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GB-16 Eye Window to oculomotor dysfunction

The topic of my presentation for to you today is window to the soul. My personal MRI research application of gallbladder 16

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Hi, welcome to this week’s American Acupuncture Council’s Live Facebook podcast show I’m your host for today. Poney Chiang of neuro-meridian.net coming to you from Toronto Canada. The topic of my presentation for to you today is window to the soul. My personal MRI research application of gallbladder 16 in Chinese name is I window and its application for oculomotor dysfunctions.

Let’s jump to the slides.

So I want to preface by give me a little bit of information about what we do know currently about the indications of points on the scalp. They’re the most common indications of points on the scalp. And I’m talking about your co your common traditional acupuncture points from the gallbladder gardening vessel, bladder Meridian, as such, I’m not talking about microsystem line style of scalp acupuncture.

If you look at some of the indication of the points on the scale, they all seem to have some application to headaches, dizziness, perhaps convulsion, perhaps something indicative of epilepsy. But if you look at these points a little bit more kosher detail, we’ll start, begin to notice that the points that say over the occipital region benefit vision, for example, points, governors versus 18 butter, nine gallbladder 19, for example, have visual reads.

Functions and it’s long been thought that one possible mechanism for this is that there must be some kind of transcranial effect of stimulation. The points on the scalp that is able to send a message to the visual cortex that happens to also be located hospital area of the head. And perhaps that is the mechanism by which these points such as due 18 bladder nine and so forth are able to have a visual related effect.

Certainly if we were to look at points in the temporary region, it’s been said to benefit deafness, for example, points like all about our 10 GABA, 11 Sandra 18 and 19 and so forth. These points are very close to around the year area, but the resolve of the temporal region. And that’s also precisely where the auditory cortex corresponds to.

So another example that perhaps the mechanism has a transcranial effect. If you want to take this concept before. And apply that the the knowledge of the homonculus among this is the representation proportional representation. Of of the surface of brain and as a corresponds to the body.

So you might be familiar of the, these lit there’s little figures. I call them California reason type of cartoon characters, where they have very big hands and very big mouth. And that’s because the hands and feet have the most densest nerve endings. And therefore they receive proportionally greater representation on our, on the cortex or surface of our brain.

And that’s the idea of a homonculus. So if you apply that to the way that the functions of do 20 has been passed down, which is one of them has many functions. The ability to treat Energen are the problems in Chinese medicine. We always say that it’s the idea of treating opposites of do 20 country problems and do one or rent one.

But if you think about the homonculus it’s represented It’s a way such that the midline is exactly what the foot and genitals are located, then followed by Sally laterally, Diablo shrimp, and even more Laddy the face. So by stealing the midline, you are stimulating the anal genital portion of the homonculus.

And so that’s another way we can understand how a point like do 20 said to have the effect, the tree enter general problems on the other end of the pole might actually be again, functioning, fine transcranial effect, but specifically to the somatosensory cortex region of the energetic whole representation of homonculus.

Now the other points that suggest that might have points that we able to treat conscious. Such as the gallbladder 15, there are some points that able to treat persistent vomiting, such as gallbladder eight. Now, could that be because of some kind of vestibulocochlear problems so that if your sense of balance is off, then you feel basically emotions stationary, and also want to always want to vomit all the time.

And so the list goes on. And so there’s definitely a lot of traditional indication that suggest that the results are getting must be a result that can be explained to the central nervous system. For example, if your eyes are staring upwards, okay. Or for example, you have hemiplegia such that say, for example, you have a stroke, for example, and there are certain number of points.

So I should do 21 do 24 and so forth that treat these kinds of problems. So th the fact that we can put needles on the scalp and be able to treat paralysis of parathas is on the bottom. Below the neck. We mean that somehow we’re able to obviously not put any needles in the extremities. The fact that we can have that effect must be through some kind of central effect on the peripheral nervous system, central nervous system effect on the peripheral nervous system.

So there’s a lot of these indications to be passed on to us. And it’s always me implied that the mechanism must be some kind of transcranial effect. And and so what I decided to do as part of the research I’ve done in the last two and a half years is to take a very systematic MRI based approach to look at which points on the scalp corresponds to which part of the surface of the cortex of the brain, so that we can add more insight as to what some of these points are doing, but also perhaps add more information that has yet to be passed down, to look at what other application we have of these.

So in order to do this we designed a MRI’s research project using six males, six female, they’re all right-handed. They all happened to be acupuncturists, and then we scan them all. And then we use a software to then image analysis software to label the acupuncture points on the scalp.

And the name of the software is called brain site. The report at 40 IQ points on the scalp. There’s 34, regular points, six extra points. And it’s because system’s home is is symmetrical left and right. So it’s actually only just three unique points. The front end boxes are unique, left, and right.

Are not unique because they just mirror images of each other. And how to income tie on Diana, et cetera. So in total tally 40 acupoints per person, whereas product subsequent to the scanning process. And then we’ll use this, the Mr. And the analytical software to tell us which part of the surface corresponds at the scalp correspond to which part of the surface of the brain.

Then we average this cordon is in all 12 subjects. And then we can then use existing research about what we know about these areas on the surface of the brain. And these areas of the brain are called Bryman areas, named Abby neurologist by the name of Broadman. And then from that information, we can then go on to interpret.

The functions of these points, and that allows us to compare to existing scale acupuncture systems. It allows us to look into the names of these points, a traditional nature of the points. If the points give us a hint of what these points are supposed to doing and how that match the modern research, that’s already been established from the Brahma air research.

We can compare to traditional functions at these points. And most importantly, can we broaden the application? Because as I said, initially, a lot of these point just say they treat headaches and convulsion and dizziness that there’s gotta be more to it than that. So hopefully this research will help us ha add more ammunition to our tool belt.

This is a example of a research subject that we were preparing prior to the scanning process. We put these little sticky pads on the hairline. These are actually vitamin E oil capsules. And the reason why we do that on the hairline is that as a lot of acupoints actually, in fact, all the acupuncture points on this job are located by using the hairline and either interior, lateral, posterior hairline, as a reference point.

So it’s important that we define the hairline because what happens in the MRI, the hair actually doesn’t show up so we can not go back and reconstruct the hair if we didn’t prepare this in advance. But fortunately these vitamin E capsules do show up in MRI so that we can figure out what the hairline once was.

And from there, it’s just as good as having the actual hairline and with the software go in and actually plot the points on the scalp. This is an example of a MRI software I’m RS facility at the York university, where I’m an adjunct professor where the research was conducted. And yet. As the subject is being Stan, we get this little blister bumps things.

That’s the vitamin E capsules that are, that is defining hairline. And you can see, you don’t see any hair in the MRI. Okay. But instantaneously, we get a read out and we start able to take section on images of the brain prior to actually defining which part is service or brand correspond, to which points on the scalp.

We have to let the Mr software know the XYZ boundaries of the brain. So that when we did, we used, when you talk about, which part of the surface of brain, which coordinate XYZ so that we can cross references for do they exist in prime, in research. For example, before we do that, we have to define what, how wide and tall and deep as XYZ these are.

So this is there’s a software. We can see here where we’re defining that with these green boxes and to ask they pursue aspect, latter aspect, for example, and it should appear in a few aspects, so on and so forth. Okay. And then once we do find that information and we tell this image Mr. Software, where is the space that they are permitted to work within, then we label, I keep on your points on the scalp, as you can see over here, but we didn’t have enable any points that are below the skull.

Okay. So for example, do 16 or do a gallbladder 12 is actually below the mastery process. So that’s technically off the scalp off the skull. Points points a submersible line like gallbladder 20 and bladder 10. For example, if you feel that they’re below the occipital bone. So again, if you’re off the bone, that means you’re too far away from the brain.

And so the assumption is that then is far less likely that a needle can have an effect on the brain if the needle is not actually even on the region of the cranium or the skull. So this is for that reason, these points are excluded. Okay. And then as you can see, once we plot that down, the computer, the Mr and ethical software can start immediately giving us information.

And so this is a bit too small for you to see, but you can start to see some of the points have been labeled and that we can correspond to different regions of the brain. And and then we can. Very cool image like this, where if you imagine that the scalp and the cranium is no longer there, then all you have is just the needle as the vis directory penetrating into the servers that are brain.

So these are the exact same points you saw earlier labeled on the scalp, but the software allows us to determine where that is in a coordinate system. It’s called stereotactic coordinate. That was the XYZ I mentioned on the SCUP. And this process is called registration. When you correspond the location on the scalp to the surface of brain there’s process in neuroscience on your imaging studies is called registration.

So essentially we registered 40 points, combination of regular and extra points on the scalp. For 12 individuals. And then from there we retained the coordinates and we averaged the coordinates of all 12 people to arrive at the average coordinate on the scalp or on the surface of the brain corresponding to the 40 points as being passed down.

So the reason we’re doing this is so that we can confidently say that I say the point bladder nine, for example, on the average human being is effecting coordinates XYZ, and therefore affecting this specificity functional. This is an example of a pretty little picture that we can get from the MRI analysis software.

In this case, we’re only showing you the bladder points on the scalp and these different colorful areas that are brain correspond to different Brotman areas that I mentioned. So there’s already been over 50 years probably like over 60 years of research on the ramen areas and what they do and that knowledge is always being updated as we speak.

So once we figured out what the coordinates are on the scalp, not only are we able to learn what functions they have as we are today, as more research are being added to these functional areas we will be able to add to the indication that we’ve learned for these traditional 40 points on the scalp.

So for the purpose of today’s. Presentation. I’m going to only focus on one or two points. Obviously this is a work that took me more than three and a half years to conduct. I wanted to focus on just two points. And as you saw on the title of the presentation to today, I’m gonna focus on a points gallbladder 16, and how we can apply that for ocular motor dysfunctions.

Before I go there, I need to give you a little bit of brief introduction about the surface anatomy in the brain. Okay. So while you’re looking at here is the interior, the frontal lobe, occipital lobe, temporal lobe, and parietal lobe, and the frontal lobe is further divided into different gyrus. This one here is a superior frontal gyrus.

This one here is called the middle frontal gyrus, but they can further divide that into rostrum, his head or Caro tail portion. So that’s where they put different color. And finally are. If there’s a superior and the middle funder gyrus, then there must be an inferior frontal gyrus, but that is further divided in three different regions.

They’re called pars or

and so forth. Don’t worry about so much. I just want to help you appreciate which part gobbler 16 falls into. So it’s going to be falling into this superior frontal gyrus portion. So it’s an F so it’s in the frontal lobe. Here’s a central sulcus, so that have the motor and premotor regions. And as a matter of sensory regions on either side, but even more interior to that, we have what’s called the prefrontal cortex, which is divided into three different viruses.

Okay. So what we’re going to be focusing our attention to is specifically in a superior frontal gyrus region or the prefrontal cortex. And if you now overlay the prominent information on top of that, This line division here between one prime area, 1, 2, 3, and four. How there’s different colors, that’s the demarcation of those central sulcus.

That’s the motor in, and there’s a matter of century you’re there. And if you go forward, we have brought from area four, which is the motor cortex. Six is the premotor 8, 9, 10, so on and so forth. And so as far as prime and correspondence goes, if you remember the image from before the superior frontal gyrus is processing over here, then we’re looking at maybe GABA, prominent area, six province, area eight.

That’s going to be approximately where the point GABA is 16 is located. This is just a quick, low reference a slide for everyone, because I know that unless people are using traditional points system to do the points, scalp acupuncture head, it’s been a while since they learned these tune measurement and we’re testing on these in school.

Sometimes we don’t remember exactly where they are. If you look at the, to measure over here, this black line here is supposed to represent the hairline. And then so gallbladder 16 is if you look at this two measurement here, right here is 0.5. Green is a 1.1 0.5. So that means that in total God, our 16 green gobbler 16 would be to turn from the interior and tear hairline.

Approximately I want to just mention that the the point location. And air land and not to scale. Okay. It there, they’re only, the color is only meant to tell you the relative measurements that the arrows themselves are not to scale to one another. Okay. So the make any case, gallbladder 16 is over here and later on, you’ll find me mentioning the point bladder six, notice that they’re quite close to each other.

And and they were roughly fall on that. Definitely call out, fall on the front of the frontal lobe, for sure. Cause there’s a front half of the head, but because they’re on either side of the midline, they’re going to be corresponding to superior frontal gyrus, and then the middle of front of the gyrus, we’ll be here and then finding inferior, energize to be even more lateral as we come from a middle center out.

Okay. So that’s talk a little bit about part of the scalp functional area. That’s really that critical is functioning area. Something called a frontal eye field frontal. I feel a previous FEF for short in non-human primates is in progress area number eight and but when I was conducting this research in the beginning I was a little bit disappointed because the point gallbladder is 16 which had a Chinese name for the point.

You can see here, the point is I window mood, trunk. Okay. It suggests that there may be some kind of, I really to function to this point. So I thought, oh, wouldn’t it be pretty cool if this is a point to do with irony function correspondent to the frontal eye field, because it’s not the first time it’s never it’s.

We have seen a lot of examples in the past where the name of the point doing this project is function. So wouldn’t it be cool if the point name I window matched frontal eye field, but unfortunately I was a little bit disappointed because all the research literature showed on a nonhuman primates that the frontal eye field was located in area.

We’re in fact that point gallbladder 16, I window, was actually located in Bravo six. So it was, close they’re right beside each other, but wasn’t really reading on. So I thought, oh, maybe there is had to do with the way that the needles angle a direction maybe, or maybe just coincidence.

There’s actually no correlation whatsoever between name, the function and the point. But fortunately as more research came out about the front of IPO in humans, as opposed to non human primates, it turned out that in humans, the front that I feel was indeed I’m prime and . So I was very excited when I found out about that, because that means that gallbladder 16 falling up brother area six is a perfect match.

It’s the frontal eye field, which I’ll explain it as functions for matches the Chinese name of the point for I window. That’s pretty pretty cool. And it’s in of itself. So what does the front. I find the I field is involved in movement of the eyes, but specifically horizontal darting, quick glancing movements, not slow tracking movement at a cold pursuit.

These quick lateral or inferior superior starting movements are costs the cards. Okay. And and so the front door, I feel plays a role in this quick psychotic movements of the eyes. If you had lesions on your, I’d say frontal eye field on the right side, then what’s going to happen is that both eyes are going to deviate towards the side of the lesion.

So it may say her lesion on the right front, the, I feel both eyes are going to deviate. Towards the right to the right. If you have lesions in the left frontal eye field, both eyes are going to deviate to the left. And what that means is that they are unable to track to the opposite side.

So in other words, you’ve had lesions on the right from the infield IDV to the right then I’m unable to do psychotic mood. To the left. Okay. So there are a lot of quick neurological tests that that you can learn that to be able to assess. And you’re not neurological patients as to if they have any ocular motor dysfunctions, you need a psychotic test.

The ocular motor functions belong to the midbrain. So cranial Creo nurse three and four primarily are located or have their nucleus in the midbrain cranial nerves. Cranial nerve six is also involved in in the eye movement. But that’s more located in the Pines, but for the most part, a frontal eye field test gives us an appreciation of the integrity of the midbrain, because if the migraine was compromised in some way, perhaps by degeneration, there is nucleus, which includes the nucleus of.

Three and four, you said ocular motor and and and trochlear nerves then you’re going to have eye motor movement issues. So these are called ocular motor dysfunctions. So here’s a graphical representation of what I just mentioned, suppose that you have a damage on your right motor cortex.

So in this case it would damage your right frontal ICU as well. Then what’s going to happen is that your eyes are only are going to deviate towards the silent region. So if say delusional deviation, and that is because the the right brain controls as, movements on the left. If there does the dementia, the right brain, then the dotted line.

That control movements to the left are not functioning. Therefore they are unable to oppose to the move of movements to the right. Therefore that’s why all your movements are going to end up to the right. Okay. So don’t worry so much if this is a more deeper neurology that you’re ready to dive into, but it’s very powerful tool because acupuncture is able to treat central nervous system problem.

It’s great. It’s been proven to be able to treat great peripheral nervous system problems. Now what’s next. Now we need to actually show the acupuncture had benefits well beyond just the peripheral nervous system working as you use as a treat central and peripheral nervous system problems. So here’s the image acquired for the goblin Meridian region.

And as you can see, I’ve labeled GABA point 16, 17, 18. And this is the lateral view, and this is the bird’s-eye view. And what I’ve done is I’ve drawn in yellow dotted lines, to the extent you, the Sockeye in that region, because it’s a bit, this is because zig-zaggy, it takes a bit of training to visualize this.

What we’re seeing here. This, the superior inferior Sockeye here is called the superior frontal circus. So the superior funder soccer separates a superior from the Gera and the middle front of the jaw, right? And this thought, and over here is the precentral. Soccer’s this darker more notice?

My here is the central sulcus. Therefore the line that’s in front of it is the precentral circus. And it’s been reasonably established that the frontal IPO in humans are located. It’s located at the cross section of these two soccer. Where did this line meets? This line is where the P where we’re the frontal I feel is thought to be located in this general region over here and now look at where the point GABA R 16 is located.

GABA 16 is very close to this intersection area. And if you were to follow them, varied direction and Meridian and needle from 16 to 17 or intuitive, posterior, why as indicative as air dashing over here, that needle is covered this entire frontal IFL region. And gallbladder 16, as I mentioned is Chinese name is I window.

So perhaps it’s not a coincidence that the ancient acupuncturist named this point I window, because they realized, find empirical observation experience. These points have something to do with eyes and vision. Similarly, at another point that’s located very nearby to this area. And a prostitute over here on the bladder Meridian called bladder six it’s Chinese thing is called light guard, meaning it guards or protects light and light to suggest that optics when the eye light enters your eyes, how you pee, you’re able to see it may not be a coincidence either.

That another point that is very close to the frontal IFU approximately over here also has in its name, something suggest stiff a vision or site.

Okay. So this is a side-by-side comparison, butter six over here. . Over here and there. So if I were to supra, bring gallbladder 16 over to help you visualize go by 16 would be where my cursor is pointed. See how those two points are very close to each other. So if you were trying to in intersect that area, you would need on call bar 16 posteriorly and viruses laterally, and in a intersection kind of way here.

And that will allow you to cover the frontal eye field as much as possible.

Now I’m going to segue a little bit to talk about something else that’s in this area. We’ve been talking about Brahmin numbers, area six. What is, what else do we know about ? Other than that as free dated frontal eye field, as you can see from this bird side, We have probably here four and six, probably the air force actually motor cortex.

So corresponds to movement at execution, but problem area six is in a premotor cortex. And the difference between six and four is that four has more to do with the planning of the movement. Whereas, sorry, six, as much as the planning, because as you get closer to the frontal loads, more reasoning decision-making so six is the coaches that are fun to look.

It has some more to do the thinking aspect and movement. Whereas for itself, the motor itself is the actual movement portion. Now, if you looked at this picture more closely, you’ll see that number six actually has two colors. The darker one is the central portion. And the light, the lighter ones are flanking it.

So the lighter ones is actually the true premotor cortex that’s involved in preparation, the movement. That’s more medial portion as. As a different name, it’s called a supplemental motor area. It’s still a , it’s a supplemental motor area and it is important in initiating complex sequence of movement. So it’s very specific for initiates it is.

So it’s the middle part over here. Brought me a six, the supplement area initiates it. And then the regions flanking it, prepares it. And then finally the motor area itself executes the movement. Okay. This is important because these points are mentioned GABA 16 and I’m better butter six. They fall in the, in addition to being part of the funder, I feel they also fall in this supplement and more area that initiates complex sequence of movements.

Okay. In addition to the funding, I feel being known to be important for control eye movement. We actually know the reason that it does it is bad. There’s direct connection between the cortex where these Fanta IFA regions are located to the ocular motor system in the midbrain, the track technology, or the study of the connections between different regions that are bringing it has asked me to be established.

That is a direct correlation to the mid-brain area. So even though maybe areas of what’s called subcortical structures are too deep for us to affect funds of scalp acupuncture, we might be able to indirectly reach it by stimulating the surface of the cortex. If we know which part of the more deeper structures it connects to.

Now, just as a interesting little trivia if. Not only do we think that is how to do the movement, you remember how it had in the supplement Moria motor area. It has to do with initiation something. And I mentioned how it was closer to the frontal lobe. So I had to move to do a thinking.

There’s actually a lot of interesting research that shows that the frontal I feel is involved in thinking as well. If you ask somebody a question and they don’t have the answer right away, watch the way they think a lot of times people will point their eyes upwards or point their eye to the left, or right.

As they’re thinking as if the answer is somewhere in space to the left or to the right or to the above, really people are not looking down when they thinking, but that’s actually engagement of your front frontal. I feel you’re fun to, I feel part of the brain is helping you to retrieve memory information.

So the eye movement control. My ashy be indicative of memory, recall functions as well. Very interesting. So just because, oh, I’m not interested in neurological eye movement problems as the bit to neurological for me, don’t think of it that way. It’s actually a way for you to assess somebody’s memory and, or or a memory degeneration.

And as these movements improve, it’s actually indirect way for you to to assess whether the patient’s memory and pay and information recall. And the speed and accuracy of that recall is improving or not now. So that’s a little bit, that’s a lot of background, but now I’m going to jump into how I applied these points for two very interesting cases that are very different.

The first case is a case of what’s called Havana syndrome. Have you ever syndrome is something that made the cover of time magazine in the year approximately in the year 2017. And it was happening to diplomats of Canadian, us diplomats, R B station in Havana and and the SIM, for some reason, there was a concerted presentation of neurological symptoms, very similar to concussion symptoms that was happening all across Havana, but only in the embassies of the committee Canadian and the U S diplomat star station there.

So there is, there was white speculation that perhaps there’s, this is some kind of political. Motivated attack some kind of weapon that is unknown, that is perhaps some kind of energy, pulse, electromagnetic energy of some store. Nobody could explain it, but it was undeniable that there was this was happening to not just Americans, but the Canadians and only seeing, not seeing the tourists are visiting there, but only seeing this in the staff that was working there.

So this is being recognized as a real thing and so much so that the journal of American acupuncture association, Gemma actually published a report of the symptoms and the title of the paper is neurological manifestations among us government personnel reporting, direct directional, audible, and sensory phenomenon.

Yeah. Cuba. The the symptoms for these patients are very much like concussion symptoms. They might have dizziness or nausea, headaches, sensitivity to light. They have balancing problems. They have some eye movement disorders. Some of them find that they have the sight difficulty or language, memory loss.

And so these, this, these symptoms are symptoms that the patient never had before. So it was considered a type of acquired injury, but it just that in this case, there was no known trauma physical trauma to the head that could explain this concussion. And there’s suspected that this was perhaps some kind of secret weapon, energy propo projection that was affecting those people.

But these people get tested and Realogy cause second opinions and undeniably have these symptoms. For some reason, I got an American who his mom is the Canadian and they were visiting Canada and and for six or eight weeks or so. And so the mom did the research for the son and mom listen, Canada.

So found me and sent his son here to see if I could help him. And so it was, it’s pretty interesting never in a million years, but I think that I get to treat like the Havana syndrome up in Canada. And so these are the symptoms that the patient presented with 35 year old male civil servant had an acquired brain injury in April, 2017.

Imaging results show that they’re scattered white matter of the brain and S as a focus in the cerebellum area. So it doesn’t make sense. The Serbian has to do the movement, coordination of movement. So if the patient presented with some kind of movements of balance, where it’s about has a balance as well, problems, that would make sense because there’s some kind of scattered white matter.

That’s visible for imagings person who has SIBO, headaches who have tinnitus, but that tends to abate after two weeks later. But the subro headache continued. There’s some challenges, balance issues, patients that reports that there some difficulty retaining information. And also they’re very easy to have ice strains and one of the triggers, bright lights, and also when he was rotating head while tracking with his eyes.

So that’s a, you’re looking at something, but you had to rotate your head, fix your gaze on that, something that kind of eye fixation combined with neck movement. We’re bringing line headaches or sense of dizziness, imbalance and so forth. And also he found that he’s not as precise with his use of language.

And that for example, he would say things like I put the feet on top of the stairs, what he meant was he put the slippers or shoot on top of the stairs, but, footage slip an issue I’ve raised similar ideas, but just to represent what, one of the represent that my part of the body or pods represents something that you wear, but in his brain, they, you could see his brain.

Wasn’t able to retrieve that information as effectively. So given the limited amount of time who was going to be in Canada, we were only able to do eight sessions. And so at first it’s, his headaches would be averaged every two average twice a week, but you started having about two hours and this is much, much better than, when when this order just started.

And then the tongue is thick white coat from root to tip or suggested. There’s not a damn a system that he does. He are redness in the root of the town. There’s hate in a liberal region and heart, mild heat in the heart region. Definitely. More suggested lower jaw heat and liver fire, and a lot of dampness.

Okay. And he had this injury in about June, so April, 2017, but didn’t come and see me until December of 2018. And and so it’s closest to six months after the incident. So I treated points. As it relates to the LA dentist, I see on the tongue, but points high stakes PCs, six, these are points that are known to have the ability to calm the autonomic nervous system.

So I was using that to help them reduce some of that stress and anxiety from dealing with an unknown ETL disease and disorders uncertain as to, whether am I ever going to get better, especially when this solar information know about this kind of problems. So it was necessary to calm and relax the patient.

And I also did the F the scalp for sensory motor area. And so if those of you have studies, scalp acupuncture, there’s these two lines around the vertex or the brain, and these points also have a global because it’s shadow, there’s the Corpus callosum, either hemispheres, they have a global level, right hemisphere, so a balancing effect.

So I tend to just start more conservative and more general without focusing in too much. I did do a speech area too, because it has on war retrieval issues. And then in terms of your acupuncture, I did points in the vestibular point because he had some business issues that will occur when he has fixing his diaper, moving his head and hypothalamus because there’s a point that also regulates oughta nervous system.

The next session I continued to treat the scalp acupuncture areas. Now I added the balance area, which is located in the hospital region. Still have the speech area and for the. I still have thalamus then now at a singular gyrus, which is a point that is just about the course proper skill OPSM.

And so there’s a little bit deeper down at the surface of the brain. And then I added some points in the body at different points in the body. Gallbladder 39, as is a point of if there’s a point of marrow, which should release the idea of brain and Chinese medicine. I thought it too. Now, Ching now changes the point.

That’s relative to the horizontal crease of the ankle is what is two, two up and once in lateral from from a stomach 41, it’s now changed, literally means clarity to the brain. So it has some kind of neurological symptoms as well. So I. Cognitive significance. So I thread it all by three 19 arching.

So I’m at 40, as you know is for phlegm. And Sandra has five, there’s some studies that shows that it helps communication between left brain, right brain. So I had this kind of idea. I’m starting, I’m putting on to treat this patient. And then it wasn’t until the third treatment that I decided to add GABA R 16 I window.

Because at that point I was learning to make sense of the research that was presented to you earlier. I thought, I wouldn’t have to ocular motor movement. It can’t hurt if I try to add that point as well to see what happens. By the beginning of the fourth treatment, a patient hasn’t had any headache for three weeks.

Whereas previously he was ha he would have headaches at least twice a week. So I, what I suspect is that some of that headache is actually due to the brain, trying to. Makes sense of balance. And I related information between the eye movement and the cerebellum areas of the head. And when I cannot make sense of that information, your your point of reference, your point of balance is off and makes you feel dizzy.

And that can then, bring out a sense of nausea or may bring a sense of headache and so forth. Even though I wasn’t directly treating headache by calming down the sympathetic nervous system by working on the balance and ocular motor area, or the fungi, a few areas that made him have better balance and in, so doing may his brain able to not have to divert his resources to other types of problems.

And so unfortunately men, he has no disease. He has no disease. Okay. And then and then the, one of the main thing that you constantly need new will be what are the kinds of things that you’re constantly new were given business problems is that when he was driving, he would have to shift this case between his eyes and the GPS, and was driving, looking at the row, looking at the GPS and that change of eye movement and depth movement will cause them to become busy.

And that was coming that habit every single time. So that was a very good tool for us to use, to gauge our progress. If he was able to have, if that is the getting better, then we know our team is working. So the fifth treatment, he no longer would get cheap headaches or dizziness. When he, when you was doing the GPS looking at GPS, looking on the road.

Okay. And so we continue to do the similar type of thing. Continue to come the cemetery nurses using points as is Vegas point, the reticular formation points a year, shaman points in a year. And and and he, on his last visit, he came back he was starting to have a little bit of headache, but it didn’t cause nausea like I normally would do, but that, that dizziness or headache that brings some for changing eye movement was still not there.

So it seemed like that was very stable improvement. So I like to think that the GABA are 16 point that I use in combination with cerebellum points or vertical points played a big role in helping him be able to have more confidence in both independence to be able to drive on his own and go about on his own.

The next case is a pediatric cerebral palsy case. The child was born in 2020. And and has history of taking prednisone to limit seizures that has only seen on EEG is not seen clinically like by the parents or, day to day. And then the the patient is Delvin, developmentally delayed.

He’s born on may 20, 20, but only began rolling more than a year later in June, 2021. Normally you expect that, maybe like seven, eight months maybe. And so there was definitely some delay And there’s a child has tendency to lower the head and gaze to the bottom, right?

So the head is lower case the bottom, and there’s an inability to control the eye movement. And and there’s also some spasticity of the fingers at difficulty opened them to grasp objects.

And there’s a tendency for the eyes to want to, rest towards the bottom. So the I is better to, as able to there’s more awareness spatial awareness of the things that are alive and less awareness of space on the right side. At almost 22 months, almost two years old was still unable to crawl.

So this is a child who was very delayed and neurologist believed that what he, mostly, I, he has his say we were policy was maybe some kind of brain damage or something to show that in happening in utero. And he was born this way and had difficulty lifting his body up from the stomach.

Usually you should be able to crawl and go on all fours, there’s Encore and I’m moving. There’s no precision grassing object brain to the mouth to chew or, to bite on that the kids are supposed to have. And and then. And so does the general tissue, we gave him this child.

So patient didn’t want to see what we can do at scalp without scalp acupuncture or with with acupuncture. And I mentioned the best thing to do would actually be scalp acupuncture because because this is undeniably a central nervous system problems. Scalp acupuncture is a system that was designed for this.

And I explained to the risk and possible risks and so forth. And because of the concern that the fontanelle might not be closed, this child is too, they are developmentally delayed. So we cannot confidently say that if fontanelle is fully closed, right? So for that reason, they didn’t feel comfortable doing active scalp acupuncture point closer to the vertex of the head.

But I explained to them that, hospital region, those fundamentals those bony plates would have fuse already. And so it would be safe to near that area. And I, we might be able to do the balance minds for, to help with balance related issues. So we, for the fourth three sessions, We did the balance point and the scalp and all we just did with just plain six pericardium six and sand gel five, Sandra five.

I mentioned I’m insured for using, I mentioned before research shows that it helps to stimulate left-brain right-brain communication , and its main states are specific points to affect the tibial nerve in the median nerve to help create sensation into the fingers. And oftentimes that’s been helpful to help open up spasticity of clenched fingers and toes.

And so after three sessions, parents report that the right hand that was previously the most close is now able to open a much more. And then both hands are now open about 75% of the time. Whereas before there were closed a hundred percent of the time and I’m there and requested if I could do something about this passage in your bicep, which I basically just do a local Twitch response, muscle twitching cabins.

And I said very forth. This is now the fifth treatment, hands up, fully open, and now is able to actually grab toys to this mouth, but it’s not doing it with any type of purpose or desire to read something and grab it and bring it themselves. If they happen to swing their hand and grab something, then I’ll bring it to them out to divide it.

Okay. And then we also did some nutrition recommendations such as Alliance, Maine. It was just been shown to help re regeneration of nervous system tissue. And then we continued to help them with treating spasticity in the calf and by surgery. This is just local muscle needling is very similar to.

A technique that a surgical intervention that that they have created in Western medicine is called social surgical myofascial, lengthening where basically they are making tiny decisions in the ligament to help the extension. So they have less contraction of muscles. So we were doing acupuncture.

Needles was essentially the same thing, just a little bit less invasive and less surgical. I added copper scholars point in a year. That’s the point that the cruise stimulation communicates to me left and right brain. And then the patient stopped coming for a month because of scheduling reasons with me.

But despite not having any treatment for a month, fingers are remains open. And now the child is able to start sitting up and lean four on the high chair. Whereas before, if there was four on the high shirt, there’s just totally fall over on their face, on the high chair. So that means that there’s some core control that this child didn’t have before

we treat it local Twitch response on mussels hamstrings and gastrocs and soldiers to help with the spasticity that this child is presenting. And and then and then the parents, Charles the P the, this boy had a brother. And so because of a busy being, having a newborn in the family, he they stopped bringing him for awhile.

And then. And then I want to the reason why I show this slide is that there’s a point here called master sensorial point over here. And and what it corresponds to is actually the junction of all the different lobes of the brain. So the frontal parietal occipital temporary, so and so forth.

So this point of the brain is it’s called the masters and Sora point because essentially because the junction or the lobe stimulates all the brain at the same time. Patient, the parent came with a new imaging results showing that there was diffuse Y white matter patterns across the brain.

So I needed to have a way to, to treat. Across the whole brain and it has been in and they’ve and they also found that there was extra amount of degeneration in the course of Corpus callosum, which is why I needed to focus on points. I sent out five and the regular course crevasse and point to try to focus on th delivery, more stimulation to the regions.

So they came back in January 15th and they had a seizure in late 20, 21. On top of, having a younger brother, they were just too busy and didn’t come for awhile. So because of that, they put the doctors put them on an anti-seizure medication. Just to repeat what I say, or their CT shows us there’s reduced white matter and and thinning of the all across the brain and thinning of the Corpus callosum.

So this is why the treatment needed to have the masters in short point to stimulate the whole brain, but also to specifically focus on the Corpus callosum, because there was thinning of the Corpus callosum. Now the patients feel that they’re seeing a lot of progress and it’s been awhile. Now this, they feel that is pretty safe with their son.

So there’s now they requested me to do scopic Highlands in other areas that are approved, that they were previously worried about. The fontanelle is being closing. So the air would be the first sensory motor on the midline. And now I think, can you do to balance the area and Knoxville region? And then so after we did that one treatment with including the the Prada lobes and the frontal lobe for the first time, Patient came back and noticed that there was market improvement in the core strength.

The kid was starting to lean over in a high chair, but now actually it’s able to complete sit up in the high chair on his own. And actually when they’re lying down on the stomach and a bag trying to change the diaper is starting to want to do sit-ups to come back up. So this is very interesting because the only thing that was done differently was areas that are known to affect the core and immediately that got, that, got that, that improve.

So we can see if it’s working, don’t change it. We keep on doing that. And and we can understand why we do that because the area, of course, the first sensory motor area and the mid line, as you re very close to the supplementary motor you’re right. I mentioned to beginning, which helped initiate movement.

And then in February, on February 2nd, February, I decided that since this kid has this preference of the eyes going down to the bottom and has difficulty seeing things on the left side, there’s obviously some kind of ocular motor issues. What do I have to lose by trying to put the gallbladder 16 there and also put governing vessel 17, which corresponds to the primary visual cortex is back.

So what is both of the sensory aspect division wide for the movement as a vague vision? And can you do the rest of the point? And at the end of that session for the very first time the child was hugging the mom’s face. Okay. And so according to the mom has never, the child’s never done that before. And then that was pretty promising, but two days later I received an email from the mom and this is a video I’m going to show you.

After only adding the gallbladder 16 point, which is really the eye movement that at the child biweekly or weekly physiotherapy session, when they’re playing with toys and learning to move their hands and eyes for coordination purposes, that there was for the very first time a intense, intentional grabbing of objects, fixing it, seeing, grabbing it and being able to bring it back with purpose, not just randomly.

Okay. So this is a video that I’m going to show you to finish today’s presentation. And and so let’s have the video please,

so you can see very well. He is reaching for the. This is it, you have been using the special how many times he never did. And then the mom is commenting that they always use this for all the time, but this person

Okay. So that means that as they move the toy away, he’s aware of it and is changes, naked eyes to continue to track that toy. So this is, I just thought it was very interesting to be able to share that outcome, that research with you, that scholars 16 call I window, has in his name, something to his vision and based on our MRI research.

Safe to say that is probably the frontal eye field, which is involved in ocular, motor hyperbole, and specifically for six psychotic movements. So I hope you appreciate the excitement that I get when I do this kind of research, but as obviously the reward is to be able to help, we are conditions like Havana syndrome and the two little boy who, is so severely developmentally delayed.

Now we actually can help them in their physical therapy or occupational therapy so that they have a better chance of having a a a a higher quality of life. Thank you very much for your attention. And next week for our our show, our guests are going to be Brian Lai and Matt Callison

Spring & Liver Detox

And today it’s very exciting because I’m going to be talking about the spring time and the liver detox.

Click here to download the transcript.

Hello and welcome. My name is Tsao-Lin Moy. I’m a licensed acupuncturist and herbalist with a brick and mortar practice in union square in New York city. And I’d like to thank the American Acupuncture Council for providing this platform where we are able to share information and knowledge. For our community, both the patients we serve and also the professional community to keep dialogue open about how acupuncture and Chinese medicine can help people make informed decisions about their health.

And today it’s very exciting because I’m going to be talking about the spring time and the liver detox. Okay. So we’ll, let’s go to this slide. So springtime as a. You practitioners know is considered the time of the liver. It coincides with wood and the emotions are anger. The energy is moving up. We have this energy of pushing through the earth.

So during the winter months, which is the kidney time, is this a time of hibernation and also the energy. The emotion can be a lot of fear. And we have been experiencing a lot of that because we’ve got these news cycles and if we don’t release and detox from that, we end up getting. A lot of built up frustration and anger and you can, you see how it will affect our emotions and our patients.

And important that we are with the season, we look to move with the season and that actually makes it a lot easier for healing to happen. Okay. So spring element is, would also relating to the liver and gallbladder. We’ve got the energy of movement and also. The warmer weather and increased sunlight, which is great because that means we can get some vitamin D and that is also a metabolized and made through the liver.

So when you have good liver function, you are actually able to produce enough vitamin D emergence from the cold again, hibernation, and really from, as we’re moving out of the pandemic. We have a lot of stress hormones, a lot of people, maybe your patients were self-medicating with alcohol. People are on a lot of like multiple or poly farm, a lot of medication like anti-anxiety blood pressure, cholesterol, and not sleeping well, not exercising.

And so as the weather gets warmer, we’re going to start to have this movement and I want to be able to help our liver detox. So the, if we work with the energy of the season, which is now the liver energy, it’s a lot easier because we’re going with the flow. We’re not going against nature. We’re actually using the rhythm of the seasons and aligning our biological clock.

To heal right. Facilitate healing and yes, if anybody has questions, please drop them in the chat. Let me know. If you have something that you want to ask me let me know if this is interesting for you. If you have Some comments. And yeah, let me know where you are.

If you’re in New York or California or Australia just give us let us know in the chat. So in Chinese medicine, the liver is role is to, is the smooth flow of cheat. Also the emotions and the blood liver stores, the blood. And also filters and detoxifies. So at nighttime, if you’re not sleeping well, then you’re also, your liver is not processing.

Now the interesting thing about the liver, it is the only visceral Oregon that possesses the ability to regenerate. And interestingly that if somebody 50 to 60% of the liver cells can actually be. Killed let’s say for example, in a, someone overdoses on Tylenol, that can happen.

You have a lot of, if you have patients that have pain in their medicating with Tylenol, it is possible. Hey Alan, in the Berkshire it is possible to really kill, like really destroy your liver. And the thing is that the liver can actually completely repair in 30 days. If there are no other complications, meaning they don’t have other problems going on in their system.

So let’s go. Oops. Okay. So here we’ve got a. The anatomy of the liver. And if you can take a look at where it is. It literally crosses over the entire midsection and really like stips right under the diaphragm. So things like, with liver, it’s like the sighing, the feeling you can’t take a deep breath.

And the reason is because the liver, if it gets swollen and irritated, it’s right up against the diaphragm and with. Make it very difficult to breathe and then also can actually affect the stomach, right? Because the it’s continues to cause contractions in the the diaphragm and that’s where we get the flank pain, difficulty breathing.

And then the referral pattern of, feeling the throat is clearing up is clogging up the plumping. So here oh, we’ll go to the next slide. We’ll talk a little bit more. So the major, the five major functions of the liver, and this is according to Western medicine is. Digestion metabolism and detoxification protein synthesis, and actually storage of vitamins and minerals, which I think is probably in Chinese medicine.

When they talk about the liver, storing the blood maybe really meaning nutrition or neutral. Nutrients for the blood, right? So blood has to have a lot of oxygen nutrients for it to bring to all the other organs and the different parts of your body. Also as an aside, recent studies actually show that the liver has a regulatory function in the central nervous system.

And is innervated by both the sympathetic and parasympathetic fibers, which really does mean, it is responsible for the smooth flow of emotion, right? So there’s a feedback loop that actually happens and comes together. When we’re feeling either in a place of fear or also facilitating a place of rest.

And just another, for all you acupuncture people out there, practitioners to really take a look of the picture on the right, gives you an overview of where the liver is. And then on the left. We’re looking at, Hey, look at where all these points are. And in particular, you look at a CD, 12 moot point of the stomach.

It will really land right where that ligament is for the liver and just surrounds it. So it’s really between the liver and the. Great. And see B12 is a point for making blood. It’s a blood point. It’s a very important point. And then the other points that are on the abdomen, but the different move points, you start to look at where they are in terms of surrounding the liver and the gallbladder, and actually how that helps to increase circulation and lymph flow and really functionality.

So liver patterns I made a list here. I’m not going to go over the patterns because that is as entire modules in the foundations of Chinese medicine for the most part as a refresher like liver cheese stagnate. Really any kind of liver issue is most there’s stagnation involved.

Of course, blood led deficiency. We’ve got energy, the young rising, a lot of wind, when we see wind, we know that liver is involved. A lot of digestive it’s always, liver is involved in that to gallbladder the dam, Pete, and any kind of blood deficiency. And for sure, a women’s health and reproductive health.

So one of the things that I would say is, especially around this time in the spring also allergies, we’re getting allergies and you get itchy. That’s a liver thing to really take a look at your patients and whatever their you have as their diagnostic, just to look at it from a perspective of liver oh, how is the liver involved in this?

And I think that is a, a very interesting angle to look at. You can actually do it for other organs too, but really what role does liver play in this? And if we do a detox and I’ll talk a little bit more about detox what does that mean for the outcome? And especially you want to do it now cause springtime, right?

Okay. So liver congestion, we have in this country, a lot of liver congestion and fatty liver stress hormones, they increase the enzymes in the liver and cause inflammation, toxins, chemicals, antibiotics, medication, plastics are huge. Apparently a lot of microscopic particles we consume about credit cards worth of plastic per week.

And our body has to. Process that or not. It’s also all over the environment. So even when you’re having the healthiest diet it you’re, we’re still being influenced by the things that we don’t have control over. We see in the U S a lot of metabolic syndromes, like diabetes, pre-diabetes insulin resistance.

Especially with polycystic ovary syndrome, a huge, more than 50% of our population is. And then what follows is, cholesterol, triglycerides, and high blood pressure. Like these become the that’s the triple where we see then the next thing is heart disease. A lot of people will have their.

Gallbladder removed a li like cirrhosis, all of like alcohol, a lot of the problems are not necessarily coming from a consumption of only alcohol, but it’s the, it’s all of it. Know our lifestyle, the foods, a lot of things that are called food are not really food, their product. And they lack so much nutrition that they actually have to add in vitamins and stuff.

And we’ve got a lot of endocrine disease and disruption and allergies, a lot of allergies and sensitivity. So that gives us a clue that the liver is getting overwhelmed and is not able to filter.

Statistics. And this is an old statistic. About 20% of adults have fatty liver, 5% of children, and this is really linked to obesity. And then again, two thirds of obese adults and half of the children that are obese have fatty liver, which is pretty scary because that is going to. Predict, with an actuary, how many people are going to end up on medications if they don’t do something right.

And a lot is this non-alcoholic fatty liver, right? So this comes from a lot of food relief. And also what I want to say is menopausal women post men in their fifties, the lower estrogen also increases things like fatty liver and metabolic changes. Pros and cons of detoxing. The pros are a liver detox program.

And what w what a program looks like is going to help the organ itself work as efficiently as possible. And this is because the liver organ that’s its job is to detox and to filter. So we’re looking at. If you have a healthy liver, you want to help it along. It’s going to relieve inflammation and toxicity in the body.

It also will help to lose weight because a lot of toxins are things like chemicals and pesticides are in a steroid type. I guess form. And what they do is that toxicity will then bond with fat cells. So if you’re trying to lose weight, what happens is you have to detox your body. So then the fat can actually metabolize.

And again, that reduce can reduce cholesterol and it’s sport it, supporting the liver, doing its job. And we’re really looking at balance and harmony, right? The cons of it. And this is really. Based on a Western model. There’s no evidence that we need to detox. And actually, obviously that’s not true.

But it’s really gonna come down to how are we going to detox? Certain programs increased that we don’t really know, they, they’re not really measured, but for our purposes in Chinese medicine, we actually look at a lot of other things, we look, is your skin getting better, if it’s working, are you having better? Bowel moves? How about are you have better sleep, also, on the market. And this is really more of the Western stuff. That’s out there with supplements. They’re, they’re very extreme and anything that’s extreme is gonna put a stress on the body and then actually have the opposite effect.

Also a lot of the detox supplements. There’s no. It, unless you’re able to really have a good digestive system and absorb. And that’s the idea of like detoxing or digestion is that your digestive system is working so that you’re actually able to absorb and process nutrients. And if that’s not happening then all these like supplements and things that are being marketed.

Are really going to just clog up your system. You’ll get minimum benefit from it. So really have to look at what does, when we say detoxing things like maybe fasting for a little while and just having fluids. So allow your your body to get a break that is also a way of helping to detox, and eating better foods. Simple steps to guide your patients. Definitely food diet there. Herbal teas, exercise, breath, work, massage acupuncture. So next. Okay. So it within the diet and you might already know. Of course of food. Food is one form of Chinese medicine, one of the eight branches and really eating within season, looking at the five elements.

What are the flavors? What are the the meridians and the organs that they help? So food as medicine for the liver and to actually lower, let’s say, lower cholesterol, or try to get glycerides, eating things. Green vegetables, steamed roasted, right? Not fried, using less of those oils.

You want it to be very easy to break down garlic and onions. Research shows that actually improves Habad hepatic function. So you start to look at. Adding certain kinds of foods into what you’re eating, and also the way that you cook the food sour and fermented foods like coleslaw pickles kimchi are also probiotic and prebiotic interesting lemon, lemon with water, they say, wake up in the morning, have a little lemon with water.

That it actually helps the liver to produce more of those enzymes to start metabolizing mushrooms. They’re very high in nutrient dense, low in calorie, and also have many antioxidants and anti-microbial properties immune function, they are a food. They also can boost the levels of leptin and leptin is that the hormone that tells you’re full and also helps to metabolize.

Coffee so recent I didn’t have a chance to put it in to the slide, to actually be in the slide. But like a new study is found that, coffee all kinds lowers the risk of liver disease and fatty liver cancer and death from liver disease. And really the benefit comes from drinking three to four cups of coffee, even de.

So they say and we’re looking at, it’s not about the caffeine. It is about what is the bean itself, if you’re going to have decaf, you need to make sure that it is the way that it’s processed. All of those things. So not just any coffee, like w you really want to take a look if you’re gonna drink coffee and coffee is a very strong has a strong psycho effects in the brain, neuro psycho effects in the brain.

It’s extremely strong, right? The also caffeine, has a big effect. The other thing you want to do is avoid animal proteins. You want to steer clear of a lot of. Meet a better to go with a fish something clean, like I wanna say cleaner, but easier to digest. Also dairies, very hard. A lot of people can not digest dairy and cheeses.

The other thing too is we’re looking at most of the dairy that we have is very, it comes from two cows or two to two genetically I would say modified but really bread. So they maximize output of milk. And so what happens is we don’t have a lot of variety and interestingly enough, that a lot more people are showing up as having a lactose intolerance again, avoiding processed foods because they add lots of chemicals and again, they may not even be food.

They may be products, that have little bits of food in it. Sugar is like a killer. You want to not have sugar? There’s plenty of things that you can have in fruits and vegetables, et cetera, et cetera, which your body will break down into the sugars that it needs again, alcohol. And if you are smoking really important to not smoke cigarettes, right?

Lots of chemicals and things your body has to process. So this is a, this is what detox would look like. Healthy living, herbal teas, and herbs. So dandelion, I put in dandelion, right? It’s poo gonging. It’s a. Antidiabetic antioxidative anti-inflammatory studies show that it ha acts on inhibiting oxidative stress in the liver reduces cholesterol and even reverses the streptozotocin induced diabetes, which is coming from taking a chemo drug.

So it’s really interesting that what I like about this is that you can actually buy. Dandelion tea over the counter. You can just tell your patients, go to traditional medicinals or you can buy, the dandelion and make it right. So very easy to do with not complicated.

Again. Chuck who Sao that’s more of an urban clear as in purge is heat a lot of like swamp swellings. It’s a summer drink. You can bring. Chrysanthemum again, milk fissile as well, and interesting Allo, it actually helps to clear the liver and constipation and kills parasites. A lot of people are, have parasites and a lot of digestive problems, and this is one way like clearing out toxins.

We’re looking at, okay, you’re activating this process and then you need to make sure that. And then again looking for drinking more like black tea or green tea, right? Because of its antioxidant effects.

Exercise stretching movement in particular like twisting movements, because that will actually massage the liver and also the organs. And so this is an opportunity like why exercise actually helps because as you’re moving, you’re also breathing and that will push down the diaphragm. And that actually helps to massage and milk, the organs to get their The blood and the lymph and the circulation

breathwork. And here just as an example of actually from the sod, you look at, it actually regulates the nervous system. And it also will help with the restorative sleep physically. You start to look at how the movement of the diaphragm and again, where the liver is seated will actually help to increase the limp flow and circulation.

And also you’re increasing oxygen into your body, which then you also, as you exhale, you are exhaling any of the Toxins. So you’re helping to filter out of the body in the system, giving it the oxygen it needs. And these are all free. You can do this on your own. It’s also just a great practice, especially if you feel like you’re sighing that’s a good sign that you need to do something.

Massage and lymph drainage. So the liver is the largest contributor of limb production. It accounts for up to one half of the body’s lymph fluid and, working with a massage therapist or actually certain kinds of movements are going to help to clear lymph and waste and swelling. And you can actually see, with patients have a little puffy phase puffy legs.

Poor circulation. We really want to help to. Drain the lymph. And most 70% of lymph vessels are just right under the surface of the skin. So things like skin brushing or gently, you could even probably do some lymph massage on yourself to help the flow. And also, people who have experienced a R serve up, have survived from cancer.

They have a, they really need to repair their liver, acupuncture and acupressure. You guys know all about acupuncture. And again at the beginning I said, the strategy and maybe think about how the liver is going to play a role in your patient’s health, especially now to shift from, okay, I’m going to do what I’m going to do.

My patient center. Custom radically customized treatment. And then I’ve got to see oh, from this angle, maybe liver is a big, like it is a big thing, but it really like slight shift of let me go with the season. Acupressure and Meridian massage, especially along the inner, the inner thigh, the legs, the liver spleen and kidney channels, really helping to move all of that up to, towards the big lymph area of.

The inner thigh and go to the next slide, I guess we’re done with that. So really I have to say very exciting is doing, the research right. To prepare for, Hey, what w what am I going to talk about? And the more that you dig in and research, especially if you suspect as a practitioner that there’s something connected to something else, you can actually go down a rabbit hole and find a lot of information.

And I, when it back in and I was looking at aloe, I was like, wow, aloe. Yeah, it’s good for digestion. But then I said, Hey, it, it actually relieves parasites too. And. And worms, and we never know we’re, where our food comes from. And so a very gentle and easy way for someone to drink a little bit of aloe juice and just help to gently move things.

And I think it’s a lot easier for your patients to incorporate yes. Drinking more water. I didn’t put that down, but it’s pretty obvious. If they can just add in some lemon to their water. It’s going to actually help them if they are thinking about when they’re moving or the movement to incorporate some kind of body twisting and moving and breathing, as a kind of meditative form, of course, we have to detox ourselves from social media, right? That’s a form of consumption, which really causes a lot of stress hormones. And that actually we see probably a lot of that, with irritability. And anger. And then of course, I talked about last time, a amygdala takeover and more inflammation.

And that would be really, a big area to really look at. Of course you need the social media because we’re doing this with the American Acupuncture Council. The but to really think about doing that just like a spring fast or something to take a break from some of the news that you’re reading and really like clear, clear out.

And again, also, in your home when to clear out the thoughts in your mind, but also, spring detox is also spring cleaning and maybe start to just really. Some of the attachment and also the fear that we’ve been, really take a look at that and how that’s been affecting our life.

So please comment and you want to join us next week with Poney Chiang he is going to be doing a fantastic presentation and please comments and messages. And also if there’s something that you really want to, some topics. That you were finding. Interesting. There’s always more so just know that this is all very much on the surface just to spark your curiosity and keep everything fresh.

What Happens when you put Gui Zhi and Fu Ling together?

today we’re going to be looking at formulas that include both Gui Zhi and Fu Ling together and what they all have in common.

Click here to download the transcript.

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

Hi, this is Sharon Weizenbaum. I’m really happy to be here this month and I want to thank the American Acupuncture Council for hosting me to give this series of talks. I hope it’s been educational and enjoyable for you. So today I’m going to keep on growing from what we talked about before.

So we started just talking about why classical formulas, and then we looked last time at. And today we’re going to be looking at formulas that include both Gui Zhi and Fu Ling together and what they all have in common. So I’m ready for the slides. So when we combine wager and pooling, you might remember from last time, if you were here that oops, back again.

When we were here last time we looked at the fact that wager treats upsurge that’s the first thing that the Shannon bonds have Jane mentioned about what wagers function is that he treats upsurge. And this is upsurge of young that loses its relationship with the. So when we combined greater and who’s playing, there is often an upsurge of pathological fluids.

So when we put greater and pooling together, we are bringing the warmth back in and transforming pathological fluids. So we’re going to look at how that works in a few different formulas. We’re going to, if you could change the slide. Yeah. So here’s a formulas that include wager and fooling. We’re not going to be able to go over all of these formulas today.

I’d like to just look at willing son and link way juke on tongue and mentioned the pooling Gunza tongue as a comparison. I think next time we’ll really go into glacier fooling one. Such an amazing formula. So useful clinically. They all are, but it deserves a lecture of its own. But all of these formulas have in common that they use Granger and fooling together.

And so they all have something in common and that’s transforming fluids and treating upsurge. Okay.

So here in my own words, since Granger is pungent and warm, it moves from inside towards the exterior. So punching flavor goes up and out in the body. We can see that a pattern that uses great jurors. One in which this function has not occurred. Glacier keeps the incoming young on the inside. So we’ve got young, that’s floating out, going upward, flushing up pathologically.

And when we take wager the new young that’s coming in is kept inside. And when it’s combined with Hulu and we can see that this as fluid accumulation due to failure of the young to steam, that yin upwards. And so the yen sinks into. Instead by giving glacier and pooling we’re reestablishing the warming upward and outward from within, in order to turn the pathological fluids into the life.

Giving steam. Okay.

Okay, so fooling is bland and it’s chalky. It means it’s a percolating earth. That means that actually strengthens earth, w if you’ve ever worked in a garden, like having really good soil rather than sand or clay means that the soil absorbs water and it drains really well. So we have a farm here and as working on our farm, we want this soil to be really good.

Absorptive. Soil because it holds water and it percolates watering. It helps drain water at the same time. So fooling really works that way in the body, increasing the absorptive capacity of the spleen so that it drains better. So this formula, which is a. The willing son is got a really high dose of fooling.

And actually it’s got a high dose of too much. Yeah. Also, so treats water causing Polis in the Abbey, gastric, just an art area. So in the water is really severe. You might even have pulsations as the water restricts the movement of the main artery. I’m also vomiting and retching dizziness, palpitations, inhibited, urine.

Okay.

So here’s a picture of our union symbol that I love so much. And we can see that the young is actually going down on the right. No, my hand is going down on my right, which looks like your left, but just imagine the union symbol that, that orange side is the fire that’s going down and the inside is going up, and this is what we would call young and right.

Relations. So in the, oh no, this slide has an animation. I hope that works here. Yeah. So in the pathology, the young is actually going up. It’s not rooting underneath the yen. And then what happens is there’s this accumulation of fluids. The youngest, not underneath the yen in order to transform it.

So gets swampy in the lower body and swampy in the middle,

and it can be swampy in the upper warmer. So different formulas that include quite you’re improving are going to treat water in different places.

So looking at willing son, when you combine this combination of plagiarism, pooling with Xhosa, jeweling and bite you, then you’re really working on water that has sunk down mostly into the lower body. To the extent that let’s say. There is thirst. And so when we give wager, we’re bringing that young back into right relationship and it steams that upward like that.

So the pathological fluid becomes this physiological mist. It spreads in the body. And with this formula, a key symptom for this formula. Thirst. And the reason why it’s thirst is because when that water is pooling down below, it’s failing to steam upward into the stomach and moisten the tongue. So it’s all puddled downward and not.

Physiologically moistening upward. So thirst is really a key symptom and it’s a bit hard to understand, isn’t it? Like you have all this pathological water. Why is the person thirsty? And it’s because it’s sunk down into the lower body. So when the wager comes in with the fooling, it brings that young into yen.

That’s being now absorbed into the body, steaming that upward all the way to the total. And you’re also able to pee out pathological. Okay.

So if we look at a formula here where we have more great. Like a really strong dose in Williamson. The glacier is actually quite low. We’ll look at the ingredients in a moment, but in this formula language, Yukon, tongue wager is a lot more and there’s a bunch of fooling and then it’s combined with guns and bite you.

Now, if we remember from last time that flushing up of grader can really affect the heart. And This formula language you gone, tongue is for water. That’s more in the middle warmer. We can see that with the gun sound bite. You instead of Xhosa Ling, so more in the middle warmer. So I put the cloud in the middle, but also the flushing up is going to really easily affect the upper body.

So there’ll be flushing up, not just a beyond, but a flu. They’re going to, that young that’s out of right relationship is going to act on the pathological fluids and make that flush up. So you get upper warmer symptoms of even more pulsations, palpitations, dizziness, nausea. Meniere’s syndrome.

This formula can be really good for many years syndrome, if there’s this water pathology. So that’s the picture of how that language you’re going to tongue works.

Young comes back into right relationship, and now let’s see.

There we go. So the water disappears and instead there’s that life-giving steam instead. Okay.

And of course it enables normal urination.

Okay. So now if we take out that bite, you and we add Shung Jong instead. Now, what does shone John do so good dose of Schunk Jong with great germ pooling. So we still have flushing up. We have flushing up a pathological fluids, but now we take out the bite you in. Sean, John. And really what this is for flushing up.

That’s really effecting the stomach. Showing John is really a stomach herb and it it kind of warms and steams fluids that are inside the stomach. So this formula is going to be more for vomiting up fluids, coughing, or vomiting up fluids. And it’s actually a much more Physical formula where the very physical in terms of affecting those stomach, particularly where as the language you’ve gotten, Tom by Jew is a deeper herb and a more dense, urban, a slower herbs, it’s what I mean by slower is that dog acts very rapidly to just evaporate the fluids in the stomach.

But I do works in a slower way and in a more it’s a denser verb. So it works in a more physical way. I, and I, that’s not exactly what I mean, a physical way that affects the psyche and more internal Functions in the body. So things like dizziness and spirit disorders where the water flushes up and affects the Shen.

So even like panic attacks for the language going Tong, whereas this formula would just fooling guys out on these worms as much more about just vomiting and you’ll be vomiting, fluids.

So great. Jeremy will bring that young right back into right relationship. And then there’s that nice standing up and warmth. And then the natural movement of the stomach can be restored, which is to go down. The stomach is meant to go down.

So here’s, we’re going to go back over each of these. Here’s the rulings. So you can see that the that the wager is actually small compared to the herbs for water. And really what this means is that the flushing up symptoms on so much, when you look at formulas this way you can see from the dosages in the way that they’re combined.

What the pathology is going to be, that there’s not as much flushing up of water at the same time. There’s pooling up a water and it’s sinking lower in the body. Okay. Slide.

So again, here, because the fluids are sinking down. You are thirsty and not often, this is called mouth thirst because your mouth is dry. But since there’s a lot of fluid there, they, you often don’t want to drink a lot. You want to sip and moist in your mouth. And even if there’s a lot of fluids that drinking could.

Cause if you guys are water, it could cause upstairs. And it could cause vomiting. And the key signs for Wilmington is also a floating posts. And that’s because the young has so left the year and there’s this separation of young Indian, up here, it’s dry and down below it’s wet. So we think of where the pulse is as where the young are, where the life force is floating up in the book.

Often, what I find is that in the Guan and triple says, it’s wiring. Why are you? It’s really a water poles because the water. Constricts the flow of the life force. And then there’s abnormal urination. Cause there’s a cooling up of water down below, and that could be frequent urination in continents or inhibited your nation where there’s a stopping and starting.

And I really suggest you ask your patients about this. So a lot of times, so you ask like, how’s your urination and they’ll say, oh fine. And. It’s normal. It’s normal for me, but if you ask a little bit more deeply, do you ever sit down and you’d have to wait a little while before you be, or it stops and starts?

A lot of people will say, oh yeah, a lot of men will say, oh yeah, it’s just my prostate. And and that you want to take that as that means there’s water stagnation down in the lower body. So all of these things that urination can be Abnormal urination as well. So the agitation is because up here in the upper body is dry and that dryness and warps agitate the heart.

There may be vomiting. There might even be a slight fever, richness, and even sweating with that feverish madness. So the young is leaving the yen. The yen is staying in play in non distribution of fluids. Okay.

So here we have a picture of the pot biology. You can see the young is leaving. And so there’s dryness, especially above the heat could be agitating. It’s going to be flushing up heat and there’s all this fluid that’s causing abnormal urination. So I have that, that lower dry there, because it’s very common with a willing sun pattern to actually have dry constipation because the fluids are leaving and cooling up, leaving the intestine dry.

And what I do in clinic is if there’s this pattern of water with a dry stool, Then I really increase the Baidu by about three times the normal nine grams, because Baidu is really excellent for helping water go backwards, supposed to go, getting water out of the earth, into the large intestine.

So we don’t necessarily know you think of bite. You he’s been more as a diarrhea or however, it’s good for diarrhea for the same reason, because it helps water go where it’s supposed to go. So it’s an excellent constipation or been John dome. Jamie even talks about that. So that’s why I have that lower dry there.

Cause it’s not always just in the. That you feel the dryness, it can also be in the margin testing. Okay.

Okay. Now we’re going to look at the language you’re going to talk, and this is more, we don’t have so shell, we don’t have jeweling. So that tells us that it’s more in the, it’s not as much in the lower warmer we have Baidu and Gunza instead. So it’s more related to the middle of. And so you have the flushing up and we have a lot more water.

And actually the dose of wager and fooling are relatively high compared to wooing sun. So there’s lots of water and lots of flushing up. So compared to Wilmington, flushing up is a really important symptom for language event. So let’s take a look at. Physiology of it. You bring wage or back inside with fooling and bite you, and it just transforms those fluids and young gets in right relationship, so we really want to think of Granger as an urban gets young back inside where it’s meant to be.

And when it’s combined with fooling, it gets it back inside. So it can transform both.

And of course functional urination.

And you can see the happy days because now that upsurge is going down just a little side on how to diagnose the water. What you’re really going to be looking for is water sounds in the abdomen. This might be subjective for the patient, but you can also put your hand on the person’s belly, especially around their stomach, middle warmer, and stretch it and tap on it and see if you hear sloshing water sounds.

So that’s looking for water slashing sounds in the back. But again, the tongue could be really wet, possibly a thicker white coating, but more often a watery slippery coding or this formula and the pulses will be wiring for this. And if it’s cold or they could be also Tight, but definitely wiring because there’s this fluid accumulation and, Leo do, Joe says that the wiring pulse is the fluid accumulation pulse.

And when we think of the winery pulse, we usually think of liver cheese, stagnation or something, but here. It may also be submerged because the water is submerging the life force, but it’s also constraining it. So the wiring POS is really just saying the lifeforce is constrained in some way. It may be constrained by blocked emotions.

It may be constrained by really tight muscles, but it could also be constrained by fluids. So we want to think of the wiring pulses, also a pulse we can explain by the accumulation. Fluids in the body. Okay.

So inside this formula is the formula

which is a teeny tiny formula. Which includes teeny tiny for me means that it only has two. Of course, if it only has one or it’s teensy tiny, which is one or teeny tiny is two herbs and tiny is three herbs, just so you know, my nomenclature, but this is a teeny tiny formula wager and gun cell. And the Grainger’s in a two to one ratio with gone south and this nourishes and warms the heart and treats palpitations.

So the fact that this formula is inside language, tells you that. We’re really at the same time, bringing. Physiological nourishment back to the heart, so instead of the heart being flooded with water surging up on it, it’s being nourished by this warm nourishment with wager and gone sell.

And also, I just want to mention something. I said that this formula language you got is really good for panic attacks and. And part of what happens is, the life force is warm. And really, if you think about the fact that when we’re dead, we’re cold, then the idea of cold is the opposite of life.

And so when we have water in our body, that’s pathological water, meaning it’s not water, that’s infused with warm it’s cold water. And that starts encroaching on our heart. It can feel like death is encroaching on the heart. We associate cold with dead. Then this cold water is coming up into this space of the Shen the space of the heart.

And it can feel like death. And that’s why a lot of panic attacks are feeling. That you’re going to die. Like you’re driving down the highway, you get scared, you think something terrible is going to happen. Even though everything is fine notes, this feeling of impending death. So not all panic attacks are due to water or a language you’ve gone.

Tongue pattern. There are other reasons why panic attacks can manage. Energetically in the body, but definitely water is one of them. And water often comes with this feeling of I want to die or I’m going to die. So just something to keep in mind.

Okay. Now I just want to compare the language Uganda Ugandan. , for me looking at these formulas as a younger herbalist, I would just get dizzy oh my God, they all have almost identical ingredients. Like how do I ever remember what the. Subtle differences are about. And so one thing to look at is, the herbs that are similar and then the herbs that them are different.

And we already did this looking at language. You’re going to talk including by June. How that kind of goes deeper into the body where Shung Jong is really about the stomach transforms fluids, rapid way inside the stomach. And so the fooling guns, her tongue is, by having Shandong, instead of bite you, it really treats the stomach.

But also look at the dosages. The fooling gods have taught me is a really small dose. And it’s used for a relatively light problem. It’s an excellent pediatric formula for vomiting in children. And also it’s used just lightly for a very short period of time. Had an episode of vomiting.

I can take Boolean guns. So Tom, where language you got to talk, we can see altogether, the dose is much higher and here we have this really high dose of pooling compared to, and fooling Gunsight tongue and a high dose of Granger. So it’s much more flushing up and where the fooling concept time is more for water in the stomach itself.

Okay.

So the line for liquid you’ve on tongue, it says line 28. If after vomiting or purging there’s reversal fullness below the heart with cheese surging up into the chest, dizziness upon standing a deep, tight pulse. So again, it’s like submerge and it’s submerged by cold waters. Tight and the more cold it is, the more tight, the less cold, the more wirey the promotion of sweat will lead to move into the channels.

So this is not a pattern where you want to just give grades your tongue or my long tongue. And that, that will further deplete the young and the yen. Okay. Then the jink way, it repeats the. Same idea of language of on Tom

and there’s a picture of the four ingredients.

So here’s the middle warmer and it’s all wet.

And there’s this flushing up into. The heart caused vomiting and retching palpitations, chest depression. I’ve used this for people who have been diagnosed with CLPD or have really bad breathing problems that are due to water stagnation in the middle chronic cough.

And it can go into the head. Dizziness, blocked, nose rhinitis impaired sense of taste. You’ve got this water coming up. Meniere’s syndrome, plum pitchy. Headaches hypertension, even epilepsy, I can really block the channels. Benton is this running piglet, which is often like a panic attack and acid regurgitation, making the stomach go up.

But it can also those fluids in the middle can cause constipation. And again, you’d want to really increase the Baidu. If it’s causing constipation, if it’s diarrhea you probably want to use child by June, the stir fry find you, but that water can even cause a Minnery I’ve seen it cause amenorrhea and language you got Anton can.

By clearing the water, it can help to clear the water in the womb. And often I use it in combination with other, I know we’re going going beyond our time, but I’ll just finish. Okay. So here are just some things where it can affect the language you can. Tongue pattern can cause these different kinds of symptoms in the box.

It can not the cheese, so it can, cause if it’s in the middle of warmer, it can make you feel distended and, full in your epi, gastric region or in your bowels.

Okay. I think we’ve gone over that email. So we’ll just go through this, the fooling concept more in the middle warmer. And. Here for the fooling concept, talking again, just comparing these because they’re so much alike. This is a pattern of stomach, young deficiency with water stopping in the epigastric area.

It can cause epic gastric palpitations. This method warms the stomach and scatters water. This is why the dosage of Schengen must be relatively large. Lots of formulas. We see just a little in here. It’s relatively large because we are transforming fluids in this. Combining this with cooling and wager assist the function of opening the yarn transformation of the G.

And I would add the down bearing of the stomach.

So thank you. I really I love talking about classic formulas and how they work. And so it’s really nice that the American Acupuncture Council has given me this opportunity. And I want to also, if you’re interested in more educational opportunities, the white pine circle is an incredible. Get all kinds of amazing teachings along this line.

If it resonates with you to think about herbs and formulas this way. So you can go to white pine circle.org. And and I also teach it to your program called the graduate mentorship program, where we go through everything having to do with diagnosis and herbal formulas over a two-year period with a lot of close contact with.

So anyway thank you again to the American Acupuncture Council, and I will see you next month.

Cosmetic Facial Aging: What’s Lurking Below the Surface?

The title of today’s presentation is cosmetic facial acupuncture. What’s working and lurking below the surface, and I am a cosmetic facial acupuncturist.

Click here to download the transcript.

Thank you for the American Acupuncture Council for inviting me here today. It’s really an honor and a pleasure to be here and thanks to all of you who are here and watching and listening and participating.

I appreciate you being here and I hope that you enjoy this presentation today. So I am from Florida. And happy to be here. So let’s go. We’re going to start the PowerPoint presentation. The title of today’s presentation is cosmetic facial acupuncture. What’s work w lurking below the surface, and I am a cosmetic facial acupuncturist.

So I’m going to help you to see what’s lurking below the surface. Here we go. So cosmetic acupuncture. It’s really a form of my rung. It’s an ancient, traditional form of healing based on the concept of beautiful appearance. And in China, we’re in, when we talk about beautiful appearance, we’re not talking about just the inside, but we’re talking about acupuncture and herbal medicine.

That was notably used by the ancient Chinese emphasis and anchors to keep their concubines looking beautiful and healthy. And it was practiced in Asia for centuries as part of a holistic regime to both enhance beauty and to delay the visible signs of aging. And it was also designed to promote systemic health and overall wellbeing.

Today, cosmetic facial acupuncture is one of the most popular specialties among acupuncturists in this country. And I was part of a 2014 NCC AOM acupuncture, facial rejuvenation needs assessments. And in that survey, we asked a number of questions, reaching out to all of the members of the NTC AOM organization.

And based on the feedback that we received, we found out that 62% of the patients of these acupuncturist, patients inquired about acupuncture for appearances. That’s a lot of people. And when I asked myself the question both for the, from the perspective of the patients, but also from me as a clinician’s perspective, why do people come for cosmetic facial acupuncture?

They come for prevention. They come for a desire for a natural alternative. That’s more congruent with their belief systems because times have changed now. And I find that my patients are much more interested in something that’s a holistic or natural alternative, as opposed to say surgery or some invasive procedure.

But also this I thought was particularly interesting and it has to do with the patient’s conflict about aging. What happens when someone begins to age? What happens on the inside? And what I’ve realized is that as we age, we start to change both in relationship to ourselves and in relationship to.

Ourselves when we’re dealing with others. So for example, in our twenties and thirties, what are the primary goals or what are the primary objectives or things that are important to people in their twenties and thirties? They’re interested in their social life. They’re interested in their careers.

They’re seeking partners their lifestyle, their homeless. At that age, there aren’t a lot of visible or physical changes. So it’s not really in the forefront of their perspective about themselves or the things that they’re concerned about. As we begin to age and move into the gen Z generations or decades of our forties and fifties, we start to shift our priorities, start to shift our relationship to ourselves and to other begins to share.

We are a little more invested in our career. Our partner may be starting a family or having a family. We have friends, and this is when we first start to see those visible and physical changes. And then as we move into our later years, sixties and up, this is when those visible changes are very visible and much more.

We’re much more affected by them. And this is when we start feeling our relationship about aging and re-examining ourselves and re-examining our life. Good looking at well, what have we accomplished? What haven’t we accomplished? Am I happy with myself? Am I do I feel like I’ve given enough or received enough in my life and all of these questions bring up what we call either a life crisis, or a big change in our life.

And it’s somewhere between this fifties and sixties. And it’s well-documented, we know it as say our life transition. It’s a period of questioning. Our identity may be challenging. Our self-confidence this typically occurs from about 45 to 65 years. It lasts about one to two years and clinically it’s described as a psychological unraveling brought about by events that highlight.

Our person’s growing age, inevitable mortality and perceived life, a Cod accomplishments. It’s when we start thinking, okay, I might be on the other half of my life, I may have lived. Longer than I have left to live. And it really, I don’t know for those of you who have gone through that are in it now it’s quite can be quite traumatic.

And it often spurs this desire to make drastic changes in our, in their current lifestyle or in our current lifestyle. And a lot of that comes from the urge to recapture our youth or to hold onto what we perceive as our. And for some people, this is exciting. It’s an opportunity to really look at themselves to really self evaluate, to see our insight, look at our insights, maybe a self-exploration and reassessing and reappraising, and there’s an enthusiasm behind it and it challenge and it’s a very exciting.

Part of our life, let’s say that’s not always true for others. For others. It can be a time of confusion. Emptiness. Meaninglessness or restlessness, maybe we’re not happy with what we’re thinking. Maybe we’re not happy with ourselves. Maybe there are some things that we feel like we have not accomplished or places where we felt like we felt short, fell short in our lives and it’s disturbing.

But then there are others and this is really sad, it’s so challenging and it’s so fraught with turmoil that it can lead to depression. It can lead to anxiety. It can lead to disillusionment self-doubt self-loathing. And a lot of these people have a kind of a shallow or not a strong sense of themselves or not as strong.

Since of their confidence. And so when, and they’ll rely on the superficial aspects of themselves, their looks their social life to actually validate who they are as a person. And when those things that you’re look start to Duane or not be up to what we thought we should look like what’s left.

There’s not much left. And it’s actually very upsetting and very difficult for ourselves and for our patients. And particularly in our Western culture, we are a very youth driven culture. And when we are faced with. No longer looking like the youthful person that we think we should be. It throws us into turmoil.

And from a clinical perspective, we know that although our patients are seeking treatment for appearance enhancement, they’re coming in for their wrinkles, there’s their skin or whatnot. We know that it’s not just that superficial make-over that they’re looking for, but there’s this deeper, emotional and spiritual healing that needs to be attended.

And this is the beauty of our medicine as acupunctures. And particularly as a cosmetic facial acupuncture, as big as acupuncturist, because our treatments are both physical. They treat the psycho emotional and they treat the spiritual component, especially when we’re looking at it from the principles of Chinese med.

And when I say according to the principles of Chinese medicine, what am I talking about? I’m talking about the balance of yin and young cheap blood fluids, the meridians organs and all of the systems that are involved. So for example, when we look at the pair organ systems and all of their attributes, From the perspective of the heart, the small intestines, the pericardium, and the San chow.

We know that as a system, they rule the blood vessels well in our world as cosmetic facial acupuncturist, we’re looking at complexion, we’re looking at fine lines, broken capillaries, rosacea, that type of. From the spleen and the stomach, we know that system oversees the muscles and the muscle, the health and integrity of muscles.

That’s the same for facial acupuncturists. We’re looking at the facial muscles and the integrity or the attenuation of the facial muscles every time. We know from our Chinese medicine, that the lungs in the large intestine oversee one skin or the concept of skin and in our world, what we’re looking at is skin quality, texture, poor size acne, rosacea.

That. And then we also know from our Chinese medicine knowledge that the kidneys and the bladder oversee the bones and aging, the entire concept of aging. And so a lot of conditions that are involved, premature aging bone fragility, bone resorption on the face. We’re looking at the kidneys and the bladder.

And then this is the kind of the one that’s a little bit different, but we know that the gallbladder and the liver oversee. Ligaments and tendons will in our world. What we’re thinking of is not so much ligaments, intendance, but the smooth flow of cheer, the way that the muscles contract relax.

And when that smooth flow gets loss, what we begin to see is the skin on top of the muscles of the face, begin to crease and fold, and that begins the development of bringing. From a psycho-emotional perspective, we’re looking at the five elements. We’re looking at the fire earth, metal water wood perspective.

And we know that fire has to do with one’s ability to socialize their healthy socialization whether they over socialize under socialized, that balance that occurs in the fire element. The. Is about how we digest our thoughts. It’s about our ideas and it’s about self-esteem from a metal perspective, we’re looking at lungs grief, the way that we breathe in, breathe out, letting go the ability to let go of the old and bring in the new and the inability to do bringing grief, resentment, or regret. From the water perspective or the kidneys again, we’re looking at acceptance and fear. How are we aging? Are we okay with aging? What do we anticipate? Can we accept it? Is it fearful? Is it so fearful that we actually get paralyzed and depressed? That type of. And the wood element being delivered and the anger, it’s about the inability to actually make those changes, leading to frustration, bitterness, resentment, lack of hope, change remorse, all of the emotions that go with the frustration or the inability to actually let go and change.

So as practitioners, we are balancing both the physical and the imminent. And what’s interesting for a facial acupuncturist is our ability to correlate those facial features with the systems of the water wood, fire earth, and metal are the five elements and the organ systems. And we can actually see on the face, those changes that occur both on the physical and the emotional perception.

So let’s look at wrinkles. If you look at the different aspects of the face, starting with the upper forehead, that’s ruled by the kidneys around the eyes and the lower portion of the forehead is the liver. The lungs really ruled the cheek area. The spleen, stomach and digestion around the mouth in between the eyebrows.

The kidneys are the ears as well as the upper forehead and the lower aspect of the chin. And when there is an emotional disharmony within those organ systems, it can show up as wrinkles. It can show. And changes in skin coloring. It can show up in terms of say dyschromia or pitting in this tissue.

And so as facial acupunctures, we actually learn how to look at the face, diagnose the face, both from a physical and an emotional perspective. And then there’s also an emotional map. This is from Lotus Institute, Lillian. And she has actually outlined the direct emotions that occur within those features, whether it be wrinkles, skin pitting, flattening changes in color of the skin.

Is the skin a little white or pale meaning frozen or is it red? Meaning there are signs of. Yeah, when we treat, we definitely need to treat all of the emotions. We need to treat the emotional component as well as the physical. And when we are looking at those underlying pattern disharmony, we see that the wrinkles that the skin color.

So that the flattening or trajectory of the face those are just the symptoms. What we’re really looking for are those underlying pattern that as harmony and that we differentiate with our signs and symptoms through our poults and our tongue. And then we treat the superficial or the root. Which is the the wrinkles as the symptoms.

So for example, we’re going to look at ours signs and symptoms, tongue called that type of thing. And we’re going to discover whether it’s liver cheese, stagnation, frustration, repressed, anger, and we’re going to treat that with body points and then the branch, the wrinkles that show up, particularly if we’re looking at, say the liver around the forehead we’re going to treat those with these.

So here’s an example. This is a patient of mine and he was a 44 year old male. He was looking for acupuncture treatment to enhance his facial appearance. And his chief concern was what we’re calling disfat satisfaction with the forehead and glabellar area, the glabella areas that crease in between the forehead.

Sometimes it’s a single crease. Sometimes it’s a multiple crease you can see in this patient. That’s a very deep crease on one side. And then a smaller crease rate by the inner campus of the eye on the other side. So even though this patient had bilateral headaches, he had a history of carpal tunnel syndrome.

He had asymptomatic mitral valve prolapse and periodic lumbar pain. Those were erotic. But he wanted treating was this creasing between his forehead. So we spent a lot of time talking about it. We spent time talking about the physical component of it, the underlying patterns of disharmony. And then we reached into the emotions, the frustration and anger for him about aging, because the peer pressure for him to look youthful was hi the standard was so high in his world that he just couldn’t get past it. He did not like himself. He was so frustrated, anger, angry about it. So we had to trust both of them. And we did we came well. I came up with a liver cheap pattern with blood stagnation and congestion in the gall Meridian validated by the tongue and pulse.

The treatment plan was to harmonize. And then we decided we were going to do this for 10 weekly treatments and then reevaluate. So I chose some points. I showed somebody points to reflect the treatment that I was doing face points to actually subsidize the underlying pattern disharmony. And then I did some of your points.

I always use your points. I think they’re really. Okay. And so this is the before and after this is what happened after country meets. And as you can see, there’s a significant difference for those of you who do practice facial acupuncture, some of these changes may be more obvious to you, but even for someone who doesn’t.

Visible difference. The first change that you see as the softening in the creasing between the glabellar region, but look at his whole face, look at his entire demeanor. Can you see? And the before picture. In the heel Muslims angry, his face has pulled in his jaws. Clenching his face is very tight. And then in the after 10 treatments, you can see his face is so much more relaxed.

He’s more comfortable with himself physically and also emotionally as well. So this is just one example of many ways that we are treating, not just the. Superficial, because if I had just treated deliberately stagnation, if I had not addressed what was going on underneath, I may have seen a difference.

I don’t think it would have been the significant and it certainly wouldn’t have been within the timeframe that needed that we were given. I gave ourselves. But again, just to reiterate and validate the significance of not just treating the surface, but really treating the physical, the emotional, the spiritual, and using that with our pattern underlying patterns as harming.

Using surface points to treat the face and pulling the whole thing together. So it, again, not just one one aspect of it, but particularly in facial acupuncture, because when you think about the face and when you think about the orifice as the face, your eyes, your ears, your nose, your mouth, we are the face picks up everything.

It’s the first line of defense. And we know that we hold all of our emotions and our muscles and the fascia and tissue and the face is the first place that we hold everything. And one of the last places that we’ll re let go, because in order to make big changes, you have to actually resolve the emotions that go with it.

You have to resolve the underlying trapped trauma that’s in there. And so this is actually makes it extraordinarily rewarding for them. As a facial acupuncturist, because when I can make a change, not just a visible change and their surface, but when I can actually affect them on an emotional and a psychodynamic level, I feel like I’ve done a really good job.

Just to say, for those of you who are interested in learning. This program is that I teach is part of the Pacific college of health sciences. It’s called the facial applications for cosmetic enhancement or the face program. And you, it’s wonderful because we’re not just bringing in me, but we’re bringing in all the known leaders of today’s world.

Their classes are start once a year in January and there’s information for our, you, for those of you who are interested. I can also follow me on Instagram or if you want more information, I can certainly give you more through my website. But just want to say that this has been such an amazing and rewarding profession for me because I really feel like I’ve helped people to not just look better and feel better physically, but to actually.

Age in a way that they are comfortable and more productive, both in terms of who they are for themselves, but also just to make a small difference in who they are in relationship to the world too. So thank you very much. And I appreciate. Being here. And then also before I entertain questions, I want to say that there’s another pro wonderful presentation.

So stay tuned next week for a Sharon Weizenbaum who will be presenting as well. And I have to just say that the quality of presentations through the American Acupuncture Council is really it’s dependence. And thanks again for having me here today, Alan. I appreciate.

Are there any questions from anybody?

I actually had a question about the gentleman whose face you worked on. Was he literally a happier person as a result or that didn’t really make him any happier in the long run. Thank you for asking that. Not only was he a happier person, but the the stress that he was feeling and the trauma around.

Feeling like he was getting judged by his peers dissipated. And in other words, he didn’t care as much. What other people thought about him, which is pretty amazing. Yeah. Last question then we’ll wrap up. Because I’m really was curious about, do people become addicted to the treatment in other words? Oh, wow.

This was great. And now, people become addicted to facial surgeries when they’re doing surgeries or body surgeries that just keep wanting to change and change. Is that something that you find in working with people? I it’s, yes. It’s different. I, and I know exactly what you mean. When people are addicted to facial surgeries the addiction.

Is that is wanting to look better and better, but it doesn’t change. What’s on, under what’s going on underneath, which is a self dissatisfaction. And that’s what the addiction is. The addiction is based on needing to. Look better because they’re not satisfied or happy or content within a, with this, what people get addicted to as a they look better.

But they feel better about themselves. And it’s the feeling better that becomes the addiction similar to say meditating, you feel like you’re a better person in a few meditate. There’s something that happens to you and you, your relationship to yourself within the world becomes a more peaceful place to live.

It’s the same with this type of acupuncture, a you look better, but also more importantly, you become at peace with yourself. And when you are at peace with yourself, not only you’re you a better person for yourself, but you’re a better person for others.

Nice.

Getting Paid Directly from Medicare

So I want to talk about Medicare because there are so many things that are confusing or misunderstood or misrepresented…

Click here to download the transcript.

Billing expert for acupuncture and the American Acupuncture Council network, as well as the American Acupuncture Council Malpractice Insurance. With another time to get with you to update you on what’s going on, what’s changing to make sure your practice is thriving. Remember the American Acupuncture Council was always your partner.

If you have a question and need an answer, trust me, we’re there for you. So what are we going to talk about? Medicare. So let’s go to the slot. So I want to talk about Medicare because there’s so many things that are confusing or misunderstood or misrepresented that I think are going about. And I’m getting so many calls and requests for this, whether it’s people on my network or coming to seminars, what is going on with Medicare?

What does it really cover? And what is the. Differences between Medicare part, B and C who pays me. So I want to make sure there’s a clear understanding. Regular Medicare part B is what you see on the left side here, that standard Medicare card, but you’re going to know a lot of people have something else called Medicare advantage.

And so we want to kind of talk a little bit about that to make sure there’s a really clear understanding of what’s going on because of course you are being in a. With people requesting information or saying, I heard it’s covered. Take a look at some of these ads. The upper left is from a RP where they put out, Hey, Medicare will cover acupuncture for back pain out or regular med take care of patients sees these types of things and thinks, well, I want to get the care because notice even blue cross blue shield has an ad for it.

In addition, here’s another one, indicating a zero acupuncture for 24 visits. And this was a commercial where they literally show acupuncture on the commercial. Realize acupuncture has become a commodity. For these plans because it’s their way of enticing people to get their plan. Ooh, join ours because there’s a benefit.

Now the confusion of course, is what are the differences between this part a and part B and really what is Medicare? Well, who are the Medicare patients? Will Medicare patients, is it going to be people 65? Obviously, at least as long as you’ve paid into Medicare, I think for 10 years you will automatically get Medicare benefits when 65.

But remember Medicare is not just for people over 65. There could be some people who are younger that have a permanent disability and as a consequence are entitled to Medicare. So don’t be surprised when a Medicare patient is younger, but it also could be people with end stage renal disease, probably not ones that we would see, but certainly the.

Now what’s going on with Medicare is understanding the types of Medicare. Now we have standard Medicare part a, which is the one everyone gets it’s hospitalization when you go to the hospital. But the one we’re speaking of is very typical as well. And it’s Medicare part B I’ll call that traditional Medicare.

So this is the original Medicare benefit that covers going to the hostel. Going to a doctor’s office and having a drug benefit. Now, the good news is these people can use it. Anyone within the system, does it matter? The state and Medicare pays its portion and the patient pays 20% of it. So not bad, a good, nice coverage for people who are over 65, for those that don’t remember prior to the implementation of Medicare, many people who are older would literally go bankrupt with any illness.

So this has been something that’s been quite the good, safe. Bottom line though, is what’s going on for acupuncture? That’s what we’re concerned about. So you notice I have it in red here and it says acupuncture is covered, but it says for chronic low back pain, only under direct supervision of a medical provider.

So all of a sudden, well, yeah, But it’s only covered when done under medical supervision. So that makes it somewhat limited. The low back pain of course is limitations for it as well. But nonetheless, the supervision makes it hard. And part of that reason is acupuncturists have not yet become Medicare providers.

We need to get a bill, which we already have one going. That’s going to make acupuncture providers under the social security, social security. To be part of Medicare. So until we get that, we’re going to be stuck with this type of issue of needing the supervision or, or referral, if you will, from a medical provider, that bill is being moved and hopefully we’ll see something in the next couple of years, but this is kind of the cart before the horse.

If you think that Medicare was really going to first do a study of how good acupuncture could be to see if it was working or not, the evidence was so overwhelming, they decided to cover it. The problem. The cart before the horses while they’re covering it. But because acupuncture’s can’t join, Medicare is still had to have some tangential way of getting in, which means under the medical provider, meaning for traditional Medicare part B, it still has to be billed by a provider within Medicare.

And that’s limited to basically medical providers, so that one’s a little more complicated or a little more difficult, but nonetheless, still the late. Let’s talk about though. Also what a lot of you are experiencing and misunderstanding is there’s this second type of Medicare that’s often referred to as a Medicare advantage plan, or also known as a Medicare parts seen.

I know of those letters can be confusing, but I like to think of it as a Medicare advantage plan. What a Medicare advantage plan is a way for a Medicare patient to literally chip trade their Medicare benefits to this point. And then this plan takes over for the benefits and it’s under companies like United healthcare, Aetna, Cigna, all these ones offer them and they have to offer all the same benefits as regular Medicare.

Sometimes it’s actually even cheaper. Which to me is interesting. When you think of it, how is it that we can manage Medicare patients for like 500, 600 a month in premium yet when we buy premiums for someone that’s younger, it’s thousands of dollars. Well, that’s because it’s insurance companies making sure.

Bottom line though, is that these plans have to cover exactly as Medicare does. So in other words, they have to cover the low back pain, just like Medicare to however many of these fines. And you’ll see this in a second. The last bullet offer extra benefits like acupuncture, and these can be built directly by an acupuncturist to the plan without being part of quote unquote.

Now, some of these plans may require you enroll, and I frankly will have no problem with enrolling because it only gets you into the one and gives you access. These can be pretty darn good, but let’s understand the. Traditional Medicare part B regular. Again, acupuncture is a benefit now, but chronic low back pain only, and up to 20 visits a year or so, not bad.

What it says though, is that the there’s 12 visits within 90 days. And assuming the patient improves another eight, the difficulty for us is that an acupuncturist can perform. But it must be supervised by a medical provider. And this could be an M D a D O a PA, an NP or a CNS. And so these are all medical providers that are enrolled in Medicare.

So in other words, you’re working kind of for this person, if you will, it’s not a referral, but something you’re working with because it has to be built by. So to take a look at it, this under this national coverage determination, you’ll see here. It says the most recent is that it will cover for chronic low back pain.

And that is defined as back pain. That’s more than 12 weeks. Now that doesn’t mean like, oh, I’ve had it exactly 12 weeks, but think of how many Medicare patients talk about all my. I’ve had back pain on and off for the last 10 years. Well, by definition, that’s certainly going to be chronic. It certainly can’t be associated with other inflammatory diseases like infections or metastatic cancer, but traditional, as most people get back, pain realized 85 million people a day habit.

That kind of makes sense. It will be covered. Now here’s something interesting. Obviously you’re all aware that back pain codes updated and part of the complications in dealing with this when they update. Medicare published what codes they were going to allow, even though M 54 50 is one of the codes new for back pain under the Medicare guides.

What they indicated is that it’s only going to be M 54 51 for routine progenic or other specified in 54 59. So make sure if you’re billing Medicare, part of the reason if you’re getting denials is you have to update to one of these two codes and bear in mind. There are some payers that have been delaying until April 1st, for some reason, but.

Those are the codes. If it’s back pain, notice the code, doesn’t say, uh, chronic. It’s just the idea. And that’s why M 54 59 is the more likely now it pays up to 12, but notice it says an additional eight sessions will be covered for patients demonstrating improvement. I think that’s fairly straightforward.

Most patients, in fact, getting acupuncture with back pain, almost always improve, obviously. And it’s just as long as that’s there they’ll allow additional eight meeting up to. Now the complication here is this is not a yearly benefit in the way you might think, meaning it starts over in January. It’s a rolling year.

So by example, it says if the first services performed on March 25th, The next service beginning of the new year, can’t be until March 1st of the following year. So they do it as a rolling month. So it’s literally 20 visits with any within any 12 month period, not January to January, but it could be from March to March and so forth.

Now the complications here is that physicians can furnish it. Of course, medical doctor certainly could physician assistance, but they also have to have some additional licensure for accurate. Bottom line is you’ll notice here. It says auxiliary personnel can do it so long as you have a master’s or a doctoral degree for acupuncture, which is going to be all of you.

And therefore you can provide it. Now here’s the problem you’re providing it, but it says here, auxiliary personnel, furnishing acupuncture must also be under the appropriate level of supervision. Now, a lot of people have misinterpreted appropriate level. It’s thinking, oh, it’s just based on a referral.

And they come in the office, unfortunately, not that simple under this rule, that’s under these two regulations I have, here are 4, 10, 26 and 27. You have to be present in the same office. So it means you gotta be in the office with this medical provider when the service is delivered, they bill for it.

But yeah. This can’t be a simple referral, but in the office, this means either you’re in their office working, or maybe they come to your office, realize that a lot of nurse practitioners, CNS and others are traveling. Maybe they come to your office one or two days a week. This might be helpful, but this is certainly a benefit for someone working in a larger medical clinic.

In fact, this might be an opportunity for someone that goes into a medical practice that does geriatric medicine to deal with low back pain and pain management. So certainly something to think of it. But bottom line. You’re going to be working for this medical provider. Now keep in mind, working for them could be under two ways.

It could be as an independent contractor. It also could be as an employee. So either way it is certainly possible. But again, you can see the limitations here. It has to be done directly under supervise. Now you may wonder, well, what does Medicare pay? So what I’ve done is I’ve just put up a few areas of Medicare payments and you all notice this increased about 10% this year.

So a nice little jump for us, of course, that also helps for the VA as well, but notice in all areas, whether I’m using California, Illinois, Florida, Texas, you’ll notice the first set is generally around $40 or higher, maybe up to 45, the additional sets in the 30 range. So I’m just going to round up. 44 first set 30 for additional sets, which means approximately a hundred plus per visit because generally you’re going to do three sets and I’m not saying always, but generally that’s what Medicare loss, that means a hundred dollars a visit that certainly can be pretty good.

We’ll talk more about that, that money part of it towards the end, but I think this is something viable. If you’re getting a hundred percent. This certainly makes a lot of sense. Now it’ll make the most sense when we can directly. Cause now if you’re working with someone, obviously that a hundred dollars per visit has to be split between two.

So therefore it may not be quite that you’re getting that full amount, but again, this is not. So again about 41st set, 30 for additional sets. Now you’ll notice if you’re doing an electroacupuncture it’s more like 50 and 40. So now we’re looking at probably about 130. If you’re doing a electroacupuncture, by the way, these fees also will apply to VA, but also the.

To Medicare advantage, which I’ll demonstrate in just a second, but here’s what you’ve probably all been noticing. The Medicare advantage is an area that I certainly would say you should be looking into. Medicare may have some limits because of the way we can access the patient Medicare managers. Aren’t that complicated.

Here’s what I took literally off of my television, where they are using acupuncture to advertise this plan. And I’ve seen this over and over notice here. Zero copay. In other words, a patient comes in and they pay nothing. Now with these types of plans, you’re generally going to have to be in network and, or be a deemed provider, which I’ll explain in a moment.

But bottom line is these are going to pay approximately the same and in many instances more, which is not bad. So when a patient has a Medicare advantage plan, this is what you’ll see. They won’t have that traditional Medicare card, but one like this and you’ll notice it literally will say. Medicare advantage right on the card or Medicare part C.

So that’s how you’ll know. Be careful though, the person will still have their old Medicare card. So always ask them, let me have all of your Medicare and all of your insurance cards so you can verify. Cause once they have this plan, they no longer actually have traditional Medicare. They have this plan they’ve traded for it.

And to give you the numbers, there’s about 63 million people with Medicare. That’s a lot. And about half of them now have Medicare advantage plans simply because the benefits with them are often a little bit better, less out of pocket. And yet what’s interesting. How has it, can Medicare advantage plans offer so much?

Yeah, it’s from a plan that Medicare is paying them 600 a month. And again, I go back to, it shows how much insurance companies profit off of others, if they could take the sickest people. So here’s an actual card for a Medicare advantage plan. And this is one that was sent to me. A member of the network was saying, Hey Sam, what does it mean in this Medicare advantage of place?

The Medicare limiting charges, and often that’s misunderstood because acupuncturist aren’t part of Medicare. So you’ve never heard the term limiting charge. Medicare has fees that are called par non-par. The limiting charge is literally 15% higher than the regular rate. So you remember those fees, I just showed you add 15% to that.

So let’s talk now, probably with these closer to $50 for first set. So I want to make sure when you’re billing these Medicare advantage plans, don’t build what you think they’re going to cover bill your normal fee, bill, your 60 or 70. If they allow 50, they’ll pay it. But if you bill thinking, they’re only going to pay you 42.

And you go 42. Well, sure. They’re going to pay you 42, but what if they would’ve been paying you 50? So always bill your regular rate, just know that you cannot collect the difference. And this is what brings up this term deemed provider. Many times when you get into these plans, you may have to join, but often you’ve done.

All you have to do is accept the patient. But when you do accept the patient, it’s like you become in network on a claim by claim basis. In other words, we call it deemed D E M Dean to provider. And what this refers to is this, when you take the patient, then you have to accept what the plan allows. For your billing.

So in other words, if there’s a zero copay, the patient has a zero co-pay except the plant, or if there’s a small copay. Now these benefits actually are pretty darn good. As you can tell what the limiting charge add 15% to what I just said, and you can go, wow, wait a minute. Now, Sam, are you meaning $115 just for acupuncture?

Yeah, that’s exactly what I mean. Now these advantage plans are pretty good and advantage plan has to do exactly the same. As regular Medicare. So it has to cover just like it does here. What is covered the chronic back pain. But most of these plans you’ll notice here. It says acupuncture routine. You can find a net that you can find a network care provider, you know, searching for the acupuncture benefits, online directory.

So what are they looking for? This routine acupuncture. What is routine acupuncture? Routine acupuncture means they cover for pain management, no need for a referral or anything. Notice regular Medicare says they may require a referral or working directly. So I had someone last week contact me and say, Hey Sam, I heard they’re going to implement a referral.

No, no, no, no. For regular Medicare. Cause you have to be under super. But for these plans, you don’t require referrals for routine acupuncture, which means basically pain management, the same you’ll build any United health care plan to illustrate that. Take a look at how they cover it. This is the Medicare advantage plan for acupuncture.

Notice it actually covers dry needling. If you choose to do that, now I’m going to suspect, do acupuncture because that’s what you are. It pays. In addition, you can’t combine dry needling with acupuncture anyway, but notice what they cover here. It’s noting routine acupuncture codes, not a complete list. So what I want to highlight Medicare advantage plans, cover acupuncture, but also covered.

Exams and therapies, because notice it’s not a complete list. It lists the ENM codes and acupuncture codes, and then notice therapies, electric stem, infrared ultrasound exercise. It could include massage and manual therapy always think of what is within your scope. And they will. I have some offices doing some very aggressive care with this.

And while I think it’s a lot for one visit, I have one office that bills well close to $400 per visit. And he literally gets paid almost all of it under this type of plan. Now these are patients that a lot of pain and a lot of things going on, but again, pretty good. So a Medicare advantage plan is something I would probably say I’d want to be part of, because look at the access that they have, the key.

Do people know that you’re willing to take these plans? Are they aware of it? Have you joined any of them? Because to me there’s no downside. If you join a Medicare advantage plan, is there any cost? No. If you join a Medicare advantage plan, does that mean you have to join the regular plans with them?

Generally not. You can join just for Medicare advantage, which means the only downside is you join and you don’t get a patient, but assuming you get one or two more people are looking for a thing of how many people have pain over age 65. I mean, that’s almost a given for many, let’s learn to manage that so that they can start to do it without medication.

So I want to make sure you always are up to date. The American Acupuncture Council Network is always updating information. If you’re not familiar with our website, please go to our website. It’s AAC info network, nothing insurance, but info network. And you’ll notice here we put out newsletters. And one of the things we just put out Aetna is.

Acupuncture to all of their commercial plans now. So that’s a really good benefit, but how would you be aware of it without going to our new section? We want to make sure you’re always up to date. So anytime something’s changing, we’re the resource. Just go to our new section. There’s no cost for it. Just go to the new section and click on it.

Take a look once a week, sign up for our email alert and you’ll get that as well. We also posted out on our social media, in addition though, notice here about how to deal with financial agreements. Remember we did the no surprise, not that long ago. So we’re going to be a resource. Allow me to be part of your practice.

We have a hotline service where you can call me, email me, fax me on any type of information you need questions with. We’re here to help you get paid. We have a vested interest. We want your success. I do because I really want to, before I retire, making sure acupuncture is fully integrated into Medicare.

So take a look at our hotline and we’re always going to be a resource with you. The American Acupuncture Council Network, go to our site. Give us a call. We’re here. I’m going to say, thank you everyone very much. We’re going to have a special Friday show and the guests, the guest hosts will be Shelly Goldstein.

And I’m gonna say to all of you be well, take care of yourself. Remember you’re important, but it’s more important to be good. Thanks everyone.

Being Laser Focused on Patient Results – Lorne Brown

Click here to download the transcript.

I want to, again, thank the American Acupuncture Council for inviting me to continue hosting my show on their series to the point my name’s Dr. Lorne Brown and I’m the founder of healthy seminars. And I have run my practice in Vancouver, BC, and I’m the author of. Missing The Point why acupuncturists fail and what they need to know to succeed.

Our topic today is being laser focused on patient results. And I’m very excited. I’m going to give a thorough introduction to our guest today, which is Dr. Steve Liu. And we’re going to talk about being laser focused on patient results. And you’ve probably heard me talk about this before, where I say to her.

Thriving fulfilling practice where you’re helping people and you have abundance in your life as well. Yin and yang have to be in right relationship. And that yin and yang is your clinical results or clinical skills. And then there’s the practice management, your business skills, and many, I’m a charter account and I’m a CPA and I’m a doctor of Chinese medicine.

And it’s important to have those in balance if they separate or they’re out of balance and you have no practice management skills, even though. Skilled practitioner in the world, you may have no patients, so you’re not really helping that many people. So my goal is for you to develop that practice skill.

So with integrity, you’re helping your patients. So you experience abundance and you help heal your community. When we talk about being laser focused for patient results, it’s a pun, but we’re actually going to talk about low level laser therapy and how this can not only. Help with your clinical results.

And that’s why I’ve asked Dr. Steve Liu to come on with us. But also I’m going to share a little bit about this, the practice management of, by adding that special added value in your clinic practice, that you’ll become more attractive to your patients. So let’s introduce Dr. Steve Liu. He’s become, he’s not only a colleague, but he’s.

A friend of mine over the short period of time that I’ve gotten to know him. He is a licensed acupuncturist from from Arizona. He used to be an electrical and laser engineer in the Silicon valley. So he’s been fantastic for me to talk to when I want to ask about the different lasers out there and how they work, because he’s got that background and he’s combined low-level laser therapy, which the scientific community calls photobiomodulation and what we call laser acupuncture.

In his acupuncture practice. So he’s integrating the two and it’s been doing that since 2000. So he’s had quite a few years since the year, 2000 of combining those. So he’s the perfect guest to have on our show. You should know that he is a member of the north American association for photobiomodulation therapy since 2001.

And he was it’s presidents from the years, 2008 to 2010. So that’s quite a feed as well for an acupuncture. To be ahead of that north American laser association. He also served as the president of the Arizona society of Oriental medicine and acupuncture as well. And he’s also served as a board member of the international society for medical laser application.

So you’re starting to see. Steve is very involved in the communities and sits on boards because of his skillset and his knowledge. And he founded in 2006, the American society for laser acupuncture as lat and in his practice. He treats many conditions. He’s going to talk about some of the neuropathy chronic.

Alzheimer’s disease and Parkinson’s disease as well. So let’s bring Steve on and I’ve got some questions for Steve. I want to let our audience know right away. Steve, these are the questions I’m going to ask you. So for all those of you, why do you want to pay attention? I’m going to ask Steve why laser acupuncture and regular acupuncture, why he sees it as a perfect.

I’m going to ask him what he’s using it for in his practice. Why are people attracted to his practice and what is giving him better clinical results since he’s doing the combination. And then we’ll talk a little bit about as lad as well. So Steve, welcome to the point. I’m so glad to see you again.

My good friend let’s dive into this why laser acupuncture and photobiomodulation also knows a lot of laser therapy. Why do you think this is a perfect marriage for us acupuncture?

Thank you Lauren. Thank you. Thank you again for the wonderful introduction. And my name is Steve Liu. I’m a laser acupuncturist.

That’s what I call myself now. I think there’s a three folds Y acupuncture and TCM will form a Perfect marriage. And number one we see a lot of older patients. And I always tell my older patients that we are not 20 years old anymore, including myself. So our healing ways slow. So we, as as an acupuncturist, we always try to convince patients that how to help heal faster, but then they are older and laser can leave.

Help speed up that healing along with acupuncture treatment and number two, or, some patients may be afraid of needles. So they are needle phobic and kids, especially, and younger people or even older people. So you can use a laser acupuncture in place of of the needles.

And number three, I think is the most important part is the. When you see chronic pain, which is what we see all the time, it’s very challenging as and because these are patients that came from, I call them medical rejects because they’re being rejected by the medical professionals, whether it’s medical doctors or chiropractors.

And because the techniques they tried and they don’t work for these patients, then they come to us as a last resort. And how are we going to heal these chronic. And laser is the one acupunctured get the healing started. We know that we can do that. And then once we got healing going, we need the laser to help speed up.

And I think that’s the best part of that in this matter.

Yeah, I think I’ve heard you call it. It’s the great normalizer. And so you’re finding that using the laser with your acupuncture, you’re helping these older chronic patients bodies behave more like they’re younger or an acute stage. So you’re getting those results.

Yes. I love that term normalize it. That’s why I use that too, because when you have a older patients and how do you get this healing going? Just like a young people and whether they are 60, 70, 80, 90 years. So I have a, my oldest patient now is 95 year old with chronic back pain. And she’s walking around with pain, without pain.

How I can do it because I normalize that. And with acupuncture using laser. So I love that word, Laurence, the normalizer the laser to normalize,

What are the conditions that you predominantly see in your practice? And I know there’s many out, like I predominately see gynecology, fertility, PCs, endometriosis, and I’m using my acupuncture laser.

You’re doing a lot of other conditions outside of the fertility. Can you share where your clinical experiences. The laser acupuncture along with acupuncture.

Yes. I love to talk about that because later I always tell patients that. Photobiomodulation works on cellular levels and what are not cells in our body is everything right?

So we, this laser work on muscles and tendons and soft tissue. That’s what I really like to work on because as I see a lot of these cases in my clinic, but they also work on the nerve tissues and which is very challenging for us like a neuropathy. And I wrote an article for the acupuncture today a few months ago that.

To me, it’s a, one of the best technique we can have is combined, combining acupuncture, like often and toes around the toes. But at the same time, use the light right around the toes and balls of feet, because that’s where the nerve has become dysfunctional. So this is why the nerves also offer quite very well.

Laser works on the Mito con. So for instance, Parkinson disease, sometime the scientists called the mitochondrial dysfunction in the brain, even though it could be the substantial Niagara without the they’re not producing enough dopamine, but what if you shine the light in the brain? And there’s a tons of study for that.

So why don’t you combine the. That body acupuncture, scalp acupuncture with light over the scope. And it’s wonderful combination that you can have. So this is why there’s an unlimited, sky’s the limit. Really? The sky’s the limit. When you combine in photobiomodulation laser therapy. With acupuncture.

So this is why anything you can think about you can use laser. So I don’t have any pain case that without laser, it’s always as a part of the electricity on the needles. And I always have laser around the needles and I always have a heat over the needles. So I called it the whole enchilada.

So this is why it’s a wonderful results. And that’s why we can get referrals from your clients. And from the top.

Sorry, I just want to summarize that you’ve been using it in your practice to help slow down the progression of Alzheimer’s and Parkinson’s disease. And you were sharing a little bit about the mechanism.

It, it’s outside the scope of our interview today to go into detail, but there’s photobiomodulation that you’re using in your practice. So you’re using it as laser therapy. Then you’re doing laser acupuncture, laser on the points, and then you’re doing needle acupuncture. So that’s what you’re doing.

And the mechanism of photobiomodulation the laser therapy. You talked to the mitochondria, the battery, the cells. And so if those batteries of the cells are repairing, they can divide better. So there’s that healing response and what we see with Alzheimer’s and Parkinson’s regulates inflammation. Chronic systemic inflammation is becoming the cause of so many diseases.

So if it can help with that, Reduction in pain and then all these other disease processes, scar tissue, and adhesions. So if we think of all of those injuries with scars, and then you talked about the nerves, even nerve regeneration, and then blood flow increases blood flow to the area. So that’s why, we’ve talked, you said is the perfect marriage, right?

And then the needle-phobic patients, this just opens up your practice to everybody now because there’s probably. Close to 50% of the people that would want to see you as an acupuncture, see, to get relief, but they can’t come through your doors because their fear of needles is so bad. And so by doing non needle acupuncture, you now open your door to other people.

I often hear from our colleagues, that are doing the needle, that all, how can laser acupuncture work or is there a research that it works? You and I both have access to the needle and the laser, and we love using both. And we. The laser. So that’s why I like hearing from you because you’re not biased because you have both, you’re trained in both and you can use both and you are choosing use both, but can you share, is there research, what’s your, what are you aware of about the research on laser acupuncture, having an effect on the body similar, or if there’s any difference from needle accurate?

When I thank you again, Lauren, you’re such a good summarize a thank you. And my, when I first heard about laser acupuncture with my from my mentor, Dr. Margaret Naser in Boston, and that she published first study on the. With the laser acupuncture, you can look it up. And and she was so excited when that first heard about her and got to know her, and then she got so excited.

And then call me up since this is the first time in may journal American medical association journal that actually published a study that contained word. Acupuncture and laser acupuncture. So that was the first thing. That first time I was just blown away with what laser and laser acupuncture can do for something like a carpal tunnel, as you can see, involve a median nerve.

So what happens in front of this? I began researching more and more. There’s a study that I run into a study. They use a regular laser acupuncture, shine, the laser lights on the acupuncture point in the year to help quit smoking. And I love to see more studies and I would love to do someday in the future that I can do on the quit smoking.

I do acupuncture, quit smoking myself. But when I come to like a pain, like a lower back pain and a soft tissue injury pain, and I really have to combine acupuncture in the. And the laser member lasers there to help lower the inflammation. We don’t stop inflammation. Inflammation is a part of a healing.

That’s how acupuncture help. Okay. So when we put needles into the tissues, guess what we produce some low level inflammation, and that’s why we need. But lasers is there to help speed up that, that mechanism Becca kickstarted by the acupuncture. But when patients really have a problem with needles, for instance, you can use laser acupuncture in place of the knee points.

So you can use a red lasers on the distal points like. All these points on the fingers and the palms and the risks. And then you can use an infrared lasers on the body, like a stomach 36 and spleen six. And so on screen 10. And deeper because you want to target the third nerves underneath that acupuncture point.

So this is why we can combine laser and acupuncture or laser acupuncture by itself. So this all can come to. In the therapy

and not all lasers are created equal. And so the wavelength matters. So the color of the light’s going to matter about how it’s going to affect the cell, the tissue, and how deep it’s going to go.

The power of the laser is going to affect. The dosage of photons at the target tissue. So that’s important because how much time you need to keep the laser on the body. And so some of the lasers are, can be a large investment for acupuncturists. And this is why I love talking to you because I know Steve that you’ve built lasers because you remember everybody Steve’s a doctor or Chinese medicine, and he’s also a electrical and laser engineers.

He can look at a system. He actually helps some of the manufacturers improve on their systems. Cause he’s got that skillset. I wanted to ask you a little bit that first of all, not all lasers are created equal. So some lasers, although there are a couple hundred dollars, they’re no different than using a PowerPoint light.

You’re not going to get any therapeutic value really on it. So still. You have to invest. It seems to get a good laser. Personally, I want to share this story and then just talk about how you have found that, how this is helped your practice grow by having the lasers. And th the story I want to share with you is my first laser I invested in.

Was about $6,500. And I used it for onsite for IVF clinics, laser acupuncture because the clinic had shown that it increased implantation rates by 15%. So that was a big investment and that’s what I use it for, but I wanted to get the results, help my patients. And it made our patients more attractive to our clinic as well, because we were offering this and then I wanted to help with egg quality, and that required a different laser system and help with endometriosis and polycystic ovarian syndrome and and engaging the relaxation.

There’s lots of things we can do with the. And so that system costs me $20,000. Now I got to share something with you that I was not expecting, but I understand why it ha it helped. Because when you create value, the marketplace, your patients will seek you out. They will. They will see you over other people.

They’ll actually people get on planes, pre COVID to are to go to our clinic, to be treated with our laser for fertility and PCRs. They’ll drive an hour in my city to come to our clinic, even though there’s many acupuncturists in their area, because they want somebody, a clinic that has the experience, the knowledge and the good quality lasers to get them results.

So here’s the quick story. And then I’m curious to hear what your experience has been I have when I introduce the laser for fertility in our clinic, several of the patients that I was treating, and let’s just say they were being charged $95 back then for acupuncture only. And I would recommend twice a week and many of them would say they couldn’t afford twice a week.

So they’d come once a week. Or some of them said I can’t afford. And they did not have. When I introduced the laser, we increased the price of having acupuncture with the laser. And so we increased the price to say one for $140. So actually it was 130 back then. So 95 for acupuncture only, or 1 35 for both.

And what we know, and it was three times a week because we were following a group that had done, had seen an improvement pregnancy rates when they did the laser fertility approach three times. In the follicular phase. And so we replicated that and that’s what we educated our patients, these patients that said they could not afford $95 once a.

Or even twice a week, it started coming in three times a week. So what I learned from that is it wasn’t that they couldn’t afford it was that they didn’t see the value in what I was doing in acupuncture, how I educated them to spend $95 a week or $95 twice a week. They just didn’t see the value there.

But when I shared how laser fertility has the potential to improve egg, quality and pregnancy rates, whether you’re trying to concede that. Or an IVF and share some of the research. They then were willing to pay 1 33 times. To get the results. So it was never always about the affordability. It was. Is there enough value to pay that much money?

So I wasn’t expecting that, but that’s what the laser has done in my practice. It has made me, it has separated me from other clinics that are just doing acupuncture because many of the patients are learning about this, get an educated, and they actually want the photo by modeling. With their acupuncture.

What was your experience? Have you found that by what you’re doing and you have a fast program, which you can introduce as well because you’re getting the results in using laser. Has that also a major practice, even that much more busier before you compare to before you added the laser?

Yes. I always say results resolved.

And as an acupuncturist and. Pretty much all the time is the last resort, a practitioner that patients see and see you, you want to produce results. And to me, laser is the is probably the only way that when it’s combined with acupuncture really get the result. And because you heal, you.

And I know sometimes it’s hard to say the word cure, but then it’s how it works. And so yes, this is a value added because you can do, you can charge you $150 for acupuncture, but if you does not if you do not produce the results, it’s still worthless. But if you add it in this so in my practice, I combined a laser and acupuncture was when fee I don’t have an additional fee for laser.

I consider as a value added so that when I produce results, They are, they’re going to see effect within a few treatments and guess what? And then when they were completely here, And they are going to refer all their friends and relatives and neighbors. And then the thought is, begin to hear about you name and they began to refer their clients to you.

So guess what? You can love busier practice. That’s how I see it. And that’s why it’s a laser is a result driven. And and I absolutely agree with you that Lauren is. I don’t think it’s really the money. It’s a, it’s the result when the patients see the result and they say they will pay for it.

Yeah. Definitely want to get, they want to get the results and adding the laser helps give you that result. And they also is the education like, so when the understand for whatever reason I just, it’s an observation. They understand photobiomodulation, it’s more modern, it’s more sciency. And when you can see the mechanisms, they understand that and they’re willing to give it a go or give it a try where acupuncture is old and they’re questioning it.

I’m not saying it doesn’t work. I use both. So it does work. And I have found that it’s. It’s something that has been attracted to patients. And I always say in my book, and when we talk at the beginning, we want to help them with integrity. So when you charge, because again, when you’re making investments in $20,000 lasers and you only have so many there’s value there.

So if you choose to charge more. You’re doing it with integrity because Ava invested in more equipment, but your patients don’t care about that. They don’t care about your debt or how much it costs you. They care about what kind of value they’re going to get when they pay you. And so I’ve made that investment and then patients are willing to endure.

In me because I have the tools to help them get the results. I know in your practice, you have a program called fast for chronic pain, and you go off and we’ll help people under 10 treatments get incredible relief, chronic pain, and so that makes you busy, but that fat program requires laser and it does.

Correct?

Absolutely. It’s the key F a S T I came up with this idea is how to heal and again, a lot of the time you can cure these a chronic soft tissue problem, like tennis elbow, conference elbows, and people come in and say, I bought these for three months. I have these for three years.

Why? Because all the cortisones, no, the anti-inflammatories and all this, they literally stopped the healing. But the needle is there to help kickstart a healing. But how do you get this healing going in the better rate, quicker rate that could useful rate? When Joel, like when you were in 20 years old laser lasers there to help speed it up.

And so laser is really the key and to help. And so I can literally tell my patients that with intent treatments, you will be. Done. And then the pain’s all gone, all completed relief. So this is why, and I’m I’m very proud of this this program FST and you can look it up and I intend to bring it up in my conference with Aslan, which is American society for.

Lola laser acupuncture therapy asset work. And we’ve intend to have a conference in this later this year and that bring this fancy program certification program out. And I’m working on that pretty much every day, try to figure out how to get this program together and in module of structure and Lauren and I are trying to figure out how to put this one together.

Yeah, looking forward to that. And so that’s, website’s important. So if you’re looking for more information about laser acupuncture and photobiomodulation, that’s the term that’s replacing low-level laser therapy is photobiomodulation and laser acupuncture, check out the athlet website. Cause you’ll see more information available there.

And this is something. Again, I’m going to put the practice management twist on it is when something is a value and people want it. Then other people start to offer it just like acupuncture. It’s not just train acupuncturist that offer the acupuncture nurses. Do it, doctors do it, physios, do it.

Chiropractors do it. I know in our profession. Acupuncture’s don’t like it, then other people are doing acupuncture, but when something is effective, other people get it into their scope with photobiomodulation laser acupuncture, massage therapy are doing it. Chiropractors are doing our physios. They’re doing it.

So it’s out there. It’s really big in Europe, but more so in Australia, less so in north America and in Canada, in the us. But it’s great. It’s gaining a momentum so quickly right now. And so this is. Learn about this because. It’s going to be something that if your colleague has it or the physio has it, and if the physio can do acupuncture and laser, and you only do acupuncture as a public member, you’re going to go to somebody that can do both.

Steve said, one fee for both. Somebody’s going to go see him versus somebody on the same street that can only do acupuncture. So this is my invitation that. If you don’t give this some attention, there’s a possibility that you’re going to miss out and other modalities, other professions are going to have incorporated this.

So I think it’s important that acupuncturists incorporate, especially the laser acupuncture part. And as Steve said, at the beginning, it is a credible marriage. Practitioners that I talked to that are using photobiomodulation with their acupuncture. Never turned back. They love it. And again, I, my whole focus is on gynecology, fertility using the laser acupuncture with my needles.

Steve, I want to thank you again for joining me today. Can you tell us a little bit about asthma? That’s what we’ll finish off here. But just tell us a little bit. The asthma organization that you’ve created and just what’s available for acupuncturist on that website. Yes.

Thank you. Lauren athlet against Stanford American society for laser acupuncture therapy.

I came up with this idea back in 2006 and I reserved the domain name as lab. Beautiful. And it’s nice and short, and I need to have this name reserved obviously long time ago, but I haven’t had a really chance to really get him going until last year. And then this is really the year 2022.

We’re going to learn. I help bring this to the community. This is a, you can look it up and there’s a mission statement. I really want to use this as a community for Acupac. We are the acupuncture. We cannot own laser acupuncture, not any other like chiropractors was physio in massage therapists.

We are going to have it. And in order to, for us to integrate this tool into our practice, you guys need to, of course be educated. And I love to be the educator and also teach you how to sell. Lasers devices and what is technology and what is led and what’s the different between laser and the LEDs and what are all these companies they’re making all these devices, then what’s the protocol for all of these providers and so on.

So this is a community I like to have, and that’s always all for us, the acupuncturist. And then, so we can. Successfully integrate that into our practice and make like a Lauren. I know Lori is a very passionate to make us a good businessman as well. And it’s important. It’s Ian in not only need to have a good skills, but we gotta be a good businessman.

You notice this. Thank you gotta

have. You gotta have those business skills. So it’s not so many people give it a negative connotation. And we’re talking about, you just got to know how to run a practice. You got to know how to charge for things so you can keep your doors open so you can keep treating your community.

It’s just really simple. It’s matte and you can do it with integrity. And so that’s where we talk about the laser therapy today and laser acupuncture. So as lab we’ll have a conference or as a conference, it was information. Unhealthy seminars.com. We have continuing education courses available for laser therapy.

On our community library, we have many interviews with experts and researchers on laser acupuncture, Dr. Steve Liu being one and is going to be offered many more. So do check out healthy seminars.com for the photobiomodulation laser acupuncture courses. All right. You’ve been listening to. To the point with AAC and tune in next week when Sam Collins comes in and joins us on the AAC to report to the point show.

I want to thank you, Dr. Steve Leo, and I want to thank you guys for tuning in today.