The Get Healthy Tampa Bay Podcast

E92: Natural Pain Relief and Healing Through Acupressure with Dr. Victoria Menold

• Kerry Reller

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Welcome to the Get Healthy Tampa Bay Podcast with Dr. Kerry Reller! This week, I'm excited to welcome Dr. Victoria Menold, a physician blending Western and Eastern medicine in her practice. In this episode, we delve into the fascinating world of acupressure and its applications in pain management and overall wellness. Dr. Menold shares her journey from public service medicine to establishing her own practice, where she focuses on personalized patient care. We explore the differences between acupressure and acupuncture, the significance of specific acupoints, and how acupressure can benefit various health conditions, including digestive issues and allergies. Dr. Menold also provides practical tips for self-application of acupressure and discusses the importance of lifestyle medicine in managing chronic diseases. Tune in to discover how to harness the power of acupressure for better health and well-being!

Dr. Victoria Menold works in a solo practice in Odessa, Pasco County FL. This is a Family Practice Primary Care holistic patient centered  approach to healthcare which blends the Western and Eastern practices in a membership-based model which allows for extra time for prevention and wellness. Born and raised in Youngstown, OH, Dr. Menold graduated  from Youngstown State University with a bachelor’s degree in Combined Sciences. She earned her MD from Northeast Ohio Medical University and completed her Family Medicine residency at Bayfront Medical Center in St. Petersburg, FL, in association with USF. She is Board Certified in Family Medicine.

Dr. Menold practiced in St. Petersburg for three years in private practice, worked as a contractor for MacDill Air Force Base in Tampa, and served at the Veterans Administration in Primary Care for 18 years. In 2023, she took a sabbatical to study various Eastern Medicine techniques. She graduated from Helms Medical Institute for Medical Acupuncture, is certified as a Meditation Teacher from YogaMu, and is pursuing advanced studies in Yoga and Ayurveda. She has been volunteering since 2023 at the Good Samaritan Health Clinic in New Port Richey and the Doctor’s Free Clinic of Citrus County, where she serves on the Board of Directors.

Dr. Menold lives in Odessa, FL, with her husband Rich, their two teenage sons, and a Golden Retriever. She enjoys outdoor activities, especially bicycling and paddle boarding.

0:28 - Introduction and Welcome
1:04 - Dr. Menold's Journey into Medicine
5:08 - Blending Western and Eastern Medicine
6:27 - What is Acupressure?
7:30 - Battlefield Acupuncture Explained
10:14 - Differences Between Acupressure and Acupuncture
14:46 - Conditions Treated with Acupressure
21:11 - Self-Application of Acupressure
25:54 - Acupressure for Allergy Relief
29:13 - Evidence and Research on Acupressure
39:19 - Overview of Dr. Menold's Practice
43:04 - Closing Thoughts and Final Remarks

Connect with Dr. Menold
Website: https://w-eprimarycare.com/
Facebook: https://www.facebook.com/profile.php?id=61564265943055&mibextid=LQQJ4d
Instagram: https://www.instagram.com/victoriamenold/
Tiktok: https://www.tiktok.com/@drmenold_wepca?is_from_webapp=1&sender_device=pc
Youtube: https://www.youtube.com/channel/UCIdnxyfVjxjpuACxO2xkrEQ
LinkedIn: https://www.linkedin.com/in/victoria-menold-038421278/

Connect with Dr. Kerry Reller
Podcast website: https://gethealthytbpodcast.buzzsprou... 
My linktree: linktr.ee/kerryrellermd
Facebook: https://www.facebook.com/ClearwaterFamilyMedicine
Instagram: https://www.instagram.com/clearwaterfamilymedicine/
Clearwater Family Medicine and Allergy website: https://sites.google.com/view/clearwa...
Podcast: https://gethealthytbpodcast.buzzsprou...

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Kerry:

All right. Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller. And today we have a very special guest Dr. Victoria Menold. Welcome to the podcast.

Victoria:

Thank you.

Kerry:

Sorry if I messed up your name, but I think I did a good job.

Victoria:

You did fine.

Kerry:

Thank you. All right. So why don't you tell us a little about your background, who you are, what you do, and then we'll go into your special topic today that I'm excited to discuss, especially since we had something a little similar a couple of weeks ago, but different, very different as well. So why don't you share with us your journey?

Victoria:

I knew I wanted to help people in high school and at first I thought I wanted massage therapy, but my physics teacher said, you're too smart for that. Go to medical school. And it worked out. I did get an academic scholarship, went to medical school and went to family practice residency down here in St. Petersburg at Bayfront Medical Center. And I wanted to do as broad of a helping doctoring aspect of things as I could. So I stuck around South St. Pete in Roseville Park Medical Center for three years. And at that point, family became more important to me, wanting to have a child and in a small group practice with less than 10 employees I couldn't get full leave and then I moved on to work for the base as a contractor in Tampa Air Force Base. And contractors they're expendable to the military. So when the contract with my employer ended, my job ended as well. And I thought, you know, I like public service medicine. Let's look into see what else we can do. And I moved on to the VA and spent 18 years there. For During those 18 years, and particularly the last 10, I noticed a trend in medicine and primary care, where it was becoming more corporate and nationwide quality measures, and it became less about the personalized care that it's between the relationship between the doctor and the patient and they became numbers game and this was happening in private care as well. So, that got to a point between my health at that time and this frustration that I decided if my job is not going in the direction that I want it to, and I can't seem to make an impression when I try to make changes in my workplace, I'm going to create my own job. And let's do what I really love. And what I really love is taking care of chronic pain patients with Means other than opioids if possible and while I was in the ambulatory care pain clinic for many years at the VA I learned a lot about how to do that and they even sent me for battlefield acupuncture learning which is needle points on the ear five specific keep it simple straightforward points that caused in 60 percent of my patients significant amount of pain relief and that blew my mind because most pain medicines are considered a success if they produce a 30 percent improvement long term. So we did study it and that seemed to be consistent for about six weeks. And then certain redistributions of resources happened and the acupuncture aspect of things went to whole health at the VA. I'm glad that we had a whole health department. And so what I love to do went back to what I didn't love to do. So at the end of those 18 years, I recreated it on my own in a solo practice. We just opened last month and celebrated our grand opening a couple weeks ago. So what I intend to do is offer Western and Eastern medicine with patient centered care. Maybe I should be pointing at me. I should be pointing at you. So and in family practice, we sort of were doing that. We did what we call biological, psychological, and social related care. So we took into consideration all those things, but with patient centered care, It's all about what's important to the patient, and then you surround the patient with resources, you look at different aspects of their lives, and in my case, you apply both western medicine ideas and eastern medicine ideas to that. So acupressure is what I was hoping to give tips on today, and acupressure is one of the eastern medicine ways of handling problems.

Kerry:

Awesome. Well, I mean, thank you so much for, you know, your public service. I think it, you know, it takes a special doctor to be servicing the veterans and things like that. So thank you for that. And congratulations on the opening of your business. And that's super exciting. And I think it's exciting also that you are in Florida. I think you grew up from Ohio, right? And then you did residency down here and luckily we, you know, got to keep you. So you're-

Victoria:

yeah, my husband moved down here, and it was, you know, six chances of staying a split relationship in terms of geography, and one chance in being together, and it ended up being that one chance through the match, and I'm very pleased with that, because it produced a long term relationship with him, and my two children.

Kerry:

that's awesome. Yeah. Sometimes the match is leaving us all up to, up to odds. But interesting. So you are blending obviously Western and Eastern medicine. And I was looking at your website and seeing this name of your practice. And I was so confused. I'm like, what is WEWE? And then I looked at the icon or what are we, what do we call it? The logo, right? I'm like, Oh, okay. So she's got, A directional thing. I should know this word because my daughter had a geography test yesterday. That

Victoria:

it's a compass.

Kerry:

yeah, I guess. Yeah, the compass. Anyway, it has the eastern and western side. I thought that was really clever. So that made a lot more sense when you know, I figured out what you were trying to say with

Victoria:

But also, we, you and me.

Kerry:

Right. Yeah. So multi, obviously there's going to be multi meaning there, but yeah, I love it. That's fantastic. And then, I mean, I can't wait to hear about, acupressure, especially like, I had no idea that you were using it for, you know, those on the battlefield and things that, Those kind of like that could be even done. Like that's amazing. So I want to hear more about it. So what is acupressure?

Victoria:

Acupressure is the non through the skin version, but rather pressure on the skin version of acupuncture. And it's more likely to work on individual active points on the body, and less likely to cause entire meridians to unblock or move energy, but it still creates benefit. And how battlefield acupuncture got its name, in case you're curious and it sounds like you were, is that when people were being lifted off the battlefield, they would be, in pants to keep them from going into shock from the bleeding, they would have a People on either side of them working on their chests and their lungs and IVs going and masks and everything. And you can only really get at the ear. So they tried needles on the ear to control the pain, which meant less morphine, which meant less shock, which meant more survival. And that's where it started. And then it spread to chronic pain clinics in the military and then to chronic pain clinics in the VA.

Kerry:

Yeah I mean, that makes sense. Like if trauma, everybody's working on the patient. And the only thing available is I thought that's what you're going to say is

Victoria:

Yeah, and why the ear if problems are another part of the body is that when we were just two cells and then we were an oblong blob as before we became a fetus, and we're just in those very early stages, we kind of have a top, a bottom, a side to side, and our electrics lined up along those ways, and it was just a groove, and a groove became your whole entire nervous system, but part of that groove pulled out and became your ears and retained the connection to the brain and the brain knows exactly where on the brain different parts of the body is and apparently the ear does too, they figured that out.

Kerry:

So cool. I mean, it makes sense when you describe it in that way. I think that's neat. Yeah. So What is the difference between acupressure and acupuncture?

Victoria:

Pressure, we use these little magnets I don't have any handy but they also have seeds that are stuck to band aids and it just focuses the pressure more than just your finger pressure. You also could use a pen the retractable pen is better. I've got one here, which has a little circle on the end and you can put the pressure on the spot on the ear or else on the body and twirl and press and twirl and press. It might leave an indentation of a circle, but it does not break the skin. Acupuncture uses different kinds of needles, longer needles that go in temporarily and come out, small little, looks like you just got a bunch of jewelry of pierced ears on your needles, gold needles that stay in for a few days and then skin grows out and they fall out, or sometimes leave in the skin needles. And interestingly, also laser, laser penetrates to lower level the skin and sometimes even into muscle. So those are penetrating acupuncture treatments. And if you set them a certain way, usually offset one side of the yin and yang with three and the other side with two, then it creates an imbalance and then the energy circulates better through those blocked areas. Eastern medicine says when you have energy circulating around you, from the environment, and it's flowing nicely, you're healthy, and if it's blocked, you're going to have pain or problems. And we don't fully understand in western medicine how that works, but we do understand that the body has energy and is influenced by magnetic fields and static electricity. Oops! I just shocked you. And things like that. So we know that we are charged individuals and one day we'll figure it all out. But the Eastern Medicine ancients of old weren't really interested in figuring it out. They were plenty happy to follow the wisdom of their ancients and take care of their village populations.

Kerry:

So a couple of weeks ago, we had an episode on dry needling and he was explaining the difference between acupuncture and dry needling. And I did not, I was not aware that acupuncture actually leaves the needles sometimes in, I thought, you know, they always remove

Victoria:

It's a rare thing and we were taught that it exists, but in our medical acupuncture course, there's a higher risk to leaving needles in. So our school did not suggest doing that,

Kerry:

Okay.

Victoria:

permanently in the ones that we put in and leave in, we leave in for between five and 40 minutes, depending on what the patient needs. If they're what we call a kind of hot headed state and pain and inflammation, one of the things is heat. Then you leave the needles in because it sort of allows the energy to evaporate off and surrounding the needle will first get red and then fade away and then you know it's time to take the needle out. If they're in a colder state or a yin state from yin and yang, then they need extra energy and we sometimes put electric endings on the needle and put energy through the body. And you would think that that sounds like torture, but it's very well tolerated. It feels more like a tick, tick, tick than any kind of electric jolt.

Kerry:

Okay. So acupressure, you know, kind of noninvasive and then acupuncture does penetrate the skin. Can you explain a little bit more about the acupoints and the fascia and their role of influencing the body systems?

Victoria:

Right. So, it so happens that the points that the ancients discover that If you press on them or put needles in them, do things to help the body line up in the grooves between the muscles or where a bunch of blood vessels come together and turn out and make right angle turns in the skin. And if you were to take that piece of skin and cut it up and put it under a microscope, you would see it's very different than other parts of the skin. It conducts electricity much better than other parts of the skin, which where the fat sort of creates more of a resistance. And so, it's just, or different under the microscope, and what does that mean? We don't know, but we do know that it, the nerves go with the vessels, the blood vessels, and so you're going to end up be dealing close to a nerve. The idea is not to needle into the nerve, but close to the nerve, and then that has some influences. But also, there's this stuff called fascia, which, In medical school at the time, we just peeled it away to see what, there's the real thing I'm interested in, like the muscle or the tendon, but this is like saran wrap wrapping, but natural in your body, it holds together and sticks together parts that should be, and protects, and this is actually a living tissue that has the potential to alter your immune system, your endocrine system, your nervous system, and The local nearby healing cells that come to the area and build new tissue. So when you use the needle, sometimes you twirl, and when you twirl, you create a kind of a wraparound tug effect on the fascia, and then that sends off the signal. And to give another example of fascia, if you stretch to your utmost and sort of twist, It will feel like a sort of a line of tension going across your whole body, and it's thought that that communication from a needle one spot might get as far as the far end of the fascia. And so it's a far reaching skin organ that you're working with when you use the needles in the acupuncture or pressure.

Kerry:

So you mean like all the way to the fingertip when you were stretching out like

Victoria:

Right, if you're, I'm going to see if I can do this, but if I were to like reach for a high shelf and go on my tippy toes, then you can almost feel a stretch across your whole body and interesting things like when people are rehabbing from chronic pain from nerve damage. You can get them better by teaching them through a mirror that one side is working, so the other side might be working. You also can get them better faster if you get them to stretch their nerves to their utmost or stretch their fascia to the utmost. We don't know why that works, but we do know people rehab better from that. So fascia is very interesting. There's books on it. I haven't read them all. I only learned a certain amount to get through the acupuncture medicine school, but I'm going to end up looking more into it.

Kerry:

Yeah. Very interesting. Very interesting. so you mentioned pain, obviously, and acupressure can treat that. What other conditions or things can it help treat or do you want to elaborate more on the pain part

Victoria:

Sure. Well, for pain there are parts in the ear that relate to the interior part of your brain pain system and also the relaxation system, which if you're tense, you're going to be in more pain, and if you're depressed or anxious, you're going to be in more pain just because of how close those centers of the brain are. But there is also unknown reasons why, I mean, there's an eastern explanation why, but unknown from western medicine explanation why certain points down on the far extremities will help. Other parts of the body and their pain. We just have to one day figure it out. But in addition to pain, the Eastern medicine take on these things is it's not just the pain system, it's also other major systems of your body. The musculoskeletal coordination, how well can you escape the tiger that's running after you, the digestive system, the system that they thought was controlled by the spleen, which has to do with your overall fluid balance. These days, we kind of consider it being controlled by the kidney and the endocrine system and also general energy. You know, we, we start off young, we're bouncing around, we have endless boundless energy, and by the time we're in our 30s, 40s, especially if we have a burnout inducing workplace, then we're pretty exhausted, and we wonder why. But the Eastern Medicine says you can, you can manipulate that. You just need to put an acupuncture point here and here, and you'll have more energy. So a lot of patients come to us with fatigue or trouble sleeping, a lot of functional complaints. So it's not so great at Fixing problems that are densely, densely established, like a huge kidney stone although some people film and even can work on these sort of things but it's much, much more effective at handling functional problems, pain, mood, energy, And these finely tuned balance systems like endocrine system immune system neurological system, and healing.

Kerry:

Can you expand a little bit on the digestive track part of

Victoria:

Yeah, sure. So there is They, they name the meridians or the flow circles, there's different aspects of the body, one set of four, they could have called it the cherry blossom red, blue, green, and white, but instead they decided to name them after one of the more important organs. So they, lateral part of your body, the side part of your body, that's which involves with coordination and locomotion, they decided to call that gallbladder and liver, and on the part of the body that goes through the back where your kidneys are located in the back, they call that the kidney and bladder, meridian, and the parts closer to your heart, like from here on down to your finger. You know, when people have heart attacks, they tend to fill in their arms. They call the heart meridian, and so they labeled them after different organs. So there's one goes from near the eye, straight down through the stomach and lands near the groin, and in some cases goes all the way down toward the outside of your shins in the front all the way down to your toes, and that is called the stomach meridian. And so if you're having problems with bloating, digestion, aster reflux, these functional stomach problems, then having a acupressure treatment to the most powerful stomach point, Stomach 36 is very useful, and I'll see if I can do this in focus, but, I'm pointing now to my kneecap. I'm placing four fingers below the bottom of my kneecap. My pinky finger is finding the shin bone and is moving more to the pinky toe side of the muscle right there. And if a person were to dig in there with their finger and move around in circles and dig with their fingernail or use that pen or pencil technique, then they would be treating What they say in Eastern medicine is the point that cures all ills. I think that's kind of overreaching. But it's a point that does have an effect on the mood. It has an effect on the gut. It has an effect on pain. It has an effect on the automatic nervous system. And it's just a good point to use as part of a bunch of protocols. But that is the point of Oh, I'm trying to think. Not tranquility, but something that sounds like tranquility. It's over advertised in Eastern medicine, but it is used in a lot of the treatments. So that's one. And then they call it large intestine right in from the index finger running all the way up to your nose. I don't know that that makes a lot of sense of labeling it large intestine, but they do. And if you were to grab your fingers of one hand, say your right hand, and you were to reach into your thumb web of your left hand and pinch between those two fingers and circle around, there's a little tender spot there. And that spot is well known to be helpful for headaches and also it tends to help relax and help with your mood. So for what that's worth. There's also points on the ear I mentioned already for pain, but the ones for headache are, if you go to where an earring is placed, and you go up and a little to the out, there's a bump there, we call that the antitragus, and if you had your fingernail all along that bump, more from the back would be the back of the head, the middle would be the middle of the head, and the front would be the front of the head, and pressure there tends to help take care of headaches. And then, if you just need a little bit of tranquility, you can have a tranquility point, which is if you find where your earlobe attaches to your face, and right in that groove, you put your fingernail on the face, just barely on the face and less on the ear, and you can dig in with a fingernail, or dig in with a pen tip or pencil tip, and give it a good Circling motion for 10 to 30 seconds is meant to help you be more tranquil if you slide down and actually land on the earlobe, but on the side closer to the face and go up and down in a groove. That is the thinking too much area. So if I'm in the middle of the night and I get. you know, a song that goes round and round in my head, and I can't stop it, and I can't sleep, then I will pinch on that groove, and it really does help me sleep. Other sleep points are if you go to the out part of your ear, as far out as you can go, but not on the outer rim, just into that first groove, slide down to where the end of the groove is visible, and you put pressure right there, that's insomnia point one, slide up all the way up to almost where the edge of that groove broadens out, and that's insomnia point two.

Kerry:

Interesting. Yeah. So I've, I've heard of the, the thumb one. I can't, but yes, I've heard of that as a help with headaches. I should probably be using that more often cause I get migraines, but very interesting with the ear spots. I think is, you know, people are going to be pinching their ears in the middle of the night when they can't sleep. So that's fantastic. Obviously more than pinching, but so. You, you didn't really go into I guess like the difference, like you mentioned it's C bands or something. Is that how you associate this pressure type thing? And the other thing is you didn't mention how you can do this yourself, right, versus acupuncture. You kind of need an acupuncturist, but can you tell me a little bit about how they could do this, like at home? I mean, you kind of did, but

Victoria:

right, well, I'll get more into C BANs. So C BANs is like, whatever I do, I try to explain to the patients. This is the Western way of looking at this and what we know about it. And then this is the Eastern way of looking at it, which I tried to do during this podcast as well. So the only thing that Western medicine acknowledges for acupressure beyond the few people that read the acupuncture literature is that we all will tell our patients, Oh, Hey, there's these things called C bands. And if you have nausea from pregnancy, maybe it made and works well, but if you're going on a, you know, a cruise and you don't know how rocky the boat's going to be, or you just don't even know if you have sea sickness, you might wear these bands. And what they basically do is they put pressure Between your wrist crease and where your watch can slide down comfortably, again about three fingers down from the wrist crease, there's a spot between the tendon that if you make a kind of a Spider Man shoot web movement with your finger and you just simply curl all your fingers between those two tendons is a spot and it's called master of the heart. Which is sort of like pericardium and I don't know why,'cause that's usually over here, but this, it is what it is and that's what they call it. And this spot here is known for helping nausea. And so if you have seasickness or nausea, they have a band that's like a sports band and it has a little point in it and the point sits right there. And so Western Medicine acknowledges that one. The next thing, I

Kerry:

so my mom used to wear those C bands when we go on the, whatever, anything.

Victoria:

question? Oh, who can apply acupressure and who can apply acupuncture? Acupuncture has more risks, so if I were to fall into you because I tripped and you were to cough at the same time and the needle went straight in your chest, it could actually collapse your lungs. We don't generally intend to have that happen, and we're very careful about angling needles in the chest area. But just because of that and certain other areas of the body that come close to more critical nervous tissues and major arteries, we prefer that acupuncturists only apply needles. There's also a 1 per 1 million needles chance of infection and a doctor should know how to handle that complication should it occur. But pressure can be applied by nearly everyone. There's one big, huge exception, and that is if you are pregnant, a lot of the things that I just explained have an effect on labor and delivery and can cause an early pregnancy. Going into labor. So anyone who's pregnant thinks they might be pregnant should not be applying acupressure to themselves. They should be seeing an acupuncture trained physician who is specially trained in obstetrical aspects of acupuncture and or probably and getting permission from their obstetrician before undergoing any self applied pressure or acupuncture. Kids. Kids are hard to, you don't want to give them too much medicine, but you don't like to see them suffer, so there are acupressure points for the pain that I've already described, and parents can supervise the kids applying the acupressure to themselves, because it might be be misinterpreted as mommy you hurt if you put too much pressure on your child. So it's better to make it a game. So if the child is, you know, in a whiny state because, you know, they're sick or they're hurting and you want to help, but you don't want to give medicine, then it's one of those things where here's mommy. Mommy's going to do a nice firm pinch or maybe not use the word pinch. Lots of firm pressure here. I'm going to be really strong. How strong can I be right here? Look, here's teddy bear. Let's do it on teddy bear. Now you do it on you. And so Parents can talk their kids into it, and the older kids, it's fine, but you don't want kids running around with pencils and trying to poke their friends, so it should only be done under supervision.

Kerry:

Yeah. I mean, you answered two of my questions already, which was, who is it not good for and can, you know, can children benefit from it? So that's

Victoria:

Yeah. I would also add that if the skin is not normal in some way, that it's either going to interfere with it working, or it might create a potential for some skin damage, so if there's a burn, an open wound, or say some people's legs get really swollen from varicose vein related type problems. You don't want to be applying acupressure on those areas. There's a chance of ulcers or poor healing in those areas. If you were under the care of an acupuncturist, they could help you get less swollen legs or use other parts of the body to address the problems.

Kerry:

yeah, probably not a good idea to be doing it over like cellulitis or an infection or even lipidema because they're in a lot of pain as well. And then what about patients who, what about fibromyalgia and

Victoria:

Yeah. Fibromyalgia depends on the patient. It depends on the location of the acupressure point that you want to work with, because a lot of acupressure points are lined up here by the neck, but those are also classic areas of extreme tenderness for fibromyalgia. And with fibromyalgia, sometimes normal Touch can be painful touch, just depends on their person and their control. So on the other hand, fibromyalgia, there's a lot of sleep disturbance with fibromyalgia and pain. So if you can find a spot that's not that uncomfortable and maybe the ears would be a good candidate for that. And especially if you start with acupressure and you have the patient apply their own then they can get away with some. Aspects, but that would be something I wouldn't try to do yourself. That would be something I would do under supervision.

Kerry:

Okay. Can you tell me about different types of patients who may benefit from different types of acupressure.

Victoria:

Yeah, there are a lot of allergy and inflammation conditions, mast cell problems, chronic Lyme I would be treating the allergy and inflammation spot people with irritable bowel syndrome, irritable bladder syndrome, people with just kind of fatigue and aches and pains and just maybe not clinically diagnosed as depressed or anxious, but know themselves to be keyed up and less involved than they want to be. And just like, this is struggle. Those patients are really good and chronic pain, but it's going to take It's not going to take one visit to get better from chronic pain. It's going to, it took a long time to get the chronic pain, so it's typically 8 to 12, 14 visits, usually about twice a week, similar to the pattern you see with chiropractic, to get control of the pain to the more functional standpoint and then to keep the control going. It's going to be between once a month and once a quarter. And those folks do better if they maintain contact regularly with their acupuncturist. So at my clinic, we have a two tier pricing level to address that. So if you're already stable because you're under the care of a acupuncturist and you just need the chronic care, that's one level. But I do prefer to do an intensive evaluation for a new patient. And if you are new to acupuncture, then there's going to be a lot of explanation and a lot of work going on. So it's a different basic level.

Kerry:

Mhm. So we have a lot of allergy listeners. Can you just point out what that spot is?

Victoria:

Oh, yeah, that's a good point. So the allergy is the very tip, tip, tip top of the earlobe, right at the very top. You can grab it from underneath the curve and on top of the curve and apply pressure with both fingernails and go in a little circle. And this is a major point for allergy and inflammation,

Kerry:

Okay. So definitely a good idea to watch this one on YouTube. I think too, we'll have to mention

Victoria:

and then another famous spot, I'm going to say, which sounds left. Okay. L I 11 is if you take your index finger and trace down the side of your arm, that's on the thumb side and you land in your elbow groove at the end of the crease. You can see in the video right here. And this point is also very strong for the immune system, especially for like healing from colds and germs and things like that.

Kerry:

So how often are you supposed to do this if you're trying to help something at home?

Victoria:

I don't think that they have a published protocol for acupressure. So I'm like, I've done it for myself for my migraine pain instead of reaching for medicine. So I would say apply those special areas of the battlefield acupuncture and the headache points. And sometimes I would do a muscle relief point which is kind of hard to describe and that's just really better for somebody else to do for you. And sometimes the base of my head where those knobs are I'll put a little finger pressure there and again most of the time my medicines will wear off in the middle of the night and then I'll fall back asleep so it's hard to tell how long it lasts for but when I've done it during the day it's more like hours and less like minutes and it's more like hours than days. The exception being is if you get those little miniature pierced earring gold things on the ear, those will stay in your ear 24 7 for three to five days, depending on your risk for infection. The doctor may want them out earlier versus later. And they tend to provide relief the whole time they're in and for a little while afterwards. The more often you do it, like every two weeks, the more things stack and the longer lasting the relief is. So after a program of say every two weeks for six weeks, some people had months and months of relief.

Kerry:

awesome. so I guess some of the questions like what are the myths behind it? Does it really work? You know, is there any evidence like sometimes we talk about scientific evidence behind certain procedures and medications and all the stuff that we use in Western medicine? Is there anything like that for acupressure?

Victoria:

So we'll talk about eastern medicine perspective on that first, and in the eastern medicine perspective it was my master is a master of acupressure or acupuncture, and he is teaching me the protege. I dare not question him. And one day I will be the master and I'll have my own pro protege. And look at all these people in our town, they're doing better. And that's our small population study. And that's how that word would translate into Western medicine and research oriented people. So they had lots of small population studies, but acupuncture is designed to be individualized for each person, even down to the point of the person's personality. And the placebo effect makes it challenging to study in a way that satisfies Western Medicine evidence oriented physicians. So, the more strong you are about being insistent that it must be a double blinded, placebo controlled, population based Moving forward, I forget the word for that type study to say, yes, this works better than placebo, then the less you're likely to believe in the perspective. That's right. The less you're likely to believe in The true effectiveness of acupuncture to help this out. They've invented sham acupuncture, which is meant to help a patient thinks that they're getting acupuncture because it looks like a needle, but there's like a little soft tip and you feel the point of it, but it doesn't break the skin. It just kind of is sort of like applying small. acupressure and they have determined that real, the correct location with the needle acupuncture works better than sham acupuncture in the correct location, but that sham acupuncture in the correct location works better than sham acupuncture in an incorrect location and That strongly imagining that you have a effective acupuncture treatment does not work as well as a real acupuncture treatment in the real areas, but it still works to some extent, which is fascinating. So the more innovative or sharp or kind of scary a medical treatment is, the greater the placebo effect is. This is true for western and eastern medicine. So if you say to someone you've got pain in your knee, I'm going to give you a shot. And if all you do is prick the skin, but it looks like you're really giving them a shot, they're going to have a bigger effect than if you say, here's a rub. Okay even if the rub and the shot had no active ingredients. Fake shot. So this is true for acupuncture too, and it's hard to come up with, if we already know sham acupuncture works, then it's not a good placebo. But if we use No acupuncture versus acupuncture people are going to be very clearly understanding whether they're getting the real treatment or not, and they may drop out if they're not getting the real treatment, and if you have a study with a high dropout rate, then that's not good medicine either. So there's a lot of reasons it's hard to get good answers to is acupuncture scientifically valid? Like I was saying, there's personalities in Eastern medicine that you're treating as well. And that tells you what to treat. So I'm just going to use general American personalities that we all know and love so well. And in a sort of humorous way not meant to offend anybody, but if I was setting up a scientific experiment to find out if I can fix somebody's back pain with acupuncture, and I had a group of type A brown noser, climb the corporate ladder to executive types, and I had a group of slacker sit on the couch, watch TV types, and I had a group of Chad and Karen types they would all be treated differently, correctly with Eastern medicine. Western medicine says, no, no, no, no, no, you can't have that many variables. You have to have one variable. So pick one spot. And so that spot might be right for type A, but wrong for type B and Chad and Karen. And so the best that you can get out of that circumstances is 30 percent, even if it was 100 percent effective for that group. So then it looks like you didn't have a good result, and then people don't want to publish you. And the only people that want to publish you is if you're doing it your own way, and it shows effective, and then the Acupuncture is Awesome magazine wants to publish you because they already know that readers are going to be happy to hear that, and happy readers are people that look at advertisers favorably, so they will publish anything. So, then the evidence based people kind of look at those kind of magazines as though they don't even pay attention to that stuff. It's challenging to answer that question.

Kerry:

Okay. So in a little bit of a summary, there are no prospective double blind randomized control trials on this because you can't do it because you're saying there isn't a good control group, right?

Victoria:

I believe there are two randomized controlled trials with sham acupuncture showing benefit over sham acupuncture and that has to do with dental analgesia and nausea from chemotherapy. But those are just two limited circumstances. There's also Medicare acknowledges the amount of evidence that is behind treatment of chronic nonspecific back pain to the point that they have started to cover it in limited fashion. But that's, that's where we're at with trying to use evidence to prove a benefit to, to then create coverage in the insurance market for a service. Yeah,

Kerry:

Yeah. So the control group. If it were sham, acupuncture would work. So it's

Victoria:

extent, but

Kerry:

then placebo also works, but the location, I think you were saying really matters, right? Where they're getting the,

Victoria:

But again, so the placebo effect would be in effect if you were using sham acupuncture at the wrong location. And acupressure effect would be in effect if you were using sham acupuncture in the right location. And acupuncture effect would be if you were using acupuncture in the right location. Sometimes you need big differences to prove a difference. Each of these are smaller differences potentially, but some of them came out to be big enough to be what they call clinically significant with a P value less than 0.5. And those are the ones that everybody is excited about. But acupuncture literature, the more scientific ones of them that don't have the advertisers they publish research that's of a level that. It isn't as published in JAMA, but might still be published in other scientific magazines with a little, Ooh, more research is needed. And that's what mostly you get out of even the JAMA articles. So yeah, so

Kerry:

obviously you are a big proponent of personalized medicine. And I think maybe that's where we're going. You'd be very interested to Listen to a podcast that I would listen to recently by with Nick Norowitz. I can't remember who the podcast was with though, but he's basically saying that randomized controlled trials are dead. And he's very in the metabolic and nutrition space. And because everybody is so different in their, you know, nutritional standpoints and how we react to certain things. So he has, he has this great little argument about how like RCTs are dead. You might, you might want to check that out. If I can find where I listened to that, I'll put it in the show notes for the listeners as well. But like I mentioned, you have personalized care. So why don't you tell us a little bit about your practice and where people can find you?

Victoria:

my practice is called West East Primary Care and Acupuncture. We're located adjacent to 54, Route 54 in Pascoe, halfway between Gunn Highway and either, you can call it the Veterans up to that point, or the Suncoast from north heading south. And so we're fairly convenient to a number of communities up on that border between Hillsborough and Pascoe. And if you're really motivated, you can drive further from places like Land O'Lakes, Wesley Chapel. Tarpon Springs, and down into Carolwood and I live out that way, it's not too bad of a drive, 20, 30 minutes, just depends on what you're looking for. And so what I did is, mine is a membership model practice, so that you can have what I call All You Can Health Buffet, slightly different than Concierge, where you had a podcast about a month ago. I would call Concierge All You Can Health Buffet at a resort. And some things are extra like, you know, the pool boy and the masseuse. And I'm more like, oh, you can health buffet at your favorite restaurant that has stuff that's on the buffet and stuff that's on the menu. And that's how we do our health delivery. And it's a direct contract between me and the patient. The only boss I have is the patient. The insurance company is not my boss. Some big box company is not my boss. It's the patient at the center. Some people value that, and if they do, then a membership model is really good for you, because if you need to come in frequently because you have complex conditions or you're trying to get control of pain, then Knowing that you don't have to have a co pay every single time, but you already took care of it with your monthly membership, knowing that the doctor has enough time to really listen, focus in on what you're actually doing, think through things, do the testing that normally in a current model primary care practice, a lot of times people have crunch time, 8 to 15 minutes. They don't have time to think through things like My husband was referred off to a foot doctor for gout, and I went to family practice school. We know how to take care of gout. Why would you refer someone? Two reasons. One, you don't have time. Two, your company says sending him to the gout doctor, whether it's a rheumatologist or the podiatrist, they charge more. And even if the insurance cuts our pay down by half, we'll get more than if the family practice doctor took care of it. And so. With me, all that stuff is not an issue. It's all about what the patient needs. And from my particular standpoint, kind of unique in Tampa Bay, I look at it from the western medicine standpoint, the eastern medicine standpoint, and both of those do a lot of preventive care and lifestyle medicine.

Kerry:

That's, I mean, I think it's a perfect blend of practice. Obviously you understand the problems that are going on with our country, with insurance and things

Victoria:

Right, and my

Kerry:

I don't think you have to get into more detail on that, but I'm, you know, in agreement, it's an

Victoria:

there's more information on my website, which is www w dash e primary care. All that runs into one word.com and my phone number, I do give my phone number out to my patients so they can text and call me is(813) 553-1880.

Kerry:

Perfect. Is there anything else you'd like to share with the audience before we close up?

Victoria:

I really can't think of too much. We covered most of it. I just hope that everyone will begin to work on lifestyle medicine because that's what helps chronic disease and our country is trending ever more towards chronic disease. The more that we wake up and take care of our lifestyle, which you can do better with an extended visit primary care visit than almost anywhere else. The more happy, healthier, likely to be into your older years.

Kerry:

Very true. Very true. Well, thank you so much for being a guest. Thank you for sharing your expertise on acupressure and acupuncture. And we'll put all your information in the show notes and everybody just tuned in next week for our next episode. And thank you so much for listening.

Victoria:

Thank you so much, Dr. Reller.

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Dr. Kerry Reller

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