Archive for tag: faculty

It's Alive!

2014-12-04_plantMy lychee plant is alive! I can hardly believe it, because I've almost certainly killed it at least four distinct times. Dr. Cai gave several of us AOM students a small branch -- a twig, really -- around 18 months ago, and those of us arrogant enough to think we could grow them proceeded to take them home and plant them in something.

2014-12-04_stick"Don't worry," Dr. Cai kept telling us. "It's easy to grow." I felt so reassured that I would be growing my bush/tree in my own yard and harvesting handfuls of lychee berries in the fall. I was definitely wrong. Although I pride myself as a master novice gardener of vegetables, the lychee proved to be a new beast. Sure, I've grown a few potted herbs for cooking. Yes, I dry my own peppermint leaves and make tea. These small feats in no way prepared me to raise a baby lychee.

For most of its 18-month life with me, the twig remained a twig. Yes, it sprouted a couple of leaves here and there, only to be killed off again with the next cold night. Did I mention I tried to grow it outdoors in Chicagoland? Technically I forgot about it a few times, leaving it out in the snow and hard frost. Ooops, sorry Dr. Cai!

2014-12-04_nutsThis October I pledged to be a more responsible lychee parent. Sure, I'm successfully raising two actual human children, but that's different. They scream when they're cold and hungry. The lychee just sits there and practically dies in silence. So this October, I brought it inside. I placed it lovingly next to my dining room window, and I think I managed to water it every few weeks or so.

2014-12-04_berryThis week, the unspeakable happened. Out of the corner of my eye, while speed walking through the room in a late, chaotic frenzy as always, I thought I saw something different about the lychee...something...red?! Could it be? Did I facilitate the birth of the first Baby Lychee Yelnick berry? I leaned in for closer inspection, and I couldn't believe it. Not one, but TWO berries had grown on my tiny, twig-like plant.

Who cares about lychees anyway? Well, the Chinese do. They use it to tonify the Spleen, improving transportation and transportation functions around the body. Lately, the West has been turned on to the powerful anti-oxidant feature of the gogi berry, as we tend to call it.

How many names can one fruit have, you might ask? Well, let's take a look:

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So, lychee, lycii, goji, gou qi zi, whatever your name is...Grow on! I'm happy to have you in my humble home for the winter. In the spring I will place you back outside in my herb garden, and I will probably almost kill you again (sadly). I'll try not to, but I'm just being honest.

Put Those Hands Together When You Pray

If you don't pray, put them together anyway. In the age of anything goes, I've taken to the lazy practice of praying silently in my head while lying in bed at night. I don't know where my hands are exactly, but they sure aren't folded nicely in front of my chest like the iconic prayer image of the olden days.

Who cares? Why bother pressing your hands together and holding them in that fairly awkward position that drove me nuts as a Catholic school kid? I'll be the first to admit that I let my fingers fall and intertwine into the sloppy prayer paws pose as soon as the priest looked the other direction.

Now I realize I was screwing myself out of some real benefits. Sure, God was probably disappointed in my faulty direction following, but I'm not focusing on the spiritual deficit here. I'm focusing on the physical and even the psychological benefits I -- and many other lazy prayers -- had been missing out on all my young life.

This whole conversation hinges on one important point -- an acupuncture point -- called Pericardium 6, or "PC6" as we call it, because again we're all too lazy to stick to the formalities in life. What does PC6 have to do with prayer paws (as my kids call them)? This now famous spot, two inches proximal to the inner wrist crease, has been dubbed the most researched acupoints of the modern day. You know those "anti-nausea" motion-sickness type bracelet bands, with the ball that presses into the inner wrist? That thing's stimulating good ole PC6.

Why is PC6 such a beneficial acupoint? Our trusty guide to acupuncture points and meridians and their energetic functions is a beefy, rust-colored book usually referred to by its author's last name, "Deadman." What does Deadman say about PC6? Oh, nothing too exciting. Just that it treats all diseases of the chest, particularly the heart, but also benefits the lungs, too. It can be used for heart surgery analgesia. What? Yes! No anesthesia necessary...just squeeze PC6 for me while I go under the knife!

In TCM terms, PC6 "unbinds the chest and regulates qi," "regulates the heart and calms the spirit," "harmonizes the stomach to relieve nausea," and "clears heat." It's indicated in conditions such as heart pain, palpitations, cough, asthma, insomnia, anxiety, abdominal masses, fevers, malaria, irregular menstruation, and swellings in the armpits. Nothing important there, right? Not! PC6 does just about everything you could want an acupoint to do.

During a recent advanced seminar class with Dr. Robin Fan, we discussed the benefit of stretching the Kidney meridian in cases of heel pain. Suddenly, all I could picture was the traditional prayer pose--hands out front, pressed gently together, stretching and stimulating the bulk of the Pericardium meridian!

It makes sense. What is the function of prayer if not to calm the mind and spirit? It's not just Catholics and other Christians who have always used this prayer pose, either. As my mind wandered -- sorry, Dr. Fan -- around the globe, I saw the Chinese practicing qi gong poses, the Indians practicing yoga poses, etc. Every tradition I could think of involved some use of this position.

In anthropology, when we see similar customs or values amongst a variety of cultural groups around the world, we call those core elements "cultural universals." In other words, everybody's doing it. Why? The answer is one that, despite my need to create an evidence-based practice, I've always secretly promulgated; sometimes, you don't need to sit around waiting for a formal research study to prove a truth. It's lovely that western medicine has put together some studies that do show the efficacy of PC6 in some conditions, but I'm not waiting for them to prove the rest. I'm going with Deadman and the ancient world traditions on this one.

Pray on, prayers!

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.

How to Use Chinese Herbs

Think it's too difficult for you? I think you're wrong. File this post away under the "if I can do it, you can do it" series. Unfortunately, this practical how-to post is the result of someone actually needing to use raw Chinese herbs to feel better--and that someone is me.

Remember that whole "damp-heat in the gall bladder" thing from a couple of weeks ago? Yep, me too. Turns out, I still have that going on. Yes, I self-diagnosed and self-treated in near silence. Did I say I was good at this? I'm sorry. No. I'm a student. I know close to nothing. In my defense, upon an actual visit to the NUHS AOM clinic to exercise my student-access-to-free-care privilege, I learned that I nailed my diagnosis and was only one off in my acupoints selection plan.

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Ingredients for Treatment

I was indeed on my way towards getting back to normal, but not quite there yet. No. What I needed was a boost -- a big powerful boost in the health direction. I needed herbs from Dr. Cai. After showing my tongue and displaying my pulsating wrists to the masses of interns, I left the clinic with my trusty sack of Chinese herbs. At Dr. Cai's request, I also needed to add in a slice of fresh ginger and three red dates with each batch, which I happened to have on hand.

Many people would peer into this bag thinking, "What the heck do I do with this pile of roots, bark, mushrooms, berries, and other unidentifiables? Technically, there could be geckos and cicada shells in there...shudder. In fact I refuse to look up everything in the formula shown on my receipt just in case therearegeckos and cicada shells in there.... So, here it is--your pictorial step-by-step guide to using raw Chinese herbs in a decoction. This is the instruction sheet that goes home with the patient.

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Instructions for Cooking Chinese Herbal Formula

What this is trying to say is dump one batch of the herbs into a pot, soak it, bring it to a boil, then simmer to reduce the liquid to a drinkable amount. Now, you'll want to find the perfect balance between "disgusting taste" and "effective dose," and that isnoteasy. You know you want to concentrate the liquid for potency, but you also know that you're increasing the taste by the same stroke.

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Before Cooking and After Cooking

Most herbal decoctions do not taste good. Face it. Most of us are damp. We eat dairy and fried foods (mmmm...fried dairy), and we end up with damp-heat. Thus, we need bitter herbs much of the time. Who's the lucky fella who gets a simple Spleen Qi deficiency diagnosis that results in a sweet licorice and berries formula to take home? Not this guy!

So, I soak my bitter herbs, I boil my bitter herbs, I simmer my bitter herbs. I drink my powerful decoction, and I go to sleep to let my body do its thing. I wake up a little better, and I know I have five more nights of chugging down my "bedtime tea" before my tongue can register just how gross it really tastes.

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"Bedtime Tea"

I could avoid much of the "hard work" in this process by requesting my herbs in granule form (like a dusty powder that you stir in warm water to dissolve). But then I'd lose a little potency. I could avoid all the work and the taste by requesting a patent pill formula, but then I'd lose even more potency. No thanks, weak sauce. I need the most full-strength option known to man -- ancient Chinese man, specifically. I need to decoct my raw herbs!

Why There is No Such Thing as Sham Acupuncture

I get really annoyed when I'm reading the results of a scientific study about the effectiveness of acupuncture, and the author concludes that actual acupuncture was "not significantly more effective than sham acupuncture." What they seem to be saying is that acupuncture is not effective at treating X condition. What they are actual discovering is that needle insertion almost anywhere in the body will have an effect on the body's condition, often providing relief from X condition.

I like this part. As Dr. Kwon always told us in Point Location class, you can still help the patient even if you don't stick the needle in the exact acupoint. This realization saved my sanity on more than one occasion when trying to palpate and count thoracic vertebrae to locate the oh-so-important points of the Governing Vessel running up the spinal column. It's supposed to be located at T6, but T7 will be good enough? Awesome. Thank you for your flexibility, ancient wisdom.

So, back to the studies that drive me nuts. Here's how they commonly shake out:

Exactly 100 patients were studied for chronic knee pain, with 25 receiving no treatment, 50 receiving actual acupuncture (inserting needles at specifically proscribed points), and 25 receiving sham acupuncture (inserting needles randomly in the body). Guess what? The patients receiving no treatment did not experience improvement. The patients receiving actual acupuncture reported a 50% improvement, and those receiving sham acupuncture reported a 45% improvement.

I call that good news. The study concludes, instead, that actual acupuncture is not significantly more effective than sham acupuncture at treating knee pain. Wrong. What they actually did is prove Dr. Kwon right -- not that he needs any additional validation, seriously -- that even when needles are inserted at the "incorrect" location, acupuncture still has therapeutic benefits for the patient. Is the goal of an acupuncture treatment for knee pain simply to eliminate the knee pain? Not exactly.

Any time acupuncture happens, that patient's body experiences a shift in energy. We can usually feel a difference in the person's pulse after treatment, compared to before. The qi (energy) has moved, and in western terms, circulation usually improves. Sure, the knee pain is improved, but the patient might also sleep better than usual that night, awake with more energy than usual the next day, or even notice that a new head cold has resolved overnight.

Were these other effects coincidental? Maybe, but probably not. Any acupuncture is better than no acupuncture, and the results of studies comparing no treatment, sham acupuncture, and actual acupuncture will often reveal this truth. In fact, this little "secret" is why I'm not against other practitioners doing acupuncture on patients. We've all heard the buzzword "dry needling," which is when say, your physical therapist needles your arm when your elbow isn't healing as nicely as you'd like. I know several chiropractors who have completed the 100-hour certification in acupuncture, and they can often be seen sticking some needles into a sore back muscle.

Some acupuncturists are completely against this concept of non-acupuncturists needling patients, but I'm pretty much OK with it. I know the patient is probably receiving some benefit regardless of whether or not the needle goes in at an exact acupoints. What's important to me is that the patient is aware that dry needling or someone sticking some needles in where it hurts is not all that acupuncture has to offer. Those techniques have benefits, but not the full array of benefits that needling specific acupoints on specific meridians can produce.

So, if you know someone who's been needled before and didn't experience a great symptom reduction, it's still worth their time to try acupuncture from an acupuncturist. Crazy, I know. It's not that other providers are doing anything wrong; it's just that they aren't receiving the more complete system of treatment via acupuncture that we acupuncture students use.