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.

TCM and fertility

Things tend to come in cycles. Yeah, punny! Anyway, I have weeks where almost everybody has the same thing; I’ll get like 5 back pains in a row, and the next week everybody has digestive upset, and the week after that everybody’s neck hurts.

Lately, there is a fair amount of lower back pain (but when is there not?), and I have been getting a lot of calls about people wanting to get pregnant. I’m sure there are studies about uterine bloodflow and conception rates with acupuncture, but I figure y’all have google. So, what is it that I do?

Well, first I rule stuff out. A lot about my job is not entirely explicable by modern science, but I don’t believe in miracles. If diagnostic tests have been done and the sperm count is low, for example, I’m not particularly interested in just seeing the woman. If the fallopian tubes are pretty scarred, my expectations are low enough that I would advise going straight to IVF. And little details like boxers vs. briefs, use of hot tubs, or laptop computers held directly on the lap. Nobody thinks of that last one, but to encourage conception, don’t defeat anatomical design by roasting the external gonads!

Then I look at general health. Does either partner have a condition that needs management? If there is no diagnosed disease or syndrome, do Chinese diagnostics determine stagnations or deficiencies? Common syndromes are Liver qi stagnation, Spleen qi deficiency, and Kidney deficiency. I’ll very briefly define these.

In TCM (traditional Chinese medicine), Kidney is the system involved with reproduction. A doctor friend tells me that in the embryonic development, the kidneys and reproductive organs develop together, so it’s not completely divergent from modern medicine. The Kidneys store the essence we receive from our parents, and as we live and age, the Kidney system runs down, faster, if the lifestyle is overworked, overpartied, or otherwise unhealthy. Kidney deficiency is a usual suspect in infertility cases and is often addressed with herbs.

Nearly everyone in the modern world has either/or/some combination of Liver qi stagnation and Spleen qi deficiency. Each organ system has an associated emotion, element, bodily substance, function, etc. The emotion of Liver is anger, i.e. stress, and the emotion of Spleen is worry.

The Liver (according to TCM) is involved in blood storage and smooth flow of qi. It is heavily involved in menstrual and emotional disorders. Which is to say they knew stress affected conception thousands of years ago! Liver disorders also tend to invade upon the Spleen system. Timing of treating stagnation is important, since pregnancy is a functional stagnation.

The Spleen has a digestive system role in TCM. It is in charge of transporting and transforming food and fluids into muscle and energy.  Spleen controls blood and holds everything in place, including the fetus.

So, am I treating infertility? Sort of. When I’m treating a specific area of pain, I am treating a localized meridian imbalance. When I am treating other symptoms, I am trying to re-establish a systemic balance. In my mind, I am less treating infertility than I am trying to correct a stagnation or tonify a deficiency, which is what I would be doing if the chief complaint was any other thing than infertility.

Pain is an acupuncturist’s bread and butter, because progress of pain management is generally pretty easy to track. Pregnancy is a binary condition; you are or you aren’t. It’s something with a fairly limited window to change, as well. With or without assistance, it may take a month, it may take a year. Acupuncture can certainly help temporarily with relaxation, but if you are really looking to affect fertility, it will do the most good on a regular basis. Take time for acupuncture, take time for sleep, regular meals, general well being, and (this should be a no brainer) take time for baby-making! Some of y’all almost seem too busy to get busy!

alternative abdominals

thinker

My latest thing is hula hoop class, and it’s really fun! I had been looking for a good core workout, and this may fit the bill. I hate doing sit-ups like you don’t even know, though I did manage to complete the two hundred. A few months ago. And I don’t think I’ve done a sit-up since. Finding a wide open space has motivated me to go to the gym better than the elliptical, and an hour of hooping does work up a sweat!

If you suffer from headaches, one of a few things that could help is developing your core muscles. Also, if you get acne on the lower half of your face, have TMJ problems or back pain, notice if you find yourself adopting The Thinker pose. When your core muscles aren’t strong enough to hold you upright, you end up propping up you head in/on your hand. This puts a lot of pressure in your jaw, where it is not supposed to be. Holding any position for a long time is going to cause discomfort, but this one has a few telltale signs and is a really easy one to make into a bad habit.

Exercise is an essential habit to get into, anyway. Might as well make it fun.

New look for Bishop Acupuncture on the web!

Hi, y’all. Let me know about dead links and other bugs, but please be patient with me as I get used to Word Press. Thanks!

Why I got a flu shot

I’m not going to tell you to get one or not to get one, but I’ll tell you why I got mine. I’m unconvinced it was the flu, but I’ve lost work to illness the last couple of winters, and I don’t get paid sicktime. It’s been years since I had a flu shot, so I said to myself in my sickbed this February, “I’ll try it and see if I get sick this year.”

So why had I been avoiding it? Well, I hadn’t had a flu shot since they were free in the corporate world. When I did get one, I got sick. I heard things about mercury and autoimmune disorders. I was underinsured.

Obviously, I don’t need a double-blind study for everything I believe; I’m an acupuncturist! I drank the Kool-Aid about vaccination for a while, but I have to tell you, being a complementary medical practitioner and being a scientist are not mutually exclusive. And I never stopped believing in germ theory; wash your hands, people. All the yu ping feng san in the world won’t make you invincible.

Vaccination doesn’t make you invincible, either. Viruses mutate. There are many different strains of flu; every year, the vaccine makers pick which they think are going to be the key players. If it’s a good match, vaccination can decrease infection rates from 70-90% in healthy adults. Sometimes the shot isn’t a good match, and sometimes the recipient isn’t healthy. The vaccination doesn’t work as well in the elderly, the very young, and those with decreased immune systems, in other words, the people who need its protection the most. It takes a couple of weeks for the body to build antibodies, anyway; if you are exposed to the flu the day you get the shot, you may be SOL. Sometimes it makes people feel sick for a day or two (rather than the 2 weeks of awful that is, not just a cold, but the actual flu).

So, getting a flu shot is a gamble; it might not actually protect you from the flu at all. Or it might. So let’s look at some other things the rumor mill would say are a big risk. Mercury, for example. There is four times as much mercury in a can of tuna than there is in a flu shot. The autism thing has been disproven. Guillain-Barré. One of the scare articles I’ve been spammed with says, “an undisclosed number of people” receiving swine flu vaccination have come down with it. In my life, I can’t remember hearing about swine flu, so I Googled it. You know when the last time swine flu vaccinations were a big thing? 1976. You could say an undisclosed number of people who got that shot had car accidents, and it would make about as much sense. I’ve read around 500 out of millions and that it is not out of line with the regular rate of this disease.

Now, critics of western medicine and Big Pharma will say that corporate representatives advertise their products to the general public and schmooze doctors to get their products used, whether the research backs it up or not. Here’s the thing, though, the same thing happens in alternative medicine. I can’t even tell you how much spam I got in email and phone calls from every player in the herbal market once swine flu started making headlines. (And unlike with the medical doctors, they don’t even bring me breakfast or promotional gifts! This is not because supplement companies are more honest, it’s because I have less purchasing power.) Do I carry a vitamin D product? Sure I do. I’m not promoting it as a panacea, though.

These days my asthma/allergies are under a lot better control than they were a decade ago, which may be a reason I had no complications from the shot this time and took ill for a couple days last time. It didn’t hurt me, though some of my friends have complained about sore arms. I’m fully expecting a bill, since I remain underinsured, but the pharmacist said it was covered.

Now, as far as swine flu, I do plan on getting that one, too, since there have been cases in my city. I didn’t panic when swine flu hit the media, and I’m not panicked now, but I’m going to go ahead and get vaccinated if I can. The way I see it is, if I get sick, I probably won’t die, but I might. And getting sick is mighty inconvenient anyway. To me, the risk of some rare but horrible side effect is worth a chance at preventing very common illness.

There are lots of scary articles out on the internets, but I rather enjoyed these:

http://www.ctv.ca/servlet/ArticleNews/story/CTVNews/20090724/vaccine_faq_090725/20091022?hub=Health

http://www.sciencebasedmedicine.org/?p=851