A Resting of the Soul
In my pursuit of being a skilled health care provider, I focus on reading journals, attending classes, staying current on medicinal research, and choosing the correct billing codes. However, most of us would never have started down this career path if there wasn't something more.
End of Life Treatment
TCM looks death in the face. We do not camouflage it as if it were poisonous. "We must allow our patients to die but we cannot allow them to perish," was my first lesson the day I met my teacher as a teenager.
The Secondary Insurance Plan
I have a patient that has Medicare, but also has a secondary insurance plan that does cover acupuncture. How do I bill Medicare to get a denial so that I may bill this secondary payer?
Blockchain Health Records?
Keeping data secure has become a nightmare for the average consumer. Just consider general user account hacks on Yahoo (3 billion records compromised), eBay (145 million records compromised) and Facebook (87 million records compromised), to health record breaches involving Anthem Blue Cross (78 million records compromised) and TRICARE (almost 5 million records compromised).
Art of the Associateship: It's OK to Trust, But Verify
Trust is a valuable part of any business relationship. It serves as the foundation for all business operations and ultimately long-term success for owners, employees and customers. This is especially true in the world of health care.
Reducing Hip, Knee & Shoulder Replacements (Part 2)
In the first article in this series, "Early Detection Reduces Hip, Knee, & Shoulder Replacements," I described time tested screening procedures and perspectives as indicators of when to encourage your patients to seek further medical evaluation.
Autoimmunity, Gut Health and Diet: Connect the Dots
According to the National Institute of Health (NIH), autoimmune disease is recognized in approximately 24 million individuals in the U.S., consisting of more than 80 various disorders that contribute to the top 10 causes of death in female children and women of all age groups.
Doc, Are You a Social Media Holdout? Your Future Is Now
Whether you like it or not, to compete in any business, even chiropractic, you really should know and consider using social media. It is no longer a small, sleepy, local world we live in; it has become a far-reaching community.
Confessions of a Former Drug Rep: Statins Are Endangering Your Overweight Patients
As I sit at my desk on the sixth anniversary of my successful liver transplant, I can't help but reflect on what caused that life-threatening ordeal. Looking back on my personal situation, I want to offer my insight into what is happening routinely to many patients.
Why Take X-Rays When You Already Have an MRI?
Let's clear up the issue regarding the efficacy of plain-film studies when an MRI study has already been performed. I review imaging studies primarily for chiropractors, and often their patients have been to other health care providers before finding their way to a DC.
#TechPain: Causes, Solutions
For the past several decades, the science of ergonomics has blossomed. The workplace is much safer and life is generally more pleasant thanks to the application of ergonomic principles.
The Certified Practitioner
Certified Chinese herb practitioners often identify themselves with the credentials "LAc" (Licensed acupuncturist).
Help Shape the New Neck Pain Best Practices Guideline
The Clinical Compass (originally the Council on Guidelines and Practice Parameters – CCGPP) has issued a call for interested chiropractic clinicians to help shape a new best practices guideline for chiropractic care of neck pain.
News in Brief
WFC Among Founding Members of Global Rehab Alliance; HealthSource Selects GoChiroTV as Exclusive Digital Signage Partner; Western States' Online Degree Programs Among Best in the Nation; Logan University, University of Missouri-St. Louis Forge Partnership.
Facebook Marketing 101
Many of the health care practitioners we work with have smaller practices. The provider tends to wear many hats – office manager, salesperson and healer.
It's All About That Ki
As an industry are we shifting too much toward a Western mind set? We strive to understand how acupuncture works using imaging and extensive studies. We spend numerous hours of our training learning Western medicine and learning to speak their language. What happened to our core though?
A Bold Strategy to Take Chiropractic to New Heights
Building public awareness of an entire profession requires strategic planning – especially when it pertains to the exploration of ground-breaking marketing tactics that target new audiences with key messaging about the value of chiropractic care.
NCCAOM: A Route to National Certification
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) is offering a route to achieve national certification—without having to take any of the NCCAOM exams. This is specifically for California licensed acupuncturists that meet the eligibility requirements.
Trending: CBD / Hemp Oil
A recent survey of DCs regarding cannabidiol (CBD) / hemp oil provides food for thought as to the viability of CBD-based products as a component of chiropractic patient care. Here are some observations from the executive summary of the survey:
"Community Care" for Vets: It's Really a Big Deal!
As a preamble, while I regrettably never served in the military, I have the highest respect for those who did and those who currently serve.
Why the Automatic Denials for Modifiers 25 and 59?
Your experience is one shared by many chiropractic providers who bill through those plans. It appears to be the national trend, but by far is more prominent in Texas and Illinois.
The Classical Texts & Integrative Medicine
The acupuncture profession has been undergoing many changes in the past years. There has been a shift towards a more integrative approach to medicine as more hospitals include integrative departments.
UnitedHealthcare Can't Seem to Keep Chiropractic Down
AA decade ago, UnitedHealthcare announced changes to its chiropractic services policy that declared manipulative therapy for headache unproven.
Vaccines & Autism (Part 1)
It turns out chronic inflammation is the driver of autism expression. Unfortunately, those who emotionally embrace the vaccine issue rarely, if ever, consider this relationship, which hinders a rational view of the vaccine issue.
Treating Pain With Nutrition
Back in 1910, when D.D. Palmer published The Chiropractor's Adjuster and introduced the world to what he called the "triad of health" – thoughts, trauma and toxins – he explained that the body can only be made optimally healthy if all three aspects of health are addressed.
Does Dairy Cause Dampness?
The topic of dairy consumption was brought up at a scalp acupuncture seminar I recently attended.
CBD for Athletes: The Advantages of Cannibidiol
For athletes, pain is often part of their sport or activity. And to a certain extent, it is to be expected. However, after pushing themselves to the limit, soreness and fatigue set in, hampering their ability to perform and recover.
Valuable Adjunctive Therapies
Based on the latest CDC statistics, more than 795,000 Americans have strokes per year, 140,000 of which are lethal. Approximately 87 percent of all strokes are ischemic with an estimated health care and missed work cost of $34 billion annually.1
September, 2002, Vol. 02, Issue 09
Yin and Yang Deficiency, Part I
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
It is often said that all of Chinese medicine can be reduced to the fundamental theory of yin and yang. If you practice Asian bodywork therapy, the ability to understand, interpret and apply the concept of yin and yang are essential to one's practice.All anatomy, physiology, pathology and treatment principles boil down to yin and yang. The beauty of yin and yang is that something so simple can be all-encompassing and profound when examined more deeply.
You may remember a past article that presented the basic principles of yin and yang. (Editor's note: See "Got Yin/Yang" in the Dec. 2001 issue, or online at www.massagetoday.com/archives/2001/12/08.html.) Just about every other article I have written has mentioned yin and yang as well, including "Korean Four Constitutional Types, Part I and II" (March/April 2002), in which I discussed taiyang/greater yang and yaiyin/greater yin type of people. That two-part article gave an idea of what someone with an excess of yang or yin might look like from a Korean point of view, but I haven't really discussed in depth how yang or yin deficiency manifests.
It is interesting to see that as people age, they naturally start to get low in their gender-related yin or yang energy. For example, as women age and their yin begins to decline, they go though menopause. They may experience hot flashes, night sweats and frequent waking, which are all symptoms of yin deficiency. Their character also tends to become less yin. Some women grow less meek -- going out, doing more and standing up for themselves. If they become pathologically yin-deficient, they may become agitated, demanding and shrill. This is all relative, I suppose, based on your perspective or proximity to the person (e.g., "Your mother's driving me crazy!" Dad may say).
The opposite happens with men -- their yang decreases and they mellow with age, becoming more yin: easygoing, less confrontational and less combative. It's a good thing this happens to men, because their partners may be going in the other direction! This certainly isn't to the point of being pathologically yang deficient; on the contrary, both men and women may feel more centered, balanced and comfortable with themselves and others as they develop more gender-neutral dispositions.
If yang deficiency develops, men may become sexually impotent, thus the multi-million dollar market for Viagra. Getting up at night to go to the bathroom, cold extremities and lower back pain all point to a possible yang deficiency as well. A man's character may become too mellow, to the point of losing his confidence, becoming listless and apathetic. If he tries to "treat" his boredom with a younger woman, how ironic it would be if he couldn't "perform." It would be safer to get a sports car to prove his masculinity, but better still, he could start Asian bodywork treatments!
Please understand that this is a generalization. We can by no means put everyone in these categories. For one thing, men are not all yang, and women are not all yin. There is a balance of yin and yang within both genders in different proportions. But there is a tendency that you may have noticed for men and women to switch polarities slightly as they age.
This depends on how strong they are constitutionally, and how much they take care of themselves over their lifetime. Stress, drugs, overwork, environment and poor diet can contribute to depletion of yin or yang. This doesn't only pertain to growing older; anyone can become yin or yang deficient at anytime. In future articles, I'll address other causes, along with symptoms and treatment.
The symptoms of yin deficiency are mostly -related, but of small magnitude. This is called because the heat is not caused not by excess yang, but insufficient yin. So if you look at the first drawing below, you will see that it is only because there is less yin that the symptoms appear yang. An excess heat condition will give you symptoms showing the heat is predominant, whereas the heat caused by yin deficiency will be fairly mild in comparison.
Notice in both figures that the horizontal line signifies "normal balance." In the case of yin deficiency, the yang is not excess, meaning, above normal. Instead, there is only more yang, because there is relatively less yin.
The second drawing shows a true full-heat condition -- yang consuming yin.
In this instance, you see symptoms such as a rapid pulse, which signifies heat, but it's also thin or empty, which indicates yin deficiency. If it were rapid and full, it would indicate excess heat. With an excess heat condition, the tongue is deep-red, but with yin deficiency, it's red or even light-red. You will also notice that due to the depleted yin, there will be patchy areas or no coating. A full heat will cause the face to be all red, but with yin deficiency, only the cheeks will be red (called "malar flush" in Chinese-English). A full heat will cause someone to be hot all of the time all over his or her body. On the other hand, yin deficiency will cause mild heat, mainly in the afternoon or evening, night sweats and/or warm hands, feet and chest (called Five-Centers Heat).
Yin-deficient people find that they are thirsty but they don't really feel like drinking a lot, or they take small sips. They want to drink mostly in the afternoon or at night. Those with full heat want cold drinks and have a dry mouth all of the time. Both will have scanty dark urine and suffer from constipation (from being dried up), but those with full heat may have pain as well.
Emotionally, heat causes restlessness, but yin-deficient people experience vague anxiety and are not really able to pinpoint why in particular they feel edgy. They could even be defensive. A person with an excess heat condition is much more obviously agitated, and sometimes arrogant. Any heat will cause difficulty falling and staying asleep, but yin deficiency heat keeps people waking frequently during the night or early morning, whereas with a full heat, their sleep is extremely restless and dream disturbed.
All of these are general yin deficiency signs and symptoms. A person doesn't have to have all of them to be considered yin deficient. Become familiar with them in contrast to an excess heat and then look more deeply to figure out which organ is involved and what the etiology could be.
Yin Deficiency/ Empty Heat Excess Heat/ Full Heat Principle Signs and Symptoms Afternoon, mild fever High fever Night sweating Feeling of heat all day Five Centers Heat Hot all over Scanty, dark urine Scanty dark urine Dry stools, no pain Constipation, pain Thirsty with no desire to drink, or just small sips Thirst for cold beverages Dry mouth and throat at night Constant dry mouth & throat Mentally restless but tired, vague anxiety, fidgety Extreme restlessness, agitation or manic behavior Defensive Offensive or arrogant Waking frequently at night Dream-disturbed and very restless sleep Red line inside eyelid Red eyes Mild red, painless spots Red skin eruptions, burning pain Overextended Driven Complexion Red cheeks/ Malar flush Whole face ted Tongue Red with little coating, or peeled Red with yellow coating Pulse Rapid, thready, empty, floating Rapid, full Treatment method Nourish yin Clear heat
There are five common types of yin deficiencies, and three types of excess heat/fire. You will find others described in texts. In part 2 of this article, I will discuss what I see most frequently in my practice. The beauty of making yourself familiar with the general symptoms for a large category like yin deficiency is that all you then need to memorize are a few key symptoms for each organ/meridian, instead of a long list for each different pathology. In the next issue, I will be able to discuss many syndromes in fewer words, because now you know the basics!
This series of articles is only the tip of the iceberg. For a list of schools that offer in-adepth programs in Asian bodywork therapy, go to www.aobta.org. For information on the national ABT exam, go to www.nccaom.org.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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