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11/16/2009 6:00:00 AM
Doc sticks it to pain management patients
Acupuncture works well when coupled with traditional treatments, Yang says
Courtesy
Dr. Stevens Yang, a pain management specialist at KRMC, inserts needles around a patient's ear in a process called auricular therapy, which can be used as a form of detox and is often used to help people quit smoking.
Courtesy

Dr. Stevens Yang, a pain management specialist at KRMC, inserts needles around a patient's ear in a process called auricular therapy, which can be used as a form of detox and is often used to help people quit smoking.

Erin Taylor
Miner Staff Reporter


KINGMAN - When Dr. Albert Yeh's Golden Valley pain management clinic was raided by the Drug Enforcement Agency in February, the pain management center at Kingman Regional Medical Center was flooded with patients.

Yeh is accused of improperly prescribing narcotics. His displaced patients, many reportedly with an addiction to opiates, came to KRMC hoping to refill their prescriptions and continue using narcotics.

But Dr. Stevens Yang, a trained anesthesiologist specializing in acupuncture, is hoping to offer patients an alternative to more pills.

"We can only manage the pain," Yang said. "If someone truly has chronic pain, like fibromyalgia, there is really no treatment. But we don't want to just give someone a pill and have them walk out with an opiate addiction on top of their condition."

Yang believes that acupuncture, one of the oldest forms of Chinese medicine, can help. When coupled with other more traditional treatments, acupuncture seems to have a noticeable effect on pain, Yang said.

"A lot of patients have already tried everything from other pain management clinics that didn't work," he said.

Acupuncture therapy involves a series of weekly or biweekly treatments during which an average of five to eight ultra-thin, disposable needles are inserted along the body's meridians. Meridians are channels through which energy, called "qi," flows.

It is believed that stress, trauma, illness and other conditions disrupt that flow of energy along the meridians. That disruption ends up manifesting itself as pain, Yang said. Acupuncture focuses on treating the whole body by identifying and correcting the body's energy flow imbalance, he said.

"Once the energy is restored, the symptoms usually go away," Yang said.

The practice of acupuncture as a healing art has been used in Chinese medicine for more than 2,500 years. Yang said that there is recent evidence that the insertion of the needles helps stimulate the body to produce more endorphins, although there have been few studies done to quantify acupuncture's effectiveness.

It's also not guaranteed to work for everyone, which is why the only way to find out is to try it, Yang said. And because it's considered an alternative therapy, it isn't always covered by insurance policies. Acupuncture costs around $60 per session.

There are few dangers associated with acupuncture, although pregnant women are urged against it because the process could stimulate the uterus and result in a spontaneous abortion of the fetus.

Patients who couple their treatment with acupuncture should have patience, Yang said.

"It doesn't happen overnight," he said. "It can take up to several weeks."

Patient John Pool said he noticed a difference after his first treatment. Pool has suffered from back pain for five years. He had lower back surgery to help ease the pain. When he went back to his surgeon after the pain returned, the doctor recommended he try pain management therapy.

Pool was reluctant to take any narcotics for the pain.

"Once you're on the pills, you're on them," he said.

Instead, he went to the clinic at KRMC and began therapy and acupuncture treatments.

After his first session, Pool said the muscles in his lower back felt looser and he was able to stand up straight for the first time in two years.

The pain does return, but after three treatments in four weeks, Pool said his pain has gone from a seven or eight on a scale of one to 10, to a two.

"I don't want to say it's a miracle cure, but it has allowed me to do things I haven't been able to do in years," Pool said.

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Reader Comments

Posted: Thursday, June 24, 2010
Article comment by: Jay Fleming

It's really sad that a doctor doesn't know the difference between addiction and dependence.

Addiction is characterized by poor control over drug use, or compulsive drug use, and with addiction the patient continues to use the drug despite harm.

Physical dependence is the body's adaptation to a particular drug. The patient's body gets used to a certain level of the medication.

When the medication is abruptly stopped the person will experience withdrawal symptoms. It has nothing to do with addiction.

The real reason doctors don't prescribe opioids, is their fear of regulatory agencies like DEA. Ask any real pain doctor, opioids are the corner stone of pain treatment, and less than 2% of pain patients get addicted.


Posted: Tuesday, February 9, 2010
Article comment by: Skye Soleil

Dr. Stevens Yang impressed me as an excellent and ethical Physician. I spoke with him on behalf of my husband, who has been suffering chronic pain from osteoarthritis and was referred to Dr. Yang through his (also excellent) Primary Care Physician. I asked about holistic methods and acupuncture in particular and received an honest response from Dr. Yang: he could give acupuncture treatments a try and was willing to do this, but for the fact my husband's insurance would not cover the treatments -- and we cannot afford them. The insurance, for which we are most grateful, is provided through the state of Arizona. My husband does not want to become addicted to opiates, but this is the option he must take in order to receive medical treatment and pain relief. Acupuncture may not work for everyone, but those people who are open to this option and are willing to undergo these treatments, who might obtain relief through acupuncture are denied coverage. It seemed rather suspicious to me that the state appears to prefer creating addicts rather than making non-narcotic treatments an option. I will also add that Arizona is also known as "The Kentucky of the West" because there are no medical marijuana laws in place. Marijuana has been proven to be of great benefit for alleviating the primary symptoms of many medical conditions, including that of chronic pain and has saved the lives of people receiving chemotherapy or suffering from wasting syndrome related to a variety of diseases. I did not discuss the pros and cons of medical marijuana with Dr. Yang, but will tell you he spoke with my husband about the prescriptions being written by the Primary Care Physician and agreed that, under the circumstances, these medications were the best "traditional Western" option, as they are the lowest dose and least addictive of the narcotics approved for use by the State of Arizona. So to say "Dr. Yang did nothing" and advise people in and around Kingman to drive to Phoenix is rather an extreme reaction to not getting what you expected. Find a good Family Medicine practitioner or Internist in Kingman -- I guarantee there are several in the city. And do not expect to walk into any ethical Physician's office and demand Vicodin or Oxycontin and magically have your wishes fulfilled. When you visit a Physician for the first time, you are responsible for providing evidence to support your need for strong narcotics. And I disagree with your assessment of Dr. Yang having a "short attention span." Medical professionals have heard a lot of complicated stories and tend to get suspicious when a new patient appears and is using lengthy passive-aggressive tales of woe in an attempt to obtain the drugs they want rather than listen to what a Pain Management Specialist has to say. Perhaps your husband's approach in advocating for himself is less than optimal. Again, I will tell you that a good doctor will offer alternatives which unfortunately are not available to all of us. A good doctor will want existing proof or tests to be run that establish the need for heavy-duty opiates. "Those who abuse narcotics" can also be found among the chronic pain sufferers. I've seen people selling the Lortabs they don't need; I've seen a woman with "Fibro" lose count of the 10/325s (codeine with acetaminophen) she'd taken in one day drive highway 101 with a minimum of *nine* of those pills in her system, in addition to muscle relaxers, an SNRI, an antihistamine which causes drowsiness -- plus she downed a glass of wine with lunch and had two passengers in her car! All of this was perfectly legal, although the times she sold off her surplus to "friends, neighbors and members of her church", she committed a Felony. If your husband is an honest man, he'll have tangible proof (X-rays, documentation, recent proof that these drugs were being prescribed for him...whatever) and these forms of proof will speak volumes to a Physician unfamiliar with his case. Considering that you've written a succinct and coherent letter, perhaps *you* could help your husband by gathering all the data, compiling a list and speaking *for* him. Do not show disrespect for a Doctor who demonstrates integrity, but, like many people in the medical profession, has a finely tuned "BS Detector." I'm sure you'd have been overjoyed had Dr. Yeh remained in business. So, you've heard from one of the "po folk" who cannot afford $60 per visit telling you and everyone else to consider what "quality of life" means. Having more clarity of mind is preferable to being strung out on morphine. My husband would have tried the acupuncture treatments, but instead took the good advice he got from Dr. Yang: to stay with the conservative regimen he'd been taking. Although he is rarely entirely free of pain, taking medications with lower potency which make movement (or consequences of having to sit or walk for extended periods) tolerable for him. We both know what the future holds. He will develop tolerance to the medication over time. There is no cure for his condition. So he will gradually need to take stronger and more addictive medication to achieve the same relief. Of course, before any pain medication was prescribed on a regular basis, he had to undergo numerous tests, many dozens of x-rays, a cat scan and yes, urinalysis.

Posted: Tuesday, November 17, 2009
Article comment by: LA Med Student

The drugs FDA approved for fibromyalgia are pain MANAGEMENT drugs not TREATMENT. When you treat something you are anticipating a cure. Hence management is not a cure simply an alleviating effect. Acupuncture is an alternative management method to reduce or eliminate the need for drug therapy.

The FDA approved drugs fall under the class of SSRI's or Selective Serotonin Reuptake Inhibitors. The category for serotonin drugs include: MDMA (ecstasy), amphetamine, cocaine, dextromethorphan (an antitussive), tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Keep in mind what you are taking here. Acupuncture is a drugless alternative. I personally don't believe acupuncture is a 'cure all' by any means; however, if there is no definitively known treatment and there is an alternative to drug use, I'd recommend trying it. There is a reason people become addicted to something, and it isn't because they are forced to become addicts. A taste for side effects of SSRI's: "...same "black box" warning as antidepressants about increased risk of suicidal thinking and behavior in children, adolescents, and young adults."

I cannot attest to Dr. Yang's bedside manner. But keep in mind that he's an anesthesiologist, and oddly he's not pushing you a drug! If he's in the hospital he's making about $100 per hour, and he only has to talk with sleeping patients, very cush!

I've spent a minimum of 4 hours with each of my patients for their history and physical examination. Because I am a med student, I wanted to listen to everything the patient has to say, but once you have it all written down you find that about 90% of it has no relationship to the current condition e.g. one of my patients discussed his sexual history with me in detail when his problem was a genetic bowel disorder. I listened because I had time, but if the patient next door needs me to take care of them, I will cut the convo short... 'just the facts!'

Posted: Tuesday, November 17, 2009
Article comment by: Broken Man

"fibromyalgia, there is really no treatment." Then why is there FDA approved drugs for it? Also clinics are opening all over the country to treat it. The thing is many docs still do not believe fibromyalgia adds up as a disease. Most of these docs refuse to continue learning new things. Despite the controversy, the American College of Rheumatology, the Food and Drug Administration and insurers recognize fibromyalgia as a diagnosable disease. And drug companies are aggressively pursuing fibromyalgia treatments, seeing the potential for a major new market.

Our local docs have alot to learn still. The few Rheumatologist we have here do not believe in it either. It is not fair that people with real pain have to pay because the docs do not know how to deal with the real junkies. Because our area is small it does not mean we need to be behind in the times. Kingman is being held back because of thoughts like this. Lets run these lazy Docs out and replace them with ones that are hip to the times and treatments. I have been to DR Yang and he has also seen me bedside. Not one time did he even write down a progress note nore a change in treatment but I sure did get his bill. For what? he did not do anything diff from any other doc even though they asked for him to consult and start "pain management" he is just another doc in this area that has made it their business to do nothing! The proof is easy to pick up on as it will start of like this "so what did DR so and so say when you last seen them". No mind of their own and all they do is whatever the last guy did. Sorry to rant but I have been a Victim of quackery that plagues this tri-state area. I'm still sick and I been to all of them...

Posted: Tuesday, November 17, 2009
Article comment by: Disappointed

Accupuncture is a wonderful therapy, and if you're one of the few who it does work for and can actually afford $60 a week for it, it's a terrific alternative to medications. But what about the larger amount of people this doesn't help or can't afford it? Are they just supposed to live in pain and suffer? Dr. Yang saw my husband, who has tried accupuncture to no avail, three times and three times he did nothing for him. He came into his hospital room, listened to his story, which is long and complicated, and besides asking him to hurry up because he has a short attention span, he did NOTHING! He better stick to pushing accupuncture because his doctoring skills leave a lot to be desired. It's unfortunate that those who abuse narcotics make it that much harder for people who are in real pain to get the treatment they need. It's also unfortunate that the people of Kingman and Golden Valley are left to the inept care of doctors like Dr. Yang. Phoenix, here we come...



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