Dr. Angelica Kokkalis, O.M.D L.Ac.

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Category: Conferences

Acupuncture and Cupping at the Lafayette Health Fair at Subaru Automotive

Dr. Angelica Kokkalis recently attended Lafayette Health Fair at Subaru of Indiana Automotive in Lafayette on Thursday, July 12, 2018. It was so nice to interact with the community to help promote wellness.

Acupuncture at the Lafayette Health Fair at Subaru Automotive

Cupping at the Lafayette Health Fair at Subaru Automotive

This blog post was originally posted here: http://www.han-institute.com/acupuncture-and-cupping-at-the-lafayette-health-fair-at-subaru-automotive/

Musculoskeletal Recovery Protocol

At the Han Institute, we have created the Musculoskeletal Recovery Protocol that combines products from two innovative companies (American Elk Velvet and Wei Labs) that we have found over the years that strengthen patients’ bone and muscle health.

The patches we use from Wei Labs, the FASTT Patch and WHITEE Patch, contain natural herbs that operate synergistically to increase local blood flow in order to enhance nutrient supply. By increasing the nutritional supply to the site of degeneration, it accelerates the healing mechanism necessary for recovery. The patch also increases the local temperature, catalyzing metabolic reactions for effective damage repair. The patches also enhance the lymphatic circulation to remove accumulated metabolic waste.

When we combine the Wei FASTT patch with American Elk Velvet we can expect excellent results for ligament, muscle, tendon, and bone injuries such as sprains, strains, tendonitis, plantar fasciitis, bone fractures, and carpal tunnel syndrome.

When American Elk Velvet is used in combination with the Wei WHITEE Patch, it can be used for damaged cartilage and discs, cysts, scarring, nerve pain, osteoarthritis, stenosis, bulging herniated discs, pinched nerves, and torn meniscus.

Let me give you an example. When someone has tendonitis, the muscle needs to be treated, not just the tendon. This is because tendons connect muscle to bone, so when muscles are weakened or inflamed, they need to be treated too. In the same way, ligaments connect bone to bone, and also need to be treated.

Both ligaments and tendons are made out of collagen and the building blocks of collagen is IGF-1. American Elk Velvet, which naturally contains IGF-1, promotes collagen production, which will help with the repair of the tendons, ligaments, as well as muscle recovery and inflammation.

Dry Needling in Indiana

Dry Needling: Indiana

By Jennifer A. M. Stone MSOM, LAc

Dry Needling is acupuncture and utilizes acupuncture needles. Under Indiana law, acupuncture falls under the definition of surgery: 

Indiana Medical Practice Act section IC 25-22.5-1-1.1(a)(1)(C))                   

“(C) the performing of any kind of surgical operation upon a human being, including tattooing, except for tattooing (as defined in IC 35-42-2-7), in which human tissue is cut, burned, or vaporized by the use of any mechanical means, laser, or ionizing radiation, or the penetration of the skin or body orifice by any means, for the intended palliation, relief, or cure;”

Those who penetrate the skin…for the intended palliation relief or cure… in Indiana are practicing medicine, surgery without a license therefore violating the Indiana Medical Practice Act.  A class D felony.

What is dry needling?

Dry Needling is a generic term for a therapeutic treatment procedure that involves multiple advances of a filament needle into the muscle.

http://www.kinetacore.com/faq/#whatis

Dry Needling is a western form of “Acupuncture” and this treatment has been described using many names.

http://www.physicaltherapyfirst.com/services/dryneedling/

Acupuncture definition:

As defined by the World Health Organization, acupuncture “involves penetrating the skin with thin, solid, metallic needles that are manipulated by the hands or by electrical stimulation.”

Problem: Physical Therapists, Athletic Trainers, and PT assistants are preforming Dry Needling (acupuncture) in Indiana with little (12 hours) or no training. Physical therapy is not a field that has historically included the use of needles.

http://iuhealth.org/bloomington/rehabilitation-services/

http://topflighttherapy.com/dry-needling-2/

http://priorityrehabindy.com/dry-needling/

https://www.ivyrehab.com/treatment/dry-needling/

http://www.physicaltherapyfirst.com/services/dryneedling/

Significance:

Public Health – Unnecessarily exposes the public to serious and potentially hazardous                risks. Complications such as pneumothorax and severe tissue damage have occurred.

This article reports on a case where pneumothorax occurred during a dry needling training: http://aim.bmj.com/content/early/2014/09/19/acupmed-2014-010659

            Legal– Physicians, MD’s and DO’s who refer to PT’s can be held liable if injury is caused by dry needling. 

            PT’s are fraudulently billing dry needling as manual therapy and getting reimbursed by      Medicare. Medicare does not cover acupuncture.

Recommendation:

  1. The Indiana Society of Acupuncturists requests an opinion from the Attorney General’s office on whether dry needling is within the scope of PT’s in Indiana.
  2. The Indiana Society of Acupuncturists suggests that legislators re-evaluate dry needling in the future when appropriate training and certification is established for PT’s.

Dry Needling history and trainings for PT’s and DC’s:

KinetaCore coined the term “dry needling” in 2007. KinetaCore began when Edo Zylstra developed an introductory and advanced dry needling course in 2006. KinetaCore® was founded in 2007 and has the mission of offering quality continuing education courses for the manual therapist while actively participating in elevating the profession of physical therapy across the globe. http://www.kinetacore.com/about/history/

Fishkin Center for Dry Needling 12 hour training:

http://fishkincenter.com/dryneedlinginstitute/

Myopain Seminars:

http://myopainseminars.com/seminars/

Requirements for license to practice acupuncture in Indiana:

The practice of acupuncture in Indiana is governed by the medical licensing board IC 25-2.5-2.

IC 25-2.5-2-1 Requirements for acupuncture license

  • current active status as a diplomate in acupuncture of the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM);
  • successfully completed a three (3) year postsecondary training program or acupuncture college program that: (i) is accredited by; (ii) is a candidate for accreditation by; or (iii) meets the standards of; the National Accreditation Commission for Schools and Colleges of Acupuncture and Oriental Medicine; and
  • successfully completed a clean needle technique course approved by the National Certification Commission for Acupuncture and Oriental Medicine.

Note: NCCAOM requires 60 CEU’s every 4 years to recertify and maintain active status.

IC 25-2.5-2-3 Affiliated professional license

 (b) An applicant may, upon the payment of a fee established by the board, be granted a professional’s license to practice acupuncture if the applicant submits satisfactory evidence to the board that the applicant is a:

(1) chiropractor licensed under IC 25-10;

(2) dentist licensed under IC 25-14; or

(3) podiatrist licensed under IC 25-29;

with at least two hundred (200) hours of acupuncture training.

Note: Physicians’ scope is unlimited in Indiana, however, the American Academy of Medical Acupuncture provides training and certification for physicians including a 330 hour training + minimum 100 clinical hours. Here is a list of AAMA certified physician acupuncturists in Indiana:  http://www.medicalacupuncture.org/Find-an-Acupuncturist

PT Practice Act; unlawful practice:

Under section IC 25-27-1-2 “Unlawful Practices” of Indiana’s Physical Therapy Practice Act, it is unlawful for physical therapists to “practice medicine, surgery (as described in IC 25-22.5-1-1.1(a)(1)(C)).”

Indiana Medical Practice Act section IC 25-22.5-1-1.1(a)(1)(C))                   

“(C) the performing of any kind of surgical operation upon a human being, including tattooing, except for tattooing (as defined in IC 35-42-2-7), in which human tissue is cut, burned, or vaporized by the use of any mechanical means, laser, or ionizing radiation, or the penetration of the skin or body orifice by any means, for the intended palliation, relief, or cure;”

Therefore, physical therapists practicing dry needling in Indiana are practicing medicine, surgery without a license.

Select Official Positions on Dry Needling:

American Academy of Medical Acupuncture:

Physical therapy is not a field that has historically included the use of needles. The recent trend of some physical therapists to embrace dry needling under the umbrella of physical therapy practice is one that marks a distinct departure from traditional physical therapy practice. The fact that many physical therapists receive only minimal hours of training speaks to the potential danger of their practice.

Including dry needling into the scope of practice by physical therapists unnecessarily exposes the public to serious, potentially hazardous risks. We feel a duty to inform legislators and regulating bodies about the inherent danger to the public of this practice.

The AAMA strongly believes that, for the health and safety of the public, this procedure should be performed only by practitioners with extensive training and familiarity with routine use of needles in their practice and who are duly licensed to perform these procedures, such as licensed medical physicians or licensed acupuncturists. In our experience and medical opinion, it is inadvisable legally to expand the scope of physical therapists to include dry needling as part of their practice.

AAMA December 2014, Updated 2016

http://www.nccaom.org/resource-center/press/press-releases/aama-policy-on-dry-needling/

American Medical Association:

Dry Needling is an Invasive Procedure H-410.949

The AMA recognizes dry needling as an invasive procedure and maintains that dry needling should only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed medical physicians and licensed acupuncturists.

AMA 2016

http://www.asacu.org/wp-content/uploads/2017/06/AMA-Dry-Needling-Policy.pdf

American Academy of Physical Medicine and Rehabilitation:

The American Academy of Physical Medicine and Rehabilitation recognizes dry needling as an invasive procedure using acupuncture needles that has associated medical risks. The AAPMR maintains that this procedure should only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed acupuncturists or licensed medical physicians.

AAPM&R June 2012

http://www.asacu.org/wp-content/uploads/2016/09/AAPMR-Position-on-Dry-Needling1.pdf

Select Attorney General Opinion letters:

New Jersey http://www.njaaom.net/resources/Documents/Dry%20Needling%20opinion%20-%20NJ%20AG%202.9.17.pdf

Texas https://texasattorneygeneral.gov/opinions/opinions/51paxton/op/2016/kp0082.pdf

Oregon http://www.oregon.gov/PTbrd/docs/Dry%20Needling%20Opinion%20May%2019%2C%202017.pdf

Washington http://www.atg.wa.gov/ago-opinions/scope-practice-physical-therapy

Illinois http://www.ipta.org/news/171339/Dry-Needling–Important-Update.htm

Ohio http://www.ohioattorneygeneral.gov/getattachment/e7388f87-37a4-48c9-9011-228d9b838794/2016-015.aspx

In the media:

USA TODAY Torin Yater-Wallace bounces back from collapsed lung with top run. https://www.usatoday.com/story/sports/olympics/sochi/2013/12/13/torin-yater-wallace-dew-tour-ion-mountain-championship-halfpipe-qualifying/4019707/

USA TODAY ‘Dry needling’ for pain therapy is under scrutiny

https://www.usatoday.com/story/life/2016/07/17/dry-needling-acupuncture-pain/86940278/

News 13 Investigates Dry Needling Debate: http://wlos.com/news/local/news-13-investigates-dry-needling-debate

Quartz Media: Is dry needling a safe acupuncture replacement, or a shortcut around years of essential training? https://qz.com/958309/is-dry-needling-a-safe-acupuncture-replacement-or-a-shortcut-around-years-of-essential-training/

Document prepared by:

Jennifer A. M. Stone MSOM, LAc

Indiana University School of Medicine

Department of Anesthesia

Indiana Society of Acupuncturists

Vice-President

Member: Acupuncture Task Force of the Medical Licensing Board

jemeador@iu.edu

Dr. Angelica Kokkalis Presenting Dr. Han’s Research at the AAMA Annual Symposium

Dr. Angelica Kokkalis will be presenting Professor Han‘s research at the AAMA Annual Symposium in Pittsburgh, PA, in April, 2016.

Successful Treatment of COPD Symptoms and Mycobacterial Infections

This article was originally posted on FamousDoctor.org:

Successful Treatment of COPD Symptoms and Mycobacterial Infections

67 y.o. female who was diagnosed with COPD 6 years ago came to see Dr. Kokkalis. Her symptoms included coughing with clear Phlegm and severe shortness of breath with wheezing. Patient had started to use oxygen. Patient was recommended to use Wei Laboratories lung treatment formulas including Soup A, Soup B, and LC Balancer. Dr. Kokkalis also gave her some hydrogen peroxide and cordycips to use.

After 3 weeks of the combined treatment, patient reported feeling well but her lungs are not keeping up with her just yet. Patient explains that she has a low temperature fever that comes back every few weeks. The episodes included chills, low temperature fever, and shortness of breath upon exertion. It was suspected that the patient may have been dealing with a mycobacterial infection in the respiratory tract in addition to the COPD. Treatment including ClearLung, Java, Jade, NewBase (at 2/3 dosage) from Wei Labs was recommended that target lung mycoplasma.

During the first few days with the lung mycobacterial treatment, the patient reported that she was up all night, coughing up phlegm and blowing her nose. After giving the treatment another week, she felt a lot better. Patient reported no longer feeling sick but did still get out of breath. At this point in time, it was recommended that the patient complete the full lung mycobacteria protocol (4 weeks) and then stay strictly on the Soups.

After finishing the mycobacteria protocol, patient felt much better. She was no longer experienced the re-occurring low grade fever and chills. At this point in time, the patient was also able to walk out to the mailbox without oxygen to pick up mail, go shopping without the use of oxygen, and pick up medicine at the pharmacy herself as well. When back on oxygen, her oxygen level went up quickly from 87% to 96-97%. She was able to recuperate much faster.

After 2 more months on the Soup A, Soup B, and LC Balancer, the patient reported drastic improvements. She has been able to not use the oxygen at times, up to 12 hours. Patient was happy to report that she was able to attend a class reunion and did not use oxygen at all during the evening; she was happy that she did not have to carry the oxygen tank around. Patient is now continuing on the Soup products and incorporating exercise a few times a week at the hospital using their bicycles and exercise equipment. Treatment is moving in the right direction.