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Dr. Virginia Doran

The Science Behind Promoting Digestive & Cardiopulmonary Balance with Acupuncture

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– Hi, I’m Virginia Doran, your host for this episode of “To The Point” very generously produced by the American Acupuncture Council. Today our show is called A Fresh Perspective on Zu San Li, Stomach 36, and Neiguan, Pericardium 6. The science behind promoting digestive and cardiopulmonary balance with acupuncture. And I am so honored and pleased that we have as our guest today, Narda Robinson. Narda has a very interesting history and approach with this. She has a Bachelor of Arts from Harvard, Radcliffe, a Doctorate in Osteopathic Medicine, a Doctorate in Veterinary Medicine and Masters Degree in Biomedical Sciences. She’s a Fellow of The American Academy of Medical Acupuncture, Vice Chair of the American Board of Medical Acupuncture and a former member of their board of directors. She has launched the first Integrative Medicine Service at Colorado State University and for eight years has directed Colorado State University’s Center for Comparative and Integrated Pain Medicine. She’s taught a variety of scientifically-based continuing ed courses ranging from medical acupuncture and massage to botanical treatment and photo medicine. She’s a leading authority on Scientific Integrated Medicine from a One Health perspective, having over two decades of practicing, teaching and writing about integrative medicine approaches in both veterinary and human osteopathic medicine. She’s the founder, CEO and Lead Faculty and Course Director for the CuraCore MED and CuraCore VET based in Fort Collins, Colorado. And she’s also the author of a most wonderful book called “Interactive Medical Acupuncture Anatomy”. It’s very comprehensive. She has a very interesting neuroanatomical and evidence-based approach. So I don’t know how she’s done that all in just a couple of decades because it’s really quite formidable her accomplishments. So for anybody who hasn’t seen it or who can possibly get it and now that you’re home staying in place, you might actually have time to read it. I really recommend the book. You can find it on Amazon and see some excerpts there, as well as if you search on Google, you’ll see some highlights from it as well. It really adds to our field by putting a lot of the scientific point-based research altogether with the points in, it’s a book of points basically, and explains with a really comprehensive describing of the neuro, not just neuroanatomy, of all the anatomy that contribute to the points and how that actually affects the uses of it, and basically verifies what we’ve learned from, you know, classical sources. So, I guess how I found the book was a student took my class and he was an osteopath and he came up on a break and he said, “Oh, you have to see this book.” And I was kind of like, “Yeah, yeah, whatever,” he was new at it and I just didn’t expect much. And then he showed me, I was like, “Oh my gosh.” And then I had to buy it. It’s not an inexpensive book, but with the work that’s in it and the information that has been assembled all in one place like that, it’s very valuable book, I really recommend it. It can be used however you think about things, but it can help verify things for your patients and the field of Western medicine. So without further ado I’d like to introduce Narda, and give it to her to explain this from her experience and knowledge which is formidable. So Narda, thank you very much for being here.

– Thank you, thank you Virginia, it’s great to be here. We’ll be talking about, Zu San Li and Neiguan and while I am presenting a big focus on the points themselves, I am going… In clinical practice of course we use other points that are mandated or suggested by the patient’s presentation. So this is though is an opportunity to see how some of the mainstay approaches or the mainstay points such as Stomach 36 and Pericardium 6 work from a neuroanatomic perspective. So as you can see here on the left, we have Pericardium 6 in the forearm and Stomach 36 here on the pelvic limb. And just in a different form here is the individual with a different view of the hand so of course when we move around the point locations change, here’s Stomach 36, in just part of the larger context because when we again want to use these clinically for something like Stomach 36 we might want to treat knee pain, we might want to treat pain in the calf, we might be addressing immune function. But if we are working with something for digestion from my scientific neuroanatomic connective tissue approach, I am going to be interested in how stimulation of this point, whether we’re using needling, pressure, heat, laser, whatever it is, how is that going to affect internal organ function? Because I think that that is one of the perplexing ideas from Chinese medicine where we can say it balances Yin and Yang or moves Qi, but we also have information now on exactly how this is going to affect internal organ function. So the objectives for today are three. We’re gonna review some of the Chinese medicine indications and mechanisms for these two points, we’re going to identify key neuroanatomic connections between each of the points and areas of the spinal cord and, or brain. And describe how knowing the structural underpinnings, which was everything my book was about, but of these two specific points, how we can link that directly to the physiologic outcomes that happen from needling, which I as a clinician, as a veterinarian and an osteopathic physician, I appreciate knowing how the points are going to influence my patient and to know that there’s quite a bit of scientific background and backing for what I’m expecting to see. And I will talk as we go forward about how to search for scientific literature so that when you want to come up with papers that substantiate what you’re doing, that you can see how easy it is to do that. So with the images that I use in this, if they are not from Shutterstock photos that I have it mentioned here, so this is from TCM Wiki. But just looking at the stomach channel as a whole, we can see that there is often described in the Chinese medicine kind of literature, a divergent branch that goes to the organ after which it’s named. I mean I learned acupuncture from I mean a variety of perspectives. The Chinese component, the French energetics, the scientific approach, neuroanatomic connective tissue. So I had that as a background. And so this idea suggests that you have energy or Qi going into the stomach somehow and hence the stomach line is a name. And that maybe the idea from that would be that, okay, you stimulate Qi and somehow there’s a branch that takes that to the organ. But what I’m going to add to that is the knowledge about the actual structures that we can dissect and feel and test that give us objective understanding of what these sites of stimulation will do. So again, this is one of the images from my book and it’s with all the different layers on. Because what happened was this was from the Visible Human Anatomy Database and there were computer animators that put it all back together so that as I was photo editing for 15 years, I could add in muscles or take away muscles and just see vessels and nerves or organs or things like that. So by starting with the points on the surface and then going down and removing the skin layer from photo editing, then I could see the different structures that I would be stimulating as an acupuncturist, plus using neuroanatomic information from other sources as well. But this is Stomach 36, as you would see with the skin gone. And the description being on the anterior aspect of the lower leg, three cun below Stomach 35 which is up here in green and one finger breath from the anterior crest of the tibia, which we can also look at as a tibial tuberosity right here. And this is a cross section which I really appreciated learning by dealing with these cross sections, learning the different depths of muscles and fascia and vessels and nerves once you go into the skin, both from a safety perspective as well as a tissue activation perspective. So here on the left, I have cross section through Stomach 36 and I’m showing that, sometimes I’ll say cranial tibialis ’cause that’s what the terminology is as a vet, but the anterior tibial, and it points to how at least in an individual like the person that made up the Visible Human Database was, how far in depth we can go where it’s safe versus when we start to get into other structures. But the point of this slide being that research has shown also that we have all the different muscle afferents available to us at the point. So groups one, two, three and four, which have different levels of myelination and whether they are mechanoreceptors, so transmitting information about light touch or vibration or the subtle activation from an acupuncture needle or nociceptors, so they don’t have any myelin and they’re more conveying pain. So typically what we are thinking about as far as Stomach 36 for indications are have to do a lot of times with digestive things; gastric pain, vomiting, abdominal distension, diarrhea or constipation. But then some mood-based things, even epilepsy or depression or insomnia. Then of course local things for the knee pain or we have leg weakness or paralysis, maybe even a fibular or used to be called peroneal nerve injury. So just coming into acupuncture, one might think, “Okay, how does one point do all these things?” And so that’s what I loved in the process of those 15 years of putting this book together. Coming from a standpoint of just really relying on the Qi in the Chinese medicine approach with some of the scientific background in there. But then seeing as I would start with the neurologic connections local at the point and then put together where they hit in other reflex zones within the central peripheral or autonomic nervous system. It to me explained the effects that were these conventional indications. And so it didn’t leave anything more for me to wonder about. But just to review that the point Zu San Li changes to Leg Three Miles when we convert that to English, which has a lot of different interpretations that we don’t have time to go into. But the Chinese medicine description is that it will tonify Qi and blood, harmonize and strengthen the spleen and stomach, strengthen the body as a whole, and the Wei Qi raises Yang, calms a Shen, activates the meridian, stops pain. Okay, so that’s quite a bit of complexity there. And so what can we start to see? So–

– You know I always say that Stomach 36 does everything except wash windows.

– Yeah, yeah, that’s good. Or like with laser therapy, sometimes when we lecture, talk about it treats everything but death. So I guess maybe you could, I mean you say it tongue in cheek, but that’s a good point, Virginia, yes. So with Helene Langevin’s work, from the ’90s that the needle-tissue interface has been described as, as you see here being able to wind around the collagen that’s in that connective tissue, and then with that we are deforming fibroblasts which is activating their metabolism, causing them to make all kinds of changes through their structure function, just alterations, but there are also nerves in the vicinity. So while we are doing some connective revisions or interactions causing some fascial relaxation, even several centimeters away, there’s also that profound effect which is on the nerves which is neuromodulation. And that will get us into some of the analgesic effects and some of the autonomics or the parasympathetic, sympathetic or the digestive system, the Yin-Yang general balance. And then just taking this from a website talking about modulation, like what is modulation? Well, it is putting in your own signal that is going to interface with what is already there. And so you are modulating or you are changing the status, the resting tone of what that organism is going through. So that when there’s an imbalance, we can come in with our somatic afferent stimulation, meaning on the surface, the somatic afferent, the afferents, the nerves are coming into the nervous system equation and then we are stimulating it initially, but the body is going to respond with a modulating effect. So we are relying on the intrinsic healing mechanisms, self-maintaining mechanisms of the body to take our input, our somatic afferent stimulation with the needling and do what it normally does, bring it back to normal. So it’s like, “Oh yeah, right, this is what normal is.” And we’ll talk about how that happens. And it’s comprised of some neurotransmitter shifts, whether peripherally or in the spinal cord or in the brain, and then other things that happen with larger brain networks. For the analgesia or the pain relieving approach, we can distill some of it down to what happens from our input. So not a pain causing, that’s where having a nice gentle approach with acupuncture is so important where we’re subtly manipulating the needle and that is going to activate the mechanoreceptors preferentially. And what that means, so those receptors respond to light touch or vibration. Think of just a nice gentle soothing electroacupuncture. These are thicker well myelinated fibers that are important in pain control when they get to this dorsal root ganglion. So they’re the good guys. I mean the ones that convey, they’re also good guys ’cause they convey information, or tissue deformation. But let’s say you had some kind of pain elsewhere or if you needle too aggressively, that is sending information through these other types of fibers, the nociceptors. So we really wanna touch or inputs in the way I teach is to be gentle and well-received. There are gonna be some responses in the dorsal horn of the spinal cord that connect to that hand in this case. And those light touch receptors, the mechanical receptors, I think through the next side we’ll see the gate control idea of pain. They can help shut down pain influencers that are coming into that same location in the spinal cord. Of course the big complexity of the whole thing with acupuncture analgesia is that we’re gonna be affecting the whole brain and different pain networks and the thalamus and limbic system, all kinds of areas with our acupuncture analgesia. But just to distill it down right now we have those three initial areas that we’re concerned about. This is just an expansion of that spinal cord dorsal horn area where if we have acupuncture here, they have skin massage. If we just say that’s acupuncture, acupressure done gently that we’re bringing that information through these mechanoreceptors, the well-myelinated mechanoreceptors coming in here. And they are helping to block the pain impulses from on that same ultimate neuron that’s going to come up and then send impulses to the brain. So that’s just a peripheral way to block the pain impulses. This is a Stock photo. This is not necessarily how I would approach knee pain ’cause I would be tailoring it to the exact expression and location. But in general, this is electroacupuncture and I’m bringing that in because here’s Stomach 36 more or less. And they’re doing a typical four treatment before needling approach around the knee, and took it up to electroacupuncture. So if we look at knee pain, how is Stomach 36 participating in that? Well, there’s some local pain shutting down, so peripherally, but then there’s also going to be affects, I like to consider all the anatomy that’s being affected, but we don’t have really time to go into that much here. But there’s also even for knee pain going to be impulses that are going into the spinal cord so that ascending to the spinal cord and brain that are also going to be pain alleviating. And so that’s important to know from a neuroanatomic perspective ’cause we can reinforce that with points on the back and the spine that will help shut down pain information that’s being communicated in the relevant levels of the spinal cord and really reduce what we call peripheral sensitization of nerves that are going to the knee. But it’s never really knee pain. It’s we, I as an osteopath and a veterinarian, I mean we look at the whole body and what are the compensatory biomechanical alterations? Where are the myofascial restrictions? It’s really a whole body kind of thing that in clinical appreciation. But if we’re talking about digestion, one of the things that we can be aware of is that Stomach 36 afferent information is coming into the cord at the sort of the lumbosacral junction. And so when impulses arrive into the cord, there’s something called somatovisceral and visceralsomatic reflexes that we’ll look at as the next slide. Then there’s another component that goes to the brain that will cover. But seems a little bit confusing here. But let’s say we have a dysfunctional viscous, so a problematic organ in on our belly somewhere and that is sending afferent pain impulses into the cord. If those go unabated then we could get tenderness to palpation. This is the whole rationale with the diagnostic exam with the Back-Shu and Front-Mu points. So that is crosstalking with somatic or muscles, skin and subacute areas so that we get essentially spinal reflexes that are originating in a viscera of viscous. And then having a somatic presentation where we can go along the back and find tenderness to palpation and think, “Okay, is that local on the back “or is that from something inside?” And we put that together with the whole patient presentation. So there are lots of reflexes like that to consider whether we’re coming from a viscous and going into the muscles or we would come from the muscles and the external. So if we’re doing a treatment and we are involving low back points, then through these reflexes working the other way, somatovisceral reflexes, we can help to shut down some of that internal pain. So that is why I would use those baby back points in addition to a Stomach 36, I’d be palpating and seeing what’s involved. But here are typical bladder points that are associated with the spinal nerves that in my framework that somatic afferent stimulation is being picked up by the spinal nerves going into the spinal cord and having repercussions there as well as going to the brain. But if we’re talking about where’s that impulse from Stomach 36 coming, then we talked about local peripheral nerve effects very briefly ’cause of not much time and then spinal cord effects and reflexes. But then we’re gonna go up to the brain and this is really what explains a whole bunch of Stomach 36 effects. There’s a little site in the brain stem in the medulla called the nucleus tractus solitarius. Here’s just the brain stem looking at that. And the interesting thing about this brain stem center is it sits side by side with this vagus nerve, which is actually longer than this. And the vagus nerve is what is covering, you know that’s doing most of our parasympathetic nervous system. So versus the sympathetic system, which is fight or flight, this is more you’re vegging out, restorative, calming down kind of thing. And so it has effects that are going to balance out that fight or flight sympathetic system. So it’s gonna slow your heart rate, it’s going to help digestion flow and all the secretions from the gland, stimulate bile release, help regulate blood glucose, help you with elimination and digestion and all that. And for the cognitive effects, I mean, vagus nerve stimulation, so this parasympathetic medic effect is so good that it’s like they implanted vagus nerve stimulators for things like depression and epilepsy and different things. But it’s like we have the ability with Stomach 36 and some other points to actually give parasympathetic benefits because of these long loop reflexes that we now understand. And these are… So the nucleus track, the solitarius is one of the two main somatoautonomic convergence sites. What do we mean by that? This is where the somato, so the somatic input from Stomach 36 is going to join at this site in the brain stem called the nucleus tractus solitarius with inputs from the vagus nerve. So 80% of the vagus nerve that’s coming into the brain, which we just saw a bit ago, is afferent information. So the brain really needs to know a whole bunch of information about what’s going on elsewhere. And so that is coming into this site, the nucleus tractus solitarius along with information from the body of which the Stomach 36 has a nice big connection there. And then it’s like this operator here. So if she’s the nucleus tractus solitarius, she’s getting information from the Soma, which could be Stomach 36, and the viscera, which is your guts and things, and then making decisions. So, what she has to do is, well what she does, who knows how this all happen, but it because of her side-by-side connection to the vagus nerve, the nucleus tractus solitarius can up or down regulate vagal nerve output. So that means if you have constipation, you can change it and the vagus nerve can change its activity so that it speeds up digestion. So this is a structural piece of how, might call it Yin-Yang balance, but it’s how our body keeps things stable. Our temperature, our blood pressure relatively, we have these real estate centers in our brain that are in command of doing all this and keeping us alive on a day-to-day basis. And it’s really very amazing that we know this and that we can have pathways with acupuncture to deal with it. So Stomach 36 for GI problems. It’s that homeostatic balance whether we’re dealing with the long loop reflexes to the brain stem or and the lumbar segments as well. So it’s a way that we can understand how even disorders like this, which is our representation of inflammatory bowel disease. When the nucleus tractus solitarius is not doing its thing, then there is a, and with its parasympathetic effects for the vagal nerve, then things can get out of balance. And when the sympathetic nervous system, the fight or flight area takes over too much, then we get a pro-inflammatory state. So not just fire or too much Yang but its actual inflammatory state and if it’s going to affect the GI track, then we can get an inflammatory bowel condition. So by having Stomach 36 in there, then we are pushing the balance of the body to a parasympathetic level, calming things down. So if you just go to pubmed.gov you can do, see this as well. And all I did was I did Stomach 36 and NTS for nucleus tractus solitarius. And you can see various research articles, you can select for free full text if you want so that you can get this whole article for free. It’s online shopping. You don’t have to take out your credit card. So there are so many studies that support this idea that it’s a great way to move forward and to be evidence-based with acupuncture. So we just have a few minutes and just–

– You want to, I don’t know how much you have to speak about Pericardium.

– Okay

– Do you want, anything else to, you wanna discuss about Stomach 36 and do Pericardium 6 another time? Or do you wanna move on?

– No. I think we can show like that there’s another point that has similar effects.

– Okay.

– But I think we’re good. Because it has a different brain stem center for the most part and a different, I don’t know, just clinical applications. So Neiguan, Pericardium 6, again, instead of just thinking maybe there’s an energy connection there, we can look at here and its proximity to the median nerve and indication. Some of which overlap. So the nausea, vomiting piece, that’s because the fibers from the median nerve, from PC6 ultimately go to a very nearby center in the brain stem. It’s called the rostral ventrolateral medulla. But a lot of fibers go there. But some of them go to the nucleus tractus solitarius, which for me explains the GI piece here. But otherwise we’ve got cardiopulmonary indications and we can see how Chinese medicine explains it. But if we look at the science and begin again at the site, just like with Stomach 36, we know that there’s muscles and tissues and fascia and bones and here’s a cross section and especially that median nerve is nearby. But when we get to the rostral ventrolateral medulla, which is not far from the nucleus tractus solitarius, we it… that site is more concerned with cardiac, just antiarrhythmic effects and the pulmonary influences. That’s why it’s this master point for the chest. And so we look at a paper like this, for example, “Cardioprotective effects “of transcutaneous electrical acupuncture point “stimulation on perioperative elderly patients “with coronary heart disease” showing that just to cut to the chase here, that electroacupuncture at PC6 and PC4 can reduce postoperative troponin concentration so limiting heart damage and change the autonomic balance to a much improved state. And PC4 makes sense here because that was right along the median nerve if you saw that in the picture from my book before. It’s median nerve stimulation that hooks up to long loop reflexes in the brain. Here’s “The effectiveness of PC6 acupuncture “for the prevention of postoperative nausea “and vomiting in children” Again, just seeing that yes, there are brain stem connections and that is what helps us understand how physiologically, how anatomically we’re put together so that we can understand that you stimulate here and you get effects kind of body-wide or internally, and we’re not sticking needles in organs. To me it helps to really understand this wiring diagram. So the key points of all this are the anatomy or structure and physiology or function are inextricably interrelated. It’s with architecture and it’s with acupuncture and anatomy. So the more we know about the anatomy of the acupuncture points and their physiologic effects, that’s how we can better understand what the Chinese acupuncturists from way back when and Japanese and whoever else was doing acupuncture back then. They might’ve described it using metaphorical language, but if so inclined one can also understand a lot of it now scientifically. And that then informs my needling protocols, because I can take what my hands say, what my heart says and what my mind says and make treatment protocols that are very tailored to my patient based on what I feel, what I know and just a certain level of intuition but not having to have just a belief somewhere, but really having a clear expectation with objective endpoints that I can rely on. So with that , I am ready for any further questions or if you’d like, you can email me at narda@curacore.org.

– Yeah, I think, I don’t know, Alan, you can tell us if there’s any questions or if we’ll leave that for after the show. But there’s just so much you’ve presented . That’s why I couldn’t look up at the camera. I was like, my eyes were glued to the slides. Well I think we’ll, in this case, I hope you can come back another time because I feel like we’ve just touched on the surface of something’s really interesting. Some people will ask questions and they can be addressed after the show. Thank you again for coming and thank you to the American Acupuncture Council and to all our viewers and hope to see you next time. All right, bye now.

– Bye bye.

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Poney Chiang Thumb

Neuro-scientific Posturology – Poney Chiang and Annette Verpillot

Hi, welcome to today’s Facebook live [inaudible 00:01:08] show for American Acupuncture Council. My name is Poney Chiang, your host for today, and I’m coming from Toronto, Canada. I’m a continuing education provider, and acupuncture practitioner and herbalist. Today it is my honor to have the opportunity to interview our special guest for today, Annette Verpillot. Annette is a founder of a company called Posture Pro, a health company specializing in restoring the brain body connection. She’s a Canadian entrepreneur, therapist, public speaker and internationally recognized posture specialist.

Annette has developed some of the world’s most advanced rehabilitation and injury prevention techniques, and she teaches this method called Posture Pro to professionals in various fields. Her unique posture evaluation system is recognized throughout the world for eliminating chronic pain, increasing strength and improving sports proficiency. Through her teaching, speaking and research, Annette tackles global health issues and trains professionals to have a lasting impact on clients and patients. Thank you very much for joining us today, Annette.

Thank you so much Poney, for having me on the show. It’s a true honor and pleasure.

Can you tell us where you’re joining us from today?

I’m located in Montreal, Canada. You and I are not too far away from each other.

It’s only five, seven hours drive maybe.

Yeah, I prefer taking the plane. But yeah, it’s fairly close.

Yeah. So the reason why I wanted to invite you to our show today is that I understand that you have a very special way of addressing posture. And what fascinated me about your method is that you incorporate a lot of application of the understanding the peripheral nervous system, the central nervous system, and even using cranial nerves as such. Would you be able to tell us how did you become interested? Were you always interested in posture aspects or interested in neurological things?

Yeah. I come from a family of neurosurgeons that from France moved to Canada at the time when I was much younger. So I was raised in a medical environment where I would always listen to my aunt and uncle talk to my father about the latest in neuroscience. I was always very much interested in the medical field. I recently found a book of myself, a book that they had asked us to draw a picture of yourself of where you saw yourself in the future. And in this book I wanted to be a surgeon, a neurosurgeon, and then I found the picture. It was actually really quite funny. So I’ve always been, I guess indirectly involved, not really realizing it in the world of neuroscience, of course through my family.

But at the same time I was always very much involved in movement in sports and very quickly became aware of the aspect of movement and performance, and of course injury because I could remember my father saying to me, at the time I made it to the Games of Quebec, and he was like, you can’t go to this because the ultimate goal is for you to make it to the Olympics. This is how it starts, and by the age of 30 your body will be ruined. And I remember not being very sad about this because he literally interrupted the whole process. But now that I think back, I guess the myth of movement, and training, and athleticism and injury go hand in hand.

May I ask a what was your area of focus specialization in sports?

The 100 meter sprint was my specialty. No one can catch me.

Very impressive. I know it’s a very diverse, and broad and in depth topic, can you tell us a little bit about Posture Pro?

Yeah. So Posture Pro opened its doors in 2004. The idea was to combine training with rehabilitation. At the time I had studied different types of rehabilitation therapies to be able to accommodate my clients. I myself went through some injuries while I was training. I’ve always been involved in fitness and trainings as far as I can remember, and for me was something that was very important to be able to try to address injury. So of course I naturally learned rehabilitation methods and techniques to be able to apply them with my clients in practice. Very quickly realized that working manually was only providing temporary results, not really understanding why that was actually happening and kind of following the flow that everybody does. They teach us to do A, B, C, D when you find that there is different types of local problems, but I guess that part of the problem that eventually I came to realize was that they were not really telling us why the problem existed to begin with. So the cause behind the symptoms that we are taught to manage. So, a quick Google search kind of got me going on the way, and then associating myself with different professionals and specialists in their fields, really some of the best in their field as far as rehabilitation, to try to combine all of this knowledge together to create what we call today the Posture Pro Method.

Can you tell us a little bit about the approach or the rational in it, how is it different or what makes it more effective, for example?

Yeah. So combining the knowledge of neuroscience, and biomechanics and movement all together, but also the knowledge of how the brain develops in the first place in human beings and working with a method that allows us to kind of connect which brain part, brain, body connection parts are broken is what I find makes our method unique. We work on what we call specific sensory receptors. Yes, we do work with the eyes, obviously the cranial nerves that innovate the eyes. But where I think our strength lies is in all the links that we make within those different cranial nerves and the symptoms that we’re seeing in clinic with our clients, but also the fact that we address one component that I think is the missing link in most therapies, which is the weight bearing surfaces of the clients that we’re working with.

We never really take into account, I mean in North America when we talk about the feet, we tend to think of feet specialists or podiatrists, but in reality what we’re looking for is the way that this person learned how to walk in the first stages of their lives, which we know is ultimately between zero to 12 months of life, and the postural strategies then that the clients will then develop and the links between the symptoms that they’re presently experiencing, the posture that they have today and the brain connection or the broken brain connection, if I may say, that they are living with which are creating the symptoms that we are seeing in our practice on a daily basis. And this holds true for children as well as adults.

So there’s a lot of emphasis on the information inputs coming from the feet. You mentioned about the vision. What are some of other important inputs that you take the time to assess or provide exercises for?

Yeah. So another really interesting link is the position of the mandible, the position of the jaw, and how the actual stomatognathic system will develop how the motor acted, the tongue posture, if you wish, nasal breathing, all of that complex has the potential to influence head posture, position of the head on the shoulders, which will challenge your center of gravity. The ultimate goal for us, what makes us human as humans is the fact that we’re bipedal, and fighting this we’re constantly fighting against gravity. And how we fight gravity ultimately will dictate how much energy we have throughout our day. So for example, someone who has what dentists call a class two occlusion, which is where the upper teeth of the maxillary will cover the lower teeth by more than one third, this will bring about, how can I say, the mandible will move up and back pushing the head forward.

And this would be a permanent state of disequilibrium that the client would be living with, which we can very easily imagine how this can cause lower back pain. But there’s also missing teeth, there’s also tongue posture and there’s also many other links that could be made within the TMJ in itself. As well we work with pathological scars. This is any type of surgical intervention that someone may have had. We treat it with either essential oils or with laser therapy. Would love to learn about acupuncture. I know that acupuncture is absolutely phenomenal when it comes to pathological scars. But where we try to make the link is again with the symptoms that the client is experiencing and whether or not the scar is actually creating a postural, a muscular imbalance in the context of the session.

That’s very interesting. So you mentioned the tongue posture. Most of our listeners are acupuncturist, and we actually really love to diagnose each other’s tongue and our patients’ tongues. I think they would be very interested to be able to add a dimension of postural analysis from the tongue. You also talked about equilibrium. I was wondering if the vestibular or the years come into play in this system, or is more focused on jaws and other inputs?

No, we do absolutely consider the vestibular, the vestibular ocular reflex. But what we’ve tend to see is when we actually realign someone’s posture by working on their feet, we really always start with the two extremities, the sole of the feet, the eyes. Is there anything going on with the jaw? If there is, we must neutralize it. We like to work by process of elimination. What’s causing what? Is it the feet, is it the eyes? But we know that ultimately all of these sensory receptors together have the potential to affect our posture and our stability. So what we’re going to try to basically, how can I say, what we’re going to try to determine is, is the client clenching even? Are they excessively stressed? We know that stress is psycho-emotional. When I’m stressed, I’m going to clench my teeth. But some clients who are doing this or patients who are doing this on a daily basis are not fully aware of the negative impacts that this can have, not only on their posture, on their hormone production, but on all of the different physiological systems of the body, really.

Right. Fascinating. That’s definitely something, clenching and a tight muscles of mastication, temporalis muscles. Those are actually a lot of things that acupuncturists see on a daily basis. So I think there’s definitely a lot of opportunity for an acupuncturist to employ some of this diagnostics, perhaps even use that to not just reduce the stress and the pain, but actually improve posture from that. As you know, acupuncturists is kind of well known for treating pain, and now there is actually more of a movement in the acupuncture community where we’re trying to start to use acupuncture to affect neurological issues. So Parkinson’s diseases and stroke rehabilitation. And obviously there’s a lot of gate problems in these visuals, postural problems in these individuals. So that’s really why I became interested in your work. Could you help our fellow listeners understand how might your work or being an expert in posturology make them better at what they’re doing?

Yeah. Well I mean, as you know, Meridian’s is kind of like an energy highway that flows within our body, and if we look at the way that someone’s posture has developed, and I put the emphasis on this, because understanding how someone developed their postural strategies from the get go is a really important factor in determining where they are at today. So I’m not an acupuncturist, but it’s very easy to imagine and understand if someone has a forward displacement of their center of gravity, a lower shoulder, a rotated pelvis, vertebraes that are in a subluxed state 24/7, poor body posture, I mean in that context, can poor body posture affect the energy flow within our body? We know that it can affect many other factors from our sympathetic to parasympathetic, to our circadian cycle, digestion, blood flow, stress, and of course energy within our bodies. So I think there would be many benefits of incorporating the Posture Pro Method with any type of therapy, but also Meridian therapy and acupuncture because it will simply just enhanced and double the therapeutic effect. If someone’s posture is better aligned, you’re actually giving them the chance to be able to fully recuperate and tap in into that healing process that they have within themselves, and of course the natural flow of energy that we all have within us.

I’m just going to sprinkle a little bit of Chinese medicine terms for the benefit of our listeners. For us, we talked about points around the neck that are called window to the sky points. These points directly affect psycho and emotional presence and awareness in health. So you imagine how problems in your neck can actually cause psycho emotional issues. For acupuncturist thinking in terms of those points around the spine called the back shoot points which affect individual organs. So if you are having subluxations or you’re having abnormal curvatures, it would affect the energy aspect of the bladder Meridian or affect those back shoot points and they can actually cause internal somatovisceral problems. So I think knowledge of this posture analysis comes hand and hand with acupuncture, and I think there’s a lot of things to be excited about, about how we can actually combine these knowledge to actually improve our ability to help patients, both physically as a posture aspect, but also internal viscerally. Because after all, the nervous system is [inaudible 00:16:49] and she controls all of our autonomic systems also.

If I may just add to to what you just said, I very much appreciate the description that you just gave. So within this complex as we know, and again, from the method that we’re working with, if there’s a crossbite, for example, or poor breathing habits that have been acquired since the beginning of life, or eyes that are not tracking properly through the cranial nerves within the brainstem, we know that just these two components alone can affect the stability of our suboccipitals and C1 and C2, which hence can this have an impact on the energy flow? And as you’ve just explained, my guess is is that it can. So if we’re starting from the perspective that you can’t build a house on a crooked foundation, so trying to align structure as quickly, and as fast and as best as possible, 24 hours a day, seven days week, so this work is actually being done without you having to think about it when you work with a brain based approach. And then incorporating any other types of therapy, like acupuncture, is always at a greater benefit to the patient.

What you just mentioned gave me a couple of more ideas I want to share with our listeners. Eyes for Chinese medicine practitioners have very much to do with the liver and has to do something to call wind and movement. So isn’t it interesting that by analyzing eye movement, which we are basically looking at its connection to the liver and wind. So you can see how there’s a lot to the ancient teachings about how eyes have to do with wind, because by analyzing eye movement you have the entire ability to assess a nervous system, which a lot of nervous problems are due to wind, but also relationship to coming and going and movement issues. Tongue. Again, back to the eyes. Eyes are supposed to be where is the spirits or the from Shen emanates. So you can have added tools to assess the patient’s state of Shen and spirit.

Their tongue is supposed to be the opening of the heart. And so by looking at the tongue posture, you have an indirect way of gauge into the Chinese business date of the heart’s health. So these are all the thing that’s [inaudible 00:19:14] and I’m really looking forward to finding out and learning more about this from you. Now, I know you have a lot of experience working with athletes, working with people with chronic pain, and even children and developmental problems, people with central nervous system problems, and I would love to hear all your experience. But because of limitation of the time we have today, could you just share with us with one maybe from recently that you’ve seen that was really highlighted to the power of this method? Something that’s really meant a lot to you personally as a therapist, you’re really able to transform somebody. Or something’s just really neat and something that was very cool that even surprised you for so many years of practice. Just a story. Basically just tell us a story, we want a nice story.

Oh, I have many stories to tell you. What I love about the Posture Pro Method is that there is not a week that goes by where I don’t have shivers on my arms because we realize that we’re actually changing the lives of people. And when I say, we like to use the hashtag changing lives, is when you give someone the ability to be able to regain their pain free living and live a life free of pain so that they can enjoy their lives, that for me is the ultimate reward. The case that I could think of, the first case that I sat on for a long time was when I got contacted by someone called Diane Murphy, and this is going back maybe over 10 years. And she left a message at Posture Pro saying, I’ve just recently been diagnosed with Parkinson’s disease stage one. I’ve tried everything, I’m desperate, please can you help?

And this was really the first case of Parkinson’s disease that I would ever encounter in my practice. And not knowing how far I can actually push the nervous system and really being afraid of the unknown, I didn’t respond to her call for three weeks. After the third week, I said to myself, Annette this is silly. Face your fears. The worst thing that can happen is that nothing happens and so be it. But at least try. And I did try. And I’ve put the video on my YouTube channel of that first consultation originally. Well, obviously the full consultation was recorded, but we trimmed it down to five to six minutes. Was the most rewarding moment that I ever had. You could hear Diane saying how her entire symptoms in the session completely disappearing. And funny enough, what did it the most for her was a scar that she had in her lower back.

So we proceeded in correcting the foot, we worked with the eyes, we actually looked at the jaw. We’re going through this in the video, we’re going through this step by step as we’re explaining what’s happening. But what really worked for her was, so we had to do all of that first, and then lastly we looked at the scar. I said to her, Diane, do you have any scars? And she goes, yes, I had lower back surgery years ago. And just by working on the scar she was like, her testimonial was overwhelming. I mean, I could not express it more how she was so verbal and expressive. So that was really one of the most ooh ha moments for me in my practice. And I’m lucky enough to say that these moments have followed and continued to follow every week of my life and in practice here. So this is, again, I’m so grateful to be on your podcast because ultimately I think that everyone should have the right to know what is out there and choose the best therapy treatment for themselves and for their loved ones really.

Thank you. That was a great, very heartfelt story. Unfortunately, due to time limitations we have to wrap up real soon. Could you give us a little appetizer or a little bit of amorous goose, a little bit of teaser, something that, I don’t know it’s very complicated or if it’s even possible, but something that is a little technique or something like that we might start to incorporate and to get us to see the power of posturology?

Yeah. So doing simple eye exercises as I demonstrated in my Ted Talk, which consists of doing simple circles and trying to converge, trying to focus on a specific target as your eyes are moving in 360 degrees. Some people find that very challenging. If they feel dizzy while they’re doing it, simply just pull away the finger and continue doing those eye exercises. This a great way to start working out your eyes on a daily basis. And quite frankly, I think it should be incorporated in for everyone. Regardless of the context, I think everyone should work out their eyes in the morning when they wake up.

I think I’ll also add to that, being aware of whether or not you clench your teeth. I love to have people become aware, just awareness of whether or not the teeth are in constant contact by putting red dots on the wall, and when you see the dot in that moment, you will say to yourself, are my teeth touching? And if they are, simply taking a moment to just stop whatever you’re doing if you can, position your tongue on top of your palette, hold it there with your lips closed and breathe for one minute. I think that doing those two things already is a great way to calm your parasympathetic, your sympathetic system down. Tap into parasympathetic, give yourself a break, disconnect. And of course if you retrain your eyes, you’re also retraining your muscular system.

Thank you very much. So if people out there would like to learn more about your methods and your teachings, where can we go to find out more about this information?

Our website is posturepro.co, and we’re very active on social media. We post daily tips, and specifically before and after cases on our Instagram channel, which you can find us very easily at @posturepro. Same address for Facebook.

Great. Thank you very much for joining us today, it’s been an absolute pleasure.

Thank you so much, Poney. It was a pleasure meeting you.

I look forward to studying with you soon in the very near future.

God bless.

Thank you.



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Personalized Chinese Medicine Logic or Magic? Yair Maimon

Hi everybody and welcome to the show, The Spark and Evidence of Acupuncture. I am Yair Maimon. I would like to thank the American Acupuncture Council for providing the space and broadcasting this show to you. It’s quite a unique show and I will explain why. I’m very fortunate. I’ve been practicing Chinese medicine for more than 30 years, and in the last 20 years working more closely with oncology patients, so caring very much on how Chinese medicine affects cancer and immune system. Immune system specifically now at this time has another potential or understanding the effect of Chinese medicine on the immune system, especially because of the outbreak of Corona has another interest of how we as humans can protect ourself from viruses. I’ll try to touch it. It wasn’t in my original show, but since part of the research is about immunity, and especially in native immunity, we’ll be able maybe to expand on this burning issue of the Coronavirus and its spread. Welcome to the show. I would like to start with the slides.

As I say, I have this daily dilemma as an acupuncturist, and also working in a hospital, of looking at personalized medicine, because eventually we know that the best for us will be to prescribe a personal formula to a patient. Western medicine has the advantage of researching one molecule or one agent and seeing placebo versus real, seeing if it effective or not. In Chinese medicine, in a way, each person is a whole world and to each patients we are providing a specific medicine. The question is, can we actually test it? That’s why I call this lecture Personalized Chinese Medicine, Magic or Logic? Because if we can put some logic into it, I think we are moving into the next potential of Chinese medicine and integrating Chinese medicine, especially herbal medicine, which is very difficult to integrate into regular medicine. I’ll touch on it a bit. As I say, this is my daily quest and also interest to have Chinese medicine available to patients within the regular system, and definitely for cancer patient or patients who are in a great need that can benefit from both medicines, the Western and the Chinese.

As I said, I’m very fortunate. I’ve founded this research center in Sheba Medical Center. Sheba Medical Center was one of the top 10 hospitals, a leader in medical science and biomedical innovation by Newsweek. It was one, not just in the Middle East, but worldwide, so this very innovative hospital with a lot of research facilities. That’s really, I can say my luck is to be able to also have a laboratory and research facilities and good researchers working with me and taking Chinese medicine sometimes one step forward, or challenging the ability to bring science into what we clinically do and validate it. You see the uniqueness on one side. There is, you can see the laboratory and how it looks. On the other side we have the clinical facilities, and that’s where patients get treated.

My interest is both in the research part and that’s where we provided the Tal Center at Sheba Hospital. We provide also the research and the clinical facilities. Also my deep research is in education, because I believe that one of the most needed thing, especially if you’re practicing with cancer patient or different immunological challenging diseases, we need extra knowledge. Knowledge is really the strength. With this thing in mind, is with the dream and the vision to bring this knowledge to everybody. I’m part of the TCM Academy. You can find also some of the lectures and especially a very specific course which is designed for oncology acupuncture that has an online part and offline, and is unique in this way that provides worldwide ability to understand Chinese medicine for oncology in a very kind of unique way. There’s already like 250 people graduating from this course worldwide. It provides a common knowledge to people worldwide.

As I say, Chinese medicine is personalized medicine. It is a challenge. It’s much easier in a way. There’s always a saying that Western medicine is hard to learn but easy to practice. Chinese medicine is relatively easy to learn but difficult to practice. That’s true, because each patient brings us a different challenge. For each patients we are like almost starting from the beginning, building up a personalized approach for him. We know that each person is unique, and therefore personalized approach is the right approach to provide him a good medical care, but even zebras have stripes, but they display individual stripes. As with zebra, the human DNA is 99.9 similar across the population, but this special crossing for the zebra, but also for us being so different for each other, is just 0.1. That allows us to display our individuals stripes and to be different. It’s quite amazing number if you think of it, but there is, as I said, a lot of power, and there is so much in little.

When we do a successful treatment, we look and I put on the gene level and a DNA level, because on the gene we are different. On the Shen, we have something in common, but when we want to provide a specific treatment to a specific patient, then we look at something very specialized and very personalized. That presents a challenge.

I want to prepare the lecture. Actually, it’s a patient of mine, and this is really where the story starts. As you can see, I like to look at it, she had actually a dress or a shirt with a zebra crossing. That’s how I came across to thinking about zebras in this case. She’s a female, 55 years old, a nurse, married with two children, and she has metastatic adrenocortical cancer with metastasis to the liver, lung and bones. I’ve been seeing her for quite a while. After a while, she had a very stable disease, which was like extremely good health, very stable disease for more than four years. She [inaudible 00:08:24] to the Chinese medicine, also in acupuncture, Mitotane and Cortisone, which were the usual care for her in Western medicine, and the treatment I provided her.

Her condition was stable until it started to deteriorate. When it started to deteriorate, I started, because again, it’s quite unique cancer and every patient is unique, so there’s like two concerns. What will be the best formula for her in this deterioration? I did the regular Chinese medicine diagnosis. I used the four pillars of diagnosis: observation, feeling her pulse, palpating her pulse, looking at her, asking her specific questions. Then I had three formulas in mind to right her. I put it here like formula one, formula two and formula three. I wrote almost three different formulas, one based more on my Chinese diagnosis, one thinking more about research, about different herbs that can be more specific for her cancer and for her type of medication that she was taking, and then another formula, which I said, I’m trying to be a little bit more creative, taking what I see in Chinese medicine and research and combining them together into a third formula.

This really was where my debate was, which formula will be most effective for her? Will it be the first one? I put some just few herbs from each formula as an example. Each formula contained more herbs. I had this debate between this formula one, formula two and the third one, thinking which one will benefit her most once her condition got deteriorated. The question is, since I was in and working in a hospital, can I help Western medicine and scientific testing to verify or to assist in this decision making? Can we use Western technology, and especially laboratory technology, to validate or to assist us in the decision making in this respect for the best herbal formula for this patient, and overall, to see if this formula is effective for her or not? I wondered if we can combine the healing and the part of the healing that is so strong in Chinese medicine with the science and the logic of Western medicine. This is the place where I say, is it logic or magic?

In her case, I was able to isolate her natural killer cells from her blood. This is where you see actually the oncologist taking her blood test from her. In the laboratory we can isolate her natural killer cells, her innate immunity, which as I say, this part of immunity also deals with cancer cells on a daily basis, but is also very important in the fight against viral infections. I isolated her cancer cells. We shared the shared operation. From the operation we took part of her growth and we started to grow her cancer cells in our lab. At this point, we are having in our lab two things. One is her part of her immunity system, her personalized immunity system, and we have her cancer cells growing in two different sets.

On this two different preparation, I started to see if we can put different formulas and see how they react, how her immune reacts and how her cancer cells are reacting to the different formulas. Remember, I was debating between these three formulas. This is called ex vivo. We take something from the patient, we grow it outside the body, and we try things on it. There is human research, ex vivo or in vivo. In this case, when we tried the three formulas, this is the result we got. On the first formula, her immune system got stimulated six times more than the control, so her immune system was six times more active than the control one with the first formula. With the second formula, three times more, and with the last formula, as you can see, two times more. We saw a big difference in the way her immune system responded to the different formulas. We have the first one, second and third. You can see the first one is responding in the best way.

Now the second part was looking at her cancer cells. Again, we are looking at the cancer cells and to see the death rate of the cancer cells. The first formula killed 50% of her cancer cells. This is also the same formula that increased her immune system almost six times more. The second one killed 50% of the cancer cells, and the last one 10%. The phenomena that we see, that the same compound with the same amount, the same concentration, on one hand activates the immune system six times more, on the other hand, it actually kills 50% of her cancer cells in the same amount.

We are looking, because it’s a compound, because it’s a formula that has also anticancer herbs and have herbs to increase her immunity, it works on these two arms. This is very unique. Of course, we don’t have molecules or Western medicine that can do this to action. The most interesting things to me is this is the first formula is the formula I prescribed to her just from the Chinese medicine diagnosis, just sitting in front of her, taking her pulse, looking at her tongue, hearing her story, thinking about the nature of her cancer and prescribing.

It was a kind of very great relief to me to see that formula that we prescribed in the clinic, based on our knowledge of Chinese medicine, had such a strong effect and are better than formulas that we are trying to formulate just from our mind and just from based other research or based on other criteria. Here again, the personalized formula that was made for Chinese criterias was the most effective on both arm. It has also great effect on the patient. She looked at it and results and she felt very happy and content that she’s taking something that she knows that effects her both immunity system and cancer.

But with traditional Chinese diagnosis we go even deeper. We also look at the Shen, which is a bit beyond sometimes the normal consideration, definitely of Western medicine. We want also to see how we can affect the spirit in a personalized way, not just the body. From observation, for example, we look at her eyes. As you can see, this as a picture of her eyes. You can see the fear there. It’s not just the fear of cancer. It’s something deeper that has been there all the time. If you think about it, if her cancer is in the kidney and there is a fear, then addressing this part in her will also aid in healing.

That’s definitely have an effect when we choose a point, like if we choose a point for her, I would choose the points on the chest for one of the points, like kidney 23, which called Spirit Seal, which will have a deep effect on helping her to protect her fear and her heart and feeling more, I can say, strong in herself, not just in the ability to deal with cancer and all the difficult issues dealing her, but also deep side in feeling more content and being more one, that the Shen and the gene or the heart and the kidney are uniting in a good way and communicating in a good way. Her ability to sleep, her ability to deal with the challenges she has will come much more from inner strength and inner peace than just from fear.

When there is a lot of fear there, always to me, both the prognosis is not so good, but also that person’s ability to heal are much more limited. Addressing it also in the herbal prescription, using herb like Yuan Zhi, or herbs that are addressing the kidneys and strengthening the kidneys, which have also some kind of deeper aspect. Deeper healing aspect brings us this, I think, this uniqueness of Chinese medicine of being able to see the patient and finding a prescription formula point which are actually matching the person in a very deep way and allowing and creating a deep healing, which and as we know, a human’s potential is much greater than the physical. This allows us to address it.

To me, seeing this result, and we repeated it with more patients, and the same results, always the formula that was prescribed when we see the patient has a much better ability than the other ones that were like speculated, or at least that I was debating. It was one that I felt more comfortable with according to the diagnosis. The other ones, I brought other criterias in but I felt less comfortable. It’s amazing you bring it to the cells and it shows the same. It gives us much more trust in our diagnosis in our medicine. This personally prescribed medicine, I think to me, and I hope to all of us, brings us much better confidence in the medicine and the way we deliver it on a daily basis.

It also validate the concept of holism that is very strongly embedded in Chinese medicine, that we look not just at the body on the physical plane, but we are looking at the complexity of humans, addressing the body, the mind and the spirit in whatever way you can to enable healing. I think this is one of the strong and most important points that we are making dealing in Chinese medicine in the Western world and in Western environment.

But this testing may have further application. One of the further applications that we did was interaction with her chemo. Obviously the result was a great fear, that for herbal medicine, that it will negatively interact with the patient’s Western medicine intervention, and in her case, was especially the chemotherapy. This possibility provide us again to take ex vivo to check if we can take the formula, her cancer cells, and the Western medicine that was prescribed to her, and see if we see any positive, negative or no interactions. Taxol and Gemcitabine were the two herbs that were prescribed to her. We could see that the chemo alone killed 70% of the herbs. Again, we are looking at a certain amount of chemo. This is for Taxol alone, but when we added the herbs, there was additional killing effects, so not just that it didn’t interfere with the Taxol, at least in ex vivo format, it actually enhanced the killing effect.

With Gemcitabine, we saw same, 85%. We were looking at a certain amount of chemo. Then we looked, when we’re adding the herbs, it’s increased. It was added on effect. Everything we look at in the timeline, so we are checking in during the time in a different concentration, but I’m showing you just time. If I’m picking up the easy results to understand, but everything is time-based and concentration-based, but the bottom line, this kind of potential situation in the laboratory allows us also to look at interaction with regular drugs. As we see in this case, as then I’ve seen in quite many cases in my clinic, the interaction has a much more potential positive effect than danger, as a lot of time is feared. This is definitely another way to start to look at it more scientifically.

What about the future of such testing? Because I hope and see the Chinese medicine has much for interaction with Western medicine in different ways. To me, it brings us a much stronger and broader horizon. There is few options. One is optimizing. I did actually, for her, another patient, I took again these cancer cells for example, and tried different herbs, and to see from the herbs I have, which one is killing more and which one less, and then maybe adjusting the formula accordingly, testing it again. We can optimize formulas. We can add or reduce certain herbs. We can look at interaction with chemo or interactions with other agents that the patient are receiving. We can develop a new methodology that maybe can help us in clinical decision making, create a new paradigm.

Especially at the moment, everything is elaborated, takes sometimes days and weeks of research, but soon can be achieved, can be very simple method that can isolate it definitely from the blood, even circulating cancer cells in the blood, and we can immediately or very fast do tests on them. Things that look today a bit futuristic, when we look at technology in a few years, many things will be possible. To me, it’s another paradigm and another way to think about a potential future and potential interaction with technology and Western medicine, and also discovery of new combination, very effective combination. For the last 15 years, I’ve been researching one specific formula, LCS101. If you’re interested, you can read a lot of published research by us on this formula. By now, it’s probably one of the most recent formula in the Western world. We collaborated with people from MD Anderson, from Miami Children Hospital, even the latest collaboration was with one of the good oncologists from Harvard Medical School.

Once we can show science, it’s very easy to collaborate, very easy to discover new combination to see how they are working, how safe they are. I think this give us the potential to make more and more new discoveries. Obviously, if you want to look more at my research, you’re welcome.

Just to end up, I think that one of the best future possibilities is combining the science of medicine with the art of healing. This combination can open a new horizon, both to cancer patient, but also for almost everything that we look on the level of humans. As I said, for example, now there’s this greatest fear from Coronavirus. One of the most important things is that your innate system, your immune system, innate immune system will be at its best. Then Coronavirus will be as every other virus, you either don’t get infected, or if you do, you recover quickly. Chinese medicine definitely has a potential in enhancing immune system. It’s overlooked in this potential. Everybody is looking for immunizations or other means, but I think strengthening the immune system definitely is one of our strengths and one of the things that we can bring back from ancient medicine into humanity today, and to reduce suffering and help also people to be less ill.

We can trust this path of seeing the uniqueness in each patient, because as I said, as a clinician, you always want to bring more trust in what you’re doing. To me, this research, and as I said, we did it on many other patients and the same idea repeated itself.

I would like to finish with my hero, Sun Simiao, and that’s really a sentence that goes with me always, that, “If the heart has no worries, the body has no limits.” It’s an important way to me to finish this lecture. I would like also to thank people at the hospital and people I’m closely working with, especially Zoya Cohen, Noah Samuels and Raanan Berger, who is the head of the oncology department, and the Jacobson family who provided the fund and the ability to do all this research.

I hope this was of an interest to you. If you’ll have any further question, you can always email me or ask me. I think it’s quite unique to see how Chinese medicine can be verified and validated in many ways. We shouldn’t forget that each one of us is unique and has individuals stripe. Thank you very much for watching it. As the last words, I would like to thank again the American Acupuncture Council for providing this platform and providing this show. Next week there will be Lorne Brown having a show on the same platform, so you’re welcome to watch it. All the very best to you. Be well and healthy, and I wish you all the best of health.

Please subscribe to our YouTube Channel (http://www.youtube.com/c/Acupuncturecouncil ) Follow us on Instagram (https://www.instagram.com/acupuncturecouncil/), LinkedIn (https://www.linkedin.com/company/american-acupuncture-council-information-network/) Periscope (https://www.pscp.tv/TopAcupuncture). Twitter (https://twitter.com/TopAcupuncture) If you have any questions about today’s show or want to know why the American Acupuncture Council is your best choice for malpractice insurance, call us at (800) 838-0383. or find out just how much you can save with AAC by visiting: https://acupuncturecouncil.com/acupuncture-malpractice-quick-quote/.

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Wear Your Heart on Your Sleeve: Neuro-anatomy of HT-4 to HT-7 – Poney Chiang

Hi, good afternoon. My name is Poney Chiang. I’m a practitioner of acupuncture and traditional Chinese medicine from Toronto, Canada. Welcome to today’s American Acupuncture Council live Facebook podcast show. I’m your host for today. And since this video is taking place on the week of Valentine’s Day, I thought I would do something fun and present something that is heart-related or heart region-related. So, let’s get started with today’s presentation.

The title of my presentation is Wear Your Heart on Your Sleeve. And the subtitle, Neuro-Anatomy of Heart-Four to Heart-Seven. It’s kind of a tongue-in-cheek idea that Heart-Four and Heart-Seven are very close to our wrist, so it’s very close to the sleeve and obviously because it’s Valentine’s Day, I chose to talk about the heart meridian.

The painting you’re looking at is the painting that was done in the year 1900, and it was painted by artist named Edmund Leighton. It is, as you can see, a princess or a fair lady tying a scarf or handkerchief to the sleeve or the arm of a knight. This is supposedly one of the origins behind the English expression to wear one’s heart on your sleeve, which of course means somebody who speaks their mind, somebody has no agenda, who is very direct. What you see is what you get. And here, this knight, by wearing the sleeve from the lady, from the princess, means that he is fighting for the princess’ honor. And therefore, he is identified as vouching or speaking or defending the lady pictured here in the painting.

What we’re going to do first is we’re going to look at the historical development of these points, particularly heart meridian points in the early classics. What I mean by early classics are works around the time of the Han Dynasty or shortly after. So, as you know, the LingShu or the Yellow Emperor’s Classic of internal medicine has two volumes, the plain question, which is the Suwen and the LingShu, which is spiritual pivot. And in chapter 10 the spiritual pivot we learn about the channel theory… And the channel pathways of the different channels on the body. And there is one paragraph that is focuses on the heart channel. Now in this paragraph, on the chapter 10 of the LingShu, entitled Channel Vessel, it says that there is a Luo Channel or what the classic described as a separation.

So if you look at the second bullet under it says “Pathway: the separation of the hand, lesser yin or shao yin is named Heart Five”. And so here we actually have a point identified by its name. Of course then there’s your classic, it would be called Tong Li, the Chinese name of the point instead of heart-five. It says that it’s located one and a half cun from the wrist, separates and course upwards, follow the channel enters into the heart, connects to the tongue root, joins the eye connection and so on and so forth.

Now if you are very good at point location, you might be scratching your head a little bit and wondering, hey, wait a minute. Tong Li, it’s not one point five cun, it’s actually supposed to be one cun from the wrist. So this is an example, a lot of discrepancies we see in the classics at the time of the LingShu, heart-five was actually considered a one point five cun on their wrist, as opposed to the way it is currently taught as one cun from the wrist crease.

But that’s another reason why I’m talking about this. That’s just kind of interesting trivia. I’m introducing to the idea that in the time of the suspicion pivot, we’re starting to have a little bit of introduction to certain points in the heart Meridian, and we know at least our heart file Tong Li is supposed to be in the heart meridian or the hand lesser yin meridian. But you may be surprised that very few points from the heart Meridian are actually recognize by name and location at the time of the yellow in person internal medicine. The only other place that hints at a location of a heart point from the heart Meridian is in the insert chapter 52. The title of that chapter is called Wei Qi as in defensive Qi and there they talk about, if you look at the fourth bullet on the page: the root of the hand shao yin, it’s at the tip of the sharp bone manifest at the back shu.

So here are the top of the hand shao yin, which is the heart meridian and that the root of this Meridian, it’s at the tip of the sharp bone. We modern scholars believe that the sharp bone refers to the pisiform bone in the wrist, in the carpals of the hand which has a bony protrusion and what I want you to notice is that they’ve located this point where we would consider a heart-seven but there’s no mention of shenmen or the name or the Chinese name for heart-seven itself.

And so what that means is that at the time of the Yi Jing, we only have one point for the heart Meridian mentioned by name and location, which happened to even be in disagreement with what is taught later on. And even heart-seven or shenmen, it’s simply just described by location and as names are not mentioned at all.

So that’s only a two out of the nine points in the heart meridian that has been passed down to us today. So the other seven points and not even mentioned by name or location. They don’t actually appear in the knowledge of Chinese medicine textual history until, if you look at the last final bullet in the Jia Yi Jing. This is the meta classic of acumoxa [inaudible 00:07:49] which is probably around the third century.

I put down eight points because heart-seven wasn’t actually mentioned by name. This is why it’s a meta classic where Jia Yi Jing considered the first complete acupuncture manual. There are points that are not described at the time of the of the yellow emperor.

This a nice little zoomed in view of the points on the wrist and the center of the photo is as you can see, heart-four, five, six, seven closely juxtaposed to each other. In fact, heart-seven is right on the crease line. Heart-six said to be half a cun from the crease line, heart-five is one cun from the crease line, and heart-four is one point five cun from the crease line.

And we just saw that even that is disputed because back in chapter 10 where the LingShu, they actually say heart-five is one and a half cun, which is where we look at heart-four today. So the reason why I decided to talk about the heart Meridian points in the wrist. You know obviously you tongue in cheek play on words about the one issue one wears the heart on one’s sleeve and it happens to be Valentine’s day.

But I love examples like this because it really highlights for us the specificity and the lack of redundancy that goes behind how ancient acupuncturists and who I like to call ancient anatomist pass down these points. A lot of people would ask me in my workshops is heart-four or five, six, seven just one point. Because one looks at them as so close and any reasonably educated person would ask that question, why would you have four points? That’s such a tiny little space. Now this is where the brilliance of the ancient acu-anatomist comes in. They pass on these points for very specific reasons is because in fact they are different anatomically. And this is the focus of our presentation today.

Before we jump into very new anatomical, I’d like to just acknowledge William Shakespeare in his work, the Othello at point scene 1. Is this the first textual? A record of the saying wearing my heart upon my sleeve. So there’s a character in the play, Othello’s play, who says that “when my outward action doth demonstrate the native act and figure of my heart in compliment extern, ’tis not long but I will wear my heart upon my sleeve, for daws to peck at”, daws are apparently some kind of Ravens and not what I am.

So if I am not consistent internally and externally I’m not what I seem to be, I am therefore not worthy and deserve to be pecked at by these ravens or and as such. So just in case you were wondering what the expression means and I like to share these kind of food for thought information. It gives a little more context and also helps give us some association when we think about these points.

Now we’re going to jump into the real anatomical and this diagram here comes from Grey’s Anatomy and I would like you to note that there’s two red boxes here on the very top of the page is the ulnar nerve box. And then in the lower box if you read closely, there’s actually two different branches here. One says superficial branch ulnar nerve, the other one says the deep branch of the ulnar nerve. So what I would like you to appreciate is that if you follow the deep branch of the ulnar nerve, you can see that it kind of plunges into the thin arm muscles. And then it actually kicks across towards the left side of the slide, that horizontal branch, that is as also labeled, it’s called deep branch ulnar nerve, it innovates the interior osseous muscles.

These are the muscles that allow you to abduct and adduct the fingers. And it actually makes it all the way into the abductor pollicis muscle. And that’s the muscle that allows you to abduct the thumb. So just another [inaudible 00:12:26] muscle. But because it’s associated with the thumb we call it abductor pollicis instead of interosseous pollicis. So all these branches become important because in a moment we’re going to see how brilliant ancient acupuncturists are in their knowledge of this anatomy and assign different points to each of these specific branches.

So in this video I’m going to show you the needle is inserted into heart-four, and heart-four is assigned the ulnar nerve trunk. Obviously you can stimulate heart, the nerve channel front, I’d say small intestine eight in the elbow, but at that level, the anatomy, it also innovates some wrist extensor muscles. But once you come distally to the level of heart-four it is sort of the first stop before it branches into this deep and superficial branches I just mentioned.

Now because it is superior to the deep motor branch, which I just described, innovates the interosseous muscles, when the electric stimulates that it would stimulate everything downstream of it. So including the superficial branch, which is responsible for the cutaneous sensation of the palmar in the back of the hand, but only for the median one half fingers. Okay, so according to ulnar nerve distribution, but unfortunately because the video cannot demonstrate parasthesia or tingling sensation that the subject is feeling. All we’re going to see is the motor aspect of this mixed nerve trunk at heart-four.

So when I play this video, you’re going to see that there is movement of the fingers. The thumb is moving. In fact, when they sustain a stimulation, what you can see is that there’s an opposition. So the thumb and fingers are coming together by virtue of contraction of the Athena and hypothenar muscles. Sorry, by virtue of the contraction of the hypothenar and abductor pollicis muscles, not the hypothenar muscles. That actually is in fact innovative of the meridian, not the ulnar nerve. I’ll play the video one more time, so you can see. But in addition to the motor aspect you’re seeing with interosseous muscles moving, this subject is feeding tremendous paresthesias or numbness and tingling into the palmar side of the hypothenar and also into the dorsal side of the median one half fingers.

So this color coded image is meant to remind everybody how the ulnar nerve and median nerve covers different terrain in the hand. If I can draw your attention to the left side of the slide, you’ll see the dorsal aspect of the hand. And you can see that in pink, that’s the distribution of the meat of the radial nerve. Now, whereas in green is a distribution of the ulnar nerve. But if you look closely at the dotted line that’s pointing to the back of the hand in the green section, it actually says the dorsal branch. So we haven’t talked about that branch yet. There’s a dorsal cutaneous branch that goes to the back of the hand, but only the one and half fingers. In some people it can be two and a half fingers. Okay. As you can see by the separation where the pink and green separates in the center of the middle finger in this diagram.

Now if I can draw your attention to the right side, now we’re looking at the palmer side of the hand, and you will notice that the palmer side is innovated not by the radial nerve anymore in Brown color. We see that is innovated by the median nerve. So the median nerve is in fact responsible for the palmer innovation, including the palm and fingers of the lateral, three and a half fingers. And then whereas in green you see that the ulnar nerve, if you look at where the dotted line is pointed to the palm, you’ll see that there’s actually two sections. There’s a cross hatch section closer to the heel of the hand that is labeled as the ulnar nerve palmer branch. But when we look at the dotted line as pointing to more kind of the ball of the palm, that is innovative as the ulnar nerve digital branches.

So all in all we have seen palmer branches, digital branches, dorsal branches. Let’s take a look at how these all perfectly super impose on these acupuncture points around the wrist. This slide talks about heart-five and heart-five is also the low point, which means that it’s supposed to connect into an exterior relationship. So the exterior relationship to the heart is there is none other than the small intestine the hand tai Yin. So as a point, it is supposed to traverse from the yin side of the wrist and hand into the yang side of the wrist and the hand going from in other words, the heart to the small intestine or from the shao yin to the [foreign language 00:17:38]. And now what’s very beautiful is that there is exactly a nerve branch of the ulnar nerve that does that.

If you look at the black and white photo on the bottom portion of the slide, you can see on the left side, I have two points as labeled heart-five and small intestine five. The dotted white line on the left side of the photo here represents the outer contours of the ulnar bone. And you can see that the ulnar nerve is labeled in white here with the arrow, is continued into the hypothenar, but on its way to doing that, we have this brand exactly where heart-five is located, where the red dot is on a slide. It branches towards small intestine five in other branches from the yin side to the yang side of the body. So this branch is called the dorsal cutaneous branch and it perfectly satisfies channel theory that is a low meridian point.

This is a dissection. That is from The work that we’d done, the nerves are not naturally yellow like this. They’ve been colored in by an artist to make it more easily visible. And so I want to just start by helping you orientate yourself. You look at the legend on the bottom right, you’ll see that the arrow pointing down is distal. Arrow pointing up is proximal. So imagine this is somebody’s arm pointing downwards and then the ulnar side is actually the right side of the slide and the left side of the slide is the radial side. Let me just help orient you again. This metallic probe you see towards the left side of the wrist here is lifting up the tendon of flexor carpi ulnaris to expose the neurovascular bundle of the ulnar nerve and artery.

In this slide here, C would be the flexor carpi ulnaris muscle. B is pointed to the neurovascular bundle and A is pointing to that [inaudible 00:19:53] branch that is now going to become heart-five. Just as an aside, [inaudible] is actually ultimately bifurcates and becomes small intestine six and small intestine five later on. But that’s beyond the scope of our [inaudible 00:20:08] and discussion for today. If I can draw your attention to heart-six, the arrow heart-six, you’ll see that it is centered over the vessel and we’ll talk more about that. And then heart-seven is on the wrist line.

What’s interesting about the heart-six is that this point has an unusual location. Remember I said these points other than heart-five was just identified by name or location in the special pivot. Points like heart-four, heart-six and seven are not even mentioned by name in the yi jang. So the first time that heart-six ever appears is in the jia yi jang systematic classic and its location is kind of unusual. If you look at the description at the top of the slide I’ve bolded it and highlight it for you in red. It tells us that this point is in the pulse behind the palm, five fen towards the wrist. A fen is a 0.1 cun so, five fen basically means half a cun. But it’s interesting is that is located at a pulse. Now if you can take a look at this black and white photo.

This photograph is taken from the article, The Nerve of Henle: An anatomical & immunohistochemical study for the general hand surgery. And these hand surgeons were interested in finding out more about the anatomy of the ulnar nerve. And you can see it labeled in this diagram here. A, if you look at the left side of the black and white photo, A is the ulnar artery, n is the ulnar nerve. But you see that there’s a star labeled. That star, see how I try for a case on the right side of the photo, that’s actually the branch that goes to the palm and if you remember the colored photo of the distribution of the nerves in the hands, I talked about a cross hash portion around the heel portion of the hand. That’s in fact where those three branches towards the right side goes through.

That’s called a palmer branch. But notice that they’re asterix in addition to the star in this photo and notice how those small branches that represent labeled by the asterix are actually intimately touching the ulnar artery itself. So the significance of this is that the ulnar nerve gives innovations to the ulnar artery. What kind of innovations? Sympathetic innovations, a type of autonomic innovation that controls the smooth muscles of the ulnar artery to control its vasal constriction. And that the classics is the meta classic, we’ve mentioned that this point is in the pulse is telling us that they are more concerned about stimulation of the rich autonomic fibers associated with the artery.

Now it is of no coincidence then that we have learned through pre-occurring experience and knowledge passed on by our mentors that heart-six is one of the most important points to regulate sweating inside of body together with kidney-seven. And why would that be? Because these points are intimately related, associated with the vessels and by stimulating the vessel you are stimulating the sympathetic aspect of the nervous system and sweating is indeed a part of our physiology that is controlled by the sympathetic nervous system. Isn’t that very interesting how the function and anatomy and the historical point locations all perfectly intersect.

The last point is heart-seven. If you look at the color photo on the bottom of the slide here, you’ll see heart-seven clearly labeled. But if you just look a little bit to the right of where heart-seven’s located, you’ll see that there are three branches, right? So the letter C is pointed to two branches that corresponds to the digital branches of the palmer side of the ring, the index and the pinky finger. And then there’s our breads B. That B branch is actually that deep motor branch, the one that actually innovates interosseus muscles.

We saw how stimulation of the the mixed nerve trunk, which contains a sensory and motor aspect. What activate the interosseous and adductor pollicis muscles. So the significance of heart-three or seven, my apologies, is that it is the beginning of the superficial branches of the ulnar nerve. I hope you can see that every single location differ slightly in terms of what nerve has already left the main trunk. So that there is very, very high degree of specificity in the rationale behind why these points are passed down individually and so close to each other.

So I’d just like to finish by giving you a little bit of clinical applications. Anatomy is interesting, exciting, but at the end of the day, that information is to give us more intention, clarity and specificity in our needling. And so we want to talk about how that can be used in a day to day situation. If you are familiar with the type of nerve entrapment called Guyon’s Canal Entrapment. If you look at the picture on the bottom right, it’s also called a handlebar entrapment it’s very common in cyclists that might press the weight of their entire upper body onto the heel of their hand. And as you can see if on the red little lightening symbols, that’s where the pressure and people can feel a nervy electrical sensation. And so if you have some understanding of the… it can differentiate diagnose this type of entrapment.

One way for you to deirritate and improve neural conductance, restore proper neural conductance back into his nerves because it was impeded by pressure. You can needle points like heart-seven, points like heart-four and apply electricity to help deirritate this nerve that has been impinged. One situation that often used the heart-four point for is actually is for restoration of fine motor function. This can happen in patients who have multiple sclerosis. This can happen in patient who has suffered a stroke and they lose the ability to do fine opposition movements and I have found that electrical stimulation of their mixed nerve trunk allows a reactivation of the interosseous muscles and the adductor muscles and hypothenar muscles so that patients can increase their motor control or motor activation of these muscles so that when they do occupational therapy exercises or hand specific fine motor exercises or games, they are going to get more out of those exercises because now the nervous system is firing at it’s optimal efficiency.

Heart-five, it’s name is called Tongli which translates, that’s penetrating interior. It’s traditionally associated with the treatment of aphasia because as you know, the heart orifice is the tongue and the channel theory pathway tells us that heart-five has control and dominance on the heart. But because these points are so close, heart-four to seven, how do you know you actually stimulate heart-five? What if you stimulate heart-seven instead, right? Heart-seven stimulation would feel like palm numbness and parasthesia in the pinky and the ring finger and the palmer side. But whereas heart-five there’s just sensation or parasthesia, ought to feel like numbness and sensation on the dorsal side because of the dorsal cutaneous branch that covers that territory.

So if you are really wanting to use this point to benefit aphasia and tongue and speech and so forth, or to just open the lower vessel, the proper sensation needs to be parasthesia and numbness on the dorsal part of the hand as opposed to the Palmer side of the hand. Finally, heart-seven is called shenmen or a spirit gate, is associated with calming the nervous system. And we already talked about how things like… Points like heart-six because close association to the vessel as very rigid RNI fibers. We saw that how we can conceptualize how that can have effect on sweating, which is a sudomotor response where they get regulated by the automatic nervous system. But similarly heart-seven being able to calm their shenmen, helping insomnia means that by regularly the automatic nervous system is somehow puts the body into a parasympathetic state to improve various type of autonomic dysfunctions.

I want to finish that up this last slide as example of how to use this for a neuro rehab situation. So what you’re still about to see is a patient who has multiple sclerosis at a time that she saw me in the clinic, it’s been about four or five years. She’s developing a lot of spasticities. She has some drop foot happening and upon physical examination we noticed that she was losing fine motor dexterity of her hand. So the top video I will play to you, will demonstrate to you that she’s been instructed to open and close her fingers. The effected side is her right side and then she’s instructed to open and close her fingers. Then she’s going to be instructed to abduct and adduct her fingers. And you can notice that there’s some contracture in the index and middle finger. That’s her attempt to abduct and look at how well the left side works.

The right side cannot abduct at all. And now she’s shaking out her hand because you’d probably be embarrassed. Okay, so just play that one more time so you can just compare for yourself. I’ll stop talking. There’s not much abduction and adduction of the fingers whereas the left hand side is completely normal. And this is important because the deep motor branch of the ulnar nerve is that responsible for the innovation of those interosseous muscles. And so what I did is I put needle heart-four, apply electrical current and because heart-four is the mixed nerve trunk, it will get everything downstream. They’ll get the sensation on the palmer side, on the dorsal side. You’ll get the deep motor branch, you’ll get the supervision branches and immediately after the first treatment and there is that. Now the ability abduct and adduct the fingers is immediately improved.

And that just goes to show you how adaptive are plastic our nervous system is even for something that’s been going on for several years. One treatment, as long as you’re able to have high specificity, you can really do a lot to help these patients. So that’s all I have prepared for you guys today. I hope you enjoyed that. I hope you learn something interesting about the heart points around the wrist and that they are in fact not the same point. They are very, very specific information that ancients have passed down for us. I hope that inspires you to review anatomy. Because I firmly believe that the more you understand neural anatomy, the more specificity you can have with your needling and then the better outcome you can deliver to your patients. Thank you very much everybody for listening. I wish you have a happy Valentine’s Day and don’t forget to join us next week. Our speaker for next week is Sam Collins. Thank you.

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AAC To The Point - Lorne Brown

The Magic Word That Gets You Committed Patients – Lorne Brown & Chris Axelrad

Lorne Brown, I’m your host. I’m a doctor of traditional Chinese medicine. I have my practice in Vancouver, British Columbia, and Canada. I’m also a CPA and an author of Missing the Point: Why Acupuncturists Fail and What They Need to Know to Succeed.

I’m very excited and fortunate to have a colleague and friend on today, Chris Axelrad. Chris is a leader in the industry. He has been the president of the American Board of Oriental Reproductive Medicine. I can tell you he knows his stuff and he shares his stuff, evident by the fact that he’s taught all around the world in US, Canada, and Europe. He’s spoken on healthyseminars.com. He’s been a presenter at the Integrative Fertility Symposium as well. This man, this practitioner follows his heart. He beats to his own drum. This is also evident by the fact that his family, his late father, his siblings, his uncles are all medical doctors, and he chose to go into acupuncture against their will and their desire. So there’s the man that follows his heart, his dream. He is very successful, and that’s why we have him on the show. He has at least four clinics, the Axelrad Clinics and growing with many associates. Now he also mentors acupuncturists so they can be successful. Chris, welcome to the show.

Thanks man. It’s awesome to be here. Appreciate you inviting me.

I want to hear about this topic that we chatted about that you’re going to share today on the magic, the magic word that gets you committed to patients. Can you start off with what do you mean by a committed patient?

Well, committed patient is somebody who shows up and is really serious about getting help. So they’re not kicking tires or just kind of looking, to see what it might be like to get some acupuncture or to get some herbal medicine or whatever. They have a serious problem. They’re seriously interested in solving the problem, and that in and of itself just lends itself to a different kind of attitude, a different kind of willingness to be led and to be really taught about the things that are going to help them to escape their problems. As opposed to patients, and I know all of us have had these kinds of patients before that are just sort of kind of showing up but then asking a lot of questions and constantly having doubts and constantly never know if they’re going to show up for their next appointment, things like that. So that’s really after a while of being in practice.

I think most of us start to realize that it’s going to be really tough to have not just a successful practice but a practice that we enjoy and a practice that we really feel is fulfilling if that’s the type of people that we’re attracting into our practice all the time, people who are just not at a place where they’re really serious about the process that we have for them. So to me is someone who’s committed.

It reminds me of one of my teachers that used to say, “The client has to want it more than you do, and the client has to work harder than you do.” You’re still showing up giving 110%, Chris, but you’re saying you want that patient not only to match it but to exceed that.

Well, here’s the thing, I mean, to a point, to a point. I think that for most, most people are just not aware of the amount of self-care and kind of work on themselves that goes into their process of healing, especially if they have a really serious medical condition. So sometimes we can’t just like in any way in my process, which has proven to be pretty successful by the fact that we do have four clinics, and I’ve trained three other people in my process and they do it pretty well. Our process is really predicated on not overwhelming people with and making them work, like they don’t even realize they’re working that hard. So it’s like this stealth kind of way that we go about it that gets them on board doing the most important things.

A lot of times they don’t realize how many things they are changing but, yeah. I mean, the bottom line is that you’re right. I mean, a patient can’t want it… If a patient doesn’t want it, we can’t want it for them. We can’t want the results on their behalf. A lot of people do make that mistake, and it’s a very draining way to go about practice because at the end of the day when you want it more than your patient wants it, you’re just going to a well that has no water in it trying to get water. So it just gets to a point where it’s fruitless.

So in this magic word, they get you committed patients. You mentioned when we have a committed patient then so they do want to do the self-care, and you have a system in place that stealth-like. So they’re making the changes and it’s not considered extremely hard work. What is this magic word you’re referring to when you say the magic word that gets you committed patients?

Well, I thought about it after I presented that idea. There’s really two magic words, but the first magic word is the name of their problem, the name of their problem that they were told by doctors, right? So I think what happens in our industry a lot is people avoid common terminology for diseases. Because sometimes maybe it feels like, “Oh, that’s not really Chinese medicine. That’s not really holistic. That’s not…” So we aren’t going to use that term. What we have to understand is that someone who doesn’t know anything about Chinese medicine, which by the way is 99.999999999 many nines you want to think about, a percentage of people in the West don’t know anything about Chinese medicine. So the terminology that we put out there if it’s not in their language and in their sort of meets them where they are, then they don’t pay attention to it.

So someone goes to a doctor and they’re told that they have, let’s say infertility, you’re in fertile. Okay, granted. I know in the fertility world there’s a lot of people who think that that’s a bad word, infertility, and I get that. The key is that to a person who has been told that by their doctor, that’s the label that has been sort of put on them and that’s the key word that’s going to get their attention when they’re starting to look for help. That’s the word that’s going to get their attention.

At same thing with, for instance, Crohn’s disease. So there’s a lot of people who want to brand themselves like, “I help people with digestive problems. I help people to have awesome digestion.” Well, no one’s looking for help with digestive problems per se. I mean, if it’s a digestive problem, what most people think of is, “Oh, a little reflux, a little upset tummy,” a little whatever. I can just go to the drugstore and spend five bucks and buy an over-the-counter medicine for that. Like I always say, if you’re competing with Zantac, Advil, Tylenol and all these things, Claritin, you’re losing. You’re going to lose because that’s not a fair fight.

When you start to call out the names of serious problems that people can’t go to the drugstore and buy a pill to fix Crohn’s disease, ulcerative colitis, not just headaches, not just neck pain but migraine, chronic, recurrent, severe, some type of severe headache; I’m not an expert in headaches but I’m sure there’s a million different terms for headaches besides migraines, or spondylosis or herniated disk, not back pain. Because again, the average person with back pain, yeah, back pain it sucks. No one likes to have back pain. At the same time, the average person with back pain is probably just taking over-the-counter meds or stretching or doing something like that.

When we start to call out real problems that have a connotation of a different level of severity, number one, when those are the words that we’re using, the terms that we’re using all the time whether it’s in our marketing or advertising or public speaking, whatever, then it connotes a different level of expertise, connotes a different level of skill and a different willingness to solve serious problems. That’s how we want to position ourselves. I mean, we don’t want to position ourselves as an accessory, as an alternative, as the cute little acupuncturist down the street that helps people relax. I mean, I don’t take that personally. Of course, I’m happy to help anybody who comes into my office.

When it comes to building a big practice, if you’re not really reaching out and offering to solve serious problems, it’s going to be a tough row. Because, again, the level of commitment. If someone comes in and it’s like their back hurts a little bit, you can probably fix that. I know for sure I can fix that in one or two treatments almost every single time, and then you just had patient come through and do two visits. It’s like, “Well, okay, now I’ve got to get another patient.” When that person goes out and just tells their buddy or their friend whether it’s a guy or a woman or a man, “Hey, my back’s better now. I went to acupuncture,” and all their only friend reference is this really easy problem that you help them fix and they tell their friend who has easy problems, “Well, guess what,” you might get a few more people in. They’re going to do three or four visits, and they’re going to quit. Why? Because they’re better, which is fine. That’s totally cool.

If we really want to have successful practice, we have committed patients that are coming back that are really working on a problem, then we have to actually use the names of those problems and not be afraid to use the big scary words like Crohn’s disease, again, getting into eczema, psoriasis. Again, infertility is a big one, endometriosis, you name it. If you call out these big problems, then people will start to pay attention and people who are really actually in need of our help. Because at the end of the day, a lot of these are chronic problems that Western medicine has no answer for. Because, as we all know, not that Western medicine is inherently bad, not that we should avoid Western medicine all together, however, Western medicine is like a sledgehammer sometimes. Sometimes you’re applying a nuclear bomb to a problem that just requires like just a basic, “Oh, no. I don’t want to use an analogy of a pistol.”

I am in Texas by the way, so you know. So you don’t need to bring a nuclear bomb to a gunfight, okay? If one little bullet will fix it, there’s no point in bringing all this power. That’s where Western medicine sometimes has a problem. That’s where we can come in and do amazing things to help people’s natural, innate healing process to kick in and fix the problem itself. The people who need that help the most are people who have had Crohn’s disease for 15 years and are on five medications, and the medications themselves are almost as bad as the condition itself. They’re really tired of that, and they really want something that’s going to give them a real way out.

When you start to brand yourself that way and you start to use those words, it brands you as an expert. It brands you as a high-level authority, and that’s what gets you the reputation and then, of course, you have to actually treat people. What I’ve found honestly is that our medicine, despite what a lot of people would tell you and even people in our own field might say, our medicine is immensely capable of helping people with these kinds of problems and in not that long of a period of time. So people will really, really start to buy into what we do more and more as we call out these serious problems and are willing to go out there and actually attack these serious problems and build ourselves that reputation of being able to solve these serious problems, so.

Let me see if I got this then I’m going to summarize what I think I’m hearing. You’re talking about a committed patient and also known as a motivated patient. So if you’re going to treat, you talked about eczema aforementioned. Eczema is something that somebody really wants to get rid of that usually. It’s more of a complicated serious problem versus somebody who got hives from eating something. If somebody’s got hives, they’re going to try something over-the-counter antihistamine and see if that would work. If somebody’s got a chronic condition, people with chronic like migraines or eczema or infertility, then looking to get good at even specialized like you’ve done with fertility is find an area where the patient is committed. So skin conditions, somebody has skin conditions especially around summertime, they’re going to want to make that clear if they’re going to put on T-shirts and shorts if it’s on their arms and legs or even on their face.

So am I hearing that right? You’re committed patient, you’re motivated patient, you’re looking for things where there’s not great alternatives for them. There’s not this over-the-counter quick fix. These are people that have chronic conditions, and they’re going to be motivated because of their condition. It’s interfering with their quality of life. They’re going to be seeking out help and a lot of these chronic conditions, although allopathic conventional medicine has done wonders. We’re alive here past age 40. It does great things. Cubed carrot is great. Some chronic conditions, Chinese medicine can treat effectively also, and we’re an option for that. So did I get that correct?

Yeah, exactly. I think it just has to do with, again, using these terms that are very specific and that connote a different level of problem. So it’d be like saying, “I treat allergies.” Allergies is a very general term most people don’t really feel. If you just say allergies to somebody, they’re going to think, “Oh, hay fever,” or just a little bit of a head cold one day taking antihistamine. When you start saying things like eczema, when you start saying things like severe allergic recurrent rhinitis or severe allergic sinusitis, I mean, again, I’m not an expert allergist, but there are lots of different conditions that are allergic conditions that we can certainly help people to balance their immune system more, help their immune system be less reactive so they may not need as much medication, things like that. But we’ve got to actually call that out.

Now the other secondary benefit of that is that if you say, “I can treat Crohn’s disease. I can help you with the symptoms of Crohn’s disease,” or, “I can help you to feel better with Crohn’s disease,” right, what does that say to the person who doesn’t have Crohn’s disease but has some type of digestive problem as well? It may not be Crohn’s disease, but maybe, I don’t know. They haven’t been diagnosed with that, but they just know they don’t feel well. They’ve been to doctors, whatever. What does it say to those people? Well, it says… It’s this kind of thing where it’s like, “Wow. If this person is offering to help people with Crohn’s disease, my problem’s going to be pretty easy for them.” Like I should definitely like check this out, right? So you kind of get this bigger benefit.

It’s called aspirational marketing, where you really call the big shot and what that does is it, and even people who don’t necessarily need that much help will still see you as an expert and someone capable of helping them.

For the practitioner, you’re going to want to have some, for me anyhow, some form of passion in treating that area. So Chris is sharing that. Use the terminology that the patient’s going to be familiar with, so be patient-centered focus. So use the terminology and the terminology will be some of the Western diagnosis they have received from their medical doctor. For example, if it’s Crohn’s that they received from their Western medical doctor, well, in Chinese medicine that is a disease category diarrhea, bloody diarrhea. This is something, it’s not called Crohn’s in Chinese medicine. However, we’re able to pattern differentiate the symptoms into your Chinese medicine and so you’re still treating the Chinese medicine pattern. You’re treating the individual. You’re not treating Crohn’s. That’s just the map that Western medicine has given that body, right, but that’s what the patient’s going to understand.

So that’s what I’m hearing. You say, Chris, is use the terminology that they’re familiar with. I’m adding that because Chris does a lot of work with fertility as do I in my clinic. We’re passionate about helping bring in healthy babies into the world and helping this population. We find it fun to work with hormonal imbalances and work with women and men wanting to have children. So it’s something that you’re going to need to have passion for because you’re going to want to do all that additional learning and studying, and you’re going to see so much of it. You’re really going to want to like it if you’re going to see that much of it.

Yeah. But I would say also I’ve gotten to a point, Lorne, for me anyway, this is just me and maybe it’s because I’ve been so heavily involved in helping people with their marketing and their practice management stuff over the last three years since I started my program. To me, the passion is seeing that smile on someone’s face when they start to realize like they found something that’s working. The fulfillment of the fertility thing is amazing to know that you’ve changed someone’s life in that way. It’s just as life-changing for someone who has suffered with a severe chronic illness for years and has not really been able to have a really good quality of life to suddenly feel empowered and realize that they’ve got something that is really truly changing their life.

So I always encourage my clients not to focus so much on the specific thing, the problems so to speak. Because sometimes we can’t decide what problems are going to come to us. I mean, it’s like the market is going in some ways make that decision as well. The main thing is to have a positive attitude and not focus so much on what you’re getting out of it and your own thrills, but focusing on like just the service aspect and certain people and empowering people. So when we’re more focused on that, then the specifics of exactly what we’re specializing in, to me, that’s what drives any successful practitioners, just the joy of knowing that you’ve changed someone’s life.

Sometimes that life change is very subtle. It’s not this really big obvious thing like a child, which is a super obvious change. Sometimes it’s a very subtle change that they’re no longer having trouble sleeping through the night. They’re waking up every day. They’re able to focus more, and that’s going to change their life in millions of ways going forward, I mean, so-

I think you hit it with the service to others. Because in the spiritual books, they talk about service to others. In the law of attraction books, it service to others. In the entrepreneur books, to be an entrepreneur, it’s about service to others. I think one in the Bible said, “Do unto others as you want them to do on to you.” It’s all about service to others. If you can do something that’s going to help the masses and it’s more about them than yourself, you’re on the right track. That seems to be a common theme in most of [crosstalk 00:22:01].

That’s it, man. So like there’s a lot of people who want to have a specialty fertility practice and maybe that’s just not going to happen because of several factors. Could be competitive factors. Could be just that in their city or their market, there’s just not enough people that have that problem to really have a whole practice revolving around that. So we’ve got to learn how to be humble and not want to make it all about ourselves and [crosstalk 00:22:34]. This is amazing that I’m helping you with this really simple, easy problem, but watching you grow and watching you overcome this. I’m not saying I’m saying this in patients, right, but just in my own mind. I mean, that to me gives me a lot of fulfillment.

I wanted to say real quick because I know we’re up against time-wise, but the other magic word that’s really important is actually a magic phrase is, “Yes, I can help you.” You need to learn how to say that even when you’re not sure, and here’s why. Because nobody’s ever sure. Even when someone goes in for IVF or someone goes in for a sinus surgery or someone goes in for to take a medication for that, as much evidence as there is that that procedure works, no one’s ever sure it’s going to work for that person until we try it. So we just say, “Yes, I can help you,” so that people will trust us and will be willing to try it out.

What I always do, look, and this is very counter what most people would say to do, but let me tell you why. Let me tell you why. I have chosen and I have realized that I always want to be the person who believes my patient can heal and be wrong. If I’m wrong, I will accept that. But when my patient is sitting here, I believe in them 100% and I’m not going to hold that back. I’m going to tell them, “Yes, I can help you. Yes, we make this happen. Yes, well, let’s do this.” I will take the hit of being wrong rather than being the person who holds back and says, “Well, I’m not sure. Maybe da, da,” and be right.

That’s not who I want to be. I don’t want to be the one that predicts or hedges against failure. I’m going to be the one that hedges for success. So you’d be surprised, man. I’ve never had a patient come back to me who didn’t get pregnant when I told them that I was really confident they could get pregnant. Honestly, I felt that way. I’m not lying. I feel that way, and we can’t control who gets pregnant. We can’t control who overcomes their Crohn’s disease or overcomes their eczema, but I’ve never had a single patient come back to me and tell me and tell me I lie to them or anything like that. In fact, I’ve had a lot of my patients who never got pregnant working with me, they still referred to me to this day. They refer people for other stuff. They even refer people to me for fertility.

So what they want from us is full effort. They want to know that we’re on board, and we believe in them. In my opinion, not one shift can bring you, I mean, at least double your referral rate if you just show up that way, because people want to know that you’re an advocate for them.

Speaking of the referrals. So you’re looking for the motivated, the committed patient, and you’re a practitioner that you feel you can help people with certain conditions you want to serve others. What are you suggesting they reach these patients to let them know they exist to get them into their clinic, this idea of the magic word to get committed patients? Do you have some suggestions for our listeners?

Well, yeah. I mean, we use a lot of paid advertising in my clinic. We’re hardcore about that. Last year, I want to say for 2018; I don’t have my books for 2019 yet, but for 2018 we spent almost $40,000 on advertising. What you have to understand is that’s for the entire year. Our monthly revenue is somewhere between 80 and $100,000, so you take that 40 grand we spent for the whole year. The point is, is that we’re spending that money and we’re paying Facebook and Google. We don’t do YouTube ads yet, but I want to be doing that this year.

To put the word out there in front of thousands of people every single day, every single day, here’s what we can help people with. Here are the things we help people with. What’s really cool about that is when you do that, you do it consistently over a period of time and you don’t like stop. That’s the thing. A lot of people make the mistakes like, “I run an ad for a month. It didn’t quite work. I’m going to stop.” Well, number one, you got to say the right thing in your ad. Number two, you can’t just advertise then disappear. Sometimes it takes six weeks, eight weeks, two months for people to see your name and get comfortable with you enough to actually take action. So you have to be consistent, especially at the outset.

What I was going to say is that we use those terms, we put them in ads so that people will see that word which applies to them. That’s like the leak in the chain that makes them stop and go, “Oh, wait, this is about me. Let me read this. Let me pay attention to this. Let me watch this video. Let me click this link and go see what this person has to say.”

When you know how to build this ecosystem of advertising and remarketed stuff and all that, you build a really powerful system to get people into your clinic. Like I said, we spent half of one month’s revenue per year on our ads. We never worry. We never ever, ever, ever, ever worry about whether we’re getting new patients. We get at least three to five new patient requests every single day, some days more, every single day.

You know what I’m doing? I’m in here treating patients. I’m at home. I treat patients two days a week. I see about 50 to 60 patients a week in two days. I have my associates. None of my associates are seeing less than 40 patients a week. One of them sees 70 patients a week, and it just rolls like that. I’ll have to check my ads every couple of weeks just to make sure they’re not getting stale, especially on Facebook. But other than that, man, I mean, it’s fun.

You’re having fun, and that’s a big part of it as well, having fun while you’re doing all this.

Yeah, it’s fun, man.

I want to thank you, Chris, for coming on and sharing. People, if they want to get to know more about some of the mentorship that you’re doing for acupuncturists on building practices, can you give us a website please?

Yeah, it’s chrisaxelrad.com. Axelrad is spelled A-X-E-L-R-A-D, so chrisaxelrad.com. I don’t have a big fancy website. Actually, the homepage is just a video, because I have a busy practice. I don’t have this whole thing, this whole big fancy operation-

His picture, it was good. I had a chance to see some of his material. So you’re right on, Chris. I know colleagues that have been doing your program and you’re transforming their practices, and I care about that because I want prosperous healers. I have a mission to help heal the planet, and you heal the planet by healing yourself, that was a self-care. So I think Chinese medicine is part of that as other modalities are as well, but Chinese medicine is part of that. It’s part of the plan. I think it has so much to offer on a spiritual, emotional, mental, physical level. So thank you for joining us.

For those you want to check out, I have healthyseminars.com is my website for Lorne Brown. I also just opened up lornebrown.com where I have conscious talk, so you can check that out at lornebrown.com. Next week, checkout To the Point. I’m at the AAC webinar series. We got Virginia Doran. Thank you guys very much.

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