|Histological section showing the decrease in corticotropin releasing hormone via electrical acupuncture in chronic stressed rats.|
Episode 24: Ladan Eshkevari, PhD, joins the show to review the research she is doing at Georgetown University on the treatment of Chronic Stress and Pain Management with acupuncture. Her findings… Just get acupuncture!
Ladan Eshkevari, PhD, CRNA, LAc, is doing what all acupuncturists dream: She is proving the mechanisms by which acupuncture works. Her research involves understanding how acupuncture works on the interplay of stress hormones with respect to the hypothalamus, pituitary, and adrenal glands (Eshkevari, et al 2012). Even more interesting is her ability to needle rats and her use of a well-designed Sham Needling protocol. The studies indicate that acupuncture does provide relief for pain and chronic stress by decreasing adrenal Npy mRNA. This classic stress response mechanism has been studied for years and leads us to believe that it may be the one key process in the degradation of the homeostatic balance and can lead to all forms of disease and maladaptive stress.
Which points did Ladan choose to research for chronic stress?. Most of us would assume Yin Tang. Ladan thought so as well but she ran into a problem. “Yin Tang, between the eyes, I tried for about 6 months believe or not and I couldn’t get the needles in there with the animals sitting still and I was causing stress on the animal, because when you are doing stress studies on animals you have to be really careful where the needles are, where you insert them, and not to give them anesthesia… For practical reasons you have to keep the needles away from the rats face because otherwise what they will do is they will turn around and they will chew the needles and the electrodes, so it (ST36) was far away enough from the rats face you could insert the needles, insert them (rats) back into the cage, and they (rats) will not disturb them. The sham points were selected also away from the face so the rats would not disturb the needles.”
What truly makes Ladan interesting is that she is an acupuncturist, scientist, associate professor, and nurse. She is engaging and dynamic and her passion for understanding how things work is infectious and guides her in her quest to understand what happens with acupuncture and how it can be transferred to human models. She has spent months perfecting the Sham point location. She has spent months making rats cold (induces chronic stress similar to humans). And she does it with such zeal, but with the drive to truly make Western science pay attention to what acupuncturists have been accomplishing for centuries. Her biggest focus: To find an outlet other than opioid for pain management; particularly when it comes to acute and chronic stress and the adaptations that the body can create to cope with those stressors.
- K.K. Trou and L. Eshkevari. Pain management in the parturient-in Varney’s Midwifery. Burlington, MA: Jones and Barlett Learning, 2013.
- L. Eshkevari. D. Jasinski, Pharmacokinetics-In Nursing Anesthesia. Philadelphia, PA: Churchill-Livingston, 2005.
- L. Eshkevari, E Permaul, S. Mulroney. “Acupuncture blocks cold stress-induced increases in the ypothalamus pituitary adrenal axis (HPA) in the rat.” J Endocrinology 217.1 (2013): 95-104.
- Hupman, and L. Eshkevari. “Propofol and Ketamine for Targeted Muscle Reinnervation after Limb Amputation.” Anesthesia e-Journal 2.1 (2013); 1-4.
- L. Eshkevari, KK Trout. “Management of Post-Partum Pain.” J of Midwifery and Women’s Health 58.6 (2013); 622-31.
- L. Eshkevari. Rupert Egan, Dylan Phillips, Jason Tilan, Elissa Carney, Hakima Amri, Susan Mulroney.. "Acupuncture at ST36 prevents chronic stress induced increases in Neuropeptide Y in rat." Experimental biology and Medicine 237.1 (2012); 18-23.
- L. Eshkevari. B. Baker. "Knotting of Pulmonary Artery Catheter: A Case Study." AANA Journal 75.6 (2007): 423-8.
- L. Eshkevari. J. Health. "Use of acupuncture for chronic pain: Optimizing clinical practice." J Holistic Nursing 19.5 (2005): 217-221.
- Eshkevari, L.. "Acupuncture and pain - a review of literature." AANA Journal 71.5 (2003); 361-70.
|Ladan Eshkevari, PhD, CRNA, LAc|
Assistant Director of Nurse Anesthesia Program