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Food as Medicine Part 2

 

 

So today we’re going to go over a little bit of the specialness, if you will, of how TCM looks at food.

Click here to download the transcript.

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

Hi, this is Dr. Martha Lucas, and today I am. I’m doing part two of the presentation, Food as Medicine, and I want to thank the American Acupuncture Council for this opportunity. So let’s go to our slides.

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Okay, so last time I mentioned that we, that language can cause experiences, and that a part of what our medicine can do for our patients is give them advice about food. Because food, let’s face it, food is medicine that you can take. three, four, five times a day. Also, Western medicine is looking into it too, but we have a different viewpoint of food.

So today we’re going to go over a little bit of the specialness, if you will, of how TCM looks at food. First of all, we’re going to talk a little bit about the seasons, because in Chinese medicine, food advice can vary with the seasons. Spring is the season of new birth and new growth. And according to Chinese medicine, spring is about the wood element and about liver functioning.

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And we know that some places where we live have a lot of wind in the spring, and the liver is especially susceptible to wind. We know that it regulates chi, regulates emotions, and the liver is a part of our digestive system. If it’s out of balance, then we can say that it’s attacking the digestion. So we don’t only think of spleen and stomach, but also, obviously, liver and gallbladder.

If our patients or us think that If we don’t adapt to the changing climate in spring, we may get susceptible to seasonal health problems like flu, pneumonia, or a relapse of a chronic disease or allergies. How many of our patients only in spring seem to get allergies? And I’ve noticed over the years that sometimes it’s in the more windy spring.

So there we have that relationship between the liver and wind. So we would recommend that they reduce the intake of sour flavors and increase sweet and pungent flavors, because those are the flavors that facilitate the liver to regulate the chi throughout the body. So examples of recommended foods for the spring, there’s a list, would include onions, leeks, leaf mustard, Chinese yam, wheat, dates, cilantro, and you’ll notice that we have a wide variety, like wheat is one of them.

If you have a patient who’s gluten intolerant, we need to have other options for them so that they don’t feel like they are going to have to eat some. In fact, You need to always read the labels of the herbs that you recommend to people because some of them do have weed in them. Fresh and fresh green and leafy vegetables, include those in meals, sprouts and in addition, uncooked, frozen, and frozen vegetables.

Fried foods should only be taken in moderation because, number one, the liver has a harder time digesting fried foods, and of course, cold foods are harder and harder for the spleen and stomach, or your overall digestion, to tolerate. Because remember, You partly don’t get all the nutrition if your digestion is spending all of its time trying to warm up the food.

Also, because previous to spring, sometimes people spend a lot more time indoors during winter. Then they might more quickly develop a heat imbalance in the spring. So some other symptoms people might have in the spring include having a more dry throat, bad breath, constipation, or a thick tongue coating, because those are heat signs, right?

So then we would recommend foods like bananas, pears, water chestnuts, sugarcane, celery, and cucumber to help clear excessive heat. What I do sometimes is suggest that my patients do something like put slices of celery, cucumber, and watermelon rind in water. And that makes a nice hydrating drink. Plus it’s more tasty than just drinking plain water.

So sometimes you have to be a little creative because as I mentioned in part one, We’ll call it attached to their diet plan. They’re very attached to how they eat food. So sometimes they really don’t want us to be playing around with it. In summer, plants grow fast, right? People have more energy. The body’s qi and blood become more vigorous than in other seasons.

Now, Chinese medicine can say that physiological changes make the heart over function and that there’s a little too much yang flowing. around and in the body during summer when it’s hotter. According to five elements theory, an over functioning heart restricts lung functioning. It’s advisable to eat more foods with pungent flavors and reduce bitter flavors, because that’ll enhance the lung and maintain normal sweat mechanisms in summer.

Sweat is the fluid of the heart and also the bladder and the lungs, and excess of sweating can scatter hardship and weaken the mind, according to some theories. So the person can have be more annoyed, have a little bit of depression or a lower spirit, and be restless and have sleeping issues. And this would be during summer heat.

Foods with sour and salty flavors help ease these symptoms. Now, summer isn’t the same in every region, right? I am in Denver, the high desert, so our summers our whole year tends to be drier. I might give my patients slightly different advice than Some are somewhere where it’s hot and rainy, or it’s very humid and damp.

We have to realize where we are living and. and create the plan according to that. For example, if you, in Chinese, in ancient Chinese medicine, the suggestion was to eat the food you grow. In Denver, we don’t have a really long growing season. It’s probably three or four months, but in a place like Gunnison, Colorado, I think it’s 31 days.

In some, again, you have to look at where you’re living And create the food plan according to where the patient is living. Now hot humidity, rainy atmospheres can disturb the fluid and electrolyte balance of the body. And there again, lead to lethargy, weakness, fever, thirst, lack of appetite, and even in the extreme, loose spleen.

stools. So again, looking at that’s dampness causing those issues. So foods that will help keep the body cool and balanced include things like watermelon, strawberries, cucumber. Again, you can help your patient just put those in water and create a nice hydrating cooling drink for the body. In general, The daily diet, even Western medicine says, should contain more fruits and vegetables, always, but especially at this time because they’re cooling and they can help provide adequate fluids to the body.

Now warm and cooked foods help the digestion work better because spleen and stomach love warmth. They do not like heat. Ice cold drinks. So with my patients, I like to start their nutritional advice in what I call baby steps. The first baby step is no ice drinks. So well, maybe sometimes the first baby step, to be honest, is no soda.

I recently, I’m working with a woman, one of my weight loss patients was drinking sodas every day. And so for her, the first step was no soda. Again, know your patient, listen carefully to What they usually eat, and so I might say in this case, no iced drinks, and explain to them that in Chinese medicine, and even in Western medicine, your digestion is warm.

It’s not ice cold there inside your body. So if your digestion has to spend all of its time warming up the food, you’re missing out on some nutrients. So even in the winter, sorry, even in the summer, it sounds like lots of people are like, oh, I could never eat soup in the Summer. Your warm and cooked foods help your digestive system work more effectively.

Whereas, greasy, raw, frozen foods can, what we call, damage the digestive system. And then the person might have less of an appetite, or diarrhea, or acid reflux, or some other stomach upset. In, even in Chinese tradition, in summer, making soups, you can add ingredients that help clear heat and reduce dampness and help the person’s digestion keep working well.

In autumn, things begin to fall fall off the trees and fall off stems, and, but mature, right? Remember, it’s always a cycle, right? help support good soil, and then the next year they grow again. In Chinese medicine, autumn correlates with the lung system. We have things that regulate the skin, respiration, body fluids, immunity, and can be res associated with depression.

The lungs hold grief, so if someone has grief or depression you always need to treat the lungs. Like Lung2, the translation of it is something like cloud break or release the clouds, because it’s talking about the cloud of emotion, and it could be some damp also, but the clouds of grief. Now the vigorous summer is over, and things are moving inward to prepare for winter, where we might even be more inward.

Right now, we’re going to adjust our nutritional advice for the changing seasons, because it, the weather can be drier, and again, the person might get things like an itchy throat, or a dry nose, chapped lips and You might see more hair loss in autumn and also allergies again. Now those can be really related to things like a dry nose.

So I have all of my, I ask all my allergy patients, do you do a nasal rinse? Because a lot of lung issues, it turns out, start up in the sinuses. So doing some sort of a nasal rinse, keeping your nose more hydrated can help with, help prevent things like the flu. For one thing it’s less, the flu doesn’t like moist, doesn’t like dry nasal passages, so it’s helpful to do a nasal rinse.

And we’ll need to promote because they’re going to help lubricate the body as the weather is getting drier. So nuts and seeds are appropriate, pear, pumpkin, honey dairy products. But again, remember too much dairy is cloying and damp. I had a patient who had, was growing these little, tiny little clear nodules on his skin.

They were so small, but you could feel them. It turns out he drank, I’m serious, like a gallon of milk every two or three days, ate ice cream every night. The worst thing you can eat according to Chinese medicine, right? Because it’s dairy, which is cloying and damp and it’s frozen. I suggested that for two weeks, he, cut down on his dairy and lo and behold, those little growths went away.

Dairy can be really cloying and then you can eat more food with sour flavors and reduce pungent flavors like onions and ginger and peppers that can lead to a decrease in body fluids. And then in winter things really. Slowed down to save energy, right? This is why root vegetables grow underground.

It’s like how animals hibernate and even humans might conserve energy and build spring, sorry, build strength wanting to move into spring. Now, there are a lot of people who exercise all winter, who go out all winter, but in Chinese medicine, theoretically, it’s when we’re slowing down and we’re trying to save energy.

So we want to enrich our bodies at that time. Maybe we eat a little more protein at that time. Beef, goose, duck, eggs, Chinese yam. There’s a list of ingredients that are common in Chinese dishes during the wintertime and winter corresponds with the kidney system. So it’s, advisable to eat more foods that associate with the kidney.

And the kidney’s flavor are, is salty. Its color is white. So we might choose foods like, for example, I have asparagus on the list, but maybe you would get white asparagus during that time.

Winter is also a good time to boost your natural constitution. At this time we can help. boost the constitution so that in spring the person’s chronic conditions don’t show up again, for example, allergies. We would be working on the person’s allergies during the winter time so that their body is absorbing the nutrients from those foods that we recommend so So that in spring, their allergies don’t come back.

So it’s harmony between food and weather on a more practical experience. As I said, this, some of this advice might seem to contradict what Western medicine says, or again, you’re going to have to be careful in what part of the world patients live in so that you know how to coordinate the food advice with the weather in their area.

Foods become a part of our body after they’re consumed, so we are treating the person’s body with food. Food is one of the eight foundations of traditional Chinese medicine along with other things like herbal medicine, body work, including things like gua sha and twina, and of course acupuncture, which is the most well known therapy in Chinese medicine, but A knowledge of food energetics can deeply supplement your ability to help your patients.

This next section, we’re going to talk a little bit more about how to work successfully with food with certain conditions or procedures that your patients are going to have to go through. Because the stronger our digestion is, the better we are able to tolerate, The food we eat, we’re better, we are better processors of the food.

If we have to have a procedure, for example, a surgery, our immune system is going to be stronger because our digestion is our earth element. It’s the core. Everything surrounds the digestion. So trying to make our patients have good digestion or improve their digestion is going to help everything, including their skin.

And remember, if they’re going to have something like a procedure, they’re likely to start worrying about it or ruminating about it. And we have to help them with that also, because As we know, worry actually makes the digestive pulses go backward and then back toward the kidney, what I call attacking the kidney.

So something like worry and ruminating, we really do need to help our patients with that. So for example, before a surgery, I recently had a patient have surgery for breast cancer, so I always tell my patients you need to come in before your procedure and then after your procedure. Before your procedure, this is what we need to do.

Build up your system, your digestion, build up your immune system, because surgery is really it’s, Even though the person may need it, it’s a quote unquote good thing because they’re having something like a cancer removed. It’s still going to potentially create some negative impact on the body. For example, stagnated chi.

So we want to get their immune system working. We want to help them with some ideas. Don’t mix food and work. In other words, pay attention to eating. Chew well. That’s how you get nutrients out of your food. Stop before you’re full. Let’s cut down on cold foods. No diet, no soda or diet soda I have down there.

It just has too much sugar and chemicals in it. So helping them work with their digestion before their procedure looking at, Are they cold? Do you need to add warm foods to their diet? Do you need to warm them up before their procedure? If they’re yin deficient, now, here’s this woman was She’s in her 60s, so probably yin deficient.

If they’re going through, they’re elderly, going through perimenopause, or they have issues with yang rising like headaches, then you need to add yin strengthening foods to their diet. Like I love sea plants for that. And so keeping them looking at what’s going on, getting their digestion stronger before their procedure.

Chi deficient patient, you’re going to, number one, recommend fresh air and exercise. Those are actually good recipes for your chi deficient patient. Obviously, they might need to start slowly, but that’s okay. Fresh air and exercise are good for them. They can make an oat porridge. You can recommend qigong to them.

You’re blood deficient patient. Now they’re going to be blood deficient after surgery. So this is why they need to come in before and after surgery. So we might have some post op recommendations for them too because they need to build blood again. So foods that are chlorophyll rich Of course, meat has blood in it for your vegetarian.

They can use things eat foods like beans. And then blood is particularly weakened by sugar. So trying to get people to cut down on the amount of sugar in their diet, plus we know too much sugar negatively affects the spleen, right? It’ll start to create dampness. The spleen is, Its flavor is sweet, but it doesn’t like too much sweet.

And then looking for people who have phlegm, right? Now they might have acne, right? Acne is absolutely can be a damp issue. It can be a heat issue. That’s why we not only need to treat it topically, but we also need to treat it internally. So you might have them reduce things like dairy products if you know that they have too much damp in their bodies.

Foods that can resolve dampness are adzuki beans, barley, celery, radishes, seaweed, and garlic. And remember, some of these foods have more than one property. Most of them do. Looking at that helps. If a patient’s going to surgery, they’ve had surgery, they’re going to have chemotherapy, they’ve had chemotherapy, food is a great way to help treat them.

Boost their immune system for chemotherapy, you always need, also need to make sure that you’re helping reduce the toxic heat that’s affecting the kidneys. And then, boost their immune system, get their, reduce mucus, if they’ve had chemo chemotherapy. Analgesia, which they have for surgery.

You want to help the liver process all that. So there’s a lot to do post surgery. Boost their immune system with cruciferous vegetables. Garlic has antibiotic activities and inhibits viruses. So that might be helpful for them after their surgery. Deep water fish are rich sources of omega 3 fatty acids.

And seaweeds, of course, for overall. Immunity boosting. Almonds have a lot of amino acids and essential fatty acids. Ginseng and chicken is a great combination for people recovering from surgery, childbirth, or prolonged illness. And then improving the digestion, you can use things like ginseng licorice tea.

And ginger is, of course, great for the digestion. Oats strengthen digestion and build qi. Omega 3 fatty acids are important for immune function, brain development, and treating malnutrition. And then also another source of omega 3s is alpha linolenic acid. And this is in vegetable oils, flax seed, pumpkin seed.

A lot of things we can do for our patients. after and before surgery. Have them add dark green vegetables. The western diet really doesn’t include enough omega 3s, so anything we can do to help people get those into their bodies is important. As I said, sugar, they need to cut down on that. Especially processed sugar.

Natural sugar takes longer to digest in the body, just like whole grains, but we need to have them reduce their sugar because it can actually damage the digestion and the immune system. Also, too much processed sugar contributes to herpes outbreaks, PMS, nervousness, and irritability. So the best source of sweetness for our patients are foods like sweet potatoes, natural sweeteners, instead of allowing them or giving them good advice on why not to eat too much processed sugar.

And then the post surgery diet can include a lot of things I’ve said, grains, vegetables, seaweeds supplementation with fish for essential fatty acids and then a little more So we can get the toxins out of their body. And finally, to treat arthritic or rheumatic conditions, avoid excess meat or protein, alcohol, tobacco, coffee.

Again, refined sugar, all of those can lead to having a little more pain. And Some say nightshade vegetables can increase pain, and then I have down eat fresh goat milk because it’s a more digestible fat and has a broader mineralization, but barley and wheatgrass, anything that’s anti inflammatory and detoxes, for example, I have that.

arthritis and rheumatic conditions can be treated well with the post op diet that I just mentioned. So there you have advice about using food as medicine. It is one of the basic standard traditional Chinese medicine therapies that we can help our patients with. And again, this is Dr. Martha Lucas, and I want to thank the American Acupuncture Council for allowing me to share this information with you.

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VA Community Recoupment

 

 

In fact, I’m sure a number of you have heard about what was going on with the VA community care and doing recoupment for some billing that you’ve done for cupping.

Click here to download the transcript.

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

Greetings friends and colleagues, welcome to another episode where we’re going to give you help to get paid to make sure you’re not paying anything back. In fact, I’m sure a number of you have heard about what was going on with the VA community care and doing recoupment for some billing that you’ve done for cupping.

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So let’s go and go to the slides. Let’s talk about this. What’s going on and what’s happening. I’ve got a lot of good news and I’m really happy to share that with you. So obviously a lot of you are treating and billing for VA patients. They are great patients. They need a lot of help and it’s the one insurance that does cover cupping.

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So you can bill with cupping and we have been billing with the unlisted code having no problems. However, something came up. I had an office that came to me and said, Hey, Sam, I’ve got a problem. I received a request for recoupment for billing 97039 for cupping and the indicated dates all the way back to 2022.

And I thought, Hmm, okay, interesting. But I thought, how much are they asking for? And I kid you not. This particular office was a heavy, heavy VA office and they’re wanting close to a hundred thousand dollars back. Now you’re thinking, how can that be possible? Well, let me tell you, they treat a lot of VA patients and they paid pretty well for cupping.

That’s what they were coming back for. So there was obviously a lot of panic. Wait a minute. How can they come back? And ask for something they’ve already paid for. That was really part of what we were doing. So in the VA, they have something called the standard episode of care specific to acupuncture. And what these are, are a listing of the services that you may provide an acupuncture patient.

Without any additional authorization, this includes E& M codes, lots of therapy codes, it even includes laser now, but it also includes codes for cupping, and before was codes that listed unlisted. So this is a very current one. You’ll notice this one is dated April 9th of this year, and you’ll notice I’ve highlighted in red the codes that they are allowing, and you’ll see here the first one that’s for laser, But it’s got dry needling.

It’s got 97016. By the way, that is the code you should be using for cupping, 97016. And you notice you just go along manual therapy. And of course, all the acupuncture codes, what you’ll notice is missing. is the code for 97039, the so called unlisted code. It’s an unlisted modality, and many people had used it for cupping, and I certainly recommended it.

It paid well. It just allowed you to describe it as cupping, and we were paid for it. Now, again, you’ll notice this is the most current acupuncture authorizations. You’ll notice, again, conspicuously, there is no 97039. or even the 97139 which is again unlisted codes. Well that’s what they’re coming back for and you notice for each of them whether it’s going to be the initial care plan or the follow ups for chronic care even you’ll notice it’s missing.

However once I received this I said hold on a minute This cannot actually be correct. And the American Acupuncture Council, because of course, a lot of you are insured through them, we began to work in the background to say, this is improper. So we got the attorneys involved, myself as the coder, and we said, wait a minute.

We went back and researched and specifically the standard episodes of care that they’ve published through the, uh, VA from 2021, 2022, and 2023. did indeed list the code 97039. So being it’s part of the standard episode of care and it was allowed during all phases, whether initial continuation of care or chronic care, it was there.

So now they’re coming back saying, well, we know we published a code, but we’re saying we shouldn’t have had it and we want the money back. Well, that certainly doesn’t seem to be proper. So what we did, the American Acupuncture Council and myself is to start to have our providers respond back to them with this letter.

It says, I received a refund request for 97039. And it dated all the way back to dates of service from 2022 as being overpaid. And we’ve researched it. The schedule, the standard episode of care specifically shows from 10 18, they all allowed this code. Now I will keep in mind that they did eliminate it.

And I think this is where the problem began. Because it was eliminated in February, they said, Hey, we’re going to go back and look prior. Well, you can’t. Obviously, if you build 97039 after February 23rd, technically that would be improper. And they could recoup it, but any dates prior, it was part of the standard episode.

So, per the published guidelines of the VA, it says, repayment appears improper because the code was in the SEOC, we identified it as cupping, and per the guidelines, when there’s no specific code, Because even the code I’m recommending, 97016, doesn’t actually indicate cupping. It says vasonomatic device, which would technically be correct.

But you could use either, and they were paying it. So we’re pushing back, saying, well, there was no overpayment because the code was properly identified as an unlisted service and the dates of service for the code should have been paid. We, in fact, even went further and talked about recoupment in that when an insurance pays you for something that they later determined was paid improperly, Even if they shouldn’t have, case law says that they can’t go back for it.

And so really we pushed back in a lot of ways. So everyone panicked. I said, hold on, let’s see what’s going to happen. Well, about a week ago, actually a little over a week ago, this was Optum’s response. It says Optum’s claims department worked on a special project intended to remediate historical claims logic concerns, which impacted unlisted procedure codes.

Although our analysis of the Unlisted Procedure Codes is ongoing, the current recruitments are in the process of being voided. So all those ones they sent letters, now being voided. If they haven’t, go ahead and push back. We sincerely apologize for this inconvenience this has caused and appreciate your patience as we work to void these previous specific recruitments regarding the Unlisted Procedure Codes.

Additional communications will be coming. So in other words Oops, we made a mistake. That’s why often be careful. And that’s really why we do the network is to be there to help with this type of issue. When someone joins the network, not only do you get seminars, but you get this type of help. Quite frankly, this doctors, this office that had this issue.

Literally paid for a hundred years of the network based on what we charged, based on what was there. And realize though, network members, we’re going to get it to you first, but always know that we’re going to be here to support. If you had went to our website, which is the AAC Info Network under News, on July 25th we posted this.

So I want everyone to kind of calm down and say, wait a minute. The unlisted code should have been paid because it was part of the standard episode. From this point forward, do not use 97039. From February of this year, cannot. Now, for those of you that attended my VA seminar earlier this year, you heard this information.

You knew it was changed, but again, they can’t go back and recoup. As always, we want to be your advocate because Your success is ours. The American Acupuncture Council is really your partner. We’re always here to help. And that’s why we do the network where you can work one on one with me because members, I gave them this letter directly.

So if you’re a member. of our AAC Info Network. Now not insured, insured is your malpractice, but members of the network, if you’re still running into this issue, just reach out to me and I’ll send a letter to you. But I’m going to highlight this is going to be for members only. For others, you may have to go back and read it, but it falls in the same category.

Our goal, keep you going, keep you doing what you do well is to help people. And when people want to come after you, we’re going to be your line of protection. Until next time, everyone, this is Sam Collins.

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Food as Medicine Part 1

 

 

We are going to do that is by learning about how to give our patients advice about food.  And that’s why I call this presentation, Food as Medicine.

Click here to download the transcript.

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

Hi, this is Dr. Martha Lucas, and I am happy to be here today with you to present a presentation called Food is Medicine. And first, I want to thank the American Acupuncture Council for this opportunity. And I want to remind you that good health is easier to maintain than it is to acquire. And part of how we are going to do that is by learning about how to give our patients advice about food.

And that’s why I call this presentation, Food as Medicine. So let’s go to the slides. Now, first of all, language creates experience. For example, I have a lot of patients, as we all do, who are doing PT and they will sometimes whine a little bit about it Oh, every night I have to spend blah, blah, blah time doing my PT.

So I have tried to change their language about it to say they are pampering their body or they are pampering themselves. Like when you go to PT, you’re pampering your body. When you get a massage, you’re pampering your body, even when it’s a deep tissue massage, because As we get older, our body needs more and more pampering for most of us, especially if you’re athletic, if you’re active, you’re going to occasionally have some muscle aches.

As we get older, maybe we get some bone pain. So I’m, with food, it’s the same way. Believe me, and I’m sure most of you know this, people don’t like you to, what I call, fool around with their diet. First of all, diet just means what you eat. Diet just means lifestyle. People have come to think of it as a negative word with a negative connotation that a diet means some sort of restricted way that we have to eat.

But all of the original meaning is lifestyle. How you are existing with food. Now we, I’m going to present the food advice from a Chinese medicine perspective, but I want to start by reminding you that We, as practitioners, also need to know the Western medicine ideas about food advice because your patients are going to say something like, oh, I don’t know, this list of foods you gave me that’s for springtime looks like it has a lot of carbs in it.

Is that okay? So we need to be able to balance what they are learning from either just general society or Western medicine with what we are going to be teaching. telling them. Now, let food be thy medicine and medicine be thy food is a saying that we think came from the ancient Greek medical doctor Hippocrates, who is known as the father of modern medicine.

So foods that we eat can have a profound effect on our health. And that was known many. years and centuries ago when he started talking about medicine and food. And studies have shown that eating a healthy diet can help prevent or manage a pretty wide variety of chronic conditions like heart disease, stroke, cancer, diabetes, certainly heart disease.

Dietary interventions have the potential to have a very large effect on our health. But part of the issue is integrating it into the system. Integrating it into the health care system. Integrating it into our practices so that people will benefit. Listen to us. For example, when I have Mazen Cosmetic Acupuncture patients or Facial Acupuncture patients, like you might have, they’re super willing to eat the foods that we tell them will help their skin.

But for other kinds of health issues, sometimes it’s a little bit harder. We know that besides just giving us nutrition, food can prevent and treat disease. But again, prescribing food is a lot harder than prescribing a pill because the people just, lots of people just don’t want to change. Now in Western medicine, there is a food is medicine movement, and they have what they call medically tailored meals, and they have used those to help treat diabetes, heart failure, Obesity, chronic liver failure, they’ve shown that it helps reduce visits to the ER and generally lowered health care costs.

They also have what is called medically tailored groceries. Now this is where they give participants nutritional advice before they go to the grocery store with a kind of a list of foods of what to buy that mainly they’re studying to help lower blood pressure. And then they even have Produce prescriptions.

And again, that is, they’re starting that with children, produce prescriptions to help reduce diabetes in young children. Again, in Western medicine, what are their, what’s their food advice? One of them is bump up your fiber. Apparently only 5 percent of the U. S. population eats enough fiber, and we know that can help your gut health.

It helps lower cholesterol. It keeps us more satisfied after we eat a meal and it controls blood sugar. That’s one of the ways Western medicine would tell you to change your diet. Okay. Whenever you’re ready. Another piece of advice, which is a little more generic, is eat a variety of fruits and vegetables.

And of course, the amount they tell you to eat every day is almost impossible for people. But we know that fruits and vegetables have a lot of antioxidants in them, vitamins in them, and fiber. So again, we’re back to the fiber thing. They ask you to choose whole grains instead of refined grains. So like whole wheat instead of refined.

what we might call white bread or white wheat. And that helps with blood sugar levels. And again, blood sugar levels going up and down can create havoc with what we’re trying to do with our diets. Include healthy fats in your diet. So healthy fats like avocados, nuts, and seeds rather than unhealthy fats.

Limit processed foods. This means if you go to the store and buy a box that says, add chicken. That’s processed food. The only fresh food in there is going to be the chicken. Okay, sorry. Okay, that’s okay. Read food labels carefully. And again, this is the way Western medicine looks at it. And in just a minute, I’m going to get to the way Chinese medicine looks at it.

I just wanted to remind you that we need to know both medicines. Drink plenty of water. Water, enough water, staying hydrated, can even help with joint pain. Like your arthritis patients may just need to drink more water. And then have people make gradual changes. And even when I start the slides to Chinese medicine advice, have people start gradually.

We’re not going to be like, Oh, and today, in today’s visit, I’m going to change your whole diet behavior and your whole water drinking behavior. So make sure that we’re doing everything in a gradual way. And then Western medicine also recommends things like berries, again, lots and lots of antioxidants.

They have fiber, beans, Fiber again, green tea, which is something for the skin too, so your amazing cosmetic acupuncture or facial acupuncture patients. Green tea has a ton of antioxidants in it, although be careful about the caffeine of it, and then nuts and whole grains. So let’s look now at the west, the Chinese medicine way.

So when we see people in our clinics, a lot of modern medicine, modern, ways of eating and a lack of nutrition can impact my treatment of the patient, right? I mean if we have a person coming in for weight loss or an obesity related condition we need to give them nutritional advice. We need to give them lifestyle advice because that’s going to affect how effective our treatments look.

And we know that a lot of modern diseases, what they call modern diseases, can be helped with nutrition like hypoglycemia, insulin resistance, diabetes, food intolerance, adrenal fatigue, hormonal imbalances. So all of these, the treatment is going to be way slower. Our successful treatment plan is going to take way longer if we don’t.

add food as medicine, food advice as medicine. For example, kidney deficiency is very closely related to adrenal fatigue in allopathic or western medicine. We might prescribe herbs and acupuncture, and again, some lifestyle changes, but One of the major causes of that is blood sugar imbalance. So that again is not only what the person is eating, but how frequently they are eating.

So these are the things we need to know. So when I prescribe specific nutritional supplements and Chinese herbs to support the adrenals, I have to look at specific styles of eating of each different patient, because Acupuncture and herbs can improve the patient’s kidney deficiency, but we’re going to also be adding food into that.

When we add food in, the patient’s improvement can continue after we take them off herbs, or as we wean them off the frequency of acupuncture, because we’ve added that level of food as medicine, or nutrition as medicine. Now in Western, the Western diet foods are evaluated for things like proteins, calories, carbs, vitamins, and other nutritional content.

But in the Chinese diet, which includes herbs, we’re not only looking at vitamins, But also the energetic properties of the foods, like the energy, the flavor, the movement of the food energetically into some channels. Other aspects include organic or common actions of the food or the herb. Which organs does it affect?

Which meridians and which organs does it affect? For example, celery acts on the stomach and the liver and carrot acts on the lungs and the spleen. We need to know that sort of information in order to know which foods to recommend to our patients. The energetics of food refers to the capacity to generate sensations also.

Heat or cold, usually, in the body, so yin and yang. The five kinds of energy are cold, hot, warm, cool, and neutral. And this isn’t the state of the food, like I just made it warm physically. This is its effect on our bodies. For example, tea, in general, has a cold energy. This means that when we drink hot tea, Even though we heated it up, it can still generate cold energy and may therefore, according to Chinese medicine, be considered a cold beverage.

Now, we know that shortly after you drink the heat, the tea, that we have warmed up physically, the heat begins to fade, and quickly, according to Chinese medicine, it can start to generate cold energy internally and allowing our body to cool off. Other cold foods include bamboo shoot, banana, clams, crab, grapefruit, kelp, lettuce, persimmon, salt, seaweed, sugarcane, water chestnut, and watermelon.

So we might give those cool or cold foods to our patients who are suffering from a heat condition or this list of cool foods. Which includes cucumber, apple, barley. I don’t need to read the whole thing to you. Again, cool foods you might recommend to a patient who is having some sort of heat issue, some sort of too hot, or during the summer they live in a really warm climate.

Maybe we need to add Some cooler foods to their diet. Now remember, cold foods can damage the digestion or negatively, we won’t say damage, that’s a strong word, negatively affect the digestion, which is why we tell our patients, or sometimes we do, to stop drinking iced drinks because our digestion, our spleen, stomach, our earth, does not like iced foods, does not like iced drinks, it prefers warmer foods.

So again, with the cool and the cold food advice, you’re going to have to balance that with how much you drink. Am I going to be asking the spleen and stomach to tolerate when they prefer warm, energetic foods, and warm physical foods, to be honest with you. There’s a list of neutral foods. Okay, these are somewhere in the middle, energetically.

And again, there’s a list. Corn, apricot, beef, red bean, rice bran, sweet potatoes. Sweet potatoes are a great herb. Sorry, food that I often recommend to my patients because not only is it neutral energy, so it’s neither cold nor warm, but the earth loves earth tone foods, our earth energy, spleen and stomach.

So brown foods, orange foods, yellow foods. Then we have warm foods, which include chicken, abracadabra. seed, brown sugar, all the way up to walnut and wine. And again, these are warmer energetically. So if the person has more of a cool condition or a cold condition, we might start recommending warmer foods.

And then hot foods, again, you need to be careful because these hot foods can, for some people, be a little too hot, but they include foods like peppers, cinnamon bark, ginger. And ginger is interesting because we often like to give that to people for things like nausea, or I’ve Actually prescribed it for acid reflux, which doesn’t seem to make sense because it’s a warm or hot food.

But I tell people to just take a potato peeler on the fresh ginger and just that much of it in 8 or 10 or 12 ounces of water to just help get control their acid reflux because it’s so good for healing the digestion. So it’s important to know about the energies of the foods because they are going to act on the body in different ways and therefore affect our state of health in different ways.

If a person suffers from cold rheumatism and the pain is particularly severe on a cold winter day, then obviously you would be recommending to them that they should eat warm or hot foods because the According to our theory, that will help warm up the body and relieve that cold pain considerably. Or, I have down if a person suffers from skin eruptions, acne, or rosacea, things that worsen when exposed to heat.

then we would recommend cooling foods to them. So consider whether a food is more yin or more yang. If it grows in the air and the sunshine, it is probably more yang. If it grows in the earth or darkness, it is probably more yin. If it is soft, wet, and cool, probably more yin. And if it is hard, dry, and spicy, or needs heating up, then it is probably more yang.

TCM is, in TCM, when talking to your patients, it is essential to talk about nutrition, just like we need to talk to them about engaging in some sort of meditation or relaxation every day. And, they are probably, especially your weight loss patients, already talking to you about nutrition. TCM. What diet they’re on, whether they’re eating organic or not, whether they still drink soda or not, so they’re open to it.

And it’s not going to be a magic pill. It’s everything takes some time to heal. They’re not going to be, we’re not giving them a magic pill or a magic pill. Prescription like they think they can go and just buy at the grocery store. So they’re already asking you questions So this is a good time to start asking them about how their digestion is and what they are eating What is their like I just have a I just have a weight loss one of my weight loss patients Gave up soda a few months ago.

Yay, too much sugar probably drinking with ice in it and she recently had been telling me that she used to go to a coffee shop and every day or four or five days a week and get a drink and a piece of some like pumpkin bread. So I needed to talk to, I said you need to read those labels, read the nutritional advice about those things that you’re buying and see how much sugar is in them, how much saturated fat is in them, and She was able to stop doing that also because she is committed to losing weight.

Now, we know that the ability to build qi and blood is directly related to our digestion, so we may be giving a patient herbs for this, or again, look up blood building herbs, look up qi building herbs. Foods, blood building foods, qi building foods because again, those would be the building blocks for digestion.

1st things 1st, we want to hear how their digestion is, and we want to advise them on food that will help build their digestion. And reading labels, because a lot of our food is much less nutritious than it was. 40 or 50 years ago. According to a study published in the Center for Disease Control and Prevention’s Morbidity and Mortality Weekly Report, 70 percent of adults do not eat at least two fruit servings and three vegetable servings a day.

As I said in the introduction, The Western medicine, just in general, we hear that we need to be eating that many fruits and vegetables. And as we know, about 70 percent of adults do not do that. So this is partly why people in Western medicine started to look at nutrition when they started to study what people are actually eating.

So health is not created in a vacuum and nor is disease. We know in Chinese medicine that lifestyle affects health. How healthy we are and how much disease or how many conditions or how many symptoms we have. If the patient has a poor diet, we know acupuncture and herbs can work, but also we need to give them advice for at home.

And a lot of times that’s going to be food. When acupuncture was first developed all those thousands of years ago, people lived and ate closer to nature. It was easier to eat nourishing food back in the days of Hippocrates. But today, processed foods and those containing large amounts of hydrogenated oils, high fructose corn syrup, and dyes have de vitalized our food, literally made it less nutritious to eat.

So eating a lot of de vitalized. Food can lead to devitalizing blood. And that is in processed foods. Processed foods are the most de vitalized foods and the ones that are probably most closely linked to diseases like obesity, diabetes, heart disease, and cancer. So this is our challenge, both for ourselves and the people with whom we work.

For the first time in human history, we can make conscious decisions. We must make conscious decisions about our food and lifestyle habits because we have so many choices. I remember the first time I taught over in Turkey years ago and was in the European side of the city, there was a beautiful mosque with the first floor was a McDonald’s and I thought, Oh my goodness.

Look at that. Mosque, ancient history. Back in the days when food was more vital, had more vital energy in it. And now we have, no offense to McDonald’s, but McDonald’s underneath. So that’s what has started to happen with our foods. We have left the old world style. And now we are eating what you might call more unnatural food.

So we have, Sources to guide us, like the collective wisdom of our ancestors, and that’s from generation to generation, right? And in the West, like I said, we are starting, Western medicine is starting to look at lifestyle and food. But, we have a much greater history of that to look at in our medicine.

This is the end of part one. Of my presentation about food as medicine. And again, I want to thank the American Acupuncture Council for this opportunity. If you have any questions about this presentation or about any of my teaching, you can look up my website, lucas teachings.com, or my private practice website and my email or@acupuncturewoman.com, and I am always happy to answer any of your questions.

So I’ll see you next time for part two.

 

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Acupuncture in the Heat of Summer

 

 

Click here to download the transcript.

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

Hi, my name is Moshe Heller, and I’m from the Moshen Herbs. I’d like to thank the to AAC for, for hosting my talk on the heat of the summer, how to support children and adults through this hot summer or the heat of the summer. So I wanted to mention that I’ve been seeing in my patients lately a lot of Heat diseases which manifest with sore throats and typical heat symptoms and a lot of damp heat.

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I’ve had quite a few cough, this dry, barky cough patients that also have this heat symptoms that usually comes with cough. Fever, they feel feverish, whether they have a fever or not. And also, a lot of COVID 19 presentations with slight fever, feeling very body achy. And also sore throat as part of that presentation and after a few days that develops into a dry cough.

So as I was seeing these cases that came very soon after that kind of damp heat weather that we were I think that I correlated that together and I started thinking of how I can support these patients that are going, that are presenting with these very hot and damp symptoms to prevent those things from happening.

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So let’s move to the slides. And this is going to be what I’ll be talking about, is the heat of the summer. And I just wanted to, I wanted to talk about this subject because this summer has been particularly hot. And, and, uh, there has been, I have been noticing that, And that there have been more than usual cases of colds and flus and strep and COVID 19.

More than usually what I usually see in the summer. So usually in the summer we see a lot less. illnesses. And so we’ve seen in the past two months that we’ve had already a few heat waves, and that is a little bit that shows that there’s a unusual pattern this summer. So this summer has been unusual in that sense.

And that’s why I wanted to talk a little bit about how do we support our patients in this kind of A different type of weather, and especially when we see that there are changes in, in, in the presentation of our patients. I usually don’t think of this formula, I think of this formula more in the weather changes, but since this has been an unusual weather pattern, I have seen, I have been prescribing more and more of this formula, what I call the SHIELD formula for Moshen herbs.

And it is based on Jade Windscreen and in combination with Gui Ji Tan to help support the yin and the wei. And this combination together with some more harmonizing herbs and supporting the wei qi has been very effective in treating and supporting and preventing diseases in my patients. Thanks. It is, um, it’s it’s Uh, a formula that really supports this kind of wei qi on the exterior, but also I added some ban qia and qian pi to help transform some dampness.

Since this summer is damp and hot, we needed those. It actually works really well to support releasing or preventing some damp from accumulating. I also added Gaggen to support the muscle layer, and Lingzhi as an adaptogenic mushroom that supports the immune system. So this formula creates a really great support for the immune system.

You can see how it’s laid out here. We have Yu Ping Feng Sang as the base, Gui Ji Tong added, and also JinYinHua, I’m going to mention this herb again, is a very important herb. A lot of times we’ll see in China the summer tea of just JinYinHua and JiuHua together to support this ability or to help the ability to go through these summer damp, hot days.

And the combination of Urchin Tongue in this combination. I also wanted to mention Cunning Tongue. This is a great preventative formula for summer digestive issues and summer colds and stomach flus. And I usually use this formula in, in, while I’m traveling or away and especially in countries that I’m not, that have these.

It tends to be damp and hot, like India or even China. And we add, so the, you’ll see the original formula here is in black. Fuling Yi Ren, Ho Xiang, Hupo Bai Zhe, Shenshu and Changzhu, and you’ll see all the other ingredients. This is a great formula. I usually add, I do some changes when I’m working with that formula, either because Shenshu has.

Wheat, I sometimes substitute that, and especially if there’s some concerns about wheat allergies, and sometimes either substitute Zhuhong with Chen, or, um, or add Chenpi. I also like to add Qiankuang as this kind of anti inflammatory, it’s basically turmeric, and also, as I mentioned before, Ji Ninghua, Sha Ren, and Jurgen Sao.

So this cunning tongue or curing formula is another amazing formula that you can give to your patient during the summer months as a preventative for getting, uh, sick. I also wanted to mention Digest, Because this is, um, similar to the curing formula, but it’s based on Baohe1, um, which is, um, slightly different and works a lot on the ability of the body to digest food.

Um, and we’ve, again, I modified it a little also to support digestion and clear wind heat and regulate the qi. And so I included Lian Xiao, Ge Gen. And Ji Ning Hua, as I mentioned, and Zhu Hua. So, actually, this digest could also be used as a preventative during the summer months to keep our systems clean. A very, very balanced.

Again, you can see here, strengthening the spleen and generating fluids, transforming foods, stagnation. I have Sanjiao, Liufuzi, Laifuzi, uh, Sha Ren and Gu Ya and Wu Mei. And then I have again, Urchin Tongue to resolve dampness. And some herb, wind, wind releasing herbs. As far as acupuncture, and this can be also given as acupressure, we, of course, when we’re seeing our patients, we need to make our basic pattern diagnosis.

But, on top of that, I usually think of adding things like points Do 14, Large Intestine 11, to help the body clear heat. As well as Stomach 36 and Spleen 9 to support the qi and drain dampness. Stomach 25 to regulate the intestines and pericardium 6 to help regulate the qi and this sometimes this combination of heart 6 and kidney 7 is appropriate when you see some heat going or tendency to have these heat coming up like night sweats and symptoms of this kind of deficiency in Rising.

Stomach 36 and spleen 9 is something I teach my patients to do a self acupressure to help, especially in those damp days, to help that the damp won’t penetrate and keep the chi flowing well. And so this is something I just give as a tip to my patients to help them move through these damp, hot days.

Thanks. In terms of diet, we also, we also remember that the summer is a season of fire and young and growth and maturation. So the food that we eat should reflect that. It should be light and colorful and lots of vegetables that are in season at this time. We usually tend to cook lightly, steaming, sautéing, um, a quick sauté so it gives them the first boost of heat but not overcooking or even grilling slightly to give that first fire going on.

And usually we tend to recommend to eat slightly spicy and pungent because actually a lot of times, We think that we need to eat cooling herbs to reflect the summer, to be in contrast with the summer hot and damp. But the truth of the matter is, if you think about it, it actually is better to eat warmer foods during the summer because that heats the interior and then there’s less of a difference between the body and the exterior and the body can withstand that much better.

So, these are just examples of how you can, what you can give as a, as a support for the summer in terms of diet. And also, one kind of traditional remedy is this mung bean soup or mung bean tea, where we use mung beans since they are cooling and supporting and helping to relieve summer heat. It’s a great addition to the diet.

To support these months. I hope I gave you, uh, a little bit of an in introduction to what are the things you can do to help your patients move through these summer days, and I’ll be happy to. If you have more questions, you can contact me@theMoshenherbs.com or in the Moshen center.com. That’s my new office, and I, I thank you for listening.

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The Importance of Clearing Blocks before Treating the Face Part 2

 

 

I’m going to do a presentation, which is part two on the importance of clearing blocks before treating the face.

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

Hi, my name is Michelle Gellis, and I would like to thank the American Acupuncture Council for giving me this opportunity to talk to you today. I’m going to do a presentation, which is part two on the importance of clearing blocks before treating the face. You can go to the first slide.

So last time I did a presentation on the importance of clearing blocks before treating the face, part one. And you can find that at the AAC website. And it is also available on my website, Facial Acupuncture Classes.

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So a little bit about me quickly before I get started. I am currently on the doctoral faculty at Yosan University in Los Angeles, and I’m a former faculty member and clinic supervisor at the Maryland University of Integrative Health. I was there from 2003 until 2021 and I teach facial and cosmetic acupuncture classes internationally.

So last time I talked about what an energetic block is, and I would just like to do a review of that quickly. So an energetic block essentially is a break in or an impediment to the smooth flow of chi. and blocks can prevent treatments from being effective or can prevent treatments from holding. And in the Lingxu we are taught that only when stagnation is cleared away, the channels can be vented and yin and yang can be harmonized.

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So When you’re performing acupuncture, whether you’re doing facial acupuncture for cosmetic or neuromuscular conditions, there is a lot of chi and blood brought up to the face. To help with the circulation of the face. And if that chi cannot flow smoothly through the meridians, through the channels, to the points, then your treatment will not be as effective.

So last time the blocks that I talked about were a possession and aggressive energy. This time, I am going to talk about husband wife imbalances, or an HW, and also entry exit blocks.

A husband wife imbalance is probably of all the blocks that I covered today. Last time, or of all the blocks that can exist that we treat, an HW is probably the most serious of the blocks and If someone has an HW, it is a sign that their health is declining, their natural healing resources have been depleted, and Yin and Yang.

are losing their their functions, their functional contact. So left untreated over time, the person’s health will deteriorate to the point of them being beyond health.

Due to the severity and the nature of this type of block, the and the number of needles usually used during facial acupuncture treatment, it’s imperative to clear this block, if it is present, before doing any sort of cosmetic treatment on your patient. Otherwise, you could further deplete your patient, leaving them weak.

and at risk of serious physical or emotional deterioration. So how do we determine if someone has a husband white imbalance or an HW? So what you will notice is, so normally the left hand pulses, the pulses on the left side, are stronger than the pulses on the right. But if someone has a husband wife imbalance, then the right side pulses are going to be stronger in quantity, so they’re going to be bigger, stronger pulses, and they will have a different quality, sharp fighting quality to them.

So the right side pulses will be stronger than the left side. So the right side pulses are considered to be the wife’s side pulses and the left are considered to be the So you’re, you have this imbalance where the, Wife pulses are bigger.

So what it looks like is this. Normally these pulses here are your wife pulses. These are the husband pulses. So these are the pulses that are on your right side. So we’re going to have the right side of fire. So we’ll have

your fire, and we’re going to have your earth pulses and your metal pulses. So this energy goes like this. The part of fire on the right side says Sanjiao. And So your Sanjiao pulses and your pericardium pulses will be bigger than the left side of fire, which is heart and small intestine.

So your right side pulses are all going to be larger. And so you’ve got all this process. But there’s a block right here. And the energy is not making it over to the water and the wood, which is all about growth and expansion. So we’ve got all this process, but there’s no growth. So how do you treat it?

You are going to go, first thing you do is you’re going to start down here and you’re going to tonify the metal points. in water. So you’re going to go to bladder 67 and kidney 7. So you’re pulling, you’re trying to break this block here by pulling the both sides of the yin and yang of water. So bladder 67 and kidney seven, you’re pulling that energy over and you’re going to tonify.

And then you are going to pull the energy from earth down to water. So kidney three, Then you are going to bring the metal to wood, and that point is liver four, and again these are all tonification. And then you are going to tonify the source points of small intestine and heart to bring the energy to heart four.

and small intestine with heart being last. So between each set of points you’re going to check pulses to see where the where the block existed.

Sorry. Okay.

The next block that I’m going to talk about is an entry exit block. And the reason why these are really important when you’re working on the face is because there is either an entry or exit point for each one of the zong on the face. So here we have the exit for small intestine, the entry for bladder, we have the exit for Sanjiao, the entry of gallbladder.

the exit for large intestine and the entry for stomach. So if this is the Chinese clock and energy moves around from one, from liver to lungs, the large intestine to stomach right around the Chinese clock, if there is a block while the energy is moving around through the meridian system, through the Chinese clock, then there is a place where the chi is not getting through.

I’m a J. R. Worsley trained five element acupuncturist, and one of the things that J. R. did was he set up the meridian system. So for each meridian, he gave it a Roman numeral, and part of the reason why he did that was it makes it easier to talk about To while your patient’s in the room. Let’s say you’re supervising in clinic and you have a student and you wanna talk about the patient, but you don’t wanna alarm them, you could say, do you feel this quality on one?

So they are numbered according to the flow of energy through the body, according to the Chinese clock. And we always start. with heart as one, and so heart is Roman numeral one, small intestine is two, bladder is three, kidney is four, pericardium is five, sangio is six, gallbladder is seven, liver is eight, lung is nine, large intestine is ten, stomach is eleven, and spleen is twelve.

And do note that the entry exit points are not always the first and last point on the meridian I have marked out. You can see here, for example, Large Intestine 4 is the entry point on Large Intestine. And Gallbladder 41 is the exit point on Gallbladder. Lung 7 is the exit point on Lung. So it’s not always the last point on the meridian.

So if you don’t remember where the exit, what the exit and entry points are. You can refer to this chart. So again, the energy goes from heart to small intestine, to bladder, to kidney, to pericardium, et cetera, et cetera. And then once it gets to spleen, once it gets to 12, it goes back to one again, right around the clock.

So I used a highlighter to show the different pairs. So if this is a pericardium, pulse chart. When you’re feeling the pulses, what you’re looking for are going to be breaks between, so you’d be looking for a break between the paired meridians, so small intestine, to bladder, right? So this would be a 2 3 block.

So if these pulses are larger than these pulses, then you have a block. So small intestine to bladder, Would be a 2, 2, 3 block. Then you go again in order, you go from kidney to pericardium. Then we go from sanja to gallbladder, from liver to lung, from large intestine to stomach and from spleen to heart. So you can see.

the way the the blocks could occur. The ones we’re most concerned about are going to be the ones on the face. So between small intestine and bladder, between large intestine and stomach, and between sand jaw and gallbladder. Those are the ones that have either an entry or an exit point. on the fifth.

So again, we identify them on the pulse, and if the pulse of the lower numbered meridian is stronger than the pulse on the higher numbered meridian, according to the Chinese clock on that chart I showed you, then we have what we call an entry exit block. Some people call them exit entry blocks, but it’s just semantics.

In my book, I changed the, this is from one of my PowerPoint presentations, but in my book, I I changed it to exit. entry block because it’s an exit entry block, which you’ll see in the next slide. So the treatment is you’re going to tonify the exit point of the lower numbered meridian, which is the stronger pulse.

Then you’re going to tonify the entry point of the next meridian. And by tonify, the way that we do it is you’re going to insert the needle, And in the flow of energy, in the direction of the flow of the energy, and you’re going to turn it 180 degrees clockwise, and then take it out.

There are entry exit blocks that exist. on the chest, and these would be between spleen and heart, kidney and pericardium, and large intestine and stomach. And these have to do more with the heart and the lung functions. Here we have, again, the entry exit blocks on the face, and these are going to be closer to our senses.

So I already went through all of this. So this is what I was trying to explain. If this it’s like a kink in a garden hose. If the energy of the smaller numbered meridian, let’s say small intestine, bigger then the energy on the next numbered meridian, so bladder, then we have an exit entry block.

And so when I feel pulses, I put my hands on both wrists and I go around and I feel two to three, And then I go 4, to 5, to 6, to 7, to 8, to 9, to 10, to 11, to 12. And then back around again.

And I already said this. The last block is a CBGB block. And that is a less common block. It is between Ren and Do. And REN and DEW are like the seas that feed the rivers. So the rivers and are the meridians, but the repository for all of our all of our energy is through REN and DEW and REN and DEW.

If there is a block between rent and due, then that energy is not going to be able to get out to the meridians. And what you will feel on the pulses is all of the pulses will be very low. And this can happen due to sexual abuse, trauma, or if a husband wife imbalance goes too long without being treated.

The treatment is you’re going to tonify CV1. And you’ll tonify, so you there’s special draping that you’ll have to do, and you’ll have to have gloves, and you talk to the patient ahead of time about what it is you’re going to do, but you are going to tonify CB1, you take the needle out, change your gloves, our new gloves, you’re going to tonify CB24, then you would tonify CB1.

Take off your gloves, put on new gloves, and then you would tonify GV28 and you check the pulses again.

My book is hopefully going to be out the first week in September or thereabouts, maybe the second week in September. And it will be called Treating the Face. It’s a comprehensive manual for acupuncturists and allied health professionals, and it’s going to cover everything from cosmetic and neuromuscular facial acupuncture, cupping, gua sha, Red Light Therapy, Microneedling, The Anatomy of Expression, Self Care, Skin Care, Nutrition.

Everything involved with treating from the clavicle. And if you are interested in getting on the waitlist to pre order, you can go to my website, facialacupunctureclasses. com, and there is a place where you can pre order. Sign up to be in my waiting list. So thank you again to the AAC for this opportunity, and I look forward to seeing you next time.

 

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Qigong for Wrist and Elbow Conditions

 

So today we’re going to present on some therapeutic exercise, some qigong exercises for the wrist and elbow.

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

Hi, I’m Brian Lau. I’m with Sports Medicine Acupuncture, also with Jing Jin Movement Training. I want to thank American Acupuncture Council for having me again. So today we’re going to present on some therapeutic exercise, some qigong exercises for the wrist and elbow. Maybe a little more towards the wrist and for wrist dysfunction some mobilizations and just range of motion movements for the wrist, but it’ll also engage the elbow and we’ll look at the mechanics for both of those. So I have a presentation, we’ll go through a little bit of anatomy and then I’ll show some exercises. So let’s go to the slides and we will jump right in.

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All right, so first of all, the wrist joint is also called the radiocarpal joint. That is a condyloid joint. Condyloid joints, you can see it on the right on that image, it’s a modified ball and socket joint. This particular joint allows for flexion, extension, and it allows for, depending on your terminology, you might say radial deviation and ulnar deviation.

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You might call those abduction and adduction too, but basically those four movements. So flexion, extension, radial, and ulnar deviation. So there’s a decent amount of range of motion for the wrist joint. But then we can also look at pronation and supination that occurs at the distal and the proximal radial ulnar joint.

The exercises we’ll be doing will be employing those ranges of motion of flexion, extension, radial and ulnar deviation, and then of course pronation and supination, really pronation and supination are key to proper functioning of that joint. So here’s a little bit of an image that shows those.

I’m sure everyone’s familiar with these movements. But we have the normal ranges of motion. So for flexion and extension, normal range of motion is 80 to 90 degrees for flexion. 70 to 90 degrees for extension. So there’s some variability, but you want nearing 90 degrees. For ulnar and radial deviation, you have a little more range of motion for ulnar deviation.

We’ll look at the mechanics of why. So that’s about 30 to 35 degrees for ulnar deviation, a little smaller range of motion, 15 to 20 degrees for radial deviation. And again, we’ll look at the mechanics for that. And then for pronation and supination, we have about 90 degrees for both pronation and supination. Looking at the mechanics of the wrist, so the radiocarpal joint, there’s less space, your articulation is between the radius and the carpal bones. And there’s a little bit more space between the ulna and the carpal bones. And there’s a fairly complex structure. The triangular the triangular geez there’s a blank on the name triangular fibrocartilage complex, sorry about that is in this region.

It’s a collection of ligaments. There’s a meniscus and a disc. So there’s a lot of anatomy here that can get injured. That TFCC can become injured, there can be tears in the meniscus, and tears in the ligaments in this structure. But there is a little bit more space, and that greater space allows for greater movement and ulnar deviation. When we’re doing radial and ulnar deviation, I just wanted to highlight a couple things with the anatomy here, is that we can do a little manual work to help open up that range of motion. And in particular, we can come in between, to the ulna, between this fascial compartment that that contains the extensors of the wrist, particularly extensor carpi ulnaris.

We can move that away. and stretch that tissue as we’re doing the radial deviation to help stretch that tissue. We can also come in at that space pretty much along the large intestine channel here between the extensors of the wrist longus and brevis. So we can go in these fascial spaces and open those up while we’re performing the motion.

We’ll look at that when we come to the actual exercises. We’re going to look at a couple stretches for the wrist and then we’ll look at a couple more complex movements. So just so we have an idea with that, when we’re doing radial deviation, we can go into this space and kind of move this fascial compartment away from the bone, move the extensor carpi extensor carpi ulnaris away from the bone and create a little bit more space as we’re doing radial deviation and same thing applies.

When we’re doing ulnar deviation, I can come into the large intestine channel along the extensor and brevis brachioradialis, this mobile wad of three is what it’s called. These three muscles that are very mobile, I can get into that fascial space and open up the compartments while I do ulnar deviation.

So we’ll look at that in context in just a moment. We can also work on the lung channel on that same. Mobile WADA3, but on the volar side of the arm, the anterior portion of the forearm, and open up that fascial space. So the elbow itself is a hinge joint that’s going to allow for flexion and extension.

We’re primarily going to be looking at the wrist movement in this webinar, but but we will employ some movement in the elbow and it’s going to be that flexion and extension. But there is also that proximal radial ulnar joint does pronation and supination. It happens at both the proximal and the distal.

Radio ulnar joint. When we’re doing the pronation and supination, it helps link those motions. And it’s the case that when I do supination, I can increase that supination by going into elbow flexion. So supination, I can go a little farther with elbow flexion. And pronation, I can go a little farther when I do elbow extension.

So there’s a relationship between the movement of pronation and supination with elbow movement and we’ll look at that in just a moment. So for pronation and supination, we have multiple muscles that perform those. For pronation, we have pronator teres, we have pronator quadratus at the distal part of the forearm, and we also have both the extensor carpi radialis the, excuse me, the flexor carpi radialis and the brachioradialis.

Thanks. Both of those help maintain a certain amount of radial deviation when I’m doing pronation. So especially, some sources say brachioradialis more, some flexor carpi radialis, but they’re both involved. with pronation. For supination, I have the supinator, biceps brachii, and then the extensor pollicis longus of the thumb, so that helps pull the forearm into supination.

So a lot of muscles involved with those beyond just the pronators and supinators. So that’s the overview of anatomy. Let’s look at some of the exercises. Moved back just a little bit. We’ll start, I’m going to stay seated. We’ll start with some wrist mobilizations. So the first thing we have is we can work on extension.

So I’m going to bring my fingers together, index, ring finger, and the index finger. I’m going to put my middle finger on top. So Thumb and pinky together, holding something away from me, and elbow extension. I want to contract the flexors and stretch the extensors. So I want this to be somewhat active in the sense that I’m contracting the wrist flexors to be able to inhibit those extensors.

I’m giving a little over pressure to stretch those. That’s a nice stretch. If I want to increase that though, I can put my thumb inside and make a loose fist. Same thing, activate the flexors that’s going to stretch the extensors and a little extra overpressure to be able to really stretch that extensor compartment and do that a couple of times.

Exhale, contract the flexors, overpressure and stretch. Maybe do that three times.

And stretch. So to stretch the flexor to turn palm up into supination, straighten the elbow, and same thing, I want to engage the extensors to help inhibit those flexors. So I want this to be an active stretch. I want to pull my fingers back, pull the wrist back into extension, exhale, and a little over pressure, maybe for about two to three seconds.

Then again, open into extension, pull the fingers back, exhale, stretch, flexors. One more time. So again, I’m active, engaging those extensors to be able to stretch the flexors.

All right, so ulnar and radial deviation. So again, there’s less range of motion for radial deviation, a greater range of motion for ulnar deviation. That’s normal mechanics. But, I would say that many people get restricted on that radial deviation part, and everything sits and lives a little bit more into the ulnar deviation.

Think about typing on a keyboard, there’s a lot of things that we would do that would favor that ulnar deviation, and that can really compress and wear down that TFCC, that triangular fibrocartilage complex. on the ulnar side of the wrist, at the sand small intestine five region. So that would be a way I could go in with an acupuncture needle.

I can stimulate that area, increase blood flow at SI5. That’s a really good point for that. But then at some point I want to be able to stretch and open that side up. So I’m going to start with radial deviation. So I’m going to put my, I have my palms together. I’m going to put my little finger side out.

Stabilize the wrist. and pull into radial deviation. So this is where I can do a little bit of manual work if I want to help increase that. I can do it by just giving a little over pressure to go into radial deviation, but now I can go along the small intestine channel right up against the bone, pushing the extensor carpi ulnaris away from the bone, pulling down, and as I pull it’ll give a fascial drag on the periosteum of the bone on the extensor carpi ulnaris muscle.

So again, move down, push the extensor carpi ulnaris away, so I can lock me down into the bone, and then radial deviation to give a little stretch. So I can work down, eventually as I go farther towards the elbow, farther proximal, I’ll run into the anconeus muscle, right about there is where I’m starting to get into anconeus, but my goal is really at that extensor carpi ulnaris.

I can work more distal and work towards SI6. which is the border of that is the extensor carpi ulnaris right there on the bone and stretch. That’s a part of the triangular fibrocartilage complex is that extensor carpi ulnaris tendon. So it’s nice to be able to work on the tendon sheath and start to loosen that up.

Ulnar deviation. If I have a triangular fibrocartilage complex, Tear, that might be a painful motion. So I have to let pain be my guide for this, but for most people it’s gonna be fine. So I can stretch this way, but same thing I can now go at the along the ally channel, at the border of that mobile wat of three, and I’m going over the thumb muscles, the extensor lysis, brevis.

And Abductor pollicis longus. These are muscles that get injured with De Quervain syndrome. They can become very painful, especially when you go into ulnar deviation. Finkelstein’s test would be just that, where you put the thumb in and, oh, that hurts, that would be a positive for De Quervain’s.

So it’s useful to stretch this compartment out. I’m going to hold and same thing, pull down, ulnar deviation. So working over those thumb muscles. And then following along that border of the mobile WADA3 to be able to stretch, I’m going right up against the bone. So into that fascial space, up against the bone, pull towards the elbow, stretch.

So this is something you could do with patients. You could also show them this as a corrective exercise. I can go also along the lung channel, pull down, ulnar deviation to stretch.

Working to free that mobile WADA3, to free the borders. and help increase the range of motion into ulnar deviation. Okay, so last mobilization, we’re going to do pronation and supination. So this one, I want to have my arm by my side because I don’t want to be doing a lot of shoulder motion. So I’m going to use index finger, middle finger.

I’m going to stand up a little bit so you can see this one a bit better. Back up.

Index finger, middle finger, surround the thumb. I’m going to use my thenar eminence to block the wrist on the ulnar side, wrap around. So I’m going to pull with my fingers, push with my thenar eminence, and increase supination. I can use my extensor pollicis longus to pull back. That’s going to increase that supination.

Lift my little finger, that’ll increase supination, and overpressure. So Index finger, middle finger, either side of the thumb, thenar eminence against the wrist, overpressure. Pronation, palm down, thenar eminence on the radial side of the wrist, wrap the fingers around, and this is the one that I really want to be cautious, not because it’s going to cause injury, but I’m going to miss the stretch not to lift my elbow because that becomes a shoulder motion.

Not very challenging on the shoulder either. So I need to stabilize that elbow to the side and just do pronation. So same thing as I can bring my thumb down, little finger up, over pressure into pronation.

All right, same thing, two, three times to start to increase that. Again, don’t let the elbow come up because that takes the stretch away from pronation, brings it up into the shoulder and it’s not going to really do you much. I need to keep that elbow up against the side, pronation. Alright, so supination, pronation.

Alright, so let’s look now at a couple Qigong exercises. I’m going to back up just another step. Move this chair out of the way. So this is a common one that I use in Tai Chi and Qigong classes. Also on my own. It’s a very simple exercise. It’s actually built from standing meditation. In standing meditation, you might have a shoulder width stance, sitting a little bit, dropping the pelvis, letting the pelvis sink down, the head rises up, so there’s a little bit of stretch in the spine, and I’m slightly engaged in the center, round.

So there’s a round structure as if I’m holding a paper ball. My hands are open, fingers are spread out a little bit in the abduction. And the wrists and the fingers are aligned. So that would be a typical standing meditation posture. When I do this exercise, I want to use that standing meditation posture.

I want to have that little bit of a drop of the pelvis, a little bit of a elongation of the head. So do 20 towards the ceiling, a little bit of compression in the torso. And I have my shoulder blades coming around. And very round like I’m holding a paper ball. So that’s going to be the starting position, and from there I’m just going to rotate.

So I want to keep in mind how the thumb and other structures are keeping that wrist aligned. I don’t want to get too floppy with the wrists. A lot of people, when they do this, they start flopping, they lose the pronation and supination. I want to keep that alignment there. Almost as if I’m going around my middle finger or my index finger even better.

So just turn, I can go slow, or I can go fast. Once you get comfortable with it, you can speed it up a little bit. And I want to just let that motion move the body. So I’m pronation supination. This one you could do for about a minute or two. Just a nice warm up for the forearm. Starts really working the wrist and the elbow joint.

Next one is going to be built from that. Same posture with the body. Turn the top palm out, reach out, other hand comes in. I want

this one to move the ribcage, maybe a topic for another day, because there’s a lot of diaphragm motion, a lot of movement in the liver and the spleen. But we’re thinking about the elbow and the wrist, so I want to be able to fully pronate, turn the palm out, straighten the elbow.

Other hand supinates, comes in.

I can make this one slightly more round if I want, and reach,

letting the shoulder blade come around the ribcage.

Alright, last one. So this one I actually did in another webinar with American Acupuncture Council, it works on opening the chest up, but it also features that pronation and supination, so pronate, pull the chest open, straighten the elbow, reach out. Fully pronate,

chest rises, open,

open. Turn the forearms, line the hands up. Keep opening, hands are slightly in front of the elbows. Pull the shoulder blades together so this one starts really working on the chest quite a bit too. Fully press out, chest starts to compress, back

to neutral. Line everything up, fully open the chest,

and finish. So three exercises, all part of a standing meditation, Yi Quan type training. Their derivatives of that, first one’s just rotating the forearms, then the forearms rotate as I reach out, mobilizing the ribcage, but it also gives a nice stretch to the elbow. Stretch and challenge to the wrist joint, keeping good alignment to the wrist, and then opening the chest,

and involving the elbow, wrist, and shoulder girdle. Alright, so hope you find those useful. Those are great exercises to do for yourself. Especially after a long day of work, last one in particular, but great for patients. I use those quite frequently for patients for a whole host of issues. We were looking today at wrist and elbow, those would all be useful for those types of, many of those types of conditions, but that last one also very useful to open up the breathing, open up the shoulder girdle, so good for shoulder health.

Any of those motions, if there’s sharp pain or something discomfort, uncomfortable when patients are doing that, you have to let pain be the guide and modify it based on that. But they’re very adaptive, easy to work with, patients find them very useful. They’re pretty easy exercises too with a little bit of coaching.

So I’d recommend doing them yourself, get used to it, and then start working with those with patients. They’re really nice exercises. Thanks again to the American Acupuncture Council. Always fun to come and to present some of this information. I’ll see you all another time.

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