Hi all! I hope everyone had a very happy Thanksgiving! As I promised last week, today’s post is going to explain a little bit about a very important concept in Traditional Chinese Medicine (TCM), which is that of “qi.”
Qi (pronounced “chee” and sometimes spelled in English as “chi”) is a foundational concept when talking about Chinese medicine. Unfortunately, it’s also a concept that is hard to explain in something like a short blog post. People far smarter than I have written volumes about qi over the years, but this post is just intended to give a brief introduction to the idea of qi and its use in Chinese medicine.
Qi, when written in Chinese, combines two ideas to indicate something that is both substantial and insubstantial.
Part of the character means “rice” and part of the character means something like “vapor” or “steam.” Thus, when the two parts are combined, it indicates that qi is both something substantial (like rice) and insubstantial (like steam). I am definitely not an expert in the Chinese language and do not read Chinese, so my apologies to any linguists if I have grossly simplified this concept, but this it how the character of qi was always explained to me in school.
Qi is a very difficult concept to translate directly into English, which is why we almost always leave it as is. Some of the more common translations include phrases like “vital energy” and “life force.” These aren’t necessarily incorrect translations, but they do leave out the idea that qi can also be something more material. Giovanni Maciocia, who is a very well-respected scholar and teacher of Chinese medicine, writes that “Qi is the very basis of of the universe’s infinite manifestations of life.” The way that I usually explain qi to patients is that it is the force that both makes us who we are and helps our body undergo all of its vital functions.
So what does this mean for you when I talk about qi during an acupuncture treatment? During a treatment, we may do different things to affect the different manifestations of qi (but don’t forget that all qi in your body is essentially the thing at its core). Confused yet? Me too. Qi is one of the concepts that the more you think about, the more puzzling it seems. We’re not even going to delve into the many different aspects and subdivisions of qi here. However, what’s important for you to understand is that with the use of acupuncture and Chinese herbs, we basically help the body’s qi do what it’s supposed to. Sometimes this means working with a more substantial form of qi- for example, nourishing what we term “original qi” to benefit what Maciocia calls matters of “growth, reproduction, and development.” It can also mean working with a more insubstantial form of qi- smoothing the general flow of qi in the body to treat headaches, irritability, or PMS or strengthening the qi of the digestive system to increase energy and resolve problems like gas, bloating, or loose stool.
Qi is thought to move along meridians or channels that cover the body. Along these meridians are located the acupuncture points.
These points are thought to be areas where qi can easily be accessed or influenced. Once we decide on a treatment plan after careful questioning and physical exam, we use the acupuncture points that we have chosen to help direct the qi of the body into assuming its proper functions.
Thanks for hanging with me on this concept! I know this post was a little less fun than the last one, but I hope this sheds some light on the concept of qi. If you are a practitioner of TCM, you know that I’m barely scratching the surface of the complexity of qi here. But if you’re just learning about Chinese medicine and want to understand what it means when we talk about qi in a treatment, I hope this has made things a little clearer.
Up next on the blog: I’ll be discussing why on earth I make all of my patients stick out their tongues for me! As always, please share this post with anyone you think might enjoy it. Leave any questions, concerns, or things you’d like to see in future posts in the comments. Be well!
All quotations are from The Foundations of Chinese Medicine (2nd edition), by Giovanni Maciocia (Churchill Livingstone Press, 2005).
I’m sure you have all heard the phrase “There’s no such thing as a stupid question.” Now, I don’t necessarily believe that’s true in real life (looking at you, deli guy who asked if I was sure I wanted the extra large sub…I know what I ordered, kiddo). However, the saying definitely applies when it comes to acupuncture. Chinese medicine in general is still a pretty new idea to most Americans. Acupuncture was virtually unheard of in this country until the 1970s when President Nixon went to China and one of his aides had surgery done there using acupuncture for an anesthetic. So, I never ever take offense when someone asks me a question about acupuncture. I love being able to teach people about this system of medicine and to help them understand what it is that I do. So, without further ado, here are the most common questions I hear about acupuncture. Most of them are questions I get from patients, but they are also questions I hear from the general public when I tell people what I do (especially the first question- I almost never get that one from patients since they wouldn’t be coming to see me if they didn’t think it would work).
1) Does it work?
Alright, remember how I said I never take offense at a question someone asks me? That’s still true but sometimes the tone this one is asked in makes me want to just yell “YOU’VE FIGURED ME OUT, SIR! THIS IS ALL AN ELABORATE RUSE THAT I USE TO MAKE MY MILLIONS AHAHAHAHAH.”
I get it. Acupuncture looks a little weird and frankly, a lot of published articles about acupuncture make it sound like it’s a nonsensical practice that uses the placebo effect to scam people out of their money. Here’s where I like to come in and point out a few things.
Acupuncture has been around for several thousand years. It is a complete system of medicine that has evolved over millennia to treat essentially every human condition. For millions of people, it is still a first line medical treatment. I wouldn’t have dedicated my life to this medicine if I haven’t seen countless instances where acupuncture works.
The reason that acupuncture often gets a bad name in published articles is that because we are still figuring out how to study it effectively. Most clinical trials have historically been done in China, and some of those may or may not make it into American news outlets. Trials done here in the States historically have relied mostly on testing “real acupuncture” against “sham acupuncture.” A lot of what is published will eventually say that there is not a great deal of difference between the results of real acupuncture vs. the results of sham acupuncture. Sham acupuncture can be done in several different ways, but is generally intended to mimic a regular acupuncture treatment. It can be done by inserting needles into parts of the body where no acupuncture points are located or by using a device that mimics the feeling of a needle being inserted (so the needle touches the skin but isn’t retained). Couple problems here. Based on theories about meridians/channels (which we will get to in a minute), this is not so good. Inserting needles essentially anywhere on the body will have an effect in some way. And using a very light insertion technique where the needle may or may not go deeply into the body doesn’t work so well either. There are many different systems of acupuncture technique. Especially in Japanese acupuncture, needles are very often inserted extremely shallowly; the idea that needles can’t have an effect just by touching the surface of the skin is not necessarily true.
Luckily, research methods are evolving and changing all the time. Many recent publications I have seen tend to show that acupuncture is indeed effective. Some of these trials pit acupuncture against a standard course of treatment (i.e. treating low back pain with acupuncture vs. pain medication). This is a better design, and I think it is the way of the future with acupuncture research.
2) How does it work?
This is a complicated one. My next blog post is going to be called “What is qi?” and will explore more of the basics of Chinese medical theory. Without going into a ton of detail here, acupuncture works on the idea that qi (which often gets translated as “vital energy” or “life force”) moves through a series of meridians or channels throughout the body. These meridians provide access to almost every inch of the body. The flow of qi can become obstructed through illness, injury, weather changes, diet, lifestyle, emotions, and much more. When this flow of qi becomes unbalanced, we use needles to activate acupuncture points, which are areas where it is thought that the flow of qi can be most easily influenced. By restoring the proper flow of qi, we can restore balance and health to the body. There are about 450 acupuncture points located all over the body, from the top of the head to the bottom of the feet. We obviously don’t use all the hundreds of points at once, but instead we pick which ones would best serve the patient that particular day. Usually about 20-25 needles are inserted in total.
Now this acupuncture theory can sound a little woo-woo. Biomedically, we are finding that acupuncture points are different from other random locations on the body. By inserting a needle at a specific point, we create a micro-trauma in the system. This increases blood and lymphatic flow, which in turns reduces inflammation and helps to heal the area. It also causes a release of your body’s natural painkillers. Acupuncture also has an effect on the brain, which releases substances that can reduce pain and regulate the body’s activities.
3) How did you learn how to do this?
Short answer: lots of school.
Here’s the long answer. People are almost always very surprised when they find out how long my schooling was. I have a Bachelor’s degree from The College of William & Mary. I graduated there in 2008 and almost immediately began my education at Pacific College of Oriental Medicine (where I graduated from in 2012). I was in school for four years, full-time, with no summers off. The program I went to is one of the best in the nation. Our education is over 3,700 hours, including extensive clinical training. I currently have a Master’s of Science degree in Traditional Oriental Medicine, and I am exploring the option of continuing my education to receive my doctorate. I have done an intensive internship in Beijing, China as well as specialty training at the San Diego Hospice & Institute for Palliative Medicine. It’s a long haul to become a licensed acupuncturist, and it doesn’t end after we leave school. Like any other medical professional, we have to do lots of continuing education to keep and maintain our license and board certifications.
4) Does it hurt?
This is an understandable one. Needles are extremely common fear, and the idea of having needles stay in you while you relax on a table for twenty minutes makes a lot of people queasy. But have no fear! Acupuncture needles are MUCH smaller than the needles they use to draw blood. On average, 15 acupuncture needles can fit inside the opening on a hypodermic needle (like they one they use to draw blood). Acupuncture needles are very thin and aren’t hollow-bore (which means they are solid and don’t have an opening in them).
Everyone experience acupuncture a little differently. Sometimes you might feel a quick prick as the needle goes in, but once it’s in, most people feel nothing at all. Sometimes you can feel an achy or heavy sensation at the site of the needle. This indicates to us that the point is being activated, and as long as it’s not bothering the patient too much, we usually just let things settle down. Some points (like on the ears or tops of the feet) may be a little more uncomfortable going in because there’s not a lot of fat or muscle there, but, again, once the needles are in, most people don’t feel anything at all.
And yes, it is definitely possible to relax while the needles are in. In my treatment room, when I leave, I turn off the overhead lights so all that’s left on is a small pink salt lamp. I also have relaxing music playing, and it’s nice and warm in there. Most people either zone out or fall asleep. And if you don’t want to be left alone, no worries! I’m happy to hang out with you and either silently work on my charting or bore you with stories about my dog.
5) Is there anything on the needles?
This is a surprisingly common one, and a question that I didn’t think I would get asked. But it makes sense! When have you ever had a needle in you that wasn’t either taking something out or putting something in?
The needles we use are sterile, single-use needles made of stainless steel. Nothing else is on the needle: no medicine, no anesthetic, no herbs. They come in a sealed blister pack that we don’t open until right before treatment. The needles are used one time each at one acupuncture point. When the needles are taken out after about 20-25 minutes, I dispose of them in a sharps container. Eventually they go to the great biomedical waste site in the sky where I assume they are melted down.
I use two types of needles in my clinic. Every acupuncturist tends to have their own personal brands of needles they bond with (it’s like Starbucks vs. Dunkin Donuts…I love me some DD and I hate using Carbo needles). I use DBCs, which are a brand of needle from Korea, for most of my needling. I also use Seirins, which are a brand from Japan when I want to get into an area that may be a little more sensitive or on patients who might be a little nervous. These needles are designed to be less invasive than other needles, so while they are considerably more expensive to purchase, I do think they have a definite value.
So that wraps up the five most common questions I hear about acupuncture! Next post will be on explaining the concept of “qi” in Chinese medicine. And a note of frequency of posts: according to the people in charge of the internet (whoever they may be), posting frequently will help more people see this blog as it moves up through the search engine ranks. So my goal is not bore you every day with acupuncture things, but to try and post once or twice a week. Please feel free to share any of these posts anywhere, anytime! And as always, shoot me an email or leave a comment with any questions or suggestions for future posts.
Before we get into the good stuff on this blog, I wanted to give you a little background about how and why I got into acupuncture. It’s a unique job. No two ways about that. I hands-down win every cocktail party conversation that delves into the “And what do you do?” territory. Also, telling people what I do is a fun way to find out quickly how people feel about needles. But it’s an awesome job. I can’t stress that enough. I absolutely love what I do, and I am super fortunate to have discovered a career that I legitimately get excited about every single day.
So, how did I stumble into this career? I always wanted to have a career in the medical field. When I was a kid, I was pretty sure I wanted to be a neurosurgeon. I would get medical books as Christmas gifts and loved watching medical shows on TV. Obviously, I was a super cool kid. However, as I started to explore more seriously what being a doctor entailed, I also began experiencing health problems of my own.
Starting when I was about 13/14 years old, I started getting headaches. Like, a lot of headaches. Every day headaches. This went on for awhile, and nothing seemed to be changing. My parents were terribly concerned and so began the rounds of doctor appointments. Pediatric neurologists, endocrinologists, headache specialists, and on and on. Long story short, I was eventually diagnosed with daily chronic headaches (a condition that is basically short-hand for “Huh. I guess you have headaches every day. Not sure why.”). Over the course of the next few years, I tried about thirty different medications, most of them doing little to nothing. Many of these meds had heavy-duty side effects. I gained a lot of weight, felt sluggish or spacey most of the time, and had some issues with hand shaking and other fun things.
As I was bouncing around all these medications, I also started seeing some alternative doctors. My endocrinologist recommended a chiropractor. I went to see him, and he was (and continues to be) an absolutely lovely and talented doctor. I wasn’t getting the relief from his treatments that he hoped for, so he referred me to an acupuncturist in town. My mom remembers calling to make the appointment and literally crying because the woman who answered the phone was so genuinely interested in helping me feel better. This woman, Emilie Connor, L.Ac., began treating me weekly. I eventually found that a combination of a certain medication and acupuncture helped to control the headaches. When we wrapped up our course of treatment, Emilie offered me a job. So at the age of 16, I began working in an acupuncture office. I answered phones, scheduled appointments, tidied up treatment rooms, and soaked in the world of acupuncture.
For the next six years, I worked for Emilie in the summers. I also began figuring out what I wanted to do career-wise. As I started taking higher level sciences in high school, I began to realize that a long stint in med school (and a whole lot of chemistry along the way) was not really what I wanted. I also began thinking about how I could help people in the same way that I had been helped through a more holistic form of medicine. Watching Emilie work and seeing the amazing results she got with her patients, I decided that acupuncture school was the place for me. My junior year of college at William & Mary, I began looking at acupuncture schools. By the beginning of my senior year, I decided on Pacific College of Oriental Medicine (PCOM) in San Diego, CA. Known as the “Harvard of acupuncture,” PCOM offered a vigorous four year Master’s Degree in Traditional Oriental Medicine. My training was four years of full-time school that included extensive clinical training along the way. I graduated in 2012 with a 4.0 (nerd alert!) and began my practice in Waterbury, CT. I currently practice in my hometown of Middlebury, CT. It’s a small town of about 7,500 people, and it’s been incredible to be practicing in the town where I grew up.
So, this was a little long winded, but I think it’s a really interesting journey. Most of the time, I’m the only acupuncturist that people know, and I like to give a little background on how I got to where I am today.
And the headache thing? That’s a story for another day…unfortunately, I had to stop taking the medication that worked so beautifully with acupuncture because it made my hands go completely numb (not so super when you poke people with needles for a living). It has been a battle to manage a chronic pain condition, so there will definitely be blog post(s) on how I use acupuncture and other alternative medical techniques to treat my headaches.
So, I’m only about a million years late to the blogging trend, but better late than never, right? I wanted to start this blog as a space to expand on some of the things that I’ve posted on my business page over the last few years. I love talking to people about acupuncture, Traditional Chinese Medicine, and healthy living, and I’m always looking for new ways to reach out to people. I’m excited to help you feel your best and to help you find a way to lead a balanced and healthy life in a world that doesn’t always seem to be dedicated to promoting wellness.
So here we go! I look forward to seeing you around the page. Leave me comments and let me know what are some things you would like to see me write about. I look forward to interacting with readers (and hearing from you will make me feel less like I’m shouting into the internet void).