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Acupuncture Malpractice Insurance – Facial Motor Point Use for Cosmetic Applications Part 2

 

 

Today’s talk focuses on facial motor points. Last time, if you missed part one, I talked about using facial motor points for cosmetic applications. And today we are gonna be talking about so cosmetic applications like, Crow’s feet or frown lines.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name is Michelle Gellis and I am an acupuncture physician who teaches facial acupuncture classes internationally. Today, I will be presenting part. Two of a lecture on using facial motor points for facial concerns, and if you would please go to the first slide.

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This is a list of the different classes that I teach. They are all recorded and on my website, and today we will be going over some of the. Topics that I cover in treating neuromuscular facial conditions and some of the advanced techniques from my facial acupuncture class.

Today’s talk focuses on facial motor points. Last time, if you missed part one, I talked about using facial motor points for cosmetic applications. And today we are gonna be talking about so cosmetic applications like, Crow’s feet or frown lines. But today I am going to be talking about using facial motor points for a couple of different types of neuromuscular facial conditions, and the two that I’m going to discuss today are Bell’s Palsy and Ptosis.

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But first I wanna review quickly. What is a motor point? If a muscle. Is not functioning properly. Using an acupuncture needle and putting it into the motor point of the muscle is like a reset switch and it will bring the muscle back into normal functioning. Because on our face, the skin is attached to the muscle.

Using the motor points on the face can help the face to not only look, differently getting rid of tension and wrinkles and lines and folds, but it can also help the face to function properly so that if someone has some sort of a neuromuscular facial condition, using the motor point can help to resolve that.

A motor point is different than a trigger point. A trigger point is like a knot in a muscle, whereas a motor point is, so if this is your peripheral nerve, you have your sensory nerve, and then you have your motor nerve, and the motor point is where the motor. Attaches into the muscle. It is the most electrically excitable part of the muscle where the motor nerve is attached.

The face has two nerve branches that are in charge of the functioning and the sensory of the face. So we have the trigeminal nerve, which is. The fifth facial nerve CN five, and that takes care of sensation. And also mastication, it connects to your massacre, the facial nerve which is CN seven, cranial nerve seven.

Helps the functioning of the face, so your facial expressions and also taste. So you can see the two different nerves. We have the facial nerve and the trigeminal nerve. And the trigeminal nerve has the ophthalmic branch, the maxillary branch, and the mandibular branch, and the facial nerve has five.

Branches, the temporal zygomatic, bcal, the mandibular branch, and then the cervical branches which go down to the platysma.

The first neuromuscular condition we’re going to talk about is Bell’s Palsy and. Be’s palsy is the most common cause of facial paralysis that you will find in your treatment room, that you’ll see in your treatment room typically, and it’s a disruption of the facial nerves, and it can result in facial paralysis, weakness, drooping, inability to keep the eyelid open or closed.

You can patients can get unusual taste sensations, hearing loss, ear pain and normally the symptoms get at their peak within 48 hours and can last for several weeks up through a lifetime.

Palsy is typically in Western medicine. It’s typically thought of as a result of a virus and, mostly it is seen in individuals between the ages of 15 and 60, although I have seen patients as young as two in my treatment room with Bell’s Palsy, and it usually follows some sort of a viral infection.

It is seen. In a very large number of pregnant women and Western medicine treats it with drugs such as Acyclovir. And also usually so the acyclovir is an antiviral, and then frequently they will give some sort of a steroid to help with any inflammation. So the first thing you would do is an exam protocol, and in order to ascertain which of the muscles is not.

Functioning properly. So you would look at, for example, the frontals. The way you would determine if that is working properly is you’d have your patient raise their eyebrows, close their eyes, and you’re going to be looking for any disparity between the two eyes. Have them smile, and this is going to let you know how the zygomaticus major and minor.

Functioning the orbicularis, orus, the lator muscles, and ZOS. Et cetera, et cetera. So you’re gonna go through the exam of the different facial muscles and you’re going to look for any disparity, and then you will know which muscles to treat, and then within that muscle group. Where the different motor points are, and fortunately for us, the motor points on the face, most of them are either on an acupuncture point or they’re right between a couple of acupuncture points.

So it makes it easier for us to find them because the muscle, the face does have a lot of muscles.

So the first motor point that we would use if someone could not pull their eyebrows together and frown would be the motor point for the corrugator muscle, which is just lateral to bladder two.

The next, as I mentioned the frontals that raises the eyebrows and the motor point for that is gallbladder 14. So you would treat the affected side for the orbicularis oculi. This can help with. Closing the eyelids, and that can sometimes be a problem. People with Bell’s Palsy, they have to take their eyelids shut and the motor points.

There’s two for each eye, and one is between Sania 23 and gallbladder one, and then the other is the extra point Q Hoag, which is right on the orbital Ri. It’s between stomach two and gallbladder one. The next is the motor point for the Zygomaticus major, and that is SI 18, and you’re going to needle into the muscle, but not through the muscle.

The Zygomaticus minor helps to elevate the lip and the motor point for that is between stomach two and stomach three. For the levator Labii Superioris, the motor point is between LI 20 and stomach two, and the levator labii Superioris helps to elevate the lip individually as if snarling the Tallis, is on either side of Ren 24 and it is a half soon lateral to Ren 24, and this helps to elevate and protrude the lower lip.

So in addition to ascertaining which muscles you’re going to treat. If you were treating a condition such as Bell’s Palsy, you also would want to do a full body treatment. And so you would do your TCM diagnosis and look for the pattern and treat the underlying pattern. In the case of Bell’s Palsy, it is either blood stagnation, a lung wind invasion, or a spleen chi deficiency.

And then you would do local points and motor points on the face where the person has the deficiency. In addition to any body points, posis is another neuromuscular facial condition that. You will see commonly in your treatment room, and it can affect one eye or both eyes. It’s when the eye lids are not opening fully.

Everyone has a little bit of ptosis, but it can happen as we age. Some people are born that way and for others it can happen after some sort of an injury or even an illness. And this these are different levels of ptosis. This is slight ptosis, very slight ptosis. And this is due to aging. And then this is more severe ptosis.

I already went through all of this. There are many different causes of ptosis again people, sometimes people get ptosis when they have cluster headaches and, some sort of brain injury as I mentioned injury. A brain injury, spinal cord injury can cause ptosis as well. The motor points that you would use ver posis are the orbicularis oi, and also the frontalis can help the major muscle that’s involved.

Is the levator muscle, but there is no motor point for that. There is a way to treat it with cosmetic threading techniques, but I cover that in my cosmetic classes. When you’re looking at posis of the upper eyelid, it’s either a deficiency of spleen. And kidney or and or spleen deficiency with wind phlegm or oh, I’m sorry.

Let me back up a step. The slide is confusing. The it’s either a spleen deficiency with wind phlegm. Or a deficiency of spleen and kidney. And so the, you would do your differential diagnosis based on what the symptoms are, and then you would treat the underlying symptoms accordingly, as well as using the motor points.

This is information on how to find me if you are interested in. More information. You can follow me on Instagram or join my Facebook group, facial Acupuncture and my website for all of my recorded and live classes I do teach internationally is facial acupuncture classes.com.

I wanted to say thank you for today for coming, and thank you to the American Acupuncture Council for giving me this opportunity to spend some time teaching you.

 

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Acupuncture Malpractice Insurance – Pulse Diagnosis: Beyond Slippery and Wiry Part 2

 

 

Lovingly call a slippery and wiry school where all the patients we saw in clinic had slippery and wiry pulses, or thin and wiry.

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, I am Dr. Martha Lucas, and I am here with part two of Pulse diagnosis Beyond Slippery and Wiry. I am located, my practices are in Denver and then in Littleton, Colorado. I. Work at a regular internal medicine, modern medicine practice. They asked me to come there many years ago to what they said was help them with their diagnoses, which I thought was pretty cool.

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I also, I. Teach Chinese medicine classes. I’ve been in practice for more than 20 years. The name of the course is, or the name of these webinars in my book is Post-Diagnosis Beyond Slippery and Wiry, because I always say that I went to what I call a slippery. Lovingly call a slippery and wiry school where all the patients we saw in clinic had slippery and wiry pulses, or thin and wiry.

Occasionally we could say thin and wiry, but that was pretty much all we learned, and my school did not have any courses on pulse diagnosis. I was very lucky and. In my very first semester of school, my mentor, Jim Ramal, offered a full semester long course in pulse diagnosis, which I was so excited to be there that I took the class because I had previously been, or still working in Western medicine as a research psychologist, but was very curious about what else is going on besides my patients were cardiovascular.

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Patients who had just had bypass surgery and researchers are curious and I just wanted to know, hey, your engine just got fixed, but what else is working to keep that engine working well? So that’s why I started to study various energy medicines and ended up in Chinese medicine school. Just because I had, as a regular person, taken a color puncture course, but needed to know why certain colors, why on certain points, which I knew nothing about ’cause I was just a regular person, but.

My mentor made me fall in love with his method of pulse diagnosis, and and I never looked back. I continued in school, became a, obviously became a practitioner, and my specialty is the diagnosis. People come to me for. An in-depth diagnosis because guess what? Your treatment is going to be more effective if you actually give a correct diagnosis, and I would like to take that sentence.

I had acupuncture and it didn’t work out of the English language because either the patient didn’t work at it. They expect you to cure their five year long back pain and two treatments or. The diagnosis wasn’t right and then the treatment just didn’t work right? So I want to very much thank the American Acupuncture Council for allowing me this opportunity to go on and on about Pulse diagnosis, because as you can tell, I’m super excited about it.

And you can always look me up@lucasteachings.com or my private practice site is acupuncture women.com, and I am always happy to answer. Any questions that you might have. So let’s go to the slides. As I said, this is part two. So I asked this question, what is this thing called the normal pulse? Because in part one I talked about how even historically, and not only in Chinese medicine, I.

Doctors talked about this thing, taking the pulse during healthy times, and they talked about what a normal pulse is that practitioners need to know how to feel a normal, balanced pulse as well as morbid pulses or imbalance or the pulses of a person who has an illness. And we are going to talk about the normal pulse.

Jin we said it is imperative to know the normal pulse or the pulse in the healthy person before the morbid pulses are to be learned because a morbid pulse is in fact. The abnormal change of a normal pulse? My school never told me what normal was. They talked about I think my school might have been a stomach cheese school that they said, oh, a normal healthy pulse is slightly slippery and somewhat wiry.

Oh my goodness. Could that be more ambiguous? What? What do you mean slightly wiry or slight, somewhat slippery. That’s wrong. That is not what a normal pulse feels like. What a normal pulse is a sine wave yang and yin. So yang rises, yin falls, and then they connect each other. So it’s a series of sign waves, yang and yin yang and yin.

And it’s symmetrical. So the yang isn’t founding up, and the yin is this little tiny thing. It’s symmetrical, it feels smooth, it’s connected. The yang and the yin are mixing, which is what they do, right? They mix with each other to create a wave that they’re each supporting each other. So that’s what normal feels and that’s the goal of every treatment.

The person comes in, you feel they’re outta balance pulse. You determine what you need to do with whatever you’re going to do. Acupuncture gua, una, herbs moa, and then you do your treatment. I recommend a little bit of treatment, refill the pulses to see what happened or what didn’t happen. A little bit of treatment.

Refill the pulses, so it’s a kind of a little puzzle that you’re trying to fix. So any break in symmetry from that normal sine wave yang and yin yang and yin is pathological. If the body isn’t able to self-regulate itself anymore. I. Without help in a perfectly healthy world, the body would self-regulate.

You’d have some outta balance. Let’s say there’s a cold or something and your pulse gets a little bit outta balance, but then your body regulates itself and it goes back into balance. If that. Doesn’t happen. If it can’t return to the normal sine wave, then we need to see people, which is why I recommend what I call maintenance treatments, which is, okay, we got you back into a healthy state.

I’ll see you in a month. And I always tell people, don’t go back to square one. Don’t not go back to square one and call me and say, oh my goodness. Because that would be. Your body is going back into the old pattern of imbalance, instead of staying in a more balanced state.

And believe me, we can retrain a person’s body to learn how to reregulate itself and get more balanced. Are we all ever gonna be perfectly balanced like we were in utero? And sometimes, not even then, frankly, depending on our parents’ health, depending on our parents’ relationship, et cetera. But we can get closer to it.

We can go out of a sickness state into a wellness state more quickly or out of an emotional state, into a calmer state more regularly when we, as the practitioners retrain the person’s body to remember what normal feels like. Because when all of our energies are substantial in communicating with each other, then there is not what we call a pathological pulse.

So we can deal, we can literally watch the health issue go from healthy to unhealthy to back to healthy, as I said, the front of the position. The uprising part is young. That’s the functional aspect of the organ and the back or the downward flow is the yin, which is more the physicality of the organ. So again, using this idea, we can see is this person’s problem more a function or more of a physical?

Problem the large intestine and constipation, we would maybe be able to determine whether the constipation or change in bowel habits is due to a weakness in the large intestine function handling a typical food load, or whether or not it’s over that physical organ is overburdened or both. Other interesting qualities are the co-sign.

So in my way of my system, we have the sine wave, which is normal. We have the co-sign wave, which is the opposite of a sine wave. So it starts more in the yin part and goes up. So that’s, and you, when we, when I teach this in classes and you get to see it like depression is a co-sign in the liver.

Position. Once you see a co-sign, then you are able to recognize it more and more. As I say, it’s often seen in the liver, but it’s seen in other positions as well, and we need to know what level it starts at. If the co-sign starts at the deep level, it’s an older issue with the person, an older emotional issue, or an older.

Physical issue, maybe even they’ve adapted to it. If it starts at the top level, it’s more current, something that they’re dealing with right now. For example, taking that depth idea, sinking or emptiness or you don’t feel anything, it’s empty in the spleen, stomach, the earth position. That can mean early childhood trauma.

It can mean what? What is called the relinquishment wound by psychologists, which means. The person was separated from their mother right at birth. For example, my oldest grandson was a preemie, and so he was, had to be taken out by emergency c-section, and he was taken away from my daughter at that moment.

All right? So he would have a tendency to have what is called the relinquishment wound, and sure enough, because. Spleen, stomach, lung, large intestine, rr immune system. What did he have as an early young one? Immune system issues. What did he have as an early, young one? Skin issues. So these were predictable according to his, preemie experience leading to immune problems may be seen. And he recently got diagnosed with asthma. So all of that, and he’s, thank God, and I also thank Chinese medicine. He is what I would call a very healthy 17-year-old, despite the fact that he went through some early life problems with strider and with rashes, and now has asthma.

But he’s a track runner in cross country. So Chinese medicine, I. Really as you if you couldn’t tell. Really love it. And then other interesting qualities are nodding. This movement is a three dimensional movement, so it comes up in the pulse. You can feel it, touch your finger, and it stays there. You probably heard about it in school as called the spinning bean pulse.

What you would feel in the beginning as you’re learning how to feel an knotted pulse is just it hitting your finger and no flow. It’s not going anywhere. That’s what a tumor feels like. That’s what a cyst feels like. That’s what a fibroid feels like, because what is that diagnosis? It is stagnation.

Stagnation in one spot, right? That cyst is in one spot. That fibroid is in the uterus, the nodding movement is eventually you’ll, if it’s growing, especially, you can feel the spinning at the top. You can feel the movement at the top, but that knotted movement is you feeling a localized stagnation.

Sometimes you feel it after people have a surgery because they just had localized. Trauma, localized damage in their body. You might feel it in the lung pulse because the person has some sort of mucus blocks in there. So that’s what nodding is. And it might seem like a pause because it’s not flowing.

It seems like a pause because it’s rising up. And you feel it before you feel the movement on. Some people think of this as an intermittent pulse, but sometimes you need to be a little more discerning to see whether it’s an actual or not, and. I’m talking to my patients while I’m taking their pulses because when I feel something, as I just said, it can be more than one thing.

So to asking the patient, how’s this, how’s that? Have you ever had this? Is this happening? Is that happening? Then we, I. Are getting down to the nitty gritty of what’s going on. Like the person says, oh yes, I’ve just been diagnosed with colon cancer. That’s why I’m here to see you. Then we might feel that in the right distal position because that’s the lung large intestine.

But we also might feel it in the proximal position because we are feeling the physical organ, the pulses can be a model for the whole body. What’s deep inside and what’s more on the surface, and where it is not only located in what we learned as the traditional pulse positions, but also where is that organ in the actual body.

So we are doing a lot of observation along with what we might call clinical findings, what their doctor has told them they have. So we we might think we’re looking at energetic qualities, but actually we are looking at impulse diagnosis at the physical body, the emotional bodies, and the spiritual bodies.

For example, we don’t ever wanna see a scattered pulse, right? That’s someone who’s living in fear, right? And fear and anxiety are almost the same thing. Fear is a little more dramatic than anxiety, but this person is in constant vigilance. Their kidneys get overloaded, get what we call scattered.

We don’t ever wanna feel, scattered kidney position. And then everything gets more tight after that because the kidneys aren’t flowing, they’re scattered. The sympathetic nervous system is showing up in the pulses because their muscles are getting tight. They’re. Central nervous system is overloaded, so it feels scattered little points of light under your finger instead of a nice kind of flow.

So this patient might think of everything as threatening, and that’s because they’re not centered, right? Their pulse. Can’t moderate itself back to calming the nervous system down and regulating and centering them anymore, they’ve become in that pattern of fear, anxiety, nervousness, and what we do is help that get regulated back to normal, back to balance, back to flowing back to the kidneys, being not scattered and supporting all the other organ systems.

So we talk a little bit about the pulses in cancer development, since we’re talking about nodding in tumors. In a healthy person, we know about the microcosmic orbit, right? Think about it. It’s a sine wave, and what happens when you do a sine wave? The other wave. So sine wave. Sine wave, which is how we communicate left and right, is the infinity symbol, right?

Sine wave this way, sine wave that way. And so we want to support the lower Dante N. We want to facilitate that connection. Some people call it the Tai G connection between yang and Yin and. There’s this story about how monks used to click their teeth actually pumping the salivary glands to catch and contain the fire element Ming Mu, to generate the saliva and swallow it, guiding it down.

The Ren Ma, back to the Dante. And so this idea of preserving your Ming Man fire has been around for a long time. And there are various ways that people in the past have done it. Now a blockage in the diaphragm, what we would call a dmai block, may prevent that saliva from getting down to the Dante.

And it’s the same way energetically, if the dmai is blocked, the vertical flowing channels are not communicating with each other anymore. So if you are, for example, treating a fertility patient and men and women, and you’re. Tonifying, the lower, their reproductive system in the lower J and also trying to help their digestion, but their dimmi is blocked and you don’t know it, you’re not helping them because where’s that energy gonna go?

How are, how is digestion going to communicate with the reproductive area? How is the middle or the upper going to connect with the lower? It’s not because those organ systems are dissociated when there’s a DI block, we need, that’s an example, a simple example of something that we need to be able to feel in the pulses so that we can reorganize those systems so that they’re flowing into each other.

So I recommend taking the pulses with your non-dominant hand for one thing with your right hand, I mean with your dominant hand. It happens to be my right hand. I might take, be taking notes. I might be writing down something that the patient says, and I’m also going deep to superficial. So feeling the Ming man feeling the kidneys.

Feeling what’s going on in their core and then moving up to what’s more current. And for example, a short kidney pulse that can be a blocked dite. Usually a blocked dite feels a little stronger than just a weak kidney. But if the, if there’s a short kidney pulse, a short proximal position, pulse, the kidneys aren’t flowing, that’s the bottom line.

If it’s short, they’re not flowing. They’re not supporting the other organ systems. A short heart pulse. Liver attacking the heart, maybe liver attacking the heart, and the heart is. Stopping that because it’s trying to protect the spirit. Is it old trauma that’s causing that? It could be. These are all things it could mean, and this is partly why we need to communicate with the patient.

I said in part one that like the great sociologist, Andrew Greeley said people will say anything and he was talking about surveys, how you can’t believe surveys. Because people will say anything. Same thing with po with the person’s body. They, I’ve had so many patients that I have felt some sort of old unresolved emotional issue or trauma.

I don’t use the word trauma in the first treatment, of course. And they’ll, I’ll ask them, oh, do you have anything unresolved? Something from the, and they’ll say no, I don’t think so. And then the second or third visit, they’ll say, I was thinking about what you said, and you’re right, I had blah, blah, blah.

So it’s. I just helped that patient know themselves better. I just helped that patient understand the cause of their fibromyalgia or their stomach, their digestive issues. So we are helping the patient know themselves better and understand why. Understand why they are having this particular illness or symptom.

Knotted left kidney pulse in the system I’m using in teach, the left kidney position can be the uterus and the prostate. So if it’s knotted in there, maybe it’s uterine fibroid, maybe there’s some prostate inflammation. A knot at the top of the stomach and or large intestine position is thyroid. In Chinese medicine, we don’t have a thyroid organ, right?

We don’t talk about it. We don’t have, certainly don’t have a thyroid channel per se, but where is the thyroid? It’s near some channels where it’s blockage it’s having little nodules or it’s inability to function well, can be felt in the pulses, and then the gallbladder and San Jal positions, especially at the sensory level.

Can show brain or central nervous system activity. In fact, gall bladder and Sanja channels are very good channels to treat the brain. So let’s talk for a minute about a couple of case studies. So a large gel pulse, right proximal. Remember, we’re gonna look at the positions in some unique ways. This can be, as I said, something going on with the brain.

Or. Something going on physically, right? A patient who has IBS, you might see that big movement in either the middle or the lower gel, but sometimes it’s nervous tension going to the brain. It might have some heat and dampness in it. So we’re looking at things in a unique, more detailed way. A young woman after a C-section, and she has a very stiff and painful neck.

All the tests come back normal, right? She doesn’t have any spine issues. If her pulse in the small intestine position is. Empty. Okay. Of course, her neck is full of muscle tension and knots and inflamed trigger points because there’s no oxygen and blood flow in the small intestine channel. So you know, you might be thinking, oh, wait a minute.

I should be feeling a choppy pulse. No. Remember, sometimes back problems, neck problems, muscle problems are hidden. Because it’s severely depleted, cheat, in her case from childbirth. It’s the hardest thing a woman’s body is ever going to do. Build. Then deliver another human being. So we, this is what I’m saying, we need to be open to what’s going on in all of the channels near where the person’s symptom is.

Or they may have a short wry movement going from the stomach backward. That’s what worry feels like. And we never wanna have worry in the pulses because not only is it not going forward to. Help the lung, large intestine and the immune system be strong, but it’s going backward and attacking the kidneys.

So case study examples, block dite, like I said, fertility example. The person has fallen, they’ve been rear-ended. They’ve been in some sort of accident. And by the way, falls include things like ski falls and sports falls where the person falls and gets right back up. They look down, nothing’s broken, they’re not bleeding.

The Dai still gets blocked. So again, it’s important to know what the person’s history is, what their activities are, if we’re feeling the Dai block, because our treatment is not going to be as effective as we want it to be. If there’s a Dai block. I mentioned a little bit about earth and metal connection.

That’s the immune system, right? So the spleen, stomach, lung, large intestine, they all need to be flowing with each other. So that would mean the kidney position, earth position, metal position, all Y and yin yang and yin. So we can have a strong immune system. Let’s say the person comes in with acne, maybe that is liver stress shooting out.

To the skin, especially on the forehead. Stress, acne especially shows up on the forehead. So again, with acne, we can’t just look at hormones, we can’t just look at heat. We have to look at other possibilities. Of what’s causing this person’s acne. And then the separation of yin and yang, they call that the end of life, right?

That looks like you. What it looks like in the pulses is you only feel yang. And when you go down into the deep portion, it’s pretty, pretty empty. That’s ’cause the organ systems are getting weaker. They’re not able to hold energy anymore. And so what happens? There’s no root. So the pulses just go up y yang, young.

So you know, that’s I treat internal medicine, that’s my specialty. So I always say practitioners who only treat pain are fairly lucky ’cause they’re probably never gonna have to go through the death of a patient. But I went through the death of a patient my very first year out of school. I just had one pass away last year.

It’s when you treat internal medicine, you are going to eventually, as your patients get older and older. Feel that separation of yin and yang, and I don’t like it, but I, it’s a hint of what I need to do. Try to get some of that connection back so they have more of a flow in their pulses. And I’m always optimistic.

I am really, no matter what the person comes with, I at least. I am optimistic that I’m going to be able to maybe slow down the progression of the disease, slow, slow down their symptoms, take their symptoms away, make them feel better quality of life. Always super, super because I get a smile out of the pulses every day.

I. I’m one of those people who’s really lucky that as a woman of a certain age, as I like to say, I still love my work. It still makes me smile every day. It makes my patients smile every day. They’re always interested when they’re like, oh, you’re feeling something, aren’t you? I appreciate your listening to this part two of Pulse diagnosis beyond Slippery and wiry, and I will hopefully see you for part three.

Again, I want to thank the American Acupuncture Council for allowing me to express my excitement to you about Pulse diagnosis, and hopefully I’ll see you next time.

 

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Acupuncture Malpractice Insurance – Getting Paid with Timed Series Documentation

 

 

Click here to download the transcript.

Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors. Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi everyone. It’s Sam Collins, the coding and billing expert for acupuncture and the American Acupuncture Council. We’re here for you and we wanna make sure your practice continues to thrive. Let’s get into it. Let’s talk about what’s happening with documentation of acupuncture services, specifically time services.

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This is continuously a problem and I want to help you solve that and make sure you understand it with some ease to make sure your claims are paid. Make sure you’re getting paid what you’re supposed to be paid. So let’s go to the slides, everyone. Let’s talk about documenting and recording time specifically for acupuncture.

Where we’ve run into a ton of trouble is to realize that acupuncturists probably never really learn this correctly and don’t understand the value of their time. I think acupuncturists probably more than any other provider, spend more time. With their patients one on one and any their provider, and I’ve been to lots of different types, but my acupuncturist is the one I spend the most time with.

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All I’m saying to you is that’s true. Let’s make sure to document it. So acupuncture highlights specifically time and I underline it here. Notice each of the codes indicate initial 15 minutes of personal one-on-one. Contact the additional one each additional 15 minutes with personal. One-on-one contact.

So it means acupuncture requires that you spend time one-on-one with the patient, and of course, inserting needles. Now I just highlighted the manual acupuncture, but it’s the same is true for electro acupuncture. Whether or not it’s electro or manual, please document the time. It’s the one area that so frustrates me ’cause I have so many good acupuncturists who are doing really well in getting paid hundreds of dollars per visit On some insurances, I kid you not, but we run into problems where their claims are denied and I want to see what’s occurring.

Here’s one for United Healthcare, and you’ll see here this is for 9 7 8 1 1 N one three and it says, not supported. It says the add-on type of code requires a primary code. It cannot be accurately seen. Therefore the validity of the accuracy of the bill services cannot be verified. So in other words, there’s no time you think no, it doesn’t say that.

Let’s see. 9 7, 8 1 3. The initial one says the submitted medical records do not support. 9 7 8 1 3 was performed. The documentation submitted does not indicate the time. Was personal one-on-one contact. Now notice it’s telling you the time didn’t indicate as personal one-on-one. It is not sufficient to just say time, because time could be the time the patient is resting on needles.

We wanna know the one-on-one time. Now here’s an interesting one. Notice some of the claims and initially for the followup set says not supported. Notice the initial set is, so what did they do differently on the first? They didn’t do on the second. You’ve got to get in the habit of saying, I spent one on one time.

So by example, what is this one-on-one time, and I think many acupuncturists forget what this really includes. So let’s get into this 15 minute code. The 15 minute code is personal. one-on-One contact. Literally that means on an acupuncture visit day, not with exam, just treatment. As soon as you walk in the room with a patient.

The time starts. So what I’d like you to do is look at your watch and go, oh, start at 10 0 5, or whatever the case may be. Give me specifically the start time, or at least start a timer because this means, and you’ll see here, the acupuncturist is in the room with the patient and actively performing a medically necessary act component of acupuncture.

Now, realize, what is that gonna include? When you first walk in the room, you might review their note and say, Hey, last time you said such and such. That’s included. It’s going to be review of the history, asking them how they’re feeling. Notice none of this is even yet putting needles anywhere, but just asking the patient what’s going on.

It’s then going to include your day-to-Day evaluation could be tongue and pulse, range of motion. You name it. Any of those things you might do realize includes washing your hands, sanitizing. Choosing the points, cleaning the points, getting the needles open, inserting the needles, manipulating the needles if you have to.

And of course it actually includes removal so you know how you’re in the room with a patient. You might leave them rest on needles. I. Maybe you come back 10 minutes later, as soon as you walk in the room, time starts again because the time to take the needles out and dispose actually counts and notice this component as well as completion of chart notes while the patient is present.

So that means, you finish it up when the patient’s there, that actually counts. Now what wouldn’t count is if you do it later sitting in your office, but if it’s while the patient is there, it all counts. So you know you’re asking those few questions at the end. Just gimme the total time. I love that we’d have a program somehow.

Maybe there’s a mat. When you walk in the room, the mat turns on a timer, and when you walk out of the room, the night timer goes off. Because if you’re in the room, it’s a component of acupuncture. You’re doing something towards it. Unless it’s another therapy. Now, where a lot of people get fooled on this though, because they said Sam it’s 15 minutes.

Do I actually have to spend 15 minutes? Technically, no. It’s what we call the eight minute rule, and this eight minute rule is true. For all codes that are 15 minutes when it comes to CPT, including physical therapy and physical medicine, but actually acupuncture. So I’ve given you a simple breakdown of it.

Notice one unit is at least eight minutes. So do you have to spend 15 minutes to do acupuncture? No. If I spend eight minutes and insert a needle. I can remove it and they’re out of there. That actually could be enough time. Now, I don’t think anyone’s doing an eight minute visit, but I think you get the premise here is that we’re just looking in increments that if you’re doing more than 50% of the time, meaning eight minutes, you qualify.

I don’t think anyone has any problem doing the first eight minutes. Of course, where things get a little trickier though is how do we do an additional set? That requires additional time and additional insertions, but it doesn’t require. 15 minutes. The answer is no. It requires an additional eight.

Now here’s where it’s confusing though. What if I do eight minutes on the first and go, I did eight minutes on the second. What’s the total time for eight plus eight 16? Is that enough? No. ’cause there has to be at least 23. So realize the second unit of time, that eight minutes begins after 15 minutes and it’s plus eight.

So that’s why you’ll see one unit is as little as eight, but two units or two sets is 23. Three sets would be 38. So you have to make sure that time matches. So by example, if you did eight minutes on one and eight minutes on the other, that wouldn’t be enough. It would’ve to be 15 plus eight. Or how about this?

What if you sp you spent 12 minutes on the first one and 11 minutes on the second one, would that be adequate? It would, because there’s 23 minutes, so please make sure that you’re just simply documenting the time. Notice it wasn’t saying, the time wasn’t documented, they were indicating the time wasn’t clearly indicated as face-to-face.

So get in the habit of saying face-to-face time with the patient. Because what if there’s time where the patient’s resting on needles? I know when I go to my acupuncturist, she will put in needles. Then she usually leaves the room about 10 minutes or so. Great. It gives me time to relax. Realize though that time simply doesn’t count towards the coating, but then when she comes back, it does.

So it has to be actively part of it. So if you come back in the room and stimulate needles, it would be if you come back in and insert more, that would be an additional set. So please note here it says yes. Do you have to do insertion of needles? Yeah, reinsertion. Bad term of course, but additional insertion.

So keep in mind, just retaining needles for an extended period of time does not give two sets. Stimulating needles does not. There must be an insertion. So keep that in mind and realize I’m showing. This is from Regents Blue Cross Blue Shield from their acupuncture part. Notice it says here, eight minute rule, eight to 22, 20 23 to 37, so you can see clearly.

This is not just a SAM rule. I’m not trying to just say I’m the know it all. No, I’m giving you the rule based on the guidelines. Notice it says if you do seven minutes or less, doesn’t count. As soon as you do. Eight minutes. Yep. So right in there you can do it. So realize that UnitedHealthcare is the one I just showed you that had a problem, and it says, for any time-based code, the duration of service must be clearly documented.

And the time service is not clearly and properly documented, then the service is not supported. And it needs to be because we have to indicate face-to-face time, acupuncture. Often patient patients will rest on needles. And so the reason that we’re seeing some of this is ’cause I think we’re combining that and not separating it out or.

Just not making it clear. Just make it clear. Notice a couple of things here because it tells you how you document, so you might wonder, how do I’m supposed to document this, Sam? It’s unacceptable Documentation of time-based services. What’s unacceptable? Documenting in terms of units. You can’t just say, I did two sets of acupuncture.

You can say that, but I need you to tell me set number one, how many minutes did you spend face to face and where’d you put needles? We cannot use a range of time. You can’t say, I spent between 20 and 25. It should be, I spent 20 or 21 or 22. You also wanna make sure that you’re not specifying a measurement or increment used, meaning that I did from this time to this time.

That range part, or just not mentioning time at all. I think the easiest way to see this though, and for those of you that have been to a seminar with me and or have our accu code, you’ve seen this is a sample of a soap note. What I wanna do is just blow up. Where the area is, that time is documented.

Take a look here where it talks about acupuncture and it says Set one, two, and three. Now realize this form. If you wanted to add a force set, you just add another column, but nonetheless, notice set one. The points that were inserted or reinserted could be either one. We list the points and then we indicate face to face time five 20 to 5 45.

That’s 25 minutes notice, there’s retention time. There is a rest period, but notice set number one is 25. Notice set number 2, 5 55 to 6 0 5. That’s only 10 minutes, but does that meet the eight minute rule? Yeah, it’s more than eight plus. The first one being 25, that’s 33. We’re easily above. And then notice the third set is six 10 to six 30.

Now, may wonder how come the middle set was so much shorter? Doesn’t take that much time to add more probably. And the last set was also 20 minutes. Why was that last set longer? Think of all the things you do at the end of the visit, counseling the patient, removing the needles, and disposing. Just give me the time.

None of that is hard. Acupuncturist by, right? Always brag about how much time they spend with someone. I talked to someone this morning that goes, Sam, I spend God between 40 and 50 minutes with every patient, and I believe that to be pretty true. For most of you. You know what I want from you. Document it.

You’ll never have an issue. Now you may think I only do cash. Great. You still have to document the services. So realize this has nothing to do with insurance. This is just to do with you properly documenting what services were provided. Tell me how much time you spent, what points you did. We’re good.

It will also equal you get paid. I’m not sure you’d notice, and I’m not gonna go back to it. Did you see the prices on some of that United Healthcare? So if you wanna rewatch this later, you’re gonna go, oh my gosh. Now, I’m not saying we wanna bill that much, but if you’re in certain areas, why wouldn’t you bill what it’s actually worth?

Acupuncture is a great service. You’re at a great time to be an acupuncturist. Take advantage of the advancements of your field in getting access. Please document the time. It’ll never be an issue. I wanna say thanks, but realize we’re always here to help our network service and our seminars are where you can go for one-on-one help.

We can do zooms together and deal with you specifically, not just a general question. Please go out and do well because we’re dependent on you, the American Acupuncture Council and myself. We count on you. Your success is ours. Until next time, my friends.

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Acupuncturist Owners’ Insurance – The Benefits You Should Not Overlook


Why is acupuncturist owners’ insurance so important? There are two main reasons: For one, to comply with a regulatory requirement as most states (if not all) obligate an acupuncture business (or alternative treatments, in general) to have insurance, among other requirements, before they are allowed to conduct a business. Another is that insurance serves as a cushion so that if an issue of enormous magnitude (like a patient filing a case) falls upon an acupuncture business, the owner will handle it with assurance, knowing it has the needed protection.

If you are into alternative treatments and planning to open your acupuncture clinic, acupuncturist owners’ insurance should be on your must-do checklist. Here are some of its benefits:

Protection from malpractice complaints – for alternative treatments that include treating delicate parts of our body, such as acupuncture, anything can happen on the part of the patient. When a patient files a complaint claiming malpractice, you can rest assured that, with acupuncturist owners’ insurance, you have the necessary protection; there’s an entity that will help you financially if it requires you to shell out amounts of money for any expenses incurred.

Worker’s compensation – covers all of the employees of a business except when the concerned is an independent contractor. An employee working away from their state needs special provisions. Worker’s compensation is a no-fault system, which means injured employees do not have to sue their employers for compensation. For example, compensation is automatic for covered benefits, except for extreme negligence – where employers have protection from liability due to work-related injuries and illnesses.

Premises liability protection – here at the American Acupuncture Council, we call it Business personal property (BPP), which can cover the named insured for lost, stolen, or damaged property of the business, such as equipment. For example; a treatment table, furniture, or other business property that is not a permanent fixture of the building structure can be covered by this insurance policy.

If you are looking for a reputable company that offers acupuncturist owners’ insurance, look no further than the American Acupuncture Council. Please call (800) 838-0383 for inquiries.

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Acupuncture Malpractice Insurance – Pulse Diagnosis: Beyond Slippery and Wiry Part 1

 

 

In a very blessed way, my pulse diagnosis mentor, and then I became in love with the way I take pulses and frankly, that’s what’s kept me interested in Chinese medicine for the last 25 years.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, this is Dr. Martha Lucas, and today I am going to be talking with you about pulse diagnosis. I have a special system that I’ve been using for my whole Chinese medicine career in my offices in Denver and Littleton, Colorado. I am a research psychologist, so I started out my. Quote unquote medical career in Western medicine doing research in hospital settings.

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But I was immediately curious as researchers tend to be about what was operating with the patients I was seeing other than. They just had cardiovascular bypass surgery, so I knew the engine had been fixed a day or two before, but I wondered what else is operating for their healing. So I started to study various energy medicines including reiki, tonal alignment, and then I learned something called color puncture.

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Which as you would imagine, is based on acupuncture, which is based on Chinese medicine. But the teachers didn’t talk much about the theory of why you did certain colors on certain points. So I went to Chinese medicine school. I. To learn that I didn’t really intend to become a practitioner of Chinese medicine.

I just wanted to learn why I was doing certain things, because I couldn’t imagine my patients asking, oh, Dr. Lucas, why are you doing blah, blah, blah? And I say, because Aquila said, Dr. Mandel says so there I met very. In a very blessed way, my pulse diagnosis mentor, and then I became in love with the way I take pulses and frankly, that’s what’s kept me interested in Chinese medicine for the last 25 years.

If I was doing prescription Chinese medicine, I’d be bored. So my goal, part of my goal in my practice is to help as many practitioners as want to be most excellent diagnostician. So we are going to be talking about pulse diagnosis. I. And I want to thank the American Acupuncture Council for allowing me this opportunity to do this show.

This will be part one in a series about pulse diagnosis. So let’s go to the slides. I, the whole presentation is called Pulse Diagnosis Beyond Slippery and Wiry because. I always say I went to a slippery and wiry school where everybody’s pulses were slippery and wiry. That’s what the teachers all knew.

And occasionally we could say they were thin and wiry, but that. That was about the extent of our experience with Pulse diagnosis. So I am excited to show people that there is so much more in Pulse diagnosis than just three and wiry, which is why I call my book and this presentation beyond slippery and wiry.

I am fascinated and I hope we all would be fascinated by the history of Pulse diagnosis. In fact, it has a very storied history, so I really don’t understand why in modern schools they’re not teaching it as our. Primary diagnostic tool. As I said, I was lucky to have a mentor. My school didn’t teach pulse diagnosis.

I think the theory teacher talked about it for about a week. Maybe occasionally someone would say, oh, let’s go around the room and feel everybody’s pulses. And guess what? They were all wiry, where students were spleen deficient, et cetera, et cetera. I the old pictogram actually is an image.

It’s the classic pulse taking with using three fingers. The other diagnostic methods or examinations are used in modern medicine as well as Chinese medicine. There’s an inspection, but in modern medicine, its imaging technologies. Our inspection tools are our pulses and our eyes, our fingers rather to take the pulses in our eyes.

There’s listening, obviously, or maybe not. So obviously the DOT MDs listen, they want to hear what your chief complaint is. We certainly listen to our patient’s chief complaint, but. As the great sociologist and survey master, Andrew Greeley said, people will tell you anything. And so that’s why he suggested we shouldn’t believe surveys.

I believe in pulse diagnosis that people will tell me anything or they’ll tell me nothing. How often does somebody tell you their digestion is great or. With women, oh no, they don’t have any PMS. Their periods are quote unquote normal. So I have learned for many years that people will just say anything and that it’s our job to really figure out what’s going on with people.

I know you’ve all heard someone say, oh, I’ve had acupuncture and it didn’t work. There are two reasons for that. Number one, the patient didn’t work at it. They had back pain for a bunch of years. They come in, they’re hoping you’re gonna make it better in one or two treatments, and so then they tell their friends, oh, I had acupuncture for that, and it didn’t work well, the patient didn’t work.

And then there’s the other reason, which is an incorrect diagnosis. A non a, not a total diagnosis that the practitioner just touches the pulses for a second and sees their wiry, and that’s their diagnosis. No, that is not, that’s not what you would call an adequate diagnosis. So that’s our inquiry part.

We can question the patient, but as I said they’ll say anything. So I feel like. We need to have a tool that even while they are talking with us, we can have our fingers on the pulses and we can be talking with them about what’s going on. For example, I have a patient who’s struggling with Lyme dis he is struggling with the treatments for Lyme disease, and right now he’s taking three different antibiotics.

That’s the protocol of either one or two doctors that he’s going to see, and of course, he. Tells me yes, he’s doing well because he can tell there’s die off and this other stuff. And I’m feeling his pulses and I can tell that his digestion isn’t right. And finally he admits. That he’s having some watery diarrhea.

And I explained to him already about the cold energy of antibiotics and how your digestion loves warm energy. And so he should be expecting maybe some negative side effects from the antibiotics. And of course, he tells me he’s. Pumping lots of prebiotics and probiotics, which also by the way, can have a negative effect on digestion.

Because I could tell that the digestion was struggling with the cold, I just put a Ong on Ren 12. No needles yet and put my fingers on his pulses and immediately could feel some young coming back, some more fullness to the pulses. And this young man has been seeing me and another practitioner who was trained in pulse diagnosis by me for a long time.

So he loves to talk about it, he loves to be educated about it. He’s very curious about how his kidneys are doing, how his liver is doing. And so it’s. I like educating our patients as well because an educated patient is a better referral source for you because they can say, I saw Dr. Lucas, she did blah, blah, blah.

She said, this is why this is happening. And then she treated it instead of, oh, I’m getting acupuncture and I don’t know what they’re doing. And it’s just a magical tool. It isn’t. It is not a mystery. It’s a medicine. And pulse diagnosis is not a mystery either. It’s a diagnostic tool that can be explained.

So for us to be able to decide what’s going on with the patient is the primary goal of every treatment in Chinese medicine. And we also have smelling right in, we would call these in modern medicine, more like blood tests and urine tests. My very first kidney disease patient, I could see. Smell. I could smell his kidney disease and he hasn’t had that smell since I think two treatments out.

So we’re all trying to do our diagnostic tools. And then the art of changing yin and yang. I call it balancing like my kidney disease patient. I balanced yin and yang. He came to me with priapism, and when I explained to a few students that I was doing some kidney yang points, they couldn’t believe it.

They’re like, yang. Oh my gosh. That would create an erection. Why on earth would you be doing kidney yang points for priapism? Because I was balancing. Not only kidney, yin and yang, but the whole system of yin and yang. So in the old days they used to say that the diag, you diagnosed the causes of illness according to what they called the complicated pulse.

And I just taught a seminar in cosmetic acupuncture, and we were talking about pulse diagnosis, and the students were saying, how, oh our teachers told us it’s too complicated. It would take a whole. 30 or 40 or 50 years longer than we’re gonna be in practice to learn it. And that is totally wrongheaded.

That is absolutely not true. You can absolutely learn how to be a good diagnostician. And the process back in the day was called ology, and this was as early as the inner canon talking about the normal pulse and the morbid pulses. Now, why is that important? Because if you don’t know how to see a normal pulse, if you don’t know what normal feels then you’re only ever going to be feeling.

Out of balance pulses. So part of what I like to teach people is the goal of every treatment is the normal pulse and how that feels. And I love the whole history of it. I love the original names and labels of things like the lung, great abyss. And honestly, if you think about the names, the original names.

It can also help you think about what you’re feeling in the pulses large intestine Union Valley of the Hand, young Ravine stomach surging young, like I just said, with that case study of the young man suffering through his medical treatments for Lyme disease. I put that Mong on run 12 to raise some young spleen surging gait, young pour the heart or also inside spirit gait celestial window, the small intestine beside the throat bend center, bladder bent part of the knee.

Great ravine, the kidneys. Of course the kidneys fund everything, right? Of course. They’re a great ravine. They fund all of the other movements, which is partly why they are so important. We all learn. Kidneys kidneys Ming Mu Fire, original Chief Fire in the belly. Why? Because that’s funding everything.

So if that starts to go down, then all of the other organ systems are going to be out of balance. There’s no such thing as an out of balance kidney pulse. Everything else is balanced. Not gonna happen. Palace of Toil. A colorful network vessel in the palm and rep represents the heart harmony, bone hole, sanja, suspended bell gallbladder, supreme surge liver.

And we know the liver helps. Move everything according to the inner Canon Pulse examination inspects the distribution of blood, and we know it’s of blood and oxygen inside the channels or meridians, and that diseases generate uneven distributions inside those channels. In other words, we are feeling the imbalances, the disruption of oxygen and blood in those channels, and that’s a part of how we make our diagnosis.

I. Some historical positions because I teach in my diagnosis courses, I teach it maybe what sounds like a few different positions. The basic positions are the same, but there are additional things we can feel like the uterus in the left uterus and prostate in the left kidney pulse. So in the old days. We might talk about the left distal pulse being heart, chest center, small intestine or pericardium or the right sun being the lung in the chest and the large intestine left, middle position, liver, diaphragm, gallbladder, spleen.

So these are all things that historically were felt you could feel in that position with the right side stomach and spleen. The left chair position, kidneys, pretty much the kidneys have always been in that. Most proximal position, kidney, abdomen, bladder, large intestine, and small intestine, because they’re deep, they’re in the lower jaw.

So it makes a certain amount of sense that we would feel that what’s going on with that organ system in the HUR position. Right side. Kidney, abdomen, pericardium, sanal, bladder life gait, small intestine, large intestine. Now, these are all historically talked about, the organ systems that we can feel in the certain positions.

The inner canine indicates that the stomach is the regular chie of a normal person, which of course I. Think is super, super ambiguous. But again, we’re going over a little bit of the history of it. And we talk about that being the person’s y qi. And if it gets weak, the stomach is going to come, become a little bit weak if it gets.

Vanquished gone. Stomach chi will be then scattered. And that’s a basic sign of life, right? That’s how we make our energy. So to have a good earth, solid earth, spleen, stomach, right middle side position is very important. And in my system, which goes back to early sixth century Korea. And from, in my experience, I know and teach about how early childhood trauma is held in that position, in that middle position on the right side, spleen, stomach, earth.

And it has to do with nurturing, lack of nurturing or even perceived lack of nurturing being separated from a parent at an early age or having early trauma. The classic of difficult issues mentions that if the upper part doesn’t have a pulse and the lower part has a pulse, that’s they call cumbersome, but we need to look at getting that better, right?

There shouldn’t be just a low pulse or a high pulse, a deep pulse in a superficial pulse. We need to get those pulses. Communicating with each other because the pulse can’t only have a root. It should have a root, but not only a root. And we all know that absence of a root pulse is going to show that there’s some debilitation in the kidney going on.

In the energy of the kidney, the history of pulse diagnosis isn’t only Chinese medicine either. Hindu physicians looked at the pulses they likened them to certain animals like the serpent, the frog, the swan, the peacock diseases were attributed to the humors, air, bile, and phlegm. And they felt like they were all reflected in the pulses.

And we talked certainly about. We talk a lot about phlegm being in the pulses. Otherwise, this wouldn’t be called beyond slippery and wiry. And they said that a disturbance in phlegm, the pulse would be slow and heavy, like the motion of a swan or a peacock, whereas dis some sort of disturbance in the air would be like the motion of a serpent.

Greek physicians also used pulse diagnosis. They included the knowledge of both music and geometry they felt were necessary in order to interpret the pulse and they. Paid attention to its rhythm or cadence. They also recognize size, frequency, force, and as I said, rhythm. And it is said that the physician Galen wrote more books on the subject of Pulse diagnosis than anyone before or since.

He emphasized the importance of feeling the pulse during healthy times so that we knew what a normal pulse felt like. And then the irregular, the imbalance, the illness pulses became more clear to us. They also studied the speed of the pulse length, depth, broadness strength, so you can see that not only Chinese medicine historians and doctors studied the pulses or all of these little subtle distinctions that can be in the pulse.

In fact, Galen even drew wave pictures, which is part of what I teach in my classes in Europe. Bordeaux brought about the idea of organic pulses and talked about. The, some of the pulses being shown above the diaphragm, seeing the organs above the diaphragm and some below the diaphragm, and then the superior pulses were divided into certain organs and the inferior pulses, the lower ones.

And I talked to people about feeling the upper, middle and lower jou locations of the organs in the pulses. So the earliest case histories used visual exam, listening, questioning, but palpation was the main diagnostic tool. They were palpating or reading what they called the grand rendezvous of the vessels.

And that is that area, the three finger width on both sides of the wrists, the grand rendezvous of the vessels. We have one dimensional models, which say the pulse is wiry. We have two dimensional models, which might say, I can feel a young pulse and a yin pulse, but we’re gonna be looking at more than three levels, three or more levels.

It’s quantum mechanics, which does sound complicated. Physics, quantum mechanics, that all sounds like it’s super, super comp complicated. But I can take that into. A discussion that everyone can understand and we can. Learn what I call a plausible methodology. So we’re going to be talking eventually about the top level skin, superficial level, skin surface, meridian activity, chief flow, emotions, the body’s interaction with the environment, middle level blood, functional aspects, organ function, metabolism are interfaced with.

Our internal organs in the environment. And then the deeper level, the bottom bone marrow organs, chronic disease, hidden emotion, unconscious emotions, adaptive level patterns that are fixed and you might not even know about. So unconscious emotions. And all of this means that we are going to be able to see current situations with the patient and older situations with the patient.

So the physical space that we’re feeling is going to give us a diagnostic. Perspective from birth or before birth up to the current because nothing is omitted in your pulses. It’s like a Rosetta Stone. It’s one symptom didn’t just come from yesterday. It’s a historical. Adding up of events that we can see in the person’s pulses.

So we are gonna be able to look at the circumstances, emotions, healing, disease progression, and that’s all gonna show up in the pulses. And the pulses should change during the treatment. You’re. Your treatment should work like that little Moab bong, changing the pulses while I was watching it, or your acupuncture prescription, changing the pulses.

So acupuncture treatments should be fluid, not prescriptions. I am not a believer in pre what I call prescription Chinese medicine, which means, oh, the person has. PMS. Let me look in a book and see what acupuncture points I should do. That is totally wrongheaded because not everyone’s PMS is caused by the same thing, and that’s your job to figure that out.

So this ends part one of my story or my training in Pulse diagnosis, my ex. You can see how excited I am about Pulse diagnosis and in part two, next time we are going to talk about what a normal pulse feels like. Talk about some emotions, talk about some case studies. So again, I wanna thank the American Acupuncture Council and I will see you next time.

 

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Acupuncture Malpractice Insurance – Facial Motor Point Use for Cosmetic Applications Part 1

 

 

And today I am going to speak to you, I’m doing part one of a lecture on facial motor points.

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Disclaimer: The following is an actual transcript. We do our best to make sure the transcript is as accurate as possible, however, it may contain spelling or grammatical errors.  Due to the unique language of acupuncture, there will be errors, so we suggest you watch the video while reading the transcript.

Hi, my name’s Michelle Gellis. I’m an acupuncture physician specializing in facial and cosmetic acupuncture classes. And today I am going to speak to you, I’m doing part one of a lecture on facial motor points. Can you go to the first slide please?

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So the title of this talk is Facial Motor Point, use for Cosmetic Applications, and in part two I’m going to talk about a little bit about facial motor points for neuromuscular facial conditions. Here is some of my publications from the Journal of Chinese Medicine. And I’ll put links up at the end to my social where you can actually view some of these publications.

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And these are all the classes I teach today. The Motorpoint lecture will focus on treating neuromuscular facial conditions and some of my advanced techniques. Motor points have been used for a very long time, not just by acupuncturists. They’ve also been used by medical doctors and they. Date way back to the late 18 hundreds.

And more recently some acupuncturists and other physicians have been using facial motor points for neuromuscular facial concerns. So what is a motor point? When a muscle is either in spasm or in a flacid state. It is not firing properly, and if you take an acupuncture needle and insert it properly into the muscle’s motor point, it will cause the muscle to jump and reset it into normal function.

So this is what motor nerve looks like here. So this would be a sensory nerve going out to the skin and here’s a motor nerve going to the muscle, but in. With our face, the muscle is actually connected to the skin, so when you reset the muscle, it can help to enhance the appearance of the skin.

Now, motor points are not trigger points, mo trigger points or sore spots and muscles, but. Fortunately for us, many motor points are acupuncture points on the face. So it makes it easy for us to find them. So here’s a, just a picture of bone and muscle. And on the face, the muscle is connected directly to our skin, which is why we can move the scan.

On our face. So again, if the muscle is pulled tight, then the skin will wrinkle. So when we’re thinking of neuromuscular facial conditions, when we’re looking at the motor points, the face is innervated by two nerves, CN seven, and. Also the trigeminal nerve. So when you’re using facial motor points, they are wonderful for any conditions involving paralysis.

And what you do is you needle into the muscle, but not through the muscle. So on most of the face, you’re going to go on an oblique angle about a quarter to a half an inch into the muscle. And facial motor points will treat the muscle and the fascia, and this can help to enhance the appearance of the skin unless it’s some sort of a skin disease discoloration or a scoring.

So when might you use motor points if you’re doing cosmetic acupuncture? As someone who practices cosmetic acupuncture extensively, I always start with basic cosmetic acupuncture treatments and if they, my patient has a difficult to treat. Concern then I will use these motor points to help to enhance the effectiveness of my facial acupuncture treatment.

So here is what a face looks like as it’s aging. We have nasal labial folds, chin wrinkles. You can get loss of volume in the temples, we get lines between our eyebrows. The face can hollow, the jaw contours change. And we can get wrinkles in our chin and neck and also sagging underneath the neck.

So here would be an example of someone who’s not showing many signs of aging and then coming into their fifties, some signs of aging, and then more advanced signs of aging. So let’s talk about some specific types of wrinkles that you might see in your treatment room and when using cosmetic acupuncture motor points might be beneficial.

So one of those. Would be forehead wrinkles. And frequently an individual will have forehead wrinkles because their frontalis muscle has become very tight. And even when they feel like they’re relaxing their forehead and they’re not making an expression, the muscle itself is very tight. And the. Folds in the skin remain there.

So by relaxing the frontalis muscle, the entire forehead will relax and it will smooth out the wrinkles. Also treating the frontals can help to lift the lid, the eyebrows and also the eye lid at the same time. This was a patient of mine who came to me and she was noticing her brows were starting to descend as she was getting older, and so I treated just the left her left.

Eyebrow and I used the frontals muscle, and you can see after one treatment, when the muscle relaxed, the skin laid flat and it pulled the skin up into a more normal functioning for her.

So here we have the frontals muscle and the motor point for the frontals is fortunately for us, easy to find gallbladder 14. So if you wanted to work with the frontals muscle and the, again, the frontalis muscle wrinkles the forehead, it raises the eyebrows up and. What you would do is you would put the the needle straight in on a very slight oblique angle.

And you’re going to go into the muscle, but not through the muscle. Depending on how thick their forehead skin is, would determine how deep you have to go before you hit the muscle. So here’s a quick video. I had a patient who had Bell’s Palsy and they could not raise their eyebrows and they could not fully open their eye because of the Bell’s Palsy.

So I had put this needle in and stimulated it. And you can see the needle started moving immediately after the needle went in. And I put the needle right in the motor point. Is another example of when you might use a facial motor point would be if someone had very stubborn lines between their eyebrows, either the two or the one we call them frown lines, and we would needle the corrugator.

Muscle and the motor point for that is just lateral to bladder two. And it’s right in the corrugator muscle. The corrugator muscle pulls along with the procerus, pulls the eyebrows together very strongly,

and you would also, whoops. I have a little delay here. You would also needle the motor point for the processis, which is yin tongue, and when you’re using it as a motor point, you’re going to needle it slightly towards the nose.

Another area that. Motor points are very beneficial for is treating wrinkles in the chin. And as we age, these chin wrinkles or chin dimples can be more noticeable because the mentalis muscle and the depressor ang oris muscle, they can become. They don’t function as well. And so by doing the Le Depressor, Labi, inferior Aus and or the Mentalis and or the Depressor, angular Aus, all of these muscles are going to work together to cause that issue.

But. I’m showing you the de depressor, Labi inferiors and the motor point for that is the extra point. One soon lateral to this extra point here. And the way you. Oh. I’ll show you that in a second. And then medial to that is the mentalis and the motor point for that is a half a soon lateral to Ren 24.

So here is a video. And this was a patient, another patient who had Bell’s Palsy. And I had put the needle in the mentalis. And as you can see, when I stimulated the needle, the muscle jumped and my patient reported back to me that. The issue that she had been having with drooling when she was like brushing her teeth, she couldn’t spit she couldn’t drink through a straw and she had Bell’s palsy many years prior.

But still in this one side, she had issues.

Lip wrinkles can be treated very effectively with facial motor points. We would needle the motor points around the orbicularis orus, and there’s two of them on each side of the mouth. One is LI 19, and then the other one is between stomach four and Ren 24. So it’s like right here. Some other uses for facial motor points would be points on some of the muscles pertaining to the levator muscles and the oculis oculi.

So the lator muscles in the face, on the cheeks. Will if they’re not functioning properly, along with some of the tendons and other things, but can contribute to the nasal labial folds, the motor point for the rezos. If you treat that, it can help. With the little marionette lines, there are motor points for the neck that can help with the necklace lines and the neck bands.

And then there are motor points around the eyes, which I go over all of the motor points on the face in my classes. But there’s motor points around the orbicularis oculi that can help with crow’s feet. In part two of this lecture, I will go over facial motor point usage to treat neuromuscular facial conditions like Bell’s Palsy, Ramsey Hunt Syndrome, TMJ Hemi Facial Spasm, and others.

If you’re interested in checking out my classes, you can go to facial acupuncture classes.com and my social is for Instagram, it’s Michelle Gillis and Facebook. You can look up my Facebook group, which is facial acupuncture. Thank you so much.

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