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What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
March, 2003, Vol. 03, Issue 03
Yin and Yang Deficiency, Part VI
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
This is the last of the series of articles on yin and yang deficiency, By now, you should have a pretty good idea of the primary organs involved and how to differentiate between the two conditions.
Always remember: Before looking at details, go back to the larger picture.Yin is cool, dark, relaxed, quiet, reflective and receptive; yang is warm, light, restless, exciting, outgoing and relatively more aggressive. When comparing the two, yin has a more substantive nature, whereas yang is more energetic. Yin and yang are relative terms; neither exists in isolation. They are in constant dynamic balance.
So, if you keep that in mind, all you are doing when treating yin or yang deficiency is readjusting the relative balance of yin and yang in the body, which is more important than quantity. Depending on the time of day or the season, we all feel different yin or yang qualities, but sometimes we get noticeably out of whack. In the case of a yin deficiency, the opposite back to the body, and determining how yang became so depleted in the first place.
Characteristics of yin are present, i.e., a relative excess of yang. In the case of yang deficiency, look for symptoms you might consider yin, but are actually representative of a relative lack of yang. A person might feel cold day and night, summer and winter, not because of an excess of cool/yin, but because, for some reason, his or her yang has been depleted or damaged. In this case, the treatment plan would have to include adding yang.
Let's start by discussing how to treat yang deficiency with Asian bodywork therapy (ABT); Later on, we'll address lifestyle, diet and environmental changes. I find ABT is often better than acupuncture in the case of deficiencies, because it can be extremely nourishing, tonifying and relaxing. Often, needles can be depleting if overstimulated and left in too long.
General Yang Deficiency Treatment
Anytime there is a yang deficiency, the primary treatment principle involves using moxa or a TDP lamp to tonify and warm yang. Make sure you are correct in your assessment, because you don't want to do this if the person has any excess heat! I don't use heating pads, hot water bottles or hot rocks, because they have no herbal penetrating energetic quality.
A TDP lamp is a strange, expensive device I call a "Chinese magic lamp." I don't think the lamp actually has supernatural powers, and I really don't know why it works - but it does. And every Chinese acupuncturist that I respect uses one. It's a heating lamp made with mineral plates that have the same penetrating action as moxa. It actually adds something into the body energetically that other therapies don't. You can get TDP lamps at any acupuncture supply store, but shop around, because they can be pricy.
To use a TDP lamp, heat it up first, then place it over the point you want tonified. For any yang deficiency, I would place it over Du 4 and Ren 6 for at least 15 minutes each. Make sure not to put it too close for too long, or you will burn the patient. If he or she gets a headache afterward, or if sensory feedback is compromised in any way, stop using it. Common sense rules.
The same goes with moxa. I would caution you not to use any kind of moxa unless you have been properly trained. You can cause serious burns or misgauge treatment, which is not only bad for business, it's not great for your karma or your client's health, either.
A moxa box is easiest, but it's also the smokiest, which can be a problem if you are sensitive to smoke or share your office, particularly since it smells a bit like marijuana. People give me side glances after using it, and I have had police come to my door inquiring about the strange smell. It is a box with no bottom but a screen in the center. You fill it with crude moxa, light it, and set it over an area such as the abdomen or lower back.
A moxa pole is also fairly easy to use. You gently circle over the point, visualizing spiraling the energy into the person's body. Don't overheat it; we are talking tonification here, so, as you know from my previous articles, be gentle, gentle, gentle, like you are petting a cat. Encourage the qi to come to the area.
I am not crazy about big, fat cone moxa that you knock off when it is too hot. It's fine if you like that technique and are good at it, but try to remove the cone before the patient starts screaming.
Since I was trained in Japan, I prefer another way of using direct moxa. I use an ointment called shiunko: a sesame- to rice-grain-sized, super-refined gold moxa cone, lit with incense and burned down to the ointment. It is somewhat labor-intensive, particularly compared to a TDP lamp, but it is quite effective once you know what you are doing.
You can use any of these techniques to warm Ren 6 and Du 4. Using either the pole or direct moxa, warm all of the Du points from Du 2 to Du 14, going up the spine, repeating a few times (general back treatment protocol). This is a powerful technique for tonifying yang; people will jump off the table warm and full of energy. As the Sea of Yang, the Du meridian is the best place to start to access the yang of the body. Warming Du 4, Ren 6 and Du 14 are general ways to tonify and warm yang. Utilize them in any session in which you are using that treatment principle, adding the specific treatment protocols below.
Kidney Yang Deficiency
Start the session with the back protocol above. Po Sum On is an herbal ointment you can rub on the client's lower back and sacrum before hand so the warm feeling lasts longer. Moxa Ki 3, Ki 7 and Bl 52, while the patient is face-down, gently and repeatedly warming each point. Next, hold the lower back area at the level of Bl 23 and Bl 52 with your fingers and heel of your hand, in a "bye-bye" squeeze. As you are holding, gently thumb press up each Kidney meridian on the legs, concentrating on Ki 3 and Ki 7. I suppose you could do this on the table, but the way I do it is on the floor, sitting between the client's knees, supporting their leg up on my knee, working one leg at a time. Obviously, this is not a position you would use unless the client is fully clothed! When the person is supine, moxa Ren 6. At the end of the session, reach under and cup both Bl 23s as you hold both Ki 27s with thumb and forefinger for a few minutes (mu-shu combo).
Spleen Yang Deficiency
Start the session with the general back treatment protocol. Use bilateral thumb pressure on Bl 20, 21 and 22, gently sinking in and holding each point. When your client is face-up, you can use a moxa box or TDP lamp on Ren 6 while you moxa Sp 3, Sp 6, Sp 9 and St 36. If you are using pole or direct moxa, continue up to Ren 9, Ren 12 and St 28, then gently thumb press up the Spleen meridian, one leg at a time, focusing and lingering at Sp 3, Sp 6, Sp 9, using your mother hand on Ren 6. Hold St 36 with firm thumb pressure as you hold Ren 9, Ren 12 and then St 28 bilaterally. Do the same with the other side. End the treatment by cupping your fingers and the heel of your hand under the patient's back, holding Bl 20 and 21 with one hand and Ren 12 with the top hand. Hold for a few minutes. Keeping your bottom hand in place, holding each Lv 13. Again, by doing this, you are holding the Spleen and Stomach shu and mu points simultaneously.
Heart Yang Deficiency
With the client prone, moxa up the Du meridian, as noted in the general back protocol. Go back and moxa both Bl 14s and 15s. Repeat moxa on Du 14, as it is particularly indicated for Heart Yang Deficiency. With the client's palms up, moxa Ht 5 and Pc 6 on each side. Hold Ht 5 with your thumb as the "mother thumb," press up the Heart meridian, ending at Bl 15s, holding Ht 5 with Bl 15s for a few minutes. Go back and hold Pc 6 with your mother thumb, then gently press up the Pericardium meridian as far as you can go, ending as Bl 14s and holding this combination for a few minutes. Repeat these two meridians on the other side. When the person is supine, moxa Ren 6 and Ren 17. Palm press the yin aspect of the arms while holding Ren 17.
It's always a good idea to suggest ways clients can support their health between sessions. For example, if they repeatedly expose themselves to cold weather, yang deficiency may persist. Make sure you tell your clients to bundle warmly, particularly around the waist. In Japan, they wear haramakis, which means "belly wrap-ups," to protect against cold.
The exercise you might recommend for yang deficiency would be any self-cultivation techniques, such as qigong or taiqi. Either one is gently tonifying and warming. If the client has lower back pain caused by yang deficiency, recommend exercises, in addition to stretching, to strengthen the back. If the client participates in more vigorous exercises, such as aerobics or running, and feel tired afterwards, suggest that he or she think about cutting down, stopping or switching to a more gentle form of exercise. Yoga is great if done properly. Again, if the client feels awful afterward, he or she is probably overdoing it. It's not about how great you feel while in class, or how far you can stretch; it's about how good it can help you feel in your everyday life.
Besides exercise, challenges and accomplishments tonify yang. This is one reason many people who retire start to become yang-deficient soonafter. They need to find something else that gives themselves purpose and adds meaning to their lives. Having goals, outside stimulation and activity nourishes yang.
Having sex too often also can deplete yang, especially that of the Kidney; however, Felice Dunas notes that being sexually rejected repeatedly over a period of time will also deplete yang. Continuous rejection can decrease sexual desire to the point of impotency or frigidity, which are symptoms of yang deficiency. When I see a client with a pronounced yang deficiency, I ask if he or she (or the partner) is depressed, and if so, if it has affected their sex life. If either is the case, I highly recommend they seek counseling.
Feng Shui is sometimes referred to as "acupressure for the home." Hope Karan Gerecht, author of Healing Design, says:
Diet is a factor in yang deficiency. Repeatedly eating cold foods inhibits our body's warming function, eventually depleting yang. This includes ice cream and other frozen foods, iced drinks and an excess of raw foods and fruit. Antibiotics are also considered cold and can be damaging if taken over a long period of time.
According to Daverick Leggett, author of Helping Ourselves: A Guide to Chinese Food Energetics, cooking food longer will increase its warming function and will encourage the heat to penetrate deeper into the body. Don't make the mistake of thinking "the hotter, the better," however. Food that is too spicy will cause us to sweat and we will begin to cool off, illustrating how yin and yang transform into their opposite in extreme situations.
Yang tonics tend to be sweet, pungent and warming. Choose foods such as: basil; garlic; lamb; sage; cinnamon; dried ginger; lobster; raspberry; thyme; chestnut; clove; kidney; nutmeg; rosemary; shrimp; and walnut.
Finally, encourage your clients not to rely heavily on stimulants to create the fiery yang vitality in their lives. Eventually, their body's ability to generate yang will be depleted. It's hard to keep going and keep pace with the demands of life. Bringing balance into our lives with self-awareness and self-care allows us to rise to life's challenges when needed ... and take a well-deserved rest afterward!
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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