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

Picture of Angelica

Category: Traditional Chinese Medicine

Connective Therapy Healing Retreat 2018

In September of 2018, there will be a Connective Therapy Healing Retreat on how beneficial connective tissue therapy is along with acupuncture. Dr. Kokkalis will be attending this seminar along with Chad Wright, COTA, CMT, CBCT. This retreat will be a hands-on connective tissue bodywork (giving and receiving) and physical and cognitive practices for peace and interconnectedness. Participants will receive the benefits of physical freedom from pain and dysfunction, improved posture, emotional freedom and balance, clarity, and gained insight.

“We’re in a time where we can all benefit from more healing and peace. That starts with an individual inner commitment and understanding of how to live that way – going from a separate view and experience to a connected one.” -Chad Wright

Chad Wright will be sharing insights on treating the connective tissue called fascia that holds every part of our bodies together in a three-dimensional web-like manner through his amalgamated approach called Connective Therapy. Chad promotes a simple way of living in peace, joy, and passion through the perspective of everything being connected, which is called Connective Living. My clients are encouraged to take this workshop and learn ways to take care of themselves.

Chad is now available for appointments out of my Lafayette office.

How the Military is Using Acupuncture to Fight Pain

The United States military has found that Traditional Chinese acupuncture provides immediate relief for acute and chronic pain without the risk of addiction that can come from opioids. The process involves a small needle inserted into the ear, which has a “central effect” on the nervous system and the cingulate gyrus, an area of the brain that processes pain.

The US Military is now using acupuncture to treat pain instead of addictive pills.

“They don’t have to wait hours for medications to take maximal effect or endure side effects, like drowsiness or allergic reactions, of common pain medications,” said Air Force Col. Lynda Vu, who recently administered Battlefield Acupuncture. “This allows personnel to go back to the fight with minimal impact to continuing mission operations.”

Acupuncture may not work on every patient, but it can also be used in combination with oral medications, which Niemtzow said are helpful treatment options when used appropriately. Patients are encouraged to explore other holistic treatment options, and to look beyond medicine and surgery. Vu recommended full spectrum acupuncture as a complementary therapy.

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