Archive for November, 2009

I love the insomniac culture. Weird people stay up late and do crazy stuff. I feel more creative at night. I know a lot of people who do. It’s our own time, not the man’s time. However…

Your body needs sleep. You can’t run at a sleep deficit all the time and expect not to be tired. Especially as you get older. Again with the telling you things you don’t want to hear: Your body is limited. It works a lot better with 8 hours of sleep every night. If you don’t take time to recharge, you will crash.

I know. There’s just so much you have to do and so much you want to do. But look at it this way, if you don’t get good sleep, you’ll be tired all the time. Wouldn’t it be better if you could spend your time doing the things you want to do, efficiently, actually getting them done, instead of being tired? When you are well rested, not only is your energy higher and your thoughts clearer, your immune system is stronger, you are more capable of managing stress, and your metabolism is more efficient.

For better quality sleep:

  • Stick to a schedule. Try to wake up, eat, exercise, and go to bed, around the same time every day.
  • Snoring isn’t just annoying for your partner. Sleep apnea means you aren’t getting enough air. Changing your pillow, sleeping on your side, using a neti pot, or using a nasal strip may help. With more severe cases (more common than you might think!), talk to your doctor.
  • Finish eating 2-3 hours before bedtime.
  • Avoid caffeine in the 6-8 hours before bedtime.
  • Don’t consume alcohol close to bedtime. Though it may help you fall asleep, it will be less restful sleep.
  • Set realistic expectations, and set your alarm accordingly. You’ll get a lot more out of your day if you plan to get enough sleep rather than hitting the snooze button for three hours.

My license is to practice acupuncture and herbal medicine. However, those are the last two parts of Oriental Medicine. OM has five aspects by which the body is kept in balance: diet, exercise, meditation, acupuncture, and herbs. Now, it used to be that the village doctor was a shaman, and he would pray over the sick. As acupuncture and herbology were being studied, a novice once asked the master why they didn’t just pray and chant over illness anymore. The master said that the world had gotten too complicated for shamanistic ways to be adequate.

That was hundreds of years ago. The world has gotten even more complicated, as has the field of medicine. Lots of people look at what I do as some kind of primitive, shamanistic thing. In some ways, I can absolutely see myself where the master had placed the shaman. If you’re having a stroke, I’m definitely not adequate, and you’ll get much better care from an ER. But the master didn’t say the shaman had no place, either.

In the modern world full of double blind studies, graphs, charts, and statistical analyses, we often pay too much attention to the numbers. I read the greatest thing in the comments section of a gloom and doom article the other day, something along the lines of, “Even if you don’t believe in global warming, no matter what the numbers say, that’s not the point. How about not polluting because it’s the right thing to do?”

You shouldn’t need a journal full of studies proving decreased risk of diseases and lowered inflammation to know that you should eat your vegetables. Studies proving that environment really doesn’t affect susceptibility to the common cold? I get it, it’s still the virus, not the breeze that is making you sick, but if your nasal membranes are dry, they’ll be more open to viral infection. That still boils down to “don’t stand under a vent.”

All the folksy stuff became well known because it seemed pretty reasonable once upon a time. Granted, there are dangers where we never thought to look, but a lot of it seemed pretty reasonable because it was right. So, I reject hydrocortizone as a miracle healing balm (sorry, Mom), but I do listen to Mom quite a bit. (Even though I still sometimes leave the house with wet hair.) Usually doesn’t hurt, and often helps!

A tip for my retail working friends, and with holiday temp season upon us, there may be more of you!

You might think they look silly, but so do varicose veins, and so does your face when you’re wearing that end of the day grimace. Compression stockings now come in different styles and colors; they don’t have to be your old white nurse’s stockings. I know, I hate pantyhose, too. You still get some benefit with knee highs and thigh highs. I haven’t tried many brands, but I’ve found AmesWalker to have the best prices.

I discovered these when I worked retail; 8 hours on my feet on a concrete floor, Danskos or not, my feet, legs, and back killed me by the end of the shift. If I wore compression socks or hose, I was such a happier person. Your heart pumps blood out. Gravity tends to keep it there, pooled in your feet and calves. The pressure of the stockings with the movement of your legs really helps to keep circulation going. Where there is blockage there is pain! What do you have to lose?

In googling for studies and interpretations on the flu vaccines, I came across Science-Based Medicine. A little snarky at times, they seemed like my sort of people. Then I read what they think about acupuncture. Apparently, I am unethical, irresponsible, and practicing tooth-fairy science. Much of this has to do with the lack of well designed scientific studies. Hi, there, Pot! You can call me Kettle!

I pause to link in this context, I really do. Because I don’t want to be giving the antivaxers anything that can be construed as support. But I conclude flu vaccination is beneficial, given vaccination’s history, even if the current studies aren’t all well designed with great numbers. I conclude that acupuncture is worth doing, and I can’t conceive of a well designed study. There are just too many variables. Needling placement. (I can think of five schools of theory that will come up with different places to put the needles to treat the same thing.) Style. (Tonify or sedate, in school we talked about at least 9 ways to do both. I don’t think modern science even accepts the concepts of tonify or sedate.) Depth. Gauge. How in the world to make it truly double-blind. What’s being treated, and how severe it is. Even if I could think of an acceptable study, here’s the thing. Acupuncturists who are successful enough to fund a study tend to have enough of a reputation for results that they don’t need scientific papers on the field. Acupuncturists who don’t have that sort of clout don’t have any money. So the studies are left to the scientific establishment, people who aren’t particularly interested in acupuncture theory and leave out so much that anyone who does employ acupuncture theory finds the study to be quite flawed.

It’s also commonly said that acupuncture is unsafe, carrying large risk of disease transmission, pneumothorax, and makes patients delay seeking effective treatment. Common to the point that pneumothorax is standard on a consent to treatment form. It has made a potential patient leave at least once. Thing is, I am licensed in acupuncture. I’ve taken my anatomy classes. And been certified in clean needle technique. We who have had the education are held to the double standard where we have to take exams and pay considerable fees to maintain licensure, but we’re painted with the broad idiot-brush for the mistakes of those who have not. I’ll admit it’s not that hard for a patient to get a minor hematoma. Sometimes I stick a blood vessel. It happens. Maybe a couple times a year. But to do serious damage like puncturing a lung, you’d either have to have no idea where the lungs are, or be careless to the point of almost trying to cause damage. In Texas, if not for chronic pain or substance dependency, my patient needs to have been seen by an MD or DC first. And we acupuncturists have a time/treatment limit we need to meet. Progress, or send them to an MD. I’m okay with that. As I’ve said before, I am not the ultimate authority on anything. I don’t want to be, either. (Malpractice insurance fees, anyone? My current premium is ugly enough as is.)

I’m an engineer’s daughter, my sister and her husband are both MDs, and pretty much everyone I socialized with in undergrad went on to medical school. My undergrad degrees are in computer science and math. Trust me when I say I never imagined I’d be doing this when I grew up. I tried it, acupuncture helped me, and I studied it. I have since helped others. So, I think I’ve covered tooth-fairy science (it is, what’s your point?), responsibility (regulation by the Texas Medical Board is pretty good about making sure I do no harm), and now we get into ethics. How can I live with myself, practicing an unproven modality? Isn’t it wrong of me to sell the placebo effect for my own personal gain? Aren’t I no better than an antivaxer making a fortune on immunotonics?

What I see most is chronic pain. Probably any acupuncturist would say that. Those patients don’t have to have seen a doctor, but usually they have, and usually it didn’t help, or didn’t help enough. Maybe it’s not the needles. Maybe it’s the personal attention I give them. Maybe it’s the relaxation of lying down on a padded table with quiet music and the aromatherapy diffuser I usually forget to put oil in. They usually leave feeling better. (I wouldn’t be able to make a living, or if I could, wouldn’t be able to stomach making a living like that if my results were mostly bad.) Does how really matter? I would never tell someone to go off their meds. In fact, I’ve used acupuncture to help patients stay on chemotherapy. But sometimes they don’t want to be on meds, want to be on fewer meds, are on meds that aren’t effective enough, or they are going to avoid or delay surgery anyway and would like to be more comfortable. Is it more ethical to deny them care because it hasn’t been sufficiently statistically proven in a published paper, or is it more ethical to say, “I think I can help you with that” and at least provide temporary relief with few side effects?

AntiCAMers, I used to be one of you. Why use primitive healing when you have modern medicine? Modern medicine is great; I was sure glad to have access to it when I had appendicitis. On several of my patients’ back pains, not so much. That’s okay. I don’t think there’s any one right way. If you don’t like the idea of acupuncture, don’t get it. You might try it if you’re hurting badly enough. If you’re incensed about safety, you don’t have to be an acupuncturist to get on the board and draft the rules. But it’s been around (evolving, BTW, like any other academic field of worth, since there is also the argument that it is NOT an ancient practice, so longevity is NOT a rational argument) for several millenia, and I don’t think it’s going away.

I went to a health fair on Thursday at the Travis school. There were lots of different fields represented. As I’ve mentioned before, I’m an acupuncturist; not everything I believe has to have been proven through double-blind studies. I was assigned a table next to the School of Metaphysics, and we had some interesting conversations about dream interpretation and the mind-body connection.

I also have a strong background in science and a twitchy BS-ometer, and I realize how easy it would be to mount a fear campaign against dihydrogen monoxide. (It’s used in the manufacture of pesticides! It’s a major component of acid rain! It contributes to the greenhouse effect! Promotes corrosion and rust! Injection in pure form causes cell death! It’s in our oceans, lakes, and streams! It’s…water.)

At the fair, we were provided with a packet from a clinic, with a refrigerator magnet and an explanation on how nutrition can help the body, with outrage that we spend so much money for drugs against noncommunicable diseases. That, I can’t say I find objectionable. However, there was also a note with instructions about vaccination exemption, lists of various chemicals and biological substances and the questions “Do you really want this in your body and in your children?” “Did you get a swine flu shot? (scary list of things, implied though not explicitly stated as ingredients in said shot) What did you get?”

I hope the community of a TAG school would be interested in learning more and being informed. I hope that people are smart enough to get their information from informative materials, rather than from advertising. Because make no mistake, that packet was advertising. There will be many posts on this blog that are advertising. This is not particularly one of them. But be aware that while we alternative practitioners rail against Pharmaceutical Corporations, it’s still advertising when we suggest your dollars would better line our pockets instead of theirs because _________. Advertising is not a bad thing; without it, the business owner could hardly stay afloat, even those who don’t make a living out of peddling fear. You should still seek information elsewhere. For this, I suggest the CDC, WebMD, and the Institute for Vaccine Safety.

I know that many of my colleagues have issues with vaccination. I admit I am not the ultimate authority on anything, and there is a lot I don’t understand. I concede that people should have a degree of autonomy. However, vaccination isn’t so much about personal choice as it is about protecting public health, which is why there are requirements for kids in school.

I’m glad there are skeptics who ask questions and don’t implicitly trust authority. There would be no innovation if everyone accepted norms. In this case, I’m not sure what the point is except to instill fear for personal gain, and that is not an ethical way to run a practice.

How do vaccines protect public health? Vaccines increase immunity in most people to the pathogen in question. No, they aren’t a guarantee, but as you can see with smallpox, polio, measles, and mumps, fewer people in the population get sick when most have been vaccinated. And, it’s true, vaccines are not as effective in babies, the elderly, the immunocompromised. Which is why it’s so important for the rest of us to get vaccinated, so we don’t pass disease onto them; they won’t bounce back as easily as we will.

Every decision or nondecision in the world will probably expose you to something that someone could convince you is a hazard. Life is a collection of risks. For the individual, the question is, is the risk greater to vaccinate or not vaccinate? Who has calculated those risks? Where are you getting most of your information?

For the alternative practitioner, where did YOU get your information? If you did not stand to profit financially, would that change your reasoning? Are you sure that your patients are going to follow your immune-boosting protocol? Whether they do or don’t, are you confident that you have stopped the spread of the communicable disease in question more effectively than by vaccination? It’s easy to rail against The Establishment, but remember that people depend on you. Wield your authority responsibly.

In any yoga class I’ve attended, the focus has never been on crazy positions and flexibility of the body. All poses were optional. It was always about the breath. As it should be; it is easy to focus on the body, less so on the involuntary act of breathing. It’s involuntary; it happens even when we’re not thinking about it, so why should we examine it?

Well, breath can make things easier or harder. I’m not sure how it worked out with evolution that we’ll breathe shallow or hold our breath under duress, but so it goes. It’s weird, isn’t it? Breath sends oxygen to the lungs, where it goes into the blood, which delivers it to every cell to do its job. Every cell needs oxygen, so when you’re breathing efficiently, your whole body works better. You have more energy and less fatigue. You think more clearly and are better able to handle stress. Your pain tolerance goes up. It is a beneficial cycle with good posture. When you are aware of your posture, you breathe better, when you breathe better, you have the energy not to slouch so much.

Things tend to be easier on an exhale. Perhaps this is why we sigh or shout in frustration. You can test ease-on-exhale with weight-lifting or push-ups. Try 10 reps without paying attention to your breathing. (And since I said not to think about the purple elephant, you may notice that you’re holding your breath a lot!) Then try 10 reps, breathing out on the push.

For some people, mindfulness is enough. Some people benefit from doing breathing exercises. Laughter is great breathing exercise. Got a long commute? Vent your road rage by singing instead.

Specifically, I’m talking about food preparation, though it could apply to all sorts of things. Now, I’m not advocating making things on your own all the time, for what would our economy be without the exchange of currency for goods and services? However, making your own has several benefits. It gives you an appreciation for how things are made, and particularly, what goes into them. Which means what goes into you.

While they are all essential substances, your body has limited ways of dealing with too much fat, sugar, and salt. Obesity, heart disease, gall bladder problems, diabetes, and hypertension will result from a lifestyle of overindulgence. But what is overindulgence? How can common foods be so bad for you?

I am not a fan of dieting as a concept, but I do think that periodic tracking is a good way to reprogram the way you think about food. Sites like fitday can make reports that show your surpluses and deficiencies. Like I mentioned in yesterday’s post, you don’t have to feel guilty about everything you eat, but be mindful of what it will and won’t do for your health. For example, a little dark chocolate is a nice treat and provides antioxidants. A lot, and the excess sugar outweighs the benefit.

I made a pumpkin latte this morning and realized I had to use too much coffee and too much sugar for it to taste sufficiently awesome. (And it was really awesome, and I’m not sorry for it. I’m just not touching any candy for a few days.) And now I have a visual cue of how much sugar is in a blended drink I’d buy from a chain. If I make desserts, I share them, for I know exactly how much sugar and butter went into them. Even the so-called healthy stuff can contain unexpected things. I made a pot of black beans with salt pork the other week, and it was amazing! Why was it amazing? It contained a ton of fat! Of course it was delicious! So, a menu might not mention the fat that is flavoring my healthy beans and rice, but knowing it’s there affects my other food choices, including how much of it I’m going to eat.

I know, boo hoo, everything’s bad for you, why do I gotta be such a downer. But for the eat what you want, when you want, without thinking about it? If you were really happy with the results, you probably wouldn’t be reading my blog, right?

but you may be surprised to hear I take cetirizine almost every day. I have a love/hate relationship with coffee. I drink beer. I got a flu shot. I consume dairy. I am absolutely not a vegetarian. Here’s the thing, though, I drink a lot of water, too. And I don’t eat a lot of dairy or meat.

People get these crazy ideas about folks in my business, and I’ll admit I do have colleagues who don’t eat meat, dairy, added sugar, inorganic produce, gluten, etc. But even these people eat more than salads and strawberries. (Somehow, this is always the response when people tell me they’re eating healthy. I just don’t get it.) And pretty much everyone I know is just as happy to drink too much wine as to detox and do yoga all weekend.

So what I’m getting at here, is we’re here to make you feel better, not to judge. Be realistic. Be honest. And if you diverge from the path you’ve set to your goals, you don’t have to beat yourself up about it. And it’s not our job to beat you up about it. Acknowledge, re-evaluate, and get back on the path. Or, a path, anyway.

I love my neti pot! It took years for my friend to convince me to try it, but I have since convinced at least 3 others, including my mom. I wish I’d known about them in college.

A neti pot is a small vessel, ceramic, plastic, or metal, in which a warm saline solution is prepared. The pot has a long spout, around which you seal one nostril. The solution is poured through your sinuses, going in one nostril and draining out the other. “It’s amazing,” my friend told me, “you look in the sink and go, ‘That used to be in my head.'”

While I have yet to see truly scary things pour out of me, I do have a much better time of it with congestion and other allergy symptoms. And it was a lot easier to learn than I thought! If you can swim with your face in the water, you can definitely neti. It isn’t much harder than washing your face. There are just a few crucial things, water temperature, salt concentration, and only breathing through your mouth.

It is easiest to use a neti pot in the shower, because you have good temperature water (the brain freeze from using a neti pot with cold water is way worse than eating ice cream too quickly) and you don’t have to worry about splash. In this case, I recommend using a plastic model. Some neti pots come with pre-measured packets of salt. I have a little plastic jar that stays next to my neti pot; I fill it with mostly kosher salt and a bit of baking soda to buffer it. 1/4 teaspoon will create a fairly strong solution in a 1/2c neti pot.

So you have a warm solution mixed in the pot, now lean forward a bit, put the spout to one nostril, turn your head so that nostril is on top, breathe through your mouth, and let gravity do its thing. It kind of tickles at first, just don’t breathe through your nose! Then, gently blow the remaining water out of your nose, and repeat on the other side. I try to neti at night, but if I have to in the morning, I hang my head for a bit and try to force the water out of my sinuses; there is usually a little bit remaining.

Why would you do this crazy thing? If you suffer from any of the tagged conditions, if you tend to get nosebleeds from dry air, it can help! When you have a sore throat that’s above your throat so a lozenge is useless, this feels great!

Sometimes the nose is so stuffed that nothing goes through. There are a few options for this before you reach for that addictive spray. Similar to the neti pot, there are squeeze bottles with one-way valves (preventing backwash) to pressure the solution through. There are powered devices that also add force to the solution. And of course, acupuncture.

It’s still warm enough here in Texas to think about wearing sandals, probably not enough to worry too much about this topic, but it’s a pet peeve of mine. Can acupuncture treat plantar fasciitis? Sure. But in my experience, it is not a terrifically comfortable treatment and such an easily preventable pain. To prevent plantar fasciitis flare-ups, wear shoes with heel support. And arch support, and enough cushioning. Almost everyone I’ve ever seen with plantar fasciitis came in wearing backless shoes. No. Just, no.

I also maintain that flip flops should never be worn by people who value their feet. Not only do they offer no support, but the way they are designed is a recipe for bunions. Pain we can deal with, but once your feet are structurally deformed like that, there really isn’t an easy way to straighten them out, and you’ll never be able to find shoes that fit right again.

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