FAQs

Here are some common questions about Patterns & Pathways Acupuncture.

Getting
Started

How is my price determined?

My prices reflect my ability to achieve outstanding results for my clients, and the dozen years I’ve studied and worked in my field. My services are truly unique due to my experience, training, and lifelong pursuit of personal cultivation and professional development.

Do you have an office?

I am currently looking to rent a clinic space in or around Redwood City, CA.

I can deliver treatment at your location by appointment only. See Services Offered: Home Visit Acupuncture for more information.

How can I book an appointment?

The first step in the process is for us to consult briefly to determine if Patterns & Pathways Acupuncture is a good match for your heath concerns at this time. To book your free 30-minute consultation, click here.

Alternatively, you can click on the Services page and select the desired service from there.

How can I pay?

I gladly accept cash, check, major credit cards, and PayPal.

Is there paperwork involved?

There is a little paperwork. Please spend enough time with this preliminary step to thoughtfully complete it before our  first visit. Your responses help me to diagnose and treat you. Thanks for your cooperation with this.

Procedure

Does acupuncture hurt?

For most patients, acupuncture doesn’t really hurt in a significant way. However I am a little reluctant to say that it flat-out does not hurt. Let’s put this needling-pain issue into perspective.

Why can I not promise an entirely pain-free modality with acupuncture? The biggest reason is that different patients have different tolerances to pain. On one end of the spectrum, we have the patient who will never feel even a single needle insertion. On the other end of the spectrum, we have the patient who is so sensitive to needling that they will yelp and jerk with every insertion and will ask me to keep the treatment protocol to a single-needle treatment. These are, of course, the extreme cases and most everybody can tolerate acupuncture treatment with little or no problem at all.

Another reason has to do with the choice of points the practitioner makes. Some points are, by their very nature and location, more sensitive than others. Often the points nearer to areas of greater nerve innervation are more effective than those farther away from areas of nerve innervation. We generally want to choose the most effective acupuncture protocols to render the biggest positive change in your symptoms and condition.

Needle insertion pain with an acupuncture needle is usually much less than we would at first expect. The needles used in our clinic range from 44 gauge (thinnest) to about 28 gauge (thickest). They are very, very thin and because acupuncture needles are filiform in nature (i.e. they do not include an injection hole) they are very comfortable and do not cause nearly as much tissue damage as even a blood draw could.

Needle insertion, if it produces a pain at all, usually only produces a temporary pain of 5-10 seconds duration at the level of an insect bite. Patients have described this to me as a “pinch” or a “zing” which is very short-lived. It is generally very do-able and most patients agree that the potential benefits of treatment are worth any slight discomfort you may experience.

If at any time during your acupuncture experience you should feel a sharp, searing, or electrical pain which dies not resolve after a minute or two, let the practitioner know so the needle can be adjusted or retracted. We would never expect you to live with a pain that was intense or progressive in nature due to an acupuncture needle. This usually means that the needle got too close to or struck a nerve.

Some things that you may feel with acupuncture treatment are actually desired outcomes of needling. The sensation we refer to as “de qi” can be described as a dull, achy or distended feeling. This means that we really hit the acupuncture point and we can expect the desired acupuncture effect to follow. If you can live with it, try to go with it and chances are that it will decrease or fluctuate up and down during the treatment session.

Patients may feel other sensations during treatment as well. These may include “activation” of acupuncture points, vibrations or waves of energy, heat or coolness, and perhaps even little pains that turn on then off again within a short period of time. All of these responses to needling are normal. Again, if it is something that you can live with for the duration of your treatment then please do so. Otherwise, let Dr. Scott know and your comfort needs will be attended to immediately.

What can I expect on my first visit?

If you need to use the restroom it is best to do that before we start the evaluation and treatment. This session is an opportunity for you to express your health concerns confidentially and for Dr. Scott to gather the information he will need to diagnose and treat you. He will ask questions specific to your chief complaint and general questions pertaining to your health status in a review of systems.

Next, you will move to the treatment table. Please remove your socks and shoes (or other articles of clothing which may impede his ability to deliver acupuncture treatment). Unless otherwise specified, Dr. Scott will ask you to lay in a supine position (face-up) on the treatment table. He will help you get comfortable in this position.

During the exam, Dr. Scott will observe you, take your pulse (at the radial wrist), ask you to stick out your tongue, perhaps press on your abdomen or in other areas, and ask you to point to or otherwise indicate the affected area(s) of your body.

Occasionally (but far less frequently) he will ask that you get on the table in a prone position (face-down). For those who cannot lie in these positions we may be able to deliver the treatment with you seated in a chair or while laying on your side. In any case, your comfort level and Dr. Scott’s ability to deliver the treatment are the critical considerations.

Once you are comfortably arranged on the treatment table, Dr. Scott will swab your acupuncture sites with 70% isopropyl alcohol in order to create a clean surface for needle puncture. Once it dries, he will insert the acupuncture needles. Once the needles are in place and you are comfortable, Dr. Scott will step away and let you rest on the table for a minimum of 30 minutes with needles retained. This is your opportunity to relax and heal. Dr. Scott will check in on you to ensure your comfort level about halfway through.

At the end of the treatment session, Scott will retrieve the needles and stop any bleeding that may have resulted from the acupuncture. He will give you an opportunity to get dressed and to gather yourself in privacy. Then if he has herbs, supplements or other products prescribed for you he will give them to you at this time, He may give you specific instructions on how to proceed. He will ring you up for the services and products received. Lastly, he will reschedule you if you don’t already have follow-up appointments scheduled in advance.

How should I prepare for my acupuncture session?

There are some things you can do to set yourself up for success with acupuncture and Chinese medicine treatment. There are some things you should avoid as well. I will present to you here the top “do’s & don’ts” for your consideration.

DO:

  • Avoid caffeine on the morning of your appointment
  • Wear loose-fitting clothing whenever possible
  • Please urinate before the treatment begins
  • Be prepared to relax during the treatment
  • Turn off your cell phone
  • Call with 24-hours notice of cancellation or reschedule

DO NOT:

  • Wear fragrances, perfumes, colognes, essential oils, etc.
  • Attempt to multitask on the treatment table.
  • Consume caffeine, alcohol, or other toxic substances the day of your treatment
  • Move the body parts during treatment which have needles retained in them
What should I do after my acupuncture session?
  • Try to take it easy and avoid stresses whenever possible
  • Do not swim or bathe for one hour following acupuncture treatment
  • Try to avoid over-exertions on the day of your treatment
  • Avoid exacerbating your symptoms if at all possible while away from the clinic
  • Take steps to modify your lifestyle in order to support the healing process
  • Eat well, drink enough water, and get enough rest every day
  • If you are prescribed herbs, shoot for consistency in taking them
  • Please follow the recommended frequency of treatment
Will acupuncture actually work for my condition?

The efficacy of acupuncture depends upon a few factors, which are unique to each individual case. As practitioners of acupuncture and Chinese medicine we say, “the treatment is the diagnosis.” This means that we give the patient a few treatments and then we know a lot more about prognosis given the patient’s response to treatment. The five most important factors as to whether any given patient will get well with acupuncture and Chinese medicine are as follows:

  1. What is the difference between your lowest pain level and your highest? Stable symptoms are harder to change than fluctuating ones.
  2. How responsive are the symptoms to acupuncture and Chinese medicine treatment? Some conditions simply don’t respond to acupuncture treatment.
  3. What is the self-healing capacity of the patient – how healthy are you in the first place? This will in part determine how quickly and how completely you can heal with acupuncture.
  4. What is the patient’s age? As we get older, our self-healing capacity diminishes.
  5. How long have the symptoms been in place? The longer they have been around, the harder they are to change.
  6. How many dietary or lifestyle factors in the patient’s life will inhibit progress in the acupuncture clinic? It’s easy to undo the work we accomplish in the acupuncture clinic when you make choices that exacerbate or prolong your symptoms.
  7. Are you engaged in a proper frequency of treatment? The more frequent, the better. (See below)

Because acupuncture therapy engages the self-healing capacity of each patient and everyone has different levels of general health, the rates at which people heal with acupuncture vary greatly. What patients do either for or against the efforts of the acupuncturist also matter to the outcome of treatment. Generally speaking, the more severe or long-lived the symptoms, the more therapy it will take to change them. Lastly, haphazard or infrequent treatment will not often render good results.

This helps to explain the outcome is not entirely dependent upon the condition or disease. In the case of sciatica for example we could have  “Patient A” who will will heal completely, “Patient B” who only partially heals and “Patient C” who doesn’t heal at all. All of the above five factors play a role in the outcome of acupuncture and Chinese medicine treatment.

Acupuncture is an amazing and safe natural medicine modality but it is not supernatural. It utilizes your own self-healing capacity, so if your medical problem is something that your body just is not capable of healing, it may not with acupuncture treatment.

While there is no guarantee of a result, a large percentage of our patients report significant health benefits following a course of  acupuncture treatment.

Is there anything that can enhance or hinder my progress?

Actually, there are quite a few things that could be working against your success with acupuncture and Chinese medicine. Below is a partial list of inhibitors to the processes of self-healing. As the patient engaged in these behaviors, it is up to you to decide whether or not you will change these or not. This list is for your education only – I am not saying you should stop any one or all of these. I would, however, ask that you think critically about which of these (or perhaps other) factors are inhibiting your healing. Believe it or not – you have the power to change your behaviors. If you need support, just ask! Dr. Scott here to help you achieve your health goals.

INHIBITORS TO SELF-HEALING:

  • Smoking and tobacco use
  • Use of recreational drugs, caffeine and alcohol
  • Use of opioid drugs (i.e. morphine)
  • Use of prednisone (a steroidal anti-inflammatory drug)
  • Poor diet (this could be inadequate nutrition & hydration, excessive caloric intake, poor choice of food, or all of them)
  • Stress that is uncontrolled or poorly managed
  • Certain mental / emotional disorders
  • Lack of cardiovascular exercise
  • Over-exercise or over-exertion leading to re-injury and/or exacerbation of symptoms
  • Obesity
  • Lack of a proper frequency of treatment

TO INCREASE YOUR CHANCES OF SUCCESS:

  • Meditate, mindfulness, deep breathing, etc.
  • Exercise, stretch, move (but not to the point of pain)
  • Eat well and stay properly hydrated
  • Manage your stress
  • Lessen the impact of your lifestyle on your symptoms
  • Commit to a complete course of treatment with frequent treatment sessions
What outcomes are possible?

There are three possible outcomes from treatment. The first outcome is that the patient does not perceive any shift in the symptoms or condition. This commonly occurs in about 30% of the patient population following the first few acupuncture treatments. This is not something to be worried about – acupuncture is a therapy and by definition, we must deliver a number of treatments in order to enact the result. Be a little patient with this process, we will need to build-up an accumulation of effect over time.

The second outcome is that you do feel better for some amount of time. This doesn’t always mean that your symptoms disappear completely (although that can happen). You may have relief for some number of hours or days but then your symptoms may return at some point. This is progress and about 60% of the patient population will experience this outcome after the first few treatments.

Some small percentage of patients (about 10%) will experience an unfortunate increase in their symptom level following treatment. This increase is usually short lived (typically lasting 24-48 hours). If this happens, try to take it easy and follow-up with the Acupuncturist as soon as possible. This is a normal response to acupuncture and expected in some cases but we are unable to predict in advance who or when this outcome will occur. In terms of prognosis, this is actually a good sing, showing that the chief complaint is being “activated” by the treatment. Don’t allow this outcome to deter you from future treatment as it can be a natural part of the healing process.

Another outcome which can combine with the three above is experiencing significant fatigue or sleepiness following a treatment. This is, again, your body’s attempt to assimilate the acupuncture and to heal itself. Please try to allow for this eventuality in your schedule.

The good news is that for those who respond to acupuncture, it takes a relatively short amount of time (in terms of number of sessions) to achieve 50-80% improvement in a condition. If the patient is responding to treatment, I would expect to achieve this result within 5-10 sessions of acupuncture.

Conversely, it often takes a long time or a lot of treatment to get the last 20% of a chronic condition resolved. If a patient reaches even 80% improvement in the short course, I do not think that another short course will typically resolve that last 20%. If the patient has a chronic condition and has a goal to reach 100% improvement in their condition, they must accept that they are in for a long course of treatment which could last months or years.

What kind of relief can I expect?

We know that patients seek acupuncture and Chinese medicine to achieve some relief. As a practitioner of Chinese medicine, I exist to quell the suffering of my patients. The relief you will experience from treatment falls into three broad categories:

Cumulative Relief: This type of relief is seen in most patients. This usually includes some relief following each treatment session and major or complete relief after several treatments. Because this is the type of relief we see so commonly in patients, it is necessary to engage in a proper frequency of treatment in order to harness this effect. Please see the question, “How often should I receive Treatment?” below.

Immediate Relief: This type of relief is expected in young, healthy patients with relatively simple and short-lived symptoms and conditions. Those with great self-healing capacity have a chance of experiencing this type of relief. This could look like the patient who comes in for their first treatment and walks out of the clinic with 80% or more improvement and a complete resolve after a very few number of sessions. This is not the most common form of relief.

Delayed Relief: This is an odd one but it does happen from time to time. The patient may receive some number of treatments with no perceptible effect on their symptoms or condition. Then, abruptly there is a great change in the symptoms for the better. This delay may occur days or even weeks following a treatment or a course of treatment. I have personally had several patients who reported 0% improvement during a short course of acupuncture later report complete relief after a couple of weeks of no treatment, so I know from experience that this can happen.

How often should I receive treatment?

The standard of care for acupuncture treatment of chronic pain in Chinese hospitals is daily treatment or every-other day treatment but not less frequent than every-other day. For in-patients in the Chinese hospital, acupuncture may be administered up to three times per day. Clearly, the standard is for very frequent treatment. At some point in the history of our profession in the United States, somebody decided that once per week was the standard frequency of treatment. As illustrated above, there is no medical precedent for this approach.

I will strongly urge each patient to take the issue of frequency of treatment very seriously as this is a very important factor that may very well determine whether one gets well with acupuncture and Chinese medicine. Usually acupuncture therapy is cumulative in nature – that is that with each treatment we build up an effect. If we prevent you from “backsliding” too much into your symptoms while you are away from the clinic, then we can achieve more success with each consecutive treatment. Controlling the frequency of treatment is the best way (in combination with lifestyle modification) patients can empower themselves toward success.

At the beginning of the course of treatment, 2-3 treatments per week is recommended and the first 3 sessions should be booked within a 7-9 day timeframe. This will allow us to “spark” your own body’s healing capacity. After a few weeks of this frequency, we can drop to 1-2 per week. Then after more time has passed and if the results of treatment confirm this, then we can drop the frequency to 1 treatment per week. Eventually we can go to one treatment every two weeks or even once per month for maintenance purposes.

How does acupuncture work?

In plain English, acupuncture works to stimulate a self-healing response from the patient. Acupuncture works to cause the body to heal from the inside-out, which is quite distinct from the outside-in approach found in the biomedicine (Western) setting. So, the goal of therapy is to cause your body to improve its healing capacity by 10-20% so that it can heal your condition naturally.

If this is a medical condition that you have not had very long and you have otherwise good health, then the chances are good that you will notice a change within a short course of treatments, usually 5-6 sessions. If you have had the condition for longer or you have multiple factors working against your self healing capacity, it could take longer to start to feel a benefit, more like 8-10 sessions.

The Chinese postulate that there are points on a human body that are physiologically dynamic in nature, that is to say, that when the point is stimulated it produces effects locally and elsewhere. The ancient Chinese have written records of the descriptions of these acupoints that date back 2200 years or more. In order to explain the actions and functions of the acupoints, they described in great detail a complicated system of meridians or channels.

There are 12+2 main channels, 8 extraordinary channels, and many adjunct channels associated with each of the 12 main channels making for a very complex system or network. Now, when you dissect a human being can you find evidence of a structure called a channel? No one has so far. Nevertheless, because this model of channels behaves as if it were there, we consider it a working model despite our inability to observe it directly with current scientific equipment.

We certainly can measure the effects of using acupuncture on real patients and many such studies exist today. These acupoints are arranged upon, or rather connected by the channels themselves. The channels also delve deep into the body to connect with internal organs and in fact, all the tissues and cells in a body. The channels are not nerves, although around 200 or so of the “standard” acupoints lie directly over “C” nerve trunks (the “C” indicates a particular thickness of afferent nerve fiber).

The Chinese state that these channels contain a substance known as “qi” (also spelled “chi” and is pronounced “chee”). This substance has been mistranslated as “vital energy.” Scholars of Chinese medicine think of it as a highly-rarified form of matter that happens to be energetic in nature. I have heard it said that perhaps qi could be thought of as oxygenated blood. In any case, qi flows through the channels and it’s counterpart in the human body is blood which flows through the vessels. The qi and blood have a significant influence upon each other. There are many statements from our classic texts which illustrate this close connection, but three useful ones here are:

  • “Blood is the mother of Qi” (meaning that blood is the substance which nourishes and fuels the qi).
  • “Qi is able to move blood” & “If the qi moves, the blood moves” (implying that it’s the qi that moves the blood).

So far, we have discovered that there is qi in the channels and this qi causes the blood to flow in the vessels. When the qi and blood is getting everywhere in the body, nourishing all organs, tissues and cells of the body, we have a picture of health. By extension of logic, it is thought that qi is akin to Yang and blood is akin to Yin in the Yin/Yang system of classification in Chinese philosophical thought. Why? Qi is active, light, it moves upward and therefore when compared to blood it has more Yang qualities. Similarly, blood is heavy, moist, dense, dark (in color) and therefore more Yin when compared to qi.

Ultimately, the blood and qi of a human being represent that human being’s Yin and Yang in terms of physiology. Yin and Yang are not static dualistic picture – it is a dynamic idea. Yin and or Yang can become deficient or excess and what happens to one causes the inverse in the other. It is thought that one always has Yin with Yang and when they separate, there is the death of the human being. It is rare to see Yin and Yang perfectly in balance like in the perfectly symmetrical picture that is so commonly seen. The goal of Chinese medicine is to bring the Yin and Yang of the human body-mind-emotions back into balance so that a person experiences self-healing.

When an obstruction in the flow of qi and blood occurs, a symptom or disease develops. An obstruction of qi & blood may occur instantaneously as in the case of trauma due to being hit my a car. Or, the obstruction may build up over a lifetime and manifest as a symptom or condition only after several decades of undetectable progression. Regardless of what is causing the obstruction, the statement of fact in Chinese medicine theory is, “when there is an obstruction, there is pain; when there is no obstruction, there is no pain.” Therefore, we Acupuncturists are “blockage-breakers extrordinaire.”

According to Chinese medicine theory, this is in a nutshell how acupuncture works. The patient has a blockage somewhere and the Acupuncturist must determine which channel or channels are affected. The Acupuncturist will then insert a needle somewhere else on your body to stimulate the qi and blood to flow to the area of obstruction. Once the increased qi and blood arrives at the site of obstruction, an attempt to break up the blockage is made. Once the obstruction of qi and/or blood is removed, the symptom is relieved.

Science has something to say about how acupuncture works as well. When the acupuncturist inserts a needle into a body, that body responds with a biochemical cascade of events (10 or more events long) which is quite complicated. The result is relief for the symptom. But why does that work?

When a needle is inserted into someone, there are two distinct mechanisms which come into play. The first is the Central Mechanism and involves the brain’s response to acupuncture. The stimulus of  “micro-traumas” being created with the insertion of needles causes the brain to activate the principle survival mechanism of the body. There are changes in the nervous system, hormones are released and regulated in the endocrine system. Blood flow increases and a mobilization of immune cells occurs. These are effects that take place systemically, so the whole body is affected.

There is also a local effect at the site of needling and this is referred to as the Peripheral Mechanism. Around the needle, the peripheral nerves will release endorphins, the body’s natural pain killer which is very similar (chemically speaking) to opioid drugs. This has the effect of desensitizing the area to pain. More blood arrives at the needling site and with it, more immune cells (white blood cells) and this leads to more rapid and thorough healing to the tissues nearby.

Some scientists are tempted to think that because of the above facts regarding the Central and Peripheral Mechanisms, that acupuncture does not in fact treat any particular pathological symptom but rather normalizes physiological homeostasis to promote self-healing. In fact, we do often see clinically that when treating condition “A” with acupuncture, conditions “B” and “C” improve as well.

Looking at it from my experienced perspective, I think to say that acupuncture does not treat any particular pathological condition is an oversimplification. The statement certainly contains truth on some level but having been trained in Traditional Chinese Medicine I do not just pick points randomly to cause a change in homeostasis. Most Acupuncturists I have ever known or studied with will try to find the most effective points for any condition, affected channel, affected organ or affected body part that they can. There’s a reason it’s called acupuncture and not “random puncture.”

However there is a crossover of ideology here and Chinese medicine is not mutually exclusive to science. When a scientist says “restoring physiological homeostasis,” he means exactly what the ancient Chinese physician meant when he said “balance Yin and Yang.” The practitioner of Chinese medicine using acupuncture attempt to view a patient’s condition or disease as analogous to a tree. It has a ben or root and it has a biao or branch.

The root is thought of as the underlying constitutional cause (or holding pattern) of the condition or disease. The branch or branches are the signs and symptoms of the condition or disease. This could equate to the scientific idea that with acupuncture there is a Central Mechanism – or an approach to treating the whole body (the root) and there is the Peripheral Mechanism aimed at the local problem (the branch). In Chinese medicine we always treat both the root and the branch so that the patient can experience relief and can also heal on a deep level.

Still need help? Send me a note!

For any other questions, please write me at patternspathways@gmail.com

 

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