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.
Publications
Books:
- 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.
Journal Articles:
- 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 Georgetown University Assistant Director of Nurse Anesthesia Program |
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