2013…Year of the Snake

2013 is the year of the black Snake begins on February 10th shortly after the New moon in Aquarius, the humanitarian of the zodiac. This 2013 year of Snake is meant for steady progress and attention to detail. Focus and discipline will be necessary for you to achieve what you set out to create. The Snake is the sixth sign of the Chinese Zodiac, which consists of 12 Animal Signs. It is the enigmatic, intuitive, introspective, refined and collected of the Animals Signs. Ancient Chinese wisdom says a Snake in the house is a good omen because it means that your family will not starve.

Oh my aching lower back and hip…

Oh my aching lower back and hip…

Back pain can sideline the strongest of us. When an ache becomes a chronic pain, even something as small as a single step can feel like too much. Here is one woman’s story of coming back from the sidelines to recover from a seemingly endless amount of pain, and how acupuncture helped.

Mindy’s Pain

Mindy came to my office after suffering for one year from bursitis in her right hip and referred tightness and soreness in her low back. She had made all the rounds with the medical doctors and had all the tests and procedures needed to diagnose bursitis of the hip. At the end of the day she was told to take over the counter anti-inflammatories and have physical therapy sessions twice weekly. 

Even with the anti-inflammatories and physical therapy, the pain was unbearable. Too much walking, standing, or sitting caused the hip to ache, which then referred into the right side of her back and into her right knee. She had difficulty getting up and down from seated positions. She walked with a limp and could not get comfortable sitting, standing, or lying down. Her sleep was disturbed because her hip pain woke her throughout the night. She had a 24/7 pain cycle that kept her very stressed, anxious, and depressed.

After months of painful physical therapy did nothing to relive the hip and back pain, Mindy’s doctor resorted to injections of cortisone shots into her aching hip. But this proved ineffective as well. Her doctor told her to take her medications daily for the pain and that she should “be happy that she didn’t have arthritis in her hip.” She felt dismissed and discouraged with this “recommendation.”

Why Acupuncture?

Through the entire ordeal Mindy had also been receiving massage therapy. While this helped her relax, it did nothing to relieve the pain. After months, her massage therapist recommended that she try acupuncture for her chronic hip and back pain. And that was how Mindy ended up in such a desperate state at my office. 

The year of pain and suffering had taken its toll on Mindy. She was losing hope in returning to her “normal” life. She was an articulate, youthful 62 years old when we met and she had lived a very active, full life up until the hip and back pain had sidelined her. Happily married with two grown children and two grandchildren, her life was full with family, friends, and travel.  

Before the pain she adored spending time with her young grandchildren that were only a train ride away. Her daughter relied on her to help with the children and up until the chronic pain, Mindy was always up to the task. It frustrated her that she could no longer go to the park with her grandchildren or get down on the floor to play with them -- not to mention that she could not longer walk around NYC without hip and lower back pain. 

Before the pain she often volunteered her time, going to third world countries to participate in building homes and structures in depressed communities. The builds were very physically and mentally demanding, lasting for several weeks at a time, and were impossible for her to even consider with the pain. She had cancelled all her upcoming builds due to her physical problems and this felt like the beginning of a long life of pain, suffering, and inactivity.

As we sat and talked during our initial intake, I noticed that she was sad and lacked confidence that she would ever have the physical ability to live her former full life again. She usually walked three miles up steep hills every weekend with friends, which was a great source of exercise, fun, and social connection for her. But with her hip pain, this was out of the question. The pain was taking away, little by little, all the things in life that were rewarding and brought her pleasure.

The Goal

Mindy had always been a powerhouse, full of life and passion. She constantly was helping and giving back to her family, friends, and communities around the world. Although she had little hope that she would regain her old life, she had some dreams.

She hoped that she would be able to go on a build again, to give back to the communities she so cared about. She hoped to play with her grandchildren with ease, rejoin her friends on the weekends, and start enjoying her normal day-to-day activities again. 

I made no promises or guarantees except that I would do everything in my power to help mend her hip and back. This is when I wished for my magic wand, to wave her back to her former active self.

The Diagnosis

Mindy’s Chinese Medicine diagnosis was “qi and blood stagnation” as well as “cold damp bi” (pain) syndrome. This was an acute condition that had persisted for the past year, now turning her condition into a chronic one -- much tougher to resolve.

Bursitis is a painful condition that affects the small fluid sacs, call bursae, that cushion the surroundings bones, tendons, and muscles around the joint spaces in the body. The bursae reduce friction on the joints during movement and it is when these bursae become inflamed that bursitis occurs. The symptoms are stabbing, shooting pain and stiffness around the effected joint. Movement makes the pain worse. Bursitis in the hip joint is very common and is usually due to overuse or repetitive movement.

This was the case with Mindy. She had been working with a personal trainer for several years and he had recently added a routine of repetitive squats and lunges that had lead up to the bursitis of the hip. She stopped all physical training when she began seeing me, as even the physical therapy was causing more pain.

The Treatment

We began our acupuncture treatments with a focus on reducing her hip inflammation and reducing the muscle spasms in her low back at the sacrum and buttock area on the right side. She came twice weekly for the first month and then when her symptoms lessened, we continued with weekly treatments. As the inflammation became less and less, we added gentle stretching exercises to encourage better range of movement and blood flow to the effected joints. 

After six weeks of treatment, Mindy was able to ride on her stationary bike for twenty minutes at a very low resistance. After three months Mindy was ready to increase her exercise routine. She wanted something more engaging than the stationery bike that bored her to no end. This was when I suggested the mini trampoline.

Bouncing to Health

Before she began the mini trampoline workouts, I scheduled a home session so we could go over proper form and establish a safe workout schedule. Her excitement and motivation to regain her strength and fitness was the force that helped her achieve this goal. After six months of working together she was back with a vengeance. 

Not only was she rebounding on her mini trampoline, but she had also incorporated strength training into her routine. Mindy was a little apprehensive about taking classes at a local Pilates gym, but she went in in spite of her fear. These strength classes have done her a world of good for both her bodily and mental confidence. She now has her muscular strength back as well as her cardiovascular strength -- all without pain. 

This past summer Mindy took part in a build where she endured heavy lifting, lots of walking, and extreme heat -- all without hip or back pain! She is back to “full speed ahead” in her active life, enjoying all her roles as grandmother, wife, world traveler, and woman extraordinaire. 

Mindy continues to amaze me with her interest and zest for life. It’s patients like Mindy that make my work so rewarding. Her spirit, inner strength, and belief in herself made all the difference in her healing.

Oh my aching back...

Oh my aching back…

Back pain is one of the most common and costly conditions that motivates people to seek medical attention. Did you know that more than one million people in the USA are affected with back pain, costing an estimated 37 million dollars annually? This adds up to millions of hours of lost work and productivity, not to mention the pain and suffering of countless people.  

Half of all adults will experience some form of back pain in their lifetime, making this a significant source of inconvenience and suffering. This is also one of the most common reasons that many patients seek my help with acupuncture and herbal treatments. Back pain comes in many shapes and sizes, intensities, and durations, making the treatment of each patient an individualized one.

How Does Back Pain Present?

Common causes of back pain are sprains and strains that can occur from over-stretching or over-loading the muscles and ligaments. This can occur suddenly, as with a fall or accident, or over time through wear and tear from poor posture, improper use, or structural imbalances (like scoliosis, curative of the spine).

Other common ways back pains present are:

• Disc herniation or subluxation -- when a disc that is the inner cushioning between the vertebrae bulges out causing compression of the nerve root in some cases. This can cause referred pain to other areas of the body.

• Sciatica -- a nerve that begins at the spinal cord and goes to the hips, buttocks, and then branches down each leg. It is when the sciatica nerve is irritated or inflamed that one experiences pain, most often radiating into the buttocks or down the legs, causing pain, numbness, and muscle weakness. 

• Osteoarthritis -- when wear and tear on the joints causes the breakdown of cartilage that surrounds, protects, and cushions the bones at the joints.  This can cause pain, swelling and stiffness throughout the spine. This condition is commonly seen in the elderly.

Types of Pain

There are two types of common back pain: acute and chronic. 

Acute back pain occurs suddenly, making it impossible to walk, bend, or even conduct daily activity. Acute back spasm can induce a pain cycle that leads to muscles that are distorted, which in turn pull on discs and joints and compress nerves.  This is a very painful situation and demands immediate attention, usually a multi-faceted approach: acupuncture, massage, heat therapy, and sometimes medication and spinal adjustments. 

Back pain can also be chronic in nature -- a dull ache that never really seems to go away. This condition takes a little more time to resolve and requires an understanding of how to correct muscular imbalances and weaknesses with restorative exercises and physical therapy, as well as all the other modalities already listed.

95% of back pain cases will resolve with therapeutic treatments without the need of invasive surgeries. 

How Can Acupuncture Help Back Pain?

Acupuncture can play a major role in the reduction or elimination of back pain by promoting blood flow, reducing inflammation, and helping restoring normal function of the muscles, joint, ligaments, tendons and nerves.

Research studies have shown that acupuncture treatments cause the body to produce natural steroids and promote the production of natural endorphins. These natural steroids reduce inflammation and swelling, while the endorphins reduce pain levels in the body. This in turn can break the pain cycle, help improve activity levels, increase range of motion, promote faster recovery time, improve function of the musculoskeletal system, and reduce the chances of reoccurring back pain.  

Acupuncture and herbal remedies can also reduce the need for painkillers or other medications that can cause unwanted side effects or delay the healing process.

Chinese Medicine Patterns of Back Pain

In Chinese Medicine the patterns of disharmony are divided into several different types of back pain and whether the condition is acute or chronic:

• Deficiency type pain is usually dull, chronic and improves with rest. Back muscles are often weak and under conditioned.

• Qi and blood stagnation is often acute with severe and stabbing pain. Back muscles are stiff and tight and the patient feels worse with rest. This pattern is often related to an acute sprain or strain.

• Cold damp obstruction back pain is worse in cold and damp weather and there is often numbness, swelling, and a sense of heaviness in the muscles. This is often seen in arthritic conditions.

The treatment approach is different for each type of back pain. In the deficiency pattern the approach is to improve muscle function, promote blood flow and reduce pain. When there is stagnation of qi and blood, the approach is to move the blood and reduce pain and spasms of the muscles. In the cold damp obstruction, the approach is to move the fluid in the lymph system, improve circulation, and restore nerve function.

In all types of back conditions the goal is to improve blood flow, reduce inflammation, alleviate pain, and increase the recovery time. Chinese Medicine has been shown to do just that, as well as provide long term benefits by addressing all the underlying health issues to prevent any reoccurrence of back pain.  

My patient Scotty is an example of how Chinese Medicine and lifestyle changes can keep back function at optimal levels.

Case Study

Scotty, a dapper, articulate man of 64 with a soft southern accent, came to me with the complaint of lower back pain that radiated down into his left leg.  His massage therapist had given him my name and encouraged him to try acupuncture along with his ongoing massage and physical therapy.

Scotty had been experiencing back pain for the past year.  His health profile revealed that he was diabetic, hypertensive (controlled with medication), overweight, undernourished, chronically dehydrated, and suffered from depression and seizures. His weighed 201 pounds and before his gastric bypass seven years ago he was weighing in at 355. This is a great accomplishment but he needed to learn better eating habits to help control his blood sugar, and to further reduce his weight. We would need to address his current unhealthy diet as well as his lower back pain.

The first order of business was to tackle his chronic back pain. His occupation as a hair- dresser required long periods of standing on his feet without rest. His spine from the upper cervical area down to his lumbar and sacral iliac joint suffered from the many years of standing and working with his arms elevated. The excess weight in is mid-section only exacerbated the situation. 

His back pain had been so acute six months prior to seeing me that he had been hospitalized for a week to determine what was causing all his discomfort. He was experiencing numbness, tingling, and a dull ache that had come on gradually, starting from his waist and running down to his toes and feet. He had extreme weakness in his left leg with a feeling that his leg could not support him at times when he was standing and walking. He had not had an accident or an injury that had caused this painful condition. 

While at the hospital he had been seen by three neurosurgeons, two neurologists, an osteopath, and a physiatrist all who could not determine why he was suffering with pain and numbness. The neurosurgeon recommended surgery, which was not something that Scotty was inclined to do at this point. He “gave up” on all the doctors and went to a massage therapist to “relax.” It was after taking the advice of his massage therapist that he came for acupuncture and herbal and nutritional advice. 

We started with acupuncture treatments that focused on reducing the numbness down his leg, while reducing swelling and nerve inflammation in his low back/sacral area.  His Chinese diagnosis was cold damp deficiency type low back pain. He felt better with rest and warmth and his low back and sacral area were swollen and cold to the touch.  The needles were placed from the cervical spine (neck) down to his ankles to increase circulation and help improve nerve and muscle function. The majority of needles were placed in the lumbar and sacral areas of the spine, while also using moxabustion to warm and improve blood flow, and electric stimulation to improve nerve function and to break the pain cycle.

In the last 5 months of every other week acupuncture and massage he is 95% symptom free.

The numbness in his left leg and foot are barley noticeable while the strength in his spine and legs have increased to the point that he is pain free and back to his daily activities without limitation. His energy is at a record high due to all the dietary changes that he has made. 

Due to the gastric bypass, it was very difficult for him to digest his foods, so I suggested that he puree and blend much of his foods. The morning anti-oxidant smoothie helped him get the nutrients in the morning to sustain him through his 12-hour workday, and his vegetable soup purees helped him get the vegetables that he so needed in his diet. He started eating on schedule and avoided sugary and fatty foods that he often ate while working. 

Scotty kept himself hydrated and avoided the diet sodas and coffee. He also started taking flax oil and herbal tonics, which helped in the healing of his muscular skeletal system.  He is always working at improving his diet and fitness level.

Scotty is always asking questions and has a renewed interest in learning about healthy living and it shows. His colleagues and clients notice the renewed bounce in his step and that his quick wit and joyous personality have returned. He has told me that I have saved his life!!  He saved his own life by taking the steps that he needed to take to change a lifetime not exercising and eating regularly and properly.  This has all changed as now he is in his “second spring” as they say in China.

We now are working together to cure his type two diabetes with diet, exercise and Chinese Medicine.

The journey continues…

Chinese Medicine, The Kinder and Gentler Approach...

Taking the long view: Chinese Medicine, the kinder and gentler approach

In Chinese Medicine we take a holistic approach to supporting health and treating disease. It is though the integration of mind, body, and spirit that health and longevity are allowed to thrive.

The model of promoting health and prevention of disease in Traditional Chinese Medicine (TCM) is based on the idea of maintaining a free flow of qi (our life force), blood, and fluids, as well as freeing and fostering an emotional equilibrium of the mind. These are all considered fundamental requirements for abundant health.

An important herbalist of ancient China, Zhu Danxi, stated that:

“So long as the qi and blood enjoy harmonious flow, none of the hundreds of diseases can arise.  Once qi and blood are depressed and suppressed, diseases are produced.”

This ancient philosophy underscores the view that a sound mind and abundant qi are the basis for health and longevity while a deficiency of qi and a weakness of the mind are the main causes of illness and aging. When life is irregular and lifestyle choices don’t support good health, the body is less resistant to disease.  Healthy living and a healthy mind create a strong, sound immune system that serves as a major player in preventing disease.

The book Yi Qing Xiao Lu states that “One should always enjoy simple pleasures such as sunshine in the winter or shade in summer, beautiful scenes on a bright day, walking cheerfully, singing in the woods, listening to birds…” In other words, one should enjoy activities that cultivate joy and relaxation as well as interest in life.

Preserving Balance

It is through the balance of yin (still) and yang (active), the cultivation and maintenance of qi, and the preservation and conservation of a tranquil mind that health and mental well-being can flourish. My patients are often reminded of an image of a scale -- when all is in balance health is abundant, but when the scale is tipped out of balance health is elusive or far from reach.  Keeping the health scale in balance by making wise daily health choices is one of the most important messages that can be taken away from TCM.

So often we live out of balance, creating many disharmonies in the body: sleep disorders, digestive distress, headaches, muscular skeletal imbalances, hormone imbalances, anxiety, and stress disorders.  The diseases of lifestyle irregularities in the country are on the rise with obesity, type two diabetes, hypertension, high cholesterol, high triglycerides, cancers, and drug and alcohol abuse all major burdens and drains on our healthcare system and our country. This is where TCM can have an important impact on healthcare in our society.

TCM helps us all make healthy lifestyle choices that are more in alignment with living in moderation in diet, work, social commitments, and helps with finding deep meaning in life itself. TCM is a slow medicine that helps the body heal before having to use strong allopathic intervention such as powerful prescription drugs or surgery.

Western allopathic medicine is a very important piece in the health care system when there are life threating situations and serious diseases that need strong intervention.  But this medicine takes the near view and works to eradicate the disease without taking into consideration how and why the patient got to this point in the first place. In many cases, if patients simply lived in balance and adjusted their lifestyle choices, they could avoid many diseases all together.

The Long View

The practice of TCM embraces the entire essence of the patients’ body, mind and spirit when formulating a treatment plan. Taking the long view is looking at the whole, rather than merely focusing only on the symptom or the disease.  

The chief complaint that a patient presents is viewed within the context of the patient’s constitution, age, lifestyle, and mental state when considering treatments. The “ten questions” that are at the heart of the intake in Chinese Medicine take into consideration sleep patterns, digestive health, energy levels, reproductive health, emotional history, as well as the presenting health issue.  This information is woven into the overall patterns of disharmony to be addressed during treatment.

And acupuncture is only one aspect of TCM that is used in the treatment of diseases and disharmonies of the body and mind. The use of herbal medicine, massage called Tui Na (Chinese medical massage), meditation and breathing exercises, exercise such as Tai Qi and Qi Gong, dietary recommendations, and lifestyle changes that require the patient’s participation in their own healthcare are all important in the treatment and prevention of disease.

As a practitioner of TCM I feel like a detective looking for the root causes of the diseases or conditions that my patients present.  Each patient has their own unique history, and it is only by delving into the underlying causes that treatment can be fully effective. It is only when there is an integration of body, mind, and spirit, as well as the full participation of the patient’s responsibility for their own healthcare that deep healing can begin.

Chinese Medicine can be seen as a powerful tool that incorporates preventive healthcare within our present system, as well as to serving as a partner with western medicine to integrate the long and near view of disease -- for both viewpoints can help in the long term betterment of healthcare in our country.

Taking the preventive healthcare mindset has the invaluable reward of living with more radiant health throughout your life, and this is the path that Chinese Medicine leads you towards.

Some parting words from the wise ancients:
“If you do not make good use of this free and precious life, what good does it do to possess a human body?” Shabkar

Taoism and Chinese Medicine

Chinese Medicine is rooted in the ancient philosophy of Taoism, a philosophy which suggests that a part can be understood only in its relation to the whole. Chinese Medicine uses this holistic approach -- a person who is living in harmony with nature has mental, physical, and spiritual balance. And when an imbalance occurs, the complete physiological and psychological aspects of the patient are taken into consideration in the diagnosis.  The treatment seeks to restore balance and harmony to the body.

In Chinese Medicine there is a systematic way of distinguishing the patterns of disharmony, understanding the relationships between all the signs and symptoms of these imbalances, and prescribing treatment that restores balance. This is a medicine of prevention and cultivation of longevity. 

Because of the importance of Taoism to acupuncture, it was not surprising that “Philosophy of Chinese Medicine” was my first required course in the Masters of Traditional Chinese program. My eyes were opened to a new way of viewing health and treating disease.

The “Tao” meaning “the way” or the “path” is the concept of living a righteous way of life that is balanced, simple and in tune with nature. Lao Tzu is considered one of the founding fathers of Taoism and in his book the Tao Te Ching one can find his profound teachings on the subject of living the Tao way.  The three treasures that illuminate the teachings of Lao Tzu are: living with compassion, in moderation, and with humility.

                                                            

Yin and Yang

Yin and yang theory comes out of the Taoist philosophy. This is another way of viewing the world and seeing that all things are parts of a whole. Yin moves into yang, and yang moves into yin, and this is the natural flow of life. The constant transformation of yin into yang and yang into yin is the source of life, and the basis of acupuncture and Chinese Medicine.

The character of yin is that of the shady side of the slope. Yin is the cold, the rest, the darkness, the moon, the inward, and the feminine. The character of yang is the sunny side of the slope. Yang is the warm, the active, the light, the sun, the vigor, and the masculine.

We are always in a state of yin moving into yang and yang moving into yin. They cannot be separated as they depend on each other for definition. Chinese Medicine seeks to balance the yin and yang.

Lao Tzu sums up this way of viewing the intertwining of these two opposites:

“Being and non-being produce each other;

Difficult and easy complete each other;

Long and short contrast each other;

High and low distinguish each other;

Sound and voice harmonize each other;

Front and back follow each other.”

Nei Jing

The Nei Jing, or the “Inner Classic of the Yellow Emperor,” is another classical medical text that contains the knowledge and theoretical formulations that form the basic foundation of the Chinese medical tradition. This text posits that diet, lifestyle, emotions, and environment all have impact on health and wellbeing. The Nei Jing text states:

“In treating illness, it is necessary to examine the entire context, scrutinize the symptoms, observe the emotions and attitudes.”

The Nei Jing suggests medicine should promote the cultivation of life force, or what is known as qi. The most important message in the text describes how to preserve, as well as create, more qi in our daily lives though healthy lifestyle. The text suggests that exercise, herbs, meditation, tai chi, acupuncture, acupressure, diet, and breathing exercises are the tools that promote longevity and vibrant health.

Breathing Arts

The ancient Taoist believed that “Breathing Arts” held the secret to longevity as well as the gateway to advanced knowledge and special powers.  The breathing techniques are passed down for us all to practice. One breathing technique is called the Microcosmic Orbit, which helps circulate energy (qi) through energy points, or meridians.

The flow of qi begins at the navel on the Ren Meridian (front of body) and then travels down to the perineum and up the spine on the Du Meridian (back of body). From there it travels to the head, down the front through the tongue, the throat, and then down to the navel again. These two channels carry a strong energy current that can have powerful effects on regulation of the body.

Learn the Microcosmic Orbit

To begin the Microcosmic Orbit breathing practice sit upright with your feet placed firmly on the floor, hands relaxed on your lap. Once comfortable, bring your focus to your "dantien" (energy center) just below your navel, and visualize a light of energy beginning to grow at your dantien. Next, focus and make your breath smooth, even, and flowing deeply into your dantien. Now you are ready to start the circular breathing pattern. 

Exhale a breath of light and qi into your "Hui Yin," the pelvic floor or the genital and anus area, and then into your coccyx.

Next inhale and draw the breath of light and qi up into your spinal column. Use one single inhalation to bring the energy all the way up to the center of your brain.

On the next exhalation feel the flow of qi come down the center of your face like a waterfall, down through the heart center, and begin the next cycle of breathing.

Try completing ten cycles and built your practice from there.

Enjoy cultivating greater qi, energy, health, and mental clarity.