Acupuncture

WW Podcast episode 13 – Eric & Amanda talk about non-judgment in holistic healthcare

 

In this episode, I sat down with Amanda to talk about judgment, and non-judgment, in the holistic healthcare environment.

In particular, we examine some of the things that commonly hold people back from getting care due to worries about judgment around:

  • Body image, such as body hair, body odor or weight gain
  • Social factors, such as identification as gay or trans, or having low income and so being unable to wear “fancy” clothes
  • Political and intellectual factors, such as having a very conservative viewpoint when you believe your practitioner to be quite liberal

 

It's just a quick 20 minutes, and we hope it will provoke questions – check out the form on the main podcast page to share your thoughts.

 

You can access the episode here.

Should you come to your acupuncture appointment when you’ve got a cold?

 

Occasionally a patient won’t be able to come to an appointment for one reason or another, because life is complicated. However, there is one kind of cancellation that I find really strange: a patient cancels their appointment because they are sick.

Now, obviously, if someone is too sick to leave their house, then this is completely reasonable. But the prevalence of this phenomenon makes me think that I have neglected to educate my patients about how effective our medicine is at treating acute illness.

So here, dear reader, is the scoop on Chinese Medicine and common bugs.

Chinese Medicine, like all medicine, grew out of daily necessity. Over thousands of years, practitioners have learned to treat the maladies that their communities and families have suffered from. This certainly includes chronic and terminal conditions, like arthritis and cancer, but the most common afflictions that affect us are illness and injury.

While we think of illness in the modern industrialized world as mostly uncomfortable and annoying, epidemic illness was the leading cause of death in much of  the ancient world. The flu virus continues to kill thousands of people a year in the US alone, even with our modern medical systems in place. Imagine the destruction it would have wrought without these systems.

Ancient physicians, then, were spending most of their time treating and curing epidemic illnesses.

In fact the vast majority of the herbal texts that have been passed down to us through the ages concern the stages that exogenous (coming from outside the body) illness pass through in the human body, and how to treat every presentation at every stage. Treating an illness early is always best, but we can’t control when a patient will come to see us, so we have intricate systems for treatment regardless of the timeline.

We also understand, based on these systems, that every person’s presentation is different, and requires a different approach.

One person’s cold may start in their chest as a hot and dry cough, while another’s manifests as profuse clear runny nose and a mild fever. Treating these two presentations differently results in a faster recovery in each case. By carefully observing your specific symptoms, we can craft an acupuncture treatment and an herbal formula that will be tailored to your exact experiences and completely resolve all of them.

We also know that proper treatment of acute problems prevents chronic ones.

This is a key concept to understand. A lingering cough from a simple cold can become a long term problem as the lungs’ ability to regulate themselves becomes more and more compromised. Such a process can predispose a person to chronic bouts of bronchitis, asthma attacks, or lung infections.

By completely treating the issue the first time, we never have to deal with any of those problems down the line. For those who already have a chronic health condition, this is doubly true. Autoimmune disease, chronic pain and depression all sap our body’s immune systems and create increased openings for acute illness to become chronic.

With this in mind, my advice is to seek out care when you first feel sick.

That woozy feeling in your head, the tickle in your throat, and the snot you woke up with this morning are telling you that you are already mounting an immune response to something. This is our opening to set you up for the shortest and least painful illness possible, and maybe even a complete avoidance of further symptoms.

And don’t worry about getting me sick; this is my job!

Treating the common cold with Chinese herbal medicine, or on when not to reach for Yinqiao san

Zhang zhongjing, Han dynasty doctor & scholar who wrote the texts I am describing

 

My Chinese herbal lineage focuses on deep understanding of the most venerated text of Chinese herbal medicine, the Shanghan za bing lun.

The first, and most well known, part of this text (often referred to simply as the Shanghan lun) contains information about treating diseases that are caused by factors outside the body. In particular, the vast majority of the formulas in the text treat the common cold, other viral respiratory infections & the secondary infections and complications that come from them. So, you could say that I spend a lot of time thinking about the topic of colds & flus!

 

 

Different types of colds?

Chinese medicine (CM) discusses various types of colds – which we call “external invasions,” to differentiate them from diseases caused by food, drink & strongly disordered emotional states. The symptoms of the external invasion, and the method for treating those symptoms, varies based on the character of each type of cold. In the simplest way of looking at it in CM, there are colds that are more “hot type” (with higher fever, yellower phlegm) versus those that are more “cold type” (with lower fever, runnier nose).

But further differentiations exist, based on the origin of the pathogen, the health status of the person invaded, and so on. The Shanghan lun differentiates the varieties of symptoms of exterior invasion into six stages, called Conformations. The conformations are a complex theoretical construct, so we can only sketch the outlines here.  If you're interested in getting a bit more information, you might want to read about it on my website for students and practitioners of CM.

The conformations relate to the way a cold develops, and also helps us to see the difference between “regular colds” and more virulent & severe epidemic type invasions. The conformations themselves include physical structures, various bodily functions, acupuncture channels and other diverse parts of the human body. In other words, each conformation is not a single structure, but a mixture several structures and functions.

In a way, each conformation is like a landscape – and as a cold travels through each of the six landscapes, the way it manifests, and the way we treat it, changes.

I list and briefly describe the conformations below in order from the most superficial / exterior layer of the body all the way into the Jueyin which is the deepest level, the most interior to the body. As disease travels through the conformations, it changes character. The more exterior layers (yang layers) look more like typical cold & flu symptoms, and so it is from the chapters describing these disorders that most of my formulas come from when I treat this type of disorder.

  • Taiyang – Taiyang contains the Bladder and Small Intestine channels & organ networks, as well as aspects of our immunity, our water metabolism and more. This is the most surface layer, and when struck, the typical symptoms of a mild cold are the result. Runny nose, mild congestion, an often lower grade fever, body aches, frontal headaches and low energy can all be the result. We treat this stage of cold by forcing the pathogen out & strengthening the surface to prevent reinvasion.
  • Yangming – Yangming contains the Large Intestine and Stomach channels & organ networks, and thus has a lot to do with digestion, but dysfunction here can also impact mental state (anxiety, mania) and temperature regulation, among other things. We are proceeding more deeply into the body here, and if a cold or flu reaches here, the symptoms tend to be more severe. Very high fevers, even leading to bleeding, severe headaches, sinus trouble including congestion, and certain types of hot lung conditions can all be the result. We treat this stage by cooling down the body and allowing the body to release as much built up matter and energy as possible.
  • Shaoyang – Shaoyang contains of the Gallbladder and mysterious Triple Burner channels & organ networks. The impacts of this conformation can be VERY diverse as befits the layer of the body that is getting so much closer to the interior (yin). As cold or flu symptoms, Shaoyang symptoms tend to be back and forth (fever AND chills), less acute and can also hang on for much longer. People who are repeatedly getting sick within one season, but never really having a fever or serious acute symptoms are often trapped in the Shaoyang stage. This can be harder to treat, and we do so by helping to “harmonize” the yin and yang aspects of this stage.
  • Taiyin, Shaoyin & Jueyin – The Shanghan lun text I have been discussing goes into detail about the treatment of deeper layers of the body as they are impacted by the consequences of external invasions. However, because these look less like what we call “cold” or “flu,” I'll not discuss them here. The same goes for the next two layers..
    I hope to talk more about the conformations and how understanding them can help you respond better to cold-season illnesses. But, for now, with that general idea explained – a word on customization of cold treatment.

Different types of people, different treatments – right?

So, there are different types of colds to begin with, but there are also different types of people having those colds! One of the most important things about Chinese medicine as a distinct profession in healthcare is how we focus on the customization of treatment to the uniqueness of the individual patient. If a person is very weak, with a thin and deep pulse, not having much of a fever and the cold lingers for weeks, we will treat them much differently than a person who comes in with a big fever, big pulse and very rapidly moving illness. Doesn’t that just make sense?

You may have a different herbal formula than your partner with a similar cold!

That's the outcome of true customization of treatment. But, of course, sometimes I find myself prescribing very similar formulas to a large group of people. While customization is important, it’s also true that many people react similarly to particular colds traveling through their town. And there are some types of treatment or supplementation that help most people feel better. This is why we see standardized over-the-counter remedies on the shelves in the first place – they are a convenient way to help large groups of people. So, as a practitioner, or for you as a member of the public, we have to find the best way to balance customization and convenience.

Over-the-counter remedies and Chinese herbal medicine – the case of Yin Qiao (or Yin Chiao)

For many of my patients, the first Chinese herbal formula they ever took was in the form of several small tablets called Yin Qiao San – said to be great for the common cold. Many people swear by the remedy and keep it on hand just in case. In fact, there are some Chinese medicine practitioners who ask their patients to keep it on hand for just this reason. This formula was formally written down in a book published in 1798 devoted to exploring “Warm diseases,” so those types of illnesses that are either caused by warming factors, or expresses itself through heat type symptoms, or both.

It contains cooling, lightweight herbs like honeysuckle flower and forsythia seed pod.

This formula is appropriate for people who have hotter cold symptoms such as : fever, burning sore throat and a tendency to a more rapid pulse & yellowing tongue coat (especially as the cold progresses). In the basic CM way of looking at things, a warm or hot pathogen creates these symptoms. Warm and hot pathogens are traditionally more likely to be encountered in warm climates. If a cold came from a more cold type pathogen – such as those typical in my home in Oregon – then this formula would most likely NOT be appropriate. Further, when the cold goes into the interior, causing a phlegmy cough or profuse nasal discharge, this formula wouldn’t be appropriate regardless of the nature of the exterior invasion.

In other words, Yin Qiao San can indeed be effective – for certain types of colds and not others.

What are the potential consequences of using a formula that isn’t appropriate for the type of cold or other disorder you’re experiencing? Fortunately, Chinese herbal medicine is powerful – but also very gentle. Yin Qiao San is quite cooling, but it is also relatively easy on the body and the dose typically taken is too small to do much damage. So while there are Chinese herbs that can cause serious complications if you take them when they are not indicated for your condition, this particular example is not one of those.

That said, if you need warming treatment and take cooling herbs instead, there are undoubtedly consequences for the yang of the body.  Long term, a person who inappropriately takes Yin Qiao San may find lowered surface immunity or mild digestive problems. That the consequences may not be severe in this case, though, doesn't mean we shouldn't attend to always taking the right herbal formula for our situation.

How do you avoid taking the “wrong Chinese herbal formula?”

Does the highly customized nature of Chinese herbal medicine mean that there can be no on-hand remedies a patient could self prescribe? Of course not. There are general treatment strategies that assist nearly anyone who is experiencing the symptoms of a cold or flu. For instance: increasing fruits and vegetables, decreasing sugar and strenuous physical activity and staying warm and hydrated will help virtually anyone have a better time with a cold or the flu.

But, if you would like to take a more active role to treat future colds and flus, or you have developed complications from one – like a chronic painful cough – seeking out treatment from a licensed Chinese medicine practitioner may well be part of an answer. If you come in for a visit, I will use CM diagnostic techniques, including a wide ranging discussion with you, to help determine the best treatment for an existing cold – or the prevention of one in the future. While I would be unlikely to prescribe Yin Qiao San, it being outside of my lineage and climate, I could certainly recommend a group of herbal formulas to have on hand for potential situations that would be appropriate for your constitution.

This is just a brief overview of the issues involved in treating colds and flus with Chinese herbal medicine. Questions? Get in touch – maybe I’ll write a future article about your question!

 

5 principles that ensure an excellent acupuncture treatment at Watershed Wellness

Acupuncture treatment is one of the foundations of the clinical work we do at Watershed Wellness

This form of medicine treats a huge variety of conditions, is safe and effective, and also is great combined with massage and yoga. This makes it a natural choice to be one of our primary modalities. I am excited to share this medicine with you, including the special way we approach acupuncture treatment at Watershed Wellness.

Our acupuncture department is united by a set of principles that make our treatments safe, enjoyable and most importantly, profoundly effective for an astonishing variety of conditions

At Watershed Wellness, we’re not just an assembly of unrelated healthcare practitioners. We work hard to function as an interconnected whole as much as we can – particularly when it comes to the energy and intention we bring to the work we do. While each practitioner brings important and unique attributes to the table, where we are most united is in the vision and values behind how we practice.

Over the next months, we will discuss more about this vision and these values and how they improve your experience as a Watershed client

I think this will help you get a good feeling of what you can expect when you come in for an appointment – this one is a special bonus because it allows me to discuss one of my favorite Chinese medicine topics, the five phase elements. That's right – we're going to dive into a little bit of Chinese medicine theory – the intricate and fascinating body of information that guides every acupuncture treatment I do.

The five phase elements (also just called the five elements) are one of the more recognizable theories within Chinese medical science.

The ancient scholars who developed Chinese medicine initially had a habit of categorizing many things according to number. There are five phase elements, six conformations, twelve organ systems, and so on. This makes things easier to learn and understand and, according to the scholars of these theories, help our work as human beings to resonate with what they understood to be the fundamental laws of the universe.

The five phase elements we use so frequently in Chinese medicine are 水 water, 木wood, 土 earth, 火 fire and 金 metal (other traditions typically would add air or void instead of metal). These are connected through a generation or creation cycle (in the order written above, with metal feeding into the water) as well as cycles of control or regulation. Nearly anything can be categorized according to the five phase elements and their interrelationships, from acupuncture points to grains to stars to organ systems.

Side note : I'm going to be doing a lot more education on the basics of Chinese medicine and how this information can help you to get and maintain vibrant health – if you want to get all the latest information please do sign up for our newsletter if you haven't already.

I've articulated five basic principles that lie at the heart of Watershed Wellness acupuncture as resonating with each of the five phase elements

I think doing it this way makes it easier to understand. But, even if you don't fully grasp how the five phase elements fit into this thing, I believe you'll recognize the importance of the principles we use to guide our acupuncture practice.

Water – Deep knowledge

watershed wellness astoria acupuncture treatment waterWater is about the depths. It is about the storage of all that is valuable, keeping it still with winter’s cold. It is about connection to ancestors and others that have come before. When it comes to Watershed acupuncture treatment, water reminds us of our commitment to constantly refresh and expand our knowledge of the world and the human body so that we practitioners can be of maximum service to our patients.

The education that American acupuncturists receive is extensive. At NUNM, where I went to school there is a strong emphasis on scholarship, independent research and adherence to the ancient, basic principles of the medicine. We are taught, early on, that lifetime study is part of our commitment as practitioners. I take this very seriously and regularly engage in all kinds of continuing education, both formally and on my own.

I utilize this knowledge every day in work with my patients, and I believe it makes the work we will do together much more effective.

Wood – Responsiveness

watershed wellness astoria acupuncture treatment woodWood is the springtime element. It is all change and youth and movement, like new blackberry canes emerging from disturbed soil, or like a 8 week old puppy’s constant exploration, mouthing and noise making. Wood gives us the ability to start new things, but also to respond appropriately when a situation is in progress.

Above all, at Watershed, we want to be responsive to your needs – and wood reminds us to do this. Your acupuncture treatment will be 100% created just for you – we don’t use the same treatment for everybody, and we don’t impose our will on you as the patient when something about the treatment is clearly not working.

Every time you come into the treatment room, I will reevaluate your situation, discuss your experience during the last treatment, and do careful diagnostic work to ensure that your treatment is exactly what you need in that moment.

Fire – Connection

watershed wellness astoria acupuncture treatment fireFire, the phase element of the Heart, is the ruler of intimacy, of connection between people, and of building community. Fire is warmth, brightness, life giving. It’s also associated with the summer solstice – that high time of joy, experiencing and flourishing.

Watershed acupuncturists pay special attention to the fire element when we engage in our work. We believe that the swiftest and most long lasting healing comes when patient and practitioner work together to address whatever needs to be addressed.

We connect with you, get to know you as a person, and hope to become trusted advisors. We make sure that you understand the treatment, and are OK with what’s to come and respect your boundaries at every step. That connection and Heart is part of what makes treatment at Watershed special.

Earth – Comfort

watershed wellness astoria acupuncture earthEarth is about nurturance, solidity, safety and comfort. Earth is at the center of our digestion, and is injured whenever we have to worry about ourselves or other people. When we pay attention to Earth in our acupuncture treatment at Watershed Wellness, we are putting your comfort at the forefront of what we do. You can see this in our waiting room, in the softness and warmth of our treatment tables, and more. This comfort allows you to feel more relaxed and safe, which in turn seems to make treatment more effective.

A note about comfort, here. Sometimes, you will have sensations during needling that can be uncomfortable. While I always seek to make sure we don’t push you beyond a tolerable level, some discomfort is usually necessary in order to treat disease. The principle of Earth doesn’t guide me to avoid that. It simply means that we will always be checking in, always making sure that you’re still OK with what’s happening, and doing everything in our power to make your total experience comfortable and relaxing.

Metal – Safety

watershed wellness astoria acupuncture metalMetal, of course, has the most direct resonance with acupuncture given the material of acupuncture needles. Metal otherwise is about letting go, about autumn, about balance and justice. Metal calls us to be precise, to make clean breaks, to keep everything in its place – and as such becomes a primary arbiter of safety. At Watershed, we take acupuncture safety very seriously.

We abide by all state regulations and professional commitments, of course, but go above and beyond that to ensure that you never have to worry that acupuncture treatment will create problems that weren’t there in the first place.

Another way that metal comes into our clinical work is in the simplicity and precision that lies at the heart of classical acupuncture treatment. While some traditions use large numbers of needles, the acupuncture we practice uses only as many needles as absolutely necessary to ensure a positive outcome. This minimalism means that we have to diagnose very carefully and be extremely precise with our creation of the point prescription. This care increases the safety of your treatment while also making it far more powerful.

We look forward to discussing these principles with you more in person – you can get on the schedule any time.