Suggested safety guidelines for Florida beachgoers who get acupuncture

Several cases of necrotizing fasciitis, also known as flesh-eating bacteria, have been spiking in different areas of Florida for several weeks. One of the most recent cases was a man who had a steroid injection in his back in the days before his beach visit (read more here).

Because of my background as a massage therapist, I had already been telling my patients for years that I prefer them to schedule massages before acupuncture, because it does leave tiny holes in the skin temporarily. Several months ago I had updated my post-acupuncture instructions to also include no swimming. Even though needles used for steroid injections are bigger than acupuncture needles, the same theory still applies. Any piercing of the skin will leave a tiny hole temporarily, so swimming in our Florida waters should be avoided if you have ANY break in the skin. And if you cut or scrape yourself while at the beach, that is a good reason to leave right away and go home to clean it out and apply Neosporin ASAP and continue to monitor the site.

How long should I wait to go back in the water?

Right now, I’m scheduling acupuncture patients two days before planned beach activities so that there is 48 hours to heal the skin. If you are slow to heal, you may want to plan on waiting longer before you go back in the water.

Who should avoid the beach right now?

Because I have an autoimmune disorder, pyoderma faciale (a severe form of rosacea), it’s been four years since I went to a beach. Here are my personal recommendations for my acupuncture patients who may want to consider avoiding the beach at this time. As always, consult your acupuncturist and health care team before deciding for yourself what is appropriate for you.

• Diabetics, especially if you use a lancet to check your blood sugar and/or get insulin injections.

• Anyone with neuropathy, lymphedema, cellulitis, cuts, bites, bruises, chronic skin conditions, acne, rash, etc.

• Anyone who has had an injection in the past three days to a week. If you recently got a piercing or tattoo, follow the care guidelines you were given.

• Anyone with autoimmune disorders, even if their skin is intact.

Is this excessively conservative? It’s possible. But now that there has been one suspected case of flesh eating bacteria from an injection site, it’s better to be a little more careful today to avoid a nasty complication later. Hopefully, these recommendations won’t be needed for very long.

What can you do to help?

Our water quality is something that can’t be left to chance or someone else to monitor anymore. Please consider helping out by:

• Picking up litter in and around water, if you can do it safely. Ditto for on land.

• Volunteer with or donate to, Keep Charlotte Beautiful, Florida Coastal Conservancy, Greater Charlotte Harbor Sierra Club, or other organizations that advocate for the environment. They’re helping protect your water quality!

• Reduce your use of fertilizers.

• Be mindful of what you flush in the toilet or pour down drains! That includes medicines too. Flushing is not the right way to dispose of your medications or other items.

• Educate yourself on water quality issues in your area. Write your elected officials and tell them how important it is for your health and our economic security. We depend on clean beaches and harbors to attract tourists and we depend on clean water for our health.

Clean water is not a luxury, and ignoring water quality issues won’t solve it, either. But with teamwork from local grass-root efforts up to local, state and federal government levels, we can help reverse this trend and clean up our waterways and beaches so we can all go back in the water safely.

Be mindful of your health status when deciding to go to the beach, and keep an eye on your skin when you’re there as well as after you get home.

Nicole Noles Collins is a licensed acupuncture physician at Vitalichi Acupuncture. Nicole has two bachelor’s degrees – Alternative Medicine and Professional Health Sciences – as well as a master’s degree in Traditional Chinese Medicine. She has a passion for both writing and natural health. Please visit her website at and like her Facebook page at Vitalichi Acupuncture. For more information, call 941-979-9793.

How I prepared my acupuncture and massage practice for Hurricane Irma

In 2017, Southwest Florida braced for impact from Hurricane Irma. I was on medical leave from my newspaper job as well as my acupuncture and massage practice after surgery, but I got clearance from my surgeon days before to resume light-duty activities. I spent a not-so-light weekend with my family preparing my home and my business for the worst.

Port Charlotte was lucky. Although some models predicted we would sustain a direct hit, Irma took a bit of a southward bend and hit Naples instead. It may seem like all our preparations were for naught, but I considered it a good exercise in disaster preparedness for my business. There’s a lot of articles about preparing your practice for a hurricane, but they don’t tell you anything beyond the basics that residents shouldn’t already know, and nothing about the specifics of what you should do before a storm to minimize your property losses….

So here’s what I did. Some of it is specific to acupuncture but most of it is good advice for acupuncture, massage, or a skin care practice, and good advice in general for a business. I’m assuming from this point that you have taken all reasonable precautions to secure your family’s safety and followed standard disaster preparedness protocols and still have the time to safely attend to your business storm plan…

1) UPLOAD DOCUMENTS TO A CLOUD STORAGE SERVICE: Save current pictures of all areas of your office, inside and out, insurance documents, equipment inventory, sharps logs, biohazard plan, licenses, NPI numbers, important contacts, etc. Make sure you have as much of that accessible on the cloud as possible in the event you need to file a claim.
2) BACKUP IMPORTANT FILES: June 1 is the start of hurricane season. Why not schedule your computer backups for the week before?

1) SECURE SHARPS: When the storm tracking models started swaying our way, we still had a few days of lead time, so I contacted my sharps disposal company and had them pick up all of my sharps containers, even if they weren’t full. I remember after Hurricane Charley seeing tons of personal property strewn all over the streets, and there was no way I wanted one of my sharps containers to end up on the street, even if I did seal them first. Just because you safely secure your sharps inside your unit does not mean they will stay there if disaster strikes. Ditto for wall-mounted sharps containers. I consider it to be the most critical prep to cross off your list.
2) SECURE CLIENT FILES: During Irma, I was part of a holistic clinic at New Hope Chiropractic, and our client files were stored in a common area. There wasn’t much we could do to improve where they were or move them. I’m assuming you already have your files in the safest, most secure part of your office away from windows and in the interior of your unit. We covered everything in the front office with as many heavy-duty trash bags as we could fit to prevent water intrusion and wrapped everything else. But what about files you transport off site? A hard-shell, locking case is your best option. In the event your vehicle is compromised or in an accident, you want your files to have the best chance to stay intact and inaccessible to the public.
3) SECURE YOUR ELECTRONICS: Since most practices these days have electronic health records, it’s important to treat your laptops or desktops like patient files. This year, I plan to keep plastic bins on hand to store all the computer equipment, and to be double safe, I would double bag the equipment with heavy duty garbage bags before putting it in the plastic bin. A bit much, you say? Aside from your treatment table and professional supplies, your computer / client files are the second most important thing you need to get your practice up and running ASAP after a disaster. And wrapped equipment in opaque plastic bins won’t be as flashy in case looting becomes an issue post disaster. Ditto for modems, phones and credit card machines. I’m not so concerned about my printers, but we did cover them, too. If time permits, I would box these too.

1) SPECIALTY EQUIPMENT: Bag and wrap all high-end equipment, and if possible, relocate to interior closets away from windows and doors. Bonus points if you have locking closets.
2) UNUSED NEEDLES, LANCETS, ETC: I took those offsite but this year I plan to have a specific plastic opaque bin for my supplies.
3) TREATMENT TABLES: Bag and wrap all your treatment tables and relocate those to the safest interior spot in the unit. During Irma preparations, I couldn’t find my massage table carrying case, and my table ended up with some minor dings. Make sure you know where the cases and carts for your equipment are before a storm threatens.
4) PRESCRIPTION FORMULAS, HERBS, TOPICALS, ETC: Chinese medicinals are not vitamins. They are patient specific and definitely not candy, either. If you don’t already keep them in a locked cabinet, bag and box them and relocate to an interior closet. I used large zippy bags with handles so I could carry them off site. Secure the rest of your inventory depending on your time constraints.

If you get all the other stuff done, here’s some non-essential prep ideas that could come in handy if your area is hit:
1) STRIP THE WALLS: I took everything off my walls that had glass, and wrapped all my diplomas. I worked hard for those diplomas; to me, the originals would be irreplaceable. Aside from making sure there would be a minimum of glass breakage, it was purely an emotional preparation for me, taking care of the items close to my heart. It’s totally skippable if the situation is urgent.
2) HYGEINE SUPPLIES: Toilet paper, paper towers, feminine items… if you have extra time and an extra garbage bag, bag those up. If you have water intrusion and the area is cut off from normal transport lanes, dry goods will be a godsend. During Irma, gas was scarce for a while, even for areas that did not receive a direct hit. In a storm situation it’s best to assume that supplies of all kinds might be hard to come by even if damage isn’t bad in your area. So save what you’ve got.
3) BACKUP FOOD, WATER AND FIRST AID SUPPLIES: We all know when storm season is coming. So if you’re on target with your personal preparations, why not have backup in the office, too?
4) BACKUP YOUR FILES, ONE MORE TIME: In case it’s been a few weeks, or months, since your last one.

This emergency plan may or may not make sense for your practice, but it can start as a template for writing your own. Don’t assume you will remember to do everything in an emergency; make whatever preparations and lists are appropriate for you and keep them handy for when you need it. Here’s hoping you don’t….

Nicole Noles Collins is a licensed acupuncture physician and massage therapist in Florida. Nicole has two bachelor’s degrees – Alternative Medicine and Professional Health Sciences – as well as a master’s degree in Traditional Chinese Medicine. She has a passion for both writing and natural health. Please visit her website at and like her Facebook page at Vitalichi Acupuncture.