction was helpful in getting someone off a serious

medication, would you feel comfortable in giving this in a extract form? Knowing that dosage is critical to

prevent flare-ups or even serious harm?

 

Comments?

 

-Jason

 

 

[Guest guest]

On Thursday, November 8, 2001, at 08:39 PM, wrote:

 

> Reality seems that integration is somewhat forced: I.e. Most patients

> with chronic diseases will be on multiple meds.

 

Yes, this is a form of integration that is forced on the practitioner of

Chinese medicine.

>

>  

>

 

 

>  

>

> I would like to start a thread discussing procedures in reducing and

> eliminating medications through herbal medicinals and issues

> surrounding this. Although I would like to hear people's general

> theoretical considerations, also important would be actual case

> studies/histories and/or research/outcome studies. 

 

I'll need some time to get it together, but I'll try to plug in some

cases in the coming week.s

>

> Something curious to me is the following scenario: a patient comes in

> on five or six meds, wants help, but the practitioner will not

> prescribe herbs out of fear (and possibly rightfully so) or just lack

> of knowledge.  I have heard we cannot treat until the patient is

> completely off the meds.

 

This depends on the medication and the situation. . . there are many

medications that we must be very cautious with, such as blood thinner

and immunosuppressant drugs, and others where complimentary herbal

medicines can be very helpful. There are Chinese studies on treating

patients using chemotherapy and steroidal drugs with herbal medicine.

 

On the other hand, if we 'cannot treat until the patient is completely

off medications', we'd have few patients left to treat!

 

>  This seems extreme… Or a practitioner will just give them a patents or

> tinctures of six gentlemen, linking etc – treating the overall pattern-

> knowing know real harm will be done, but also no real gain. Integration

> to me is understanding the pharmaceuticals and herbs from a biomedical

> perspective, as well as a TCM perspective, and if the patient desires

> getting them off the meds having the knowledge to use the tools we have

> to do so. 

 

Sometimes, Jason , 6 gentlemen or linking or the like is what is

indicated. Many chronic autoimmune patients have liver/kidney yin

vacuity with liver qi depression, which can be aggravated by many

medications, which often damage yin and blood. There are many other

possibilities, but this is one of the major scenarios that can appear.

>

> For example, using modern research that shows that a given herb or

> formula, can greatly assist in getting someone off medication by

> increasing the half-life of the drug or a body substance etc. This herb

> might not be pattern based, and in actuality with some of these

> patients on 6-10 meds there is no clear pattern anyway. 

>

> The question becomes, do any of you actively assist in getting patients

> off medication. This is assuming that the patient wants to and has

> asked your help. What are the legal issues surrounding this? This is

> also assuming that the doctor does not want to assist in the

> process. What is the group's experience on this one?

 

Many physicians are glad to have a way to help their patients get off

meds without a cold turkey reaction, especially with antidepressants.

Definitely a part of my practice. It depends on the situation at hand.

>

>  

>

> Is this type of administering of herbs, beyond our scope? If we start

> helping patients get off serious medications are we only setting

> ourselves up for attack by the AMA?

 

No, I think it is an important part of what we do, as long as we have no

resistance from patients or their physicians, or if it is appropriate or

possible.

>

>  

>

> On a side note, pertaining to my last post, if you or going to choose a

> herb/formula that modern research inChinashows that with administration

> via decoction was helpful in getting someone off a serious medication,

> would you feel comfortable in giving this in a extract form? Knowing

> that dosage is critical to prevent flare-ups or even serious harm?

 

As long as you are aware of the potency of the product, and give the

proper amount.

 

 

>

>  

>

[Guest guest]

 

 

 

 

[zrosenbe]

Thursday, November 08, 2001 10:02 PM

To:

 

Re:

Integration- MEDS

 

On Thursday, November 8, 2001, at 08:39 PM, wrote:

Reality seems that integration is

somewhat forced: I.e. Most patients with chronic diseases will be on multiple

meds.

 

 

 

Yes, this is a form of integration that is

forced on the practitioner of Chinese medicine.

 

 

 

 

 

 

 

 

I would like to start a thread discussing

procedures in reducing and eliminating medications through herbal medicinals

and issues surrounding this. Although I would like to hear people's

general theoretical considerations, also important would be actual case

studies/histories and/or research/outcome studies.

 

 

 

 

I'll need some time to get it together,

but I'll try to plug in some cases in the coming week.s

 

That would be great, I know you

have much experience here…

 

 

 

 

Something curious to me is the following

scenario: a patient comes in on five or six meds, wants help, but the

practitioner will not prescribe herbs out of fear (and possibly rightfully so)

or just lack of knowledge. I have heard we cannot treat until the patient

is completely off the meds.

 

 

 

This depends on the medication and the

situation. . . there are many medications that we must be very cautious with,

such as blood thinner and immunosuppressant drugs, and others where

complimentary herbal medicines can be very helpful. There are Chinese studies

on treating patients using chemotherapy and steroidal drugs with herbal

medicine.

 

On the other hand, if we 'cannot treat until the patient is completely off

medications', we'd have few patients left to treat!

I agree…

This seems extreme… Or a practitioner will just give them a

patents or tinctures of six gentlemen, linking etc – treating the overall

pattern- knowing know real harm will be done, but also no real

gain. Integration to me is understanding the pharmaceuticals and herbs

from a biomedical perspective, as well as a TCM perspective, and if the patient

desires getting them off the meds having the knowledge to use the tools we have

to do so.

 

Sometimes, Jason , 6 gentlemen or linking or the like is what is indicated.

Many chronic autoimmune patients have liver/kidney yin vacuity with liver qi

depression, which can be aggravated by many medications, which often damage yin

and blood. There are many other possibilities, but this is one of the major

scenarios that can appear.

 

 

Not denying this

at all… I think there is misunderstanding here:

1) I mentioned 6 gents and linking because almost

anyone, like you mention, in this type on situation can probably benefit from

these formulas- or a great majority of people. And yes there underlying constitution

will probably be benefited from these.

2) I mentioned specifically patents and tinctures, because

they are weak. The practitioner by

giving these weak forms of the Rx, there is little chance of harm, and little

chance of serious change.

3) More importantly is that many do this, to avoid the

issue of directly addressing serious complications in taking people off meds

and having to prescribe herbs with biochemical/ pharmaceutical considerations. Especially when one starts upping the

dose (i.e. raw rx) and

choosing herbs for there pharmacological properties. Example given in next post.

[Guest guest]

>At 10:01 PM -0800 11/8/01, wrote:

>>

>>

>>I would like to start a thread discussing procedures in reducing

>>and eliminating medications through herbal medicinals and issues

>>surrounding this. Although I would like to hear people's general

>>theoretical considerations, also important would be actual case

>>studies/histories and/or research/outcome studies.

>

>I'll need some time to get it together, but I'll try to plug in some

>cases in the coming week.s

--

 

Unfortunately I don't have access my case records just now, but one

area I have had success is with asthma patients that were maintained

on predisone. Also with inflammatory bowel disease. I generally

insist on the patient's prescribing physician knowing what I'm up to,

and having the reductions in prednisone approved by the prescriber. I

find that primary care docs are much more open to this than

specialists. I don't rush the process and don't mind if the patient

has to maintain a baseline of the med for long periods before the

next reduction, if that is what they need for stability, or even

increase the med temporarily. How to do it is very individual in my

experience, and progress depends very much on the patient's life and

personality as well as the medical issues.

 

Rory

--

[Guest guest]

, " " <@o...> wrote:

Integration to me is understanding the pharmaceuticals and herbs

> from a biomedical perspective, as well as a TCM perspective, and if the

> patient desires getting them off the meds having the knowledge to use

> the tools we have to do so.

 

Among other things, this is illegal. we are not allowed to reduce or

recommend reduction in prescribed meds. We must work with a willing

MD.

 

todd

[Guest guest]

>

>

> Friday, November 09, 2001 6:40 PM

>

> Re: Integration- MEDS

>

> , " " <@o...> wrote:

> Integration to me is understanding the pharmaceuticals and herbs

> > from a biomedical perspective, as well as a TCM perspective, and if

the

> > patient desires getting them off the meds having the knowledge to

use

> > the tools we have to do so.

>

> Among other things, this is illegal. we are not allowed to reduce or

> recommend reduction in prescribed meds. We must work with a willing

> MD.

>

> todd

>

>

 

 

I am aware of the 1st part- illegal for us to recommend reduction.

I guess the scenario is if the Dr. is unwilling, but the patient on

their own wants to taper, and you give herbs to support the overall

body, and throw in a few that you know biochemically might aid the

process, is there a legal issue here? Or are we saying if a patient

comes to us and says they are going to taper, without their physicians

approval, we have to not treat, because we are aiding them?

 

 

 

-Jason

[Guest guest]

Dear group,

 

TCM doctors in Taiwan can do whole TCM practices by

themselves.In some part of treatment,TCM and WM are

equal in taiwan.But,by laws,it is not.WM controll TCM

very much like western.

 

A.We have three type doctor licenses in formal

education medical:

1.WM doctoral licenses.

2.WM doctoral and TCM doctoral licenses

3.TCM doctoral licenses.

 

Above all need formal education.

 

And WM education(WM curicurumm goes first,take the

most important part of A type TCM doctor's

education.),and their TCM skills are confused with

WM.Only few of them really catched the TCM key points

after they gradulated and doing practices.

 

Turn WM approached into TCM approaches have to get

through painful procedures(like what you have been

through few days ago and I am not sure whether any of

you all go through the painful stage or not.)

 

B.special license for self eduationer.this license

preserved good quality of real old fashion TCM

approaches doctors in Taiwan because some of them are

from TCM family.And this type(B type) license will

stoped in not far future.

 

But,WM doctors and those doctors above mentioned(

type A) all critisize type B doctors are not qulify

because they didn't well educated by formal education

and WM approaches.

 

Therefore,WM approach doctors set the extreme

cruelcial rule to prohibit B type TCM doctors and

partial A type TCM(2.3) the right to use WM

approaches to diagnosis ptients.

 

Such as ,can't do BP,EEG,X-ray and other convention

test of WM approached to be references of TCM

diagnosis.

 

They also can't use Ginko leaf(and many other herbs,WM

doctor think they are expert in medication and TCM

doctor is not qualified) to be medication unless

TCM doctors can provide the evidence that ancient

TCM books real had records of Ginko leaf use method

in TCM.

 

But,after took few hours acupuncture or TCM herbs

training,The WM doctors can act like they are expert

of TCM ,and add those TCM teches to be partial of

their practice without any limitation or prohibit.

 

This is called WM mixed TCM and intergregate both of

them(do you dare to see this kind of doctors for TCM

treatment,They only can provide WM approaches TCM

while treatment)and I provide my opinions in this

group during last few weeks.

 

TCM doctor can do practice treatment independently

without any problem if you really catched the four

methods fo TCM diagnosis approached very well,and ,if

You also familer every appraoches of TCM very

well.There is no problem to treat patients independent

 

bt TCM approaches at all.

 

TCM is ship.WM is air craft.

 

It is no doubt that we can drive our ship in ship

drive methods by our self since 1000s years ago.WM 's

pilot have to show us they got real ability to drive

ships in ship methods,not in fly air craft methods.

 

I still don't think that WM doctor have right to

limited or prohibit TCM doctor doing practice in

TCM/WM approached and permit themselves doing TCM

according to a very pitty small among TCM knowledge

base.

 

It's a long way to go.learned all knowledge of TCM

and performence the ability TCM can do is the most

important thing for gain the respect from WM in the

future.

 

 

Jean

 

 

=====

 

 

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