Acupuncture CEU Online

Acupuncture Continuing Education Online Courses

 

Educational opportunities in Chinese Medicine for acupuncture and herbal medicine exist for acupuncture professionals.  Online learning with open source solutions allows medical professionals to access data to better serve patients.  Acupuncturists in California (CA) need 50 units of continuing education credit every two years whereas the NCCAOM requires 60 units (PDAs) every 4 years for national diplomate certification.  Florida and Texas also require special continuing education credits for acupuncturists.  Providing these courses should ultimately lead to improved patient care.
 
Acupuncturists encounter several difficulties with acupuncture continuing education.  Firstly, location- many courses are not available in Iowa, Wyoming and other sparsely populated areas.  However, New York City, San Francisco, San Jose, Austin, and Boston offer many courses.  Next, quality of courses is of issue.  Not all courses are clinically applicable to the acupuncturist.  For example,  an acupuncturist may already know the material or the material is not applicable  to a specific acupuncture practice.  Next, it can be costly to travel to a course.  Finally, topics of interest that meet an acupuncturist's needs may be hard to come by in remote areas. In addition, topics relating to scope of practice are of great import. For example, in a recent meeting by the California Acupuncture Board, there is mention of moving to strike certain topics and procedures from official approval from California acupuncture ceu courses. Course material perceived as extending beyond the scope of practice of an acupuncturist was suggested as inappropriate.


This is a legitimate concern, however, acupuncturists have suffered several setbacks in recent years regarding scope of practice. For example, magnets were cited in California legislation to be included in an acupuncturist's scope of practice but never made it officially. Cold laser stimulation was also cited for inclusion into the acupuncturist scope of practice. However, then Gov. Gray Davis did not sign the law and it did not pass. To exclude cold laser education based on its exclusion from scope of practice may be inappropriate as it may be included at a later date.

President Obama and Gov. Jerry Brown of California made tremendous strides into restoring access to quality preventative medicine, including acupuncture. Starting in 2014, all small group and individual health insurance plans will include acupuncture therapy in California. This is both cost-effective and humanitarian.


 
New Acupuncturist License Requirements Developing
The NCCAOM now requires a 4 hours safety and ethics course every four years for license re-certification for acupuncturists. Soon, the NCCAOM is again changing requirements for acupuncture CEUs. Online courses will be required to make a review of test answers in short written form in prior to administering a test. This, according to the NCCAOM, is to re-enforce learning and memory retention. Note: acupuncture CEUs are referred to as PDAs by the NCCAOM. Also, the California Acupuncture Board has recently considered requiring safety and ethics courses for acupuncture ceus. No action has been taken by the California Acupuncture Board. However, they have continually made more stringent standards over the years for acupuncture license certification.

Acupuncture CEUs Online Continuing Education
Acupuncture CEUs refer to California acupuncture continuing education.  Acupuncturists in CA must get 50 units of credit, 25 of which must be obtained in LIVE courses.   Other courses can be written, correspondence, and online.  Acupuncturists seeks interesting topics that allow for ease of certification combined with quality materials that benefit patient outcomes.
 
A small percentage of units can be applied for Qi Gong and Tai Qi.  Working on one's Qi is essential to the application of traditional acupuncture.  Although tube needles have become the vogue, traditional needling styles do require the practitioner to have Qi.  Seirin provides both tube and tubeless needles for application.  Both are considerable in value to the profession.
 
Other needle brands such as Mac, Peace, Cloud and Dragon, Hua Tou, etc... also provide valuable materials for acupuncturists.  The quality is so high in the modern market that the comfort level for patients is quite high.  Relaxing experiences are common in the clinic even with long needle techniques of thick guage.  Ultimately, the success of the profession relies on results.  Quality clincial outcomes are why the profession has survived 5,000 years.  A pretty good track record indeed!  Acupuncture is safe, comfortable, and effective.  The treatment of insomnia, arthritis, and autoimmune disorders along with many types of pain and infectious syndromes is treatable with acupuncture.

Acupuncturist Courses Online
 Acupuncturists seeking online credit can visit bona fide sites such as www.healthcim.com which offer quality courses for license credit.  This covers all 50 states includin NY, CA, FL, MA, TX and more.  Courses that can be downloaded in PDF format have the advantage of being searchable in the clinical context.  Realistically, written materials benefit acupuncturists when they have patients in the clinic or when reviewing.  In this way, the data is accessible and allows for the application of acupuncture and herbal medicine for specific cicumstances.  Searchability prevents having stack of books on the shelf with data that cannot be accessed in a busy office schedule.



 
Acupuncturist Approval by Acupuncture Medical Board
 
Most patients and doctors do not realise that acupuncture is both modern medicine and ancient.  Regulated by the CA Medical Board in California and Medical Boards throughout the USA, acupuncture is a profession that requires extensive education and training.  Some treat acupuncture as experimental.  Well, the experiment is over 5,000 and seems to be going well.  Despite NIH studies supporting the efficacy of acupuncture and medical bodies througout the world (including major universities), acupuncture is relegated to a lesser value in status.
 
The US Burea of Labor and Statistics cites acupuncture as a procedure but has not recognise it as a profession.  Interestingly, AcuMoxa is a better interpretation of the Chinese term for acupuncture.  Rather, Chinese Medicine more accurately describes the application of this holistic medicine.  Also, Korean, Japanese, and other traditional approaches to herbs, dietetics, acupuncture, Tai Qi, etc... meet this description.  Yet, a patient can buy insurance and not have the right to choose their own MD much less an acupuncturst in many situations.  In cases, for example, of arthrtis, migraines, and insomnia this presents a problem in that acupuncture and herbs may be superior treatment modalities to allopathic medicine and drugs.

Acupuncturist Insurance Benefits
 
Acupuncturists do enjoy reimbursement from medical insurance companies but not at the rate that MDs, nurses, physical therapists, and PAs enjoy. Also, they often are required to have referrals from MDs to get reimbursement. In addition, some plants reject reimbursement for acupuncturists for acupuncture but accept acupuncture claims from MDs with little or no training in the field of acupuncture.


Recently, California's then Gov. Schwarzenegger removed acupuncture from the Medi-Cal system. Also, efforts to get acupuncture reimbursement from Medicaid and Medicare have not passed despite efforts for over ten years. This, despite the cost effective nature of acupuncture and its proven efficacy in reducing the need for surgical procedures and medications. The NCCAM has published numerous reports supporting acupuncture as a supplement to our health care system.


Acupuncture Healthcare
Perhaps the next step is inclusion of acupuncture into the Medicare system. This is formal recognition of the profession. Prior to this, the Bureau of Labor and Statistics must recognize acupuncturists as professionals. Currently, this is not the case. Rather, acupuncture is a procedure and not part of a profession but official government tracking.


Human suffering is never desirable. Unfortunately, the health care crisis is often perceived as a health insurance crisis. Rather, it is access to care that is paramount. For example, if a person has a serious disorder, he must see a qualified specialist in a timely fashionl. It is not uncommon for a patient with robust health insurance coverage, to wait a month prior to seeing a specialist and even longer to receive test results. Acupuncturists can help to serve as primary health care physicians on the front line by providing immediate access and screening for prioritization of emergency cases.



The following is an excerpt of an online acupuncture CEU course at HealthCMi.com :

Tea
Shen Nong, the Divine Farmer, is credited with discovering tea as an antidote to 72 poisons in approximately 200 BCE. Tea is made from the leaves, buds, and internodes of the Camellia sinensis plant. Special preparations may also be made from the twigs of the plant. The tea plant is indigenous to Asia and is typically clipped to form shrubs under two meters in height. The two major varieties are Camellia sinensis sinensis and Camellia sinensis assamica. Camellia sinensis sinensis grows throughout China and reaches a height of up to 3 meters, unclipped. The Assam variety (Camellia sinensis assamica) grows primarily in North-East India, Myanmar, Vietnam, and South China. Assam tea plants reach up to 20 meters in height, unclipped.


Portuguese explorers were introduced to tea in the Macau region in the 1500s. The Portuguese explorers adopted the local pronunciation of tea, later becoming what is now the current English pronunciation of tea. The Mandarin pronunciation of tea is cha.
Tea is bitter and sweet. Green tea is cold or cooling whereas black tea is warming. Tea enters the Heart, Lung, Stomach, Large Intestine, Small Intestine and Urination Bladder channels. Tea clears the upper jiao Shen (spirit) and therefore clears the mind and treats headaches. In the middle jiao, tea benefits the digestion of food and relieves food stagnation. In the lower jiao, tea promotes urination and bowel movements. Green tea’s cooling nature makes it suitable for flushing out toxins in cases of urinary tract infections.


Tea is commonly available in white, green, brown, and black preparations. White tea is made from the new buds and young leaves of several varieties of the tea plant. This new growth maintains a silvery white appearance and is a specialty of Fujian province. Green tea, Lu Cha, is made from more mature leaves, buds, and internodes. Green tea and white tea maintain their green and white appearances because the freshly picked tea is steamed or heated and dried to prevent it from withering into a darker color. Steaming or heating the tea inactivates polyphenol oxidase thereby halting the process of oxidation. It is best not to start the day with a cup of green tea prior to eating in order to prevent stomach irritation.


The withering process of tea into darker varieties is due to enzymatic oxidation, however, the term fermentation is often used. Fermentation is an industry term usually referring to oxidation levels and is not related to the chemical process of fermentation. Many refer to green and white tea as unfermented, oolong tea as partially fermented, and black tea as fermented tea.


Brown teas, such as many forms of oolong tea, get their earthy brown color because they are allowed to wither for a longer duration prior to steaming or heating. Tie Guanyin (Ti Kuan Yin) and Dong Ding are popular varieties of oolong tea. Black teas undergo the longest periods of oxidation prior to processing and therefore wither into the darkest colors.  Red tea, Hong Cha, is the Chinese term for black tea and is named after the reddish color of tea when consumed as a drink.


English Tea
The English tradition of tea with milk has its origins in Tibet. The Tibetans are known for drinking butter tea (Po Cha, Su You Cha). Butter tea is a combination of tea, yak butter, and salt. This preparation is a high-energy drink that is helpful for Tibetans living at high elevations with cold temperatures and poor growing conditions. The English adapted the tradition of mixing black tea with dairy and added sugar. Adding dairy products and sugar strengthens the warming and tonifying function of the tea. Black tea is warming and is therefore more suitable for colder climates or consumption in the winter. Green tea is cooling and is more suitable for consumption in the summer.


Pu-erh
Pu-erh tea is made from a large leaf variety of Camellia sinensis, primarily grown in the mountains of Yunnan province. It is often pressed into bricks but is also available in loose-leaf form after completing a special process of pressing. The special preparations involved in Pu-erh production allow the tea to mature with age. Unlike other teas, the flavor of pu-erh improves with age.


Pu-erh, like many forms of tea, is known for its antioxidant properties. This is due in part to the presence of catechins and flavonoids in the tea.1 Pu-erh has the special ability to raise the ‘good’ HDL cholesterol while lowering levels of the ‘bad’ LDL cholesterol.2
Research shows that pu-erh tea reduces obesity. The study conducted by the Yunnan Provincial Key Laboratory and the College of Food Science and Technology at the Yunnan Agricultural University notes that pu-erh significantly reduced total body weight, adipose pads, LDL cholesterol, and triglycerides.3 The researchers postulate that the fat reduction may be triggered by pu-erh’s ability to boost enzymes such as lipoprotein lipase, hepatic lipase, and hormone sensitive lipase. Pu-erh tea is a traditional compliment to mooncake during the Mooncake Festival (Mid-Autumn Festival). The properties of pu-erh make it well suited to improving digestion when eating oily, fatty, and sweet foods.


Decorative pressed tea ball preparations of pu-erh are made by combining it with Ju Hua (chrysanthemum) or other herbs. The tea balls expand when placed in hot water and often provide a beautiful presentation of the tea. Another special preparation involves cooking the pu-erh inside bamboo to enhance the flavor.


 
Another Example of an Online Course:


TCM Management of FMS

Research shows acupuncture is an effective treatment for fibromyalgia. An open 6-week study of patients treated with acupuncture reported a reduction in pain levels and tender point as well as increase of serum serotonin and substance P levels. A 2006 Mayo Clinic study “found that acupuncture significantly improved symptoms of fibromyalgia. Symptomatic improvement was not restricted to pain relief and was most significant for fatigue and anxiety.” In the Mayo Clinic randomized clinical trial, fifty patients participated. Twenty-five patients were placed in the acupuncture group while the remaining twenty-five in the control group. “The total fibromyalgia symptoms, as measured by the FIQ, were significantly improved in the acupuncture group compared with the control group during the study period.”


Studies in Brazil and Japan also reported improved Quality of Life (QoL) and FIQ findings. These and other studies continue to provide results showing traditional and electro-acupuncture to be effective in managing FMS pain. In 2003, the World Health Organization identified acupuncture as a condition “for which the therapeutic effect of acupuncture has been shown but for which further proof is needed.” In this course, we will look closely at how to use acupuncture and herbs to treat fibromyalgia.

TCM Etiology
TCM identifies a number of patterns/mechanisms in patients who present with FMS. FMS is a complex condition, and the exact origin of FMS is unknown. Latent exterior pathogens are often seen as contributing factors. Beside exterior pathogens, precipitating factors may also include irregular diet and smoking as well as:


Physical overexertion
Mental stress
Chronic insomnia

In the acupuncture clinic, fibromyalgia patients may present with bi syndrome, Liver qi stagnation, and Wei qi obstruction (with excess and deficient patterns). Furthermore, in the clinic, it is normal to see a combination of patterns. Let’s now look at these three general patterns in more detail:

Constrained Liver – Liver qi stagnation exacerbates symptoms in many FMS cases. Patients who have difficult relationships, high demands, or stressful occupations tend to experience this pattern.
Liver qi stagnation is evident when patients complain of depression and irritability. Liver qi stagnation may also contribute to the digestive disturbance FMS patients experience. Liver qi invades the Stomach and Spleen causing belching and IBS symptoms (diarrhea and alternating constipation). Further, stagnation of Liver qi may manifest as a feeling of something in the throat or tightness in the throat (called plum-pit qi).


When Liver qi stagnation impairs the flow of blood in Chong and Ren, the uterus is affected. This is why some FMS patients experience severe gynecological problems such as dysmenorrhea and amenorrhea. FMS patients may also have pre-menstrual breast tenderness and distension because of the influence of the Liver channel on the breasts.

Acute Bi syndrome – Some FMS patients are affected by climatic factors such as dampness, cold, wind, and heat. These patients may suffer from bi (painful obstructive) syndrome. Bi syndrome manifests as pain, soreness, heaviness, limited range of motion, and swollen, painful joints. Inflammation is NOT a characteristic feature of FMS, however, co-morbid factors such as rheumatoid arthritis or Lupus are common with FMS. In these cases, patients may experience flares with swollen, red joints. A key symptom is difficulty moving.


Invasion of exterior pathogens such as wind, cold, dampness, and heat disturb qi and blood flow and creates pain in the joints and muscles accordingly:
Exterior cold pathogens obstructs the channels and vessels blocking qi and blood flow causing pain and limited range of movement (motion)
Exterior heat pathogen accumulates and obstructs the blood flow causing pain and swelling
Dampness obstructs the blood and qi flow causing swelling, heaviness, and pain
Wind invasion causes pain to migrate from joint to joint

Wei qi obstruction - Wei qi blockage occurs from latent pathogens. A weakness of Wei qi (or blockages in Wei qi) occurs in patients who have low immunity or defenses. Wei qi is also called our defensive qi.
Wei qi warms and moistens the skin and muscles and helps to regulate the body temperature. Wei qi functions to protect the body from invasion of exterior pathogens.
The Wei qi spreads throughout the middle and lower burner and affects the internal organs. Wei qi circulates 50 times in a 24 hour day (25 times with each 12-hour period). In the day, Wei qi circulates through the exterior of the body and at night it circulates in the five yin organs according to Maciocia. Therefore, proper flow of the Wei qi is important not just for the protecting the body but for the proper functioning of the different body systems. Wei qi blockage explains the systemic systems that manifest in FMS, such as digestive and respiratory complaints. FMS symptoms develop in three stages with the Wei qi pattern.

 

 



Acupuncture Continuing Education Online
 
The following is an excerpt from an online continuing education course for acupuncturists called "PID and Chinese Medicine."  The following section is downloadable in a PDF file for NCCAOM PDAs, California Acupuncture Board CEUs, Florida Board of Acupuncture CEs, Texas CAEs (pending), and CTCMABC credits.
 
Excerpt:
 
Cervical Infection, Cervicitis, & Cervical Dysplasia


Diagnoses:
I    Damp Heat in the Lower Burner


II    Excess Heat and Toxins


III    Spleen & Kidney Qi Deficiency and Dampness

Indications:
Completely asymptomatic (or)

White, Red, or Yellow Belt leukorrhea (typically gray or yellow color and often more pronounced immediately following the menstrual period), vaginal bleeding (between menstrual periods, post-menopausal bleeding, and especially following sexual intercourse), painful intercourse, vaginal itching, irritation of the external genitals, burning or frequent urination, lower back pain, abdominal pain, infertility. In severe cases: fever, nausea

 

Cervicitis



Symptomatically, cervicitis is often differentiated from other forms of PID by bleeding after sexual intercourse.  Unlike vaginal infections which are typically uncomfortable, a cervical infection may not itch.  Cervical infections, cervicitis, and cervical dysplasia are potentially asymptomatic. Therefore, it is strongly recommended that women have a pap smear at least once per year and more than once per year if there is vaginal discharge.  A cervical infection may cause inflammation of the cervix (cervicitis) and/or cervical dysplasia. 

Most cases of cervicitis are caused by an infection. 

Chlamydia, gonorrhea, and trichomonas are three common sexually transmitted diseases contributing to cervicitis.  Other organisms such as herpes simplex, streptococcus, staphylococcus, enterococcus, and Gardnerella vaginalis may also lead to cervicitis.  Other contributory factors to cervicitis may be a reaction to chemicals in douches and contraceptives, tampons, allergic reactions to latex condoms, and physical injury.


Cervical Dysplasia

Cervical dysplasia, labeled “pre-cancer” since it has not yet advanced to the cancer stage, is abnormal growth of the cells lining the cervix.  Mild dysplasia is the most common type and the cervical tissue returns to normal without treatment in the majority of reported cases.

If untreated (and in some cases even when treated), cervical dysplasia may advance to cervical cancer. 

Risk factors for cervical dysplasia include multiple sexual partners, HPV (human papillomavirus) infections, HIV infections, tobacco smoking of either the male or female sexual partner, poor nutrition, and the use of oral contraceptives.  Also, the daughters of pregnant women who were prescribed diethylstilbestrol (DES), a synthetic estrogen, are at risk.  Cervical dysplasia may be asymptomatic.  It is strongly recommended that women have a pap smear at least once per year and more than once per year if there is vaginal discharge.  Routine visits to a gynecologist for early detection may help in the prevention of cervical cancer.


Formulas for Cervical Infection, Cervicitis, & Cervical Dysplasia

 

FORMULA 1:

 Modified Yi Huang Tang     ... more in actual course material.