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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.
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.
Hello, everyone, and welcome! I’m Dr. Krystal Lynn Couture, and today we’ll be talking about the pelvic floor and menstruation. But first, I want to take a moment to extend my abundant gratitude to the AAC, the American Acupuncture Council, for hosting this educational video, as well as other amazing videos that are on their vlog.
Seriously, check it out. There are tons of clinical pearls and nuggets of wisdom on all topics acupuncture and Chinese medicine. So let’s get started with today’s topic. the pelvic floor and menstruation.
In today’s mini workshop, we’re going to be talking a little bit about the history of menstruation and how it was viewed through society. We’ll talk about some Chinese medicine philosophy, including what the Siwen says about menstruation. We’ll talk about the elemental cycles as well as the hormones.
We’ll also talk very briefly about some of the common dysfunctions that are associated with menstruation, such as dysmenorrhea, or painful menstruation, irregular cycles, menorrhagia, which is heavy bleeding, or amenorrhea, which is the absence of the menstrual cycle. We’ll also chat about the connection to the pelvic floor throughout the menstrual cycle.
Let’s get into it. So let’s look at the Western history first. And there are some pretty interesting things to note here. In ancient Greece and Rome, in antiquity, menstruation was often viewed with a mix of awe and fear. The ancient Greek physicians, like Hippocrates, described menstruation as a natural process but it was surrounded by a variety of superstitions.
As we moved into the medieval period, menstruation was actually framed within religious and moral contexts, and the women’s menstrual cycles were actually associated with sin or divine punishment. Now moving into the 19th and early 20th century, This was our first sort of win, if we can call it that.
Menstruation was actually considered a biological process and given a scientific definition. And this was basic in that the blood and mucosal tissue fluid flowed once monthly throughout the vaginal opening. Now, as we move into the 1960s and 1970s, Okay, so this is really recent. Women have been bleeding since the beginning of time, and yet it was the 1960s and 70s when feminists began to challenge the stigma that surrounded menstruation.
And there was an increased awareness of the impact that menstruation can have on a woman’s social and professional life. Finally, in the state of present feminism, the world has recently started talking about menstruation. Amazing! And there are some really big voices out there in both Western and Chinese medicine that are setting the stage for women to learn about their bodies, to talk about menstruation, and to honor their cycles.
As a woman, this feels huge because there are so many questions that I feel women have regarding menstruation. And growing up in the 80s and the 90s, as a child during that time, I didn’t ask questions. I wondered what was happening in my body, but it didn’t seem like there was an opportunity to ask those questions.
I didn’t feel like there was a stigma, but there wasn’t an opportunity either. And I think of women feel that way. And a lot of women continue to feel that way. So as acupuncturists, we’ve got this beautiful opportunity to help clients understand their bodies, to help them honor their monthly bleed, to help them gain some knowledge.
about what’s happening within their biological system, within their ecosystem, so that they can then, one, get help when they need it, two, identify when something doesn’t feel right, and three, feel like what’s happening is okay. And it’s normal and there shouldn’t be shame and other negative emotions associated with it.
I love this quote from Christiane Northrup, an MD. She says, The macrocosm cycles of nature, such as the ebb and flow of the tides and the changes of seasons, are reflected on a smaller scale within the menstrual cycle. I think if we can instill One connection for our clients that are coming to see us for menstrual support.
It’s that the menstrual cycle is natural and it is called a cycle for a reason. It is not a stable process within the body. The hormones are changing throughout that cycle. And it is okay to feel differently. throughout the month. It’s okay that we might have more energy at some times and a little bit less energy at other times and that our output and our input might be gauged differently depending on what’s happening in our cycle and our own unique ways of processing that.
And again, as acupuncturists, if we can support our clients to feel into the cycles, to understand that just like the seasons outside change, the season in our body is changing on a monthly basis. And that’s okay. That’s brilliant. In fact, that’s an opportunity, not a negative subset.
So the Siwen, two times seven, the age of 14, the Du of heaven rises. The Ren channel begins to flow and the Chang is flourishing. Menstruation comes regularly.
In Chinese philosophy, when we’re talking about menstruation, I want to try to bridge the gap here a little bit between the tangible of what’s happening from a Western perspective, and the more ethereal that’s happening from an Eastern perspective, or Chinese. Ethereal emotional. So during phase one, we’ll call that menstruation.
The bleed. This is usually days one to four. Most of the hormones are going to drop off during this time. And of course this is when the uterine lining is shedding if one does not become pregnant. The uterus is cleansing out the old blood. In Chinese medicine philosophy, this is the time to regulate the flow of the blood and qi.
So that means that because so much is happening in the body, we don’t want to put a lot of demands on the body. We want to encourage our clients to eat easily digestible, protein rich foods like soups and stews with Iron in them as well that are going to help them to continue to regulate that flow and also build the blood throughout the cycle.
We want to prevent stagnation of blood. which can come in the form of endometriosis and excessive bleeding, which of course that can be our depletion, right? So during this time, I like to encourage clients to conserve their qi. I encourage them to rest during this time. If they’re going to do exercise to be doing exercise that is low impact like yoga or meditation, Or Qigong.
This is not the time to encourage your client to be going for, their strongest pump or something like that because the body wants to utilize that energy. And as acupuncturists we know, there’s only a certain amount of energy to go around the body. And at certain times, like menstruation, that energy is concentrated in the uterus, which, is why we feel a little bit more fatigued, which is why we feel a little bit more depleted.
The uterus is taking all of that energy to release the uterine lining, to let go, to shed. So when we start to shunt that energy in other places, what we can have is then the uterus not having the energy it needs. So resting, staying warm, gentle exercise, avoiding sex during menstruation is really important because the process of the bleed is a downward and outward process, right?
It is a releasing process. Taking in during a releasing process goes against, in Chinese medicine philosophy, what is naturally occurring in the body. And that’s the key. Helping our clients just to tap into the logic of what is their body saying and using the simple cues of how their body responds.
To then make choices. Avoiding heavy lifting, of course, and hydrating well. This is one of my big tips for clients is to encourage them to stay maximally hydrated. The blood in essence is water. It has that capacity to it, so we want to keep the fluids in the body flowing. We want to keep the digestive tract flowing.
We don’t want this to be a time when things are bound up. Let’s talk about phase 2, the follicular phase. So this is going to be approximately days 5 to 11. During this time, this is going to be when FSH is secreted follicle stimulating hormone. Follicles develop during this phase, and estrogen is secreted from the follicles.
FSH is secreted from the follicles. There’s the activation of the egg and the endometrium thickens. The Chinese medicine philosophy here is that it’s time to nourish the blood and nourish the yin. We also want, for fertility’s sake, we also really want to be strengthening that uterine lining and the follicles, which means that a diet should include proteins, it should include leafy greens, and it also should include foods that are moistening.
So sweet potatoes are a great example of a food that is moistening. During this time, we want energy to be contained, but we can have output. So that means we can start to move our bodies more. We can start to go to, maybe a hot yoga class. We can start to get back into the gym, doing some lifting, some of those activities that make you sweat.
a little bit. Ideally, you still don’t want your peak activity to be during this time, but you can definitely ramp up to, let’s say, what one would call their normal activity level. So if their normal activity level is going out and hiking nine miles three times a week, Living in Boulder, Colorado or something, then they should be able to do that with comfort during that time.
But they’ll save their, big hike, their 20 mile long weekend hike for a different season in the menstrual cycle. So let’s talk about ovulation. Days 12 to 16, approximately. During this time, we’re gonna see luteinizing hormone LH surge. We’re going to see the basal body temperature dip down and then increase.
The egg is going to be released from the ovary, okay? The cervix is going to start to soften. Cervical mucus is also going to thin, so it’s going to be like the consistency of egg whites. This is so that the sperm can easily pass through and fertilize the egg. Now, during this time, the Chinese medicine philosophy is really such that we want qi and blood to be moving.
There’s going to be a lot of energy in the system. We want to use pungent foods to help us move that qi and blood on a dietary level, and we want to strengthen the yang. So this means this is our time for vigorous exercise. Obviously, if one is trying to get pregnant, that there’s some exceptions here.
But this is the time to do that super long hike. This is the time in one cycle, if they’re going to be doing a triathlon or a marathon, something like that. This is the moment to do it. And then we want to encourage that creative output, that manifestation and expression, right? Because the egg serves as that.
When the egg is unfertilized. We’re not producing a child, but utilizing that energy of creation, that energy of manifestation, that energy of expression, encouraging our clients to get into that slipstream. Progesterone is so important for their spirit during this phase, for them to stay on the path of their Dao.
The final phase we’re going to talk about, phase 4, the Luteal phase, days 17 to 28. So this is when progesterone is going to increase, estrogen is high, and the uterine lining thickens. The Chinese medicine philosophy here is that we need to boost qi. So we can get into this phase of vigorous and competitive exercise until about day 26, leading right up to the bleed, because we don’t want to be utilizing all the energy we’ve got and then bleed the next day, ideally.
So eating lots of veggies to increase fiber. And of course, starting that heavy increase in hydration is really important. during this phase. I wanted to post this image of the balance between yin and yang. So we see when we start off with the menstruation phase on the bottom of the chart there.
We start off with menstruation, go into the follicular phase, ovulation, and then the luteal phase. Of course we’re gonna see the red line is young, the blue line is old. Yin. Now, we’re going to see that Yin and Yang rise in correlation and coordination with each other. Yang becomes Yin during menstruation and Yin becomes Yang during ovulation.
The seasons within. Okay. So let’s think about that phase one, that menstrual phase. This is going to be our inner winter. This is a phase where we have. Blood, we have the element of water, which makes sense, and the seeds or the essence are where we return to. In the spring, our follicular phase, we’re going to have the fluid of yin.
the element of wood, and we’re going to start to see those buds form. During our inner summer, we’re going to have ovulation. This is when yang is building. We have that fire energy, right? And of course the flowers are blooming. In the autumn, the luteal phase, we’ve got the qi, we’ve got the metal element, and then we’ve got those petals starting to shed, right?
And of course, earth remains as the element in between. So just like it does in the seasons when we don’t know if it’s winter or spring, that’s the, that’s Earth, when it’s an equinox, that’s Earth, right? When things are harmonious or we can’t quite tell what they are. That’s that Earth element coming in to provide that balance and totality.
I love explaining a menstrual cycle to clients through the lens of the seasons, because it really gives them like that aha moment, that fresh breath of Oh, it’s okay that I feel this way. Okay. So let’s talk about the hormones. First off, estrogen. Estrogen is going to peak in the days just before ovulation.
It is made in the ovaries and it is secreted by the adrenals as well as the adipose tissue. It thins the cervical mucus. This keeps the walls of the vagina thick and elastic and also lubricated. The estrogen is going to support a healthy libido. It’s also going to regulate the metabolism of litter.
Lipids and our cholesterol levels, so this is really important to consider as well. It stimulates cells to develop insulin to the muscles which actually lowers blood sugar. So I’m putting some of these sort of effects of the hormones in that don’t menstruation, but they’re things that we might commonly see.
with women that we’re treating. So the connection between cholesterol and the collection between blood sugar. Okay. So estrogen also is known to improve muscle mass and strength. Again, makes total sense from Chinese philosophy as to why when the estrogen peaks, that we are really able to start pushing ourselves with exercise, right?
Promotes activity of the osteoblasts. And these are the cells that make bone. So this is important to consider, especially as women age. Finally, estrogen binds to the fibroblasts and supports collagen production. So if you start to put pieces together here, face, aging, collagen, menopause, right? It all comes together.
And finally, estrogen is neuroprotective, which means it supports brain health. Let’s talk about progesterone. It peaks after ovulation in the luteal phase. It is produced by the adrenal cortex and the ovaries. It is produced and secreted by the corpus luteum, and that’s really that uterine lining. So a new corpus luteum is formed during each ovulation.
Thickens the endometrium for fertilized egg to implant and grow. Regulates bleeding during menstruation, prevents ovulation during pregnancy, prepares the mammary glands for lactation, that’s important, and has a reciprocal relationship with thyroid hormone. So if you have a client that is having menstrual challenges and they’ve got a thyroid condition, There’s a link there and a place to start looking might be Progesterone.
Their Western physician may or may not know that there’s a connection there but it’s an important one for us to be aware of and to know especially if they have not had a blood panel done. Let’s talk about LH, luteinizing hormone. Luteinizing hormone surges to cause the egg release, peaking of course at ovulation.
It is secreted from the pituitary gland and it works alongside follicle stimulating hormone, which makes sense. Causes the corpus luteum to produce more progesterone during that luteal phase. It plays an important role in sexual development as well as an important role in fertility. So some of the chromosomal disorders that result in Sexual anomalies are related to luteinizing hormone and follicle stimulating hormone deficiencies during the embryonic development.
Follicle stimulating hormone. It is produced by the pituitary gland, works alongside luteinizing hormone, stimulates follicles, and stimulates follicles. On the ovary to grow and prepare the egg for ovulation plays an important role in the sexual development and of course infertility. So here’s a chart. I actually really like this chart.
Believe it or not, it is from Encyclopedia Britannica in 2013. But it is a great chart that shows The rise and fall of the hormones. It’s another great tool to have in your clinic to be able to show clients what’s going on with their cycle at any given time. Menstruation. In Chinese medicine, a harmonious cycle begins with the kidney supplying Qi to the organ systems that produce the blood and lining of menstruation, while also filling the extraordinary vessels.
which are essentially the reservoirs for the five vital substances. Once these vessels are full, then menstruation can begin. Healthy menstruation is pain free, with bright red blood and a moderate flow. Blood should be minimal. Sorry, blood clots should be minimal. Short cycles are generally caused by excess heat, whereas long cycles are generally caused by excess cold.
So that’s an important one to keep in mind. And to define a short cycle is going to be a cycle that is 26 days or less. Long cycle is going to be 32 days or more, depending on where you use your def you get your definition. But generally speaking, that’s how we’re going to look at the concept of what a short cycle is and what a long cycle is.
So it’s the totality from menstruation, through ovulation. Let’s talk about dysmenorrhea. So dysmenorrhea is painful menstruation, which can include menstruation. It can include pain in the abdomen, the pelvis, the lower back, even the thighs before and or during menstruation. It is also often combined with a feeling of heaviness or pressure, and in severe cases, the pain can be correlated with nausea or vomiting.
Okay, so primary dysmenorrhea is somewhat poorly understood. And it is usually linked to the excess production of prostaglandins, which cause the uterus to contract and shed its lining. That contraction is a bit of an over contraction, which is why there’s pain. Secondary dysmenorrhea is a diagnosis within the organ systems, such as endometriosis, fibroids, pelvic inflammatory disease uterine lining growing into the wall of the uterus.
And of course Stenosis of the cervix. The pain patterns that we usually see with dysmenorrhea are blood stagnation and Qi stagnation. Now blood stagnation is often going to have a sharp, localized, unrelenting pain. There’s going to be commonly blood clots And there will be relief with NSAIDs so non steroidal anti inflammatories would cause relief because they’re going to change the patency of the blood.
Now with Qi stagnation, this is usually going to be a dull, achy, widespread, diffuse type of pain. It’s going to be relieved by pressure, massage, movement, and heat. Let’s talk about irregular cycles, or chaotic menstruation, as they’re often called in Chinese medicine. They are chaotic? Inconsistent and unpredictable.
So the liver stores blood and the kidney stores essence, right? The combination moves qi and blood into the uterus and the extraordinary vessels. Thus, irregular cycles are essentially caused by either liver qi stagnation, kidney indeficiency, or kidney yang deficiency. Liver qi stagnation is going to be marked by scanty, dark blood with clots.
and difficulty releasing the blood. Kidney indeficiency is going to have a component of heat or empty heat. And kidney young deficiency, of course, the opposite is going to have that cold. Now overwork can cause Inconsistency in the filling of the vessels, right? Again, it’s about the distribution of energy.
There’s so only so much in the body. So that overwork, of course, as it affects the kidneys in many ways, it can certainly affect the kidneys in relation to how they move blood and qi into the uterus. Menorrhagia, excessive menstrual bleeding. This is defined as a heavy menstrual flow. Abnormal uterine bleeding.
We have to Define this separately because that is spontaneous and out of cycle bleeding and can also be considered flooding when we look at the Chinese medicine definition. So we’re not going to talk about abnormal uterine bleeding today. We’re going to stick to heavy menstruation or menorrhagia.
So this is often caused by spleen cheat efficiency or blood stagnation or heat in the blood specifically. Now cheat efficiency. Is going to allude to the qi not being firm enough to hold the blood, right? So often we’re gonna see a combination of spleen qi deficiency here or the spleen not controlling the blood with spleen qi deficiency, right?
Blood stagnation is going to create an overfilling of the vessels and the uterus with no place for the blood to go. So it’s a little bit of A little bit of confusion in our mind when we think about this because we say we have stagnation and an overfilling. But what happens essentially if we think of this like a stream in a river yeah, stream or a river, and there’s lots of logs and leaves and stuff like that’s blocking it up.
That’s stagnation, right? And also there’s this overfilling. There’s a seeping of the water. into the land, into the space around that river or that stream, right? So that’s essentially what we have going on when we’ve got blood stagnation. No place for the blood to go, it goes out the uterus. Then we’ve got heat in the blood, and this is essentially heat going to be agitating the blood and causing the blood to just not want to stay in the system.
Finally, amenorrhea. This is the absence of menstruation. We’ve got primary and secondary. Primary, those assigned female at birth who have not menstruated by the age of 18 years old. Secondary, no cycle for three months or more. Any age above 18. This is very often caused by dampness in the uterus. So spleen chi deficiency is often the cause here, creating poor transformation, thus obstruction of the lower jowl and the uterus, which then leads to a series of other problems in patterning, right?
We essentially end up with chi and blood deficiency due to poor nourishment throughout the system or chi and blood stagnation, which is more of an excess condition and the blood is stagnant but not deficient.
So what about menstruation and the pelvic floor? This is an important conversation and one that I have very often with my clients and my students. So there are three components that we’re going to talk about very briefly and basically. One is the muscles, two is inflammation, and three is pressure changes.
Muscles. The changes in estrogen create changes in the muscle suppleness throughout the body. Okay. This also occurs in the pelvic floor. So estrogen is the lowest when we are leading up to and during the monthly bleed. Okay. So what this means is that the suppleness is at its minimal during this time.
There’s also an increase in prostaglandins, which further relaxes the smooth muscle tissue leading up to the shedding of the uterine lining. And of course, the shedding of the uterine lining creates a micro inflammatory response, right? So now we’ve got muscles that are starting to be less supple, we’ve got inflammation, and on top of that, Progesterone increasing can slow digestion, estrogen rising can cause gas and air to be trapped within the intestines, which means we have pressure changes.
So we have some slack muscles, we have inflammation, and we have pressure changes. All of this means that leading up to one’s bleed and during one’s bleed, they can experience increased urinary and bowel incontinence, urinary and bowel frequency, urinary and bowel Urgency, loose stools, of course abdominal distention, and pain leading up to the cycle and during the cycle.
The pelvic floor is directly impacted by what’s happening with the hormones during, leading up to, and during menstruation. Now why is this important for us to know? One, when we’re questioning our clients, when we’re asking them about their cycle, when we’re asking them about their pelvic floor, and the function of their pelvic floor, it’s important for us to know, is the pelvic floor, let’s say weak or tight, all the time?
Or is the pelvic floor just tight? At a disadvantage, a hormonal disadvantage, let’s say, when they are leading up to their cycle. Now, as acupuncturists, we have a brilliant gift of connecting with our clients and understanding a little bit about their bodies on both a Western and an energetic level.
We also have this great tool in our toolkit called acupuncture. And what does acupuncture do? It creates a neuroendocrine effect. So great news about that. We can understand hormones, but we don’t have to totally understand hormones to make a difference within the body because if we understand the pattern and we’re inserting needles into the body, we’re going to elicit a neuroendocrine effect.
What does a neuroendocrine effect do? It balances the hormones. in the body system so we can really make a big impact. And I honestly see a lot of clients that have pelvic floor dysfunction specific to menstruation have a major improvement just from having general acupuncture that isn’t specific to the pelvic floor.
It’s such an amazing benefit. Thank you so much for joining me today. It’s been such an honor to have you with me for this workshop. I want to again take a moment to thank the AAC, the American Acupuncture Council for hosting this video. If you don’t already know, I have recorded a pelvic floor intro, and coming soon, you’ll have the opportunity to watch my fertility, pregnancy, postpartum, and menopause videos in relation to the pelvic floor.
And again, thank you so much for joining me. If you’d like to look at my references, go ahead and just pause this slide. Otherwise, I’ll see you next time. Thanks to the AAC!
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.
My friends, it’s Sam Collins, the coding and billing expert for acupuncture for you, the profession, and of course the American Acupuncture Council. And thank you for spending some time with me. This is an important time of year because here’s a riddle for you. When do the 2025 diagnosis begin? Now, the quick answer to that riddle might be Sam, you said 2025, it must be 2025.
Actually, it’s not. The 2025 diagnosis codes, as they do every year, actually update the October 1st before. The answer to the riddle is, the 2025 diagnosis began October 1st. So make sure that if you’re using one of these codes that I’m going to go through to update your list, to make sure you’re using the most current code for your patient, because if you use an old code, It’s going to be denied.
Now you can see here, or in fact, let’s go to the slides. Let’s go to the slides. Let’s look at it. So the update you’ll see here is the 2025 update is October 1st. You can see there’s 74, 000 diagnosis. Now let’s be realistic. Is an acupuncturist going to ever use anything like 74, 000 diagnosis coords?
Of course not. However, a lot can be covered because acupuncture, of course, for pain and pain management has a lot of ways of being coded, but you’ll know one of the most common things you’re billed for, or paid for, I should say. In fact, that’s the code that made the biggest change for you. But let’s keep in mind how these work.
The date of service determines the code. So let’s say, by example, you’re billing a patient that you saw in September of this year, but you’re sending the bill in December. or January for that matter. It’s being a little late, but you’re still sending. It doesn’t matter when you send the bill. The date of billing does not affect the code.
It’s the date of service. So if the date of service was prior to October 1st, please use the old code. If the date of service is after, Use the new code. Pretty straightforward and simple. However, let’s talk about what if change. The changes are occurring for lumbar and lumbosacral discs. Now, as an acupuncturist, you might say Sam, I’m not sure that’s very important to me.
Certainly could be as a lot of acupuncturists now are working as the referral person for back pain and pain management for medical doctors. You’re often going to get patients that will have these conditions and often they’re not going to put a code for you. It’s just going to say, Dysdegeneration.
Right now the code is M5136, so pretty straightforward, M5136, that’s fine, but here’s what’s changing. The changes now, they’re going to be a little bit more granular or more specific, where it allows you to describe what’s going on with the person. You’ll notice this first code, M51360, is dysdegeneration to the lumbar region.
with back pain or discogenic back pain, meaning back pain. So that’s pretty straightforward that it is back pain, of course. However, could there be more? There is more. M51. 361, other intervertebral disc degeneration in the lumbar region with lower extremity pain only. Now notice there now is a code that is back pain only or one that’s lower extremity pain.
So many times a person will have disc degeneration and go, man, my leg is killing me. And it’s actually from the disc. So now there’s a code to differentiate that, but there’s also one when it’s combined. So if you have a patient with combined back pain and leg pain, there’s now a code M51362. Clearly a person with back pain and leg pain, a little more severe, of course, meaning more care long term.
So this really, I think, sets up to demonstrate the length of care someone is likely going to need based on a diagnosis. Now, we have back pain. Leg pain and a combination of both, but there’s always this one too, and I’m sure you’ve seen this. There are many people that maybe they went in for some upper back issues, but they did an MRI or x rays to other areas and they found, oh, there’s disc degeneration in the lumbar spine, but it’s asymptomatic at the time.
If there’s disc degeneration that’s asymptomatic, there is now a code. Disc degeneration without mention of pain, In the back or lower extremity pain. I like that. That kind of lends to, that doesn’t mean the person is fine, but it does mean that they’re obviously having disc degeneration and we know they’re going to be closer to having a problem.
So what this does is just add a little more specificity. If you were seeing these codes, please make sure to add these new digits to get that specificity for it. Because if you send it in 5136, It’s going to be rejected unless of course it was before October 1st. They’ve done the same thing for lumbosacral discs.
There’s M5137 lumbosacral discs, meaning L5S1. But you’ll see it’s the same protocol with back pain, with lower extremity pain, or a combination of both. So just making sure no longer now is it just one simple code. But there’s going to be three codes demonstrating when it’s hurting, Or one if there’s asymptomatic.
Now you might think Sam, I don’t know if that’s significant to me. I’m an acupuncturist, but if you think of it, how often do you treat people with chronic back pain that often could be disc related, you may not be making that as the primary code, but if it’s on the claim, we better make sure we have the right code to it.
Now, one thing to keep in mind though, let’s say you’re coding someone with back pain. Just plain back pain. You cannot use a back pain code with the disc code. So never combine like an m51 series like lumbar disc or lumbosacral disc with a pain code. In my opinion, obviously you’re gonna use the disc code.
It’s more severe. I mean think if you said someone has back pain compared to saying discogenic back pain or disc causing leg pain, I think you’ll see the severity levels a little bit higher. Probably longer term care. Bottom line, I want to make clear those. Don’t combine them. If you say, Sam, I don’t want to use a lumbosacral disc code, I would say why not, if it’s already been coded for you.
But if so, make sure not to combine it with the back pain codes. And let’s keep in mind, back pain codes updated. What is that? Four years ago now, however, I wanna make sure it’s clear. The back pain codes are M 54 50 for unspecified low back pain. We have M 54 51 for vertebral genic, low back pain, and then we have M 54 59 for other low back pain.
You might be thinking Sam, that’s not new. Why are you updating it? ’cause this is a problem. I see. Obviously many acupuncturists now are beginning to access particularly Medicare. Part C plans. These are your Medicare Advantage or private pay insurance plans that many will have direct access for acupuncture, not needing an MD.
When you have a plan like that, do not use M5450. Please make sure you’re using M5451. Or, M5459. If you use M5450 for the Medicare plans, you’re going to reject it. So keep in mind M5451 or 59. My opinion, M5459, best choice. Other means something that you can name or the reason for. It could be pregnancy related for that matter.
Bottom line is, no pain codes with DISC. If you’re coding DISC, here’s what I’ll tell you. The association is it’s already there. Now you can see there is a code that says no pain, but In other words, don’t put pain with it, but one or the other. Now, there’s some other codes that are musculoskeletal related.
You might look and go Sam, I don’t know if I’d ever use this. And I’m going to say these aren’t probably common, but I want to make you aware. Because as you can tell with diagnosis, they’re commonly looking to update and make things more granular, more explained, if you will. Currently we have a code that just says, Sinovitis, tenosinovitis.
Unspecified. And that’s basically your tendonitis codes. Here’s what we have now. Codes that are specific for these conditions that are going to each area. Shoulder, arm, forearm, hand. So everything upper extremity. In addition, lower extremity. So you’ll see here thigh, lower leg, ankle and foot, and so on.
The idea is that coding is always there to try to give us our best way of describing what’s going on. At the same token, don’t be afraid to be simple when it comes to acupuncture. Often a pain code is going to be your best bet. However, when I can have something more granular, I like it. Think of disc degeneration with pain compared to just back pain.
I think we see two different things there. But also know what the carrier requires. So by example, if you were billing Aetna, even though they may have a disc issue, You’re going to code it as pain, because that’s what they accept. Cigna Insurance, Anthem. Others will accept the DistriGeneration, so know which plans you’re dealing with.
As always, the American Acupuncture Council is here for your help. I run our network. The network services, we do seminars, and we do one on one help. That’s really what we do. If you want to make an expert part of your team, take a look at our site. Take a look at what we offer. We give you two CE seminars a year, plus unlimited access to get with me.
So we can go over everything in your practice. What are your fees? Are you building the coach properly? How do you document? How do we make sure we’re getting paid? We always want to make sure you have success because your success is ours. Until next time, my friends.
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.
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 there, my name is Michelle Grasek and I am the host of the Acupuncture Marketing School podcast, and today I’m looking forward to talking with you all about effective email strategies to get more patients on your schedule. And before we dive into this, I’d like to take a moment to thank the American Acupuncture Council for the opportunity to be here with you today.
I absolutely love teaching marketing, so I am thrilled that I can have this opportunity to teach you for free. So let’s get into the slides. Alright I broke this talk into two segments. So the first segment is really about why email marketing is worth your time and your energy. And then the second segment is ideas for making your emails more effective so that they actually work to get new patients on your schedule.
So let’s start by talking about the goals of email marketing and really why does email marketing work? What are we doing that makes it effective in getting people to take an action? So the most important thing, I actually put it third on this list, is that email marketing is a reminder that allows you to stay top of mind.
So every time you send an email, you hope that people who are reading it, sit up and take notice and say to themselves, That’s right. I’ve been meaning to make an appointment with this acupuncturist, right? It’s just a reminder. And I find that’s a really nice way for people to think about it. If they have some reluctance to send emails, if they’re worried they’re going to be annoying their audience, you’re really not annoying them, but I know it’s a common concern.
Just remember that email is a simple and easy reminder that you, your business, And your practice exists. Okay. So then the second reason that email is so effective is it’s a really nice medium for teaching people about acupuncture and how it can help their specific symptoms. And it also allows you to talk a little bit about your clinic so that people get to know you and the way that you practice.
And that really leads into the third purpose of email marketing, which is to build your know trust factor. So in marketing, we. We know that people like to buy things from people they know and trust. You’re probably familiar with this concept. And the way that you write an email newsletter, the way that you teach people concepts or share information will allow people to buy things.
understand, what kind of person you are how you approach this medicine, what it might be like to work with you, and that builds trust, right? It’s building up that know trust factor. So we are going to talk about each of these in a little bit more detail. But first let’s talk about why email marketing is worth your time.
The first is that you own your list of email subscribers in a way that you can never own your social media subscribers. Now I have seen a lot of small business owners put an enormous amount of energy into social media and growing their following. And that’s why You know, there’s really nothing wrong with that, especially if you enjoy social media a lot.
I say go for it. It can be a really nice opportunity to get in front of, real life people in your community. But, I think that if you are on the fence about social media, or feel like you don’t have enough time to be consistent with it, email is a really nice alternative. And this is one reason why that’s the case.
So if you think about Instagram, for example, there have been several instances in the past couple of years where Instagram just stopped working. It went down for a day and all of the influencers on Instagram who have built their business model around selling something to their followers. They panicked because they didn’t know if or when Instagram was going to come back up.
They didn’t know what their income dip would be like based on how long Instagram was going to be out for. And at this point we know Instagram came back, obviously, right? It was only a day each time, but it’s it’s not the best business model if you’re only focusing on growing followers because you don’t have that control over these people that you are making such an effort to build with, right?
By contrast, you own your email subscriber list, and you can really control the way that your message is delivered to them. So we know that the social media algorithms change all the time, and you can spend a lot of energy creating Reels, for example, but then have only a very small portion of your followers actually ever see that content.
Whereas at least when you send an email, you know that it landed in the person’s inbox. And of course, there’s a certain small percentage that might end up in spam. That’s normal. But at least 95 percent of the emails you send are going to be they’re going to arrive at their destination. Okay. And I think that is building your email list is a good way to build stability in your marketing in a way that social media is not because social media can be unpredictable.
And again, you don’t get to control the way your message is delivered or whether you will even have followers in the future. Okay. So that’s one thing to think about. The second reason email isn’t a really good choice is that it is so low cost in the marketing world. You almost, you can’t find anything to beat it.
So for example, if you have 250 email subscribers on your list and you’re paying about 20 a month for something like MailChimp or Constant Contact that, and you send one email a month, that is 0. 08 per email, and It’s really hard to find another marketing strategy that only costs eight cents a person.
So your investment is low, right? There’s you just, you don’t have that much to lose. And another reason that email is a great choice is that it’s a very low pressure way to educate people and to get visible. So especially if you are an introvert, or if you don’t love the idea of learning to dance on TikTok, then email is a nice alternative.
I always tell my marketing clients that they get to write their email newsletters at home, in their pajamas, on their with their cats, whatever suits you, right? And especially if you already enjoy writing, email is a great medium for it’s like an opportunity to be visible in front of a lot of people while you actually get to be behind the scenes.
Okay. I hope that makes sense. And that is a much more comfortable way for a lot of people to do marketing. So I always say that if that We’re not consistent with things that we don’t like. It’s really hard to do marketing over the long term if you don’t enjoy it or it’s not a good fit for your personality.
So choose something that is a good fit. And for many people, email marketing fits their strengths. Very well. And then lastly, email is much cheaper or has a higher ROI, forgive me, than social media. So for every dollar that you spend on email marketing, the return on your investment is around 38. So that is 3, 800 percent return on your investment.
That’s outrageous. And that is partly because it’s so low cost to begin with, but also because it is very effective. at the same time compared to social media, which generally if you spend a dollar on social media, your return would be about 2. 80, which is a 20 28 percent ROI. Okay. So for all of these reasons, email is just a really good choice.
for reaching your patients, converting them and getting them on your schedule for a very low cost. So let’s switch gears then and talk about some tips and strategies for effective emails. So I have been teaching marketing in our industry for about a decade and have been doing marketing coaching for almost five years.
And I find that most acupuncturists have an email newsletter opt in. on their website, something that says, you know, sign up for our monthly email newsletter or something simple like that. But they very rarely or never send the email newsletter, right? So you’re collecting the emails, but you’re not sending them.
And remember, email is this beautiful opportunity to stay top of mind with people just to remind them they meant to make an appointment, if you’re only sending a quarterly email newsletter, for example, I find that most people send something maybe once every three or four months. If you’re sending a quarterly newsletter, that is a lot of time for people to forget about you and your practice, to forget their intention to make an appointment.
So I recommend sending emails twice a month. That is a sweet spot. Now, don’t panic. Whenever I say this, people’s response is immediately, I don’t have time to write content for one email a month. How am I going to write two emails? So we will talk about that in a moment. I have some really effective, helpful ideas for that.
But they’re also worried about annoying people by sending emails twice a month. So the reality is That twice a month is a polite volume of emails to send. It really is not too often and I find that it’s just enough for potential patients. and regular patients to remember that they meant to make an appointment, right?
You’re staying top of mind just often enough that they’re not forgetting about you completely. And I find that is a number of emails that is actually doable for people if they’re using the tips that I’ll share in just a moment, okay? And think about your favorite clothing brand. When something is on sale, they will email you multiple times a week.
Sometimes they’ll email multiple times a day. So we are not doing that. We are As I said, we are sending a polite number of emails at just twice a month, okay? So don’t worry that you are annoying people. You’re really not. People opted into your email list for a reason. They want to learn from you about Chinese medicine and how it can impact their health.
They want to hear from you. And I have a little note down at the bottom of this slide that I want to point out because this is pretty common experience. If you have not been sending emails and then you start sending, people are going to start unsubscribing. And this is totally normal. You actually want the people who are not a good fit for you to unsubscribe from your list because you don’t want to pay for them to be on your list.
So most email platforms like MailChimp will unsubscribe. It’s like a free monthly subscription until you hit a certain number of email subscribers, whether it’s 300 people or 500. If there are people who read your emails and they say, Oh, I don’t think I’m actually going to see this acupuncturist, and they unsubscribe, that’s fine.
It’s better to just let them go, to not take it personally, because it’s almost always going to happen. Every time you send an email, you’re going to get a couple unsubscribes, but you don’t want to have to pay for them to have this bloated email list filled with people who are not going to become your patients.
So just know that it’s going to happen. It’s totally normal. It doesn’t mean you’re doing anything wrong and it does not mean you’re annoying people. Okay, so let’s talk about two things that allow you to send two emails a month. Like, how can you be that efficient? And the first the first perspective is that you can send very simple email newsletters with only one message in them.
So you only need one reason to send an email in order to hit send. And we’ll talk about that in a little bit. But do you remember? And I don’t know I graduated about 14 years ago, so these kinds of email newsletters were very popular at that time. But it was very common for an email newsletter to have multiple different parts, like three or four different sections, and they usually had a theme like the liver in springtime, something like that.
And they were long, and they were complex, and they took a long time to put that content together. So There’s nothing wrong with that type of email newsletter. It’s very effective, but I don’t think it’s any more effective than just having one section, one message. And what I have found over the years with those long, complex email newsletters is that most people who intend to write them, they never finish writing them.
And then they never hit send. So it really is a barrier to actually doing the thing and sending the email. So when I say you only need one message, I am referring to, you could have one research article that you want to summarize briefly and share with your audience, and then have a call to action.
If the research is about acupuncture and knee pain, At the bottom of your summary of the research, you could say, as your call to action, If you are struggling with knee pain, we would love to help. Click here to schedule now. Okay, so it can be very simple and brief. And then the second concept that will really help you in putting these email newsletters together is the idea of repurposing content.
So I can almost guarantee that you have written or created a lot of content already. over the years for your practice, you do not need to keep writing that content from scratch. So if you’re not familiar with it, repurposing content is when you take something that you created for one platform, for example, Instagram, and then you copy and paste it and you make some edits so that it makes sense for another platform, which in this case would be email, an email newsletter.
And I really believe that repurposing content is the only way to maintain your sanity in digital marketing. If you are trying to create brand new content every week for eternity, it’s just too hard and you just don’t need to. It is totally acceptable to copy and paste and kind of reconfigure content you already wrote so that it makes sense for whatever platform you’re copying and pasting it to.
So people often ask me, what can I repurpose? The answer is everything. Anything you’ve created in the past can be cleverly repurposed so that you don’t have to write it from scratch again. And I recommend starting with what’s often called evergreen content on your website. It’s sometimes also called core content or pillar content.
You may have heard of that, but this is These are usually the pages of your website that people are reading or skimming when they are making the decision about whether or not to come see you for acupuncture. They’re deciding if you’re a good fit for them. So if you have a specialty, for example, then the page where you describe how acupuncture works for your specialty, like Fertility, Orthopedics, Cosmetic.
That page is going to be core content or evergreen. And it’s called evergreen because this is the kind of information that doesn’t change very much, but it is always relevant. It’s always helping people make a decision about whether you’re the right acupuncturist for them. So repurposing evergreen content is always a good choice.
It’s a nice place to start. If you’re thinking about planning your email newsletter several months in advance. I would begin with evergreen content. And your frequently asked questions section on your website, if you have that, is a type of core content. I also recommend incorporating that into your email newsletter.
Each Q& A, can be its own email. Okay? If you have written blog posts in the past, you can repurpose that content. If you have published Instagram or Facebook posts and they got a lot of good engagement, like your followers ask questions, they were curious, they were sharing a lot, then that could be really great content to repurpose for emails as well.
And you could either You could just copy and paste the caption, for example, from Instagram, or we’ll talk in a second what to do if you have a lot of video or visual content. So a couple examples of repurposing if you are the kind of blogger who writes like 3, 000 word blogs because you like to be really thorough and we know that Chinese medicine is complex.
So we like to explain everything. I’m one of those people. I’m a long form blog writer. You don’t want to copy and paste the whole blog post into an email. That’s a little too much for an email. So I recommend breaking it down into three or four sections or concepts and then send each as an email, right?
And You could send it as a series of related emails where you are teaching your audience something about acupuncture for this particular topic. So that’s one idea. I mentioned copying and pasting an Instagram caption. Of course, you could also do this with Facebook. Again, if you have social media content that people engaged with, that is a good trigger for you to know that this might also make a really good email content.
And then Let’s say that you are less comfortable writing, but you are pretty comfortable on video, or maybe you have a podcast, something like that. You can use free software online to make a transcript of the video or the podcast, and then you can use that text that you just transcribed, make some edits, and then send that as an email, okay?
Because people who often have a really library of Instagram Reels will say, I didn’t write a lot in the caption. How am I supposed to transform this content into an email? You can transcribe it for free. Okay, so that’s one idea. And then again, I really encourage you to take a look at your Frequently Asked Questions page and consider sending each of those questions and answers as an email, because that is really the information that people need to help them decide if they want to make an appointment with you.
And a really good example of this is how many treatments do I need for, and then your specialty, right? So how many treatments do I need for fertility? How many treatments do I need for cosmetic acupuncture? That is really important. Question and answer makes a really beautiful email newsletter. Okay, so just a couple of tips for writing effective emails so you can get better results for your efforts.
In any marketing, you always want to write from the perspective of your potential patient and think about questions they are subconsciously asking, which is, why should I read this? What’s in it for me? Why should I get acupuncture? What’s in it for me? Think about the benefits from their perspective.
And Angle all of your writing towards that, okay? So that’s number one. And then most email newsletters are successful when they focus on content that the audience would find useful in some way. So teaching and educating your audience is really great. Answering questions. I’ve mentioned the FAQs multiple times already, but that’s a great option.
Solving a problem. So a good example of an email that you could consider solving a problem would be, um, how to reduce abdominal bloating with Chinese medicine. That could be your subject line. And then the email talks about avoiding ice and raw foods, maybe avoiding smoothies, those kinds of things, teaching them something about Chinese medicine that they can put into action at home, get good results.
And then of course you have a call to action. If you want more help managing your digestion with acupuncture and the wisdom of Chinese medicine, click here to make an appointment. Okay. So that’s like a solving a problem that the patient has email. You could also think about what might be the doubts or the barriers that prevent people from making an appointment with me right away.
And then answer those doubts in an FAQ format. And then of course you can always share an email. If you have an announcement about your clinic, maybe you hired a massage therapist, you have a new receptionist, maybe you’re hosting an event that you want to invite people to. Maybe you’re just going on vacation and you want people to get on your calendar before you leave.
Okay, so all of those are just one single message that you are sharing that is a good enough reason to send the email. And I mentioned call to action several times, so before we end I just want to define that for you. So a call to action is when you tell people what you want them to do and how to do it.
Click here to schedule now. Schedule now is what you want them to do and click here is you telling them how to do it. You could also think of a call to action as letting people know what is the next step they need to take if they’re ready to work with you. Okay? So in email, really in all marketing, it is very important to include calls to action because that is literally the part that makes people take action, right?
It gives them the initiative. It turns a little light bulb on their head like, okay, I am ready. and I’m going to click the link. So I recommend having three repeating the same call to action in your emails three times. So have a button at the top and the bottom of your email that’s very simple that just says, ScheduleNow or call for a free consult, something like that.
And then you can also have a call to action in the text or in the body of your email. So if your email was about knee pain, for example, you could say, If you’re struggling to manage your knee pain by yourself, we are here to help. Click here to schedule now, and then you have the hyperlink. Okay? The idea with The frequent calls to action is that people do not like clicking around on the internet trying to figure things out by themselves.
They get distracted. They end up watching cat videos for 30 minutes and they forget their intention. So we just want to make it super obvious, no matter where they are in the body of the email, we want to make it quick and easy for them to find a link so they can schedule now or do whatever your call to action is.
Okay, so that’s a very important piece for making your emails effective. All right, so if you have any questions with me, you are more than welcome to send me an email. My email is michelle at michelleGrasek. com. You can send questions about your email marketing or just marketing questions in general.
And I’d like to thank the American Acupuncture Council one more time for the opportunity to be here with you teaching marketing. I absolutely love teaching marketing and I genuinely believe that it’s just a tool that allows us to reach more patients. So it’s always a pleasure to be here with you.
So I’m going to do a little demo today of how I do nanoneedling on myself. But first, a little bit about me.
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’s Michelle Gellis, and today I am going to do a demonstration of nanoneedling with a microneedle pen, so you can go ahead and go to the first slide.
I teach facial acupuncture classes, and part of that is Micro needling and nano needling and one of the questions I get asked a lot is do I do these things on myself? And the answer is yes, I do. So I’m going to do a little demo today of how I do nanoneedling on myself. But first, a little bit about me.
I, as I mentioned, teach facial and cosmetic neuromuscular acupuncture classes internationally, and I have for about 20 years now. I’m currently on the doctoral faculty at Yosan University, and prior to that, I was on faculty at the Maryland University of Integrative Health, and I also worked as a clinical supervisor there.
And I’ve just completed my very first book. It is a 500 page hardcover book on treating the face, and the reviews have been great. I’m I’ve opened it up for pre sale and you can get more information about the book at facialacupunctureclasses. com and then the products that I am going to be demonstrating today can be, you can learn more about those at aculiftskincare.com
Okay, I am done with the slides. So let me move these slides out of the way. Okay, so the pen I am using today is made by, everything’s backwards the pen I’m using today is made by AccuLift and it comes in a metal case. And the pen itself when it arrives, everything is wrapped up like this. I’m not going to be using this pen.
This is a brand new pen. But it comes with two batteries, and the If you want to plug it in, it comes with a charging cord and also a plug in adapter, which is on the pen right now. And the pen also comes with a really nice set of very large instructions for those old people like me who have trouble reading instructions from time to time.
These are just instructions on the pen itself. If You want to know how to do microneedling on a patient. The purchase of a pen comes with a four hour continuing education webinar that is included. So let’s just hop into it. So before I record before this webinar, I did microneedling on one side of my face.
So if you see my face is a little red, that’s why. But I am going to be doing nanoneedling on this side of my face, and the difference between microneedling and nanoneedling is a microneedle cartridge has These on this particular one, there’s 16 needles, and what happens is when you do microneedling, the needles go like this, and they make little, teeny, tiny, microscopic puncture wounds into your face, and as you can see, I’ve already done it to my face, and it’s, it shouldn’t cause anything too traumatic but So it builds collagen.
Nano needling, on the other hand, uses these nano needle cartridges, and they look different. They’re more like, if you can see this, they are more like a, almost like sandpaper. It’s a really great way to exfoliate, like the dead skin. And it’s something you can do a couple of times a week, whereas microneedling you can only do once a month, nanoneedling you can do a couple of times a week, and you can also do nanoneedling inside the orbital rim and on your lips.
What you need to do, and you don’t need any numbing cream for nano needling. What you need to do is make sure your hands and your face are clean. I like to do a little pre exfoliation before I start. And then just to make sure my face is extra clean, I take a makeup remover wipe and I spray it with rubbing alcohol and I rub I’ll go ahead and even though I just did it, I’ll do it again.
But I spray it with rubbing alcohol and then just make sure if there’s any makeup or anything on your face that. If you don’t have any issues with that, yeah, I’m gonna, everything done.
Once you’ve done that if you don’t like the alcohol, you can also use witch hazel, which is good for cleansing the skin as well. And then with nano needling, I like to grab one of my serums. I brought a couple with me. I have a superb serum, which is Vitamin C, hyaluronic acid, and collagen. I also have my peptide serum and you can use one or the other or you can mix them together.
And since my hands are clean, I’m just going to put a little of the nourish right in the palm of my hand and I’m just going to work on half of my face. So I’m going to work on this half since I micro needled the other half. We’re ready. Put a little serum on. The nanoneedle cartridges come in a sealed pouch like this and then you just tear it open.
You put the nanoneedle right on the pen, this particular pen, and there are a lot of great pens out there. And this one’s made by AccuLift and it has a triple locking mechanism. You take the, Little cap off. Don’t forget to do that. And then the way you determine the proper length for the nanoneedles on this pen is you turn it on and then you are going to dial it up just until you can just see the top of those nanoneedles coming out.
And once you can see them coming out, then you can do your nano needling, and you don’t have to press very hard, the nano needles will do all the work. And this is just a really great way to give your skin a nice refresh when I’m working around my eye area. I actually use my eye cream. Because you’re not needling anything into your skin, you’re just working on the stratum corneum layer.
You can put your eye cream on and just work right inside the orbital rim. Just make sure you’re pointing the pen towards the orbital rim and you’re gentle. You’re not pointing towards your eyeball. And it looks just like this, just like that. And then right inside, just like that. Gentle. And this is great for Those little lines we get under our eyes from smiling and it’s a great way to just stimulate blood flow and real nice healthy qi in that area.
Moving along to the cheeks,
you can do your nose, your cheeks, you just want to go right in there, left to right,
all the way down
and then you’re going to go up and down.
And right around your lips. Again, I’m only doing half of my face. And make sure you do along the jawline. Get your chin.
Oh, and I forgot to say this in my other video, but make sure you pull your hair back. That’s why my hair is back. You don’t want to get your hair tangled up in your device. So a headband or a ponytail, whatever you need. If you have hair that hangs in your face. Now I’m going to do my neck. and my chest area.
And even though I’ve done microneedling across my neck and down my chest, it’s okay to do the microneedling, the nanoneedling. I was pretty gentle when I did the microneedling. You can see I’m just a little red in this area, so I’m good for the So you’re going to go underneath your chin.
And up and down on the neck. Actually feels really nice. It’s not painful at all. And then you’re going to go down on your chest
and back and forth.
So I’m not recommending that you do nano needling over the microneedling. I’m just saying if you did for some reason it cause any harm. It might be a little painful for you. You or your patient, but for the purpose of this demo, that’s what I did. If you want, if you would like, when you’re all done doing your nano needling, you can you can go ahead and put on whatever creams or lotions you would be using.
I happen to have some of my calm aftercare, and I’m just going to use that. And I realize I forgot to do my lips, so I’m going to go back and do that. So for my lips, I usually use some serum, and if you have any kind of serum for nano needling is fine.
And you can just nano needle the whole red part of your lip. It really helps to exfoliate them and plump them up. You don’t want to nano needle, you don’t want to micro needle the red part of your lips, but you can nano needle them
and you can see, makes them look really nice afterwards. Helps to bring that blood flow out and helps with the pleating, lip pleating. That is an entire nanoneedling session for half of my face. And you can see it’s quick and it’s easy. And if you are interested in learning more, you can go to my website, aculipskincare.
com. You don’t have to buy a pen. You can just There’s plenty of demos on there, and the four hour CEU training is on there as well. And my 20 I’m not supposed to say dates anyway. My teaching schedule is on the website as well. And you can also find me on social under my name or facialacupunctureclasses.com. And that’s it. Thank you for joining me.