Ch-Ch-Ch-Chia

Or maybe I should say, "qi-qi-qi-chia!" Lately, my life has been full of chia seeds. I'm reading about them, I'm seeing recipes posted like hot cakes on Facebook, Pinterest, etc. I'm taken back to little ceramic sheep with scantily placed green sprouts growing on my dresser. I never could get a full coat on one of those things.

2015-06-24_chia

Recently though, I've looked at the chia seed in a new light. I've upgraded from the packet at the toy store to the organic bag from my friendly neighborhood grocer. Why? I have ulterior, Traditional Chinese Medicine, motives. 

2015-06-24_chia2

What are the properties of these delicious, plump little seeds? What can they do for me? Why do I bother messing with these slippery little things that will 100% certainly get stuck in my teeth for hours? We know from the western world that chia seeds are anti-inflammatory and are recommended for adrenal fatigue. They contain zinc and magnesium, antioxidants, and omega 3s. Its name even means "strength," so it's no wonder the people "are loving it" these days.

Chia? Qi? Strength? Energy? Am I seeing a connection to Traditional Chinese Medicine here? I think yes. I'd love to give you the name of Salvia hispanica  in Chinese, but I can't. It's not in the TCM materia medica, because this seed is native to the Americas, not to Asia. What I can do is piece together the bits of insight on the TCM properties, actions, and indications of chia seeds based on the years of usage in patients and the similarities to related plants.

2015-06-24_field

Chia seeds come from a sage plant in the mint family. Thus, we infer that they are cooling in temperature. They are seeds, so we see them with lubricating properties, particularly in the Large Intestine. As a qi (energy) tonic, we know they enter the Kidney and tonify Kidney qi. The cooling nature also lends itself to a nourishing of Kidney yin as well.

In other words, it's all coming together. The western world's adrenal fatigue is akin to TCM's Kidney deficiency. When TCM lubricates the intestine, it's like an American doctor recommending more fiber. The chia seed is doing it all, no matter how we phrase it.

Here's how I'm taking my chia seeds:

Chia Pudding

  • 2015-06-24_pudding3 bananas
  • 2 large scoops peanut butter
  • ½ cup chia seed
  • ½ cup hemp seed
  • 2 cups almond milk
  • Dash of turmeric
  • Dash of cinnamon

Substitute anything you have a personal problem with. Add all ingredients into blender and mix well. Pour into small glasses and refrigerate overnight.

Enjoy the gelatinous texture in your mouth. Pick gooey chia seeds out of teeth for several hours. Top with fruit if you're so inclined. You're welcome.

Somebody Water that Fire

Water and fire must be balanced. Their corresponding organ systems in Traditional Chinese Medicine (TCM) must be balanced, too. What happens if Heart and Kidney are not properly harmonized? You don't even want to know. Well, if you do, then read on.

2015-06-17_a

Here are some common Fire-Water imbalances, how they manifest, and how we harmonize them:

1.  Yin Deficiency with Empty Heat

What is it?
When Water is low, due to anything from congenital deficiency, long-term illnesses, overwork, etc., it cannot nourish the organ systems of the body. Because the Kidney controls water metabolism for the body, if it runs dry, then the rest of the body starts shriveling up. The Heart, symbolizing the Fire element, appears abundant by comparison, as heat signs appear in the body.

Signs/Symptoms:
dry mouth, red cheekbones, heat sensation in chest, palms, and soles, dry stool, scanty darker urine, rapid pulse, red tongue with no coat.

How to Harmonize:
Nourish yin, clear empty heat. Points may include KD3, KD6, LU9, LV3, SP3, SP6, PC7, HRT8.

2015-06-17_b

2.  Heart Fire Blazing

What is it?
When the watery, cold, refreshing part of the Water element (Kidney) runs dry, things start heating up - in a bad way. Heart Fire gets the word that it has free reign on the body, and before long it goes crazy. Raging crazy.

Signs/Symptoms:
Think "everything from pattern #1, plus" insomnia, heart palpitations, dizziness, and tinnitus. Maybe you'll have crazy vivid dreams, too, which can range from fun to terrifying. Your tongue is likely quite red with a yellow coat, with red prickles or a red tip. Your pulse is probably full and rapid.

How to Harmonize:
Nourish yin, sedate Heart fire, calm the Shen (spirit). Points may include: "everything from pattern #1, plus" HRT9, PC8, PC6.

2015-06-17_c

3.  Kidney Yang Deficiency with Water Overflowing

What is it?
While patterns #1 and #2 were conditions of too much Fire element and not enough Water, pattern #3 is exactly the opposite. Too much Water. You're flooding inside your own body. When there's not enough Fire to warm the body and burn off excess Water, then you just start packing on the water, particularly below the waist. Things are not warming and moving around the body. Circulation of fluids has been impaired.

Signs/Symptoms:
Edema, scanty urine, low back pain, cold limbs, excessive white vaginal discharge, infertility. Swelling, even pitting edema, could be found in the legs. Your pulse is likely deep, weak, and slow. Your tongue is pale and swollen, moist with a white coat.

How to Harmonize:
Tonify Kidney Yang, Warm Ming Men, drain dampness. Points may include: KD3, KD7, SP9, SP6, UB10, DU4, UB23, SJ5, CV9, LU7.

Do these sound serious? They can be. The good news is that acupuncture, along with the other branches and modalities of Traditional Chinese Medicine (herbs, dietary therapy, tui na, qi gong, moxa) can be very effective for rebalancing and harmonizing Water and Fire. You don't want to be too cold, but you don't want to be too hot, either. You want to be juuuust right.

Phlegmy Fibroids and Other TCM and Infertility Concepts

One in four American couples struggle with infertility. Of those women who either cannot get pregnant after 12 months of trying or who cannot carry a baby to term, around 45% seek medical assistance. A study at the University of Maryland School of Medicine indicates that acupuncture may increase the success of IVF therapy by as much as 65%, but how is it working?

2015-06-12_pic1

Dr. David Bai and Dr. Linda Xu summarize that acupuncture has been shown to:

  • Balance elevated follicle stimulating hormones (FSH) and regulate the menstrual cycle
  • Improve ovary or testicle health resulting in better egg or sperm quality;
  • Increase blood supply to the uterus and build up the uterine lining;
  • Help implantation and reduce the risk of miscarriage and ectopic pregnancy;
  • Release the stress of infertility and its related treatments;
  • Increase the success rates of IVF and IUI.

That's the western world's attempt to explain an ancient Chinese practice. Now let's put it into our Traditional Chinese Medicine (TCM) terminology. Infertility can be caused by a variety of disharmonies in the body of the woman, the man, or both. Generally speaking, it can usually be traced to some sort of deficiency, stasis, or heat condition. That's too general for me. I need more specific information.

2015-06-12_pic2

Kidney Yang Deficiency, Ren and Chong Disharmony, Jing Deficiency, Kidney & Liver Yin Deficiency, Spleen Blood Deficiency, Spleen Qi Deficiency, Heart/Liver Blood Deficiency, Damp Retention, Phlegm Accumulation, Blood Stasis, Qi Stagnation, Heat in the Blood, and the list goes on seemingly indefinitely as you combine the abovementioned patterns in a horrid and unsatisfactory mix and match fashion.

Think that's a lot of patterns? Well, there's a lot of infertile couples out there. This array of options lends itself to several western presentations of infertility. It also explains why one treatment strategy, whether it be an herb, an exercise, or an acupuncture point prescription, can't work for everyone. There are indeed acupuncture points and herbal formulas that address each and every one of those patterns of disharmony, but each patient can expect a unique treatment strategy based on his or her presentation.

2015-06-12_pic3

While acupuncture appears to give the same result as Clomid (a 50% success rate for producing an egg in a given cycle), it also has a two-fold added bonus. First, acupuncture has no negative side-effects. Secondly, acupuncture will almost always produce seemingly unrelated positive benefits on health and wellness. Going in for irregular menstrual cycles? You'll probably also sleep better. Going in for low sperm count? You'll probably also feel relief from your chronic lower back pain.

2015-06-12_pic4

Many patients seeking acupuncture assistance for infertility will also be given herbs to assist in the balancing and overall wellness. These two modalities in combination often produce better results than either one alone, similar to the way that patients receiving acupuncture with IVF have better results than those undergoing IVF alone. No matter the high efficacy of TCM in infertility cases overall, it's still not magic. If you've ruptured a fallopian tube or lost an ovary and are working with only one, it's still harder to conceive. If there's a structural issue, it's more difficult for TCM to help; in these cases, surgical repair might be indicated.

2015-06-12_pic5

What's the conclusion? If you're struggling with infertility, give acupuncture (and herbs) a try! You could experience the improved menstrual regularity, ovulation, and conception that many others have. In the background, odds favor improved balance in other aspects of wellness from bowel movements to sleep quality. Our tip, as always, is to seek out a Licensed Acupuncturist to ensure you are working with someone who has been through the most rigorous and complete education and practical programs for Traditional Chinese Medicine in its entirety, rather than a provider from another field who has "added on" some hours in acupuncture training. Happy needling!

Further Reading: Treating Infertility with Traditional Chinese Medicine (Infertility Awareness Association of Canada)

Ear-icular Egg-corns

This weekend I saw an article about the word "eggcorn" being added to the dictionary. Perfect, I thought. Someone has finally justified my mispronunciation of the word "acorn." After all these years, I've been vindicated.

2015-06-05_acorn

No. That's not what happened. Apparently, a word has been created, tested, and formalized for these types of circumstances. When enough people say a word incorrectly enough times, it can become a legitimized word. You can't just be totally crazy and wrong, though, mind you. You have to misuse a word and have it be somewhat close to making sense. Then you can be legitimized.

2015-06-05_dic"For all intensive purposes," "a mute point," "an averse reaction," "old timer's disease," and "soup chef." All wrong. Look again -- it should read "for all intents and purposes," "a moot point," "an adverse reaction," Alzheimer's disease," and "sous chef." Notice how the words commonly used are technically wrong, but still actually kind of correct? Now there's a word for that, and that word is, appropriately, an "eggcorn."

What do eggcorns have to do with TCM? Well, thanks for asking. Some of my favorite intentional misspeaks just happen to be related to auricular acupuncture, or, as I call it, "earcupuncture." Closely related is the way that I call the ear apex the "earpex." Sometimes, I just can't help myself. It's like the words are out there just calling me to stick them together. Maybe I'm not even misspeaking; I'm just making new contractions. You're welcome.

Today, on this new day, just one week after Merriam-Webster added "eggcorn" to the dictionary, I feel confident in using my slightly off the beaten Daoist path terminology. I'm using earcupuncture, or earicular acupuncture, I'm bleeding the earpex point to lower blood pressure, and I'm not apologizing. Words that are wrong but self-explanatory enough to be right are OK in my book.

2015-06-05_ear1

Also, ear acupuncture is important. It's powerful, it's fast, it's easy, and it's cheap to perform. People need to become more familiar with this modality of Traditional Chinese Medicine, but the sterile statement, "I'm going to insert needles into your ear now," doesn't always go over well with patients. Can an eggcorn or two lighten the mood? Can a spoonful of humor make the needle slide in more smoothly?

2015-06-05_ear2

Why does auricular acupuncture work so well that I'm willing to mispronounce it to help new patients accept it? The theory of auricular acupuncture is that the ear is a microsystem, where every body part is represented and connected to a particular point on the ear. Red spot on the antihelix? Maybe it's revealing your knee pain. Really sore when I squeeze your lobe? Could be your tooth infection screaming for help.

2015-06-05_ear3

Say it how you like. Whether it's ear acupuncture, ear-icular acupuncture, or earcupuncture, just try it out. I won't judge you on your pronunciation. Will it hurt? Maybe. Here's a secret tip. Sometimes we don't even use needles on the ear points. We have these things called "ear seeds," and they definitely don't hurt. If you could handle the feel of a Band-Aid with a piece of dirt stuck to it, then you'd be fine with ear seeds. Just squeeze and enjoy the pain relieving benefits. It's easier than sticking an acorn to your earlobe.

Acupuncture or ER?

No one likes to be wrong. No one likes to admit that his or her medicine is not the best. When a patient walks into the room seeking treatment, we each want to be the one to say, "Yes, we can help you." While acupuncture has successfully treated the masses for thousands of years, and has been recommended by the World Health Organization for dozens of conditions and diseases, it's not the only tool in the shed in 2015.

2015-05-29_julie1

On Thursday at Cook County Hospital, I sat at the computer in a treatment room entering the subjective information from an existing patient presenting with a new chief complaint -- left calf pain. We'd treated her in the acupuncture wing of the outpatient pain clinic before, but her chief complaint was usually lower back pain. Initially, I thought "another case of sciatica," as I worked through her SOAP note and mentally scanned the best acupuncture points for the job.

2015-05-29_julie2

"Sharp pain in the back of my leg," she said, gingerly touching her left calf. I asked, "When did it start, and have you had this pain before?" "Yesterday, and NO," she snapped back at me. "It's so swollen and the pain is sharp right here," she added. She confirmed that there had been no trauma to the area, and I released my grip and let the pack of needles slide deeper down into my lab coat pocket.

I'm kind of new here, and I readily admit that my weakness as an acupuncture intern is ruling out contraindications and sorting out red flags before I start sticking needles into the patient. Can I still needle you if your blood pressure is 150/90? Some books say yes, some sources say no. Acupuncture lowers blood pressure, so shouldn't we go ahead and do it? Refer out! Confusion. "It's normal," everyone assures me. "You'll gain that confidence through clinical experience over time." Well, as a third year acupuncture student, I don't feel like it's been enough time. I walk into the head clinician's office and start presenting the case. Something just feels...off...with this patient.

2015-05-29_julie3

The beauty of my internship at Stroger Hospital is that although it's not set up to be an integrative treatment experience for each patient, it can transform into one in under 60 seconds. Our calf pain patient came into the acupuncture wing of the pain clinic, but upon suspicion of an emergency situation (yes, we were all thinking "Deep Vein Thrombosis" or "DVT" at this point in the show), we went two doors down the hall and snagged an MD intern to evaluate her presentation from a western perspective, too.

2015-05-29_julie4

He quickly assessed her signs and symptoms and agreed that we needed to rule out a DVT before moving ahead with her regularly scheduled acupuncture treatment at that time. Within seconds, our integrated team had changed course, explained the testing process to the patient, called over to the ER, and had a nurse transport the patient.

For thousands of years the expansive Chinese empire developed what we now call "Traditional Chinese Medicine," or "Oriental Medicine," of which acupuncture and herbs form the foundation. A complete and effective medical system, the doctors not only placed needles, administered herbal formulas, gave hands-on manipulations, moxibustion, and cupping treatments, but also did bone-setting and any other emergency medicine that was required. Today, in the United States, our scope of practice is generally not so extensive as to include bone-setting, but we respect the completeness of the TCM system in its entirety.

2015-05-29_julie5

This does not mean, though, that we ignore the advancements of other medical systems or technologies. It means that instead of blindly accepting the often too-invasive and side-effect ridden treatment plans of the mainstream western medical system, we utilize only the elements that we see as truly necessary or complementary to a holistic treatment plan. In short, I LOVE DIAGNOSTIC IMAGING. Sure, it's wrong sometimes, giving false positives and false negatives alike, but overall it gives us a somewhat clearer look inside the human body than what we can piece together by looking at a patient's tongue and feeling her pulses.

I'm not saying that modern diagnostic imaging is necessary for an acupuncturist to be effective in treating modern patients, but it is another tool in the shed nowadays. The shed has grown larger in the past 50 years, but it's also full of a lot of junk. Often the expert walks in, picks up the best tool for the job -- the one he's trained to use most confidently -- and steps over the rest. The skill is being adept in choosing those tools that are best suited for the situation, even if they aren't from the same pile.

"The doctor of the future will give no medication, but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease." Thanks, Thomas A. Edison. I like that quote. Doctors of Oriental Medicine, herbalists, and acupuncturists generally give herbs as part of a complete treatment plan, but giving a pill to pop -- whether pharmaceutical, peppermint, or deer antler-- is not the only way to help.

2015-05-29_julie6

The doctor of the future will be truly integrative. He will skillfully diagnose the patient's whole body, mind, and spiritual condition, drawing from both hands-on examination findings and high-tech imaging of internal structures. In the future, when the patient presents with the new chief complaint of acute calf pain and swelling, we can use modern imaging to quickly rule out the DVT and then use acupuncture to treat her condition and balance her body. We can give her qi gong exercises and dietary changes to support her long-term health and wellness. Thomas Edison will be proud.

2015-05-29_julie7

Further Reading: The Patient Will See You Now: The Future of Medicine is in Your Hands by Eric Topol