What is “healthy?”

Who could deny that salads are good for you? How could raw vegetables be a bad thing? Particularly when not overwhelmed by a mucus-forming, creamy, high-calorie dressing?

I say that different people need to exercise different degrees of moderation in all things. More raw food is probably great for someone with heat imbalance. Someone who needs the cooling influence of raw food may have a short fuse, a red face, tendency towards heartburn, and/or excessive body heat. Raw plant matter requires extra effort in digestion to liberate the nutrients from inside the cell wall. When a body has plenty of vigor and stored fuel, this can be a good thing for weight reduction.

When someone is drained, pale, tends to feel cold, is prone to indigestion–but not the sharp heat of heartburn, more like a prolonged dull pain of bloating–then a daily salad could be the worst thing for them. When digestion is weakened, so is the body. When the body is already weakened, it is not a good idea to make it work harder for its nutrition. If you’re overweight and wonder why eating salad all the time made you feel terrible, that’s why. It probably is not right for your body type.

I’m not saying meat and starch is the answer, either. Eating lots of vegetables is generally a good thing. But maybe, instead of mixing them in a salad bowl straight out of the fridge, you can toss ’em in a wok for just a minute or so, to get a little wilt and color bloom. They don’t have to be mushy, just not stone cold and raw. I’ve never cooked lettuce, but kale, cabbage, chard, spinach? Sure.

A patient recently told me, “Hey, remember how you told me to not eat raw food? I didn’t for a while, and it was good. But then I did last week, because that’s what I eat in the morning, and the symptoms were worse.” I get it, habits can be tough to make and break, and raw food is pretty easy! But do listen to your body. If it isn’t happy, try a change for a couple of weeks and see what happens. We are all works in progress.

For the hot ladies!

Feeling prickly. Flushed. Breaking out in a sweat. Waking up at night with the sheets all drenched. So hot, you itch. Like you might never feel cool again. Summer in Texas? Try Summer in Texas and going through menopause.

If you’re reading this for someone else and never had a hot flash? (Say, too young, or male?) If you aren’t prone to low blood pressure, you can simulate one by taking 30 to 50 mg of niacin. (Not niacinamide, and check with your doctor first if you are on any medications.) In the summer, this is an uncomfortable exercise in empathy. In the winter, it’s a pretty neat trick to make doing the dishes more comfortable when on camping trips. While Asian women experience hot flashes less than many demographics, Traditional East Asian Medicine (TEAM) has a well developed explanation of the phenomenon.

TEAM has its roots in balance. The modern medical term would be homeostasis, keeping the internal environment of a living organism stable. For life processes, temperature, pH, concentrations of water, sugar, and electrolytes, among other things, need to be in a pretty narrow range.

The most fundamental TEAM balance is the yin/yang balance. Yin and yang are opposite, but complementary. Like light and dark, something is not precisely one or the other, but they are on a scale. An overcast day is darker than a sunny one but is lighter than the night of a new moon. A man can be empathetic, and a woman can be strong.

 

Yin

Yang

female

male

cold

hot

dark

light

matter

energy

wet

dry

stillness

activity

contracting

expanding

 

As modern medicine explains menopause as estrogen withdrawal, TEAM looks at it as declining yin in the body balance. When there is not enough yin, yang takes over, resulting in symptoms like hot flashes, night sweats, and irritability. Fortunately, there are ways to supplement yin that aren’t straight hormone replacement!

So how can you beat the heat from the inside and out?

Some very basic yin boosts include staying hydrated, getting enough sleep, and taking time to relax. Smoking or being around a lot of secondhand smoke is particularly bad for menopause–fire is about as yang as you can get! Although stillness is yin, exercise is beneficial. Regular activity from the muscles leads to the internal organs not having to work as hard.

While Black Cohosh is a very popular western herb, it is not in the TEAM materia medica for menopause. It is in the chapter for the common cold, though. Eating a slice of watermelon every day (nibble on the rind a bit; that part is beneficial, too) can help clear heat from the body. More fruits and vegetables are good in general. Meat, dairy, and alcohol promote heat. One drink may promote relaxation and benefit the heart. More than one makes the body work harder, so cut yourself off.

For more specialized treatment, see a licensed acupuncturist. Acupuncture is generally very relaxing and has recently gotten good press for diminishing hot flashes. In my clinical experience, herbs are more effective and efficient for these symptoms. In Texas, acupuncturists take a national exam for herbs as well as acupuncture. There are a few very commonly used formulas for hot flashes, but your particular case may call for something different.

I would recommend to everyone trying to survive summer, wear layers and wicking fabrics. Carry a water bottle–you’ll drink if it’s with you. I hope this helps you stay cool!

Looking for a miracle?

You guys, I hate marketing. Health care marketing tends to be either fear based (consume this or you will die painfully/catch a horrible disease/be ugly and unpopular) or sets unreasonable expectations (consume this and you’ll be full of life, energy, beauty, and general sexiness). I guess that’s mass marketing in general, but there is something about applying it to what I do–making a personal connection and really helping someone–that is very off putting to me. But if I don’t do it, then I don’t get customers, and if I don’t get customers, I have to look for a “real job,” one where my talents will likely be underutilized, and I’m making widgets instead of helping people.

Optimally, people see me on a regular basis, increasing the time between visits as they are getting healthier, until they feel well enough that I don’t expect to see them anymore. Over the years, I have seen a lot of temporary relief. I have seen plenty of people not have significant improvement. Most of those, I take with a large rock of halite, because if someone’s had a condition a long time and sees me sporadically once or twice? I’m not expecting much, in the same way that if a pneumonia patient takes one or two antibiotics a few days apart, that patient is still going to have pneumonia!

I’ve also had some unexpectedly awesome results.

  • “He could smell and taste his last holiday meal.” (cancer patient with anosmia)
  • “I sat up all night looking at the Christmas tree. I could see it.” (severe macular degeneration)
  • “I don’t know if it was the acupuncture, but I can tell you my husband and I were trying for four years, and I was never pregnant before!” (actually, I don’t even remember if I was treating this young lady particularly for infertility. Oh yeah, it was for amenorrhea. Which after a while was a symptom instead of a syndrome.)

Looking for your Christmas miracle? I’ve facilitated a few. I’m not going to guarantee it, but let’s see what we can do. “I can pick up my baby girl, and it doesn’t hurt.” Merry Christmas, dude who was in daily sciatic pain since January!

Thankful for my mom

Did everyone have a nice Thanksgiving holiday? I had a pleasantly uneventful couple of days. I did catch up with my mother on the phone, and she tells me her blood pressure is getting back to normal. “I’m not doing anything different, but I never was,” she reports. “But I have been sleeping pretty well in the last few weeks. I didn’t sleep well for a long time after that sting.”

Ha! I knew it was related to that episode! Folks, my mom was working in her garden this spring, and for Mother’s Day, she discovered she is violently allergic to yellow jackets. Yeah, happy freaking Mother’s Day, right? Shortly after, her annual physical showed elevated blood pressure. It stayed high for months, despite eating well, exercising daily (which she does anyway), and taking herbs that I sent to her. Much to her pride and relief, her doctor said she didn’t have to take medication just yet.

Mom used to always start phone conversations with, “Are you eating, are you sleeping?” I noticed the lack, but I figured she was starting to trust me to take care of myself. I think there was maybe a bit of denial there, too. “No symptoms, nothing is going on except my systolic is high.”

Insomnia can affect the nervous, metabolic, immune, endocrine, and cardiovascular systems, which cover every process in the body. If you aren’t getting proper sleep, your body is not functioning as it should. How long has it been since you got a good night’s sleep? Let me help! Whether through acupuncture, supplements, and/or better habits, you can stress less and get the rest you need!

Use it or lose it?

stethoscipe_piggy_bank

If you’re wondering how to use the rest of your flex-med account, now’s a great time to try acupuncture! Whether you wonder if you could reduce your medication intake, need some relief, or just want to relax a bit from the end-of-year madness, why not see if I can help? Call for your appointment soon!

 

In other news, I’m updating for the first time in several months. I remembered my word press password! Unfortunately, I don’t remember my hosting password, so I can’t implement the cool plug-ins just yet. Construction still looks daunting, but the intersections are clear! I think the worst is over on that front; as a matter of fact, I see someone parked on the street in front of my building, and it’s not a backhoe! Yaaay!!!

Charity consultations

One of my resolutions for 2011 is to give reasonably. If you’re anything like me, you have about 20 emails and phone calls a day from various causes and friends for causes asking for your support. Definitely more than my budget can afford.

Another problem I have is people flaking on their consultation appointments. Sometimes when an appointment is for a free service, people don’t feel the need to call and inform the person waiting that they’re not coming. However, as a consumer myself, I don’t like the idea of having to pay a lot before I establish trust of my care provider. I figure you should at least get the chance to meet me in person.

So here’s my idea for combining two solutions. Each new patient appointment will be reserved with a deposit of $20, either by paypal or by credit card over the phone. As soon as said patient is seen, he or she will have three options, consisting of an immediate refund, applying the deposit to treatment, or having it go to the non-profit of the month.

January/February consults go to Resource Center Dallas. Got a pet cause? Send me a referral!

How I can do what I do

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.

Pain prognosis

I’m trying to write something every day this month as an unofficial attempt at nablopomo, and I’m already not sure what to write about. What do you want to read about?

We’re all always still learning, and I do well in a classroom setting. Two weekends ago I had a refresher class in Dr. Tan’s Balance Method. Dr. Tan has a clinic in San Diego and lectures all around the world. He grew up with traditional medicine, but he had to go to school here for certification purposes. He also studied engineering.

Now, a lot of times when acupuncture points are chosen, it’s because they are local to pain or because the book says it’s good for that. There are lots of systems of how to select points, but Dr. Tan’s makes sense, usually works, and usually works fast.

There are meridians of qi or life energy all through the body. They are distinct from blood and nerves, though many points are near vessels or nerves. When something hurts, we can localize it to a meridian being imbalanced. To restore balance, we have to adjust the other side of the scale, in other words, needle a corresponding meridian.

The trigrams of the i-ching are composed of solid or broken lines, representing yin or yang. Dr. Tan observes that this is binary, the way computers represent everything by sequences of zeroes and ones. A lot can be represented in this method, and we are able to create a digital representation of the body by assigning different trigrams to different elements, and therefore to different meridians. Which might not make much sense to the layperson, but if you’ve studied any theory of traditional Chinese medicine, the way Dr. Tan lays it out makes you go, “Ohhh, I get it now.”

Like I said, there are many different systems of selecting treatment points, but this is the first one I’ve learned where the teacher expects my patient to feel noticeably better within seconds. It never gets old to have a frozen shoulder patient raise the arm all the way. It’s not always the system I use, but if you can tell me exactly where it hurts, I can usually find exactly what will make it feel better.