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Michelle Gellis Thumb

AAC-Telemedicine and Facial Acupuncture-diagnosis & treatment strategies

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Hi, everyone my name’s Michelle Gellis. I am an acupuncture physician and I teach facial acupuncture classes internationally. I would like to thank the American Acupuncture Council for giving me this opportunity to present a webinar to all of you, on how we can best support our patients, our cosmetic patients, our neuromuscular facial patients now through telemedicine and also once we start opening up, how we can continue to support our patients safely in our treatment rooms if we’re doing any points on their face. So this is one example of how we can actually work on someone’s face. This was me teaching a class… A portion of the class was watching me do some face lifting techniques that are unique to what I teach, and I’m going to talk about that in a moment.

I found this cartoon which I thought was very fitting and it’s supposed to be someone doing long distance acupuncture, and I thought during this time it would be funny… not funny, but many of us have found ourselves trying to kind of scramble figure out how are we going to support our patients if we are in a place where we can’t treat them, and especially if you specialize in cosmetic acupuncture or you have any patients who are new or current patients who have any sort of neuromuscular facial condition, how can you help them? This is a slide from one of my classes and what it is, is a quote from Coco Chanel and she’s saying that from birth until age 25 you have the face that your mother gave you. From 25 to 50 you have your own face that you create, and then from 50 on you have the face that you deserve. I put this slide into this presentation because so many of us are missing that care that we’re used to getting from outside, whether it’s for our bodies, for our faces, for our skin, for our hair, many of us and our patients are used to going outside for these services. I’m in Maryland in the USA and here everything is completely shut down and has been, we’re on week eight now of complete shutdown.

So there are ways that we can support our patients during this time. Telemedicine is actually a wonderful way that you can support your patients, not just with needles like you normally would but there are methods that you can use to help them physically, emotionally… And I’m going to go through a few of those possibilities with you. One of the most important things to think about when you’re thinking about treating the face is how the face is connected to the rest of the body, and when you’re treating the outside you’re treating the inside. So by treating a person’s face you’re treating all of them, and the same goes for if you’re doing body points it also helps to treat their outside.

In my classes I teach a full body protocol for facial acupuncture. It’s not just working on the face which will help if you’re doing cosmetic acupuncture, you can kind of get around… work around some of the things that maybe you’re used to doing by providing some of that full body work. Additionally, now is a great time to do a telemedicine intake for your new patients. Assuming that some of us will be opening up, it’s coming up in the next few weeks coming into summer, really getting prepared so that when you do see your new patients you can limit or reduce the amount of time that you have to spend doing the face to face intake, I’m going to talk about that as well. How can you support your existing facial patients, whether or not they have a neuro condition like bell’s palsy, trigeminal neuralgia, stroke, Ms ptosis. Any condition that affects them here there are things that you can do now to get… to set the stage for when they do come in. Chinese medicine is uniquely suited to help our patients body, mind, spirit and so we really are at quite an advantage over some other modalities.

As I said I’m also going to talk a little bit about what we can do when we do open. So I touched upon that a lot of our patients who are used to getting different services, whether it is their Botox or filler or their lasers or peels, or just a facial amongst other things they have not been able or they are still not able to have these services, but there are things that we can do to help them and any of you who are on social media, know the myriad of jokes that have been going around people and their inability to care for themselves saying they can’t wait. The first thing they’re going to do is get their hair done or their nails done.

So this kind of points to that. So telemedicine in general is great because it does give us an opportunity to work on some skills that maybe we would have never spent a lot of time developing for those patients who are afraid of needles, don’t like needles. It’s a nice, safe way for us to be able to practice our art. Our patients are not… for many of them not taking really good care of themselves right now. So you can speak to them during telemedicine about what’s going on with you as far as yourself care. Have you increased your alcohol consumption? Have you been following your regular hygiene routine? Are you getting enough sleep? How is your stress level? And all of these are very much a part of what your regular telemedicine sessions can be. I’m a Worsley trained five element acupuncturist. So a big part of my background and my training when I’m working with my patients, whether they’re my cosmetic patients or my pain patients is too check in with them about all of their systems to see how they’re going, and certainly you can do that through telehealth.

The reason why I… part of the reason why I was able to really make the jump from in-person to a telemedicine for cosmetic purposes is that the… so the skin on our face is the only place on our body where our muscle is attached to skin. So you can move the skin on your face and what this means to us as practitioners when we’re doing a session like this, we can look at our patients faces and we can see the different signs of their emotions. We can diagnose them constitutionally… and I’m going to break this down in a moment, but all of these emotions will get launched in the face. Since telemedicine is done through a camera, you have a unique opportunity really to look at your patient’s face and diagnose them that way. People are dealing with a lot of emotional issues, loneliness, isolation, fear, grief, people. Parents are having to homeschool their kids.

There’s a lot of over nurturing that’s going on for people that are in families, a lot of togetherness and in some cases there’s a lot of anger and frustration. So all of this is going to show up right here and this is all going to help you with your diagnosis. Also, really talking to them about what’s going on and giving them some self care skills, self-nurturing skills some of which you already know and some of which you might need to be a little creative as far as how can you take your skills whatever they are meditation or [qigong 00:12:44] and deliver those things to your patients. As far as offerings, speak to your patients about their nutritional habits, lifestyle support, are they getting enough exercise? What are the eating? What are they drinking? And as far as actually caring for their skin, you can teach your patients acupressure.

So for your current and your new facial patients, it can be acupressure on facial points and it can also be some body points that affect the face. So anything that you might be needling you can teach them some acupressure, and what I’ve done is I’ve just taken charts and highlighted or circled things, either taken a picture, scanned it and sent it to them. And then the next time I meet with them I’ll do a little training session with them, I’ll ask them how it’s going. I check in from week to week and it really keeps you engaged with your patients, and it makes them know that you care. So facial cupping, if you’ve never done facial cupping before I have a website where all of my live lectures are recorded, they’re all CEU recorded webinars and I teach facial cupping.

I also have a live stream class coming up, I was supposed to be teaching it in London. It is the first weekend in June and all that information is on my website, it’s facialacupunctureclasses.com and part of that class is a facial cupping. So this is what a facial cup looks like and it’s relatively easy to teach your patients how to do facial cupping and also facial Gua sha. The Gua sha tools I like look like this, and I’m going to talk a little bit more about those in a second. Also, micro needling is something that you can train them to do at home with a Derma roller as well. Any of my live stream classes are also recorded as well, I did want to mention.

I put this picture of myself… This is me teaching. I do make a lot of jokes when I teach our time is limited here so I’m going to keep the jokes and stories to an absolute minimum, but I put this picture up because you can see the lines on my face and those are very typical or someone who smiles and laughs a lot. When I’m teaching I go through all the different lines and what they mean and where they come from but I’m going to give you guys just a quick overview right now, and things that you can talk about with your patients or just use them as your own diagnostic tools. So on the left here is more of a picture of the different areas of the face and the organs that they correspond to, and this picture on the right is from Lillian Bridge’s book Face Reading, and I actually don’t… I personally don’t teach either one of these, I have a recording of one of my friends who is licensed to teach her class.

I have a section of that, that I include on Chinese face reading but there are a lot of different types of lines on the face that you can use when you’re diagnosing. There are a five element tools if you know five element acupuncture or if you’re interested, I go over a lot of this as well but looking at your patient’s facial color, the sound of their voice and the overlying emotion these are things that you can actually do with your patient through telemedicine. If the camera or their lighting isn’t good, they can take a picture of themselves with their cell phone and send it to you, and you can get a better idea of their color. You can also do tongue diagnosis and this can give you more information, same thing have them take a photo and compare it. Although you cannot feel their pulse, you can certainly get an idea of the pulse rate.

So if they’re wearing one of those Apple watches or whatever, whether it’s their pulse is slow or fast and if they don’t have a device, one of those Fitbits then you could just ask them to feel their pulse and count it for you. There are a lot of physical signs of aging that you can use through telemedicine to help diagnose what’s going on with your patient. If I have time I’ll get back to all of these, but I just wanted to put some of these up. These are slides from… I think they’re in their first module of my recorded webinar about diagnosis, and some liver and gallbladder lines. Some signs of kidney out of balance, [spleen 00:19:27] deficiency and then all the different facial lines and signs of aging and what they mean. These are things that you can look for when you are diagnosing your patient through telemedicine.

So, that’s a lot about diagnosis now What about treatment? What can you actually do for your patient? Well, by treating their spirit you’re going to treat their face, right? If someone is stressed it’s going to show up on their face. If someone is angry it’s going to show up on their face. If someone is fearful… if they’re grieving all of this is going to show up right here. So using ear seeds and teaching your patient… I have one of these little ears that I use and I’ll show my patient where to put the ears seeds, and then I’ll give them a diagram of the ear and I’ll put little dots. You can… here’s a great point for relaxation and then there were actually points right on the ear lobe that treat different areas of the face, the endocrine system to help with their complexion can help to balance their hormones. I’ve had patients call me their hair’s falling out, their face is breaking out. So the ear seeds can be great and they can even put them on acupuncture points. If they’re home they’re not going out which a lot of us aren’t, they could just put the seeds right on points. As far as the cupping and Gua sha, you can either take one of my webinars, you could… as long as you credit me you could use some of the pictures from that.

You could draw a picture for your patient and just show them it’s relatively easy and just because your teaching them doesn’t mean they’re not going to come to you afterwards. Because they will enjoy having you do this to them much more than doing it to themselves, but just teaching them some simple facial cupping, some facial Gua sha, how to really use the Gua sha tools and learning how to prescreen your patients for whose a candidate is important.

So I do recommend that you get trained, you don’t just try to wing it. There are some pictures from some of my classes and some acupressure that your patients can do. If you have current cosmetic patients and they’re contacting you going, “I got to get in, I got to get in.” You can teach them some acupressure on different points on their face that they can use to help to stimulate some of these points, and these are some common points that I use in my classes, and also some distal points that would be part of a facial acupuncture protocol. I found this picture online, I liked it because it was color coded and it made it easy to share with my patients. Of course, herbs are something that you can recommend for acne, rosacea, different cheek deficiencies, blood deficiency, stagnation any of these things are going to show up on the face. Puffy eyes, redness.

Any sort of skin condition usually can be helped through herbs, and I am not an herbalist so I’m not going to go into a lecture. There are prescriptions and formulations that can help with different skin conditions. As far as micro needling you can get a microneedle device. I sell them through AcuLift skincare, my company the AcuLift Derma roller and Lhasa has them, but you can buy them sell them to your patients or ask your patients to get one. These are great when you are practicing for your patients to use them between treatments or during this time when they’re looking for a really low tech way to treat their skin. It’s roller with titanium needles and it doesn’t damage the skin at all, it’s very gentle and they could just roll it on their skin. It stimulates collagen and elastin, and it can really go a long way to keep their skin looking good. When they’re at home you could teach them how to use it and again these are safe.

They are approved by the American Acupuncture Council, the AcuLift brand is approved by AAC for use in the treatment room. It is the only brand that is approved by AAC, and they can be used if their hair is falling out, you can use it on your scalp to help to stimulate blood flow, reduce [inaudible 00:25:14] excess testosterone, balance the hormones in the scalp. They’re great for pitted scars, acne scars and a lot of other things and I teach microneedling as well.

I don’t want to spend a lot of time on all this. You can go to my website and look up all of this. I want to make sure I have time for once you open. So I have noticed that a lot of people are going back to work in the next couple of weeks. So one of the big questions is, what do you do once you reopen? If your patient is supposed to be wearing a mask, how are you going to treat their face? Well, there are a few options.

So first when you think about a mask, there’s really only a certain part of the face that a mask covers, right? So if your patient is wearing a mask, the areas that you’re going to have difficulty reaching will be anything around their lips or kind of the gel area. So doing points like stomach 8, [inaudible 00:26:42], gallbladder 2 which you can still reach, and distal points, large intestine four, stomach 36, stomach 40. These points will all help the lower [Hussey 00:27:01] points will help to access this area of the face. Also, using Dr. Tan, if you use Dr. Tans you can do body imaging and you can treat their body.

So even if they are wearing a mask of course you can still treat everything here, and you can do ear points, you can do scalp acupuncture and these can all work to treat all of this, and then using some of your other tools of some of these other points can help with the rest.

So some of the… one of the skills that I teach in my class is using… utilizing the auricular muscles and doing submuscular needling, and this also helps to lift the face. Even if your patient is wearing a mask, you can still access these as well as doing points along the gallbladder 18, which works on the galea aponeurotica up which connects the occipital and frontal bellies of the occipitofrontalis muscle. These are all things that really work to lift the face. What about if you’re trying to… if you are practicing five element, and you need to do some entry exit points on the face? Well, you can access all of them actually except LI20, and in that case you would go down to the next accessible point, which was large intestine 18 which is in line with stomach nine and right behind the SCM.

Lastly, some other alternatives if you feel comfortable having your… if you’ve check their temperature and you screen them thoroughly, and they are asymptomatic and you are wearing a mask and a face shield depending on what the regulations are in your state, you could have them remove their mask or move their mask and treat their face that way, and the last thing is I did find this face shield if you could see here on the right. It was designed for estheticians to be able to treat their clients. It’s a giant sneeze guard and when I first I saw it I thought it was a joke, but I just ordered one. So we’ll see how it goes but again it’s a possibility because if you have on a mask and a face shield, you’re safe but you also want to protect your treatment space. If your patient did cough or sneeze, that it wouldn’t be spread throughout the treatment space.

So again a lot of the stuff I talked about was for cosmetics, but definitely for your neuro patients utilizing body points… any points you can access and I also have a two part webinar on treating neurovascular facial conditions, and a big part of treating a lot of these conditions is scalp acupuncture and body points with some facial points incorporated in. So, that is the end of my lecture and I want to thank the American Acupuncture Council for giving me this opportunity to share everything that I shared. If you have any questions you can go to my Facebook group which is Facial Acupuncture, I’m also on Instagram Facial Acupuncture. I have a Facebook page, Facial Acupuncture classes and my website where you can also write to me is facialacupunctureclasses.com and next week we will… AAC will be hosting Matt Callison and Brian Lau. So, that should be a great lecture and I want to thank all of you for your time, and I’ll be more than happy to answer your questions as best as I can. Thank you so much.

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