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STOP Treating Menopause and Aging Like a Disease!

So the title of this presentation is to Stop Treating Menopause and Aging like a Disease. And so this is really about embracing the wisdom of East Asian medicine and that holistic perspective of menopause.

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

Hi welcome. I’d like to thank the American Acupuncture Council for producing these lives. My name is Tsao-Lin Moy, and I’m a licensed acupuncturist and herbalist located in New York City union Square. Practicing now for 21 years. And today I’m gonna be talking about a hot topic, which is Menopause.

And so we can go to the slide.

By 2030, the world population of menopausal and postmenopausal women is projected to increase to 1.2 billion. This is about one fifth of the world population. So if we’re looking at menopause as a disease, this makes it look like we’re in another pandemic. What this is an opportunity to improve how you help your patients, and particularly women before they actually reach that point of menopause.

So since 2021, we’re looking at half of the US female population is age 40 and older. So this is a mark. This is a whole group of people that are gonna be looking for natural ways to heal and not just go the route of hormones. As practitioners, we really wanna be mindful of what cultural influences are affecting our own beliefs and acting out of the fear of getting old and decrepit because this is all around us.

We see it in social media, we see it on the cover of magazines. Really all the TikTok and, all of the. The Instagram, and I don’t know what else there is because I try not to personally get onto any of those platforms other than to share information. Hopefully the people who need to hear it can actually find it.

But menopause is really, it’s a complex phase that involves biology, physiology, metabolic shifts, emotional, and also social changes in life. Puberty is very similar. It’s biological changes, physiological, metabolic, emotional, neurological, and also social right. We see this in young people finding their group.

And while we don’t call a growth cycle for puberty to be considered a disease, it is often treated with hormonal birth control. And this is the first sign of, painful period or pimples or something young women are giving are given hormonal birth control. And this is very problematic in my opinion.

I don’t think that women should be and young women should be on hormones from the time they’re 14 all the way till through to their seventies. This is also something that shows up in fertility problems with fertility. So just as a review in case you’re not somebody who reads the classics chapter one, my favorite chapter of the Yellow Webber Classic, also known as the Universal Truth, discusses Female Development that follows a seven year cycle.

And while males follow an eight year cycle, So when we start to look at each one of the cycles we see, okay, around 14 years old the fertility arrives or they consider the menses flows and the woman can have can start to bear children. And then we’re also looking at, as we’re moving through to around the age of 35, there starts to be a decline face wrinkles, hair begins to fall out.

So we start to see some of those, so those signs of aging. And it also co corresponds with. The, the struggles with fertility, right? Actually the slide might be out of order, but one of the things that I wanna address is, for most of the time with women’s health, the approach is not changed.

New tools, but basically the same attitude. And that is like hormones, hysterectomies, and antidepressants. Now, what really surprised me, Was to find out that the hysterectomy is the second most common surgery for women in the US after cesarean section. These are estimated to be one in nine mil nine women are gonna undergo a hysterectomy during their lifetime, basically would only be one time, and that’s about 600,000 procedures each year in the us.

So the question is, what does that mean for that connection? The heart and the uterine connection, the bowel line also. Research has found that over a third of women, when they go to their general practitioner with symptoms of menopause, they’re often offered antidepressants and this is really considered inappropriate.

So this is an area where we as Chinese medicine practitioners as acupuncturists can really help women’s health and in fact, women’s health is quite advanced in terms of Chinese medicine. A little review. How does blood yin and yang and chi interact with menopause? We start to look at yin and yang balance becoming a little irregular.

The blood and yin, which we could look at as estrogen becomes depleted compared to the yang and the chi, progesterone, testosterone. And really, so when you start to see the hot flash fluctuations, it’s really this kind of, the way the balance starts to be flipping from one side to the next. Now, until recently in the western world, perimenopause was thought to be around 45 or 50 years of age.

Right before menses would stop because that’s when the hot flashes were occurring. Mood swings. So we look at that, liver chi, night sweats, yin leaking, palpitations, heart blood deficiency. So we, when we look at these symptoms that we can actually look at what kind of patterns are emerging and no, in a women know, women are not quite the same.

Of course there are always. Formulas and recommendations for particular things we still need to look at personalizing. Now, in reality, trans transition into menopause is more accurately beginning 10 to 15 years earlier, and as I mentioned before, around the age 35. Some hormonal fluctuations might start to happen.

Maybe a little bit of irregular hormones and can impact getting pregnant, with fertility. So in terms of, what is that fertility cliff that is talked about a lot I don’t really believe it. And at the same time, if we’re looking at the long view, we’re starting to really look at.

You know what is happening really early on, shifts are happening over time. When it comes to our awareness, that’s when the symptoms are much stronger. So the idea here is that you wanna start treating your patients, talking to them, educating them, especially early on. Also if you have younger patients or your.

Female patients have daughters to really also talk about women’s health, about periods and things that they can do, especially if they’re having painful periods or bleeding or. Other things like acne that we can do a lot for naturally with diet and meditation. Like all of those tools that we have.

So here’s interesting. Studies actually show that even before puberty, which would be around age seven to nine, that there are hormonal surges that are happening, right? It’s just not one day your pubescent and then the next day you get your period. No, actually, Shifts are happening several years beforehand and this is, gives us an opportunity to really help shift the attitude towards menopause.

So this is about this yin and yang dynamic. Really as we’re shifting, just like the season, right now we’re in the summertime, so it’s much more yang compared to, daylight compared to yin of winter. With more winter and darkness, and yet at some point it’s gonna shift again. And of course we see as there are the transitions that there’s a tendency for certain kinds of illnesses to come up for people like allergies or, some colds, winter colds.

So this is to be aware, we’re always in some kind of cycle, a yin and yang cycle. I really like this particular slide because it talk it like shows where, you know, both the hormone levels, where we’re looking at yin and yang, estrogen, progesterone actually follow together, right?

So eventually those fluctuations are going to. Even out, right? So we’re always looking at, our body’s always looking to go into balance. So when one thing looks like, oh, it’s too much yang or too much yin we’re actually really looking at how the body is trying to reach that state of homeostasis.

And so it makes corrections. And eventually though, as you see, like where the blue part is really where most, like a lot more symptoms are happening as the body is shifting and transforming. So here are some of the unwanted symptoms that we find with menopause is, brain fog, hot flashes.

Weight gain, hair thinning, skin sagging, bleeding, emotional ups and downs, palpitations, poor sleep. Really what also starts to happen is like the weaker knees foot problems may occur. This is also because the connective tissue gets affected by hormones. And so you might start to, to see some of that coming in like the and know that.

That can be also addressed with some herbal formulas and acupuncture. But it’s not a disease. Not a disease. So the question is, why? Are menopausal symptoms less prevalent in Asia and other countries, and I’m really comparing like the US and some of the Western European countries.

And, what’s happening, believe it or not, what makes a difference in how women experience menopause? And I also believe puberty, coming of age is the cultural attitude towards health. And aging. So oftentimes we talk about getting a period as the curse or the shame around it.

With young girls, they’re, oh, they don’t wanna talk about it. They get made fun of. It’s something to hide and really not something celebrated in other cultures. It’s really this. Time where you recognize that you’re moving from one stage of your life into the next, and this is a beautiful thing.

So really what studies have shown is that the collective cultural attitude towards menopause plays a major role in emotional distress and physical symptoms. So why do I bring this up? Because. We have to take into consideration, we’re living in a culture that has very negative attitudes towards women’s health reproductive health.

And so the western culture, and then they find that plays a high importance on fertility and also place value on youthfulness in these cultures. Menopause reflects this age progression and loss of youth. And also loss of sexual attractiveness and leads to this negative attitude towards menopause.

There’s so many negative words that are used to describe menopause, such as fertility failure, ovarian failure versus, this is a natural progression as we shift into the next stage, of course You’re not gonna be producing children, this is, there is a window for it, but that’s normal.

There’s, we’re not part of the Handmaid’s Tale. To tell you this, I think. In my personal opinion, that that series like really normalized abuse, that it like the, in fiction becomes real, but that’s a whole other story. But what this is, it’s implying that a natural, something is a natural part of life is really a flaw or a disease.

And when your patients are coming to you, Understanding that the holistic perspective is not going to, or I would say, should not adopt this, cultural idea that it’s bad as you start to get older and mature. KO or Conki means in Japanese renewal season and energy. So in Japan, menopause is looked upon as a natural life stage, and the very word for menopause, the conki means renewal, season and energy.

So why do we have such a negative view of a natural process? While women in Asia eat more fish, less processed and refined foods less sugars, caffeine, sodas, and they walk more, et cetera, et cetera, compared to the average American. There’s also a level of respect for elders, and this is something that I think really need to examine is how we treat older people as they get older.

And one of the things that I would say is this last week I was at a conference and there were indigenous people from the Amazon and they were talking about the experience in terms of indigenous practices, of how much wisdom that elders hold, stuff that is not in a book. And when an elder actually dies.

It’s like the equivalent of the library of Alexandria burning down, right? Because what they hold wisdom that people hold within them is not something that can be reproduced. And because it’s experiential. And I think we have to really look at, as people are aging, that they also are holding a lot of experience and information.

So studies actually show menopause and menopausal symptoms are really tied to a woman’s cultural environment. So if a woman is in unhealthy environment, they’re gonna feel guilty. Shame experience for experiencing something that’s really natural. And leading to. Heightening of their physical symptoms.

It could be like flashing. It could be like poor sleep and also mental, like really heightened anxiety, depression and other countries that positively view aging and I’m repeating. And menopause such as Sweden, Denmark, and Norway, positively, similarly experience fewer unpleasant effects.

So not only does an optimistic and positive environment allow women to feel more comfortable when their cycles come to an end, but it also correlates with an easier transition with menopause. And that is where you as practitioners come in with support and really look at a paradigm shift. Chinese medicine is a paradigm shift, however, We do live in a culture that is constantly intruding on our views and beliefs.

So what can we do? Empowering your patients to cultivate their health and wellness and longevity. So this is really like the long, a long view, which. There aren’t really the quick fixes, right? If you get into hormone therapy, there’re always, there are consequences and side effects with that, such as increased risk of cancer.

So here what I’m encouraging is, To check in with your patients and find out how they’re feeling emotionally with their overall health and really address like, Hey, this. Transition that’s happening. It’s a very, it can be jarring identity, right? Your identity is changing the way cult, the culture, your society is gonna regard you.

And really don’t underestimate the impact that stress and anxiety has on health, and especially around aging and menopause. I think it’s really important to have a, To talk about that in other countries, the viewpoint is very different and we can actually adopt that viewpoint in the way that we actually treat our patients.

So again, intensity of menopausal symptoms will indicate that there might be un underlying imbalances, right? And we call those root causes that are not being addressed. So you’re, if you’re not treating the root C, you know what I wanna say is you’re treating a root cause, not the disease. All right?

If somebody is having flashing, we know that we need to balance their nervous system, like all of that, it’s not a disease. Self-care practices I give my patients homework. Really look at, what you can empower your patients with in terms of. Food, focusing on sleep. Sleep is a huge issue, right?

Because the circadian rhythm is also gonna influence reproductive hormones and overall health. Exercise and movement. Those are things that actually will help with like brain fog, but also movement is something that helps with depression. You start moving, just move your body clear out, clear the stuck energy.

Teacher patience techniques such as breath work for calming calming the nervous system and also I. Those tools, techniques, and tools are really good for managing the vasomotor symptoms, which come with the hot flashes, right? So body flashes and then get excited or anxious about it. That really calming the nervous system is actually gonna help to regulate that part.

Focus on relieving inflammation by eating, eliminating certain foods, eating other foods. I also teach my patients a kind of a self lymphatic kind of practice to help them move the lymph from their body, help to move, swelling, inflammation out. It takes. 40 seconds.

And the patients that do it can’t believe how the swelling in their overall body goes down, right? Because of all of the inflammation weight gain. One of the side effects with hormonal fluctuations is this weight gain. And things like lowered estrogen are attributed to what’s known as non-alcoholic fatty liver disease.

Or, con like liver congestion. So really looking at eating foods that are considered, that have more phytoestrogens such as flax seeds, sesame seeds, soybeans, right? Actually dried apricots and pr. And the studies show that an increase in soy actually helps reduce fatty liver.

Now there are always these concerns around consuming soy products that maybe it’s going to affect cancer it’s gonna affect the, negatively affect hormones, but those are actually really unfounded. Just discussing possible dietary Suggestions to help with symptoms could be its own presentation.

So I’d like to just, thank everyone who’s listening and please leave your comments in the bottom. And if there are any questions, you can also leave those and contact me and I will, answer what I can. Thank you.

Formulas for the Season – Moshen Herbs

I’m gonna be speaking about formulas for this season.

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Hello, my name is Moshe Heller and I’m from Moshen Herbs. And I wanted to thank the American Acupuncture Council for letting me host this talk this morning. I wanted to I’m gonna be speaking about formulas for this season, and so let’s go right away and start with the first slide.

I wanted to talk about two formulas that are associated with this coming season, this spring season. So as we all know, it’s officially started. Two days ago, so we’re at the beginning of spring, and I wanted to mention or talk about or discuss two formulas. One is the the first formula is called shield.

It’s a formula, again, by Moshen herbs that I created to support and boost the immune system. And then the other formula I wanted to, I’ll be speaking about today is react, which also is another formula by Moshen herbs for that I created for allergies, which is really at beginning of the season of allergies.

As we all know, everything starts to be itchy and irritated a little bit as the pollen levels rise. I wanted to start first with the SHIELD formula. And I I th this formula I created based on NG san, which we all know as Jade Windscreen and I combined it. With WA tongue, which is cinnamon, twigg, decoction.

And together these two formulas strengthen the exterior and harmonize the functioning of the way and ying chi so that when we, when our patient encounters pathogen, the body’s able to resolve it quickly. And that’s a really important. Thing I wanted to stress is that we, it’s not about not getting sick because we, especially when we’re treating children they do encounter pathogens and also as adults we also.

Are able to, or supposed to get sick. The issue is that we need to resolve it completely and quickly and exactly that’s what this shield formula is will help. So in this encounter with this pathogen, whether it’s a pediatric patient or an adult patient, The body of our patient is learning to deal with this pathogen that they encountered.

In a sense every time we get sick, it’s a learning opportunity. And it’s important to remember that because the more we learn, the more we are able to ward off. And I think SHIELD is an extremely helpful formula for this situation. So I wanna break it down a little further and how we how I created this formula.

We, I first wanted to make sure that the CHI is strong. And also that the CH Chi transformation, or what we call sometimes chia is complete. And so on top of this two formulas I mentioned before Jade Windscreen and cinnamon Twigg Decoction, I also, and I also combined. Urchin tongue CIA and CEE mostly as the two main herbs of that formula.

And those herbs will help to transform dampness and and otherwise if the dampness accumulates, it will hinder the functioning of the spleen. And that’s why it’s important. These. Two formulas. Th this formula two cured Decoction helps in that transformation and keeping the transformation going.

And so on top of that, I added another herb Tchen, which is a really amazing herb. I really love that. And you’ll see I use it. A lot in other formulas. Also, the advantages of it is that Tchen strengthens the spleen chi, but also works on regulating the water pathways and the transformation pathways of the spleen.

It, and it helps in generating fluids, generating pure fluids, not not. Turd fluids pure fluids will help to nourish and move and will move freely in your body. Whereas turbid fluids, if the transformation is not complete, will create dampness and then fle. I really Tchen to support the, this transformation.

The, in addition, I also added wwe, which helps the formula. Consolidate the exterior, but also bringing the kidney chip support to the lung. So there’s a better relationship or communication between the lung and the kidney. That the kidney supports the lung functions in both moving fluids, transforming fluids, and keeping the way chi secure.

Finally we also added Gagan. It’s a really also another one of my favorite herbs because it works on two levels. One, it supports digestion and helps with the normal function of the spleen. And on the other hand, it really helps to support the exterior. So in harmonizing the muscle layer in our what we call the muscle layer, which is this kind of relationship or is connected to the relationship between the ying and the weight level functioning.

We also, I also added the lastly linger which is, as we know, a really good adaptogenic mushroom that cons con is considered a really potent immune system tonics. So we have All the herbs that I mentioned yeah, are structured in this way. Our main main formula is NG with the addition of Tchen.

Then we have with the audition of. Greg and also I added to help clear and clear any heat and also support exterior and and as the third layer being urchin tongue transforming that potential phlegm and making sure that cheat transformation is complete together with w weights and linker.

So this is the structure of shield. It’s as I said, it’s a really great formula. I’ve been not only using it in my office, but a lot of practitioners have been purchasing it from me with really great results on. Supporting various kinds of conditions between just as a immune tonic, especially during the pandemic.

And then also as spring, as a spring preparation. Formula because a lot of times, as we know, when we see seasonal allergies, it’s all about harmonizing the ying and the wait chi and making sure that the immune system is functioning normally and therefore will not react to the Poland as as sometimes happens.

So the next formula I wanted to discuss is react, and it’s actually a very interesting formula, I believe so at least. And it’s based on the formula, whoe one, which is an anti parasitic formula or a formula associated with the in level. It’s sometimes curious why we might use that for allergies anyway the theory and we, I’ll show you some research that’s been done on that to support it.

Is that anti parasitic herbs. Inspire. Inspire is maybe not ex the exact word, but promote the body to regulate the immune sss the immune response and specifically the allergic immune response, meaning mast cell, histamine response, et cetera. So this formula. Combines hot and cold herbs and to address the Chinese perspective of of of allergies, which is common that we have both heat and cold concurrently in in the, usually the patterns of allergies.

Classically we’ll see this kind of the nasal, let’s say discharge is usually clear which represents a cold condition, but a lot of times this kind of hyperactivity and and hyperresponsiveness is a sign of heat. So this, there’s this kind of both heat and cold symptoms that manifest in the same time.

So reacts, react takes W one as the basis of the formula, and then adds herbs that are commonly used for food environment and environmental allergies like Fei Ang, Yuin, Bechen, and gj and also Zi and fun are. Commonly used. And and then added some adaptogenic herbs like Wrenchen and Tchen, as I mentioned before in, in shield to focus the formula on recalibrating and harmonizing the way she functions.

If we look, this is the research I was referring to. It comes from Dr. Lee from Mount Sinai, but this is the the link to the article if you’re interested in reading. And you should be getting the slides. So you could. Access it. If you wanna read more about this research.

Fascinating. About the use of. WME one. And so I also put here the original formula of WME one. So if you look up WME one pills these are the ingredients. You’ll see that there’s one of the herbs I had to change it’s called a hin or her Citis. And. It, this is a herb that I had to eliminate because it’s not available.

I think FDA Rev removed it from being used or, so I had to change that. And I also, I wanted to show you that this is the finalized formula. In in that Dr. Lee used. And so the original formula fui and hin were eliminated in the in the Research formula. I kept the f the fui in the formula.

This is the React formula. That’s the breakdown. Here’s WME one. You see we have wme and instead of hin I added Sisu. Yeah. As a substitute for it. But I did keep the the aconite fu in, in, in the formula. And again, here on the right, you’ll see all the herbs that I added for known to help in regulating food and environmental allergies and as well as the adaptogenic herbs I mentioned before.

So this is the form now react is really great for seasonal and environmental and food allergies. So it, it addresses a lot of the different manifestation of aisle allergies and it’s a great formula. And I’ve used it. For many of my patients from food allergies all the way to environmental allergies and whether it manifests with eczema and or other signs and symptoms of different allergies or even gastrointestinal if it’s a food allergies.

I also mentioned mast cell activation disorder. So this is another Manifestation of an allergic or allergy syndrome. So it’s getting a lot of attention. And it’s a very interesting syn syndrome that you can look into. And react works really well. I’ve had a few mast cell, quite a few mast cell activation disorder.

Patients that were really helped by react. What I want to add is a caution. When you react, if somebody shows or manifests anaphylactic shock or anaphylactic allergic response you have to be very careful about prescribing this formula and working. And it’s really Really important that you work with the patient’s doctor for testing reduced sensitivity for those anaphylactic results and or anaphylactic causes.

And also I wanted to mention that we have a very specific dosage suggestion. This formula is not, both the both of these formulas are not formulas. You take. Necessarily symptomatically to resolve a symptom, but rather you take it long term. Both of them need a minimum phase of three months before you, before they come to their full effect.

And so there’s a three months. Minimal period. Sometimes you need longer individually, so three months is an average. Some people, some patients will respond faster and some people, some patients will respond more slowly. And it also depends on how much acupuncture is concurrently administered and how many, and how they’re responding to all the other guidelines you might give them as part of the treatment.

Excuse me, but generally speaking, it’s really important to understand that this is not a short, both of these formulas are not short term formulas. There’s an accumulating effect that happens while taking them these formulas for a few months before considering considering the results.

These were the two formulas I wanted to discuss. I I encourage you to visit our website, Moshen herbs.com and I wanted to thank you very much for listening. And I also wanted to thank again, the AAC for letting me do this presentation. Thank you very much and have a wonderful day.

Is your Practice on Fire or Burning Down?

Holly Battrum is gonna be talking to us and our topic today is on, is your practice on fire or burning down, putting resilience and power back into your practice.

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Welcome to another episode of the American Acupuncture Council, to the Point, I’m your host, Lauren Brown. And I’m a C P A. I’m a doctor of traditional Chinese medicine founder of Healthy Seminars and author of Missing the Point Why Acupuncturists Fail and what they Need to Know to Succeed. And today I have a colleague and friend on our episode.

It’s gonna be Holly. Holly Battrum is gonna be talking to us and our topic today is on, is your practice on fire or burning down, putting resilience and power back into your practice. So let’s bring Holly in here and I’m gonna do a brief introduction here, but just let you know that she is also a doctor of traditional Chinese medicine.

She’s been doing great in her practice since she started it back in 2015. She’s also an. N l p coach and mentor and before she did Chinese medicine she was involved in business leadership. And Holly, it’s good to have you on and I’m looking for you to share some of those practice management pearls today.

Hi Lauren. Thank you so much for the invitation to chat with you and of course, the American Acupuncture Council for hosting these conversations. Yeah, we’re gonna have some fun. We’re gonna have some fun. So, you know, your title is Practice Is Your Practice on Fire or Burning Down and Putting Resilience and Power Back into your Practice?

And you and I I have had, you and I have had this conversation that. People want this work-life balance, and I don’t know if that’s a realistic expectation, but I’ve heard you talk about not so much work-life balance to have joy and succeed in your practice, but you talk about rhythm. Can you kind of tell me what that rhythm is about and how that is different from a work-life balance?

Yeah. I think that for me particularly, rhythm makes so much more sense, right? When you talk about balance. What are you walking on a tightrope or we’ve, you know, it’s a very fine line of things that you’re trying to achieve. Even when we’re talking about harmonizing in Chinese medicine, we don’t, we are not necessarily trying to balance the system.

We’re, we’re trying to harmonize it and move things around and so, If we get sort of trapped in this balanced concept, I think we put a lot of energy into staying in this very narrow window, right? We have our boundaries and we need to keep those boundaries and, and it’s almost like those latency patterns that we have in Chinese medicine start going into kind of holding everything in place, which becomes very taxing.

So, Right. If you look at rhythm, rhythm is ebb and flow. It’s the what we talk about all the time and. In our medicines, but we don’t necessarily apply it to ourselves. And maybe that means you don’t have a daily habit, you have a weekly habit. I know for one thing in my practice it’s, it’s really hard the way I have my clinic set up for me to get every single thing I wanna get done every single day.

But for example, when Mondays are my really long day and I may not get my workout in, I may not get all of my. How stuff done that I wanna get done because I’m spending 12 hours in practice, whereas I’m not in the clinic on Thursdays. And so I’m able to allot more time on Thursdays for some of those other things.

So I, when I started to look at it from this rhythm concept, it just took a lot of pressure off and made the burnout less and made sort of this challenge of keeping all this structure together a little bit easier. So what do you see as the some of the factors or why people are burning out?

Because we do hear practitioners, colleagues say that, you know, they went into this, they went into this to help people but they find they’re struggling. They’re becoming a. Exhausted, disenfranchised. And I’m curious kind of what do you think some of the reasons are behind that? Maybe it’s that whole rhythm, work-life balance you just discussed, and then how can somebody assess where they are in their practice to know whether they’re going in that right direction?

Yeah. So I think in medicine in general, but particularly in our, our profession, one of the things that happens is we’re taught from sort of this authoritarian concept, right? We have, which is it’s all good information, but we’re taught from a lineage standpoint. And so everything that we do then becomes, this is the way somebody else did it, our masters did it, and you.

And you’re trying to almost replicate that. And so when that happens, we know you can’t think as well in your own sense. So you can’t think as deeply of bringing your own purpose and root into what we do. So though a lot of us do go into these fields trying to help people, we’ve kind of lost ourself in the process.

And so if we try to change our mindset a little bit, and I don’t even wanna say necessarily mindset, but if we start thinking outside of that box, then we can start thinking with more of an abstract concept, and that’ll leave some of that burnout. And do you have any like specific examples, like from, did you come right outta the gates and it’s, and it was all perfect?

Or did you learn through some of your own mistakes that I know that’s, that’s where I got a lot of my lessons and that’s how I share with my colleagues. So what about yourself? Do you have any personal stories that you don’t want people to repeat and then kind of what you’re doing to have this.

Rhythm. And, and I’ll just add, cuz you were sharing, we’re talking about the work life balance and then you’re talking about rhythm. You know, everybody. If you think you’re having work-life balance on a daily basis, those are probably difficult expectations. And I liked how you said you, you know, Monday’s your busy day, so you’re not getting your workout in that day.

But if you look at it over a week or a monthly period, it looks more like balance. And so going back to my, my question, I’m just curious, like what was kind of your experience and what are some of the things that you’ve learned that you’d wanna share with our listeners? Yeah. So no, mine was perfect day one.

I’m just kidding. . I’m totally kidding. I think you go into practice and you go into this sort of, I have to make this work. And that’s great. And that’s where that motivation comes from. And you use those resources where you push yourself forward and you continue to try and try and try, but then you start to reach a point, or at least I did where.

Everything looks great on paper, right? You have this successful practice. You’ve got all these things going on, and, and everyone’s getting better. Not everyone necessarily, but PE people are getting better. People are coming in and, but you maybe don’t really feel like you can take a breath. And that’s where I started to notice this concept of, of what is this rhythm looking like and how, what is my definition of success and how does that look?

Throughout so that I could then kind of almost take back and start that concept of running my practice versus allowing it to run me. Oh, I like that. Can you Talk a little bit more about that and emphasize that, that, and to me that’s a really interesting mindset going from or going to running my practice versus my practice running me.

Can you give examples of what it looks like if your practice is running you and, and what it looks like if you’re running your practice? I, I, I’ll throw it. One, tell me if you agree with this, but in the beginning, my schedule I would, whenever patients wanted to come in, I would see them. So at seven in the morning, seven at night.

And then eventually I created hours. Even though, you know, you wanted patients, you wanted to be available cause you wanted to help everybody. And also you wanted to have a busy schedule. So let’s say you wanted to see eight people in a day. You would maybe work 12 hours to get those eight people in. And then I realize if you’re using one room, this should be done in eight hours.

And if you’re using two rooms, this should be done in four or five hours. That was a good example for me. My practice was running me and then I started running my practice that way. Is that an example? And do you have any others you can share? I, I think that’s absolutely a great example. I know when we first start, we do need to kind of bend over a little bit and, and say, oh, maybe our schedule does need to be more broad.

I know when I started, I, I worked two evenings a week and I worked Friday mornings and you know, a whole four and a half days kind of thing and a couple long days and, and, and now I’ve kind of isolated that to three days a week and I only work one evening. And, and that’s a great example and you sort of.

Kind of work outside of your boundaries. And now I’ll still, I don’t put those so concrete that I have to control them. So I think that’s where this, this little bit of a shift concept works with the resiliency. I mean, resiliency is sort of an elasticity and sometimes I do need to see somebody when I wouldn’t normally see them.

But I’m a hundred percent okay with that before I might be putting all these people on my schedule and really just being frustrated by it. And so if I keep myself within my parameters of my rhythm most of the time, then I’m able to offer more compassion and understanding to my patients when I step outside of that.

So that is a one great example. And then I’m so sorry. If you can kind of repeat the question a little bit, Lauren, then I can Yeah. Add to that and I, well, I was talking about examples of you running your practice versus the practice running you, but you just said something about cuz that flexibility and elasticity a sense that I’m getting is that you really gotta get clear on who you are, what success looks.

Looks like for you. And so it’s more about this inner work as well. Cuz when you choose to work outside your schedule, where’s your mindset at? Like, are you doing it out of fear? You’ll disappoint other and they won’t like you. Are you doing it that then they won’t come back? That to me is the practice running you.

But if your mindset was, I’m feeling. I’m feeling resourced. I really want to help this person. It would bring you joy. You’re not doing it out of guilt, out of, out of neediness, out of fear. You’re doing it out of compassion, and as you shared compassion and you really want to do this and it’s an exception more than the norm, then it sounds like that keeps you in your rhythm.

And so I, I like how you shared that. And to me that’s, that’s about getting clear on who you are. What do you want? Having healthy boundaries. Healthy, well, weighty, right? Mm-hmm. . We talked about an example of, of your practice running you versus you running your practice. Cause I think that’s what a big, when you said that, that was like, that is a good reason why we have burnout.

Mm-hmm. , most people practice. Are running them and they’re not running their practices. What do you think? So I was looking for another example besides your scheduling, but if, but another question, if you don’t have another example right off the bat is just as we get closer to wrap up, what do you think practitioners can be doing to have more of that resilience and joy back into the practice and, and what they may not want to be doing so they don’t run into burnout?

Oh one thing that I would say that we wouldn’t want to be doing is sort of the constant mind chatter. So you’re talking about that inner work. If what we choose to do is you nailed it, you know, put a nail on the head of, of if our stuff comes from a place of lack or comes from a place of should.

Then that is when we start to realize that our practice is running us. If our joy comes from a place of groundedness and oh, this helps my purpose go forward, then we’re gonna be much more in charge. Of our decisions. So that’s the big thing of like, I think what we should and shouldn’t do one thing that I think we miss out a lot of is that creativity.

And so if you’re struggling, you’re listening to this conversation and you’re saying, oh yeah, duh, I know that, but what do I do about that? It, it starts to do the self-work, but come from it as a place of creativity. If we are more creative, which might be just giving ourselves time to let our mind wander.

We forget, we take all this information in, especially this day and age, we’re trying to download more and more information in our brains, and we don’t necessarily give our brains time to process that information or daydream. For one thing, and that can be a part of creativity. If we have a creative mind, then we’re more innovative.

So if you’re struggling with what does this look like for my practice and I wanna keep, you know, a lot of people wanna keep their lineages and I think that’s absolutely amazing. But what can creativity, can you bring into that where you’re bringing your purpose and a little bit of yourself into that as well.

So a couple quick things that you can do is, you know, even just simply as picking up a new hobby, it doesn’t have to be one that you go back to. A lot of times we talk about that and we’re like, well, I used to knit, or I used to play the drums. You know, maybe that was 10 years ago, Lauren, and maybe now you wanna actually pick up a new hobby.

And while you’re working on that, you’re gonna start thinking about your purpose and your life and things like that and your practice. So that’s, that’s absolutely one thing that we can do. The other things is a couple great assessments. So you can either take a top down approach and say, Hey, what is my purpose?

What is my vision? And does everything that I do come from that standpoint? Are my yeses because I’m furthering my vision and my purpose? Or am I yeses once again from that should so you can come at it from that way and just take some time and look at that. The other way that you can do, if that feels like.

Too much is a, is a more of a, you know, bottom up approach. And so you can literally work through almost every task that you do on a daily basis and write it down and say, Hey, I have to do this. Does that feel good to me? Do I wanna do that? Do I not wanna do that? And then once you take that assessment, you can start breaking down and, and using that as, as more of like a how do you wanna feel versus what do you wanna do?

And that’ll help you align as well. And I’ll, I’ll add to what you’ve shared, cuz I like that, that I find the top down that purpose vision, basically, if you really get clear on who you are and how you’re showing up in the world, and then your practice is an extension of that for whatever reason, it just seems like the universe kind of collaborates with you and.

And you find your tribe. So if you’re authentic and you’re, like you said, trying rather than trying to be your lineage or trying to be, you know, if I try to be Holly I may not get those patients cuz it’s not authentic. But if I’m me I’ll find my tribe. Mm-hmm. And so, mm-hmm. To me that’s that. I think of on a spiritual level, conscious, more of a conscious work, really getting clear on who I am and and bringing that into my practice and getting aligned and being authentic.

And then the, the bottom up part I like that I was just actually listening to re-listening to. The book by Eckhart Toley called The New Earth. And he actually said that in it that he’s talking about there’s certain things in during the day that you may not want to do, which is normal, right? He’s talking about feeling good.

And he says, but if you can look at all your tasks and some of your tasks, like you said, are just things you’re not gonna like, but check in on how you feel and if you can just become truly present. So now we’re getting a little, again, back onto consciousness on presence. Mm-hmm. . If you can just be honest with yourself.

You don’t like to do it, but it needs to get done and just focus and be present with it versus thinking, I shouldn’t do this. I don’t want to do this. Just do it with mindfulness. Then it, and, and accept and full acceptance that this is what I need to do right now, just now. Then it has less of a drain on you.

And then I’m sure we’ve talked about this off camera. If it’s something you don’t like to do, You can always find somebody who likes to do that and do that well, and that’s somebody you can hire and delegate that too. So you don’t have to do everything. But at some, some at the beginning you do, right?

Mm-hmm. , you can start to delegate that, those things off. So you’re doing more and more of the things that you, that bring you joy that you’re really good at. Mm-hmm. . Yeah. Let me just I know we need to wrap up, but couple little things along those lines. One of my friends. Said this to me a long time ago.

We were talking about paying bills. She’s like, oh, you know, my husband always tells me that I should just be super grateful that I have the money to pay the bills. And I think that is such a different frame of reference. It’s like, oh, maybe you don’t want to pay the bills, but, you know, changing it and like, oh, I’m grateful that I can do this.

And then my other friend runs sort of a, a cleaning, like a house wife blog kind of thing. And she always calls her house cleaning instead of cleaning. And I just sat. It was a huge shift for me. Cause I’m like, oh my God, I hate cleaning. And I’m like, oh wait, no, I’m cleaning. mindset’s so important in life.

Right? And, and it comes to our practice too. I, I, I agree. So Holly, if people are looking for some coaching and a mentorship how do they find you if they wanna follow up more with you? Yeah. You can absolutely just go to hollyBattrum.com and current offerings will be up there. Shoot me an email at holly@hollybattrum.com and I’d love to chat.

Perfect. Thank you very much Holly. And I wanna remind the listeners as well that we have lots of practice management courses and some with that spiritual twist on healthy seminars.com. And also, if you like the consciousness discussions we have on my website on lauren brown.com. I have lots of conscious talks on there as well.

So healthy seminars.com for those practice management talks. And you can email me if you’re looking for that link, but, The other website is lauren brown.com and you can check out my book as well called Missing the Point, why Acupunctures Fail and What They Need To Know to Succeed. And again, thank you to the AAC for this opportunity to be your host and to our guest today, Holly.

The Lymphatic System and Aging – Shellie Goldstein

Today we’re gonna talk about the lymphatic system and aging. Is your lymphatic system working?

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Hi everyone. How are you? My name is Dr. Shellie Goldstein and I am delighted to be here. Thank you to the American Acupuncture Council for hosting today’s presentation. I am a cosmetic facial acupuncturist. I’ve been practicing for over 30 years. In addition to lecturing internationally, I work with the Pacific College of Health and Science.

We run the facial applications for cosmetic enhancement of the face program, and at the end you’ll see my links to obtaining more information about me and other programs. I’m the author of Your Best Face Now and created the Touch and Glow facelift kit. So there’s a lot out there. Today we’re gonna talk about the lymphatic system and aging.

Is your lymphatic system working? Let’s go through these questions. How do you feel physically? Are you feeling tired or stiff or swollen? Do you feel, does your body feel inflamed? Um, are your muscles fatigued? Is your body contained fatigued? Do you have allergies? How do you feel mentally? Are you experiencing brain fog?

Do you feel depressed, stressed, anxious for no reason? Reason? Maybe you have headaches, you can’t remember, things can’t concentrate, or just simply not motivated? Uh, how does your skin look and feel? Does it look dry? Are you having acne or blemishes? Rashes, some type of irritations or itchy, tingling skin, maybe thi thick, leathery.

And then how does your body look? Do you look puffy? Do you look different than you would normally think that you look? Or how does your metabolism work? Uh, how is your bowel movements you, are they regular? Do you have stomach aches? Gas, bloating, any type of abdominal bloating, difficulty losing weight even though you’ve made dietary changes and you’re working out, all of these can be symptoms of poor lymphatic drainage.

So it’s not your fault that you feel these ways if your lymphatic system isn’t working. So let’s take a look at the lymphatic system. What does the lymphatic system do? It maintains fluids, so all of the fluids that, this is the lymphatic system, the image on the right, so all of the fluids in the skin and in the tissue that drain from the cells.

And circle in this kind of bathing interstitial tissue. So the. The fluid goes through the circulatory system, comes out into the interstitial tissue if it doesn’t continue in through the venous system, and then it gets reabsorbed back into the lymphatic system, and then the lymphatic system takes that.

Fluid in and circulates it through the body and puts it back into the bloodstream. It also filters through the digestive tract, so fats, proteins, anything that falls out or comes out of the digestive tract, the lymphatic system takes it, puts it back in, circulates it through, cleans it out, puts it back into the bloodstream.

It also helps to protect ab against foreign substances. Lymphocytes, it’s gonna produce them. It’s gonna release them, and we know that lymphocytes, white blood cells are responsible for maintaining proper immunity to help destroy bacteria viruses. Parasites, fungus, and it also is a purifier. So the lymphatic system takes all of the waste, all the impurities from our system filters.

It gets rid of it, breaks it down, gets rid of it. So it’s kinda the clean. Part of our body that cleans things, purifies things, keeps the fluid moving. So imagine if it’s not working, what happens? You get backup, you get swelling, you get breakdown of the entire body. And this is why you feel bad without even understanding your realizing why.

The lymphatic system is part of the circulatory system, and it’s also part of the immune system. So as part of the circulatory system rather than blood, the lymph system carries that clear fluid, we call it lymph throughout the body. It’s in a unilateral direction, which means it takes it from the capillaries, from the interstitial tube.

Tissue moves it through the lymph, the vessels, through the lymph nodes into the thoracic duct, and back into the circulatory cy system. It’s a one-way track here. The extracellular fluid, what is this fluid? So we think of the the arteries and the heart pumps, the arteries, and then that this blood moves, th and fluids runs through the arteries and then back through the venous system where it goes into the lungs and it gets oxygenated and then back to the arterial system.

When this pressure, there’s a gradient ion, the heart is pumping. It creates a pressure when the pressure reaches what we call the capillaries or this little area. In here it starts to shift and it moves into the venous system. There’s not the pressure in the venous system to keep moving things, so there’s a pressure gradient, which means it’s coming faster in through the arterials.

As it going out through the venous system, so some of the fluid gets lost, it goes through that interstitial tissue, and then this, the green, this is the lymphatic system. It’s gonna suck it up and transport it and push it back into the system through the nodes. Here are the vessels. So this is the surface of the skin that’s picking.

The circulatory system runs parallel to the circulatory system, and the lymphatic system right here starts to grab all of the fluid that gets pushed out of the. The vessels, picks it up, cleans it through these ducks, and then sends it back. So these ducks are, no, they’re called lymphatic nodes and they look like bean shaped glands.

They look like this. And they store, they have a number of different properties and this is where. The lymphatic system interfaces with the immune system, the lymphatic system stores lymphocytes and other immune system cells that are designed to attack and destroy and filter bacteria and other harmful fluids.

Substances in the fluid. There are about 600 lymphatic nodes scattered throughout the body. Some of them are single nodes. And if you look at this image, you can see some that are single. Others are closely collected. And this is a chain. So a few of the most familiar locations of the lymph nodes are in the armpits along the clavicular area, right below the clavicle in the groin.

Area and behind the knee. So we’re gonna look at a massage later to help move that lymphatic system. And then as the fluid moves through, the vessels gets cleaned and filtered through the nodes, it comes back right at the clavicle and empties into the right lymphatic duct and the left lymphatic duct.

And these ducts, what they do is they connect to the subclavial vein, which returns the limb to the bloodstream. And then helping to do this not only helps to maintain normal blood vessel. Blood volume and pressure, but it also helps to prevent the excess of buildup of fluids and tissues, which we call edema or puffiness or swelling in the body throughout the body.

What’s interesting for us as acupuncturists is along the face, these lymph nodes gather along the jaw area. The neck and the clavicle area. And if you look at the acupuncture points, it’s around stomach five, stomach six triple warmer, 17 down the S scm triple warmer, 16 small intestine 1716 large intestine 18 large intestine 17 through stomach 12, and here it empties into.

Kidney 27. So right below kidney 27 is the primary area of drainage back into the circulatory system on the body. These lymph nodes gather again at the armpits in the elbow area, the abdominal region, the groin, and the knees. So once again, what we’re doing is we’re looking at the vessels, the flow from the venous to, from the arterial system into the venous system.

We lose a lot of the fluid here and the capillaries, and this is the interstitial tissue. So this is the blood flow, this is the loss of tissue of fluid coming out into the interstitial tissue and then gets absorbed into lymphatic capillaries. The lymphatic capillaries are more like the venous system in that they don’t have a pump, like the heart to pump the fluid.

So it really relies on an external manual manipulation to move that fluid through the vessels. There are similar to the the venous system, there are little valves. So this is the lymph, it’s the lymph gathers through the interstitial. Tissue. The fluid comes in through the limb system. There are some little nodules or valves that help to prevent back flow, but if it’s not flowing properly, what happens is you just get a buildup.

So there’s no place to go. So they, it starts to swell. The flu can’t get in, and that’s how you get swelling. And when that happens, we start to see. Decreased lympho tissue swelling, it results in pain and it feels like physical and mental fatigue, and then all sorts of illnesses related to the inability for our immune system to function properly.

It looks like this. Think of it as a fishbowl. Here’s a bowl with fish in it. And all of these fish are our cells. And when the system is working cleanly, the water is nice and clear and pure. But what happens when the lymphatic system isn’t working problem? Then you properly, then you get this, it looks like that gray, yucky, murky stuff.

So which do you want in your system? Do you want nice, healthy, clean lymphatic system or this yucky, dull, putrid lymphatic system? And it’s amazing how easy it is. To make that transition. And also how easy it is to not have poor lymphatic drainage. And so there are things that you can do on a daily basis to help have this instead of that.

So let’s take a look at some information with regard to aging, because it’s a two double-edged sword. If you have a good lymphatic system and your flow is nice and healthy and effective, then aging slows down. If you don’t, then you actually age more on the other end of that sword. As we age, our lymphatic system does slow down a little bit, and so it’s even more important as we are aging to maintain the integrity of the lymphatic system.

In this research by Shang and Capron and others what are they saying in terms of the lymphatic system aging, the diverse etiologies of age related disease from osteoarthritis to Alzheimer’s disease, all share an impairment or slow loss of tissue functioning. Aging tissue homeostasis shifts toward progressive low grade inflammation and a dampen immune system.

So this is saying that as we age organically, things start to slow down. The lymphatic vascular is the key regulator of tissue homeostasis and health and disease. So in order to maintain health, you need to have a healthy lymphatic system. Lymphatics, transports, antigens, and other macromolecules excess.

Interstitial fluid in activated immune cells during inflammation. We know this. This is what its job is according to she and colleagues. Detrimental molecular changes occur in lymphatics with age and reduced lymphatic function is a key component regulating numerous age related diseases. Interesting. Because when we look from our T C M perspective, our team perspective, traditional Eastern Asian medicine, when we look at some of these illnesses, what we’re calling this is phlegm and blood stasis.

So you think of the lymphatic system, it’s job is to clear infection and keep the fluids in balance. And when it’s not working properly, those fluids build up in tissues and cause swelling or lymphedema. And then what happens is it starts to back up. This is what we’re calling our phlegm. It’s that inability of fluid to move that gathers and gets stuck.

It’s also when things don’t move. Think of the yin and yang chiam blood, the blood moving with cheek. She blocks can’t move. The blood starts to stagnate and then you get blood stasis. And when you look at some of the top aging conditions in Chinese medicine, hearing loss, cataracts, macular degeneration, dry eyes, Alzheimer’s, poor memory, brain fogginess, dizziness, maculas, dry skin, itching, numbness, and hair loss.

These are all from both a Chinese medicine perspective, but also an Western medical. Perspective Western medicine being portly, drainage, Chinese medicine, phlegm and blood stasis. They’re all the same. And so one backs up the other here there are a number of different techniques for making a difference for moving lymphatic drainage.

Remembering that it needs some type of manual manipulation, either acupressure. Massage or manual lymphatic drainage. And when you look at the manual lymphatic drainage research, because that seems to be the most prevalent there’s a great literature search of 30 years starting from 1989 to 2019, so 20 years.

Of study 20 studies that met inclusion criteria of identifying different effects of manual lymphatic drainage. What research has found was that the manual lymphatic drainage has been shown to help with symptoms and conditions beyond edema and lymphedema. Mainly fatigue and pain tolerance. So isn’t that interesting that a lot of our idiopathic pain symptoms could actually be related to the lymphatic system and a number of brain fog and fatigue could also be related to poor drainage.

And according to the authors, this study suggests that mld or manual lymphatic drainage can be used INSYS symptomatic treatment of various diseases like. Multiple sclerosis, Parkinson’s disease, and a number of other various systems. 2022 study explored the integrative therapies for managing fatigue associated with long covid.

So here we go. Here’s another one. Long Covid found that the student that study participants who had face-to-face treatment sessions with parent technique practitioners, along with daily self massage and gentle mobility exercises. An approximate 50% reduction in subscale scores of fatigue. The parent technique is based on the theory that different stress factors, whether they’re physical or allergies or emotional.

Or infections lead to an over strain in the sympathetic nervous system. So their job is to as manual lymphatic drainage with this particular system. They use, they look at the nervous system. And the overload of the nervous system and the buildup of toxins and fluids around the brain and the spinal cord.

So a lot of their techniques work on massage in the brain area and also along the spinal cord, as well as opening up the lymph nodes. So again, here we go again. Look at the symptoms related to long covid fatigue, palpitations, dizziness, sleep disturbances, fever. Pain, joint and muscle pain, chest pain or tightness, stomach pain, nausea, diarrhea, loss of type, brain fog again, headaches, numbness and tingling delirium.

We look at that in terms of dizziness, not dementia. Depression or anxiety, sore throat, loss of taste or smell earaches are tend, so all of this information is leading to the same thing that whether it’s on a physical level, a mental level, or an emotional level or pain related on all of these levels.

Are all affected and affect the lymphatic system. There are, we are gonna go through a small lymphatic drainage technique. So just to general safety, although it’s generally safe, if you have a high risk of blood clots, congestive heart failure, kidney disease, any type of active lymphatic infection or swelling of a night cause.

You may just wanna watch, not participate. And again, I would check this out with your physician to see if these would be precautions or contraindications or actually helpful for some of these conditions. So when we look at supporting the lymphatic system with massage, let’s just do this. We’re gonna start with the points right below kidney 27 and stomach 10.

So if you place your fingers on the chest bone right at these right below the clavicular head, We’re gonna find this area and we’re just gonna massage it with our hands. So medium pressure. Just massage this area. So what are we doing? We’re opening up the flow in the Subclavial area. The big filtering system because if this is clogged, you’re not gonna be able to move things through.

Interestingly enough, when you’re massaging this area and keep massaging ’em, I notice that because I get spring allergies and here we are is, I’m starting to swallow a little, I feel like a little fluid building up in my throat, which is good. That’s a good sign. And then just give this little tap.

Okay. Tap and then we’re gonna move to the jaw line. So I’m actually gonna take my fingers and just massage around the jaw area like this, moving from CV 23 and four, and then five, stomach, five and six. So along the jaw, just give it a little bit of massage with medium pressure so that we can stimulate that fluid so you can go from back to front.

Front to back, let’s go from front to back and then you can just slide down the SM back to that clavicular head area. And then we’re gonna try the neck area. So let’s just put our fingers at the back of our neck from reaching from bladder 10, gallbladder 20, amnion triple heater, 17, and just massage.

Along the neck area. Good. Great. Good massage. See if we can get that fluid to move and then I always slide back, bring it back to that area below, kidney 27. Okay. And then armpits. So we’re gonna lift our arms. You can do it at the same time or under, or one at a time. Just take your thumb and put it in the lung one, lung two area, and then reach under the armpit like this and just give it a little massage.

Good. And do one side

and the other. Lung one, lung, two, heart, one, spleen, twenties, stomach, small intestine. 19, this whole area. Great. Good job everybody. And little tap. Now we’re gonna go to the elbow so you can bend your elbow and a 90 degree angle. And we’re just gonna give it a little bit of a massage. At the large intestine.

11 part three, lung five, pericardium six.

I’m gonna do both sides.

There you go,

Okay, now you’re not gonna be able to see this, but in the inguinal groove, in the groin area, same place. So the large intestine, 11 lung five heart sorry. Spleen 12, stomach 30 to 31. Liver, 10 to 11 area. Just gonna give it a little bit of a massage.

Great. And then behind the knee bladder 54.

Good job. All right, so you can do this several times a day. I know that I come from Florida and drive to New York and imagine you think of these point, these areas where the joints are. So yeah, I’m sitting in a car with my knees bent in a 90 degree angle. So bladder 54 is locked. My in green groove area is locked, and I have my hands on the steering wheel and I’m clenching my.

Neck area because I’m constantly paying attention to driving and you’re just sitting there. But after three days of driving, I’m exhausted. And then I remember, oh gosh, my lymphatic system didn’t really flow because you don’t really. Drink too much in case you have to pee. You don’t wanna have to keep stopping.

This is just a really quick for me, A reminder was, oh, lymphatic drainage. Or if you’re sitting at the desk and you are worse studying or doing a lot of computer work, guess what? You’re in the same position. You’re in, Guino area is locked, your knees are bent, your arms are up. You probably, are hyper focused.

So your jaw area might be a little tighter. Again, this is such a simple thing. It took us less than five minutes, and it makes a huge difference on your physical health, your mental health, your emotional health, and just remembering that when you feel good, you look good. And. When you feel good, you’re also nicer person.

And so I think, just a five minutes of lymphatic drainage a day makes a better you and a better world. I hope this helps and thank you very much for being a part for paying. Listening to this, thank you again to the American Acupuncture Council. If you want more information about me, Instagram at Shellie Goldstein, and then my website is hampton acupuncture.com.

You can learn about me more, things that I do, classes that I teach, and programs that I’m involved with. So have a wonderful day. Don’t forget to do your, I’ll do your little lymphatic drainage massage, and we will see you again. All righty. Bye-bye.

Acupuncture and Timed Therapies – Sam Collins

And one of the things that I get commonly, whether it’s a network member or someone coming to a seminar or someone reaching out from acupuncture today is how do I manage acupuncture with time services?

Click here to download the transcript.

Greetings, everyone. This is Samuel Collins. You’re coding and billing expert for acupuncture in the American Acupuncture Council with another episode. Let’s solve problems. Let’s make sure you have the right things documented. And one of the things that I get commonly, whether it’s a network member or someone coming to a seminar or someone reaching out from acupuncture today is how do I manage acupuncture with time services?

How does that mesh if I’m doing a manual therapy or a massage? How does that time incorporate with acupuncture? It’s actually not as complicated as you think. However, it’s something that I’ve learned because I teach in a lot of schools. Acupuncturists aren’t learning. So we wanna give you a better learning curve now to do this properly.

So let’s go to the slides. Acupuncture and timed therapies. How do we manage ’em? What’s the proper way to document these time therapies along with acupuncture? And what are the minimum times, because obviously you’re all familiar with the 15 minutes, so what does that really mean? So let’s talk about what are these 15 minute services and time services.

Obviously we know we have acupuncture. We have the four codes for acupuncture. The two first ones obviously for manual acupuncture. The ladder two are for electro acupuncture, and each of the codes indicate that you spend 15 minutes. Now remember that 15 minutes is 15 minutes with the patient. in the room.

So by example, when you go in the room to greet someone, realize your time starts. So one of the things I find acupuncturists often miss out on is the true understanding of the value of time. The time is not just the point of inserting the needles, but it’s all the things required to do such as, Hey, Mr.

Jones, how are you feeling today? So that 15 minutes is incorporated into the acupuncture codes and is a requirement for each set. Now what about therapy services? Now, I picked a few here that I say are maybe a little more common. I won’t say these are the only ones, but I picked electric, stem, ultrasound, auricular electricity to accu points, exercise, massage, manual therapy.

As I would say, these are generally the more common ones that are timed. They’re more than these, but, and you may be doing additional ones, but the big issue is how do I make sure the time for those. Meet and adjust with the time for acupuncture. If I’m doing them together, what are the minimums here? And this is the concern that we run into a lot of problems with that.

Someone will not document enough time. I generically will tell you, acupuncturists spend more time with their patients than most other providers, whether are chiro. PT or medical doctor for sure. I think acupuncture spend a lot of time because the way that you work, the type of services you provide. So let’s talk about how does acupuncture work.

Now, this is actually a page out of the C P T, and I’m just using that to make sure everyone can see. It’s not just us stating it, but in C P T, it indicates that there must be 15 minutes of time that’s face-to-face with the patient. Now, face-to-face doesn’t mean touching. Sometimes people think contact means, do I have to be contacting the patient?

No, it just means. You’re in the room. So literally once you go in, it counts. So I wanted to make sure you can see it from that standpoint, but let’s take a look at it as it’s written out. Each code indicates pretty much the same thing. It says acupuncture. Of course that means needling with one or more needles and then says without electric stent, because these are manual and it says 15 minutes of personal, one-on-one contact.

So that simply means we’re in the room with the patient having contact with them. For the acupuncture service, which includes the pre, the during, and even the after. So the first set says 15 plus needles. Notice the additional set or additional sets says the same thing. Each additional 15 minutes of personal one-on-one contact with reinsertion of needles are really an additional insertion of a needle.

So bottom line is 15 minutes plus insertion. Equals each set. Now that goes with whether it’s manual or electrical. The only difference of electro acupuncture codes, 9 78, 13 and 14 is that at some point the needles have electricity attached. So you’re doing some type of device where you’re con contacting the needles and having electricity throughout.

Bottom line. It’s just simply 15 minutes per set. Pretty straightforward, but sometimes people have a hard time understanding. What does the 15 minutes constitute? We’ll get into that because let’s look at what other codes are. 15 minutes. Now, this is a list of all of the common physical medicine codes.

If you’ve been to a seminar with me, if you’re part of our network, of course you have access to this. And all this is a simple list of therapies you’re gonna notice in the upper left side is gonna be the unattended therapy supervised. The constant attendance, the therapeutic procedures plus the acupuncture, even dry needling listed nonetheless.

Let’s talk about specifically what are the timed services? Timed services are the ones that indicate time. You’ll notice the first ones that say supervise like. Infrared heat or something, they don’t have time, so these don’t matter. Those you just do or don’t do. There’s no minimum or maximum.

However, where you see ’em say constant attendance, you’ll notice now each of these indicate 15 minutes with each. So much like acupuncture. That means you have to spend 15 minutes with the patient. Now that doesn’t mean necessarily that your hands on though it could be, but it means you’re with the patient as the therapy is being provided to monitor the efficacy of it, if you will.

Now, commonly it could be electric stem, handheld type, not a type where you put pads on where you hold it by hand. Here’s that code I mentioned, the electric stimulation of auricular, acupuncture, literally electrical impulses to the surface of the year. at acupuncture points but not needling.

Those all indicate 15 minutes. In addition. In 15 minutes are the common ones that you’re gonna do. And of course I think most acupuncturists, and I shouldn’t say most, but many do incorporate therapies as part of their practice and may do some body work with a patient, whether it’s twink, haw and so forth, certainly gonna be applied to it.

And those notice all indicate 15 minutes. So what this is focusing on is making sure do I have the time? and understand the timing of it. I just taught a class last week to students at Emperors College, a college acupuncture college in Southern California, and I was surprised to see how most of them were getting ready to graduate and really had not learned anything about time.

So it’s one of the reasons their instructor had me come in, because it’s one thing to learn to be a really good acupuncturist, but we do have to understand the business end of it. How do I document this? And I don’t care if you’re not billing insurance. , you still have to document the services you’ve provided.

So let’s talk about the acupuncture time. What does it mean? What does it mean to do time in general? Now, what you’re seeing here is actually taken directly from cms. As well. And when CMS means Medicare as well as the American Physical Therapy Association, the ama, and all the adaptation of this, and it talks about counting time, and I want you to notice when time is not just time touching the patient, but notice it says time of therapy includes.

Assessment and management time, medical record review, physician contact while the patient is present. And so what it means is when you’re in the room and you’re looking at the notes and you’re getting ready to start part of it, thinking, okay, last time I did this and I’m doing, you’re gonna count all that time.

So what I’d like you to do is start thinking of when you go into the room, Either you’re starting acupuncture, so the time starts then, or maybe you’re gonna be doing a therapy. It starts when you contact the person. So this means the things you do before the service, that’s part of it, if you will. In addition, of course, it includes the hands-on treatment time, obviously, but then it’s also post-service work.

Notice that includes things like assessment of treatment effectiveness, after you’ve done making sure the patient’s feeling okay, sitting upright, making sure they don’t have any needle sickness. All those things would be included. But notice it also says, Communication. So you know those few minutes you might spend with a patient at the end of the visit communicating some things about their therapy that would be included.

I wanna be careful. It’s not overstate post-service time, but it’s certainly part of it. Here’s why we have to make sure we’re accounting for it, because I know the codes save 15 minutes. But the codes have what we refer to as an eight minute rule. Now the state minute rule is put out through C m S and adopted by every insurance, and it talks about the time required for a time service is actually not 15 minutes.

The time is actually as little as eight for one unit. It means you’re doing more than half. So the bottom line is if you were to do acupuncture or a therapy for as little as eight minutes, it could be billable, assuming there’s only one unit or set. Now, here’s where things get slightly tricky, but not too hard to understand.

Notice it breaks it down one unit. Of services. Now, I’ll even say one set, cause I like to think of acupuncture and sets. Notice one unit is as little as eight minutes, but notice it goes all the way up to 22 minutes. So if you’re doing a set of acupuncture or a therapy anywhere from eight minutes up to 22 minutes, that is simply one unit.

A second unit or time factor doesn’t begin until you’re eight minutes into the next service, which means now it’s gone to 23 minutes. So notice 15 plus eight, always the eight minute part. So it goes in that pattern all the way through. Notice two units or sets would be as little as 23 minutes. Three would be 38, 2 meaning 15, 15, 30 plus eight, and so on.

It goes all the way through. Now, that’s not too hard to see. However, it becomes an issue when, what if I’m doing two services, obviously, like acupuncture, I might just do ’em, look and go, okay, I did that, but what about a time service? And this is where things get confusing. . Where does that time count?

And again, I wanna make an emphasis here for your acupuncture time because I think many of you forget what constitutes it. It’s not just picking points and inserting needles and removing, but it includes all these things in red. Include a review of history. When you walk in the room and say, Hey, Mr. Jones, how are you feeling?

That’s when the time starts. It includes day-to-day evaluation, pulse points. Tongue, maybe range of motion, whatever you do. Obviously, cleaning your hands, choosing and cleaning the points, inserting, manipulating the needles, removal and disposal. Wow, all of that’s included exactly as well as completing the chart notes.

So clearly there’s a lot of time. If it’s an activity that’s related to acupuncture, it certainly counts what doesn’t count, and I underlined this at the end, the time the needles are retained is excluded. So be careful. You know how you might have a person rest on needles for 10 or 15 minutes? I. Perfect.

I know when I go to the acupuncturist, generally when she inserts needles for about 10 or 15 minutes, usually says, Hey Sam, I’m gonna leave you here and let you cook for a little bit, if you will. And then she’ll let me lay there for 10, 15 minutes, relax, and then come back in. That time does not count.

Now what if you did stay in the room though? What if you stayed in the room and every few minutes you stimulated the needles or you’re looking for patient response whether to insert more? That will count and it would count if it as an additional set once you would insert more needles along with that time.

The key factor here though that’s complicated is that I can only use one time code at a time. I can’t do two time codes and I have to meet the minimums. And what I think probably makes it simple to think of whether you’re doing acupuncture by itself or acupuncture with a therapy time is cumulative. So it’s not a separate time for additional services.

It’s an included time. So even though you might be doing two different things, massage and acupuncture, The minimum time to build a unit of each means you must spend 23 minutes total with no one of them lesser than eight minutes. So one thing to keep in mind though is let’s document this. This is not hard.

You spend a lot of time. You know what I’d like you to start doing. Tell me what time you entered the room, what time you left. , if there’s a particular therapy, tell me what time you started, the efforts of that and what time it was completed. But do keep in mind time documentation is only two ways it can be done.

You can either tell me how many minutes you spent. That’s easy enough. I spent 15, 18, and so on. Or you can say I went from nine 30 to 9 45. Now where I would be careful, I find often when people state minutes, their minutes are off in an average, and you may be undervaluing it. . My preference would be to actually tell me start and stop times.

Now either is acceptable. Just be careful of shorting yourself. You ever have that where someone says, Hey, how long does it take to get to whatever particular location? They go, oh man, it takes 10 minutes. Then you go to get there and it takes 25. You’re like, what? They’re telling you often 10 minutes to make an enticing, but also to say, Hey, if it’s perfect traffic, maybe I want to know exactly, so let’s make sure we’re documenting it right by telling me how much time.

Whether it’s total minutes or from and two, what’s unacceptable, and this is where you have to be careful. Don’t state doing one unit. You can state that, but then you have to define one unit by how much time, don’t indicate a range. You can’t say, Hey, I spent somewhere between six and 18 minutes. It has to be a certain number.

It can’t be a range. It also can’t be, Hey, I just did it times two. What do you mean by times two? , and then of course, not just indicating any time by just saying, Hey, I circled acupuncture. A set massage. That would not be adequate. So by example, let’s take a look at this. If I’m doing acupuncture and I spend 10 minutes on the first set, that would be billable.

I circled to say that would be one set. What if I add an additional set in there for another 10 minutes? Would that be billable? What’s the amount of time that we spent? 10 plus 10 of course is 20. What does that mean? Only one set is billable. Now obviously it’s too short. Now you’re gonna say, but Sam, it went over eight minutes.

Yes it did, but it didn’t meet the time for the second unit. What if I spent a little bit more time? Let’s take an example. What if I did acupuncture for 12 minutes face-to-face, and then the additional set I did for 12 minutes again that will be 24. Which means above the 23 minutes and I could build both sets.

In theory you could do 11 minutes on one and 12 minutes on the other. What I wanna focus on here is just be careful that you do have to add the time for cumulative amounts. So for tunes to be billed, we have to have that minimum. Which brings me to what we started with was talking about therapy.

What about time therapy when it comes to acupuncture? Now, if I’m doing infrared heat, doesn’t matter because infrared heat doesn’t have a time value. You either use it or you don’t use it. However. Let’s take an example here of acupuncture and you did 15 minutes on the first set, 10 minutes on the second, which I would say isn’t unusual.

Obviously the first set may take a little bit more time. I do want you to keep in mind though, the second set does include if you’re face-to-face, finishing the notes. So if I did 15 plus 10, good. Now I did another 10 minutes of massage. It meets the eight minutes, but let’s total this up. 15 plus 10 is 35 minutes total.

If I did 35 minutes, how many units are set can I bill? Based on the eight minute rule, what’s the min minimum time for three is 38. So this would mean this would not be billable for the massage. I would build a two sets of acupuncture. Now, you may ask Sam, why are you gonna build a two sets of acupuncture?

They have a higher value, so I would pick the ones with the highest value, but we cannot bill all three. If I were to bill all three, I would have to have spent somewhere either three more minutes on this set. Three more minutes on this, or three more minutes on the first one. The total time. has to equal 38, so be very careful.

This is where I see people run into problems. They forget to look at the cumulative nature. Think of it simply, if you were to do massage only for 35 minutes, could you bill that for three units? No, not enough. So it doesn’t matter that it would just be one service or multiple, but let’s take an example using the same idea.

We did 15 minutes of the first set, 10 minutes on the second, and then 15 minutes fully of massage. What’s the total time there? The total time is 40 minutes. This means all three services can be billed because the minimum time of eight minutes was hit for each, and the cumulative time was over 38 minutes.

So what I’d like you to think of is just start getting in the habit of these time services and units to do them in this way. Please, I hope you’re not looking going, oh, this is too complicated. It’s not at all. You’re just documenting the services you have done. And I want you to think of this way.

Documentation should be a way that someone can look back. and go what was performed on that visit, and I’m talking a complete risk management of this. What if a patient were to say, I don’t think you did all the services, or was, making an issue of money. This would be the way to make sure you’re gonna say no.

It’s all there. I would love for us to be in the habit of it. Frankly, I’m frustrated for some acupuncturists because your time is something you do a lot of with your patient, but because of your lack of documentation, when notes get reviewed or people make an issue, , we cannot defend it. So let’s just start putting the time down.

You’re spending it. Let’s meet it. So eight minutes minimum for 1 23 for two. Get in the habit of that, whether it’s acupuncture or therapies, will make your life simple. Now, keep in mind, Acupuncturists aren’t doing a ton of services. You know why most people go to an acupuncturist? To get acupuncture.

But isn’t it good sometimes to get some additional services? I know when I’ve gone, I’m a big lover of cupping. I find that’s really helped me with some shoulder issues. But also there are times where they’ve done some gua or deep tissue work, and I would say there’s ways that acupuncture stood that others don’t, that you might be doing slightly differently and maybe have a better outcome.

Don’t be afraid of additional services. Just simply document them. We wanna make sure you’re getting the patient the best care, but I also wanna make sure you’re getting reimbursed. That’s what we do at the American Acupuncture Council Network. We’re here to make sure your offices continue to thrive and make more money.

If you would love to have an expert to be on your staff, you know you can hire me for less than a dollar a day. You can zoom with me. We can do one-on-ones where we go over your fee schedule, audit your files, make sure everything’s compliant with the big issue of not so much compliance but reimbursement.

Your practice is going to continue to thrive because of your ability to run it as a business. Allow us to help you do that. Take a look at the American Acupuncture Council Network. We’re here to help. Until next time, everyone, I wish the best, continue to be that good person to all your patients. I’m counting on you.

The Acupuncture Wow Factor – Lorne Brown

And so the Wow factor that I’m talking about is for your patients to have a shift on your table and experience a shift so that they are able to relax and therefore have the trust and confidence to follow your treatment plan.

Click here to download the transcript.

Again, thanking the American Acupuncture Council for this opportunity to share with you my colleagues. My name’s Lorne Brown. I’m a doctor of traditional Chinese medicine. I’m a clinical hypnotherapist. I’m also a C P A. I’m a certified professional accountant, and I wanted to talk about the acupuncture Wow factor.

And I’m gonna set my intention that this will be simple and yet powerful and effective. That comes from the Einstein quote that make things as simple as possible but not simpler. Meaning let’s make it simple so we, it’s easier to implement, but we don’t make it so simple that it loses its effectiveness.

And also my intention is to do a small sound bite here. So you can just take one concept or one idea and run with this in your practice. I have found that sometimes the things that. Help practitioners be the most successful, are the most obvious, but yet they’re not obvious until somebody brings it to your attention, to your awareness that you’re like, oh yes, I want to intentionally do this.

And so the wow factor that I’m talking about is for your patients to have a shift on your table and experience a shift so that they are able to relax. and therefore have the trust and confidence to follow your treatment plan. Now I’m gonna unpack this for us, and I’m gonna talk about this from, I guess materialistic and quantum level here.

So when we have resistance, then we block flow and receptivity things that happen for us in life. And you’ve probably experienced this, where sometimes you just have flown receptivity, synchronicities are happening and things just seem. Easier. They just happen and flow for you as if there’s these invisible hands coming down from the heavens and opening up doors you did not know existed.

You’re probably also aware where you’re putting effort and more effort and the more effort you do, it just seems the higher things get and things just aren’t easy and there is no flow. And on a quantum or spiritual level, when we have resistance, we are blocking. This receptivity and flow, we have a beautiful term for this in Chinese medicine is called cheese stagnation.

In conscious work, I often hear it call as resistance or friction. And this ties into our patient’s ability to heal because the body has this beautiful, innate ability to heal. And I see my role as a practitioner, as a facilitator, I’m not healing, I. The person in front of me. We are learning more and more through really cool research.

Again, quantum physics level research, that it seems to be that it’s the patient’s need that determines the healing. And we as practitioners have to be that clean vessel. But we are the facilitator and even our nervous systems, our parasympathetic nervous systems, our subconsciouses. They’re syncing up.

They’re doing this through FMR, F M R studies where they can see that the nervous systems are syncing up beyond our conscious awareness, and there’s a healing, an exchange of information that happens. And we use our needles sometimes to do that exchange for information. So the wow factor for us now, I want to unpack this and go back into this patient’s innate ability to heal.

That if they have resistance, they’re not sure if you can help them. They’re not sure if it’s worth their money. There’s that trust issue. Do I really believe this? Does acupuncture work? Work? You know what the skeptics are saying, what conventional medicine’s saying? , all this can get into their psyche and disrupt their ability to receive and have flow.

So disrupt that innate ability to heal because that placebo impact, which has such a bad rap placebo, is not inert. We know this in 30% of Western trials, sorry, in Western. Random controlled trials. Sometimes it’s common that 30% and up to 90%, but it’s common 30% they attribute to placebo. From a Chinese medicine perspective, or at least from my perspective, what we are doing is engaging the individual’s capacity to heal.

They have this innate ability to heal. It’s amazing how we try to dismiss this, but I guess from our materialistic perspective, from conventional medicine, we have that ego that we’re doing the healing , but really it’s the individual. They take the medicine and through that medicine, they incorporate it in heal or through our needle or through our communication.

The healing process starts the acupuncture wow factor to allow the resistance to be lowered. So the patient is in that state of receptivity and flow to really accelerate and accentuate the innate ability, heal. That healing process comes from them feeling an a, an experience, a shift on the table. And so I’m gonna give you at least two examples here, and I’m thinking of recent lectures on healthy seminars.com, where I hosted in one week, both Pony Chung and David Uler.

It’s actually pronounced Oiler, but spelled Uler . David Uler, you probably know him if you read his name, but David Oiler and Pony Chung and their style of acupuncture gives the patient this incredible shift. On the table that even if they don’t have resolution on the table in that one treatment, which is, let’s be honest, it’s we don’t get that resolution for chronic conditions in one treatment.

But because they experience that shift, they now have that ability to have trust and confidence to follow your treatment plan. And it’s been my experience in my own clinical practice using their style of treatment and also call my colleagues that. Patients then leave the treatment room and book their 12 to 15 treatments in that two to three month period because of the experience they had on the table.

So when I talk about shift, let’s bring up David Jeweler first as a concept, and then I actually have a video demonstration that I have with Pony Chong that I’ll share with you with David Yuler. He does palpation based acupuncture. He study with Kiko, Matsumoto and her teacher, and it’s a really cool style of somatic acupuncture where you’re palpating tender spots on the body and based on those tender spots, those are called reflex zones, you needle other areas to release the tender spot.

And by doing so, that experience for the patient is an aha moment. So I’m gonna share a story with you, for example, and I’m gonna do the David Oiler idea of palpation, how this works in the treatment room. But here’s one of my. Own clinical stories and I’m gonna share one about Shen disturbance that David shared recently in his lecture.

This woman came to me after two, two months post C-section delivery of her baby, and she had poor quality of life because of the incredible lower abdominal pain that she had since the birth of her child. And she went to back to the surgeon, the gynecologist. They ruled out any infection they ruled out.

anything left inside and they just said, there’s nothing going on there. There’s nothing they can do. Obviously, she didn’t want to take high dose or pain meds because she’s breastfeeding. She had saw massage. They had referred her for some physio for post-surgical to help. Nothing had helped over those.

Two, two months. She came to my practice. She knew of me because I actually was the practitioner that helped her with her infertility, and I guess we have branded ourselves so well at fertility that because she wasn’t trying to get pregnant, she didn’t think to come back to my clinic until later say, do you think you can help me with this?

It didn’t even dawn on her that maybe this is something we can help. . And so she came into my practice with her lower abdominal pain and right away I thought about the tsu. And for those that are not familiar with that term, it’s basically a reflex zone for blood stasis. And when you have this, it can wreak havoc in the body.

Cause remember, it’s a system and we have a serious stagnation. It inf it interferes with the flow and receptivity. And I press down on her tsu and she’s oh. Like incredible pain. And so after pressing in on the tsu, I go to the distal points that are used to relieve that. It’s just two acupuncture points.

And I hold my little device, just the tube of the needle actually. And I try different angles on liver four and asking her as I palpate, does this reduce this pressure? Pain? And she goes, oh, you’re not pressing as hard. So she thought I was trying to fake her out because. She went from like a 10, outta 10 to two outta 10, and I said, I’m pressing the same.

How about you press so you take my hand and you push down? So she took my hand and pushed down while I used the handle of the tube. No pain. So I go ahead and I needle those points. I also noticed that her immune reflex was really sensitive, so I did the immune points and a week later I did follow up with her and she was immediately at that treatment.

90% relief. So she had 90% relief immediately after that treatment, and one week following, she still had 90% relief from that treatment. That’s where somebody like that now refers anybody and everybody to the practice and any plan that I would have for her. She is more relaxed, as in con, has the confidence trust in me.

One is she had relief in her symptoms, but I’ll share with you that even if the symptoms aren’t relieved, when they experience the fact that I can palpate an area, a reflex zone and then needles somewhere else, and then that zone is gone, they see that it’s doing something and it gives, it inspires them to now follow your plan.

In his course also, he talked about the reflex zone and the sternum for anxiety and shen disturbance. And there’s points that we do on the back for this. And there’s points that we do distally for firepoint on the pericardium and heart channel. We test the fire points to see if they’re tender as well.

And then we use metal and water points. To relieve that. And again, when patients come in and they’re really anxious, so the difficult trusting cuz they’re sympathetic. They’re sympathetic, is on high alert, that means can’t trust, right? They’re rarely cautious, paranoid, almost really feeling worried and anxious, palpating the sternum and it’s tender for them.

And then going and touching reflex zones on the back. And then if that relieves it, great. If not, then I go to the fire points on the palm and then I check the acupuncture points. And if that relieves it, you can just see the melt on the table. So that’s my example as a shift on the table. And so learning styles by like David Yuler is a way to really grow your practice.

Now, I was trained as what I call a barefoot doctor or Zg Fu acupuncturist, which I think many of you have been trained as well, meaning like if you have blood deficiency, it’s stomach 36, it’s red 12, it’s spleen six, bladder 17. Really? These are my herbalist, acupuncture herbalist from China teaching me acupuncture and.

Because I host healthy seminars. I’ve had the privilege and the opportunity to witness different styles of acupuncture and realizing that there is a really deep history and style of acupuncture more than how we were trained in TCM schools, where you can get really good results. and also there’s that impact on the table.

And so David Oiler is one of those examples of studying with him and being able to just palpate some points, relieve them right there, that first treatment in 20 to 30 minutes with that treatment, and then they continue on for their condition because they’ve seen such an experience of that. Plus, they also are getting resolution for what they’ve come in for.

Let’s talk about Pony Chong. Another style of acupuncture and where they’re in common is he shows a shift on the table. And in the video that we’re gonna bring up is from a lecture he did recently in our community library. And what he’s demonstrating is he’s doing a, an acupuncture point, spleen 12, and he talks about.

In the Canon and the classics, just where it travels on the Sinu channel and how it impacts what muscles, what ligaments went tendons basically in modern day. So he can treat certain conditions in the lower extremities and he’s going to needle the point. And then he tests the point with a pointer plus, and he does this because of two reasons.

One is when you. Test it. It lets you know you’re in the right place, cuz I’ll share that sometimes we always have the right intention. This is where I think SPLEEN 12 is on this individual based on landmarks. But Pony has shown through his style of acupuncture that it’s reproducible, that you can be really precise based on reading the description of what this acupuncture point does on a muscle skeletal level.

And seeing that muscle shift or move or fsic. When you touch it with a pointer Plus from the patient’s perspective, it is a wow factor because they know where their pain is in whatever their leg, and when you put a needle in and it co and they feel that sensation going down, that whole muscle, they now have the confidence that you are in the right spot.

The second reason it’s so important that I went on a quick tangent there about the patient’s experience is sometimes we have the right intention of where we think the point is, but points actually drift. They’re not. The same based on the book location on every individual, there’s a little bit of drifting and pony style of acupuncture.

Teaching shows you that you can actually get exact and know that you’re in the right spot by testing the needle. And I have to share when I use this in my practice, sometimes I have to reinsert the needle two or five times to get it. But now you get better results because originally my intention was this is the right spot for this point, but I can test and show whether I’m really in that spot or not.

This is also gonna be important for research to make research reproducible. Now we know we’ve given them the right acupuncture point for where it is in their body, and so this wow pa factor is crucial in having patients relax. So lowering the resistance, having confidence and trust to follow your treatment plan because they experience a shift, that first treatment, not let’s treat you for the next.

10 or 12 treatments and see if there’s a shift, and then we’ll reassess they believe after that first treatment. So let’s bring up the video. I’ll share with you the first five seconds, the volume’s low or 10 seconds, and then it kicks in. And this is just a discussion that I was having with Pony in one of his community lectures while he was demonstrating this idea of testing a point and how the patient experiences this.

So please bring up that video now.

And pony, this is what I mentioned in our introduction. If you could just go back to that video for a moment. Okay. That when patient experience a shift on the table and in this case when needle, when pony needles, the point and then he stimulates it with his pointer plus the structure of the leg. The muscles watch the leg move in the bottom left eyes, watch the leg move.

Confirming he’s in the right location cuz it wouldn’t move he was in, if he was in the correct. Two things happen. One is he has now accurate needle location because we have good intention and we say we’re putting it in SEN 12. We put the intention, but PONY is showing that there’s an actual real spleen 12 for each individual, and it can drift a bit from how it’s described in the book and based on the person.

And he’s confirming that he has reached spleen 12 based on what he’s seen in the leg. So a for effectiveness preciseness. Two is the patient is seeing what’s happening, she’s late leg and it just her leg gives them the confidence and trust to then pretends machine on the needle lake move. And that’s why I invite you to check out PONIES courses in the library and then really do a deep dive and he has those courses on demand so you can learn how to do this in your practice.

Thanks. No problem. Yeah. Thank you for Lorne. Thank you for mentioning the way intentioned to, that’s something I emphasize a lot when I teach the course is that we taught that, okay, you have to have good intention, right? And then, and your intent drives the cheat. Okay? And so drives the, your cheap, but also to the needle.

You drive the patients cheat. But that’s pretty much the end of the education. I got an intention, it just. But extreme attention’s the same. But the way I see it now, based on my experience in all my research, is that there’s a different intent for each specific point, and now you can predict and agree on that intention if you understand anatomy.

So for example, here, screen 12, the anatomy is the femoral neurovascular bundle. So the intention that we, when I have, when I come to Neil’s point, is that I want. This to activate the quadricep muscle, and if I apply electricity to that, it’ll activate all the quadrant muscle in the new extent. Okay? So it could be a sensory nerve in, in which case we know what that nerve travels, the duchess sensor should be felt to that area.

It’s not a guess word. You should know exactly what that intent for that specific point should be. and know if you got it or not, based on whether it moves what it should, ghost by sensation where it is. So then your intent is actually very clear and precise and it’s not just assuming that intents the same, it’s not just all heavy achy sensation e everywhere, anywhere.

Okay. But also coming back to, to like the buy-in the wow factor, patients are gonna remember. The times that you don’t succeed. But when you, if you tell them, okay, I’m needling this, I’m checking this. I’m, they don’t know what’s what they’re supposed to see, right? Only you know that. But you tell them that I’m, the reason I’m doing this, I’m checking to make sure I’m precise, but you stimulate it.

You tell them, you may feel a sensation going down the top of your quadricep. You might feel a little contraction in your muscles and quadricep. And if you say that and you try it, and if it’s one of those, one of those times that you succeed, they feel that’s instant. Because that’s pro, that’s in a way prophecy, prophesize what’s gonna happen.

And then it actually happened. More average mortal human beings don’t have the ability to prophesize. So that makes you different, that you can do something and make it happen. Exactly what you said, it’s gonna happen. They’re not gonna remember if it doesn’t happen, but they damn remember it when it does.

And that is the wow factor that Lorne is talking about before their. You’re even done treating them. It’s the first treatment. They haven’t solved the result yet. They’re already asking, do you treat this for my brother? Do you treat this with that? Okay, this is from my personal experience.

So I like his term, the prophecy. So you’re prophesizing for the patient and then they experience it. And that is a wow factor. And like he said, can you treat this? Can you treat this for my family members? Because you’re able to predict what they’re going to experience. And so from a practitioner with integrity intention, you’ve got the accurate point.

So you, you want the results, so you know you have the accurate location and then. From the patient’s perspective, they’ve experienced this prophecy on the table, which gives you that guru status and why some practitioners are constantly looking to fill their practice. And like others, like my practice, I usually have a two to three month wait list because of that Wow.

Factor on the table. And then when you learn from like a David Oiler, Or Red Yuler, but pronounce Oiler or Pony Chung. They give you language too to help with the prophecy. So going back to David’s talk where I mentioned he, for anxiety, he’ll palpate the typical area on the sternum. And when I go and palpate these reflex zones and they’re tender, and then I needle elsewhere, and then those reflex zones go away.

That’s the prophecy, cuz I’m telling them that if we can remove the blockages in the body that are preventing the innate ability to heal, if we can lower the resistance and bring back chief flowing, your body will start to heal regardless of the Western diagnosis. I just gotta remove some of these disturbances in your biofield and that is why I think.

To my colleagues that studying with Pony and David or having that wow factor where a patient experiences your prophecy in the treatment room cuz they experience the shift is important. And the last thing I wanna share for a wow factor, or just what I have found in my 20 plus years, sometimes complicated cases come in.

And I have to remind myself that it’s not my job to fix the patient, and if all I do is listen, really listen and let them know I hear them, then the healing process starts as well. Remember that there is something, and we’re this is being studied, that we know that there’s communication through our facial expression, our eyes, pheromones, and even biophotons light and packets of energy that are.

Transmitting between us that we now know that there’s information being exchanged. And what we’re noticing is that when somebody feels really seen and heard, that lowers their resistance as well. They start to relax, the flow starts to come back, and the healing response is engaged. And so really taking time to listen to your patients.

Let it Showing compassion that you understand and get what they’re going through with is really important as part of the healing process. So really making that time to hear them feel, understand, they feel understood. That lowers the resistance, and again, on a unconscious level, not something that you’re doing or they’re aware of, something is happening between the two of you.

Something has been triggered and there is an exchange of information. Add onto it when you do your treatment and you can prophesize that. When I palpate here. Anywhere there’s certain, there’s points all over the body and they’re tender. And I needle elsewhere, and that tenderness goes away. Then we have lowered the disturbance, the resistance in the body, which will support its healing.

I will share that when I was at the Society of Acupuncture Research Conference, one of the presenters there shared her research where they have. Shown a, what’s the word? They have shown that when there’s organ issues that down distally in the fascia that there’s disturbances. So tender points or even nodules or gunness happens.

So they’re sharing that this is happening. And when I heard this research, it made me think of David Oilers palpation based acupuncture style, because that’s their style is going along the channel and palpating these points. And if they’re. Tender. Then there’s other points to needle, to reli to relieve that tenderness.

And what I suspect is happening is we’re lowering the disturbance in the body, the resistance, and therefore the channel flow becomes free. And then the organs become healthy and the organism us become healthier, and so I just wanted to share that with you. Lectures by both Pony and David are available on healthy seminars in the community library.

They also have C E U proof courses on healthy seminars.com in that area as well. and a good way to just find out what I’m up to. If you like this Quantum idea and biophysics, do check out just my website, Lorne brown.com. Then you can see information about my practice management book. You can hear about my Conscious Fertility podcast, things that are doing at Healthy Seminars.

I created that website cuz I like to do a lot of things. And I decided to create that website so you can find everything in one place. So Lorne brown.com is to just go where everything is, aggravate is collected, and then healthy seminars.com is where the continued education, the community library, the mentorship, and the online learning is for healthy seminars.

So I hope what I shared with you is simple. For you and you’ll find it powerful and effective. It’s been my experience, my colleagues, and for the patients. They have found it powerful and effective. And I wish you the best of luck in your practice. I do believe we need more prosperous acupuncturists because we need more of people like you working in the C communities to help heal our community.

Cuz the world needs lots of healing and this starts with healing ourselves. Obviously. I want to thank the American Acupuncture Council again for this opportunity. To share some of my clinical and business pearls with you.