Essential Oils or Chinese Herbs

Are essential oils (EOs) the answer to the challenging questions of how to locate, transport, store, and prepare Chinese herbs? I'm starting to think so. The more I use EOs in everyday life, in everything from cleaning my kitchen floor to healing skin wounds, and even to give my beer that summery citrus flavor, the more I see the large overlap between EOs and Chinese herbs.

2014-07-28_booksAs a student of Acupuncture and Oriental Medicine (AOM), mostly derived from Traditional Chinese Medicine (TCM), I respect and value the efficacy of a freshly decocted batch of raw Chinese herbs. I know they work, I've gained a basic understanding of why they work, but I struggle with the practicality of using them either for my family now or for a future patient population.

What are these challenges? First, there are a lot of "herbs" in TCM's Materia Medica (book of medical substances, whether plant, animal, or mineral derived). To stock a shoebox-sized amount of just most of them would require a very large storage room. Some need to be refrigerated, some need to be pulverized just prior to use, and some are illegal to use in the United States. No rhinoceros horn for you!

2014-07-28_shelvesFinding them--even the legal ones--presents yet another stumbling block. Should you order online, feign condition after condition to cache all the prescribed herbs you can squeak out of your clinician at school? Drive to Chinatown and take a stab at which shop has fresh, safe and affordable herbs? Sure enough, within a few days of making each trip to Chinatown myself I realize, "DOH! Now I need that other herb, too!" Back in the car....

After a year or so of engaging in this disorderly and expensive game of cat and mouse, I'd tried all (well, most) of these tactics--even growing some of my own! All legal, of course. Think "mint," not "ephedra." So, what's an AOM student to do? For the past year, this one's been exploring the way that high-quality EOs could fulfill many of the same needs as our Chinese herbs. How? Well, I'm not entirely sure that the properties translate exactly, but many sure seem to do just that. Let's take a look at our good friend, peppermint.

peppermint plantChinese name: Bo he. Common English name: Field Mint. Latin name: Mentha piperita. Same plant...same medicinal properties? I argue "yes." Most basically, peppermint is "cold" in nature. Both West and East agree on that. TCM goes on to add other attributes such as aromatic, acrid, and thus capable of dispelling the common wind-heat invasion (think: yellow snot and sore throat). My western manual of EOs describes peppermint as "anti-inflammatory, antibacterial and invigorating," with primary uses including "congestion, fever, influenza, heartburn." Sounds...pretty...similar!

Sure, the harvesting, processing, and distillation processes change, emphasize, or even exclude some of the chemical constituents, and the final usable product of dried bo he differs greatly in appearance from the bottle of peppermint EO. Does that mean they function differently, though? I used to harvest, dry, and lightly decoct my own bo he when I felt a wind-heat invasion coming on. It worked, as long as I was at home with my own garden and had some time to prepare it all. Lately, I've been easily reaching into my oils cabinet and tapping two drops of peppermint EO into a mug of warm water. Instant peppermint tea? Definitely. Instant medicinal answer to a wind-heat invasion? I say yes again, based on my own experiences.

2014-07-28_peppermintI'm not a chemist or a doctor, but in my experience and increasingly informed opinion, I'm finding that EOs can make a handy substitute for Chinese herbsin many cases. As with raw herbs, quality is of upmost importance when selecting an EO company. Storage, convenience and ease of use are all in favor of EOs, but they are limited in number. I haven't found one called "gecko" or "scorpion," or especially "Bear Gall Bladder," all of which are clutch entries in a TCM Materia Medica.

Conclusion: If you can manage to live and treat without the more exotic or illegal Chinese herbs, then EOs might be a practical substitute much of the time. Imagine the difference between handing a patient a bag full of raw ingredients, a pictorial instruction sheet, and a handshake full of hope that they can execute the cooking process effectively vs. handing the patient a small bottle of EO and the simple instructions to put two drops into a mug of warm water.

Extra considerations abound; this post cannot attempt to cover every angle or offer every comparison point. Granule or patent pills can make Chinese herbs more practical, while some EOs are quite expensive to purchase. Frankincense can easily run $100 per 15 ml bottle. Hey, if it's good enough for the Christ Child, you're going to have to pay up! There are also some pesky mind-blocks when trying to move seamlessly from one medical paradigm to the other. How could a TCM practitioner possibly use hot cinnamon bark and clove bud for a yellow-snot, sore throat sinus infection? Yet, that's exactly what the EO prescription is in that case. Homeopaths have no qualms with the theory of treating heat with heat, but that's not the plan in AOM!

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For now, I'll chalk this entire idea up to just another piece of evidence that an integrated approach to healthcare is truly the best option. Taking what works from any and all medical systems offers our patients the most options for being well. I'm open to that...

How a Clinic Internship Works

I get this question all of the time: "Do you acupuncture people yet?"

Yes, kind of, not really, I don't know what I'm supposed to say exactly. Do I put needles in people? Yes, of course. Should I? Well, that's where you've got me. Technically, I'm not a licensed acupuncturist yet, so I take that to mean that I can't charge people for acupuncture yet. Is it safe for me to needle people? Well, I do have my Clean Needle Technique certificate filed away somewhere....

2014-07-23_internDo I know what I'm doing? Can I help someone feel better? I don't want to be a pretentious jerk and assume the answers are "yes" here, but over the past year I've certainly had some good feedback. As a sometimes full-time and sometimes part-time student in the acupuncture program, I'm somewhere around Tri 5. I've completed a large chunk of the coursework, the whole observation phase in the clinic, and now I'm actively practicing on everyone who schedules an appointment with me in the AOM clinic on campus.

For the next year, I'll continue along in this internship, enjoying the opportunity to test out treatment strategies, hone my diagnosis skills, and figure out if "patient consents to treatment" actually belongs in the "A" or the "P" portion of the SOAP note. I'll do intakes; I'll form diagnostic impressions; I'll pow-wow with Dr. Cai, Dr. Stretch, and any other clinician I can find. I'll needle patients; I'll moxa their cold feet; and I'll do as much moving cupping as my forearm strength permits. If you're really special, I'll do tui na and I'll gua sha you afterward. Want some herbs? Sure, we have raw, granules, or patent pills. Right this way!

While the patient visits are the most important and most fun parts of the clinic internship experience, the clinic lottery is the part that causes the most anxiety among the interns. "Will I get my same shifts next tri?" "Which clinician will I work under?" "Which interns or observers will be on my shift?" All of these panic-stricken questions and many more can be heard all over campus right now -- the infamous Week 12 clinic sign-up and resulting lottery has arrived!

Photo of Stroger buildingSure, interns get to sign up for their preferred shifts and locations for clinic internships. We AOM students have the luxury of choosing the on-campus Lombard Whole Health Center clinic or driving to Stroger (Cook County Hospital) in Chicago for an off-site experience. My 45-minute commute is plenty, so I try to keep it simple and stick to the main campus. There we all are, fluttering around the sign-up sheet in the clinic lounge room, which is busting at the seams on a regular day, elbowing the interns who are actually trying to sit nicely and write SOAP notes that day.

If all goes well, there is a nice white empty slot shining and waiting just for you on the day and time that you've decided would be perfect for your upcoming trimester. In reality, someone else probably agreed and already signed up for that one. In the end, many interns are able to secure an acceptable shift and everyone survives the sign-up week. Some lucky individuals end up in the clinic lottery, where randomly drawn numbers allow devastated interns to play a sort of game-show rendition of "This will be your life next trimester."

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In my two years at NUHS, we haven't lost anyone yet! The sign-up process can be stressful for some, but by the time the next trimester rolls around, we're all just excited to start treating our patients and working with our clinicians to hone our skills. I have one more year of this endearing learning process, and then it's out into the real world for me (again). No more clinicians to ask questions of, no more easily accessible chiropractors down the hall to consult with on orthopedic issues (thanks, Dr. Anderson!), and no more half-days of work! Maybe this whole clinic deal is pretty great after all....

Whoa, I Think I Just Made Kombucha

A friend surprised me a few weeks ago by lending me her continuous brew kombucha set-up. Apparently a "symbiotic colony of bacteria and yeast" (SCOBY) isn't so appetizing to a pregnant lady. "Sure, thanks!" I naively responded. I've had a couple of bottles of kombucha tea over the years...kind of fizzy, kind of yeasty and stringy, yum. I'll give it a shot!

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What really excited me was how much money I could save by brewing the kombucha at home instead of buying it at the store. That stuff can be really expensive, and I can be really cheap. I'm also down with anything that reduces the amount of additives, preservatives, and other artificial baggage that comes with my beverages.

A week later, she shows up at my house and unloads the blessed gift--the kombucha, not the baby--in my kitchen. She starts heating up water, stirring in loose-leaf black tea, requesting all sorts of wooden spoons, cane sugar, and glass bowls. I'm trying to keep up, tossing things over to her so she could work her magic on a new batch of kombucha tea for my tasting pleasure. "It's easy--here's the directions!" Technically she stayed for another hour, but I felt like she ran out right then. I was so less prepared than I knew.

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All week, I tried but failed to resist lifting the lid and looking down into the brewing tea vessel. I imagined all sorts of bacteria riding along from my exhaled breath and taking up shop in the floating white SCOBY. It's a symbiotic colony of bacteria and yeast, and I'm surely going to disrupt the balance in there. Sure enough, at the end of the week, I panicked and almost threw out the entire 2-gallon batch of tea. Relax, Juli...maybe the black spots aren't mold...how could they not be mold? I've left a colony of bacteria and yeast on my counter all week!

Compromise with myself: I'll pick off the top layer of SCOBY (where suspicious black spots appeared), throw that out, and then move on to tasting the brew out of the spigot on the bottom. Deal! Except yuck...apparently my turbinado sugar was a big deal, because it was all wrong. I was drinking apple cider vinegar out of a pretty glass. Next compromise: I will bottle this product as apple cider vinegar and use it for marinating meat, pouring in my laundry, and catching random fruit flies in the kitchen.

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With the first batch of kombucha a near failure, I pressed on. That's the great part about a continuous brew kombucha set-up. You get to try again. Immediately. You actually kind of have to try to again immediately, because that SCOBY is calling out to you, "Feeeeed meeeee!" Armed with the recipe and faced with the challenge of having to do this all by myself this time around, I readied the supplies. Wooden spoon, glass bowl, big boiling kettle of water, sugar, loose-leaf black tea, and a cup of the old batch to use as "starter liquid" for the new batch. And, Go!

I followed directions, poured in fine evaporated cane juice this time instead of big brown bad boy turbinado sugar crystals, and put the lid on that thing for another week. I slept better, knowing that black specks in the SCOBY were most likely the remnants of the loose tea that I couldn't strain out with my low-quality kitchen equipment. This time, I tried even harder, yet still failed daily, to resist lifting the lid, breathing my germs inside the brew. Despite my breath germs, Kombucha Tea Batch #2 was a huge success!

"Holy cow, I think I just made kombucha!" This is stuff you can sell in a store, people!

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Now to challenge myself again, I attempt what is called a "second ferment" of the tea. I bottle up the delicious tangy tea and dump cherries or blueberries into the jars. I leave these jars on the counter for another three days, and then I refrigerate them to stop the fermentation process. Success again! The result was a super tasty, kind of fizzy, fruit infused kombucha batch that I slurped up in the next three days. Looks like I need to squeeze three gallons into that vessel for Batch #3....

Here's a detailed plan and recipe if you want to try this at home: How to Make Kombucha Tea. I promise, it gets easier!

Choosing Your Intern

You've made the first move. You've called to schedule an appointment in the AOM clinic. Just as you think you're almost done with this first critical step, the receptionist throws a massively important, yet completely unexpected, wrench in your plan. "Which intern are you looking to schedule with?"

Oh. My. God. What do you do? Which name do you say off the top of your head? As you feel the pressure mount in those two seconds of silence on the phone, your brain quickly scans the names, personalities, general skill levels, and specific competencies of every student you know at NUHS.

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It might not seem like a big decision to some, but for many patients, your intern will make or break the entire appointment. I've heard it all in the halls of the clinic, "He got a D on that Point Location Exam, so I don't want to schedule with him!" "She's the only one who follows up needling with tui na every week--I want her!" "I only (or, I don't) want my best friends seeing me with my pants down." If you're bringing sensitive people--the elderly or young children--then even appearance might matter. If I scheduled my kids with a super-tall bearded man, they might run outside and hide by the swans!

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If you haven't thought about which intern you will choose for your first or next acupuncture appointment, here is a handy guide to help weigh your options. No, I'm not going to provide a rating list of each intern in clinic this trimester, complete with names, pictures, and assorted blasphemies or accolades. Instead, I'm going to walk you through the options that may or may not be important to you in your decision-making process.

  1. Do you want your friends to see you naked?
    Most of us don't mind in a medical setting, but if you get stage fright in this arena, consider it a factor. If you can't relax, then your acupuncture treatment can't be fully effective.
  2. Do you want to build a long-lasting relationship with just one intern?
    Don't select someone who's graduating at the end of the trimester. Many of us are part-time, which means that we will be a regular presence in the clinic for a year or more.
  3. Are you only concerned about having the most informed, top-of-the-class intern right now?
    Then go ahead and choose that fabulous intern who has the most experience with add-on extras--if you can get into her packed schedule!
  4. Should your treatment philosophy match your provider's?
    I think so, and I consider this when scheduling an appointment myself. Do I get a good feeling from this person? Do they ooze positive energy? I come to the clinic to build my qi, not to have it stolen.

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Image source: www.visualphotos.com

Now for the great part--there isn't one intern who fits every criteria! This is wonderful news, because it means that a variety of options exist for each patient who walks through the door. Each patient is different, and each intern is different. If you've tried acupuncture once, but just didn't get that great feeling, then try again with someone else! If you were lucky and hit it out of the park with your first intern, then stick with that person, or ask him or her for a referral for another intern who treats in a similar style.

Good luck, and happy hunting!

Want to Freak Out an MD?

2014-07-03_yurasekWhen they ask you why you came in for an appointment today, go ahead and let them know that your urine is coming out in long, clear streams, and that your dreams have been creepily vivid this week. Tell them that your bowel movements are light brown, formed, and coming with ease twice per day in forearm lengths that would make Dr. Yurasek proud. Mention that you've been feeling kind of cold and that you can't stand being out in the wind. That heaviness in your arms? Mention it.

Dive straight into the rest of Oriental Medicine's famed "Ten Questions," noting whether you've been extra hungry, not so thirsty, frigidly anti-sexual, exhausted from periods with quarter-sized black clots, or muzzy-headed in the afternoons. It all matters. If you're in an AOM clinic, these are the types of things you can expect to be asked by your acupuncturist or herbalist. No one here bats an eye when patients share the color and consistency of their bowel movements. In fact, if you withhold that information, we can't really help you very well.

Here they are, in detail but translated by me:

The Ten Questions

  1. 2014-07-03_outlineDo you feel hot or cold, or do you experience fever or chills?
  2. Are you sweating and is it during the day or at night?
  3. What's up with your head and face? (EENT)
  4. Do you have any pain anywhere?
  5. How's your urine and stool coming out?
  6. Are you thirsty? Hungry? Got cravings?
  7. How've you been sleeping?
  8. Anything noteworthy going on in your abdomen/thorax? Who says "thorax"?
  9. What's up with your gynecology? If male, you can put "N/A," thank goodness.
  10. 10. General/Past Medical History (in case we didn't cover it all yet)

Your acupuncturist or herbalist not only wants to know these things, but also actuallyneedsto know many of these things in order to properly diagnose your condition and begin a treatment plan. If you have long, clear streams of urine, loose stool, weak knees, a sore lower back, and feel cold all the time...well, we know what's going on. No, I'm not going to tell you here. Look it up. Better yet, visit an acupuncturist!

So, if you're in an AOM clinic, have your thoughts on these vital topics prepared beforehand. Otherwise, you might be so thrown off guard by some of the Ten Questions that you can't formulate sentences. That's actually fine, because none of the 10 questions directly correlate to grammar skill level. Thank goodness, right? However, if you find yourself in the office of an MD, keep in mind that you might not want to just jump right in with details about where you are in your menstrual cycle and how gassy you've been, if your chief complaint is seasonal allergies. Just a tip, from me to you.