Disagreement in the Treatment of Diabetes

At the beginning of this year, the American College of Physicians issued revised guidelines for the drug management of type 2 diabetes.  Central to their recommendations is a target A1C of between 7% and 8% for most patients.  Conversely, for the past several years, the American Diabetes Association has set a goal of an A1C below 7%.  The ACP and the ADA are both influential healthcare authorities whose directives impact the way we practice medicine in America today.

While the discrepancy has led to a robust discussion among physicians, patients are more likely to just end up confused.  How can two authoritative sources disagree on the basic standard for optimal blood glucose levels for those with type 2 diabetes?  Of course, as Dr Shubrook from Touro University argues, there is consensus that diabetes care needs to be tailored to the needs of individuals patients.  Recognizing the value of personalized care, the disparity between the two guidelines can be understood as being representative of a broad spectrum of possibilities that allow physicians to make case-by-case decisions.

It is even more important, however, to grasp that the numerical findings from lab testing are, ultimately, numbers on a page, subject to both a margin of error and different perspectives regarding their relevance.  Disagreements among healthcare professionals are not unique to the interpretation of A1C results but also impact our understanding of cholesterol numbers, blood pressures, and PSA testing.  The use of the PSA test, in fact, has even drawn the sharp criticism of Richard Ablin, the scientist who first identified prostate-specific antigen.

Returning to the subject of blood glucose, it is generally accepted that lower blood sugars are preferable over chronic hyperglycemia, so one wonders why the American Diabetes Association would set a higher average target A1C.  There are two possible answers to this question.  First, according to research, hospitalizations and fatalities in elderly patients treated for elevated blood glucose are, in fact, more often caused by hypoglycemia than hyperglycemia.  Furthermore, other studies have demonstrated that many of the diabetic drugs generate at least one common adverse effect.  Adding to a patient's drug regimen is, therefore, likely to result in additional health issues which also require treatment, trapping doctors and patients in a vicious cycle.

This dilemma for conventional care is actually an opportunity for  AOM (acupuncture and Oriental medicine).  As a Western medical condition, the treatment of diabetes is outside of the scope of acupuncture and Chinese medicine care, but, backed by 2,500 years of success in helping those suffering from diabetes to enjoy a better quality of life, AOM is not dependent on our modern diagnoses or testing to be effective.  The key to getting a good outcome is relying on the unique methodology of traditional Chinese medicine that facilitates authentically personal care.

The process begins with identifying the main complaint and all of the presenting patterns for each patient.  By focusing on the chief complaint, the Chinese medical practitioner sets a pragmatic goal to quickly make a difference in the patient's quality of life, while addressing all of the patterns provides holistic, individualized care to promote long-term wellness.  Although the explicit reduction of blood sugar levels is unrelated to the traditional treatment goals of Chinese medicine, patients who receive Chinese medical care typically report significant improvements in their daily blood glucose readings and A1C levels.

As the number of individuals with type 2 diabetes continues to rise, we need to use all of the resources at our disposable to ensure that patients live the healthiest and longest lives possible.  This means not only availing ourselves of the newest Western treatment options but also employing traditional medicine where appropriate.  When it comes to the epidemic of type 2 diabetes, we just cannot afford to discriminate against useful treatments that can deliver the personal, effective treatment that patients need.

Ode to Caregivers

This short poem was inspired by a friend of mine who has provided care not only for her own family but also for others around her in need.  In addition to being a tribute to one special individual, these words celebrate all of those care givers who show us the capacity of the human heart for compassionate action.

Return to Sender

Burden eased by kind befriender,

A companion steadfast and true,

Broken spirits find their mender,

Begin to walk together through.

 

Courage fierce in the face of strife,

Ne’er daunted by the struggle great,

Relinquish freedom dear in life,

Share another’s fate.

 

Tending care for every need,

No hard request denied,

Proof in doing each small deed,

Of a love implied.

 

Where winding path finds its end,

From suffering and loss break free,

The final gift preparations to dispatch,

A light across the sea.

 

For support never failing trust,

Elevation for those laid low,

Repaying kindness is a must,

Here earnest blessing we bestow.

 

Henceforth from this special day,

Without delay or hinder,

May care equal to that given others,

Be returned to grace the sender.

No Surprise Here - Benefits of Healthful Eating for Kids

This week Medscape posted an article written by gastroenterologist Diane L. Barsky entitled "The Anti-inflammatory Diet's Surprising Benefits in Children."  In her discussion, Dr. Barsky describes a diet that combines traditional Asian and Mediterranean food culture.  This fusion diet is rich in fresh foods, fruits and vegetables, and legumes while minimizing the intake of processed foods, high-fructose corn syrup, and saturated animal fat.  Research has shown that this anti-inflammatory diet benefits children suffering from allergies, asthma, obesity, fatty liver, and, even, ADD and ADHD.

From those of us who consider good diet indispensable for good health, the only thing that is startling is the fact that a medical doctor--a gastroenterologist, no less--would find the multitude of advantages of healthful eating surprising.  Far from being beneficial, our standard diet today is barely even fit for human consumption.  Until very recently in our history, human beings had always eaten fresh, natural foods with less meat and more vegetables.  The modern inventions of trans fats, high-fructose corn syrup, and chemical additives in concert with contemporary farming and ranching have led to what amounts to a long-term experiment to determine if human health can be maintained on a diet of engineered foods.

If the health of adults is affected by poor food choices, it stands to reason that children are even more at risk.  Thousands of years of astute Chinese observation have revealed several important things about children and their diets.  First, our children come into this world with immature digestive function.  For this reason, nature provides us a sublime, nourishing food in liquid form, mother's milk.  Once infants begin reaching out for solid food, it is appropriate to slowly introduce bland, digestible, nourishing food into their diets and wean them off breast milk.  Finally, between the ages of 5 to 6, human beings develop the capacity to digest a wide variety of foods, and our parents can feed us more like adults.  In other words, when it comes to diet, kids are especially vulnerable.

Modern life has resulted, however, in widespread amnesia, and we know longer rely on the grand legacy of human wisdom to feed our offspring.  Fake breast milk, a manufactured blend of powdered beans or animal dairy derivatives enhanced with added chemical nutrients, often replaces nature's live elixir.  Instead of regular meals, we instill a lifetime of comfort eating in infants by feeding them on demand.  Finally, once solid food is on the menu, we rush to try out new and unfamiliar foods, delighted when an expression of happy satisfaction signals that a child has succumbed to the seduction of an adult food.

Putting our faith in food scientists, we reason that if it does not hurt us then it must be safe for our children.  In a time when diet-related heart disease, diabetes, and obesity are epidemic, we are obviously in denial about the safety of our modern diet.  Furthermore, we sadly see all of the negative consequences of contemporary eating most apparently in our children.  The good news is that medical scientists are now gathering the evidence needed to show the dangers of engineered foods designed by their colleagues in the food industry, thus proving scientifically what any observant person with common sense should already know.

The Art of Happiness

In the West, we normally perceive thought and feeling as two distinct phenomena.  Thought is understood as an active process, reflected in certain English idioms such as "giving it some thought" and "spending time thinking about it".  Emotions, feelings, on the other hand, are seen as involuntary responses to experience.  The   language reflects this when we talk about how something or someone "makes us feel".  Although we may complain of "feeling down", the experience of a general emotional state instead of a reaction to a specific cause, this, too, clearly describes a passive process rather than a deliberate action.

Chinese medical theory, however, challenges our normal Western suppositions by grouping thought together with the seven affects of anxiety, sorrow, joy, anger, fear, and fright.  Based on this traditional group, it is evident that the ancient Chinese viewed cognition and emotion as synonymous.  From our modern Western perspective, this attitude towards thought and feeling is bewildering.  How is it possible, one might ask, to lump together the activity of thinking carefully through a math problem, for example, with the sudden feeling of sadness we experience when hearing of someone's death?

Examples both of thought without deliberation and conscious feeling do, however, abound.  We typically refer to the former as instinct or intuition, experiences many cultures tend to associate with certain individuals.  In Western societies, for instance, there is the popular notion of "feminine intuition".  This reveals the fact that, although our culture recognizes inclinations that arise halfway between heart and head, we often characterize these thought-feelings as special gifts instead of identifying them as part of a common human experience.

Conscious feeling, too, is not unfamiliar to us.  Actors are trained to consciously control their feelings with the intention of causing their audience to laugh wholeheartedly or cry bonafide tears.  The power of positive thinking converts optimistic thoughts into a state of joy, and we manipulate our moods with drugs, both prescribed and recreational.  Like the pumping of the human heart, our emotional responses reflect both voluntary and involuntary processes.

With the recognition of the proximity of emotions and thought a comes the potential for a new, revolutionary way of thinking and feeling.  On the one hand, intuition gains credibility as an alternative form of thinking, one where, instead of depending on plodding logic, we can spontaneously leapfrog to a conclusion.  Fundamental to the workings of the mind, our gut feelings and instincts are then seen not as the domain of the chosen few but a natural human response when we need to react urgently.

Perhaps even more relevant to modern life is the realization of how inextricably our moods relate to our thoughts.  While it is not only misguided but potentially fatal to try and will oneself out of a clinical depression, we should also understand that, behavioral illness notwithstanding, we can play a pivotal role in whether or not we wake up on the wrong, or right, side of the bed.  To a great extent, happiness is a choice.  The secret, in turns out, lies in cultivating gratitude and appreciation at every opportunity.  Great expectations and the ability to see the silver lining even in misfortune are the building blocks of a lifetime structured to provide satisfaction and joy.

Beyond the Science of Modern Nutrition

Modern nutritional science can be very confusing.  It often seems that what is vilified one day is redeemed the next, calling into question the reliability of the Western scientific approach to diet.  Eggs have been celebrated as the perfect protein while also being implicated in heart disease.  Last year, a study proclaimed that coffee contributed to longevity, but, just recently, consumer advocates have called for warnings about the carcinogenic compounds in roasted coffee beans.  For decades, by law, all products containing saccharin required a disclaimer label.  After pressure from lobbyists, the FDA announced that it was all a mistake and dropped the legal requirement for labeling.

Every person on the planet needs to eat to live, and many of us rely on science to make judicious dietary choices to improve our quality of life, minimize disease, and promote a long lifespan.  The origin and development of modern nutrition, however, has not generated societal health and wellness in America. On the contrary, as the science has progressed, obesity and disease directly linked to poor eating habits have spiraled frighteningly out of control.

To be fair, many of us ignore the admonitions of health authorities, allowing ourselves to be seduced by addictive treats, persuaded through clever advertising, and won over by convenience.  Case in point, few of us eat the total daily number of servings of fruit and vegetables advocated by nutritional experts, a failing that certainly impacts our health as a nation.  On the other hand, at the behest of nutritionists, the past few decades have seen Americans reduce beef consumption in favor of chicken.  Trading in our sirloins for drumsticks, however, has not paid off in any measurable benefits to health.  Is the campaign against red meat, like the science on the cancer-causing properties of saccharin, the product of bad science?

Ultimately, scientists face a fundamental dilemma handling the daunting chemical complexity of foods.  The scientific method depends on reducing and controlling variables and, at some point, as variables multiply, the dictum known as the Heisenberg uncertainty principle predicts that scientific analysis will become logistically impossible.  The human diet is a perfect example of science hitting a brick wall.

To understand this better, imagine a symphony orchestra.  Just as an orchestral performance is more than the product of a single musician playing an instrument, the foods we eat are complex aggregates of chemicals.  Milk, for example, consists of water, fat, proteins, lactose, minerals, and numerous trace elements, each akin to individual musicians in the orchestra.  Grouping together all the similar components in foodsproteins, for examplelarger units are formed that echo the orchestral instrument sections.  Finally, the skillful coordination of all the sections into a harmonious whole yields the final product:  a unique food, the alimentary equivalent of a performance of Mozart's Requiem.

Not unlike someone who gives all the credit for a performance to the conductor, nutritional science tends to characterize foods based on their primary nutrients.  Instead of identifying the special character of each food, lentils and turkey get tossed together as "proteins", while rice and potatoes fall under the rubric of "carbohydrates".  Although this simplifies dietary recommendations, it ignores the unique effect of each food on human physiology which, in turn, is a function of the sum total of its special chemistry.

Faced with its failure to achieve health through diet, nutritionists have resorted to recommending the traditional diets of healthy societies.  For example, the Mediterranean diet, scientifically proven in studies, is now offered to patients as a template of healthful eating.  This new approach not only avoids oversimplifying the intricate chemical structure of foods but also provides a more practical solution in the kitchen.  For people making real life choices, it is easier, and more enjoyable, to add extra virgin olive oil and garlic to their cooking than it is to attempt to balance the ratio of protein to carbs.

The Good, the Bad, and the Ugly

Several years ago, I was on the train from Albuquerque to Santa Fe, on my way home, when I struck up a conversation with an amicable young woman.  Once I revealed that I worked as a healthcare professional, she freely began sharing her medical story with me.  As a practitioner you find that many people do not hesitate to open up and divulge personal details about their health. 

She had tried Chinese medicine for her condition, with modest success.  In telling her story, she mentioned that the practitioner was a seasoned veteran who had practiced for many years.  I racked my brain trying to think of which senior practitioner she might have seen.  When she eventually remembered the name of the practitioner, I was perplexed and a bit troubled.

The acupuncturist had, in fact, only graduated recently, but it was possible that the patient had just misunderstood something that was said.  I wished the woman well and did not immediately follow up on our conversation.  At some point, however, I went to the practitioner’s website and read the bio the practitioner had posted for prospective patients.  There it was, in black-and-white: the unabashed claim that she had been in practice for well over a decade. 

Honestly, it made me angry.  I have worked hard to build my practice over the years.  Despite the financial struggles, the difficult cases, the emotional heartbreak when your patients do not respond well to care, day by day and treatment by treatment, I have earned the insight and skills of an experienced practitioner.  With that single fraudulent claim, however, I felt someone had robbed me of a prized possession.

We are encouraged to be nice—in academia we use the term collegiality—and to avoid judging or criticizing others, but, when the safety of the public is at stake, there is an obligation to speak out.  Not only did the false claims of my colleague affect me, she was misleading the public by misrepresenting herself. 

I contacted the board and ask them to investigate.  After a phone conversation with the acupuncturist in question, they determined that her previous work in another healthcare field gave her claim nominal legitimacy.  Of course, as my conversation with one of her clients proved, patients go to her clinic under false pretenses and give up on Chinese medical care when, what they perceive to be expert care, does not work.

I was recently reminded of this story after doing some research into a company that provides herbal supplements primarily to doctors who practice CAM.  That founder of the business, responsible for all of the company's formulations, labels herself a naturopath, but provides no history of training or education.  According to the state website, that individual currently holds no professional licenses, medical or otherwise, in California.

This is not the only time I have seen a lack of integrity in complementary and alternative medicine and, sadly, the acupuncture and Oriental medicine field is no exception.  At the student level, I have been privy to cases of blatant cheating and plagiarism.  Among professionals, it is no secret that there are Chinese practitioners who studied and practiced Western medicine in China only to magically transform into TCM experts in the U.S.  Yet another example involves an acupuncturist who only received introductory training in Chinese medicine but is a favorite referral for of Harvard-trained M.D..  The opportunities, unfortunately, for people who wish to embellish, exaggerate, or even fabricate their training, credentials, and experience in CAM are ample.

There is good news.  In my involvement with the accreditation of schools, I have met and worked alongside many individuals with exceptional integrity who are bright, extremely knowledgeable, and committed to excellence in our education system.  This translates into constant progress in AOM education which, in turn, produces professionals with genuine expertise.  Once enough time has passed, those individuals who got by in the past with questionable claims will hopefully be replaced by those who have been well trained to provide safe and effective care.

If you are a colleague, I would ask that you represent yourself accurately.  Be proud of your accomplishments and only publicize titles you have earned.  If you are a novice practitioner, resist the urge to inflate your clinical experience, keep learning, be humble, and work diligently.  Be worthy of the generations of Chinese doctors who risked their lives to find effective herbs, read and reread the classic texts to develop better treatments, and dedicated themselves selflessly to helping patients.

If you are a patient, do due diligence and do not believe everything you read or are told.  Many states have acupuncture boards that maintain websites where you can research a practitioner’s qualifications.  Take a few minutes to confirm that a clinic’s advertising is accurate.  Know that herbs and acupuncture are not always safe and select a professional who has been well-trained to provide the services you need.  Recognize that complex conditions often demand a healthcare provider with at least a decade or more of experience and rely on newer practitioners primarily for simpler complaints. 

Chinese medicine has the power to change lives, but, like all tools, its true potential can only be reached when it is used by an expert.  It is my hope that we here in the West will continue to cultivate our Chinese medical culture to ensure that we do justice to this ancient and profound medicine.

Treating Prolapse with Chinese Medicine

In my 17 years of practice, I have seen many patients, usually middle-aged women, who experience prolapse.  It is rarely a main complaint, suggesting that patients do not expect Chinese medicine to treat their condition.  In this blog, I would like to introduce the TCM point-of-view of prolapse and describe a specific, effective treatment.

Prolapse refers to the inconvenient and often uncomfortable sinking and even external protrusion of bodily organs.  Common areas affected by prolapse include the stomach, uterus, and the rectum.  Western medicine shows relatively little interest in the cause of prolapse preferring, instead, to focus on practical remedies.  In most cases, these solutions involve surgically returning the tissue to its rightful place and using implants, such as metal mesh, to corral the anatomy.

Chinese medicine takes a different view.  Qi, the fundamental resource responsible for all bodily activity, holds or contains the tissues in place.  In patients who are fatigued and weak, any form of leakage, whether spontaneous sweating, uterine bleeding, or rectal prolapse, may be seen as qi failing to contain.  In treating these conditions, the Chinese doctor primarily focuses on boosting function, or qi, to allow the body to pull organs back into place.  Physically lifting sagging tissue, possible with acupuncture, is of secondary importance.

Center-Supplementing, Qi-Boosting Decoction or Bu Zhong Yi Qi Tang is a remarkable herbal formula known for its ability to treat prolapse.  The formulation utilizes huang qi astragalus to boost qi and lift up fallen tissue.  Ren shen ginseng, bai zhu ovate atractylodes, and zhi gan cao licorice root assist astragalus by increasing the available qi.  Chai hu bupleurum and sheng ma cimicifuga, when used in small dosages, gently elevate dropped organs.  Finally, dang gui tangkuei nourishes blood, providing a solid foundation for building qi, and chen pi tangerine peel stimulates movement to prevent the richness of the other herbs from creating stagnation in the gut.

In my clinical experience, this Chinese herbal formula is an effective treatment for many different types of prolapse.  I have used it as a raw herb decoction, a granular blend, and in the form of prepared pill or tablet.  As with most formulas, the best method is crafting a custom prescription designed to meet the specific needs of the patient.  Nevertheless, I have also seen good results with a modest dose of tablets.  One colleague even reported having success treating a horse suffering from prolapse with Bu Zhong Yi Qi Wan pills.

Regardless of the exact Chinese treatment, organ prolapse should never been viewed as a simple structural issue.  Patients with prolapse have a systemic deficit that needs to be addressed to ensure a long-term health and well-being. While fixing a prolapsed region of the body satisfactorily manages a symptom, it is always essential that the physician take the next step to try and identify the root cause.

The Spirit of Chinese Medicine

In modern Chinese medicine, 神 shen, often translated as spirit, is a key concept.  Due to the many and varied meanings of the word spirit in English, this term often leads to confusion, both among patients and professionals.  Here we would like to explain the understanding of this idea within the Chinese culture.

Bob Flaws, who coauthored Chinese Medical Psychiatry, points out that there are three different connotations of the term 神 shen.  The non-medical usage describes a universal consciousness or pervasive animating force and has been compared to the Native American idea of the Great Spirit.  Within a medical context, however, spirit has different implications.  The standard medical usages can be categorized into the broader and more narrow meanings.  Many Western practitioners of Chinese medicine have been taught that 神 shen mainly describes the overall vitality of a patient.  This is the broader usage and, in practice in China, is largely employed to determine the prognosis of a critically ill patient.  This form of spirit is most apparent in the patient's eyes.

Far more important in the daily practice of Chinese medicineespecially here in the West where most clients are ambulatory is the narrow meaning of spirit.  This application roughly equates to consciousness and is the central subject of the study and practice of Chinese medical psychiatry.  For many patients who have diagnosed with a behaviorial health disorder by a Western doctor, the Chinese practitioner will focus on spirit as it is understood in the narrow sense.

Chinese medicine offers a number of statements describing the anatomical and physiological nature of spirit.  The spirit resides in the heart.  It is an accumulation of qi and blood.  When healthy, the spirit remains level in its abode.  During the day, the spirit extends outward through the orifices of the heart and connects to the phenomenological world beyond, retreating to the inner sanctum of the heart at night where it is enfolded by blood and yin.

There are three fundamental ways in which the heart spirit may be out of balance.  First, heat may harass the spirit leading to symptoms such as mania, agitation, or insomnia.  Second, a lack of qi and blood may result in malnourishment and nonconstruction of the heart spirit.  Finally, the orifices of the heart may be blocked, preventing the spirit from productively connecting with the outside world.

A person in a manic state with a predisposition towards heat, a red tongue, and a rapid pulse is an example of the first pathology.  A fragile patient suffering from palpitations, forgetfulness, and difficulty sleeping exemplifies the second case, while a schizophrenic, trapped in an individual experience and unable to connect with common reality, with a slimy tongue fur and slippery pulse, would be diagnosed with blockage of the heart orifices.

As with other translated concepts in Chinese medicine, there is no simple English equivalent for 神 shen spirit.  Only by taking the time to explore the numerous uses within the native culture is one able to get a sense of the true Chinese medical meaning of the term.  Beyond being a stimulating semantic exercise, taking the time to learn more about the Chinese perception of spirit allows us to better utilize, and receive, Chinese medical care intended to address disorders of spirit.  In many cases, a nuanced understanding of the Chinese idea of spirit may make the difference between clinical success and failure.

A Tribute to Miso Soup

For 2,500 years, Asians have been savoring the taste and healthful properties of miso, soybeans magically transformed using salt and a microorganism called koji.  In even more ancient times, Neolithic Jomon people discovered how to make fermented pastes from grains and fish.  For the modern Japanese, miso is a part of everyday life and an essential ingredient in the Japanese cultural identity.

Miso enjoys countless applications throughout Japanese cuisine.  One popular main dish uses fish, mackerel being a favorite, slathered in a thick layer of the rich paste and grilled to perfection.  Another example of the versatility of miso is the drinkers' favorite morokyu, a pleasing side featuring chunky moromi miso as a dip for spears of crisp, chilled cucumber.  In kaiseki cuisine, a dish known as dengaku drizzles creamy white miso on purple medallions of grilled or sauteed eggplant, recalling a crest of snow atop Mt. Fuji.  Even desserts in Japan have utilized this fascinating seasoning.

Of course, the most familiar vehicle for miso, both in Japan and abroad, is miso soup or misoshiru.  All but the most formal of Japanese meals can be accompanied by a serving of this satisfying Japanese soul food, and there is no better way to begin the day than with a bowl at breakfast.  Almost as comforting as a mother's embrace, miso soup can easily become an addiction.

Miso soup is not only good but also good for you.  The soy provides protein made more readily digestible by the traditional kelp base.  Miso is well known for its ability to detoxify, and the active cultures derived from fermentation, when preserved by avoiding boiling, benefit the gut.  As with any soup, adding a cup of miso to your table facilitates eating volumetrically, delivering the sensation of satiety with a modicum of calories.

Some Westerners have been known to whip up faux miso soup, an insipid blend of miso paste in water.  This misinterpretation skips the dashi soup base, the warp and weft necessary for good soup.  Although miso thinned with water may have its applications in the kitchen, it should not be mistaken for an edible dish.

For the real deal, numerous types of dashi can be prepared, but the easiest is simply made from good quality kelpavailable in Asian marketssoaked overnight in water.  After straining out the seaweed, bring the subtle, amber broth to a boil and then allow it to cool slightly.  Set aside a small amount of warm dashi and briskly whisk in a dollop of miso to taste.  Choose red or akamiso for a bolder flavor, white shiromiso for the refined taste preferred in Kyoto, or a blended awamiso when you just cannot chose. For those concerned with sodium, low salt varieties are easily found.

In Japan, miso soup is almost always served with something solid, called gu in Japanese, added into the broth.  Tangy curls of green scallions, a raw egg, cubes of potatoes or soft tofu, or certain types of sea vegetables are the usual suspects.  Any additions should reflect a sensitive appreciation of the seasons, with lighter and more flavorful choices in the spring and summer, while hearty ingredients should be reserved for fall and winter.

Whatever your preference, miso soup can be a great addition to your diet.  Start simply and then explore the plentiful varieties of this versatile dish.  We hope that, like us, you will find this Japanese staple fulfilling to the palate and advantageous to your health.

How Safe and Effective Is the Flu Shot?

This year influenza has been widespread.  We have seen patients who have reported rapid onset of symptoms with severe respiratory symptoms and persistent cough for weeks after infection.  The virulence of the current flu epidemic raises questions about how best to prevent and treat influenza.

Our research has revealed only a single study that broadly evaluated the existing medical literature on the vaccine.  Published in 2011, the authors reviewed 44 years of research and concluded that the treatment modestly reduces flu symptoms.  They found no evidence, however, that the vaccine is effective in those over the age of 65, and their analysis revealed that protection is best in children between the ages of 6 months and 7 years who have received the live vaccine. 

The study contradicts what we are told by our doctors who typically encourage the flu shot.  Is the 2011 study rigorous and reliable?  According to reviews, the research by an American infectious disease team was, in fact, of high quality, and the study was peer-reviewed and selected for publication in The Lancet, a respected journal.  Why then are our healthcare professionals making recommendations not in line with good scientific data?

Keep in mind that the healthcare professionals who interact with patients, by and large, are not obligated to follow the standards especially regarding vaccinationsset by governmental authorities, namely the CDC and the FDA.  These organizations, in turn, make decisions based on research, and meaningful, large-scale studies are usually performed by entities with deep pockets, namely the pharmaceutical companies.  Not surprisingly, independent research often challenges the findings from industry scientists, raising the question of conflicts of interest.

The authors of the 2011 study emphasized in interviews that their research should not be taken as a recommendation against the influenza vaccine.  After all, the meta-analysis did demonstrate some benefit with the flu shot.  The lack of evidence for effectiveness in older patients is attributable to the fact that, since the 1960's, it has been considered unethical to perform RCT studies which deprive high-risk patients of protection against the flu.  Due paradox, public policy likely continue based on assumption rather than scientific findings.

Like the researchers, it is not our intention here to contradict current public health policy.  But with reports that this year's vaccine is less than 10% effective against the H2N3 strain of the flu, public health authorities and researchers should reexamine our current protocols and perform additional research.  Although the medical establishment maintains that standard vaccinations are safe, the government VAERS database demonstrates a wide range of adverse events resulting from vaccines.  In a field where under-reporting is likely, more studies to clearly demonstrate that the benefits of vaccines are worth the risk are desperately needed.

Infertility, Erectile Dysfunction, and Developmental Delays Linked to Popular Painkillers

Two new studies raise concerns about NSAIDs or non-steroidal anti-inflammatory drugs.  While many people are aware that over-the-counter painkillers can result in gastrointestinal disease and liver damage, researchers have uncovered other, more indirect, risks associated with these common medications.  These recent studies suggest that male infertility, erectile dysfunction, and even developmental delays in children may all be linked to the use of popular pain relief options.

One study published in the Proceedings of the National Academy of Sciences of the United States of America investigated the effects of ibuprofen on male reproduction.  In the clinical trial of young men who used ibuprofen, the authors demonstrated that the popular painkiller alters cells in the testicles and impairs hormone production.  The resulting conditions can negatively impact both sperm production and testosterone levels, decreasing fertility and possibly leading to other issues associated with insufficient testosterone. 

Another study unveiled in the January 10th online issue of European Psychiatry describes research that attributes language delays occurring in girls at 30 months of age to prenatal acetaminophen exposure.  The authors determined that the severity of the cognitive impairment increases with the dosage of acetaminophen and higher levels of the drug in the urine.  With as many as 65% of pregnant women in the U.S. using acetaminophen, the findings of this Swedish are alarming and may lead to changes in the standard recommendations given to pregnant mothers.

Given the dangers of opioids in pain management, new evidence of the risks associated with NSAID painkillers paints a bleak picture that leaves few good options for individuals in pain.  The disadvantages of pharmaceutical treatment make it all the more imperative that patients explore alternatives like acupuncture and Chinese herbal medicine.  Public health authorities and insurance companies must adopt decisive policy to promote public awareness of non-pharmaceutical pain management choices to avoid creating additional medical issues stemming from the adverse effects of drug treatment.

What the Opioid Epidemic Really Means

America is in the midst of an epidemic.  Americans are hurting and turning to painkillers to ease their pain.  Unfortunately, opiates pave a road to addiction and death.  In 1999, 4,000 people died from overdoses.  The total number of deaths attributable to opiates skyrocketed to 62,000 in 2015, making the opioid epidemic a greater cause of death in our country than car accidents.  Put another way, prescription drugs end 78 American lives each day.

The feds have responded by declaring a war on prescription drugs and sending their agents out to investigate, prosecute, and penalize.  Cracking down on healthcare providers, government efforts have had the unintended effect of pushing sufferers to turn to heroin to ease their chronic pain.  Of course, the switch from legal to illegal pain management does nothing to reduce the chance of falling victim to an overdose, and many hooked on heroin have ended up on the slab.

Our government is missing the point.  The opioid epidemic is not a drug epidemic but a failure of our current system of healthcare to effectively treat our chronic pain.  With the number of annual prescriptions for pain meds climbing to a staggering pinnacle of 289 million prescriptions in 2016, one thing is clear:  too many patients are left with no better option than to numb their bodies and sedate their minds in order to be able to function.  Revoking the licenses of pharmacists and doctors who demonstrate injudicious or criminal behavior may be a critical stopgap measure, but we ultimately need more innovation and flexibility in our management of chronic pain to get to the root of this problem.

Others have pointed out the absurdity of government policy that is punitive without offering any solutions to the complex dilemma of pain management.  We must always use opiates responsibly to control our aches and pains but we also need to be able to perform simple daily tasks without paralyzing discomfort.  One wonders if, between massive cuts in the healthcare budget and the war on prescription drugs, American patients dealing with chronic pain will be left with no good options beyond biting the bullet and getting through life as best they can despite the agony.

To be clear, this is not a partisan issue or, even, a political issue.  The pain epidemic and the opioid epidemic that follows in its wake is an American healthcare crisis.  Although we need our government to recognize that the American people need its support, not just law enforcement, it is even more important for our healthcare providers to respond to the crisis with new ideas and therapies.

Some good options for pain management do not need discovery but only await formal recognition.  Few alternatives to palliative care with risky opioids are as promising as traditional acupuncture.  As a treatment option, Chinese acupuncture care is methodical, well researched, low cost, and safe.  It can often be used by those who are not be good candidates for surgery and have exhausted other conventional treatments, patients who desperately require relief from chronic pain syndromes, offering them quality of life without the risk of addiction.

Those of us who use acupuncture have been successfully treating chronic pain for decades, but we need a shift on the part of lawmakers who develop policies to incorporate acupuncture care more completely into the mainstream.  Other CAM methods must be explored as well.  Only by first recognizing that Western medicine is failing these patients and then seeking out practical answers for chronic pain conditions will we be able to stem the rising tide of dependence on prescription opiates.  This is the only public health strategy that promises a permanent fix and sets American patients on a course that is safer, healthier, and happier.

Why I Translate

Recently, I decided to get back into the task of translating Chinese medical journal articles into English.  While working through the first selection, I reflected on the process of translation and decided that I wanted to share something with you about my motivation to translate.

Generally speaking, translating Chinese medical material into English is considered an esoteric pursuit.  Even among those in the field of Chinese medicine, most assume that it is extremely difficult, and I have been told by those who have never attempted it that it would simply be impossible for them.  For those of us with experience in this area, we realize that translating Chinese medical writings into English is a technical skill that, in fact, demands only a limited amount of working knowledge.  Blood, sweat, and tears, not a special gift or superior intellect, are the key credentials needed for successful translation.

Having the capability to translate Chinese medical material is a motivation, but there are two far more important reasons why I translate.  First, with the vast ocean of untranslated Chinese medical material that exists, it is up to those of us in the field who cherish this medicine to get to work on building a larger body of high quality resources.  Chinese medicine is still a recent immigrant to the West and, if we want to learn all it has to offer us, we need to hear more from the architects of this system, the doctors in China themselves.  The more we translate from the Chinese the more likely we are to accurately perceive the essence of Chinese medicine before it becomes irrevocably altered in its adoptive home.

The other reason I translate Chinese medical works into English is a personal one:  going back to the source, reading about Chinese medicine in Chinese, allows me a better understanding of the basic logic inherent in the medicine.  As medical anthropologists have shown, every medical system is the product of the culture where it originated, its philosophies, beliefs, history, and its language.  The ways in which we make connections in Chinese medicine--and Chinese medicine is, at its core, all about networks--directly relate to how effectively we practice.  If there is one single thing I have learned in my many years in the clinic, it is that clinical outcomes are clearly the product of practicing Chinese medicine according to its own rules, on its own terms.

If you are a patient, share this with your practitioner in the hopes that he or she will join us in this important endeavor.  If you are a practitioner or a translator, I invite you to participate in our community effort to grow our corpus of professional medical literature and, in the process, dive more deeply into the soul of the medicine.  We will thank you, your patients will thank you, and, once the value of translation becomes obvious to you, you will be thankful to have the opportunity to connect with all of the illustrious Chinese mentors who have taken the time to share their invaluable experience with us.

New Acupuncture Research

Conventional medical sources regularly publish promising research on acupuncture.  In this blog, we will review some studies that have appeared in the last two months.

According to an article from March 14th, research done at Taipei Medical University in Taiwan demonstrated the effectiveness of acupuncture in treating tumor and cancer surgery related pain.  The sizable meta-analysis reviewed 36 randomized, controlled trials that involved a total of 2,213 patients.  Researchers found that acupuncture was effective in managing the pain due to cancer surgeries and cancerous neoplasms.  Although the meta-analysis failed to show that acupuncture improved pain due to chemotherapy, hormone therapy, or radiation treatment, the Medscape article included reports from several acupuncturists at large U.S. cancer care centers where most patients report pain reduction when acupuncture is used to treat the side effects of cancer treatments.  In fact, acupuncture has proven so effective in providing better quality of life to cancer patients that a subspecialty called oncology acupuncture is being created.

The big news in acupuncture last month was a much publicized article on acupuncture care for migraine sufferers.  Featured on Medscape on February 24th, research conducted at Chengdu University of TCM demonstrated a statistically significant reduction in migraine frequency and severity with true acupuncture compared to sham acupuncture.  Treatment consisted of daily acupuncture treatments for 5 days with a 2-day hiatus each week.  The complete course of care lasted 4 weeks for a total of 20 acupuncture sessions.   There were no serious adverse effects reported, and patients enjoyed benefits for twenty weeks after treatment.  Compare this to the use of regular Botox injections which can cost hundreds or, even, thousands of dollars and may result in a variety of minor to severe side effects.

According to a February 13th article, even the American College of Physicians has joined the growing body of acupuncture proponents.  Their new guidelines, published online in the Annals of Internal Medicine, recommend acupuncture for nonradicular lower back pain.  The authors selected therapies that were low risk and low cost, criteria that very much describe the nature of acupuncture care.  Other therapies featured in the guidelines include mindfulness-based stress reduction and tai ji (t'ai ch'i).  

Stay tuned for more mainstream research validating the effectiveness of Chinese medical care.  For those of us who are familiar with Chinese medical care, generations of empirical experience has more than confirmed the tremendous value of traditional Chinese medicine.  New research, however, adds to our understanding and opens doors for new ways to incorporate these ancient therapies into modern practice.

The Whole is Greater than the Sum of the Parts

Modern Western medicine largely ignores this gem of Aristotelian wisdom, embracing instead the assumption that the identification of all of the components in the body will ultimately result in the ability to understand and end disease.  Mapping the human genome was the final frontier, a staggering accomplishment of science that, 14 years later, has, disappointingly, not yet proven to be a real game changer.  With all of the cards on the table, there was an expectation that the cures for common ailments would naturally follow, but our newest drugs are, for the most part, just variations on a familiar theme.  No magic bullets thus far.

All of this points to something more, a ghost in the machine, if you will, that is critical to the workings of the human organism.  Like the dark matter that comprises the bulk of the mass of our universe, the fundamental nature of our human software is elusive.  The operating system - we like the moniker HS 1.0 or Homo Sapiens 1.0 - may come to be understood as a network of chemistry, electricity, some of both, or something completely different.  At any rate, it will likely take science decades to begin to unravel its complexities.

Nevertheless, it is there, the elephant in the room.  We often see evidence of the body's operating system in medical research.  Consider, for example, both fibromyalgia and IBS.  Patients who suffer from these conditions have real, debilitating pain, but decades of study have not yielded definitive diagnostic tests or discovered any abnormal changes in the affected tissues.  Instead we can only speculate about the pathology of these conditions and offer patients symptomatic relief with modest results.

The placebo effect offers additional evidence of the innate programs driving the hardware of the human anatomy.  Essential in the methodology of medical testing, researchers use the placebo effect to validate medical claims, but Western science is unable to offer a cogent explanation for how the placebo effect actually works.  Responsive to the expectations of test subjects and researchers alike, the placebo effect clearly demonstrates that there is more to the body than meets the eye, providing additional evidence of a network connecting all of the cells of the human organism, controlling balance and health.

While we wait for science to first recognize and then explore the HS 1.0 operating system, Chinese medicine offers a complex and fully realized system of theory and practice to ensure that our software is running smoothly.  Taken as a whole, the channels, network vessels, extraordinary vessels, and smaller tributaries of the human body comprise a matrix that might be likened to the motherboard of a computer.  The acupoints, not dissimilar to the keys on a keyboard, allow for user interface when the software becomes corrupted.  This comprises the system used by the acupuncturist to treat disease and restore balance throughout the body. 

The old saying "two heads are better than one" points out the value of having more than one perspective.  As proud as we may be of our accomplishments as a species over the last few centuries, it is becoming increasingly apparent that ancient knowledge, the product of a very different point-of-view, may be more relevant than ever to humanity today.  It is crucial that we recognize the value of all human knowledge, regardless of its age, so that we can work towards the best possible future for ourselves and our planet.

A Larger Perspective on American Healthcare

Both from the perspective of doctors and their patients, it may not be apparent why the United States needs to be on a different trajectory for healthcare.  For those of us who have lived or traveled abroad in the developing world, we have seen the inadequacy of healthcare services firsthand and feel fortunate to have state-of-the-art medical resources at home.  Not only is exceptional medical treatment available to American patients, it is also true that we boast some of the best medical schools and medical technology in the world.  For many healthcare workers outside of the U.S., it is often a dream to be able to study medicine and hone their skills on American soil.

Personal experience with socialized medicine and universal healthcare models may also make us feel lucky to have the system we do.  Excessive government control of medical services can lead both to fewer choices as well as lower quality of healthcare due to a lack of competition. Complacency and stagnation may threaten the quality of medical care we receive almost as much as insufficient resources and poverty.

As Americans, we realize that exceptional healthcare is available to us, but we also recognize that many people struggle to afford their insurance premiums.  In my practice, I have often heard the stories of patients who are unable to retire as they cannot afford health insurance without any employer subsidies.  For many, the cost of insurance seems to be the only real healthcare crisis, and we have all heard and read about Americans whose premiums went up, not down, with the Affordable Care Act.  For those individuals, Obamacare did exactly the opposite of what was promised, so, although the high cost of insurance is unequivocally a problem, the ACA legislation does not feel like the correct fix.

The issue, however, only becomes clear when we step back and look at the big picture, viewing American healthcare from a public health point-of-view.  Back in 1970, most developed nations, the U.S. included, spent between 5% and 7% of their national Gross Domestic Product on healthcare.  Talking about the percentage of GDP needed for healthcare is helpful as it not distorted by the effects of inflation.  Today, the total cost to provide healthcare to our European counterparts has risen to approximately 10% of GDP, but here in the U.S., depending on the source of your statistics, we spend a whopping 17.2% of our GDP for medical care.

17.2% of GDP is a massive expenditure of resources just to stay well.  Imagine if a pioneer in the American West had to devote 17% of his or her resources towards managing illness:  it would be all but impossible to survive.  The amount of money necessary to sustain American health is a great personal burden, but, with government subsidizing well over half of the costs, it is also a devastating social strain.  If our healthcare costs can rise 50% faster than costs in countries like France and Germany in just 35 years, imagine what we will face in decades to come.

Of course, we would like to think that our investment in health--roughly three to four times per capita compared to other nations--pays off with better health and longer life.  In reality, the U.S. ranks poorly in many key indicators.  When it comes to arguably the most important statistic, life expectancy, Americans live shorter lives than people in about 30 other countries.  Perhaps even more shocking, there are many places with far lower rates of infant mortality. 

So there you have it:  Americans pay more than anyone in world for healthcare that, despite its potential for excellence, does not actually provide care comparable with most other developed nations.  In a nutshell, this is the core argument for healthcare reform.  Viewed from this angle, American healthcare has to change. 

The solutions are out there.  It is easy to see which countries today are the most successful at delivering the best possible medical care for the least amount of money.  Undeniably, the Spanish, the Israelis, and, perhaps most of all, the Japanese, top the charts as providing their citizens with the greatest wellness and longevity for the least amount of money.  If you were Japanese, you would be likely to live about 4 years longer than the average American and for about one-third of the cost.

The future of the Affordable Care Act is uncertain.  In its short history, it became obvious that the ACA suffered from deficiencies, and few Americans prefer government mandates if there are alternatives.  Nevertheless, Obamacare is inspired by the most successful healthcare models in the world, those which deliver medical services to as many people as possible without an untenable financial burden on individuals or society.  If the ACA is repealed, let us hope that lawmakers keep their eyes on the big picture and recognize that a future where 25% or more of our national resources are committed to keeping us healthy and alive is simply not sustainable.  Without a major overhaul of the healthcare system, Americans are headed either towards a future where healthcare becomes a luxury or keeping Americans alive bankrupts the nation.

 

Research on Sexual Function Validates TCM Approach

A study published in the Annals of Neurology on December 5th describes the discovery of a group of neurons in the spinal cord that relate to male ejaculation.  The researchers have coined the term SEG, spinal ejaculation generator, to describe this neurological mechanism.  Men with spinal cord injuries who suffer from anejaculation, an inability to discharge semen during intercourse, have been the focus of the studies.  The authors state "The hope is now we have identified this specialized area of the spinal cord, we can use other ways of stimulating these neurons - maybe with electrical, magnetic, or pharmacological methods - to enable ejaculation to occur."

Although it is unlikely that patients with spinal cord damage would be able to experience a sensory climax, treatment might allow for procreation.  Other benefits include an observed but poorly understood post-ejaculatory relaxation of the striated muscles of the limbs that provides relief to patients who suffer from spasticity.  According to the Medscape article by Sue Hughes published December 13th, care might not only aid those with spinal cord trauma but also might help patients without a history of injury who struggle with premature, delayed, or absent ejaculation for other reasons.

This is yet another example of how new research confirms and validates the Chinese medical perspective.  In Chinese medicine, semen is considered to be jing or essence.  The term essence describes more than just male semen, but semen is a visible manifestation of this resource.  Essence is stored in the kidney (we use the singular to differentiate from the Western anatomical concept of the organ).  The kidney resides in the lower back and, in Chinese medicine, is ascribed the function of governing the bone and the bone marrow.  Ergo, the fact that the discharge of semen is controlled by a neurological mechanism nestled in the lower back, specifically at the center of the spine, is no surprise to the traditional Chinese doctor.

In those with spinal trauma, there is, ipso facto, blood stasis and qi stagnation that affects the kidney organ and its related channels and network vessels.  In the short term, blockage of the conduits that allow the organ to interface with the rest of the body inhibits kidney function, while, over the course of time, the lack of nourishment results in the kidney essence being weakened and depleted.  The end result is the inability to ejaculate normally.

In contrast to conventional medicine and science, Chinese medicine also offers a cogent explanation for why ejaculation tends to relax the striated muscles in the limbs and alleviate spasticity.  Spasticity in Chinese medicine is considered a form of internal, bodily wind, and wind is directly linked to the liver.  Moreover, it is stated in Chinese medical classics that the "liver and kidney have the same source."  Trauma to the lower back primarily damages the kidney yin-essence, but liver yin-blood, which is transformed out of essence, is affected secondarily.  When ancient doctors proclaimed that "the liver is yin in form, but yang in function" they were referencing the fact that, although the liver is the main control mechanism for the movement of qi throughout the body, it ultimately depends on nourishment and moistening from the yin, blood, and essence to function well.  Physical trauma to channels and network vessels leads to blood stasis, and blood stasis, in turn, results in blood vacuity or deficiency.  This leaves the liver high and dry, so to speak, and causes it to fail in its main task of ensuring that qi and blood move smoothly and completely throughout the body.

When qi, like the electricity in a wire, cannot flow freely, it backs up and flares and expands outward, causing the limbs to jerk and twitch. Ejaculation is a sudden, strong discharge of qi.  This relaxes the liver and allows qi to naturally dissipate in the limbs, easing tension and resolving spasticity.  Of course, without sufficient lubrication by yin, blood, and essence, the liver will soon become bound again and will be unable to properly course qi in the body.

When the authors hypothesize that electrical, magnetic, or pharmacological stimulation of the SEG neurons might assist in restoring ejaculatory function, they are proposing what Chinese medicine has been doing for centuries.  The specific area where galaninergic neuron density is the greatest, between the L3 and L4 segments, is the location of Yao Yang Guan, the DU-3 point which is indicated for sexual dysfunction, while the Ming Men Du-4 point lies between L1 and L2.  The latter point is especially renowned in Chinese acupuncture for boosting the kidney and assisting with libido and reproduction. 

Seeing research like this study that so closely parallels the Chinese medical model leaves those of us steeped in the Chinese medical perspective feeling a quixotic combination of satisfaction and frustration.  On the one hand, validation of our analysis and methods from another medical model confirms what we already know and puts us in a position to say "I told you so".  On the other hand, it is vexing to watch as humanity reinvents the wheel over and over again.  Giving credit where credit is due, the authors findings have advanced human understanding of the anatomical specifics, but it is impossible to assume that any therapeutic value generated from their work will be an improvement.  It is not likely that the development of surgical implants, drugs with adverse effects, or expensive clinical procedures will be preferable over non-invasive acupuncture or complex herbal formulations that offer the advantages of low cost, centuries of empirical usage, and a low risk of side effects.

 

Cupping at the Olympics

Chinese medicine is in the news again with cupping of Michael Phelps and other Olympic athletes.  Judging from the online images, cupping is being performed by trainers with cups using a detachable pump.  The telltale marks suggest that the cupping is being done in the anatomical areas that are generally sore or stressed, unfortunately without specific regard to the course of acupuncture channels. 

While this is great publicity for us, this sort of use of Chinese medical treatments by individuals who are not trained in Chinese medicine, in concert with the musings of journalists, can mislead the public about our medicine.  In the NY Times article, the author offers several comments about the intended effects of cupping—not exactly congruent with the thinking in professional Chinese medicine—and offers up a few studies to explore the issue of whether or not cupping therapy is a placebo treatment. 

This example is typical of how Chinese medicine is handled in the popular press.  It is understandable that journalists want to appeal to a broad audience, both the believers and the skeptics.  As a practitioner, it is, of course, frustrating to be reminded how biased the media is in regards to Chinese medicine.  Even indisputable evidence of the direct effects of acupuncture, with functional MRI demonstrating how acupuncture can modulate brain activity as one example, does not seem to be adequate to earn us the benefit of the doubt.  To be fair, there is some media coverage about the shortcomings of Western medicine, but even the biggest cautionary stories seem to be a flash in the pan.  A recent story, for example, described adverse events in hospitals as a leading cause of mortality in the United States.  No matter how alarming the news, once the clamor dies down, it is back to the business of showcasing the latest achievements in medicine and marveling at the bright future of cures, while Chinese medicine is presented with many caveats.

Coverage of Olympic cupping and the quality of the treatment aside, it is still good to have a Chinese medical treatment in the news.  As the old saying goes, there is no such thing as bad publicity, and the tempest in a teapot of Olympic cupping has at least piqued some interest.  People are talking about the use of cupping, and our patients have been asking questions and wanting to know more.  If more Americans realize that there are options available to them, our healthcare system can move forward to a more effective future.

We use cupping frequently here at White Pine.  Cupping is one of those modalities that seem to occur more frequently in clinics run by Chinese practitioners, but we pride ourselves on offering our patients the kind of care you would find in a good clinic in China.  For our patients, we primarily like to use cupping for back and hip pain and for treating stiffness of the neck and shoulders.  We favor the traditional technique of fire cup, where several balls of alcohol-soaked cotton are ignited and used to create a vacuum inside of a glass cup.  This method requires training and experience, so please do not try this at home!

In the coverage of the Olympic cupping, hematomas or bruises are attributed to the breaking of tiny capillaries.  While this may be true structurally, the Chinese understand that bruising is in direct proportion to the amount of blood stasis presenting in the area treated.  In other words, the more chronic, fixed, and severe the pain (all characteristic of blood stasis patterns), the darker the bruise after cupping.  Most of the time, bruising starts out heavy and grows lighter as the condition improves and the pain diminishes.  Of course, with traditional fire cupping, there is a limit to the amount of suction that can be achieved.  Having a ceiling on the force of the suction has an important benefit:  it is unlikely to cause damage to tissues.  The type of cupping featured in the story on the Olympic athletes, however, may involve a powerful suction that could even potentially even dislocate bones, such as spinal vertebra.  Traditional fire cupping is not only more entertaining to watch than pump cupping, it is also safer for the patient. For some of our patients, cupping is their favorite form of Chinese medical care.

Welcome to the White Pine Blog!

This is our first post to the blog on the new website.  We have been meaning to get a blog up and running for years, and the new website format has finally given us the incentive to make it happen.  We intend to post regularly on a variety of topics, both directly and rather indirectly related to Chinese medicine and the Chinese medicine lifestyle.

A new study demonstrates that the average American male has gotten even heavier—15 lbs. heavier than 20 years ago!  The obesity trend continues despite decades of public health education and the introduction of low-fat, “healthy” foods.  Over the last 40 years, Americans have shifted from beef to chicken, whole milk to low-fat, regular soda to diet soda, but we keep gaining weight.  It is time to recognize, once and for all, that the theories of modern nutrition fall short of keeping us thin and healthy.  If it is really all about the calories, then why do people get fatter drinking diet sodas?  When is the change from fatty beef to lean chicken going to pay off in a  thinner population less likely to die of heart disease?

Chinese medicine has good explanations for the areas where Western nutritional theory falls short.  For example, the sweet flavor, in traditional Chinese thinking, moistens and creates fluids that, in excess, congeal to form adipose tissue, fat, in the human body.  It does not matter whether or not the concentrated sweetener actually contains calories. So aspartame will make you fat despite the fact that it is not "a caloric food".  And, while red meat may often be high in fat, it is a neutral food--meaning neither warming nor cooling--that is less indicated for building blood and qi than chicken.  These surprises for Western nutritionists are just confirmation for the Chinese doctor that Chinese medical theory is as relevant today as it was thousands of years ago.  For those who are interested, we recommend Blue Poppy Publishing's The Tao of Healthy Eating available through Amazon or in our office.  Watch for our upcoming guide on eating right using Chinese medical theory!