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The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
January, 2004, Vol. 04, Issue 01
Introduction to the Sinew Meridians
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
Many of you may not have had much training in the topography, physiology, psychology and treatment of what are commonly called the "secondary meridians," a term that refers to the sinew meridians, which I will discuss in this series of articles, as well as the Divergent meridians, the Luo vessels and the Extraordinary vessels.We usually do not find much in our texts or training on this subject. Even the name implies they are not as important as the 12 "primary" meridians of which we are more familiar. Indeed, all of the meridians in Chinese medicine are important and worth learning and utilizing. Hopefully, these articles will broaden your awareness of these meridians, and you can start integrating them into your practice.
The body and its meridians in general can be compared to a musical instrument like a guitar or piano. Where we place our fingers on the frets or keys - like pressing the acupoints - will adjust the song or melody, heard as the client's life music. But if the instrument is out of tune, we can't produce any lasting harmony. The client needs to be brought to a place where he or she can change the "tuning" and mind set that created the disharmony. We can work on or "play" the meridians and points that we believe will allow our clients to heal. But the same vibrations or consciousness that produced the disease will not heal it; we have to alter the client's perspective. A client must be willing to change his or her way of thinking to encourage healing.
Metaphorically and, even, literally, this can be thought of as the Chinese medicine concept of Wind. Wind brings change and can be thought of as the ability to change. Since Wind is called the "root of a hundred diseases," we can think of the inability to change as the cause of illness. Fundamental to Chinese medicine is the idea that everything changes, and the lack of a willingness to change causes disease.
All of the above meridians and vessels work together as an energetic network. They can be thought of as roadmaps of not only the terrain of the body, but of our lives. The body can be divided into three levels: the external-wei-defensive qi level, the internal-ying-nutritive qi level and the constitutional-jing essence level. In one sense they are literal, as seen in our charts and texts. They can also be used philosophically or metaphorically as pathways connecting to different aspects of ourselves. The external level of our body is where our wei-defensive qi circulates. Strengthening our exterior prevents us from getting ill, according to one paradigm. At this level resides concern for our physical appearance as well as what is going on in the politics of the world. The wei qi level is our extension into the world and our judgments about how the world should be. This is a somewhat defensive state - "me against the world" - but it is our attitudes that create our relationship to the world that lead to imbalances in that level. The sinew meridians' terrain is on this level, specifically conducting wei qi.
The internal level concerns our emotions and mind that nurture us physically, as well as emotionally. Our digestive system relates to this level. It's where we digest information as well as nourishment for the body. This is the blood level, where consciousness is anchored. We make conscious choices concerning our lifestyle, including diet and the emotions we choose to feel. The Luo vessels are specific to this level; conducting blood and developing additional networks, as needed.
The Primary meridians circulate both qi and blood, which go to both the external and internal levels. Though useful, they are not specific to an area where a person may be working in their life. It could be more helpful to directly target the place where they are primarily functioning.
The Extraordinary vessels relate to our congenital factors, our constitutional level. They represent what we are born with and form our physical blueprint and purpose in life - our curriculum. The Extraordinary vessels were considered beyond our reach until as recently as the Ming Dynasty when the opening/master points were developed. Interestingly, the same debates occurred then (as they do now) with the morality of genetic engineering. Working on the constitutional level with the Extraordinary vessels was considered altering our genetic code, and the ethics of that was questioned.
The Divergent meridians go from the exterior, right to the source - the constitutional level. They divert potentially dangerous pathogens away from the internal organs to the joints and bones. Damaging experiences that we may not process well, such as sexual abuse, can be diverted by these meridians away from our heart or other organs that can be damaged. Then the pathology goes to our joints, lodging there, sometimes manifesting as arthritis or other types of pain.
I suggest becoming more familiar with these meridians from the "inside, out" through self-cultivation. Traditionally, this would mean Dao Yin, now called Qigong, or the more internal martial arts, such as Taiqi. Meditation and yoga can also bring a conscious awareness to the meridians and their flow. It's one thing to see the meridians in charts, finding and palpating them; it's a whole other experience to become acquainted with them through inner knowledge - some would say this is crucial. It is through self-cultivation and reflection that we become aware of our own path in life; which meridians we are emphasizing; and where our own curriculum is leading us.
Carl Jung said, "Our vision will become clear only when we can look into our own hearts. He who looks outside, dreams. He who looks inside, wakes."
By exploring the depths of our lives we can extend the invitation to our clients. And how much more exciting, energizing and revitalizing can that be? The ultimate satisfaction is to be working with people on that level, with the unfolding and discovery of their lives.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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