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

The Philosophy of Regeneration

In this short presentation, you will learn about an important fundamental principle of Chinese Medicine; The Philosophy of Regeneration.

You will also learn how it differs from The Philosophy of Substitution. The video also gives a brief history of Traditional Chinese Medicine.

More Patients Turn to Alternative Therapies

By Amy Patterson-Neubert Journal and Courier

For almost two years, Vicki Clark has suffered from frozen shoulder – adhesive capsulitis – a condition that inflicted shooting pain in her upper left back, shoulder and neck area.

Clark sought relief from a variety of specialists in traditional medicine but she finally found relief from ‘merging two worlds of medicine – East and West.

”A combination of acupuncture’ and intense physical therapy benefited me,” said Clark, whose treatment was under the guide of an Oriental and medical doctor, Dr. Angelica Kokkalis, and an occupational specialist, Dr. Joseph Sliwkowski, Kokkalis a West Lafayette resident who is the director of Chinese medicine at the Center for Complementary Medicine and Pain Management at St. Vincent’s Hospital in Indianapolis, also recommended that Clark incorporate massage therapy into her equation of wellness, to enhance the results of acupuncture. Acupuncture is a part of traditional Chinese medicine (TCM) that dates back 3,000 years. Acupuncture needles stimulate the nervous system, and its energy, to release pain-killing and inflammation-reducing substances to the blood. TCM believes that pain and disease are created when there is a blockage of energy; known as Qi’. More than 200 common clinical disorders benefit from acupuncture, according to the World Health Organization.

Millions of people are turning to nontraditional forms of therapy, complementary and alternative modalities known as CAM, from ingesting herbs to seeking chronic pain management with acupuncture or prolotherapy. Prolotherapy IS an osteopathic deep injection technique used to eliminate some chronic pain involving ligaments.

Some patients feel the traditional methods have let them down, and other patients are taking more of an interest in their health. The number of Americans who use alternative therapies has increased fro~ 33 percent in 1990 to 42 percent ill 1997, according to the National Center on Complementary and Alternative Medicine (NCCAM) of the National Institutes of Health.

The institute has identified five major areas of CAM practices – alternative medical systems (acupuncture, Ayurveda, homeopathic medicine and naturopathic medicine); mind-body intervention (meditation certain uses of hypnosis, dance, music, art therapy and prayer); biologically based therapies. (herbal, special dietary, orthomolecular and individual biological therapies); manipulative and body-based methods (chiropractic and osteopathy); and energy therapies (Qi gong, Reiki and therapeutic touch).

Around for Centuries

In Lafayette, the Association of Complementary Therapists Inc. meets monthly to discuss alternative therapies. There are approximately 96 members in the group and 650 mailings are sent quarterly.
But alternative and complementary therapies aren’t new to the world. Many of these have been around for centuries and are more prevalent in other countries. For example, in Germany, St. John’s wort, an herb, is more popular than America’s No.1 prescription medication for depression, Prozac. In Europe, naturopathy is well-received, according to naturopath Dr. Claudia Hanau of West Lafayette, but in the Midwest, it’s a small faction of health care.

What’s new is the two worlds of treatment are integrating nationally, and in Clark’s case, locally also.

“I think despite both camps, it’s going to happen. Both sides were kind of arrogant and lofty in the beginning,” said Dr. Palmer MacKie, medical director at the Integrative Pain Center at Wishard Hospital in Indianapolis, and internist and clinical assistant professor of medicine at the Indiana University School of Medicine. The Integrative Pain Center at Wishard Hospital has been open for about a year.

The melding of the two worlds is happening more frequently on the East and West coasts and in the southern part of the country, more so than in the Midwest.

Dr. Joseph Sliwkowski, medical director of the Regional Occupational Care Center at Unity Healthcare, moved to Lafayette from Boston more than a year ago
to join Unity, a group that is building a dedicated outpatient center in southern Lafayette. When he left Boston, he left a rehabilitation hospital, where alternative therapies including acupuncture were integrated.

“I’d like Unity to have an integrated medicine component,” said Sliwkowski, who is pleased with Clark’s progress. “I’m not threatened by it, and it’s a great alternative to have and I’d like to see more of it here.”

Kokkalis has been at the Center for Complementary Medicine and Pain Management for five of the department’s nine-year history. Here, she is involved in an acupuncture and stroke study, in addition to treating patients.

“It’s a blessing to have alternative in combination to Western. They should look at it as complementary, not competition,” Kokkalis said.

Entering the mainstream But before that melding takes place nationwide, the fear and
stigma accompanying alternative and complementary medicine will need to be abandoned. Some of it originates from the difficulties in standardizing procedures or establishing regulations. For example, herbs are not approved by the FDA because they are considered dietary supplements, not drugs. And decades ago, physicians practicing alternative therapies lost their licenses and were even put in jail.

“We’re putting ourselves at risk to do this type of medicine, and we’re all aware of it,” said Dr. Charles Turner, a Lafayette family physician who started incorporating alternative therapies into his practice during the last few years. Turner advertises that is he is specializing in a holistic approach to the art of medicine.

The apprehension about alternative medicine also surfaces from misuse or false promises.

“There is a lot of nonsense and garbage in alternative medicine. I’m not promoting all of it,” said Turner.

But in response to the unknown, more reputable institutes, such as NCCAM, are leading studies and suggesting regulations, Turner is participating in a natural growth hormone study that was reviewed by the Food and Drug Administration and approved by the Investigational Review Board.

Turner expects the demand from young doctors for more alternative therapy education and their desire to practice it will make the treatments more mainstream.

But-he also expects many will “stick to the old party line.”

“There is more money in practicing medicine the regular way. Plus (alternative) takes longer to deal with patients,” said Turner, who sees 15 to 20 patients a day now. He used to see 35 to 50 daily. With alternative medicine, “You’re dealing with more sophisticated people, who are asking a lot of questions.”

Self-Prescribing Herbs Can be Risky

Originally printed in the Journal and Courier, Sunday, July 22,2001 by Amy Patterson-Neubert, Journal and Courier.

Patients should inform doctors of all medications being taken

Garlic isn’t usually pegged as I life threatening.

But when patients self-prescribe this herb for cholesterol and blood pressure concerns and then fail to tell their anesthesiologist or surgeon, health complications can result during surgery. A recent report published in the Journal of American Medical Association highlights the potential dangers of herbs and surgery, but local general surgeons have been informed of the same concerns for nearly five months.

Dr. Kenneth Bochenek, medical director of anesthesiology services at Greater Lafayette Health Services Inc., which operates Home Hospital and St. Elizabeth Medical Center, distributed brochures to local general surgeons regarding the possible interactions between herbs and drugs, especially for anesthesia. For example, garlic can have prolonged bleeding effects if combined with anticoagulant sodium warfarin, also known as Coumadin.

A patient’s variation of the brochure What You Should Know About Herbal Use and Anesthesia is available at Home Hospital’s ambulatory surgery center.

“The problem is patients don’t recognize herbs as medications,” said Bochenek, who is also president of Anesthesiology Services.

Bochenek is not aware of any surgical complications locally from herbal medicines. Herbs can include flowering plants, shrubs, trees, moss, fern algae, seaweedor fungus. The study reported in JAMA identified echinacea, ephedra, garlic, ginkgo, ginseng, kava, St. John’s wort and valerian as herbs with potential surgery complications.

Anesthesiologists are researching nationally how certain herbals interact with specific anesthesias, according to information published by the American Society of Anesthesiologists. For example, herbs may extend anesthetic effects, and others such as garlic can increase the risks of bleeding.

When patients neglect to inform their physician or surgeon what or how much herb they are consuming, the herb can mix with medication or anesthesia. Bochenek said patients who forget to tell the surgical team what they are on is not uncommon. For example, when some women list the medicines they are consuming, many don’t acknowledge birth control pills.

In the past, patients at Sagamore Surgical Center were asked what medications they were taking. Now the staff has rephrased the question to include herbs and supplements too because patients failed to identify some products.

“A lot of people do not see these as medicines so they leave them out,” said Ann Keyes, assistant directcr of nursing at Sagamore Surgical Center. “But then you look at their lab work … and see something.”

Surgical teams also have to be cautious of herbs because they are not consistent in dosage or content. Herbs, unlike over-the-counter medications, are not regulated by the Food and Drug Administration.

“To me it’s just playing Russian roulette,” Bochenek said. “You’re just spinning the chamber and pulling the trigger with some medications.”

Patients’ faulty thinking comes from the perception herbs are natural and safe, according to Nick Popovich, professor in the Purdue School of Pharmacy with an interest in over-the-counter and herbal medicines.

“Herbal medicines can cause a lot of problems with respect to drug interaction and complications associated with surgery,” Popovich said. “The message is: Before you take herbal medicines – and if you are on prescribed medicines – check with your doctor or pharmacist to make there are sure no interactions.”

If a patient is found to be on an herb or the dosage could complication the surgery or related medications, the procedure may be delayed to ensure the herb has exited the body. At least two weeks is generally the wait time.

Dr. Angelica Kokkalias, a Chinese oriental doctor and medical doctor, is concerned the publicity of this report could deter people from herbs altogether.

“The doctors should not scare patients,” said Kokkalias, who resides in West Lafayette but practices in Zionsville and Indianapolis. “I think it’s the responsibility of the state to educate physicians about herbs.”

When Kokkalias advises patients of an herb for wellness or to treat an ailment, she doesn’t recommend they’ buy a bottle off a drug store shelf. She works with a national company that reports the ingredients of the herb, so there is no guesswork.

“Western doctors need to be more open minded and holistic, and the holistic need to learn more about Western medication,” Kokkalias said. “The safety of the patient is involved.”

Merging East with West

By Sharon L. Martin

“Take her or heal her.”

It was her mother’s agonizing prayer that saved Angelica Kokkalis’ life and set her on a journey of healing others.

When Angelica Kokkalis was 3 years old, she began having grand mal epileptic seizures. The seizures became so severe that her physician prescribed Valium. It left the girl drooling and numb to the world.

“I don’t remember my childhood,”says Kokkalis, who grew up in Greece. She was enrolled in a special needs school where she showed signs of academic promise when not on her medication. This continued for nine years.

And it was when Kokkalis was 12 years old, that her mother uttered the prayer, “Take her or heal her.” “My mom was on the bus when someone mentioned that she needed to try therapeutic medicine with me,” says Kokkalis. “It would take 40 days. She was to put me on a strict vegan diet, drink a tea rich with enzymes, take me off my medications and pray.”

That’s what her mother did.

“On the 37th day, I had the worst seizure I ever had,” says Kokkalis. “I was comatose for three days and three nights. I don’t remember anything.”

She does remember waking and being thirsty. The therapeutic remedy had worked.

But on that day, her mother’s faith in the unconventional brought Kokkalis back to the living and would forever shape her future.

In 1979, when Kokkalis was 14, she was sitting in class when a magazine editor arrived as a guest speaker. It wasn’t the speaker that caught Kokkalis’ attention. It was the cover of the magazine depicting acupuncture. Kokkalis was hooked.

At the age of 17, she received a Sino-Greek Government Student Exchange Scholarship to study medicine in China, where she combined her education in conventional medicine with training in Traditional Chinese Medicine (T.C.M.). She learned how the least invasive treatment is best. She learned about herbs, acupuncture and other treatments that soothe the body in a more natural way.

“The Chinese philosophy considers the bone to be elastic,” explains Kokkalis. “Different herbal remedies combine to create collagen. Grapeseed extract, for example, is good for strengthening.”

Kokkalis enjoys figuring out what makes a person tick and then creating a strategy that gets results. “I see the unique characteristics and make a unique creation for that individual,” she adds.

Ann Malaska agrees. She has been seeing Kokkalis for nearly eight years. What started as a treatment for a foot problem has resulted in Kokkalis helping Malaska with other health issues as well.

“Everything about a person is interconnected,” says Malaska. “The whole person has to be addressed and she has a sense of that. Everything I’ve come to her for, she’s gotten me to a better level of healing.”

Kokkalis’ blending of medicines provides patients with technological advances of the West and time-honored traditions of the East. “Look at the word ‘dis-ease,’” says Kokkalis. “When you’re not at ease with yourself, you get sick.”

Kokkalis is a firm believer that good health begins with good nutrition. She encourages women to eat healthy, wholesome foods and as use as much organic meats and produce as possible. Once your diet is in order, Kokkalis will suggest treatments that best suit your personal needs.

Options could include acupuncture, Moxibustion therapy (application of therapeutic heat), Quigong (breathing and energy exercises) and cupping.

Cupping involves placing cups containing reduced air pressure (suction) on the skin. Kokkalis also believes in the benefits of massage.

“Therapeutic massage is the No. 1 prevention of disease,” she adds. Although Kokkalis has been in the field of alternative medicine for years when it wasn’t easily accepted in the Western culture, she says she has noticed a shift. “In the last 10 years, the attitudes toward alternative methods have shifted greatly.

People ask for more answers. I’m a bridge between Eastern and Western medicines. I’ll find the right information to make the best treatment options.”

Fibromyalgia Treatments Through the Chinese System of Medicine

Treating fibromyalgia in Chinese medicine focuses on ridding the body of the invading pathogens, restoring normal circulation and flow of blood and Qi, promoting emotional harmony and fortifying the Kidney/Vitality system. Effective treatments include acupuncture, warming needle therapy, point injection therapy, Qigong, moxibustion, herbal and dietary therapies, cupping, massage and  therapeutic exercise.

A. Methods of treatment by Chinese herbal medicine

There are four methods of treatment used in Chinese herb medicine.

Regulating therapy; Includes various treatments such as the dispersion of stagnated liver-energy, the coordination of the functions of the liver and spleen or of the liver and stomach.

Warming therapy; Expelling cold by warming the meridians, rejuvenating the depleted Yang, lowering fever with drugs of sweet flavor and warm nature.

Invigoration therapy;  Invigoration of vital energy, toning the blood, invigoration of Yin and Yang.

Dispelling therapy; A treatment for dispersing stagnated energy, blood stasis, phlegm-wetness, undigested foods.

The effects of herbs are usually seen after several days of regular use, rather than immediately, but once the effects are established, they often persist for a long time.  The use of acupuncture plus herbs usually provides the most dramatic results.

B. Dietary Therapy

Avoiding foods that produce dampness or mucous that may further obstruct the flow of Qi and blood in the channels, therefore exacerbating the pain.

Foods to avoid:

Cow milk products (milk, cheese, cheese, yogurt, butter, ice cream, etc.)
Night shade vegetables  (tomato, eggplant, peppers, potato).
Deep fried and fatty foods.
Cold and raw foods (salads, fruits).
Wheat. Alcohol. Coffee. Sugar.

C. Methods of treatment by acupuncture and moxibustion

Acupuncture therapy; Application of metal needles such as filiform needle, intradermal needle and plum-blossom needle are used to stimulate certain specific superficial definite locations for the treatment of a disease. In cases of blood transmitted disease or skin lesions electro-acupuncture or laser beam acupuncture is applicable.

Acupuncture is a very safe system of health care when done by a well-trained practitioner. It feels like a needle prick but nothing like getting an injection. During the treatment the patient will experience some sensations of energy movement, but not pain. Most people fall asleep when left with the needles, and wake refreshed and relaxed.

The number of treatments varies according to the individual.  Chronic pain that exists for years may require a longer series of treatments. Treatments are usually once or twice a week.

Moxibustion therapy; A method of applying therapeutic heat produced by ignited moxa wool or roll over the well defined skin surfaces. The moxa is made by an herb called “Artemisia Bulgaris”.

D. Other methods of treatment

Massage;  a) Also called pushing and grasping; a method of prevention and treatment of diseases by applying various massage manipulation, or by passive movements of extremities. b) One of the eight manipulations of bone setting, used for relaxing the muscles, dissipating blood stasis and promoting subsidence of swelling.

Qigong (breathing exercise); A mental and physical self training for the prevention and treatment of diseases and also for health care and prolongation of life, by which life activities are self-adjusted and self-controlled with the help of the inducement of mind and the regulation of respiration and spirit.

Cupping; Is designed to vastly increase circulation to affected areas, ridding toxins and waste products that aggravate inflammation and introducing the tissues to fresh nutrients and oxygen.

Therapeutic exercises; Taiji, Gong fu, jogging five animal exercises and other exercises prevent disease and strengthen the human body.

There is no magic treatment for Fibromyalgia. In my experience of treating chronic pain for the last 17 years, a complete comprehensive evaluation is nessecary. It  is essential to determine the treatment plan for each individual. In Chinese medicine there is no ” one treatment fits all” phylosophy. Everybody has to be treated according to his or her unique characteristics.