Melanie Cole, MS (Host): Discovering acupuncture, pain relief, and holistic healing, learn how acupuncture can alleviate pain and enhance well-being today on Bryan Health Podcast. I'm Melanie Cole. And joining me is Betsy DeGrandi. She's a licensed acupuncturist at April Sampson Cancer Center. Betsy, thank you so much for joining us today. Can you tell the listeners to begin what acupuncture really is and how it works?

Betsy DeGrandi: Acupuncture is an ancient therapy. It's about 2,000 years old, but it has a lot of modern applications. And there's a lot of different ways that acupuncture works. There's a couple different systems. Most people know acupuncture that it treats pain management, and that's one system as far as the physiology of the science behind it. So, if somebody comes in for pain, it can be acute pain, chronic pain, degenerative pain, autoimmune pain, it decreases muscle tightness, decreases inflammation, increases blood flow, increases endorphins, and then it can block sensory nerve pain to the brain.

And how it does that is most of the acupuncture needles go into the belly of a muscle called the motor point. And when you put a needle in a motor point, the muscle fibers pull away from the needle. And when they pull away from the needle, that elicits a relaxation response. And as long as that needle sits there, that muscle is relaxed. So, we re-pattern that muscle at a deep level. And then, all those changes I just described happen while the needle is in retention for about 20 minutes.

There is another system called the auricular system, which is in the ear, and that's a little bit different. That taps into the part of the brain that controls the alert system. That's also called battlefield acupuncture. The VA system, the veterans have been using that at the hospital for about 30 years, and that's great for anxiety, depression, and PTSD. Both these systems can be standalone or add-on and can be used with Western medicine therapy.

Melanie Cole, MS: That was an excellent explanation of Eastern medicine backed by Western clinical trials. You really explained that very well. So, tell us a little bit about the issues. You mentioned pain relief and you work at the April Sampson Cancer Center. Tell us about some of the issues, conditions, disorders that you've seen acupuncture really work well for.

Betsy DeGrandi: Like I said, pain management, but we also treat what's called systemic. So, what that means is I can treat different parts of the body. I treat fatigue, I treat insomnia, I treat allergies, I treat GI conditions, mental health, anxiety, depression, PTSD, like I mentioned. You can also do substance, tobacco, and alcohol dependence.

As far as cancer patients, though, I'm supportive care. So, acupuncture is very good at helping deal with the side effects of chemo and radiation, and it can decrease the toxicity of the chemotherapy. It's great for nausea, vomiting, energy. It can increase appetite. And many acupuncturists are in cancer hospitals. They've been in cancer hospitals for about 25 years. Sometimes we go into the infusion room and if you do acupuncture at the same time that the patient's having an infusion, you can really help with the neuropathy. Clinically, there's been many, many, many studies with neuropathy, that it can kind of get ahead of it used as a preventative or decrease dramatically the side effects of neuropathy. So, that would be the cancer patients directly, and obviously any pain issues that they're having. But we are open to the public, so I treat cancer patients, I treat athletes, I treat seniors, we are going to start seeing the veterans here. I'm getting credential with Optum, so soon we'll have the veterans coming in. And so, a lot of different things. I mean, the list really goes on and on. And like I said, it can be a stand-alone treatment for certain conditions, but it can be an add-on with Western medicine.

Melanie Cole, MS: So, the main question here, I think the million dollar question that everybody listening who's never done acupuncture, who wants to know about it, who wants to see if it's something for them, they want to know what to expect in an appointment and, Betsy, they want to know if it hurts. I mean, it's needles, right? You've heard this question a million times, and I'm an exercise physiologist and I've heard the question a million times. So, do the needles hurt? Tell us a little bit about that.

Betsy DeGrandi: They do not hurt. The needles are not needles in the true sense. They're thin, sterile wire, one time use. If people know gauges, they're 36, 40-gauge, which is tiny. A typical treatment is about 25 needles. And most of my patients don't feel any of them. It's a sensation, but it's definitely not painful. So, a patient comes in, we have 25-minute sessions, we have 50, we have 80. A standard is a 50-minute session. And a patient comes in, it's a very relaxing room, heated table, nice music. We go over obviously their history, symptomatology. I can do a one-system, I can do a multi-system. That's the other great thing with acupuncture, I can treat several things at the same time, but it's very relaxing. A lot of the treatments are face down, depends on what I'm treating. Most of my patients fall asleep. So, I put the needles in, I stay in the room or some patients, I just check on them every couple minutes. Most of the time, I come back in and my patients are asleep.

Needle retention time is about 20 to 25 minutes. Clinically, scientifically, that range is the therapeutic timeframe for the best tissue change and the best dopamine release. I mean, one of main benefits to acupuncture regardless of what kind of treatment I'm doing, it kicks up the body's dopamine, serotonin, and melatonin. And then, it re-patterns the body to keep doing that on its own.

Melanie Cole, MS: Isn't that a fascinating field that you're in? And I imagine it's been so rewarding. For people that are interested in doing this, do they need a physician referral? How can someone get an appointment, Betsy?

Betsy DeGrandi: Physician's referral, we do need that for all cancer patients, because I need to be in correspondence with the physician where they are in their treatment. Some doctors like me to do the treatment during their treatment, maybe after a series of treatments. So yes, cancer patients need a physician's referral. So, insurance patients need a physician's referral. Cash-paying patients do not. They can book on our website, which is bryanhealth.org/spa. They can also call us directly, 402-481-7973. They can also book through our software on Epic. They can obviously walk in and book an appointment.

Melanie Cole, MS: Betsy, what about insurance? Does this recognize acupuncture if you're a cancer patient? And as you've said, it can help with neuropathy. It can help during infusions. It can really help with some of those toxic side effects. Is this something that insurance recognizes?

Betsy DeGrandi: Yes, it does. I moved here from Idaho. And Idaho, we're at about 80% with insurance covering acupuncture. Nebraska's about 50-60%. Many patients have acupuncture benefits and they don't even know they have the benefits. So, what we recommend when a patient comes in, I always say, "You know what? Just check your benefits. Call your insurance company. Ask them if they have acupuncture benefits and how many visits they have." And the VA system, they send me referrals. So, the veterans have to be pre-authorized at the VA hospital and then they send them to me.

Now, the good news is Medicare, as of right now, the bill has passed, but it hasn't been activated. So, in the next year or two, Medicare will be covering acupuncture. Some of the Advantage programs and supplementals of Medicare do cover acupuncture. Again, you need to contact your insurance company and ask.

Melanie Cole, MS: This has been such a great episode and so informative. Betsy, please summarize for us, wrap up what you would like listeners to take away from this episode on acupuncture and why it's such an important part of a whole body wellness.

Betsy DeGrandi: Acupuncture can do many, many things. And like I said, there's a lot of science backing up acupuncture, how it works. They now know with MRIs and CAT scans and Doppler studies and measuring blood levels that it does make a tissue change in the body. And acupuncture, once the patient makes that change, it continues the change. So, acupuncture, in conclusion, stimulates blood flow, decreases inflammation, initiates tissue repair, relaxes the muscles, blocks sensory nerve pain to the brain, kind of reboots the autonomic nervous system, releases endorphins, breaks up scar tissue. And again, a lot of my patients, they might see a physical therapist and me the same day. So, it can be a stand-alone treatment. I've worked with Western practitioners for over 25 years. Many therapies can work together. It can be used as an acute episode, sprained ankle, or as a preventative. I have patients that come in once a month just to stay ahead of, you know, any muscle tightness. Fantastic for stress, so it's a good maintenance for stress also.

Melanie Cole, MS: Great information. Betsy, thank you so much for joining us today and sharing your incredible expertise on a topic that not everybody understands, but they always have questions about it. So, thank you again. And that concludes this episode of Bryan Health Podcast. For more information or to book an appointment, please call 402-481-7973 or you can book online at bryanhealth.org/spa. Please always remember to subscribe, rate, and review Bryan Health Podcast on Apple Podcasts, Spotify, iHeart, and Pandora. I'm Melanie Cole. Thanks so much for joining us today.