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AAC – TCM multi-targeted approach to cancer care – Yair Maimon

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Hello everybody. I would like first of all, to thank the American acupuncture consult to put up this show. And today I will try to squeeze 15 years of research experience into 30 minutes. So two minutes kind of per year, I’ve been very fortunate to do, uh, in depth research, both in the lab and with patients with actually eventually won a formula of Chinese herbal medicine, which we took all the way from clinical to preclinical studies in order to prove a one thing the Chinese medicine works, but it’s also have evidence. Uh, this, um, research was also chosen to be presented to NASSCO two years ago when there was a TCM, uh, science day. So I was lucky to present it. I called it multi targeted approach because today all the treatment for cancer is targeted, targeted towards cells targeted towards actually a specific parts in the cells or on the outskirts of the cell.

And Chinese medicine offers a very different model and a very different paradigm. Um, most of my research, at least in the recent years were done in a, the center of integrity of medicine in the cancer Institute and cheaper medical center. It’s a huge, it’s a make a hospital. It goes one by Newsweek of one of the best hospitals actually for cancer in innovation. So it’s a mega hospitality. It has like 20,000 cars per day, 1,800 beds. So it’s really big. And as you know today, hospitals serve a lot of patients coming from also from the whole region, but also patients suffering from, uh, Corona and other, uh, acute situations in our oncology ward. We have, we are very lucky to have the center, which has both a clinical part where a patient can feel like they are in a different environment, healing environment. And it’s very unique to us to have also the research part, the research part, which has a proper lab, and it’s actually molecular biology labs.

So we can go deep into the effect of herbal medicine on immune system, on cancer cells and study even mechanism of action. And as I say, I’m fortunate, uh, to be leading this project for so many years, this is by the way, how the Herb’s look. So in the lab when we, uh, um, put them in some solutions. So you can see that they have different colors and different shapes. Um, this is part of the group that is working with me, uh, including, um, we can say faintly Zoe going, um, North Samuels and, uh, actually Steve Melnick from Miami children’s hospital came and visit us. And you could see me here as well, smiling faces. So I want to start the research actually from a very deep point of view of looking at Chinese medicine, because at the beginning we took cancer patients who were undergoing chemotherapy later, we went into looking deeper on Chinese medicine, but when we look at chemotherapy and when we look at its effect in the body, we are actually going to the deepest place.

We are going to the bone marrow and in Chinese medicine, the bone marrow belongs to the kidney and it’s like the most hidden and deep part of the body is the one it produces the immune system and produces the red blood cells. Cause the bone marrow produces eventually bends the red blood cells, the white blood cells and the platelets. And so this deep production house is housed in the most deepest part and sacred part in the body, inside the bones, in the, in a sense it could be anywhere. But if we understand it from a Chinese medical point of view, we are going to very deep essence of the body. And in Chinese medicine, it is the kidneys. So we want, when we want to address a patient, especially patient and they’re going chemotherapy or RAF treatments or having problem with his bone marrow in Chinese medicine, we know we have to think about the bones or about the marrow and in if we translate it to the substances in the body, which thinking we’re talking about gene, and when we look at the production of the gene, it’s the same as Western medicine.

So Chinese medicine already 3000 years ago, going in along the same line of what in Western medicine is discoveries just in the last decades. So the production of blood, we can look at all the blood in Chinese medicine. And when we look at the production of white blood cells, we would think about the cheap and the effect of cheap. So when we are addressing in Chinese medicine, um, and when we want to protect the bone marrow and the production, and when we want to 25 unity, we have this picture in front of us, looking at the gene, looking at the blood and looking at sheep. So in a sense, we are seeing something from the outside, which now we know is happening very deep inside the body. And if I look at the herbal prescription, if I’ll make a herbal prescription for patients, I can also talk about acupuncture.

Then I’ll put some herbs like or herbs that are, tonifying deeply sorry, the, the gene together, maybe with the herb, the tonifies, the bland and Herb’s the, tonifies the cheek Lakeisha and Juan. So this will be a prescription that you see goes into a very deep layers of the body. Tonifies the production house and also it’s product. And that’s unique about Chinese medicine. And that’s what unique about making a herbal formula rather than using one herb or even using one active ingredient, which is the common process in Western medicine and in chemistry. So when we did the research into formula, which we called LCS one Oh one, we looked at its effect on white blood cells, red blood cells, and even deeper into the immune system on neutrophils, especially in patients who are undertaking chemotherapy, that their bone marrow is suppressed. And therefore the production of the cells is reduced.

And the patients are suffering from anemia, leukopenia, and cetera. This research started more than 15 years ago. And as you will see, it has now many publication in very leading journals, medical journals in the world. Actually, one of my research will LCS one Oh two, which may be will continuing. The series was just probably three days ago. It’s a prescription that works only on immunity or mainly on immunity. So if you want to read, it was published at the medical biomed just two days ago, took about seven years. Uh, so, and by now, this formula was researching seven medical centers in Europe, in Israel and in the U S and this gives it a lot of credibility, because if you can repeat the research in different centers with different scientists, it means that whatever your findings are, they’re very valid and they’re considered more valid because if it’s one center, one place producing all the research, there’s always this question who is overlooking at the research, the results.

So by now, if we’ve kind of been involved in research in seven different institutes, um, and two of them in America. So we had the cooperation with MD Anderson, actually our last publication of LCS one Oh one, we had a cooperation with Arbor medical center. I’ll tell you in then with one of the leading oncologists there. And then we did some of the clinical work calls, not the preclinical work in Miami children’s hospital. So there was a collaboration with many different hospitals. Uh, and, uh, as I said, we were very lucky to find researchers to collaborate with us and Sheba medical center is a sister hospital with MD Anderson. So it was also helpful. This is the formula that cover researching 14 Hertz. Don’t worry if you don’t get it, it’s listed all of our research paper. And whenever you want to put dot com, you’ll find all the research that we’ll be talking about safe.

I’ll be brief on some details. Don’t worry, it’s all research published. You can download, or you can just write to me and I’ll answer questions. The very special thing that we found after we finished this whole series of research that Chinese herbal formula have multi effect. As we know it affects the immune system or they also, they, they achieve the body’s strength. It protects against side effects of different drugs. And it tells also in different research that we ran in the lab, a very interesting effect on cancer cells. But the reason I researched this formula and here is also, I can show this effect. Like I’ve put the, the Chinese herbal prescription into three different formats to show that there is a certain amount of herbs, which are addressing the protection or protecting the gene like New Zealand, Z that I mentioned before, the certain Arabs that we are considered that can kill cancer cells like band Juliane or itself.

And there is certain herbs that are more working on the immune system, like punchy, which is very known or by you, I’m using the Chinese names because I’m more used to them. Uh, and this is really where it all started because I’ve seen very good results in my clinic, treating cancer patients. And in the hospital, I was always, I got a very kind of a cold shoulder, especially from the oncologist that don’t cology department. And this was already in my previous hospital that I was working in. And I was asking, why are you so against natural medicine equals even not Chinese medicine? And always dancing was there is no evidence. And when adopted means, if there is no evidence, it means it doesn’t work because, you know, it’s, it’s a nice, safe to word to say, there is no, but evidence also is approved. So there is also more ways to eat.

But I must say that today, we have so much evidence for acupuncture and oncology acupuncture and the lecture about it. And still, you will hear doctors saying there is no evidence, so you need to read about it and find out, but that will be the very common, uh, kind of thing that, that will hear in the oncology department. They did change after all the research we have done. So we have now a total different acceptance and, and we are heard in a very different way because eventually when you bring evidence, then you’re considered when there is no evidence, you are in a different ball game, I can say. So the first research we did exactly like you do as a, um, regular medicine, double blind randomized, we took a breast cancer patient. In this example, we could have taken other, uh, cancers and they were divided randomly into two groups.

And they were given, one group was given LCS one Oh one. The other one was given placebo. That looks exactly the same. And then this patient were undergoing chemotherapy. So it’s about half year for this breast constipation. And then we compare the results, took about five years and another one year to finish up, eh, all the publications that’s the amount of time good research takes. And sometimes longer the results were quite amazing and stunning because when you look at white blood cells, so we are looking at the herbs that were protecting the bone marrow, but also increasing or helping the white blood cells activity. So if we look at the placebo, I’m looking at the one that had a, a leukopenia or under 3000 counting their blood counts. So it was 42% in the placebo, in the real one, 18%. So less than half, which means 80%, 82% of the patient, they didn’t have leukopenia.

Oh, they didn’t have reduction in white blood cells. It’s almost double, uh, if you look at it from that side on the placebo one, and the same went for a model of being under 10. So there group that took the LCS one Oh one 82%, didn’t have the, uh, the reduction in there and didn’t have anemia reduction in the hemoglobin under 10 while 52%, uh, head reduction. Well, no, sorry. 48% had reduction in 52%, not in the placebo. So see, again, it’s more than half of the women in this respect suffered from anemia. So what we are showing is that we are protecting somewhere deeper because if the red blood cells, white blood cells and we’ll be, look at the neutral fields level is protected means we are protecting the bone marrow from the damage of the chemo, and this was the results. And we published it in, in one of the most respectable, um, oncology journal.

So you can see least less than email. It’s the container and less neutropenia. All this is extremely important. And we published it in the Don cologists one of the best peer reviewed the oncology journals. Uh, so this is what we were kind of seeing that we are protecting, but it has a lot of meaning. Cause when you protect the bone marrow and when you reducing leukopenia and uh, in anemia. So first of all, people can, uh, this patient could do well and adhere to their chemo protocols so they could finish it. So they, it’s also part of the effectiveness of the protocol. They have less complicated complication that less potential secondary infection. When you have low immunity and general better quality of life for the quality of life, we did another group of people. And again, we also published it and we are showing that for fatigue, nausea, low appetite, weakness, pain, bowel function, all of this, a patient who took the LCS one Oh one and the better quality of life than expected.

Then we’re looking at the anticancer properties of the formula and republished it. And then we look even deeper. And we saw that this killing effect of cancer cells was selective, which means it was killing cancer cells and not normal cells and even the same as protection. So this selectivity means that when you use normal chemo, it will kill both the good cells and bad cells. When we were using the protective wall, we can so that instead of chemo, it is only killing the cancer cells and not the normal cells. This is like, if we go for a minute to the lab, you can see this is normal cells of a breast. And you can see on the zero to three, four, five, we take the concentration of LCS one Oh one and they’re thriving. And when we take cancer cells here, you see, they’re almost, they’re almost all dead.

So at this concentration, this one are dead, but the normal cells are alive. And the same when we go for colon cancer, prostate cancer, and later we did on a, um, and bladder cancers, lung cancers, and then other types of prostate cancer was actually also the main one. This is how we chose on the chart. And actually this is for prostate cancer. Again, you see the normal cells are reliable. Even if we go up, some of them are thriving while the cancer cells are dying. So it’s a very unique phenomenon of the selective killing. And this was even further. We shown the selective protection between when you take just a chemotherapy like Doxirubicin or five, a few, it will kill both. When we are adding the LCS one Oh one, it will protect almost totally the normal cells and helping killing the cancer cells. And this was published actually with some scientists from MD Anderson and again, a very interesting publication.

So what you saw and tell now is this protection and killing of cancer cells selectively in a, in, in vitro model. And now we look at the immunity, how the same formula affects immunity, and they always ask me, why do you need so many herbs? Why can’t you reduce the number of pallets? They, they kind of nightmare of a lab work. You know, they have so many protein apps, you have hundreds of ingredients in it, but I say, according to Chinese medicine, we have to follow this logic. And that’s why a whole formula, I call it a team can do so many things. And when we look at immunity, we can see deeply that it activates immunity, both T cells, cells and natural killer cells. This the innate immunity is also the one, which is so important to fight with viruses, but it’s also the type of immunity that kills cancer cells or mutated cells on a daily basis.

So we could have shown on human blood that we are activating the natural killer cells, even sometimes 400% more the normal. So very strong activation. What we did also through all this research is realizing that in order to deal well with herbal medicine, you need to bring it to consistency, to batch, to batch consistency. So today we are doing a very special production in order to bring it to batch, to batch consistency. We are concentrating the Arabs in a different way. We are identifying them. We are looking at their biological activity, not just their chemical activity, obviously the cleanliness, as far as residues of, uh, any toxins. And so we had to go very deep into producing something, which is reproducible for research and later on for, uh, also consumer use. So just to kind of give you a glance, we went deeper because always the concern there is interaction with chemo and radiotherapy.

So, and not a publication. We took 10 different kinds of cancer and 10 different types of common chemos. And there was no negative inter interaction in many times, even a positive one. So again, published, you can read it and everything here takes years until it comes up, but I’m very proud of it. And even also in this publication and others, there’s always oncologists. This is the head of the oncology department in Sheba medical center. But then also we have to look at Ray radiotherapy. There’s always this fear that you will use the effect of radiotherapy because you can be using like the oxygen. But we found actually that the formula is working through different mechanisms. Some of them is like ROS reactive oxygen, which is exactly the same, his radiotherapy. So when we look at the combination, when we combine the range of therapy with the LCS one Oh one, and you see the higher rate going the dosage, the more eh, killing we have for the cancer cell.

So the blue bond is only a zero, uh, formula. So it’s only a red, your therapy. You increase the dose of radiotherapy. So I see more and more cancer cells are dying, but still up to here, almost 30 of them are alive with this dosage of the radiation. But when you’re adding the LCS one Oh one, and when you’re adding them in there larger effect, you actually see a synergistic effect. And this, we also tried on almost 10 different lines of cancer consensus to show that it works, uh, on, on many different types of solid cancers. And again, a very good publication on cancer research, clinical oncology journal, one of the leading journals. So kind of to summarize all this, we need, eh, another research in summary that we published about a year ago and this publication was done with our head of the group is professor Rosenfeld from MD Anderson, from sorry, from Harvard medical school that also helped to endorse our science and to look deeper into it.

So we showed all this effect and just to bring it more to the clinic, um, I’ll show some cases how we use it in the clinic. And we have no cases that we are following more than 10, 15, I’ve even 17 years of patients. Some of them are taking the LCS one Oh one for four years for different reason. This is a classical patient. Uh, she started it when she was during treatments and then she continues, uh, also continues more for maintenance and recovery, and then also to keep her healthy during her life. So when she took it during the chemo, there was an increase in white and red blood cells and very minor side effects. This is, has repeated itself many times, by the way, this is the reason, I mean, there were the whole way of selecting the herbs. The formula was done, first of all, in there, like how can st a clinical setup?

And then when I see repeating the results in my clinic, I went to the hospital to check it with evidence-base and then to improve it and, uh, and, and prove you to also, uh, and, and this is, I think that the advantage of Chinese medicine, we see clinical results. So we start from something, we know we are proving what we know, but this proving is important and has later many implication of how we can utilize on a larger scale. Hopefully that’s my dream, that every patient will get regular therapy together with Chinese medicine together with the therapy that can enhance his quality of life can enhance and protect him from how she effects of treatments. So I can say not just Chinese telephone therapy is what we’ll call, um, today in integrative therapy. But I think Chinese medicine is deleting in the integrative medicine, both from the evidence and from what it can offer.

And the example of and a lung cancer patient who started it after surgery. Again, it was very weak after the surgery. It helped him with recovery immediately and elevation of the white blood cells. You had the throat problem and, uh, immediately got better. Uh, some patient, I think it’s, I think it’s also with him, we’ll continue to take it after. And yeah, he was one of them that was even telling me, you know, I’m like after the chemo, after the cancer, I’m on holiday, everybody around here are sick with virus. It was a few years ago, one year ago, not with coronavirus was just flu, but I’m the only one who’s not getting sick. So I think when we tonify the cheek and he was a chief efficiency and a yang deficiency, I also use acupuncture to tonify the lung. And also the point, his case, a lot of lung cancer can have also part of efficiency and some depression and feeling kind of associated with life and owning your documentary.

It will help them very deeply also on this quality of life issue. So, um, the only was telling me, and I’m keeping taking a LCS one, one. Now we call it protectable. And, um, I’m feeling better. This is another interesting case of a woman that I followed 17 years. Uh, she had a metastatic case of breast cancer and, uh, she takes it together with anti hormonal medicine. And as she started to take it two years ago, this was I’m following him around more many years. Uh, there’s a better quality of life. And also her sweat, hot flashes, sleep, everything got better. So she’s actually quite old by now still metastatic. And, um, it feels very well in her case. It was more the gene deficiency and the kidney deficiency also due to age and also due to anti hormonal medicine, which I reduced it even more, um, another case of a pretty static, eh, prostate cancer, metastatic prostate cancer took this formula for over two years in his case.

Also, we are trying to address the gene part of his, uh, uh, of the formula and of his constitution. So he feels less fatigue, better quality of life. He and I really heard it also from other prior patients. It says that they have back there, even their sex drive, the sex drive, which was reduced after chemo. And, uh, sometimes after the disease itself, because it kind of finds the gene and it kind of finds the vitality of the person. So when we use this in the clinic during treatment, as I gave an example, after helping to recover in maintenance, but also in patient with inactive disease. So usually a full dose, two dates in the tablets, I would use it like two tablets, three times a day, six tablets in full dose maintenance. Those usually have like three tablets a day. Health maintenance can be one or two tablets.

And people who have in active disease usually will be nine tablets. Like you can and make it five times more. If you want to think about the row. Herps because usually from five kilos of Moreau, Herb’s, we’ll do one kilo of powder here. We are actually concentrating in even more. So they’re taking quite a lot of herbs a day, uh, as far as quantity, but it’s quantity really matters. And that’s what we showed in the research. It’s time dependent and also dose dependent. So he really concentrating the formula very much just to finish up with the other research. Uh, there’s been quite an interesting research. This one came from Taiwan that, that followed up, uh, 729, uh, advanced breast constipation, and, uh, looked at mortality rate also. And the only two breast cancer patient who, uh, took, um, herbal medicine, um, and it followed them up.

And this was the most common herbs that they use because different prescription, we see, uh, the major three of them also in LCS, one, one, and the conclusion was following this patient, not patient who taking a herbal medicine, comparing to patients who are not taking that. Uh, they say the TCM may lower the risk of death in patients with advanced breast cancer. So this is a very interesting research, uh, um, prospective research, which compared this kind of population in Taiwan, taking her ups, comparing to the one that are not taking herbs. And, uh, it shows the effect or potential effect of herbs in even in, uh, in this respect. So just to finish up, I tried to do to in 30 minutes, I told you 15 years in 30 minutes, but I have to finish up with a dear mentor of mine. Um, eh, who was one of the, I think most of my inspirational people, as far as studying more the, of Chinese medicine and the depth of Chinese medicine.

And he kind of explains that by returning to the classic roots of Chinese medicine, we can make a truly significant contribution to the medicine of the future. And I think this is very true and the more we will see evidence of it, and the more we will see the, um, usage of it in the West and follow up, uh, the more human in humanity will benefit the better health. So just to say about, uh, how it looks when you do research and this, I heard from my colleague, one of the best researcher, a human first son, who is now himself fighting cancer. Uh, but I held it from his lecture. He says like, Gandy, first, they ignore you. Then they laugh at you.

Then they fight you when you get good results, but then you win. So I hope we are on the winning side. And I think Chinese medicine is gaining more and more acceptance. I know we are still not where we want to be, but I hope with more research of colleagues or research like this, we will help to create a significant change in Maine cancer care and this individual patient’s life. So I want to thank you very much. And again, to saying the American acupuncture consult for hosting me and especially in this days, uh, I would like to wish you the best of health and keep safe and all the very best for me. So thank you very much and have a good time.

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AAC 5 Ways To Quarantine-Proof Your Practice

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Hi there, Jeffrey Grossman from Acupuncture Media Works and AcuPerfect Websites. I am really glad that you are here right now. Thank you, the American Acupuncture Council for inviting me back here to do one of their live trainings for you. I appreciate that. And I appreciate what they are doing every week to bring all this information, and wisdom, and insight to the profession, to keep us going forward in these strange and weird times. For those of you that don’t know me, my name is Jeffrey Grossman, and I am the owner and creator of Acupuncture Media Works and AcuPerfect Websites, and also AcuDownloads. And I’ve been helping acupuncturists grow their practice, educate their patients, and keep their patients in care. Since 2002, I’ve been in this industry of helping practitioners. So, I’m really glad that you are here today. Today I want to talk about five ways to quarantine-proof your practice.

As you all know, these are some really strange times that we’re in and none of us expected to be here. None of us even prepared to be here. And as it stands now, we might be going through various lockdowns over the course of the next few years when things like this arise. So, I want to discuss five different ways that you can quarantine-proof your practice, that you can invest time and energy in now, so when it happens again, if it happens again, hopefully it won’t, but you will be prepared and ahead of the game. So, these are some of the things that I’ve been discussing with my mentees in my mentoring group. And I decided that this is information that would be interesting and, I think, important for the rest of you guys to hear about. So, the the first thing that is important to help quarantine-proof your practice is to learn a new skill.

Now, most of you are acupuncturists so all you really might know about is acupuncture, needling, cupping, gua sha, and all of those things that you do inside of your clinic. And they’re all powerful, and they’re all helpful. But it won’t help you to do those kinds of things in the future if you have to do telemedicine, or distance education, or if your practice has to close. So, it’s important to learn new skills that you can use and start to initiate in your practice now so you can cultivate that awareness. So you can cultivate that familiarity with these. And a couple of things that I would encourage you to think about doing is learning the EFT technique, the emotional freedom technique.

Learn how to do some tapping, learn how to do some distant healing. Also, healing with some tuning forks. Possibly, you might want to learn how to do some facial diagnosis that you could be doing over the telemedicine. Also, one of the things that’s really important is to asking better questions. Now, as an acupuncturist, we have some amazing skills as questioning is a part of our diagnostics. But when we are doing telemedicine and remote medicine, we’re going to need to really balance our diagnoses based upon asking better questions.

Also, you might want to learn how to properly share acupressure techniques with your patients. And some of you might be interested in learning about homeopathy. Now, these are all skills that you could learn now that you could be using with remote and telemedicine. You could be hosting online classes about these. You could be doing this process during your telemedicine classes. The other thing that would be really interesting for you to tap into now, during this time, is how to create and teach online classes and trainings. Now, there’s a lot of things as an acupuncturist that you could teach about. And one of the things that really drew me to this medicine back in the late 90s was that, as an acupuncturist, you’re also that of a teacher. And there are so many amazing things that you could be teaching to your patients to empower their health and to empower their wellbeing and to help support them during these times of quarantine, that are happening now and that might happen in the future.

So you could teach about acupressure points to help alleviate stress and anxiety, to improve sleep and possibly digestion. You could even teach about workplace ergonomics. A lot of people are working from home and they might not have specific ergonomics set up correctly for them. Another thing to teach about is TCM nutrition, kitchen remedies. You could teach about congee recipes. Even breathing techniques like Kundalini or Mantak Chia, the six healing sounds to transform stress into vitality, which is an amazing tool and technique that you can be sharing with your patients that help to talk about and educate about the different meridians. Each of the healing sounds that help activate each of those meridians.

Now, when you’re going to be any teaching, you could be teaching through telemedicine like using Zoom or, or you could be teaching via some specific platforms. Now, I’m going to review a couple of quick platforms here for you and you can choose and check out the ones that you might find more interesting depending upon what your needs are. There’s Teachable, there’s Teachery, there’s Thinkific, there’s Google Classroom, which is free, there’s Podia, CourseCraft and Learnworlds. Those are all specific platforms that you could be using to teach your class. One thing that you might be interested in, something that’s happening in some of my mentoring group, is some of the mentees are putting together online trainings on specific acupressure points. They’re offering them for free to their patients and then charging a small fee for access to these classes and hosting them on a platform like Teachable or Thinkific.

And the beautiful thing about these platforms is that they are an all-in-one solution. They host the videos for you. They will play the videos, you can add downloads that people can access. And also, you’ll be able to email patients through those platforms as well. So, it’s important for you, as a practitioner, to move beyond your skillset from treating inside the clinic, to moving outside into the world of tech. And I know that many practitioners are not very tech-savvy, and I get that. I totally understand it. Fortunately, I am. I’ve grown up in this world of tech and I’m very tech-savvy. And that’s why we do websites for acupuncture. That’s why we have a lot of digital online programs and trainings for acupuncturists. But I encourage you all to really cultivate that tech side of you and cultivate that side of you that is comfortable in this realm of doing online videos or online trainings, or even putting on courses for your patients.

Now when you do have any of these courses, some of them could be live, sure, that’s fine. Or they could be prerecorded, which gives you the option to edit them and perfect them as you will. The other thing that I would really encourage you to do is to diversify your income. And one of the ways to do that is to set up your online store. For those of you that have a website, there are definitely a lot of plugins that you could be employing on your website that create a shopping cart for you. So, what should you sell? Well, you could sell your own products. Many of you are gifted in creating herbal remedies or poultices or other topicals. So you could sell your own products in your website store. You could sell another practitioner’s products on your website store. You could do herbal consultations and sell herbal remedies through your online store, or even hook up with companies like Emerson Ecologics, and having a wholesale account with them and sell some of their supplements through your online store.

You could sell aromatherapy, you could sell ointments and other topicals, but I definitely want to encourage you to really diversify your income. And if you’re not already selling anything other than just acupuncture in your clinic, you should tap into adding to your income by selling other products. One way that I’ve been working with some of my clients is in helping them cultivate their herbal remedies in their clinics, helping them manage their process through doing herbal consultations through the internet, through telemedicine, and then making some recommendations. And then having people buy the herbs through their website store. Also, a lot of these stores allow you to dropship for you.

So you don’t even have to carry any product. So, when you get set up to sell some products through your website store, you could do it in a few ways. One, you can open up wholesale accounts. You could have dropshipping where the order’s made through your website, and then it is automatically dropshipped from the herbalist or the herbal company to your patients. You could also set it up where there’s an affiliate arrangement. Where, let’s say, you’re working with another practitioner. And if you sell their product, you get a small commission based upon that sale. Something to also make sure that you have, is you have a shopping cart on your website, you have an order page on your website. And if you can’t do that, the least that you could do is set up a direct link to a wholesale account for the products. And for those of you that have WordPress websites, it’s easy to embed some products on there with links that link out to other shopping carts.

Ultimately you’d want them to add the materials to a shopping cart on your website. That might be a little more robust than a lot of the websites that you guys have, but that is one way to help you quarantine-proof your practice. There’s a couple of different types of software that you could be using on the back-end to create a shopping cart. One of them that’s really great is WooCommerce, W-O-O commerce, Shopify, BigCommerce, Cart66 Cloud, and WordPress EasyCart. Those are really simple cart softwares that allow you to put and embed a shopping cart on your website very easily.

And the fourth thing that I encourage you to do during this time is to audit and improve your website visibility. So what to do? Now, during this time of quarantine, when you’re home, you might have a lot of time on your hands. And I would encourage you to take this time to audit your website. You want to check your SEO to make sure that your website is updated and that your pages and your plugins are updated on your website. You also want to make sure that you take this time to really update and modernize your design and your website. Make sure that if you are putting out new offerings on your website, like selling products, or hosting telemedicine classes, or teaching a class on acupressure, that there is an “offerings” page on your website that has those new services and offerings that you’re putting out there.

Make sure your blog is updated too. So we’ve spent three months in our homes, and it’s a good time to really focus on really upkeeping your website. There’s no excuse for your website to look like it’s five or six years old, it should be current. That’s the first place people go to when they start thinking about you and your services. Also, the other thing that you want to do is to really tap into social media marketing and promote your website, and your services, and the products that you offer on social media regularly. And make sure that you have a backlink from social media back to your website.

The other things to check while you’re doing this is to make sure that your title tags are set up correctly, your alt tags are set up correctly, and your meta tags. And one thing that I find anytime I do any type of website evaluation or an audit for a client, is that they do not have many calls to action on their website. So I encourage you that when a person hits your website, you want them to take some sort of action. You either want them to schedule with you, to pick up the phone to call you, to set up a telemedicine class with you, to sign up for your acupressure class, or to even just schedule a regular treatment with you. So you’ll need to have multiple call to action buttons on your website. The other thing to do is to make sure that you have videos on your website. Talk about videos about how became an acupuncturist.

What was your road to get you to this moment where you are right now? All right, what kinds of things can you teach your patients that can add value to their life during this time? Make sure your website is mobile-ready, make sure that you have downloadable intake forms, that on your website there is a link to the maps and the directions. Also, make sure that there is a way to capture an email address. So when people visit your website, that if they don’t schedule with you or sign up for a class that you’re hosting or download an ebook that you’re having, that there’s something that you have there that will capture their name and their information. Okay? So, for those of you that are interested, as you know, we build websites for acupuncturists. And if anybody is interested in a free website evaluation to find out what your website is missing, we have a team that is standing by to put together a checklist and go through your website absolutely free.

You can visit this link right here, which is And that will take you to a page where you can submit some information. And my team will go ahead and start conducting evaluations of your website so you can see what kinds of things that you might need to work on during this time to help you quarantine-proof your practice. So go ahead. For those of you that are interested, you can visit And you can just request a free website evaluation there. Absolutely no charge, nothing hidden around that. It’s just something that we do for our clients. And I’ve got a team that is waiting to kind of evaluate your website for you.

And then the last thing that is important for you to do is to make sure that you stay in top-of-mind awareness with your patients. So, couple of ways to do that. Well, before I say that, even though you’re not in practice right now, it’s important for you to have your patients be aware that you still exist and to let them know what you have available to help them to get well, to reduce stress, to reduce anxiety, and to just stay in top-of-mind awareness. So a few things that you should be doing is to email them regularly. I know many of you think that email is bad and that you shouldn’t be doing it, but especially during this time there is a lot of valuable information and content that you could be sharing with your patients and getting in front of them about immune health, or stress reduction, or acupressure techniques.

Another thing to do is to do some direct mail. A lot of people are home right now, and they’re still getting mail. And it’s rare for people to get anything from a healthcare provider. So you can send out a newsletter, regularly, through direct mail. Posting to your social media channels on Facebook and Instagram and Twitter will keep you in top-of-mind awareness. And also, it’s important to make calls to check in. With my coaching clients, I encourage them to make their list of their A-patients and reach out to their A-patients on a regular basis just to see how they’re doing and what’s going on, just to check in with them. Because your A-patients are patients that you love, they know you, they like you, they trust you, you have a really solid relationship with them. And you might not be in their top-of-mind awareness because they’ve got other things going on. But I think if you were to reach out with them and just to check in with them, just to see how them and their family members are doing, it would go a long way in building that trust value with you.

The other thing to do is to schedule regular times to reactivate inactive patients. And you can do this by making phone calls to inactive patients that you haven’t seen in a while. Let them know what your new offerings are. Let them know that you are offering telemedicine, let them know that you are offering some online healthcare consultations, herbal recommendations, nutritional recommendations, or whatever it is that you are offering for them. So, that’s pretty much it. That’s just a quick five ways to quarantine-proof your practice. Again, thank you to the AAC for having me being part of this.

If anyone is interested in a free evaluation, feel free to reach out to us. There will be a link that we’ll be adding here, and we’ll be responding to any comments that you have with regards to wanting a free evaluation. But I just want to encourage you to stay strong and to carry on. These are some strange times, none of us have ever predicted this to be here, but don’t just stagnate and sit there and freeze up and not do anything. You still have a business to run. You still have to generate some type of an income. And there are numerous ways for you to do that, that I covered in today’s training. So, thank you very much for joining me here today. Join us next week when Yair Maimon is going to be joining us on the AAC’s live training. So, if you have any comments, questions, please post them below this video. And I will be sure to respond to them. Take care, stay strong, stay healthy, and we’ll talk soon. Bye-bye.

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Michelle Gellis Thumb

AAC – Treating Cosmetic and Neuromuscular Facial Conditions with Facial Motor Points

Click here to download the transcript.

Click here to download the slides.

Hi, everyone. Welcome this afternoon. I want to thank the American Acupuncture Council for this opportunity to present on treating the face with facial motor points, and I appreciate everyone coming out in the middle of their afternoon or evening or early morning, depending on where you are. If we can go to the slides, little bit about myself, my name’s Michelle Gellis, and I teach cosmetic and neuromuscular facial classes, facial acupuncture classes, internationally. This is a picture of me teaching a class about a year ago in Maryland. What I wanted to talk about today were a couple of things that work with both cosmetic and neuromuscular facial conditions, but before I did that, I did want to talk a little bit about facial acupuncture in general.

When we use the term facial acupuncture, we are talking about a very large topic, so it encompasses anything having to do with a person’s appearance and/or a function of their face so things like wrinkles and sagging skin, and also neuromuscular facial conditions like Bell’s palsy, TMJ, trigeminal neuralgia, stroke, ptosis, and many other facial conditions. Facial acupuncture is actually the largest growing subspecialty in acupuncture right now and so getting trained is something I’m going to talk about in a moment, but it is very important if you are going to specialize.

Facial hair acupuncture can include everything from just needling to using facial cups, gua sha, or doing microneedling on the face, and facial acupuncture is not some new and trendy thing that the Kardashians are doing on social media. Yes, they are and it is really something that has been around a very long time. When they found the emperor and the empresses in their tombs, they had jade gua sha tools and there are records dating back to the Sung Dynasty and even before that of people talking about facial acupuncture throughout history. I have written two publications for the Journal of Chinese Medicine. I’ve written many publications, but to specifically of interest, one is on treating neuromuscular facial conditions with more of a multifaceted approach.

Today we’re going to be speaking about facial motor points, and this is part of a multifaceted approach to treating the face. I’m a classically trained 5-element acupuncturist. I have been teaching at the Maryland University of Integrative Health, formerly the Tai Sophia Institute since 2003, and my second publication was on the importance of clearing energetic blocks prior to doing any facial acupuncture, and links to both of these can be found on my website As I mentioned, there have been quite a few studies on facial acupuncture. I’ve listed a few here, and some of them are pertaining to the cosmetic effects and some of these are pertaining to more of the functionality of the face.

These slides will be available on the AAC site and when I teach my classes, I go over these in a little more detail, but I just wanted to let you see that there actually has been researched done on facial acupuncture. When you’re thinking about your practice and how facial acupuncture can fit in, if you’re just looking at the cosmetic aspects, it’s great because you’re not dealing with insurance. It’s a very reliable stream of cash income. Again, you’re not dealing with insurance. You don’t have to bill the insurance companies, and one thing that we’ve learned during this pandemic is just how much people depend on having other people take care of them for their appearance, and people will spend money on vanity before they will spend money on their health.

If you think about some of the signs, the protest signs for things to open up, they were, “I want to get my haircut. I want to get my nails done.” No one was saying, “I want to go see my doctor or my dentist.” People do spend money on vanity and also, if you learn the neuromuscular foundations of a lot of this, it can open your scope of practice. You can see patients or patients will seek you out because you have this subspecialty or someone who will be known for being able to work on the face. A lot of us, we go to acupuncture school where we don’t spend a lot of time needling the face. We’re not comfortable with it. We didn’t really focus on learning those points.

It opened your scope of practice, will give you a very unique skillset. These are some pictures of me doing some microneedling in a class and some facial gua sha. That’s the benefits for you, for your patients done correctly. A facial acupuncture treatment should include body points and should bring chi and blood to the face, to the muscles, to the skin. Facial acupuncture because it is a full body treatment helps with digestion, immunity, circulation, and all of these things. Everything shows up right here, and it will carry nutrients to your cells and by doing that, it helps to stimulate collagen and elastin production.

Also if you’re using intradermal needles, which are very small needles which require some specialized training to be very effective, it will actually stimulate collagen and elastin production. Again, for your patients, if your patients is having any sort of… This patient of mine had ptosis where one eyelid was lower than the other. You could see her eyelid on our right, but her left was lower than her other eyelid, and she was getting married. She was very self-conscious about it and through treatment, I was able to get the levator muscle to function better and help so that her eyelids were even. On a more cosmetic level, people that have rosacea, facial acupuncture treats the hormones.

We do hormonal points if that’s an issue, and it can help with different skin conditions. This was a student of mine in one of my classes and just during the course of class, I worked on one side of her face and she had a rosacea, and you can see how the rosacea cleared after I had done the facial cupping. People asked me all the time, does facial acupuncture work, and these are just a few of my before and after photos. This person up in the center and the top, she had a scar right in her nasolabial fold and through treatment, the scar softened and ultimately, dissipated.

This person down here in the center, had some dark spots and again, through treatment and some intradermal needles through microneedling and I also work a bit in my classes with skincare, with skincare, I was able to really help her to get some of those dark spots to disappear. This other patient here had a tremendous amount of modeling in her chin, a lot of wrinkling and the corners of her mouth were very much turned down. As you can see in the bottom picture here on her left on our right, that the corners of her mouth, instead of being turned down, they were starting to lift up. With her, I definitely used some motor points, which is the topic of today’s conversation.

Again, another patient. This was actually someone who’d been coming to me for years with wrist pain, elbow pain, shoulder pain on and off. She saw that I specialize in cosmetic acupuncture and she was concerned because she was having some asymmetry where her one brow and lid was coming down a little more than the other. I said, “Just get on the table,” and I treated the left side, and the difference was remarkable just from one treatment. Again, I used motor points in that treatment. Getting trained is important. The American Acupuncture Council does require that if you are doing cosmetic acupuncture, that you get trained by one of their certified providers, and I am one of the few people on their list of people who do training.

The reason for that is because there is special documentation, there are precautions, there are red flags and you really need to prescreen your patients for different contraindications. If someone hasn’t been screened properly and you are doing cosmetic acupuncture, you can bring on things like headaches. If they are prone to high blood pressure, it can raise their blood pressure, and many other things. The other part about training is, as you can see, there are 43 muscles in the face. Many of them are very small and when you’re working with the musculature of the face, you really need to know what you’re doing so that you don’t cause asymmetry, overstimulate a muscle or the nerves and the blood vessels, the capillaries on the face.

Some of them are very close to the surface, and really knowing where they are and how to prevent bruising is important. I’ve made a list of some of the neuromuscular facial conditions that I see most often in my practice. When someone within a 20- to 30-mile radius of where I live is looking up acupuncture for one of these conditions, I’m going to come up because this is something I specialize in. Again, specializing in facial acupuncture can be very beneficial for your practice and when I’m treating any of these conditions, of course, I will treat the underlying condition and I do use a multifaceted approach. Meaning, I use some submuscular needling and facial cupping, some gua sha, some scalp acupuncture, but motor points are a big part of treating neuromuscular facial conditions.

Also when we’re working strictly with cosmetic conditions, if you think about our emotions and how they manifest on the face, really understanding each one of the emotions, either from a 5-element perspective or just from a TCM perspective, how these organs being out of balance, what kind of wrinkles that might cause on the face. Using some of the motor points to really as reset switches, and we’ll talk about that in a second, can really help with things like hooded eyelids, the frown lines, crow’s feet and Bell’s palsy. I found these pictures in a book for artists or sculptors. They are artists, but I love them because they show a face at rest and then four different emotions, which of the facial muscles are used.

As we age, these muscles become not as functional as when we get older. Now some of them get overused, some of them don’t work as well. Some of the muscles that we overuse are going to end up causing lines and sometimes early sagginess on our face. You can see here when someone is showing rage, just how many different muscles are involved, and the same thing with joy. Motor points are something that were discovered actually quite a long time ago. Medical doctors have used them. I found an old medical text, and they were using motor points with hypodermic needles and stimulating them. I’ve listed some of the researchers, some of the people that have done a lot of work in the motor point world and what a motor point is, it’s the most electrically excitable part of the muscle.

When you find the motor point, you can stimulate it, and it is where the motor nerve bundle is… The nerve is actually attached into the muscle. Fortunately for us, many of them are acupuncture points. We don’t have to have a deep knowledge of anatomy in order to find them because we have the acupuncture points as reference points. If a muscle is too flacid, it’s not firing properly and if it’s too tense, it’s not firing properly. By stimulating the motor point, you are helping the muscle to function properly, whether it’s to relax or to get back to doing its job that it should be doing. As I mentioned, many motor points are also acupuncture points, but they are not trigger points or ashi points.

A trigger point is really a sore spot and you press on it or you needle it, and it feels good. It could be like a knot, but motor points are different, and there are motor points on the face. All of them are innervated by the seventh cranial nerve, except for the temporalis and the masseter, and those are innervated by the trigeminal nerve. In order to figure out which motor point you should use, if you looked at those other drawings, there’s arrows going in every direction. You have to understand what the functions of the different 43 facial muscles are.

When I teach my neuromuscular class or I have an advanced cosmetic class, I go through every single one of the emotions or every single one of the issues that might come up with a particular, if someone had Bell’s palsy and which motor point to use, but we are going to talk about a couple of them today. Normally, you just needle straight in or slightly at a slight oblique angle, and you want a needle into the muscle, but not through the muscle. I think I just did this slide this morning. I think this is all of the facial motor points. I’ve got one dot for each. I got a little crowded on one side, so I put some on the other side.

As you can see, there are quite a few facial motor points, and then there are others for the platysma and for the temporalis and also for the SCM, but I don’t have those marked out on here. Let’s talk about a couple, and the first two would be the procerus and the corrugator, and they give you the angry eyes or the frown lines. Here’s the corrugator muscle and the motor point. This brings your eyebrows together. It works in conjunction with the procerus, which is right here, but for the corrugator, the motor point is just lateral to bladder two. For the procerus the motor point is actually Yintang, so it’s easy to find. Again, these two muscles work together to bring the eyebrows together.

Another muscle group is the frontalis, which helps to raise your eyebrows, like if you’re surprised or inquisitive. For each wrinkle just about, there is an underlying emotion and it’s a topic for a whole nother conversation, but I just wanted to bring that up. I could talk about this for six hours so I’m trying to squeeze everything in in a half an hour as much as I can so. The frontalis again causes these horizontal wrinkles. The frontalis is two muscles right here and the motor point is gallbladder 14, and I have a little video. I had needle this on a patient and just stimulated it. You could see that her issue was a drooping eyelid on one side, and the frontalis is connected to your eyebrows so I had needled that.

As you can see, it really woke the muscle up. The orbicularis oculi is something that can be affected if a person has Bell’s palsy or a stroke, and the way you would test for it, can the person close their eyes and open their eyes. From a strictly cosmetic point of view, it is involved and these are called crow’s feet. Here is where the orbicularis oculi is, and there’s two motor points. One is between Qiuhou 23 and gallbladder one, and the other one is the extra point right here, which is more or less between stomach two and gallbladder one. Another motor point and this is something that is important for pursing your lips, bringing your top lip up.

If someone had some sort of paralysis around their mouth, if they put their lips together and they blew out, air would come out. If you or I did it, it would come out evenly, or it wouldn’t come out at all, but if someone had paralysis on one side, the air would only come out on the weak side, and it can also cause lip wrinkles. You can see a picture right here of how all of this works, and the name of the muscle is the mentalis. It makes your lip go down. There’s actually three different muscles that are involved in getting your bottom lip up to your top lip, but it can cause wrinkles on your lower chin and wrinkles all around the lips, and here is a video.

I had a student in class who had had Bell’s palsy years ago, and she said she still could not close her lips completely. I went ahead and needled the mentalis, and I noticed immediately that the muscle started twitching. I stimulated it, and you can see what happens. This was a muscle that wasn’t functioning at all. One of the things that comes up right now during this time, we’re in the middle of a pandemic, and our patients should be wearing masks in our treatment room. There was a lot of questions that have come up. I teach my classes now via livestream webinar, and my students have asked, “Well, how am I going to do my job?” Well, I just started back to work last week, and I gave a lot of thought to I can certainly protect myself, but I want to keep my treatment space protected as well.

The first thing I did was I took a box of surgical masks, and I did a little video. If you go to my Facebook group, I have a Facebook group. It’s called facial acupuncture, or my Instagram is also facial acupuncture. If you go to either one of these, you will see I have hundreds of short demonstration videos, articles and this was I think last week. I just took a surgical mask and so anyway, I have a demo video of how I made this, but I just took a regular surgical mask, cut the elastic, folded it. I use some hemming tape, like seamstress might use, or you might use if you wanted to hem your pants without the needle and thread. I just use the tape on the inside, and then I just reattached the elastic.

You can see the front and the back, and this wasn’t the best version. This was a version that I did. I hadn’t tucked the sides in, but other than LI20 and right around the top and bottom of my lip, if someone is wearing this mask, you can get to their entire face and neck. If they were to cough or sneeze or whatever, it’s still contained under a mask which works. I used one six times last week and I just give it to my patients, and then throw it out. Surgical masks are easy enough to get on Amazon right now. They’re inexpensive too. The next level that I’m working on, I saw this idea on the right, which was designed for aestheticians, and it’s a lucite box. I actually ordered one, but for my purposes, it was too open.

I was concerned that it was just too open, so I’ve actually been working with the manufacturer. I have designed this box on the left. I don’t have a photo of it, until I let them know how many I want. I’m not going to be selling these for profit. I’m going to probably order five or 10 or a hundred, and then just have them shipped to acupuncturists, so they can safely treat their patient’s face. Your patient’s head would go here. There’s holes for your arm. It’s very high up. It’s 15 inches, so your patient doesn’t feel claustrophobic, and I angled this part. When you’re sitting and working on their face, you can lean over and get a little closer. The little dots here, these boxes are actually collapsible.

When it comes in the mail, it’s whatever five pieces, and then you just put it together, and that way you can take it apart if you’re traveling or if you just want to store it, you don’t need it, but it was my extra level of sneeze guarding because a large part of my practice is treating people’s faces. That is my very quick talk on facial motor points, and I am going to open it up for questions. Alan, if you’re there, I don’t know what to do with my slides while we’re doing questions though. I see. Something in the chat box, leave the slides. Okay. I left the slides. No questions. Yeah. If you have questions, you can put them in the comments, and I will answer them later.

If you have questions afterwards, you can just put them in the comments and I can answer them. Okay. Thank you again for tuning in, and you can visit my website, There’s information about my livestream and my recorded webinars, and I want to thank the American Acupuncture Council again for giving me this opportunity. Thank you so much.

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Poney Chiang Thumb

Strategies for post-COVID-19 infection associated neurological dysfunctions

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Click here to download the slides.

Hi, welcome to this week’s live show brought to you by American Acupuncture Council. I’m your host for today, Poney Chiang, coming to you from Toronto Canada. I’m a continuing education provider, and if you’d like more information about me, you can find it on the title slide.

Today, I’m going to talk to you about strategies for dealing with neurological complications and neurological symptoms as a direct result of patients that have unfortunately been afflicted with COVID-19. And there’s actually a growing amount of literature in this area and since my interest and expertise in the area of neurology and acupuncture, naturally this is a area that I’m very passionate about. So I’d like to show you some of the readings and research and strategies that are applied in my own clinic.

The first paper that we’re going to look at comes to us directly from [Wuhan 00:01:43]. This paper was published in just March, and it is a retrospective observational study conducted from three different centers. So these patients were tested positive for COVID in the month of January and February this year, and there were a total of 200 plus patients. And they were all assessed by neurologists, and their neurological manifestations were categorized into three different subtypes.

The first type is called the central type, and the central nervous system type gives you symptoms such as headache, impaired consciousness, if you can have an acute cerebrovascular disease, that’s another word for stroke, and you can have ataxia and seizures. The second type of classification is peripheral nervous system symptoms. And the most famous one that you may have already heard about is lack of smell or lack of taste. And sometimes there can be vision-related impairment as well. The third type of dysfunction is have to do with skeletal muscle injury. So patients would complain about pain. Those of us that know people who have been infected with COVID will tell you it’s like a flu like none other. You’re just hit with it. Your entire body hurts. I even had a friend tell me that it feels like shards of glass in his joints. That’s how painful it is. Okay?

So those are the three main neurological classifications. And as I said, this is a study of 214 people. And what the research found was that 36% of these patients all exhibited neurological symptoms. And what was interesting is that those with more severe infections, defined by having more poor respiratory status, which was in this case 41% of the patients in this study, they were more likely to develop neurological problems. So somehow, the harder you’re being hit by this disease, the more likely you’re going to have neurological symptoms. Just so you have a breakdown of roughly the proportions of the three different classifications I mentioned, about 25% of these patients had central nervous system symptoms. About 10% of the patients had peripheral nervous system symptoms, and another 10% or so have muscular skeletal symptoms. So, you can see why this is something that we as acupuncturists should be aware of because oftentimes patients with CMS and peripheral nervous and now of course muscle-related problems, want to come to us for support.

Of the central nervous system symptoms, the most common ones were headache and dizziness. Whereas, in the group for the peripheral nervous system, the most common symptoms were impaired taste, which is called dysgeusia, and impaired smell which is anosmia. And a patient who had muscle injury as compared to those who had no muscular pain symptoms, were found to have higher C-reactive protein levels and higher D-dimer levels. C-reactive protein is a marker for systemic inflammation in the body. So, patients who had more inflammation in the body was more likely to have muscle pain. And D-dimers is a breakdown product that the body makes when blood clots have been broken down, which is indirectly a measure of how much coagulation there is in the body.

So in other words, those with more coagulation, think in terms of [T-blastocysts 00:05:26] and TCM, those with C-reactive protein, indicative inflammation, thinking in terms of blood heat in TCM. These patients are far more likely to develop muscle injury related symptoms. Now, I want to emphasize that neurological symptoms is not just limited to the central nervous system. We mentioned it’s the peripheral and there’s the musculoskeletal. So I don’t want you to have an impression that show COVID patients are more, are oft being afflicted with strokes. Okay? That was the picture that was being passed around in the early stages when we didn’t know what was happening. But now we’re seeing, it seems to be that they are more likely to develop central nervous system symptoms, such as acute cerebrovascular disease like stroke, but it’s not the entire spectrum of neurological symptomologies that these COVID patients have.

So, as an example, in the Wuhan study, there are six patients out of only 200, only six patients out of 214 had acute cerebrovascular disease. And two of them actually arrived at the ER with sudden hemiplegia, paralysis, weakness of one side of the body, but they did not have many COVID symptoms. That is to say, no fever, no cough, no anorexia, no diarrhea. And they were only found to be suspected of having COVID from CT scans of the lung that found there’s some lesions. And then they were subsequently tested with PCR based assays to confirm that they had indeed were infected with COVID. So this is important because one, we need to realize that patients may never have gone to the hospital because they’re afraid of going to the hospital because they were going to get COVID, you can contract COVID in a hospital, they may have neurological symptoms and they will go to the community for care, even though they are positive and not because they’re, but being asymptomatic positive.

Another interesting finding was that some patients that did present with fever and headache were presented to neurologic ward in Wuhan, and they were initially positive-negative. So either their viral titers were high enough to be detected by the assays, or it was a false negative. And then only when the symptoms really started come on like coughs, and the dyspnea, then they were retest [inaudible 00:08:00] found to be positive. So that’s important to keep in mind as conditions that we need to be aware of. Possibly the patient come to us with neurological symptoms, but may actually be symptom negative, but in fact positive COVID patients.

So in summary, from this paper, they found that all the patients that had neurological problems, tend to have lower lymphocyte counts, white blood cell counts, which is indicative of some level of immunosuppression, and therefore, they are more likely, for mechanisms that scientists are still starting to study, more likely to be afflicted with central nervous system symptoms.

And now patients who have more severe infections, meaning worse outcomes with their respiratory integrity, have higher D-dimer levels. That, again, it’s a measure of how much coagulation there was in the patient’s body, and this can explain why those with more severe infection, meaning more worse lung function, having more D-dimers, are they more likely to develop occlusion or clot-type of strokes.

[inaudible 00:09:16] reminder that the authors of this paper wanted to show us is that… I put this in red, in quotation, that during the epidemical period of COVID-19, when seeing patients with neurological manifestations, physicians should consider the COVID-19 infection as a differential diagnosis. You want to avoid the late diagnosis or misdiagnosing and prevention of transmission. So this is an important wisdom for all of us to take to heart as practices start to open and you’re seeing patients with neurological issues. You might want to gently remind them to go get tested, because it’s possibly that they could be positive and just be asymptomatic.

Now, a group in Spain replicated this type of study, but this time with a larger n size of 841 patients, and this time around with a larger sample size, they actually found that close to 60% of COVID-positive patients now presented with neurological symptoms. And this was data collected across two different institutions.

And Harvard, okay, I don’t want to be an alumnus, not all neurological symptoms associated with COVID are struck. If you look at these numbers here, only 11 out of 840 actually presented with ischemic stroke and three presented with hemorrhagic stroke. So that’s only 14 out of 840.

The mean time of occurrence was approximately 10 days after the development of the COVID symptoms. So they started having stroke 10 days later after personally having a cough, [inaudible 00:11:07] a fever and as such. And again, there was a very strong correlation between those that who had the stroke, in other words, the cerebrovascular disease, and those with higher D-dimer levels, meaning that’s the byproduct of the breakdown [inaudible 00:11:23] in the body. So in other words, no surprise, more [inaudible 00:11:26] in their body, more likely to have a stroke presentation.

Now on this side, we’re looking at a paper published in Germany, and this paper was a attempt to summarizing the amount of ischemic stroke that was being seen in patients with the COVID from three different countries. As in first column you can see from the United States, second column from China.

So this China column is actually the paper I just presented from Wuhan. And then another paper, which I’m not presenting today, is of n size of 206 from Singapore. And what I wish to point out, is that you can see the number of people having strokes in relation to the total [inaudible 00:12:22] positive number of COVID patients. It’s relatively small. Now they all have associated risk factors that we know of: have they been hypertensive, being obese, be having diabetes mellitus. These are predisposed youth to more higher incidents or infection in this diseases.

And what these researchers have found was that, in the overall picture, if you look at the type of stroke, that the patients are having, there is a preference or a more heavily weighted manifestation of large artery occlusions in contrast to small vessel types, in contrast to blockages in their heart or cardiac embolisms. Okay.

So even though the number of strokes that COVID patients have is not very high, and it really depends on the severity of the infection, it depends on how much D-dimers they have, if they were to get a stroke, based on the limited amount of data we have to date, it appears that there is a preponderance towards large artery occlusion type. And now let’s take a look at the outcome of these patients.

In China, of the 11 people that had stroke-related presentations, four of them died. In Singapore of the five people, three of them died. In the United States, none of them died, and they were then subsequently sent to ICU stroke units we have, or went to go home. So we can potentially, as acupuncture, be seeing these patients that are being sent back to the community for rehabilitation purposes.

Now, I want to talk a little bit more about this large party ischemic stroke. This paper that was talking about the five people from the United States is summarized in this tabulated form in the next slide. So this is a paper that was published in “The New England Journal of Medicine”. And this is physicians in New York were noticing that, “Wait a minute, young people are getting strokes. This is not expected.” So if you look at the first row, you can see the patients one through five. These are patients that are under the fifties. Most of them actually in their thirties or early forties. Young people should not be getting stroke. So even though I said repeatedly, that strokes are not the most predominant type of neurological symptoms in patients with COVID, it is kind of sad and devastating that these can affect young people. And not all of them had the risk factors we talked about, such as hypertension and diabetes. Look at the second, third row here.

Medical history and risk factors for stroke, there was none, these people had none, undiagnosed … One of them has undiagnosed diabetes and some of them have hypertension, but some people had no symptoms whatsoever. A lot of them weren’t even on any medication. So relatively healthy people, young people can get this.

So another thing I wanted to bring to your attention, is look at the symptoms that these patients present. So they present with hemiplegia, loss of consciousness. They can have difficulty speaking, or they can have altered sensation. They can have something called gaze preference, issues to do with the eyes, we’re going to go … and also hemianopia, which is also a vision [inaudible 00:16:47] symptom. We’re going to talk a little bit more about the visual aspect of stroke and have some strategies you can deal with that in the upcoming slides.

If you look at the vascular territory, the ones that the strokes involve, you’ll see that it is affecting the internal carotid, infecting the middle cerebral artery. Most of them are affecting middle cerebral artery with one exception here, here is affecting posterior cerebral artery. I’m going to also talk a lot about that. It means that patient that have stroke, these large vessel type of strokes, tend to be getting it in the internal carotid and its derivative, such as the middle cerebral artery.

Let’s look at the symptoms of these patients. So some patients have cough, headache and chills in the first column, patient one. Patient two has no symptoms. Patient three had no symptoms. Patient four was tired, that’s it. Other than that, no fever, no cough. I want to just stress upon you, maybe you want to take this into consideration when you screen patients, whether you accept these type of patients in your clinic or not. If somebody comes in with neurological symptoms needing help and this developed in the last two, three months, it could very possibly be asymptomatic COVID patients who’ve had this, and they’ve never had a reason to go get tested because they had no symptoms. So it’s up to you whether you want to open up your clinic to help these type of patients, or maybe request they’re tested before that you’re able to help them, et cetera.

So a little bit more about this large occlusion, artery type of occlusion. What is it exactly? [inaudible 00:18:40] saw some embolization of atherosclerotic debris. So if you think about plaques inside your blood vessel and embolization means these plaques have become free, dislodged. Usually they originated from the common or internal carotid artery in your neck, the common carotid artery divides into internal, external. I’m going to show you some pictures about that in a moment. Sometimes it can actually come from the heart itself, the vessels of the heart and they become dislodged. The large vessel ischemic strokes that develop are most likely to affect the medial cerebral artery territory.

In other words, the symptoms, the neurological symptoms the patients are going to manifest, are going to be whichever part of the cortex that the medial cerebral artery supplies. So this is why it’s important to know the anatomy, knowing which part of the vessels are more likely to be affected in COVID stroke type of patients, we can then predict what is the most likely type of symptoms or neurological dysfunctions that this patient going to have based on the vascularization of relevant function area, corresponding function areas in the brain.

So this is just a quick review of the circulation of the brain. What you see here in the center is the circle of Willis that we all learn about in school. What I love about this slide is that they color coded it as such that in purple, I’ll call the posterior circulation, and it’s called posterior circulation because comes from the vertebral artery in the back. If you look at the patient on the right side over here, VA stands for vertebral artery. Whereas the green shade, called the interior circulation, which subsequently divided into anterior cerebral and medial cerebral, also, ICS stands for internal carotid artery. These green ones come from … so you’ve color coded over here, comes from the carotid, common carotid artery, which divides into ECA, CCA is the common carotid artery, which divides into ECA for external carotid artery, this goes round the face, outside your skull and then the internal carotid artery, which as you can see is now green, and then goes into the brain and divides into enter in medial carotid artery.

So here is the picture of the internal carotid artery label over here, this big one over here in green, the biggest one, the biggest cross-section green. You can see it divides into anterior … the anterior cerebral artery, ACA over here. Then going left and right laterally, this one here is the middle cerebral artery.

So patients are most likely to have clots in here before the division, or somewhere in the neck here. Or after the internal carotid has bifurcated into the middle cerebral artery, you can have occlusions in the middle cerebral artery.

So now we’re going to take a look at where the middle cerebral artery supplies. So this is a very nice picture that shows you in a color coded manner different areas of the brain compartmentalized, based on its source of vascularization. So on the bottom here, you can see A, this is turquoise color, A part. These all supply the interior cerebral artery, it’s not relevant to our discussion. All the P part, all the red parts are all supplied by the posterior circulation. That’s also not relevant to what we’re talking about here. All the yellow ones, labeled N, shows us where the middle cerebral artery supplies.

So as you can see, it supplies a large portion of the lateral surface of the cortex, both the frontal, the parietal, and even the temporal lobe. So it is a very important area. If you look at the cross-section over here, you can see here’s the internal carotid artery and it divides into … this tiny little guy here is the anterior cerebral artery, and then it divides into common carotid artery. So patients with COVID are most likely having large vessel strokes, what that means is that most likely cause is in here before bifurcation, or in here in the middle cerebral artery. Why is it not in the interior? Because the interior is small. So therefore it doesn’t qualify as the large vessel type.

Now, as you can see, the middle cerebral artery then divides and wraps upwards to cover the parietal lobes and wraps downwards here to cover that the temporary lobes. So here’s a side view of this side here, very beautiful picture, I love this picture. You can see that if the occlusion is happening in the common carotid or middle cerebral, then all of these [inaudible 00:23:49] are going to be shut off. That means all the neuro cortical areas that are in this region are going to be hypoxic, and therefore going to go show [inaudible 00:24:00]

Now what’s in this area. If you remember your scalp acupuncture, there is the sensory line, the motor line, and that’s in relation to the central sulcus. So, where is the central sulcus? The central socket is in here. Okay. There’s just most promise sulcus over here. So interior that to the motor [inaudible 00:24:23], that is a somato sensory. So this means that somebody who suffers with a middle cerebral artery stroke is going to have sensory and motor dysfunction.

Okay. And even though the medial part, which is the blue “A” part, this is the region that’s more where the lower extremities are located, even though it is not part of the middle cerebral artery distribution, there is some overlap. So you can still expect patients to have lower extremity problems. And I’m of course, referring to the homonculus map, along the central sulcus, where if you recall the medial one-fifth is supposed to be the lower extremity, the middle two-fifth would be the upper extremity, and the lateral one-fifth would be the face.

So let’s approximate that on the picture here on the top right, in this area over here would probably be the lower extremity around here. Around here, would be the upper extremity. And when you get down to the park, closer to the Sylvian fissure over here, which separates the parietal lobe and the temporal lobe, you’re going to get closer to the facial areas. So these patients can obviously expect facial drooping, facial motor deficit, upper extremity, and to some extent, low extremity also.

Now I’m going to take a little segue now and talk about what other things are involved other than just the occlusion. There’s something that is called SIC, which stands for Sepsis Induced Coagulopathy. So this means it is a coagulation of blood clot that’s induced by having a bloodborne infection. So scientists now know how the virus gets into our bodies, through a type of receptor and uncertain cells called ACE2 receptors. “ACE” stands for Angiotensin Converting Enzyme. And these type of cells I’ve found on lung cells. So no surprise COVID is primarily an upper respiratory airway disease. It’s found in the small intestine. So perhaps this can explain why some patients have gastrointestinal symptoms with this disease. It’s found in endothelial cells, meaning these are the lining cells of your blood vessels in the dyadic system.

So now we can see how this actually can attack the vascular system and lead to severe vascular events. And it’s found in smooth muscles in the brain. So no wonder people can develop neurological central member system symptoms as a result of this infection. Now I’m no expert on the complicated receptor cascade that regulates the inflammation and coagulation in the body. So I’ll just summarize it for you: it’s two types of receptors are known to activate cardio-protected or neuro-protected effects inside the body. Now, when COVID-19 infects us through ACE2 receptors, it depletes the receptors. Meaning whichever function that these receptors are supposed to do physiologically can no longer be accessed. So what this means is that our body is in a less, or more compromised cardio-protected in your particular state, leaving us one type of receptor to act unopposed thinking about Yin and Yang regulation.

So what is one activating? A swine type of receptor, ultimately results in cascades, sickening cascades, that activate genes that lead to inflammation, and coagulation, and even hypertension’s that embody. So, as the cognition is not bad enough, now you have high blood pressure – you’re more likely to cause a stroke, right? So it is because this virus has the taste for these two receptors that is supposed to be neuroprotective for us. But, as a consequence of these receptors being also found in the brain, it’s a double whammy. You are now set up for inflammatory and coagulatory disaster.

Now scientists are proposing different ideas of how this lead to damage to the brain. We now know that there is more inflammation in the body, because of the unopposed ACE1 cascades inside the body. But what that inflammation does, is that it can actually lead to damage, or breakdown of the blood brain barrier. So the bumping barrier is a very delicate piece of barrier inside our body. And if it is broken down because of inflammation, that spells doom. What happens is then the inflammatory cytokines in your body, now can cross the blood brain barrier, and reach the central nervous system. So it’s, it’s just bad on top of that. You may have heard about cytokine storms that happen in this patient is actually your body’s immune response. That is hyper immunity response towards the virus that is actually causing damage to tissues and organs that certainly can also affect the brain now ,because it’s got causing breakdown of the blood brain barrier.

So I think that’s really interesting information about the neuro-physiological mechanism. How this virus affects us and it gives us a epidemiological appreciation of how this disease can manifest in neurological ways. Now I’m going to share with you some of my ideas about how we can help these type of patients using areas in my research that I’ve done about the peripheral nervous system and the [inaudible 00:30:54] system. This is a map called a Brahman area map where the different processes of the brain had been compartmentalized based on different functions. I showed that here, just as a quick reference for you, because in my upcoming slides, I will be talking a little bit about some of these areas.

So one of the most common peripheral nervous system functions was Anosmia, which is loss of smell and Ageusia, or hypergeusia, which is loss of taste. So how can we possibly help patients with this? First of all, we need to say the [inaudible 00:31:38] nerve one, which is our olefactory nerve, is way deep inside the brain. It’s not accessible. And unfortunately the olfactory cortex is also not accessible. It’s not posting up to the surface in the brain for us to be able to affect it through scalp cap acupuncture. If you go back to the previous slide, you’ll see that olfactory is a dark orange. The dark orange is actually area 34.

Okay, so if you see this, this is actually in the midline. This is the lateral surface, this is the midline. So it’s actually on the inside of the temporal lobe. It’s not accessible, to too far in for acupuncture, [inaudible 00:32:11] . So what can we do? Fortunately, we have points that have been passed down that are supposed to have some effect on the nose and sense of smell. That’s over, located on the midline of the scalp. But let’s take a look at the new anatomy and see if it actually makes sense based on what we know about the new anatomy of the nerve supply for the nose. I want to talk about the anterior ethmoid nerve, which is actually from the opthalmic division V one of cranial nerve five. And, let’s take a look at that.

So, anterior ethmoid nerve, here’s the ganglion of the trigeminal nerve and there’s, there’s your V one, V two and V three. So as part of the V one, you have this nerve here that branches into the posterior ethmoid, anterior ethmoid, see how it goes and makes it a little hole in the foramen, in the back of the eyes. So from here, it goes into the cranial vault. I’m going to give you a different view at the next slide here.

So it comes out of these foramens over here and these nerves actually supply the meninges. So here’s the interior meningial branches and anterior ethmoid nerve, that supplies the meninges. But, because this cross section is horizontal, you don’t appreciate how high up this innovation goes. So this next picture shows you that the opthalmic division of V one and specifically the anterior ethmoid nerve, innovate this bony membrane called the falx cerebri along the midline.

And, it gives credence to the notion that these points that have been passed down to us, global area 20, all the way to 23, 24, which is on the midline, or which is innovated by the anterior ethmoid nerve, can possibly affect this nerve. So, what’s the big deal about affecting these nerves? Well, this anterior ethmoid nerve not only just innovates the meniges, these same nerves or branches now innovate the nasal cavity and septum. So as you can see here, the anterior ethmoid nerve, after it innovates the meninges up here, comes very close to the olfactory ball, by the way. So, we don’t currently don’t have permission to confirm this, but normally what we know about the nervous system, oftentimes there are communication branches that might be able to affect the cranial nerve of one olfactory nerve.

But, even if it doesn’t, this nerve, has an external branch that goes outside the [inaudible 00:34:59] of skin, but an internal branch that innovates the septum and also the nasal cavity. So this nerve gets information about the amount of mucus or dryness there is in the nasal cavity, and, presumably, your nervous system can regulate the amount of moisture in your cavity. And, we know that dry nose is related to, mucus member is needed, moisture is needed for fragrance particles to adhere, and therefore more likely for us to detect the smell. Perhaps by modifying the internal conditions of the nasal cavity, even though we’re not affecting the cranial nerve one directly, we are making it more favorable for the cranial nerve one to actually be able to detect smells and fragrances. I thought it was pretty crazy that these points that we learned on the anterior aspect of the midline of the scalp, to do with the nose, actually has hard cranial nerve-related explanations for how they can affect the nose.

Now, a couple of case. The gustatory cortex is something that is accessible. So, the gustatory cortex is actually Brodmann area 43. It’s a tiny, tiny little area, basically at the junction of the Sylvian fissure and the central sulcus. So you can see here, this part here is the central sulcus. So, anterior to that is a motor, posterior is a motor sensory. If you continue all the way down, where the motor sensory and the temporary lobe meets, that’s Brodmann area 43, which is the gustatory cortex.

And, based on the MRI research that I’ve done, and talked about it elsewhere, we have a chance to affect this area, but it requires a special needle technique, called a cross threading technique, where you would thread down from global area five and thread anteriorly from global area six, and that will allow you to cross intersect of over Brodmann area 43, which is a gustatory cortex. So if you’ve reviewed the vascularization of the middle cerebral artery, and with the parts that it affects, you can see why it would affect the taste, because that’s the gustatory area is part of the middle cerebral artery domain. And, therefore can explain why patients with COVID may have loss of taste, if they developed central nervous system type of symptoms.

Now, another way we can possibly affect the taste is using nerves called lingual nerves. And, these lingual nerves ara a branch of the mandibular division of the trigeminal nerve. So remember, the trigeminal nerve has three divisions, the mandibular is V3. Now, even though this is, strictly speaking again, a sensory nerve, it is not responsible for taste. In fact, the tastes of the anterior third of the tongue, as the comments here are written down for you, is supplied by the facial nerve. So, just sensation is supplied by the lingual nerve, but the taste, special sense taste, it’s essentially beneficial there. However, the facial nerve relies on the lingual nerve to convey its nerve fibers back to the brain. So, this is the reason why patients who have damage in the lingual nerve, either due to dental procedures and whatnot, can oftentimes cause them to feel like there’s a metallic taste in their mouth, or a foreign taste, or a lack of ability to taste.

And, so fortunately for us, we have acupuncture points located right below the tongue to affect these lingual nerves, and that’s the extra points Gingy [inaudible 00:39:01] . So, puncturing these points, even though it doesn’t affect the special sense directly, it provides conveyance of the special sense nerve fibers back to the brain, which might be able to help to receive more signal about taste to the brain. Now, early on, patient people also published ocular motor dysfunctions associated with patients who have COVID-19. Two different research groups have presented information how these patients may develop ocular motility deficits or ocular motor palsies. And, even though the case number is not very high at this point, again, you’ve got to think about this. People who present with either of the issues, and if they’re asymptomatic, are not going to be sent to isolation or sent to the infectious diseases.

They’re going to be going to the neurologist, or even in this case, ophthalmologist. By the way, the first doctor in China who blew the alarm on the COVID-19 was an Asian ophthalmologist. So, don’t let the fact that these cases don’t seem very high dissuade you, because it might simply be a case of lack of reporting. So in any case, how may we as acupuncturists help patients who are suffering Oculomotor Palsy, possibly as a consequence of having neurological dysfunctions from COVID infections?

I need to briefly introduce you to something called a frontal eye field. The frontal eye field, we talk of the Brodmann areas, right? It’s located in Brodmann area 6, so you can have a look at that in the map in a moment. And what happens is that this part of the brain is responsible for controlling rapid changes in your eyes in the left and right direction. It’s called saccadic movements. So patients who have dysfunction in this areas of the brain, affecting this area of the brain, may manifest inability to have rapid eye movements. This is also called contralateral horizontal conjugate gaze palsy. So if you recall, the American paper show you the five different patient cases. One of the symptoms that they had was gaze preference. Okay? It’s because they are lacking the ability to see both sides so they have a preference for one side.

Now, how does this affect the parts of the brain that actually controls cranial nerves III, IV, and VI, that actually is responsible for the eye movement? Based on tractology or connectivity studies, neurologists have found that the frontal eye field actually makes connections with the midbrain, where these cranial nerves can make the eyes form.

So again, these midbrain structures and cranial nerves are too deep for us to get affect directly. But pressed indirectly through the cortical connections, neurocortical connections, we can have a fighting chance to affect ocular motor systems. I’m going to show you my research about this. You’re looking at the correspondence of the scalp and the cortex, specifically operators 16. And I was really cool about this and I love the chorus, but that when, when the Eastern West converged gallbladder 16 in Chinese is more strong. It means I window. Hello? The name is telling you that this point can do with the vision and that it actually correspond to frontal eye field, based on modern research, is just too good to be true. So where is this specific to this front IFU in humans? A lot of research in animals suggest that it’s in Brodmann eight, but we now know that’s incorrect.

It’s in problem in six. And so where is that? If you look at the yellow data line, it’s where the superior frontal sulcus meets the precentral sulcus. So here’s the central sulcus, okay. Where we divide the motor sensory and there’s an OMP. So, and then you have the premotor area or the pieces of gyrus right in front of that, it’s called a precentral sulcus where the precentral sulcus meets the superior frontal sulcus. This is superior frontal sulcus there. This one over here look other broken is the inferior frontal sulcus. So in a case where the front end superior from this office meets the precentral sulcus. Now the bird side view superior frontal sulcus meets the precentral sulcus. This area is where Brodmann six or prefrontal sorry the frontal eye field is located. And we have a point called LAR 16, which is just right in this area. If you thread it, if you’re familiar, scalp acupuncture along the Meridian, you will cover this area beautifully. And therefore you will be able to affect from the eye field and affect ibogaine and movements.

I’m going to just finish up with a case that I recently saw of a showcase. I tongue in cheek, call it the case of shotgun at time of Corona. And this was an 86 year old male patient who in early April, he, he and his family cannot be exactly sure exactly. When, where he started have developed slurred speech. Now he has the risk factors such as hypertension, diabetes, mellitus, and other non directly related symptoms. And nursing does comorbidities such as them freaking urination as a result of enlarged prostate. He’s had a history of Bell’s Palsy in his forties. Now several weeks before he had a stroke, he has some poor sleep. So it’s not sure whether that sleep was related to that’s just a coincidence or related to poor sleep having caused hypertension poorly managed by any case, he was admitted to the hospital for one night.

And because of symptoms was start to already showing signs of very fortunate men or already showing signs of improvement. He was discharged the next day. And, and which is atypical should typically, when you have a symptom of stroke, you are in the hospital for very longer. Not sure this is change in policies is dependent on the fact that there’s some lack of resources and the staffing during this time of COVID that the patient, since it was not life threatening was sent back home, by any case in addition to star specie also presented with left sided arm and leg paresis, and he felt extremely tired. I remember one of the symptoms, one of the only symptoms that, one of the five Americans that had the show with just lethargy, right? There’s no other covert, listen to this, man didn’t have any respiratory problems’ fever and such, but it doesn’t mean he’s not positive.

And for all the research that we’ve seen so far and the family noticed that ever since having a stroke is, can seem to have Mark and the aged. And, is just complaining about tiring all the time. He has a dark tongue okay a dark purple tongue [inaudible 00:46:46] that we talked about things like coral coding, which means a lot of phlegm cold phlegm inside of the body, which is we know cold, also contributes to [inaudible 00:46:58], right? So the pictures are triangulating quite nicely, unfortunately this is actually a family friend of my receptionist, and because the clinics closed due to mandating to be closed because of public health policies, he’s unable to make an acupuncture appointment with me or with anybody.

So it wasn’t until we will reopen on June 2nd, he was able to get his appointment. And so on the very first day that I was back on June 6th, he saw me for acupuncture and to date, we’ve had four sessions so far, and I’m happy to say that the results have been quite favorable after one treatment he said that his left leg, which is the afflictive site actually now feel stronger than in his right side. Okay. So patients, maybe there’s a little bit of a, a good patient and practice rapport there, maybe a little bit of psychological effect, but Hey, I’ll take it. And, but so far there’s no change in the arm strength just yet, which is actually expected those of us that have experience doing neuro rehab know that arm loss of function or paralysis is harder to regain than leg paralysis. But by the end of the fourth session, patient Ashley left the treatment room without taking or, quote unquote, needing his cane. So presumably that is indicative that his legs felt so strong that he forgot that he needed the cane.

So, that’s the latest case I can share with you all. I don’t know for certain that it is a case of COVID, but I’m using extreme PPE precautions, and I am suggesting that this case should go get tested despite being asymptomatic. So I thank you very much for your attention. And if you have any questions, just message me. If you like this presentation, don’t forget to tell your colleagues, don’t forget to let others know about it. And if you enjoyed it, show us some love. Thank you very much.

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AAC To The Point - Lorne Brown

Re-opening and Bringing Patients in the Door Now

Click here to download the transcript.

Thank you again to the AAC for inviting me to present on these informative webinars. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine. I am the Clinical Director of AcuBalance Wellness Center, I’m the founder of, and also the author of Missing the Point, Why Acupuncturists Fail and What You Need to Know to Succeed.

Today’s webinar, I have a special guest, Chen Yen. Many of you may know of he. For those that do not, a pharmacist by trade. Entrepreneur is her gig now. And she’s been helping health professionals for years be successful and build their practices so they can be of service to their community. Because as you know in my book, Missing the Point, when the yin and yang are out of balance, when it’s all clinical, you don’t have the business skills, even though you have the potential to help so many people, if you don’t have a running clinic, if you don’t have patients coming in, you’re not able to help them. And she’s created a business around helping people like ourselves so we could thrive and see the people that we want to serve.

And so, I asked Chen Yen to come in because she’s been sharing a lot about reopening your practice. We’ve been in isolation for a while because of COVID-19. And now as we reopen, the question is how do we invite and bring back patients into our practice, how do we build our practice. And so, what I plan to do now is I’m going to cue up a video in a moment of an interview that I did with Chen Yen. And the reason she’s not alive is right now she’s in Taiwan,. and it would have been in the middle of the night for her, for her. But again, her being and having that entrepreneurial spirit.

Just the other day, we got on the Zoom, we did this recording’s about 13 minutes. And she’s going to share with you marketing strategies that are working in this climate, some of the strategic planning that you could do now in the coming months, and then just some of the critical keys to bringing your patients back into your practice. And then after the video, I’m going to share with you what I’ve been doing in my practice at AcuBalance in Vancouver. And so I’m also going to share how we reopened and some of the things that we’re noticing and that we’re doing so we can be of service to our communities. So, let’s start that video now, and please stay tuned because I’m going to give you about five minutes after this some more pearls to support you in your reopening.

… how helpful acupuncture. You talk about how helpful acupuncture is. So, those are …

So, what are some of the marketing strategies that you’ve been sharing in your mentorship that you can share with our audience to help them, again, get their practice going and attractive again to patients that are, well, now that their practice is open. So, I’d love to hear some of your marketing tips, because I know that you got some gems.

Yeah, so I would say at first looking at low hanging fruit, and then looking for new areas of opportunity to reach potential new patients. So low hanging fruit, a couple of key things. One is how can you keep your existing patient base in understanding of how just overall even outside of these COVID-19 times the different health issues that could be beneficial to where acupuncture can help with. And then reminding people to book appointments if they want to come in. So, for example, in our opening email templates. So, you can send out emails, you could send out texts. You could also be educating or encouraging people to come in on Facebook or social media posts if it’s kosher with the laws of your state and profession to be doing things like that. And then in terms of emails, for example, it could be book your appointments.

And so, what I was going to say about emails is, first, a piece about something that educates about the issue, and then something with a call to action with a reason to come in. So, for example, it might be book your appointment now and get in for first line … I mean get yourself first in line for your choice of appointments as we’re reopening here, or it might be something like take care of yourself by putting yourself first and book an appointment, especially still as important now to take care of your health as it has ever been, or it might be that book your appointment space because of the health issue that you’ve been having that you haven’t been able to get checked out or get help with until now because we’ve been closed. So, there’s just kind of a reason why to be rebooking that that is brought up, and that can be helpful.

You could also look at collaborating with other practitioners. So, our clients who’ve been doing really well in getting referrals from other providers, whether it’s medical doctors or other kinds of practitioners, holistic practitioners, other kinds of practitioners is as they reopen, many times they had a good relationship with them even prior to opening. So, if those of you who have relationships with providers who’ve been referring you before, reaching out to those providers and reminding them that you’re there and how you could be of benefit to their patients is one way to go.

If you haven’t had a relationship with other providers before, for example, maybe you would like to be getting referrals more from MDs because medical doctors could be a great source of referrals for you. They have many patients who could benefit from what you have to offer, but many times their patients don’t really know about you or the doctor doesn’t really think about referring people to.

So, what can you do in those situations to build new relationships? So, something that I was working with one of my clients on was to create a short video. Because the thing is, doctors are really busy. Right? And so, if you’re able to create a very short couple minute video that starts to explain something about your area of expertise and some research tied into why this could be beneficial for those kinds of health issues or with helping support immunity, then that can also be sent off to a physician. And that way it’s just you’re more on the top of their awareness. So, really, the key is concise, short, and really to the point of how you can help their patients get better outcomes.

Another thing is to look at … you can look at interviewing other practitioners, too. So, in times where people are getting back into reopening, there’s a lot of opportunity for you to collaborate with other practitioners, because people still need help with their health issues, whether it’s during these times or not during these times of COVID. And so, it’s a matter of how can you continue to educate the public about different kinds of issues and what your services can really help with and your modality. And so, then being able to collaboratively interview other practitioners about, perhaps in particular, health topics.

So, looking at whether it’s interviewing medical doctors or nurses, nurse practitioners, tied into the different of health issues that you treat can also bring in more visibility for your practice. And it can automatically be an opportunity where if you’re interviewing another practitioner, you can encourage them to share that interview with their patient base, too. So, you’re ending up being able to reach more people with your message collaboratively there. So, that’s more of, I would say, lower hanging kind of fruit, because it doesn’t take up a lot of your energy and time to really set up.

And then other kinds of things that you can look into beyond that initial low hanging fruit could be writing Facebook ads. So, I’ve had clients, acupuncturists, who are running a combination of Facebook ads that are bringing them … It’s amazing the kind of return on investment that they’re getting for it right now. And it’s a combination, as far as what’s working right now, combination of Facebook Live video with using some of the strategies that I work with our clients on, being really strategic about what’s said in the video, plus Facebook posts alternating with that. And then, again, getting people educated, getting people to build that relationship with your practice. Yes, and then also having people be interested in booking.

Another thing is anything tied to speaking. So, we talked a little bit about interviewing. And whether it’s during these times or beyond these times, one thing that you’ll always have is your mouth. And one thing you will always have is what’s in between your years, which has been all the knowledge and training that you’ve garnered all over the years and the expertise that you have which could still be helping people, even if your practice was to be closed down in the fall, because we really don’t know if that might happen. And so, when you are able to continue to educate just as it were pre COVID-19 times as well, the more you’re able to educate people and reach more people. There’s still people who have a need and can benefit from your services. So, anything tied to speaking, for example, webinars, doing interviews, doing podcasts can be good online. And then as we get back into reopening, even doing small kinds of things even with just a handful of people can still be helpful to … to be helping others and your practice.

And then one thing I would say in terms of marketing wise. Whatever you do, there’s an education process involved. And a couple of quick tips in terms of as you think about … Because have you ever, whether it’s written an article or you have spoken about something, you’ve educated people about something, or you’ve done whatever, think about all the kinds of different marketing that you’ve done in the past. Have you ever felt like you have been so good with teaching people about things, but then they don’t necessarily book? So, here are a couple of questions that you can think about working into what you educate people about so that they end up getting more interested in booking and coming in.

Let me actually just show this to you also briefly, to pull this up here for you to see as well, which is … Let’s see here. So, this is the five stages of the buying process. And so, people need to first have awareness about that they actually do have a problem. And then they might be considering it and looking into different options at the next stage, but they’re still gathering information here. And then then they might be evaluating, for example, in terms of, okay, maybe this option and this option, what are the details of that and which provider am I going to be seeing. Then finally, more of the decision making and then the post-purchase evaluation.

But what sometimes we don’t think about as much is that there might be people in different parts of the spectrum, whether from problem awareness, who don’t even realize they have a problem, right, or they are further along in the process, but they don’t really understand what to look for between different providers and that kind of thing. So, whenever you’re making educational kinds of things available to people, think about what different stages that they might be, and how can you provide content or educational things that can help educate in those areas.

And one thing, also, a couple of quick questions to think about would be like, what do they need to believe about their health, or what do they need to believe about themselves? What do they need to believe about you? Because if these questions aren’t answered in a way that they feel comfortable with, they’re not going to come in, no matter how helpful you talk about how helpful acupuncture is. So, there’s just a few quick tips about as we look at marketing and reopening that are working well for our clients right now.

Chen, I want to thank you very much for those tips and points. And I think we’re going to have to get you on so we can spend more time with you, because we just got a little bit and this was quite valuable. What’s the best way for people to reach you? Because I’m familiar you have like the Introverted Visionary website and your Fill Your Holistic Practice. Can you share the best website so people can get more information and learn how to contact you, please?

Sure. You can go to And so, And then you can … I’m going to make available some templates that are going to be helpful for you, for example, reopening email templates that you could use for email or texts. And also, we brought up a couple of situations of what people might be concerned about with coming in. And there are other ones that I’m going to share with you as well that acupuncturists clients of ours have been experiencing. And then also like a cheat sheet for that, right? Like how do you address these kinds of common objections that people might be having about coming in as well. So, I’ll include that.

Excellent. So, to be continued, she’s going to provide us with more value. So, you just go to, and she’s going to have some more handouts for you to help you prepare yourself as you build up your practice again, it’s great news for most of us just to remind everybody that you’re not starting your practice over again. You just kind of took a holiday that you didn’t choose to take, and now people are getting ready to come back. And these are just great tips that you can use any time of your practice, not just after a pandemic. So, Chen, I really appreciate you making the time to tune in and share this with our audience today. Thank you very much.

Yeah, it was great to be here today. Thanks for having me here.

Great. And we’ll get you on Healthy Seminars so we can get you to expand on a lot of this and more, because you’ve got really good marketing tips. And for the introverted, because a lot of people don’t want to do public speaking or they say, “I can’t, I’m not outgoing. I can’t do this.” And I know you’re introverted and you have techniques and tools for people that want to educate, but feel I’m too shy to do that. And the takeaways here from earlier on, you talked about outreach. So, email contact, like start contacting your patients on a regular basis again. You talked about education, so keep educating them on the benefits and what you can do to support them during these times. And you talked about collaboration as well. So, collaboration is great. And some of the way you even outreach is through webinars, Facebook, emails, talks, so that’s great. So, thanks for sharing those tips with us today.

All right. So, again, thank you to Chen. And as I promised, I want to add a few more pearls for you guys as you open up your practices. Some of you are getting ready to open and some of you have. So, in my clinic at AcuBalance, and just to prepare some of those that are just getting ready to, I will let you know that it was more stressful in the preparation of getting all the PPE, all the safety equipment and policies in place than it actually was implementing it, so that’s great news. If you’re really overwhelmed about what’s going to happen, it’s nothing like … it’s much worse preparing for it and anticipating than it actually was doing it.

Now, what we did at our clinic when we started, we opened up on May 19, so after being closed for two months, and we decided … So, I’m going to share with you the attitude because it will make a difference for how you experience your reopening, and then I’m going to share with you some tips on rebuilding your practice. So, first of all, our attitude was safe, soft reopening, emphasis on safe. So, we got all of our equipment, we set up our policies, and what we did is we chose to open up our clinic at 25% capacity only. And we did this so we could be calm as we cleaned rooms and figured out how long it took getting our masks, getting the patients to sign their consent and wash their hands, all that stuff, we didn’t want to feel rushed or tense about it.

So, we really set up that first week with very little expectation for profit. We did not care, actually. Our goal was, let’s be safe and can we be of service to others? So, that’s what I invite you to have that mindset. You’re not going to have when you reopen, most people are not going to have what they had pre COVID. And so, just to have that expectation, to be kind to yourself so you can enjoy this reopening. And so, we were a soft, safe launch.

And so, that first week at 25% capacity only, it allowed us to work through our policies and see where we could streamline things. And then the second week we were open, we went to 50% capacity because we saw now how quickly we could clean the rooms properly and put patients in and out of the rooms. And a big part of the process for us was for the physical distancing. Everybody has their own room, so they’re distanced. And we’ve timed it so we don’t have a bunch of people in the waiting room. However, the key was in the clinic how the doctors are all situated so we had physical distancing. That was what the main criteria was, how is it that we’re in a clinic all day that we’re properly physical distancing as much as possible.

And I will let you know because our energy was calm, the patients that came to us … I was going to compare it to a colleague that had a different experience. We came in with the attitude of service to others. My colleague came in needy, like, “I need to be busy now,” pretty stressed. Our patients came with their own mask. We asked them to, and almost everybody came with their own mask. Now what we did is we bought cloth masks and we had surgical mass. The doctors all wear the surgical masks, our patients can choose surgical or cloth, but they must wear a mask in our clinic, that was one of the recommendations policies we have. And if a patient did not have a mask, they had two options. One is they could get a surgical mask which they take with them, $2 fee, or they could get a cloth mask. And if they leave the cloth mask for us to laundry, that it’s free. If they don’t leave it and they want their own, because some wanted their own, it’s a $5 charge. So, we just passed the cost onto our patients. We had zero complaints.

And our patients were great coming in. They were so happy to see us. The energy was great. They signed the consent. And it’s been a very positive experience for my team and my patients. And we didn’t come in like needy, “We need to see our patients.” We came in, “Let’s be of service to others. Let’s see who’s ready to come back out of isolation here in British Columbia.” Where my colleague really tried to pressure their patients to come back and was coming from neediness and they were quite stressed and stressing out their patients, their patients were fighting about the mask. It was just a totally different experience. And I believe the reason is the attitude, the vibration energy that you’re putting out, for one.

Now, when patients contact us and they’re a little stressed about what’s going on, we educate them. So, we let them know all the things we’re doing, all the cleaning, et cetera, how we’re doing the physical distancing, what we’re doing to minimize the risk. But what we’re not doing is telling them, “Oh, come, don’t worry. You’re going to be safe.” Actually, we do the opposite. If any patient comes across on the phone or email as concerned, worried, or stressed about COVID and coming to our clinic, we encourage them not to come because we know we can’t guarantee your safety. All we can do is minimize the risk as best we can, and that does not mean that COVID will be prevented. We can’t guarantee that, we cannot do that, nobody can do that.

And so, we realized half the population … I’m making up the number … but half the population will be comfortable coming into our clinic and half the population will not, but they all pretty much want to know what we were doing for safe measures. So, rather than trying to over impress them, like “You need to come in and this is what we’re doing,” we let them know all the safety measures we’ve put in place, all the systems we have in place. And they get to even see it on the back of one of the doors where they’re in the room, the door that holds the needles, there’s a checklist to show that the practitioner’s checking off all the cleaning things we do so it’s not forgotten, we have a system, and they get to see that.

But we don’t pressure our patients to come back. If their worried, we say, stay home. If you’re worried about COVID, then do not leave your house. As soon as you leave your house, you’re put at risk. And because we’re not pressuring them to come in, a lot of those patients, once they hear what we’re doing, still choose to come back. And those that are really worried, we don’t want them in the office. We don’t want that energy, that tension in the office anyhow. And so, we realized some people are going to be ready early on to come back and some people not.

The other thing I want to remind you is, it’s still the same education marketing practices you always do. People are going to come and seek you out if you are a benefit to them, if you are a value to them. So, it still goes back to the same model of just good education. Now what I think is important is to work on the stress response that your patients are going through. Because of the change in the loss of control and some loss of liberty in a very short period of time, some people consciously are aware of their anxiety and stress and some people are not. So, if you ask them first to educate them about stress and how it impacts the immune system, how stress impacts sleep. So, check in with your patients via email or phone calls, “How’s your sleep, your digestion, muscle tension or headaches? We know how it can lead to inflammation which can cause other health issues.”

So, maybe your patients, like Chen said, that first thing, maybe they’re not even aware they have a problem. So check in. Are your patient’s having sleep issues? Are they having digestive issues? Are they having muscle tension, headaches? See if they’re having these and let them know, this could be related to stress and how you can support them in reducing the stress, because we know stress, exasperates many diseases and leads to many symptoms. And so, your goal is to help them with their quality of life and to show them that you have value and you have tools.

Right now, conventional Orthodox medicine does not have a solution for COVID except for isolate as much as you can, right? Physical distancing as much as you can. And so, you can educate them on the lifestyle and things that they can do to help give their body the best chance of being healthy, radical well being. We’re great at talking about diet. So, you can set up consulates for diet and lifestyle, exercise, sleep, and meditation, acupuncture for circulation and stress reduction and hormone balance. So, there’s a lot of things that you can do to help with the radical well being.

And that way if they are out and about, at least their relationship with their environment, because that’s what we’re doing with Chinese medicine, is strong so they can hopefully handle whatever comes into their external environment, whether it’s CNN News you’re watching causing stress, or it’s a virus that’s out there, that your body is at its peak radical well being so it can deal with it as best as they can. And you can’t tell them or promise them that if you come to my clinic that you will prevent COVID or you’re treating COVID, because there’s not evidence that exists yet that you could do that. However, you can definitely help them with radical well being.

A great example is obesity. We know in general obesity leads to many health issues and diseases. And with COVID-19, we know obesity is a comorbidity. That is not a good thing to be, no matter what your age is. If you’re overweight, this is a time to lose weight. So maybe in your practice, you can start doing getting fit and healthy in the summer so people have the best chance of being healthy, whether they get any virus including COVID-19.

So, remember, people choose you because they see you have value, you have benefit. And so, first of all, do you have value and benefits? So figure out where you do, because you do. And then communicate. As Chen said, send out emails, do talks, collaborate and do stuff, and just take your time. The good news is, for most of you, this is not like you just started your practice. You had a forced holiday, as I mentioned in the video, and now you’re reopening, and people are just getting comfortable in certain places where you live to go out.

And so, read the room. Don’t dismiss their concerns or fear. If you can read the room and realize some of your patients, even though you may not be, are very concerned about this pandemic and come to your clinic. Hear them, and hear their concerns, and validate their concerns. Let them know what you’re doing to mitigate risk and be transparent and let them know that you cannot guarantee safety. And if concern or safety is their main issue, then they should stay inside. Okay? They should isolate. And if they’re comfortable going out to the grocery stores and other things that are not essential, grocery store is essential, but if they’re going out, then they may be comfortable coming to your practice as well.

And you want to keep your safe, so have your boundaries with your patients. We have some patients that don’t believe mask waring is necessary, but it’s a policy in our clinic. We don’t challenge their beliefs, whether masks are valid or not. The science as you go, as of today, the science is masks can mitigate the risk because it limits your exposure time. The amount is dosage and time. So, if you’re going to be in the room with somebody for 20 minutes, 20 minutes without a mask is much more exposure than 20 minutes with a mask, and so that’s why it’s being recommended. And in our practice, it’s okay if you don’t want to wear a mask in general and you don’t believe in masks. However, you can’t get treated in our clinic at this point in time unless you wear a mask. That’s not negotiable.

So, we have our policies, we’re strict with them. And so, I encourage you, too, to have your policies, have kindness in your heart, focus on being of service to your patients. Don’t worry about your bottom line now. In July, hopefully your practice is definitely back and you’re seeing it profitable. But if you just opened in late May or beginning of June, just be of service to people, educate them, be a value, and trust within a few weeks you will be back to hopefully 75% or more of what you were before COVID and profitable again. And therefore you can exist and be of service to your community, which this is all about.

If you’re looking for more information on COVID-19 and being back to practice. Under the website, it’s, we have several past talks, verbal and acupuncture, and more coming up. We’re constantly listing them all the time. We’ve got lots of free resources for you, stuff on telehealth as well. So, do check out And also, if you’re looking for all my assets, my clinic information, Healthy Seminars, and the conscious talks I do on, go to that website,, because that links to all the things that I’m involved with.

Again, I want to thank you for listening. I want to thank the AAC for inviting me for this practice management series. Some of you don’t know, but my background before a doctor of Chinese medicine is a CPA, so a public accountant. So, I like to bring both hats to the room for you guys to share both as a clinician and then as an entrepreneur and accountant so I can share what I know with you so you can be prosperous and successful and serve your community. Stay tuned to next week’s webinar because there’s more coming. AAC’s got great webinars and they got great hosts. So, make sure you come back, like their Facebook posts, and tune into their next webinar. Thank you very much.

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