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Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
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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