Cheech and Chong?

2015-07-24_a1No, I said Si Shen Cong. Next question: You want to stick the needles where? Or, patients will stop me in my tracks with a firm "I don't want needles in my head." What's happening here? No big deal, I'm just trying to utilize the Four Spirit Alarm extra point set on the top of your head. 

Does it sound alarming? Painful? I can understand that. Needles in the head doesn't soundfunto most people, but rest assured it usually doesn't hurt. The scalp is a shallow place, not too full of fleshy, innervated muscles.

Right up there on the top, slightly to the back, you'll find a special set of four points calledSi Shen Cong. Chinese pronunciation sounds something like "Shee Shen Chong." English pronunciation sounds more like "Cheech and Chong." It's ok, just keep working on it.

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One translation calls this extra point "God's Cleverness." We use it for improving concentration, memory, focus, or other related indications. In TCM treatment strategies, it helps to "calm the Shen," or "relax the mind and settle the spirit." In adults, this 4-point combination could be indicated in cases of wind stroke, headaches, epilepsy, and dizziness. In children, traditionally this point combination was used for slow development, mental retardation, and recently for ADHD.

2015-07-24_cIn clinic today I polled my fellow interns to see how often they add the point "Governing Vessel (GV) 20" into the mix when using Si Shen Cong. Why would someone do this? Well, as I argued, it just seems like the right thing to do. GV20 is a masterful point, located smack in the center of the four needles used in Si Shen Cong. Its indications are similar, not shocking, considering they are all within a couple of inches of one another.

GV20, also called the "Hundred Convergences" in English and "Bai Hui" in Chinese, you can find this point on the midline of the head, five cun back from the anterior hairline. GV20 is generally used for two indications--pulling things up or pulling things down. How can it do both, you ask? Well, Chinese medicine is magical, don't you know.

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GV20 is indicated for prolapse, thus it can pull things up. Whether it's your uterus, rectum, bladder, or vagina that's prolapsed, GV20 can help put it back up where it belongs. Same goes for hemorrhoids--other items that should not be hanging down.

2015-07-24_e2015-07-24_fGV20 is indicated for yang rising in the top of the body. Think headaches, hypertension, dizziness, red eyes, irritability, tinnitus, seizures, and more! Interestingly, in these cases, GV20 at the top of the head is paired with anchoring points found at the extreme lower end of the body. For the horrible conditions mentioned here, Liver 2 would be an effective paired point.

Whether you're rectum has prolapsed, you've been dealt a massive vertex headache, or you just want to improve your concentration and focus for the upcoming test, you might want to give needles in the head a chance. When your acupuncturist suggests "Si Shen Cong," now you'll know it's not Cheech and Chong she's referring to. But they're fun, too.

Board Exams! Wow!

2015-07-17_juli1It's board exam season for me. Right now. For the Master of Science in Acupuncture program, we need to pass three board exams to apply for Illinois state licensure -- Foundations of Oriental Medicine, Acupuncture with Point Location, and Biomedicine. Does that sound hard? Yep, it does to me, too.

"We've been doing this for three years!" This was classmate Irene Walters' response to my line of questioning about how difficult the exams were. Yes, she already took -- and passed -- all three of them. Did her comment make me feel better? It did. She's right. We've been studying oriental medicine for almost three full years, at the graduate level, full-time, year round. We've been in the clinic for two years, first observing other interns and then needling patients ourselves.  

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2015-07-17_juli3Despite her slightly exasperated but somehow very reassuring comment, I studied a lot for the Foundations of Oriental Medicine board exam. I used the NCCAOM official board exam website study guide. I bought the practice exam book, hurriedly took all of the practice tests, graded them, debated back and forth about whether a 78% is a good or bad score, and largely just panicked on and off for approximately three weeks. I kept my head down, read repetitive passages out of Maciocia, and improved my practice scores up to and including a full 88%, thank you very much.

The day of the exam I made the always long but much longer in the summertime/construction season drive to Schaumburg and searched amongst the 9,000 office complexes to find mine. I changed my shirt, because by then I had sweated out the armpits in a nervous panic not once but twice on the way. Finally, I headed up to the PearsonVue testing office, which I found at the end of the top floor in the back, dark corner.

2015-07-17_juli4Inside the office was less creepy than the hallway indicated it would be, and a stern woman was ready to take my two forms of ID, photograph, and both palm scans. I didn't even know people did palm scans. What happened to finger printing? After she was sure it was really me, she gave me the locker key and told me to empty my pockets and leave all belongings in my locker. Go pee now, it's your last chance, Juli.

Just when I thought I had been looked over fairly thoroughly, I was led into another checkpoint. Here, another woman formally instructed me on how to use the computer, how I should wear earplugs, and how I would need to raise my hand if I needed an emergency bathroom break. Alrighty, let's do this thing. Before turning me loose into the computer testing cubicle, she had me shake out my skirt, pull up my sleeves, and rotate my necklace in front of a camera -- just in case I had written all of the answers to the Foundations of Oriental Medicine board exam on the back of the one inch wide necklace pendant. OK.

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At long last, I arrived at my testing console. The next 2.5 hours were a blur. I had heart palpitations, blurry vision, great thirst, and generalized anxiety. That's fair to say. Staring into the computer screen and clicking the mouse repeatedly for 150 minutes will do that. Terrified that I had failed, I timidly and exhaustedly clicked that final button to see my results.

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"PASS." Wow. Praises. Now I only need to do this ordeal again...twice.

Should a Veteran be Homeless?

I think not. Yet, there are around 50,000 homeless veterans in the U.S. on any given night -- despite a 33% drop since 2010! "The U.S. Department of Veterans Affairs (VA) states that the nation's homeless veterans are predominantly male, with roughly 8% being female. The majority are single; live in urban areas; and suffer from mental illness, alcohol and/or substance abuse, or co-occurring disorders."

This is where acupuncture comes in, friends. The National Acupuncture Detoxification Association (NADA) protocol, specifically, is helping veterans with PTSD manage stress, addictions, difficulty sleeping, and other behavioral and mental health conditions. NADA uses a standard set of ear points -- Sympathetic, Shen Men, Kidney, Liver, and Lung -- stimulated either with needles or with ear seeds.

Since it was established in the Bronx in 1974, the NADA protocol has brought relief not only to veterans, but also others in need of assistance with addictions, from food to illegal drugs. How does it work? The acupuncturist -- or one of over 10,000 health care professionals trained specifically in NADA protocol -- inserts the five sterile, stainless steel, one-time use needles into the ear and lets them remain for up to 45 minutes. Then, we take them out. It's simple. It's fast. It's cheap. It's effective.

2015-07-10_nadaWhat are patients saying about the NADA protocol? "...improved program retention, a more optimistic and cooperative attitude toward the process of recovery, as well as reductions in cravings, anxiety, sleep disturbance and need for pharmaceuticals." 

On Friday, June 26, NUHS Chief AOM Clinician Dr. Hyundo Kim and a group of acupuncture and oriental medicine interns headed downtown to the Chicago National Guard Armory to offer free PTSD ear seed treatments to homeless veterans. That's right -- NADA can get even easier! When needles aren't appropriate or convenient, we can still stimulate the ear points of the NADA protocol with stick-on ear seeds. The added bonus is that the patient can essentially take the treatment "to go," and can squeeze the seeds, reactivating the points, for the next few days.

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At that Chicago Stand-Down event, held in June, homeless veterans are brought together in a single location to access community resources and supplies needed to begin addressing their individual problems and rebuilding their lives. Our group of volunteers provided ear seed treatments while other groups provided everything from a hot meal to a bag of clothing to an eye exam. I saw booths for flu shots, HIV tests, dental services, and Reiki. That day -- that one day -- those homeless veterans had a full-service experience.

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Representatives were on-site to match them with shelters, jobs, and the benefits they earned for their service to the United States of America. They were welcomed, they were appreciated, and they were valued.

Messy Poo?

2015-07-03_pic2Too bad. Did you know it's actually supposed to be clean when you wipe? Yes, a healthy poo is so nicely formed that even your first swipe should be a leave-no-trace expedition. Maybe that's how indigenous societies have all seemed to get along fine without rolls of toilet paper in their lives....

Unfortunately, many people upon wiping discover a messy poo situation. Perhaps you have to wipe a second time, or a third, or -- gasp -- a fourth time. Maybe you never even feel clean, despite seemingly endless wiping. Commercial products have actually adapted in response to the commonality of the messy poo -- flushable wet wipes for adults have hit the marketplace. Don't flush them, though. Free tip.

So why, according to Traditional Chinese Medicine, might an individual produce a messy poo? Naturally, there are several different potential trails of pathogenesis leading to a sticky, unformed deposit. Let's just cover one of the most common diagnoses - Spleen Qi Deficiency with Dampness. It's so common, yet so unpleasant.

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What is Spleen Qi Deficiency?

Well, let's start with what Spleen Qi is and what it's supposed to be doing when not deficient. The functional system called "Spleen" in TCM is responsible for these things and more:

  • Holding things up - We don't want your bladder or rectum or uterus prolapsing now, do we?
  • Containing blood - This is the guy who's keeping your blood neatly inside your vessels.
  • Thought - Spleen qi keeps your memory and concentration tip-top in the upstairs shop.
  • Muscles - Spleen nourishes your muscles. Serious, who wants to be described as "atrophied?"
  • Transformation & Transportation - The more liquid junk you throw down the pie hole, the harder the Spleen has to work to separate the clear from the turbid. In other words, "digestion."

If your Spleen qi is strong, you are good to go. I likely will not find you passed out in an alley, hemorrhaging and passing uncomfortable gas. Luckily, life is not always so extreme, and neither are pathologies. More often, modern American people are simply suffering from a mild case of Spleen Qi Deficiency. What's that look like?

  • 2015-07-03_pic4Abdominal Complaints - Gassy, bloaty, nauseous? Check, check, check. Maybe even dull pain.
  • Poo Malfunction - Loose stool, undigested food in the stool,messy poo? Well hello there, fourth wipe!
  • General Wimpiness - Fatigued, weak? Sweating on the third step? Worrying obsessively? Overweight?
  • The Bleeding - Chronic bleeding, hemorrhoids, bruise easily? Yah, I know it sounds serious. Eek.
  • Inclinations - You have no empathy and you constantly crave sweets.

Why is this happening to you? What did you ever do to deserve messy poo and this horrid array of sad signs and symptoms? How did your Spleen Qi become deficient? Like many things in TCM, there could be many right answers, depending on the person. Likewise, there are multiple ways to try to rectify the situation. There's more than one way to skin a messy-poo cat.

Causes of Spleen Qi Deficiency

First, the causes. Think back. Which ones apply to you?

  • 2015-07-03_pic5Dietary Choices - Too much cold, raw produce. Do you juice or, more deliciously, make smoothies? Salad every day for lunch? Woops. You just overwhelmed your Spleen with cold and allowed its pathological partner in crime,dampness, to creep in. Now you're feeling heavy, groggy, fatigued, and possibly gaining weight.
  • Excessive Thinking - Do you worry all the time? Is your job constantly causing you to overanalyze everything? What about your personal life? Are you obsessive? All of this strain injures the Spleen Qi.
  • Chronic Disease -  If you've been battling a long illness, you can bet your Spleen Qi has taken a hit. Taken multiple courses of oral antibiotics? Your Spleen is paying the price.

Treatment Strategies

What can you do about it? Is there any hope for a one-wipe life? Happily, the answer is yes. You can change your poo. Here are your treatment strategies, of course individualized to each person's exact manifestations of Spleen Qi Deficiency (and its partner, the Damp).

  • Tonify the Spleen - Your friendly neighborhood acupuncturist can use a combination of needles, moxa, and herbs to bring that bad boy back up to speed.
  • Resolve the Dampness - Spleen qi deficiency doesn't necessarily lead to damp accumulation, but it basically does. So, you also need to get rid of the dampness.

While the treatment strategies and principles seem few in numbers, they are not necessarily simple to accomplish -- particularly once the dampness has accumulated. While acupuncture, herbs, and anything else your acupuncturist does to you at the visit will almost certainly help your condition improve, you also need to make some changes at home for lasting results.

Additional Strategies

  • 2015-07-03_pic6Dietary Changes - Nobody wants to hear that one, but it's unavoidable. Stop eating all raw, cold produce. Cook your vegetables. It's the ancient Chinese way. Add some warming foods into the plan, sprinkle some cinnamon on your breakfast, and limit the salads to a couple per week. If the dampness has set in, then also limit alcohol and fried foods.
  • Qi Gong - It's like yoga; relax. There are simple movements you can do at home each day to strengthen the Spleen and Stomach systems in TCM. Check out this video of spleen excercises.
  • Relax - Try not to worry so much. Don't overthink everything. Lessen the obsessions.

If all of this sounds too difficult, then just incorporate one suggestion at a time. As always, please consult your favorite acupuncture intern for more information on your individualized pattern diagnosis and treatment plan. You don't want messy poo for the rest of your life, do you?

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.

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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. 

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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.

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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.