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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.
So again we’re gonna be talking about supporting insomnia or sleep issues with Chinese medicine, and this is part two.
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 Moshe Heller, and I’m from Moshen Center in New York, as well as the Moshen Herbs company for different herbal formulas. And today I am going to talk about… This is part two of treating, supporting insomnia with Chinese medicine. And I wanted to thank the American Acupuncture Council for letting me speak today about this important subject.
So I think we can go to the slides. So again we’re gonna be talking about supporting insomnia or sleep issues with Chinese medicine, and this is part two. In part one we talked a little bit about the pathology of in, of sleep but now we’re going to talk about patterns and formulas and how to treat them.
Again, I’m reminding you from the mechanism aspect of pattern differentiation we usually look at blood when we hear about trouble falling asleep. We think about yin when we’re talking about trouble staying asleep. And if we have a lot of restless dream disturbed sleep, we can look at the blood and Hun or blood and actually Shen or heart.
So all this is the different mechanisms that we need to look at so the first imbalance I want to discuss is this heart and kidney disharmony which is usually a representative of this yin vacuity that is not supporting the yang, and then the yang tends to rise up and disturb sleep. This is usually the pattern where it’s might be easier to fall asleep, but then wakes up frequently throughout the night.
If it’s really bad, it might be also difficult to fall asleep, but then again, the waking up at, during the night is the main thing. There could be also some night sweats and dry mouth and and palpitations and anxiety. I wrote here low-grade anxiety, but the anxiety can be quite severe. The tongue will have very little coating and be more red and the pulse will usually be more thin and tend to be a little rapid because of the deficiency heat that’s thinking– that’s happening here.
So the formula that we think about when we think about this situation is Tian Wang Bu Xin Dan. It’s a very for- famous formula for, that addresses this yin vacuity. One of the main herbs there is Shu Di Huang, Rehmannia, and is one of the basic herbs that we use for strengthening the the yin and supporting the blood.
And also there are herbs that help to relieve deficiency heat and calm the shen. So together, this is our best combination for this kidney yin vacuity with yang rising. And this in the, the correlating points then when I think of Tian Wang Bu Xin Dan is points like kidney three combined with heart seven.
Sometimes I think of heart six and kidney seven because that is the combination that allows the, the yang to go back to its source. And I usually combine that with spleen six, which supports the blood and the yin and also circulation. So those are the points that I think in this pattern. The next pattern is a heart, liver heart and liver blood vacuity where we’re seeing both difficulty falling asleep and also there could be dream disturbed sleep.
And and then there’s there could be some waking with disturbed sleep, but there … It’s not necessarily one of the important sign of the pa- pattern, and usually a little more paleness, pale tongue maybe maybe choppy pulse. There is some roughness because of the deficiency but we see definitely blood vacuity as the source.
And for this pattern, it’s more of a liver… it’s a, a livery person that we want to look for. And then the combination that we think of is Suan Zao Ren Tang. That’s the most important formula. It’s one of the main formulas we think of when we think of sleep issues or insomnia. And by the way, Suan Zao Ren could be used as a single herb to help fall into sleep.
So that’s something that we need to remember. And sometimes you can just give a handful of Suan Zao Ren and have the patient make some tea before going to sleep, and which is a great technique to help this ability to fall asleep, especially if the main issue is difficulty falling asleep.
So the acupuncture points that we might think of in this case is Spleen 6 and Heart 7 combination. We might need to also support the spleen to be able to create blood, so we can use points like Stomach 36 a- as supporting for that, and that would be our choice when we’re seeing this pattern The next pattern is a heart qi and blood deficiency with unsettled shen.
And the f- my favorite formula for this pattern is Hu Po Yang Xing Dan or amber nourished heart pill which is a very special formula. I really like that combination for insomnia, especially when it comes with pr- pal- palpitations and easily startling and this kind of unsettled shen with heart unable to support the s- the shen when it needs to go to…
when we need to go to sleep. The important thing is the Hu Po Yang Xing Dan is all about this ability to transition, but also it works on the heart’s ability to focus and concentrate. So I use this formula for children who have a lot of blood heart qi and blood vacuity together with sleep disturbances, but as well as difficulty fol- fo- focusing with ADD and ADHD.
So this is a, a, a very versatile formula and can be used in many ways and one of my favorite formulas, Hu Po Yang Xing Dan. The correlation may be a combination of Heart 7 and Pericardium 6, and together with Bladder 15, and sometimes we can even think of Bladder 20 to nourish the spleen and support that blood production.
And the next formula is more of an excess type of insomnia, right? When we have a lot of liver qi stagnation causing either depressive heat or actually depressive fire, or fire coming from this liver qi stagra- stag- stagnation. So there’s people with a lot of agitation, and they get very anxious, and they get very, they think of all the things that they haven’t done when they need to go to sleep, and they, instead of falling asleep, they start trying to solve all the things that they haven’t done. So there’s this very strong difficulty falling asleep, a lot of irritability and anger outbursts, very typical of liver constraint.
And the thing that we– the formula that we think in this case is Chai Hu Long Gu Mu Li Tang. It’s a sedative formula, right? It sup- it suppresses the liver, but also helps with moving the liver qi. And and it’s usually w- the thing that the type of insomnia that we’re looking here is more of an excess type.
The person or the patient is more of an excess patient. Then we need to think of points that move the liver, so we can use Liver 3, we can use Gallbladder 34, and we combine that with Heart 7 to calm the spirit, and we can get a good effect on that w- with these points. So these are just examples, and you– it gives an idea of how to address these issues So there’s another aspect that we need to think of in terms of insomnia and that’s when we have phlegm or phlegm-heat or phlegm-dampness, and that’s harassing the heart.
And so when we get that, we’ll have really restless sleep, very vivid or disturbing s-dreams. There’ll be also some chest oppression and sensation of phlegm in the throat. And maybe if there’s heat involved, if it’s phlegm damp… If it’s phlegm-heat there’ll be some bitter taste in the mouth. Or if there’s phlegm-dampness, it might be only a kind of feeling of nauseous and a sweet taste in the mouth.
And the pulses, of course, will be very slippery and rapid or just slippery and a greasy tongue coat is definitely could be involved. So the formula that I think in this case is Wen Dan Tang, and Wen Dan Tang is very important formula for many issues relating– emotional issues that that are resulting from dampness that’s hindering the free flow of the liver qi liver and gallbladder qi.
So I think of Wen Dan Tang when people get stuck in their thinking, stuck in their activity, and then also have this a lot of repeated dreams, like the dreams are play, are played on replay because the phlegm is causing that stuckness that’s associated with damp and phlegm that we know from Chinese medicine.
Wen Dan Tang is an amazing formula, and if there’s a lot of heat, you can think of Huang Lian Wen Dan Tang as another option. The acupuncture points that are associated with that would be maybe Pericardium 5 together with Stomach 40 and Heart 8. Or for those of you who are shy of making or of needling Heart 7, Heart 8, you can think of Heart 7 as another option for that.
That’s the, the phlegm harassing the heart, or sometimes it’s called gallbladder deficiency with phlegm accumulation. Okay. So I want to just point out two important herbs that I always think of when I I’m thinking about when I’m making the formulas for these patients who are suffering from insomnia.
One of them is Suan Zao Ren, and we mentioned that earlier how important this herb, especially in people who are having difficulty falling asleep. And there’s also a lot of information about Wu Wei Zi, and traditionally we are using Wu Wei Zi with- for as an astringent, as kind of holding the jing or astringent the jing, and it calms the shen and it helps to consolidate the exterior.
So it has to do something with the Wei Qi circulation and it’s just used a lot for insomnia. So when you are making formulas for your patients that are dealing with sleep issues, definitely think of these two herbs to add there to help with the different aspects of insomnia so again, when we are treating insomnia, always diagnose the, where it’s, where the disturbance is happening.
So you n- the– let that guide you in what’s happening. So if it’s more at the beginning of the sleep, the middle of the sleep sometimes early waking is another pattern that we need to look at. And then match your treatment to the specific pattern. And always know that there are some general things that you need to know, do.
And one of the other things that we always need to discuss is what we call sleep hygiene, which is keeping the environment that you’re… When you’re walking into a place where you’re going to sleep, how can you make it clean and not disturbing to your, the pattern of falling asleep and staying asleep?
This ends our second part. I want to again, thank the American Acupuncture Council for letting me speak today about sleep disturbances. And thank you very much. And again, if anybody wants to be in touch with me and to ask more questions, please feel free to contact either the motioncenter@gmail.com or motionherbs@gmail.com.
And you have the two relative and websites on the slide here. And thank you very much for your time.
And one of the chapters in the book is all about self-care. So what are some of the things that you need before getting started?
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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. Welcome to today’s presentation on facial acupuncture self-care. My name is Michelle Gellis, and I would like to thank the American Acupuncture Council for this opportunity to present to you today. Can we go to the first slide?
So I put this present… i’m an acupuncture physician. I’ve been seeing patients for over 22 years now. And I put this presentation together because I teach cosmetic and neuromuscular facial classes internationally, and have been for over 20 years. And one of the questions that frequently gets asked to me is, do I treat myself?
And the answer is, yes, I do. So I thought I would share some of the information today with you. And one source of this information is from my book. I have a almost 500-page hardcover, full-color textbook resource manual on treating the face, and it covers everything from cosmetic acupuncture to Five Element acupuncture facial cupping, gua sha, microneedling, neuromuscular conditions, and a wide range of topics, everything related to treating the face.
And one of the chapters in the book is all about self-care. So what are some of the things that you need before getting started? One thing you will need is a magnifying mirror. I have one here that I got on Amazon. Fingerprints all over it. But this one lights up. Wait a minute. Let me center it. Can’t see what I’m doing, but it does…
Take my word for it. It lights up. There we go. And this is a great little travel one. I have a more substantial one at home that plugs in, but this is rechargeable, and it does the job. So before I get started, I can turn that on, and I can see what I’m doing Also, if you’re going to be doing acupuncture on yourself, you’ll need a sharps container and some tweezers if you’re going to be inserting any intradermal needles, which are those tiny little needles.
I think I have a picture of them in a future slide. But these are by Tweezerman. They have a wide grip and a slanted tip, which makes them really good for grabbing those little intradermal needles and inserting them. Arnica gel. I prefer the gel as opposed to the cream. And arnica gel is also really good for preventing bruising.
Also has a little alcohol in it, which helps to clean the face. And because of the different ingredients, some of the arnica gels can help with pain and sensitivity also The needles that I use when I do cosmetic acupuncture on myself are the .14 the shorter needles, the 0.5 millimeter and the .14, 1.0 millimeter needles.
And the longer ones I use for the more fleshy part of the face and the shorter ones I use for the more bony parts of the face. I do like the Seirin needles and using tubes for insertion so that I’m not coming at my face with just the point of a needle. So these are those intradermal needles I was talking about, and lots of needle manufacturers make intradermals.
I like these because of the way they were packaged. There was five needles on a little piece of foam, and then you could just pull them by the handle. And then I typically squeeze a wrinkle and push the, these tiny little intradermal needles in not perpendicular to the skin but parallel inside the wrinkle.
Q-tips are helpful to have in case you see any bleeding or potential bruising about to happen. And then it’s a good idea to have maybe a piece of paper. Look at yourself in the mirror. Decide what you want to work on. Do a little self-diagnosis. Maybe draw some lines on a picture. And that way you have something to think about when you’re doing your treatment plan.
And of course, make sure to check that you have no contraindications or precautions. I cover all of these in detail in my webinars and facial acupuncture has different contraindications and precautions than a typical acupuncture treatment would So you’re gonna make your plan. Where am I gonna put the intradermals, and which acupuncture points am I going to do for different conditions?
Am I going to do any threading of a longer needle into a ring– into a wrinkle? And am I going to do any points on my body? I typically don’t, but sometimes I’ll do maybe some points in my feet. Or if I’m going to lay down, I can do a couple of points in my hands, let’s say large intestine four.
And then while I’m lying down, those points can work Make certain to review your safety concerns as far as what to look for veins, arteries, nerves on your face. Re-familiarize yourself with facial anatomy before you start putting needles in your face, and then review your techniques. My classes have specific mandatory points and optional points that we use.
And so you wanna think about your own needs and which points are you going to use, and really use precision needling techniques when you’re working. So threading yourself is, You could see I’m looking at myself in the mirror here. Again, these are pictures from my book. But threading the nasolabial fold here with a shorter needle and putting an intradermal in.
You can see I’m squeezing the wrinkle, and I’m placing the intradermal into a little chin wrinkle. So you want to go through your protocol starting at the lower part of your face, working your way up. I tend to work on both sides of my face when I’m needling, not one side and then the other. But that way I can work from the bottom up and do all of my threading as a first thing.
Something else I do on myself after I take all the needles out, I do facial cupping and gua sha. And for cupping, I recommend using glass cups with bulbs that are easy to squeeze. These are from AccuLift. They come in a set. This is what the set looks like. Comes with two cups, two gua sha tools, a little velvet bag, and a case for them.
And using cupping oil. These are available at acculiftskincare.com, and the oil has Arnica and CBD in it, things that are very calming for the skin and help to prevent bruising. So I take all my needles out, and then I’m going to do my cupping. Always starting with a lymphatic drainage. Again, don’t try to just wing it or make stuff up or watch some YouTube video.
It’s important to get properly trained before you do facial cupping and especially working on yourself. You don’t wanna injure yourself when you’re doing cupping. For gua sha, again I do the cupping first, and then I do the gua sha after the needles come out. I use genuine jade gua sha tools and the same oil.
And I always start along the clavicle, massaging lymph nodes and then walking working across the jaw, so from the bottom of the face up. And this entire protocol is available, again, on my website, facialacupunctureclasses.com. You can see I have CEUs recorded webinars step by step exactly what you’re supposed to do.
For microneedling, that can come in several different forms. You can either use a derma roller on yourself, or you could use a microneedle pen. And these are all tools available from Accu Lift. These microneedle pens are professional grade and professional quality pens. Or you can use one of these devices.
This is a Hydra needle, so you fill it with serum, and you would stamp the serum directly into the skin. And these are all forms of microneedling So if you would like more information on self-care for acupuncturists, for health professionals, you can go to my social, which on Facebook I have a personal page, Michelle Gellis.
I also have a professional page on Facebook, Facial Acupuncture Classes, and a Facebook group called Facial Acupuncture. I’m also on Instagram and TikTok under my name, Michelle Gellis. And I have two websites, facialacupunctureclasses.com and my affiliate, which is aculiveskincare.com for tools and serums and oils and things like that.
You can also get my book there. Again, I wanna thank the American Acupuncture Council for this time to speak to you about self-care, and I hope to see you again soon.
Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works.
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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.
Hey, greetings to my acupuncture providers. It’s Sam Collins, the coding and billing expert for you acupuncturists, and of course, the American Acupuncture Council and our network. As always, I wanna make sure you’re up to date. Hey, it is the 1st of September. What’s gonna be changing? Oh, diagnosis codes will update October 1st.
So let’s talk about it. Let’s go to the slides. Let’s look at what’s going on for 2027, what’s changing. The one thing we’re always careful with, we’re not big on hyperbole. We always wanna make sure we understand the coding, the codes that are important to your profession, and I’m always gonna be a little acu-centric.
Realize when it comes to diagnosis, best practice coding for an acupuncturist, pain. Don’t get fancy. Pain works. Realize you can have lots of diagnosis for the back, spondylosis, disc degeneration, on and on it can go, but yet it still comes back to pain. That’s the beauty and the genius. Realize that pain, symptoms, or neuromusculoskeletal diagnosis are always gonna be the most common payable codes.
There are certainly a lot of programs now that do pay for others, and I want you to be aware, but I wanna focus in on making sure are we getting paid? Do we have the right code? Of course, as is every year, there’s updates to diagnosis codes. This year is no different. So the 2027 diagnosis codes actually begin October 1st.
So here’s a good sort of riddle you can have. When do the 2027 diagnosis codes begin? And of course, most people would say 2027.” Technically, no. They begin October 1st. Now, as always, I’m going to be very acu-centric. You know what I care about? How does it affect us in the acupuncture field? Of course, there’s almost 75,000 codes.
You’re thinking, “Whoa. Are you ever gonna use that many?” Nah. You’re probably gonna use probably on a regular basis 10, and maybe occasionally a few more, with 5 of them being most often. So what I care about is the ones that affect us. We could look and say wait a minute” There’s 190 new codes, 30 deletions, four revisions.
Does that make a difference? Let’s take a look at the overview. There are gonna be changes to infectious diseases. Metabolic conditions, injuries or toxic effects, and this is ingesting things. Pregnancy-related, but pregnancy-related for more obstetrics, if you will. Oncology codes, but not related to what we would do ever, even though it might be pain, and then pelvic conditions, again, unrelated.
So the truth is, no significant changes except one, plantar fasciitis, and I’m not saying you can’t code plantar fasciitis. You can, but you might be coding foot pain anyway. So I will tell you, there’s no changes for high volume pain or neuromusculoskeletal codes. However, I wanna focus on, do I have the best codes?
Let’s look at the changes. The old code, or if you will, the code that’s being deleted, M72.2 plantar fascial fibromatosis, is the code that’s current. So if someone has plantar fasciitis now, that’s the code we use. Beginning October 1st, we’re gonna switch to the new codes, and you notice there’s three.
One says, plantar fascia, plantar fascial fibromatosis, unspecified foot. Let me tell you, never gonna use that code because can you imagine saying they’ve got it, but I don’t know which foot”? Of course you know. Is it the right or the left? Notice the code ends in one is the right, one that ends in two is the left.
Bottom line, keep it simple. If they have it in both feet, put both codes. If they have it in one, put that one code. Now, I have some acupuncturists say Sam, I’m not even gonna code that. Could I just code foot pain?” Technically, you could. Remember, pain is always gonna be a fallback. So here’s the new codes.
You’ll see here we’ve updated them. This is a list, and what I have here is a big list. I’m not showing the whole thing, but a big list of the common codes payable to acupuncture. I’m gonna give you an opportunity for all of you to get it because what this list is the list of payable codes by insurance.
Now, I will warn you, it is a big list. It’s about nine pages. It’s gonna have codes that are payable by insurance, but I’m gonna argue, or not argue, but I will state to you All the codes are payable by insurance, but not all are payable by all insurance. So you do wanna have a little bit of nuance there.
That’s one of the things our seminars note. But you wanna make sure if you’re gonna choose a code to bill insurance, I’m gonna suggest pick from this list because this is the list that there’s references to every carrier. So I’m just highlighting here, this is part of the extremities with the plantar fasciitis, but notice there’s other codes on the list, such as chronic pain, acute pain, and so on.
So to get that list, here’s what you do. Pull out your phone, use this QR code. I’ll leave it up for a moment. What you’re gonna get is a quick bounce back just asking for some information, and off it’ll come to you. It’ll be a nice PDF that you can use on your phone or also on your desktop. What it is, though, is a usable format that actually you could search.
Remember, if you go to the little magnifying glass, click in the click on that, type in a keyword, it’ll bring up every time that code is there. So if you wanna look up cervical, type cervical, and all the codes that have cervical will come up, or lumbar, whatever the case may be. What I wanna make sure is that you should be choosing codes that are specific and come from a reference as opposed to thinking, “Oh, I’m not sure.”
Now, again, always defaulting to pain is still fine, but I’m gonna say a little bit more specificity always can be helpful. What I do wanna talk about, though, a little bit more beyond that is just some recent things about the state of the profession. Here’s what I’m excited about, and I wanna show you something Acupuncture utilization has more than doubled in the last 20 years.
Now, we still treat a small part of the population, but I’m excited about that. Part of the reason, commercial plans now include the benefit. In fact, how many are familiar that Aetna now has mandatory acupuncture if it’s a commercial plan? Medicare Advantage plans, the Part C, have acupuncture. And what about complementary care networks?
They’re out there. Now, here’s something, and I want to show you where I got this. The American Journal of Managed Care from February of this year, this is a group that’s a, support group for the managed care industry that talks about how to position their business. And it says, “The most successful acupuncture providers will likely be those who combine clinical specialization, measurable outcomes, payer knowledge, and strong referral.”
This tells me where we should be looking. Specialization. You cer- deal with certain things. You’re focused on outcomes, and you understand what the payers allow. It says, “The market is moving toward greater acceptance, but payers are also becoming more focused on authorization,” meaning understanding diagnosis restrictions, utilization, and proof of functional improvement.
It then goes on to talk about, according to the CC, CDC, opioid prescribing is declining. If you think about why is the VA beginning to use acupuncture, it reduces the need for opioids 50%. It’s showing, “Our findings indicate,” and again, this is the Journal of Managed Care, “a large commercial insurer is increasingly covering acupuncture for its beneficiaries.
Unlike Medicare Part B, which limits coverage for chronic low back pain, these insurers are reimbursing acupuncture for a more myriad of conditions.” Think of for those of you in Massachusetts, they cover any diagnosis. And it says here, look at this, “Insurers should consider systemic reviews, meta-analysis, and other rigorous studies when expanding acucover, acupuncture coverage to new indications.”
Why is that? Their business strategy will be one that if they include more acupuncture, they will get more insurance. It says, “The greatest growth opportunity for acupuncture is not simply expanding the number of services offered. It’s positioning acupuncture as a measurable, evidence-informed component of conservative pain management in integrated healthcare.
Providers who understand payer requirements, document objective fun- functional improvement, and build strong referral relationships will be the best positioned for growth.” These are insurance companies that are then dictating how they’re going to do it. I want you to get on board. Doesn’t mean you have to bill all insurances, but I would certainly say I would cherry-pick a few.
Remember, though cash is king, I get that, you always wanna make sure, am I there to make sure I understand the insurance side? What I will tell all of you is I wish you really well. I hope you do fantastic. If you’ve never been to one of the HJ- or excuse me, American Acupuncture Council seminars, we’re here for you to help.
We’re always a support. Our network is there for you as well. And that’s more than just insurance. Diagnosis coding, small update this year, not a big deal. But make sure that if you need information or help, AAC is always there for you, and of course, I am as well. Until next time, my friends.
today we were, are going to talk about how do we support sleep in Chinese medicine.
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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.
Hello. My name is Moshe Heller, and I’m from the Moshen Center in New York and also representing the Moshen Herbs which is a company that produces formulas. And I’d like to first thank the Acupuncture Council for letting me present today. And today I’ll be speaking about supporting sleep with Chinese medicine part one.
So let’s go to the slides, and we can start. So a- as I said, today we were, are going to talk about how do we support sleep in Chinese medicine. And we’re going to talk about in part one about the ma- mechanisms and and how can we look at sleep from a Chinese medical perspective and support it.
And then in part two, we’re going to talk about patterns and formulas and points for the treatment of sleep disorders So I think there are two important substances that we need to discuss or remind everybody when we talk about the physiology of sleep and those are blood and yin. And so these are two important aspects of maintaining sleep.
The first of all b- in– The w- first of them, blood is the one that governs falling asleep. So blood as a substance in Chinese medicine is understood not only that it is the red fluid that travels in your arteries and veins, but also your ability to transition from an active mode to a more relaxed mode.
Therefore, for example, when if we have blood deficiency, then we tend to have muscle spasms because one, the transition between activity and relaxation is not smooth, so you get muscle cramps. The same way goes with sleep. If we have abundant blood, then the transition between being awake and going into sleep is smooth, and we will fall asleep easily.
In general, blood is this– the enables the transition from a yang state of being, from an active state of being, to a yin state of bl- b- being, so it lets us relax into sleep. Whereas yin, on the our other aspect, is actually supporting the staying asleep. So it’s about enabling us to maintain or stay asleep or go into deeper sleep.
This is the yin aspect of our th- that is in charge of that. So in fact, if we have a yin vacuity but not necessarily a blood vacuity, we’ll fall asleep easily and then we’ll wake up frequently during the sleep or not go into a deep sleep. So yin enables us to easily or stay asleep and then and go into deeper states of sleep, and we’ll see why in a second.
The generally speaking, we’re saying here, what we’re saying is that falling asleep easily but waking frequently usually points to a yin vacuity. But if we are having difficulty falling asleep but then we sleep better, then that’s more of a blood vacuity. So that’s a clinical clue for us to always remember.
So the blood has actually two roles in its ability to sleep, and it has to do with it, its relationship with two organs. One is the heart and the other one is the liver. In the first part, the blood enables relaxation into sleep, meaning it it enables us to relax into sleep, as I said in the previous slide.
But it also has this ability to house or enables the housing of the shen in the heart and then, and the housing of the hun in the liver. So when blood is full and abundant, it allows the shen and hun to rest peacefully in their relative organs. And therefore, if we have deficiency or issues with blood, liver blood or heart blood, then we will have either a difficulty of the shen to rest peacefully or the difficulty of the hun to rest peacefully, and that will look slightly different.
If so we’ll… And we’ll talk about that in a second There’s another point that I have to point out, which is very important. Sleep is part of a rhythmic aspect of our qi circulation, and we always need to take care of this or try to remember that qi circulation is part of this awakening and going to sleep rhythm.
So as we know in the Ling Shu it says that the wei qi circulates 25 times on the surface mainly through the jing jingjin sinews channels and maintains muscle tone and mobility. And in the evening, it penetrates the body at the ankle tran-transitioning from the surface to the interior, and at night it circulates 25 times through the zangfu organs following the Ke cycle and then it emerges in bladder one jing ming at the corner of the eye, allowing for the eyes to open.
So this wei qi circulation is really an important aspect that we need to remember and see if there’s blockages anywhere in that process and which allow– will allow us to understand how to treat it better. And so we can see a reflection of that wei qi circulation with our body temperature as we see here that during activity when we wake up, our body temperature usually goes down, but as we fall asleep towards the evening, then the body temperature will will be reduced and as we s- we sleep at a lower body temperature and that also reflects the yin yang activity.
So when we have more yang, we have higher temperature. When we are in a more yin state, we will have lower temperature. So there is also this ability for the blood to help us with this mental relaxation, the spiritual aspect of that. And and, during sleep, we say that the Shen retires into the blood.
If the sh- the blood is not full, then we will have a Shen not being able to rest quietly, as I mentioned before. Whereas also this kind of waking or ability to wake is managed by this kind of liver qi regulation of the circulation of qi throughout the body, including the Wei Qi’s circulation.
And so when we are having movement in the muscles when we’re trying to sleep, we should definitely look at this kind of relationship between qi circulation, the liver, and what we might call liver qi constraint, and the, in order to resolve that disturbance. This is really important to remember the relationship between the liver, the blood, the Shen, and the Hun so generally speaking, we also say that there is a lot of relationship between the Hun and dreams.
So the Hun, when the Hun moves inward drawing Qi away from the mind, then it hel-helps us or it will allow for, or it will create these dreams and the Hun wanders that’s when we c- what we might call when the Hun wanders it produces dreams and observes it’s observed as rapid eye movement or REM sleep.
Dreaming is necessary for health, for our healthy both la- function of our body. This really REM sleep is considered a very important part of not only sleeping and getting deep sleep, but also helping the body reje- rejuvenate and heal itself. When we talk about blood vacuity the heart blood is causing…
When the heart blood is deficient, this is causes what we might call fun or vexation, or when the liver blood is deficient, we might call it as restlessness and we call that jiao or agitation. So those are two different aspects of blood vacuity
So we also have to remember that our relationship between the different Zang organs and the eMoshens, and so how they the, the eMoshens affect the organs and when the organs can imbalances in the organs can affect our eMoshen. When we have too much heat or in, in the heart that might cause a lot of irri- a- anxiety and anxiousness.
Whereas when we have some disturbance in the liver, that can cause anger and and, a- and stress. And worry of course also affects the spleen, but then it can also affect the heart blood. And then when we have fear and fright, that is usually a relationship between the heart and kidney, and a lot of that is more than fright, it’s very
It’s fear and irritability, and that is associated with the kidney and heart balance. This is, summarizes very quickly what we are talking about or what different aspects that we need to look at when we look at insomnia. We have to look at what the issue is, where it’s l- the issue is located.
Is it falling asleep? Is it staying asleep? What are the eMoshens associated with it? The flow of qi and circulation, which we can assess by feeling the pulse and palpating different points, and therefore we can create a, a more clear picture of what needs to be done. So this ends part one and in part two we’ll talk about different formulas and patterns that are associated with insomnia.
But I wanted to thank again the American Acupuncture Council for letting me speak today, and I hope that we will, I will see you soon in part two. Thank you very much.
All professionals are on an equal plane. You’re no better, you’re no less. So you’ve gotta grab that mindset, and then realize that you’re no better than anybody else, but you also deserve the same as everybody else.
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Hi, I’m Michael Coates, president of Personal Injury Made Easy, or pimadeeasy.com, and we’re continuing with the six-part series about personal injury. And what we’re really getting into is I know you’re all great healers. What I want you to all be is a great business operator or owner. So to do that, the first thing I wanna mention today is that it starts with mindset.
And for mindset, realize that you are a pro, you’re a professional. And I think a lot of times, whether it’s chiropractic or acupuncture, that you think of yourself less than whether it is even the MDs or certainly dealing with an attorney, or you’re dealing with the court system, and it’s just not true.
All professionals are on an equal plane. You’re no better, you’re no less. So you’ve gotta grab that mindset, and then realize that you’re no better than anybody else, but you also deserve the same as everybody else. And the second thing is, again, realizing that you’re not just a great healer, but you need to be a better business operator.
So I really want you to grab onto those two hats. And the third part about mindset is to, something I talk about a lot is whether you are a fox or a lion. So the fox has to outsmart things. It could be a problem you’ve gotta kinda MacGyver around it, or it could be someone you’re dealing with, someone that’s trying to, whether they’re taking advantage of you, it could be someone that’s a staffer, could be a patient, could be an attorney in PI, about anything.
You gotta be a fox, right? ‘Cause no one outsmarts a fox. But at the same time, you may have to be a lion, and the lion is about strength. And you have to be strong for your patients, your staff, your family, your business, and also for yourself. So when someone says you need to be a fox or a lion, I say you need to be both to succeed in business.
You’ve gotta have both the ability to outfox those that are around you, and you also gotta be strong to stand up for what’s right and the people that matter to you So that’s the first part. The second part is I want to get into what is the success formula, and it’s a three-part form- formula, and I always think that when you get into things that they’re too complicated, it’s just too hard to implement.
It’s too hard to even get set in your head because we like to put things in buckets. So I’m gonna give you three barrels, so to speak, to put things in, or three buckets, and the first one is processes because we need proven processes to make things more efficient and more effective. And you all know about processes.
You cannot have a medical office or medical practice without being really efficient in processes. How many patients do you see in a day? It’s done because you’ve got a process for how you flow from at the lobby and intake, putting them in the room, when you’re doing treatment, and when they’re even exiting.
It’s just to realize that in personal injury, you’re gonna have all these nuances that are unique to PI, and you’ve got to learn to master those, to identify the ones that really have a great impact and to put those in place, and then you can tweak it and modify it for your practice. But if you don’t do that, you’re going to have gaps in the timeframe.
You’re going to be missing all kinds of ability to value drive. And when I say value driving through processes, there are things that you can do through processes, from intake, the forms you use, when you use them, to the documentation that you do, how you do your documentation, that literally can drive the value that you bring to a personal injury case for your patient and also for their attorney, even for your peers So if you think about it this way, you’ve got the insurance companies that are all trying to drive down PI case value, and you are remaining as this neutral, ethically bound medical provider.
You are all about just the patient’s health. You’re not about the liability or outcome of the PI case, because that’s just not your role and you have no control over it. But what you are is an avid healthcare advocate. You are there for your patient. Remember, you see that patient far more than an attorney ever sees their own client.
So because of that, you’re at this ground level to pain and suffering. That’s when you get into storytelling documentation that I’ve referred to before, and I’ll refer many times, which is about the ADLs, the activities of daily living. That’s life that you’re living. Then it’s about the duties under duress, those that affect the workplace, and then the loss of enjoyment, the LOE.
That’s about life. And so all those have this incredible impact, and it’s the impact that trauma has on our lives and on your patient’s life. So the processes that you do help to pu- and documentation help to pull that out. Now, we’re going to get much deeper into that in the next session when we really dive deeper into processes.
But I want to give you a little flavor for it, because when you do these things, it so positions you well. And let’s talk about positioning a little bit more. So when you talk about processes, that goes also the documents you use to protect your bill. So we’ll talk about a number of them in the next session, but it includes things that you have the patient sign, and it’s not just a medical lien agreement or even a letter of protection.
But there are other forms that you can do that helps to stop when the attorneys want to throw things at you. And again, it’s positioning you to be better at the time it comes to be paid. So all those processes, which include when you’ve even discharged a patient, what process do you have to follow up on a PI case?
Who do you follow up with? When do you follow up? And what are you asking when you follow up? So again, we’re going to hit that in the next session, but I just want you to realize how important processes are. Everything else flows from that. So that’s the first area of the success formula. The second area is profits Right?
It takes money to do the mission, as we’ve talked about, and your mission is to heal. And the more money you make, the more healing you can do. So I wanna really see you ramp up the profit. And for profit, remember, it’s not how much money you make, it’s how much you keep in your pocket at the end of the day.
It’s that net profit that allows you to give increases to staff on bonuses, hire more staff, do more things for your family. So profits is such an important area, and we’ll dive deeper into the two weeks from now when we get into that session, we’re gonna hit profits, and we’ll talk about MedPay and PIP.
We’ll talk about how you negotiate with law firms. The negotiation method that I have come up with and I’ve refined over the last 15 years that literally has providers owning law firms because the leverage is on your side. You just gotta learn how to identify the leverage, how to apply it, and that’s what the method that I’m gonna talk about in that session is all about.
And then there’s the third area. We talked about processes, we talked about profits, and there’s a third area that every business must do, and if it doesn’t, it cannot succeed, and it’s growth. You have to be able to scale. But what is growth? I think that I find that people think different aspects of growth.
Growth doesn’t have to mean you’ve got to have 15 offices, okay? Growth can simply be that you are maximizing your patient flow for if you’re the solo provider, you’re maximizing that out. You might have a multidisciplinary practice, though. You may have another office, a second or a third. So growth can mean different things to different people.
So when you’re scaling, it could be scaling up just your one office to maximize your potential so you’ve got the flow you want, you’re not overworked, but you are maximizing your patient mix and your patient numbers. It could be because you’re thinking of the exit strategy, like where you wanna end up, what kind of life you wanna lead.
You might want more offices. So then you gotta think about growth that way, which again, if you have processes down, that prevents a brush fire turning into a forest fire when you’ve got a number of offices. It’s why it becomes refining those processes early so important and why profiting matters, because the more you profit, the easier it is to expand And so think about how this works together.
Processes, profits, and growth. It’s a simple formula, but you cannot have any success, whether it’s personal injury or a medical practice or, to be honest, any business, unless you’ve got all three. Any of those three pillars, like a tripod that is off and goes, the tripod’s gonna fall down because it’s only got two legs.
It’s gone. It’s over. So this path that we’re talking about is to help you understand through the next sessions each of those silos, each of those buckets, because it’s all about one thing: helping you to be more successful, and you’ve earned it, and you deserve it. So again, think about that formula, think about how easy it is, because when things get too complicated, we find ways to stop ourselves.
And I have a lot of providers that come and talk to me, and they say they just want to focus on one. Michael, I just want to grow,” because they think they’re doing the processes right or they think they’re making enough. And when I dive in and talk to them, and because data doesn’t lie, and I find out the forms they’re using, the process they have, or I find out how much they’re actually getting paid by the trusted attorneys and even more what they’re getting paid by the difficult for attorneys, I found out it’s not what they thought.
So what they’re growing is is not profit. Sometimes they’re growing losses, and you never want, of course, to do that, right? So when someone says, Michael, I just want to focus on processes,” by the way, that is the best thing to start with. There is an order to things. So I do love when someone’s never done PI before, and when they say, “Mike, what’s the first thing I should be doing?”
And I say, “It’s processes.” Think of it like a, a house, and you’ve got that solid foundation in the house, and you want to have the great processes are part of that foundation, but they also get into the curb appeal, right? So that’s like the documentation. We talked about that the the last segment.
So when you build this really great house that has this great curb appeal, that’s when you can really thrive as a business, where you become a value driver to personal injury attorneys, to your patients, to your peers, to yourself And then that allows you to also not only profit more, but to grow. So I hope that gives you a little bit of a start and sets the stage for what we’re gonna talk about these next three really important weeks.
Because once you understand it’s about processes, profits, and growth, and that you need all three, I would say as we go through the next few weeks, I want you to identify one, two, or three things that I talk about that you will implement right away. So maybe you might do one thing in each of those silos or those buckets and put them in this month, okay?
Or next month when we talk about it. I think that’s gonna help you. In fact, when we talk about processes, try to pick out three things and implement that. When we talk about profits, try to pick about three things and implement that. When we talk about growth, try to pick out three things and im- implement that.
That means each month you’ll be doing more, and at the end, if you’re still, maybe you put this aside, you didn’t hit this like you wanted to, don’t stress yourself out. It’s about your life and your practice. Sometimes we’ve gotta take a step back to move forward. That’s what I’m gonna tell you instead of picking three things, pick one.
It’s still stepping forward, and stepping forward is what perfection is. Perfection doesn’t exist in this world at all. So I always say that progress is perfection. And again, if you wanna live well, you gotta build it well. So that’s what we’re gonna be doing through the rest of this series. We’re going to build it so that you can live well.
So again, as Michael Coates, I wanna give you how to contact me if you need any help on anything from me or my team. That’s, my website is pimadeeasy.com, and my email address is michael@pimadeeasy.com. And we’re here to help, so please don’t hesitate to reach out. And I want you to start compiling your questions, because I think that’s gonna really help to get things focused on what matters to you, because you matter to me.
I’ll see you at the next session.