Ep 62: Acupuncture and Chinese Medicine Before, During, and Post-Pregnancy with Dr. R. Keith Bell

Welcome back everyone! Today's episode was especially fascinating for me to put together because I don't know a whole lot about the subject area myself. I learned so much from this interview with Dr. R. Keith Bell about Chinese medicine and acupuncture and I think you will too.

Dr. Bell has a doctorate in acupuncture and Chinese medicine. He is a Virginia licensed and nationally board certified acupuncturist with over two decades of experience teaching and practicing traditional and classic Chinese medicine. Dr. Bell is the owner of Oriental Medicine Specialists in Richmond, Virginia, where his team provides comprehensive holistic care with acupuncture, functional medicine, lifestyle counseling, and herbal medicine.

Dr. Bell and I talk about how acupuncture and Chinese medicine can be used throughout your entire pregnancy journey - all the way from planning for your baby through the postpartum period. We discuss the importance of taking an integrative health approach with patients, how acupuncture can help during labor and delivery, and some of the research behind Chinese medicine. Dr. Bell also shares what you need to know if you are looking for an acupuncturist.

In this Episode, You’ll Learn About:

Misconceptions about Chinese medicine and acupuncture
How acupuncture can be used to improve fertility in both women and men
How Dr. Bell treats patients using an integrative approach that links together multiple medical providers
What acupuncture can help with during labor and delivery
How acupuncture and Chinese medicine can be used during the pre-pregnancy planning period and the postpartum healing period
What you should know and ask if you're looking for an acupuncturist
Why consent absolutely must be received before a provider conducts an episiotomy

Links Mentioned in the Episode

Keywords

acupressure, acupuncture, Chinese medicine, holistic health, integrative care, labor, Obstetrical Acupuncture, postpartum care, pregnancy, prenatal care

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Transcript

All About Pregnancy & Birth Podcast Transcript

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Speaker 1: In today's episode of the podcast, I am super excited to have a doctor of Chinese medicine and acupuncture.

Speaker 2: Welcome to the All About Pregnancy & Birth podcast. I'm Dr. Nicole Calloway Rankins, a practicing board certified Ob Gyn who's had the privilege of helping hundreds of moms bring their babies into this world. I'm here to help you be knowledgeable, prepared, confident, and empowered to have your best pregnancy and birth. Quick note, this podcast is for educational purposes only and it's not a substitute for medical advice. Check out the full disclaimer at www.ncrcoaching.com/disclaimer. Now let's get to it.

Speaker 1: Hello. Hello. Hello. Welcome to another episode of the podcast. This is episode number 62, thank you for being here with me today. So on today's episode of the podcast, it is a really informative one. I am chatting with R. Keith Bell. Keith holds a doctorate in acupuncture and Chinese medicine. He is a Virginia licensed and nationally board certified acupuncturist. With over two decades of experience teaching and practicing traditional and classical Chinese medicine, in 2000 Keith cofounded Oriental Medicine Specialist, Richmond, Virginia's first medical clinic to offer comprehensive holistic care using acupuncture, herbal medicine, functional medicine and lifestyle counseling. I am super excited to bring you this episode today because one, I know a lot of people are interested in the topic too. I believe we need to have a more integrative approach to medicine where we in Western medicine work collaboratively with others outside of Western medicine. And I just wanted to know more about the topic myself cause I don't know a lot about it to be honest.

Speaker 1: So selfishly I asked Keith to come on and talk about it. Now he is very serious about his work, as you will hear, and we have a great conversation talking about misconceptions about acupuncture and Chinese medicine, holistic preconception planning, what exactly acupuncture and traditional Chinese medicine can help with in regards to reproductive health, how he works with more traditional Western medical providers and others in his work. And then what to look for in an acupuncturist and much, much, much, much more. So you will definitely learn a lot from this episode. Now quick note, we recorded this episode well before the coronavirus pandemic so we talk about some things that are not appropriate right now like going out to coffee and public talks. So I just want to make you aware of that.

: And speaking of the coronavirus pandemic, I have updated my free online class on how to make a birth plan with information on how you may need to alter your birth plan in light of the coronavirus pandemic. And someone who went through the class, she left this note for me on Instagram, her handle is @Sayer1031. And she said, "I finished your class last night and I must say thank you. That was the most informative and helpful class I've taken by far. You explained everything so clearly in simple, it was very easy to understand. I am so grateful for such a wonderful class and teacher and now I have a better idea of what and how to make a plan and not just wing it. You are amazing and your class was the best. Thank you again."

: Thank you, thank you, thank you for those kind words about the class. I hope everyone takes advantage of this free resource for you. It's a great class that covers information on what to include in your birth wishes, how to approach the process, the questions to ask. And again, it's been updated with information relevant for changing your birth wishes in light of coronavirus. So check that out at www.ncrcoaching.com/register. And if you happen to be listening to this episode and the coronavirus pandemic is no longer an issue, then you'll get the regular version of the class that doesn't have the coronavirus information. So that is still of course a great class. So either way, check it out at www.ncrcoaching.com/register. All right. Let's get into today's episode with R. Keith Bell.

Speaker 3: Nicole: Keith, so much for agreeing to come on the podcast. I am so excited to have you. As I was saying before we started, I feel like I know you already because we're in the same town in Richmond. We've never met, but I have heard so many great things about you and the way you help women.

Speaker 4: Keith: I do my best and do my best, some of them are lies, but we'll disband those myths. But yeah, I feel like I know you too. Like I said, we see each other on social media. We're in the same fields and now we have to meet face to face.

Speaker 1: Nicole: Absolutely. Absolutely. Well, why don't we start off by having you tell us a little bit about yourself, your work, and even your family if you want to talk about that?

Speaker 4: Keith: Okay. Work. Well, I am a Doctor of acupuncture and Chinese medicine. I came here to Richmond, Virginia 20 years ago. Well, 1999 so now it's almost what, 21 years ago. Not intending on being a fertility specialist. So I specialize in reproductive health for both women and men. And we'll talk about that later. When I originally came, it was with the specialization in reproductive oncology. And so I got here, and back then in 1999, there was really no support from the medical community in oncology. I mean, doctors even just said, eat what you want, take what you want, do not get acupuncture. Don't put needles in while you're going through treatment. And so I was only seeing the people who medicine wasn't working for and most of them were at end of life. And so without the support of the community and really no patients, I flew to to see a friend out in Seattle and we had dinner and she was asking me about the practice and I was telling her about the lack of support.

Speaker 4: Keith: We now have the support, but we didn't then. And she said, you know, you have all of the information on reproductive medicine. Why don't you help people get pregnant? And that's how my practice came to be. So, you know, again, we've been here for 20 years. I went from reproductive oncology to reproductive endocrinology and working with the fertility specialist and from there and helping people get pregnant, the women started saying, can you be with me during my birth? And it became a natural progression and I was in labor and delivery when one of the Ob's came in and asked what my role was and she said, Oh, are you a doula? And I had never heard of a doula in my entire life. So I went home and I looked that up and I signed up for classes and I learned to be a doula and from working in pregnancy and then childbirth, then the postpartum care came. And so it's been a fantastic 20 years that was not planned.

Speaker 1: Nicole: Yeah. Yeah. I love it. I love it. Now what kind of training did you do in order to become a doctor of acupuncture and Chinese medicine?

Speaker 4: Keith: So when I originally started training, there was no doctor of acupuncture and Chinese medicine in the United States. There was no doctoral level degree. So what would happen is you would do your undergraduate degree and then you would apply for a Masters of Science and Oriental medicine. And so that was a four year degree. And so we had to go back to school again for four years to get a master's degree. And so when I came out of school, I had a Masters of Science and Oriental Medicine and I was licensed in the state of New Mexico. Well certain States will license what you call doctors of Oriental medicine. It's not a degree, but it's a licensure. And so New Mexico and California and in Florida still have those recognitions, but Virginia doesn't. And so I did that four year degree and then I went back two years with just private physicians to learn reproductive medicine. Fast forward, they're now doctoral degrees. And so I went back and did two more years and actually got my doctorate. So I think the doctorate doctoral degrees started, I don't remember, somewhere like 2005, 2009 and so it ended up being eight years of graduate study.

Speaker 1: Nicole: Oh wow. Okay. So you are well educated in what you do.

Speaker 4: Keith: I would like to hope so. Yes. Always learning. There's always more to learn. You know that I looked at your training and you know, see you went back to Duke for health coaching. I mean there's so much more to always learn and integrate into the medicine and I love that. So I'm always learning.

Speaker 1: Nicole: Yeah, I agree. I think in order to, when you want to provide the best care for the people who trust you, you keep educating yourself. It's a lifelong process.

: Keith: It is. It is.

: Nicole: Yeah. For sure. All right, so let's talk about, we'll get into what you do specifically, but I wanted to start off by maybe just talking about what are some of the misconceptions that you see about acupuncture and Chinese medicine? Maybe two or three misconceptions you can clear up for us.

Speaker 4: Keith: Two or three misconceptions. One, people confuse acupuncture with the medicine, so they think acupuncture is a medical system and acupuncture is just a tool that we have as doctors of Oriental medicine. So traditional Chinese medicine or East Asian medicine is a whole medical system that you can diagnose and treat disease without ever stepping outside of that system. So we have a system of diagnosis and one of our ways to treat us with acupuncture. We also do dietary therapy. We do herbal therapy, we do supplements, we do exercise therapy and manual manipulation. So the one of the biggest conceptions is that acupuncture is a medicine. It is just a tool that we use in a medical system.

: Keith: Second misconception is that there's no studies, there's no evidence that acupuncture works. There's a lot of evidence, and I know we were going to kind of talk about that, but there are places that people can go now. There's the Obstetrical Acupuncture Association that lists evidence. We have evidence based acupuncture websites. There's been studies in every country all over the world. So acupuncture in Chinese medicine is evidence based medicine. And the biggest misconception is that acupuncture works only as a placebo. But that's been disproven many times. You'll see we do acupuncture with children who have no concept of placebo and get great results. We do acupuncture with animals and get great results. So there are probably the three biggest misconceptions of acupuncture and Chinese medicine.

Speaker 1: Nicole: Nice. Yeah. And that was one of the things. Yeah, and we can talk about it now if you want about the research piece. I know that lots of people have kind of thought it was sort of fluff or that kind of thing, but there is really good research that this stuff works.

Speaker 4: Keith: There is really good research and there's better research. The research in the beginning was not the best. So you'll hear, you'll see old studies where it says acupuncture as compared to fake acupuncture or placebo acupuncture, where they were trying to combine what they call real acupuncture was sham acupuncture and it was done on pain and they were finding that the sham acupuncture and the real acupuncture were getting the same results.

: Keith: People were getting pain relief. So the first conclusion was this is placebo. It's all placebo. And it took a few doctors and researchers time to think, wait a minute, what if they both work? What if they're different mechanisms of action? And so they started comparing acupuncture and sham acupuncture with what traditional treatments and even the sham acupuncture is outperforming some traditional treatments in pain. So doctors decided that we have to figure out what's going on.

Speaker 4: Keith: And so what they found out now with technology and functional MRIs is that when sham acupuncture was being performed, a fake acupuncture, there was pain relief. But it was because anytime you put a needle in the body, you release endorphins and you get pain relief when real acupuncture was performed. The way that we do in a clinic, you actually see the areas of the brain that interpret pain change. And so when you follow the patients, even the patients with sham acupuncture, they got pain relief. But the people with the real acupuncture actually had longer lasting pain relief where the pain didn't come back because it actually acted on the area of the brain that interprets pain. So this is some of the newest studies that are out that are showing that even though you might get the same results, there's something happening.

: Keith: And so we know that with real acupuncture you get change. And so we're studying it differently now and the studies are a lot better. And they're not just comparing acupuncture to sham acupuncture, but they're comparing acupuncture and Chinese medicine to other types of medicine and see which one outperforms the other, which by the way, we talk about integrative medicine, most of the studies show that the best results are when you integrate the two medicines. When you do a conventional medicine system with Chinese medicine system and you come together and you pick the best of each medical system that patients do better. And that's integrative medicine.

Speaker 1: Nicole: It is like we are a long overdue for that approach in medicine. Like way, way overdue.

: Keith: We are. But it's coming.

: Nicole: That's true. That is true. That is true. So now you help folks, men and women, through the whole entire spectrum, preconception, fertility, pregnancy, postpartum. So let's talk about some things you do at each stage, if that's okay. So I noticed you do something, you know, just looking through your website, holistic preconception planning. I love that. So tell us about what that is.

Speaker 4: Keith: What that is is, so preconception planning in the past has been thought six months before you want to get pregnant. You need to start preparing. Women need to start preparing the body. This is traditional conventional preconception planning, but preconception planning as we know now should start at least two years before people are trying to become parents. So men, women, what we have is called distal preconception planning. This is the World Health Organization terms, that basically the moment that you know that you want to conceive a child or you want to be a parent, it's time to start planning, planning your body, planning your mind, planning your finances, your home planning your life. But the six months before trying to get pregnant is now called prepregnancy planning. So there's this term of preconception planning that should happen within about two years of the moment that you want to conceive.

Speaker 4: Keith: And so what holistic preconception planning is, and it's based on holistic medicine. So holistic medicine says that you are a physical, mental, emotional and spiritual being that exist in an environment. So what you have to do, what we ask patients to look at is take an inventory of how they're doing physically. Are you physically healthy? Do you need to stop smoking? Do you need to go off oral contraceptive pills? Do you need to to exercise, you need to lose weight? We take an inventory of where you are physically and then mentally are you in the right mind space? Are you planning and logically are you understanding what it takes to become a parent? And then emotionally we look at where people are in their stage of life. Are they angry? Are they frustrated? Are they sad? Are they in grief? Are they happy, joyous? So religion, it can be the earth, it can be a recognition that you're a part of a greater community.

Speaker 4: Keith: And then we look at an environment and environment is often overlooked, but very important. When people want to become pregnant, are you in an environment that's going to be conducive to fertility? If that's your working environment, it's your home. It's environmental medicine. Are you living in an environment full of mold and you're having problems with this? Are you working in an environment that's stressful? You work in an environment under a lot of artificial lights. Are you working shift work? So holistic preconception planning is basically taking an inventory and making adjustments to get the patients holistically well in all aspects of their life so that when it's time to conceive, it's an easier adjustment to move into pregnancy, both if they're conceiving with a partner or doing it alone.

: Keith: Because now we get a lot of patients who choose to have a family, have a baby with no partners and so they actually plan a lot harder and a lot more than couples because they know that that they have to adjust the schedule, they have to have the money to afford it. They have to have a home, they have to have helpers. And so we see the single people who are conceiving, they do a lot more preconception planning than couples. Now, that's a long winded answer, but that's what preconception planning is.

Speaker 1: Nicole: I got you. Yeah. I wish we all did that. So much of pregnancy sometimes can be a surprise. But you know, I feel like it would be much better if we all kind of took that approach and can kind of look at things from that holistic perspective. That's certainly something I learned with my health coaching training about the importance of that holistic approach.

Speaker 4: Keith: And you probably see more of the surprises than I do because the people who are coming to see me are usually people who are having issues.

: Nicole: That's true. So speaking of people who have issues with pregnancy, what do you do? How does, traditional, you know, Oriental medicine, acupuncture, what do you do for fertility enhancement, including for male fertility enhancement?

Speaker 4: Keith: Fertility enhancement. So if there's a problem, if a person has endometriosis or a PCOS or an ovulation or even painful periods, where we first start with treating what the issue is, but a lot of people are unexplained infertility. So we see a lot of unexplained infertility. And in Chinese medicine, a lot of it can do with an overactive immune system or a hyperactive immune system based on inflammation. So I spend a lot of time with unexplained infertility, working on modulating the immune system in women because that's not done well in conventional medicine. So even the conventional medicine doctors, when they see unexplained infertility, they'll send them my way and say, here's what we're going to do conventionally. But Keith is going to help you modulate the immune system and get your body to utilize hormones more efficiently. So I spend a lot of time helping the person utilize hormones from assisted reproductive technology and modulating immune system with men.

Speaker 4: Keith: We now know, and you would think this is not new information, but in traditional fertility medicine, no matter what the problem is, you treat the woman, you make her hyper fertile. So hopefully even if the sperm quality is bad, you'll still get a pregnancy out of it. But now we know that sperm quality, if it's poor morphology, poor quality leads to a lot of miscarriages esspecially before seven weeks. And it leads to a lot of failed IVF. And so what we do, Chinese medicine, especially with herbs and especially with supplementation, you can help all sperm parameters. You can help the sperm count, you can help the body utilized testosterone better. You can help with morphology, you can help with poor swimmers.

: Keith: So more and more now, and I'm actually going to have a talk coming up this spring at Ellwood Thompsons on the importance of sperm health to hold a pregnancy because fragmentation of the DNA can happen in the first seven weeks due to sperm and you lose the pregnancy and so many women are taught that it's if they have multiple miscarriages, it's all them and they feel like something's wrong or when the IVF fails, it's always poor quality egg, but the embryo is based on the quality of the sperm and the egg. And we now know that at least 30% of the time it's a male factor issue and 30% of the time it's a female issue and 30% of the time it's the two together and then 10% is unknown. There's a lot that can be done for the man and for the woman when it's time to make them more fertile, especially with lifestyle.

Speaker 1: Nicole: Gotcha. So you use a combination of lifestyle changes, whether that be dietary or activity and then also any, sometimes supplements and acupuncture. So you kind of combine all of those things together. And Chinese herbs?

: Keith: Yeah, I combine all of them together and it depends on what other practitioners they're seeing. So if a person comes to me and they already have a naturopath and they already have a health coach or they already have a reproductive endocrinologist, I like to work integratively. So the best scenario is that I'm able to call the other practitioners and we work together because if they already come in taking supplements and herbs and things like that, then it may just be acupuncture that.

Speaker 1: Nicole: Okay. Okay. Well speaking of which, how do you work with other practitioners, particularly traditional sort of Western medical professionals? I'm sure it's evolved over the course of your 20 years.

Speaker 4: Keith: It has evolved. It is all through private messaging now. There's a lot of private messaging back and forth every day and lots of different doctors. They can be orthopedic doctors, when I'm doing pain management, fertility specialists. Now some of the fertility specialists we meet on a regular basis and we discuss patients or we have phone consultations and we discuss patients. But now with all of this instant messaging that's HIPAA compliant, that's how we discuss patients. And actually, you know, the doctors will send me what the patient is going through an ask if it's a right fit. And so we start there and then we just keep, keep in touch with what the treatment plan is and if I can do anything to help or if they need to make any changes. So that's really evolved over the 20 years and it's, we have great relationships in town with a lot of physicians. So the majority of the patients that I see are actually referred from other providers.

Speaker 1: Nicole: That's nice. And again, long overdue that we work together and realize that different types of treatments and modalities can help people and working together is the best way to do that.

Speaker 4: Keith: Yeah. And the patients know the doctors who work collaboratively. So it's what I started 20 years ago. Patients didn't necessarily leave their doctors, they listened to their doctors and they did whatever the doctor said. Hence why I did not do well in oncology because the doctor would say, no, you cannot get acupuncture. And so they didn't. But now patients are looking for doctors who work in that collaborative way and they'll tell their doctor that they're getting acupuncture and if the doctor rolls their eyes, they come to me and they say, I need a new doctor.

: Nicole: And you got a list.

Speaker 4: Keith: And I got a ist. And that's what they're looking for. And you know, people know the OB GYN who if they have failure to progress and they really want to have this baby, naturally they know the ones that are going to call me into the hospital and say, can you do what you do? Because it's what they say, do what you do and you have 24 hours and if you can get things to change, very good. If not, we're going to start inducing. And so it happens all the time. I spent so many lunchtimes trying to get babies out.

Speaker 1: Nicole: Yeah. Yeah. So let's talk about that. What things do you do to help with pregnancy? I know like labor induction, turning a breech baby or some of the things that come to mind, but what, what do you do?

Speaker 4: Keith: Yeah, the turning the breech. That's fun because you see that happen. You can see that happen on the table. So you know, it's not placebo or you couldn't watch it. Some of the really cool things I like are the instant, like I had a patient this year with thrombosis, hemorrhoids, and she was going into surgery the next day and we did an acupuncture treatment and it completely treated it. She went in and they're like, it is gone. So some things respond really, really quickly and really, really well during pregnancy. One of the things that we treat a lot is morning sickness, all day sickness, sciatica, rashes because the body's not utilizing the hormones efficiently. Lots of things.

Speaker 1: Nicole: Yeah. And all of this through acupuncture.

Speaker 4: Keith: All of this through acupuncture. Yeah. Because, you know, during pregnancy, when staying away from a lot of the herbs and supplements, only the ones that we know are safe. So we do that all through acupuncture. And then with labor and delivery, I see a lot of failure to progress. Or the baby is, you know, the doctors are saying, you're at 42 weeks, we're going to have to induce and we don't, say we induce labor, but we do coax. We try to get the body to do what it can do naturally. So we do coax it along. Optimal positioning is a big, big thing that we do with acupuncture.

Speaker 1: Nicole: And how often do you find, I mean if you had to guess, like how often is acupuncture successful? I mean, I know nothing is 100% and I presume it's more successful than not. So...

Speaker 4: Keith: Well, you know, it really depends on what you're treating. It really depends on the issue. So for optimal positioning and turning breech, my success rate is about 70%. I was a part of a study two years ago on successful people who turn breech. And it's interesting because we didn't, we, none of us followed the textbook. So we actually through following 30 experts all over the world who had a 70% success rate at turning breech when the national average is 50%, we realize that that through experience we all had developed our own ways of doing things and that they were pretty damn similar. So we were all doing the same thing. As far as fertility is concerned...

Speaker 1: Nicole: I should say 70% is very high.

Speaker 4: Keith: It is. It's really good. We consider like a 80% reduction in pain success. We're not looking for 100% although 100% will be nice, but 80% is a success.

Speaker 1: Nicole: So what about the postpartum period? How do you help women postpartum?

Speaker 4: Keith: Postpartum, we do really well at postpartum blues.

: Nicole: Oh, really?

: Keith: So we, yes, I mean with acupuncture for anything that we treat, the first thing that people after treatments, even if they don't have any reduction in the symptoms that they came in for, because sometimes it can take a few treatments. But the first thing people say is, I just feel better. I feel more alive, I feel more, more myself. So I see a lot of people for postpartum blues and I work with in conjunction with their therapists and doulas to make sure it's not going into postpartum OCD and depression, although we can treat that. But I like to do it in conjunction with their therapist. We do a lot of acupuncture for milk production, mastitis, hormonal regulation afterwards, recovery from C-section.

Speaker 1: Nicole: So it's just a whole whole host of things.

: Keith: A whole host of things, a whole host of things. I remember years ago I was in MCV and this was probably 14 years ago, in MCV treating a patient during labor and delivery and another patient across the hall had gone into catatonic after birth and they did not know what to do. I mean she went catatonic and I told the nurses acupressure points because I mean I could go in there and treat her, but there was no consent and I didn't know this patient or anything. So I showed them acupressure points that we have when people go catatonic. And it worked. Now, I'm not saying that she wouldn't have come out anyway cause I don't know this person. But they went in, did the pressure points and she woke up. And so you know, we have points for weird things like that when things go wrong, we even have stopped bleeding protocols. But you know, I would not choose acupuncture during a hemorrhage. But if there's no one around button acupuncture is there things we can do.

Speaker 1: Nicole: Gotcha, gotcha, gotcha. So if someone is looking for an acupuncturist, how should they go about looking for someone? What are some questions they should ask?

Speaker 4: Keith: Okay. This is a really important question because acupuncture is governed state to state. It is not a nationally governed profession. So an acupuncturist can work in Virginia that may not be able to work in California or New Mexico. So what you want to know are they nationally certified? Because we do have a national certification commission and it's called The National Certification Commission for Acupuncture and Oriental Medicine.

: Keith: Now everyone who certified through them have at least had the training to the master's level and have passed our certification exam. So you know that they know Chinese medicine. So in Virginia you want to look for a licensed acupuncturist. That's how we're licensed. But you can also have people who practice acupuncture. So you really want to know the person's training, their experience and what they're doing. Because you can practice in certain States with only 200 hours of training if you are a practitioner, like a medical doctor or a chiropractor or dentist. Now some of them have way more training. So I'm not saying don't go to them, I'm just saying ask about the training, ask how long they've been working, ask about the experience and if nothing else, just look to see if they're nationally certified because at least you know that they have a good amount of training.

Speaker 1: Nicole: Gotcha. And then are there any specific certifications or training specifically related to reproductive health?

Speaker 4: Keith: There is. There's the American Board of Oriental Reproductive Medicine. So www.aborm.org Has their certification specifically for reproductive medicine. And in order to pass that test and become certified, you have to have a lot of extra training in reproductive medicine. Now I am not able, I'm certified, although I could be and I should be, and I was there when they were talking about making this board. I just haven't flown out and taken the exam. So if you're looking for someone and you know that they are a board certified, you know they know what they're talking about for reproductive medicine, but not everyone who practices reproductive medicine is able and certified.

: Nicole: Gotcha.

: Keith: There's also just let tell you now, the Obstetrical Acupuncture Association and it's www.obacupuncture.com and those are people who specifically have passed certifications and obstetrics and that's new. So a lot of people are going through that process right now and I'm working on that process. But you can go to them and you can see everybody who's done extra training and been certified on that.

Speaker 1: Nicole: Okay, nice. Nice. Is there anything people should be like, turn and run the other direction if they see or they should, they should be concerned about ?

Speaker 4: Keith: Now you're gonna get me in trouble.

Speaker 1: Nicole: Ah oh.

: Keith: If the practitioner discounts what you've already done, if they discount other practitioners and conventional medicine. So I am not comfortable with practitioners who, they come in, the patients come in, the first thing they do is take them off of all medication and do not talk to the physician. And this still happens. So you know, acupuncturists and Chinese medicine practitioners can work as a complimentary practitioner, which means you're complementing their traditional care. You can be an integrative practitioner where you're working in collaborative effort with their conventional care or you can be alternative. And I'm not saying that an alternative practitioner where you seek Chinese medicine instead of conventional care is bad, because there are people who do not utilize conventional medicine and so they need some type of care and they can see a Chinese medicine practitioner as alternative, but I'm not comfortable when a person discounts, a practitioner, the care that they've already been given and says, I want you to do what I say or you're not going to get better. Cause that's seen that happen. They're like, you have to listen to me or you're not going to get better. I'm just not comfortable with that.

Speaker 1: Nicole: Gotcha. And I would have to say, I am this ethic. We need to be the same way on the Western medical side. Like don't discount what other people have done or gone through. We need to work together in order to help women, everybody have the best care.

Speaker 4: Keith: I agree.

Speaker 1: Nicole: Yeah. Yeah, for sure. Is there anyone who, who is not a good candidate for acupuncture? That question just kind of popped up in my mind.

Speaker 4: Keith: You know, the patients that are the hardest are the ones who think that we do magic and we have all the answers. So I'll have people who come in and they just know that I'm going to fix them because I know something that none of their other doctors knew. And that's just not the case.

: Keith: I only know what I know and I know the science of acupuncture and there is a science behind Chinese medicine and I can work within that body of knowledge to help you get better. But I would rather see a skeptic in a day. I would rather see someone walking through the door who says, I do not believe in this, but I've tried everything better than the person who says, I've tried everything. Nothing's working. I know you're going to fix me. That's so difficult. It's so difficult because there always just, you can either fix them or you can't, and there's always a disappointment. They're 80% better is not helpful in their minds, so that's a tough patient for me. I'm trying to think of other patients.

Speaker 1: Nicole: Yeah, it doesn't sound like there's anybody who's like completely off limits in terms of at least trying acupuncture, of at least trying, right?

: Keith: I mean we do have people who are deathly afraid of of needles, but you can do acupuncture with lasers. It's laser just like you have cold lasers and in conventional medicine we have, you can do laser puncture. I don't do it because I haven't studied it, but I have colleagues that do and there are actually studies on laser puncture for fertility or laser acupuncture. I think they call it laser puncture. You can do acupressure. It works well is especially during active labor. I mean I've trained a lot of L and D nurses and during Accu active labor, the acupressure works just as well as acupuncture.

Speaker 1: Nicole: Yeah. Nice. Nice. So I mean, speaking of the needles, from what I understand, they're very tiny. They're not large and most people do fine with them.

Speaker 4: Keith: They do. They're about the size of a hair on your head. You know, needle gauge I use most of the time is 40 gauge needles.

: Nicole: Oh wow. 40 gauge. Yeah, that's it guys. That's really, really tiny.

Speaker 4: Keith: Yeah. The largest, the thickest needle I use on any given day will be 36 gauge. So it's tiny. It's fine. It's solid, it's smooth, cause you have to remember we're not cutting away skin, we're not trying to pull out a fluid or inject something in you. So a hypodermic needle is designed to cut away tissue so that you can pull out blood or it's designed to cut away tissue so that you can inject some type of liquid into the patient. This needle, it just slides the skin to the side and you barely feel it.

Speaker 1: Nicole: Okay. Okay. All right. And then how can people, you know, just kind of getting back to you saying that nothing is 100% gonna fix everything. Should people expect that you may need a few sessions of acupuncture to address an issue?

Speaker 4: Keith: You do. Most people will see a response in one to three treatments. Now we like to, depending on the length of time that an issue has been with you, it's going to take longer. So I mean I've had people come in who've had migraines for 24 years. Right?

Speaker 1: Nicole: You don't fix that overnight.

Speaker 4: Keith: Not going to fix it overnight. From fertility standpoint, the endocrine system, the female endocrine system is on a basically a 90 day cycle. So if we need to change you hormonally, it's going to take three months. It's going to take three months even with medication, when you do take thyroid medication, that's why you reassess every three months because you're on a 90 day cycle. Immune system issues can change quick. I mean you can, we can modulate the immune system in one to two treatments. So it just really depends on how long an issue has existed, the severity of the issue and the type.

Speaker 1: Nicole: Gotcha. So, sometimes things can get quick. I can't even get it out, can get fixed quickly, but also expect that for things that have been around longer, it may take some time.

Speaker 4: Keith: It may take some time. So usually when I see a new patient, I see them once a week for a month, all new patients because I want to get three to five treatments in. Now if the treatment resolves in the first two treatments, there's no reason to come back. But I like the consistency cause you're trying to break a pattern and you know, human systems are really lazy. We like pattern and you can habituate, you can habituate pain and habits and so we're trying to break that pattern. And so sometimes it takes a month and sometimes it takes three months.

Speaker 1: Nicole: Okay. Got it. Got it, got it, got it. All right. Anything else you can think of before we wrap up about like acupuncture and what the treatment is? Like anything that I missed?

Speaker 4: Keith: Well, you know, you didn't ask about insurance.

Speaker 1: Nicole: Oh yes. Thank you. I'm so glad you brought that up.

Speaker 4: Keith: You didn't ask about insurance. And most people want to know about that. Insurance companies are trying to figure out how to include acupuncture. With the opioid epidemic and, and us needing different pain relief techniques that are more natural that people are not going to become addicted to, there's a huge interest in natural medicines and acupuncture. So as we speak, laws are changing and insurance companies are picking it up. So right now most people's insurances in Virginia do not cover acupuncture unless it's for pain. But most people's insurances don't cover fertility treatments either. But, it's changing. And so if people are interested then you lobby Congress because that's who's making the changes.

Speaker 1: Nicole: Okay, good. I am so glad you brought that up. Thank you. I know someone's going to be wondering about that. So just to end, what is the most rewarding part of your work?

Speaker 4: Keith: Oh, I love seeing the babies. I love seeing people become parents. I love seeing their, their dreams come alive. I mean that's when we cry. You know, people come in the office and they bring their baby and they're so excited about becoming a parent. But you know, wellness. People realizing potential that that's what our work is really about is helping people become the best that they can possibly be physically, mentally, emotionally and spiritually. So seeing people come alive even if they don't get what they want. I mean, I have some really great letters from parents who didn't get pregnant and didn't have kids, but they learned that they could be fully alive and happy joy as beings, even though they had disappointment.

Speaker 1: Nicole: I love that. I love that. I can imagine how incredibly rewarding that is. Now on the flip side, what's the most frustrating part of what you do?

Speaker 4: Keith: So I don't have much frustration. I don't have much frustration and I'm actually writing about that right now cause I don't know if you know this, but I'm doing a lot of work in the area of burnout and I'm lecturing tomorrow night on burnout syndrome. And frustration and resentment and control are things that lead to burnout. My personality is, I'm very patient and curious so I can sit with people even if they're difficult, you know that the other people in the office will say sometimes, how can you put up with that person's personality? And I don't take things personally, so it's easy to be with people.

: Keith: I think probably the most frustrating part now that I'm talking out loud is that a lot of people can't afford it. That a lot of people that we know that we can help can't get the help because they can't afford it. So th you know, nationally things are changing if acupuncture schools have community clinics and more community clinics to come in town and people are getting grants and that's gonna change things. But I would say yeah, knowing that you can help people, but you can't help everybody because you just don't have the time is frustrating.

Speaker 1: Nicole: Yeah, I can imagine that. And I do know some places are trying to do more free things. I used to volunteer at the health brigade and they have a clinic in town and they offer free. It's a, you know, a clinic for low income folks and they offer free acupuncture, I want to say like once a week or a couple of times a month to folks. So those options.

: Keith: There are options out there and we do our best to offer reduced rates too, but still, you know, we can only do so much.

Speaker 1: Nicole: Yeah. And we got to eat and we got to pay them the lights and all that kind of stuff. So, you know, we do the best that the best that we can. But that's interesting. I didn't know you were, had an interest in just like, I'm just like in general in like health care.

Speaker 4: Keith: It's in general. So I'm lecturing tomorrow night at Owen Thompson's on burnout syndrome in general, what it really is, how to treat it naturally, how to reverse it, how to recognize it, how to prevent it. So I've been doing a lot of work in that area, just not here in Richmond. It's a lot of what I've been spending time and I'm writing about how Chinese medicine and specifically acupuncture treat burnout. And so that's kind of my pet project is taking all of this acupuncture literature and all of this burnout literature and translating it into a treatment plan in Chinese medicine. In the summer I'll be teaching acupuncture is how to treat burnout syndrome with acupuncture. And it's, it's really amazing. So that's, I'm excited about and that's been my kind of my pet project for years and I'm finally getting it out there and people were excited.

Speaker 1: Nicole: Yeah. It sounds very exciting. Very exciting indeed. Looking forward to hear more about that. So last question is, what is your favorite piece of advice that you'd like to give to expectant moms?

Speaker 4: Keith: Oh, you've got this, you know, trust in yourself, trust in your body. You were designed, it was designed to do this, that they're strong enough.

Speaker 1: Nicole: Yeah. Yeah. That is so very, very true. Very, very true. And a lot of us don't realize how strong we are, but we all have more strength than we think.

Speaker 4: Keith: We do. We do.

Speaker 1: Nicole: Yeah. Yeah. Yeah. So where can people find you if they're interested in learning more about you and what you do?

Speaker 4: Keith: Well we have a website, although I must say that I'm not very technological so it needs to be updated, but it is www.omspc.com which stands for Oriental Medicine Specialist. And I am on Instagram @DrKeithBell.

: Nicole: Are you on Facebook at all or?

Speaker 4: Keith: I am on Facebook. We're under Oriental Medicine Specialists. So the company is Oriental Medicine Specialists.

Speaker 1: Nicole: Gotcha. Well, I will link to all of that in the show notes. Well, thank you so much, Keith, for agreeing to come on. You are clearly very passionate about what you do, serious about what you do. And I love your work.

Speaker 4: Keith: And I am excited that you asked me and I can't wait to meet you in person.

Speaker 1: Nicole: I know we're going to have to have coffee for sure.

: Keith: Or wine.

: Nicole: All right, well thanks so much Keith.

Speaker 3: Keith: Thank you.

Speaker 1: All right. Wasn't that awesome. Keith has lovely energy in his passion and commitment to his work. Definitely comes through. Now after every episode where I have a guest on, I do something called Nicole's notes where I go through my top three or four takeaways from the episode. So here are Nicole's notes from my conversation with a doctor of acupuncture and Chinese medicine, Keith Bell.

: So number one, I love how Keith advocates and really practices an integrative approach to caring for his patient and he really actively works with talking with different care providers on the team. I too am an advocate for that integrative approach. I haven't done nearly as good of a job at it as Keith, that's for sure. And now that I only work in the hospital, it's not quite as um, applicable to what I do. But that is how we take the best care of people if we work with all types of different providers with that same goal of making sure that women get the best care possible, that's how folks have the best outcomes and the best experiences. So there are more doctors who are getting on board with this. I had an integrative OB GYN physician on the podcast back on episode 24 her name is Dr. Anne Kennards. If you want to check her out. She talked about nutrition supplements and environmental toxins. That's a great episode as well.

: Number two, I love Keith's holistic approach to medicine. Of course that resonates with me. I am a trained and certified integrative health coach, so taking that holistic approach is so, so important, not just for preconception health before our health in general. So taking into account the physical health as well as your mental health. Are you in the right mind space, your emotional health? How do you feel? Are you angry, sad, happy? Your spirituality, your environment is one that is very often overlooked. Not just like things like toxins or things like that, but how are the things around you supporting you and making you feel about your health, like your work environment, your home environment, and then of course I'll add nutrition, rest, exercise, your relationship. All of those things are an important part of your health too.

: Number three is the reminder that men's fertility is important too. Keith talked about how the health of sperm is very important in creating quality embryos and male fertility is a big part of fertility. I talked about this in an episode with fertility expert, Dr. Cindy Duke. That was episode number 47 so you can check that out. She also incidentally talks about how acupuncture is a way to help enhance fertility. So again, that's just that reminder that male fertility is an important piece of fertility as well. It's not just about what goes on with the female partner.

: All right, so that's it for Nicole's notes. If you're in the Richmond, Virginia area, then do check out Keith. I don't get a referral fee or anything like that. I just know he provides great services related to reproductive health. So do check Keith out if you are in need of such services. All right, so that's it for this episode of the podcast. Be sure to subscribe to the podcast in Apple podcast, Spotify, wherever you are listening to me right now and if you feel so inclined, I would love it, love it, love it if you leave an honest review in Apple podcast in particular, that is so crucial to help the show grow. As a matter of fact, I recently crossed over 1000 downloads and that is all thanks to you all and listening and reviewing and all those good, great things. So I am most, most, most appreciative when folks take time to leave me their thoughts about the podcast. I also give shout outs for people on future episodes, so do do that for me if you get a chance. I appreciate it from the bottom of my heart.

Speaker 1: Also, don't forget to check out my free class on how to make a birth plan recently updated to reflect changes necessary due to coronavirus. If you have questions after the class, then join my free Facebook group All About Pregnancy and Birth. I've been answering tons of questions here related to changes in birth, due to coronavirus and it's just a great place to be in general, a great group of supportive pregnant mamas and other folks in the birth community. The community manager is a doula. I'm in the group as well. So check that group out all about pregnancy and birth.

: Next week on the podcast, I'm going to share some advice on things you can do to help take control of your birth experience, so you'll definitely want to come on back next week, and until then, I wish you a healthy and happy pregnancy and birth. Thanks so much for listening to this episode of the all about pregnancy and birth podcast. Head to my website www.ncrcoaching.com to get even more great info, including free downloadable resources on how to manage pain and labor and warning signs to look out for after birth. You'll also find information on my free online class on how to make a birth plan, as well as everything you need to know about the birth preparation course. Again, that's www.ncrcoaching.com and I will see you next week.

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