Why New Year’s Resolutions Are Sort Of The Worst

Hi everyone! If you celebrate Christmas, I hope you had an enjoyable one. Now that the holiday season is winding down, I’d like to talk a little bit about New Year’s resolutions. Every year, you hear people talk about their New Year’s resolutions, and how the next year is going to be amazing and life changing. Then, two weeks later, everything is back to normal and people feel bad about not following their resolutions. So I’m going to explain a little about why I don’t really like resolutions and offer some solutions to help make sustainably positive life changes.

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The main reason I don’t like resolutions is because people often set extreme health goals for themselves at this time of year. They promise that they will lose 30 pounds, or go to the gym every day at 5:00 a.m., or make a giant green juice smoothie every morning.  I know it’s tempting to go on a crash diet after indulging at the holidays, but making such a drastic change is almost certainly setting yourself up for failure. Where this comes most into play is when I hear people talking about “going on a cleanse” after the holidays. These cleanses can take the form of a packaged detox program or one of a million sources on the internet that often emphasize juicing. I really dislike the concepts of cleanses for a number of reasons. The biggest thing I hate about cleanses is that they often promise to restore health by “removing toxins” from your body. Unless you’re eating a bunch of lead paint chips while simultaneously huffing glue, your body does a super job all on its own of removing waste products. People selling a cleanse will often say that the sluggish, grumpy, fatigued feeling you get on a cleanse is all the toxins being purged from your body. Uhh, no, it’s not. It’s because most cleanses are far too low in calories and nutrients, so that feeling is actually because you’re probably dehydrated and have low blood sugar. Some cleanses also incorporate herbs to help with removing toxins. This can actually be outright dangerous. Herbs, although you can buy them pretty much anywhere, are not always benign substances. Some herbs can interact poorly with medications, some can have serious side effects, and if the source of the herbs is not a good one (like if they are from overseas), they can actually contain things like heavy metals and pesticides. If you are interested in taking herbs, you should only be getting them from someone who is qualified and trained to prescribe them (like me!) rather than plucking something randomly off the shelf in CVS.

Cleanses that focus on juicing are often just as bad. In Chinese medicine, all foods have a taste and temperature (which may or may not actually correspond to the physical temperature of the food). Juices are considered cold and damp producing. In winter, it’s important to consume foods that help to balance out the already cold properties of the season, such as warming soups, stews, and roasted foods. Consuming a bunch of cold juices directly counters the idea of eating in accordance with the seasons. Eating cold and damp foods during winter can cause digestive issues such as diarrhea and bloating, as well as potentially causing fatigue, headaches, menstrual problems, and other issues.

Increasing your exercise drastically also can create problems. If you go from rarely working out to trying to run 6 miles on the treadmill, you’re going to be in for a world of hurt. Nothing discourages exercise like a fun set of shin splits from not gradually increasing your training levels. Making promises to go to the gym every morning before work will work for about a week or so, but once you hit snooze on day 6, it’s easy to feel that you’ve failed and give up on the idea that you’ll hit the gym every morning.

So what are you supposed to do if I’m discouraging you from making these profound changes to your health? Obviously, I am in favor of people trying to make positive steps to improve their health and well-being. However, it’s important to do so in a way that is sustainable. Rather than making grandiose promises of re-vamping your whole lifestyle, why not try making small goals?

Try to hit the gym twice a week in the first couple weeks and gradually increase over the period of a month or two to where you can exercise four or so days a week. Incorporate ways to make it fun. No one, including yours truly, looks forward to slogging it out on an elliptical for 45 minutes six days a week. Sign up for some fun classes at the gym, recruit a friend to go for a walk, or treat yourself to a couple sessions with a good personal trainer who can help you try out new exercises that you haven’t done before.

Rather than resolving to only eat kale and tempeh for dinner, why not start small? Buy a vegetable you’ve never cooked before and Google a recipe for it. Make a couple healthy meals on the weekend so that you can package them into portions for lunch. It’s a lot easier to eat a healthy lunch if you don’t have to wake up early to make it. Cook some eggs and veggies in muffin tins so you can microwave one in the morning, rather than grabbing a bagel on your way to work.

Buy something you've never tried before, like this crazy looking romanesco. Make eating healthfully fun!
Buy something you’ve never tried before, like this crazy looking romanesco. Make eating healthfully fun!

Try to incorporate some non-food and exercise related changes. Rather than focusing on losing a certain number of pounds, think about what other parts of your life you can improve. Try keeping a journal, meditating for five minutes every day, or finding someplace to volunteer. Find time once every couple weeks to do something to help you feel your best, like getting acupuncture, massage, or chiropractic care. When we nourish other parts of ourselves, it becomes easier to take better physical care of ourselves through nutrition and exercise.

By working to implement small and sustainable changes rather than dramatic overhauls, you can work to make 2016 a healthy and happy year without the guilt that comes from abandoned resolutions. I hope all of you have a very happy New Year’s celebration. Be safe if you’re headed out on the town, don’t drink and drive, and I look forward to sharing more with you all in 2016. Be well.

 

The Winter Solstice and Chinese Medicine

Good evening everyone! Sorry I’m publishing this post so late in the day today, but I wanted to make sure I got it out on the actual solstice. Today, Monday, December 21, is the winter solstice. This means that it is the shortest day of the year (and, consequently, the longest night of the year). Seasonal changes and shifts are important themes in Chinese medicine, and this day marks a shift into the “yin” time of winter.

I’m sure you’ve seen a yin/yang symbol before. It looks like this:

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The dark part of the figure is the yin aspect. Yin and yang are very important concepts in Chinese medicine that represent the duality and interconnectedness of all things. Yin and yang exist separately from each other but are dependent on each other at the same time in order to provide context for the opposing force. Without light, there is no concept of dark. Without movement, there is no concept of stillness. Without heat, there is no understanding of cold, and on and on.

The yin aspect traditionally represents the feminine energy, as well as as concepts like darkness, cold, stillness, and nourishment. Today is the most yin day of the year because it is the day with the longest period of darkness. Consequently, that also means there is less yang energy (light and warmth) today than there is any other day of the year.

So what does this mean for you? Although the days will incrementally start to get a little longer, winter is considered a very yin time in Chinese medicine. This means it is a time to look within- a time to rest a little more, to reflect on yourself, and to save up your energy for the winter ahead. It becomes important in the yin time of year to focus on nourishing your body and mind. This self-care can take many forms- receiving healthcare work like acupuncture, making and eating warming soups and stews, and incorporating mindfulness activities like meditation and breathing exercises.

Although winter is a yin time, we are often tempted to ignore this aspect in favor of doing more yang activities. The holiday season makes us feel like we have a million things to do, places to go, and people to see. This extroverted expenditure of energy is the opposite of what our bodies want to do this time of year. Additionally, artificial lighting and heating mean that we often override our body’s natural inclinations to rest and recover during the winter. Now, I’m certainly not advocating that we all go old-timey prairie style and give up electricity (goodness knows I freak out if I can’t blow dry my hair in the morning), but what I am suggesting is to start to listen to your body’s natural impulses. Feeling tired and worn out? Skip that holiday party you feel like you have to attend and cuddle up with a book and a blanket. Getting anxious and frustrated among the holiday shoppers? Give yourself permission to decompress, take some time to meditate or do some belly breathing, and don’t beat yourself about not getting all your errands done. Annoyed at the sun for setting at what feels like 10 a.m.? Embrace the longer nights to light a couple candles, curl up on the couch, and take some time to enjoy family and friends.

As we head into winter, keep in mind those principles and work on feeding your body and soul during the upcoming months. Listening to what your body really wants can help you live in accordance with the seasons, which is a huge part of health according to Chinese medicine.

In conclusion, I’d like to wish you all a wonderful holiday season. If you celebrate Christmas, I hope you have a very happy holiday this year. Safe travels for those of you going to see family and friends far away from home. I hope all of your holidays are filled with peace, joy, and love.   Be well.

Acupuncture Myths and Stereotypes, Busted!

This week’s blog post is brought to you courtesy of my very smart little brother, who suggested the idea for the topic. Today I’m going to talk about some of the common myths and stereotypes surrounding acupuncture and hopefully dispel some of the false information that is floating out there.

Stereotype #1: We’re all just a bunch of hippies without a lot of medical training.

Let’s break this into two parts. Acupuncture attracts many types to its professional ranks. I’m a Connecticut prep school grad who was in a sorority at her Southern college and who is generally a driven, type-A, perfectionist nutjob. I wasn’t bouncing around music festivals and selling hemp pants when I decided it might be fun to give acupuncture a whirl. Many people come to acupuncture as a second career, putting their life on pause to invest time and money into learning more about something they are passionate about. I know people who were massage therapists, physical therapists, teachers, nurses, police officers, researchers, and financial experts before they became acupuncturists. We’re a pretty diverse group, and although we definitely tend towards being the earthy-crunchy type, it doesn’t mean we aren’t dedicated and conscientious professionals.

Let’s talk about the second part of this myth. The acupuncture school I went to was four years, full time. In January I’m going back for even more online schooling (because I am a glutton for punishment) in order to get my doctorate. It’s a long haul to become an acupuncturist, and it’s not a career path people embark on lightly. The school that I attended places a large emphasis on becoming an integrative health care professional. This means being conversant in medical terms and having a very strong foundation in Western medicine. In addition to the many classes on acupuncture and Chinese herbs, I also took many classes on anatomy and physiology, clinical science, diagnostics, physical exam, and pathophysiology. So although we cannot (and should not) diagnose the same way your regular doctor would, we do have a lot of background knowledge about Western medicine. A big focus of our acupuncture and Chinese herbal training is safety. This means knowing exactly where to needle to prevent injury, observing proper needling protocols and restrictions (i.e. not needling certain points when a woman is pregnant), and knowing exactly which herbs to prescribe to properly treat a patient. We also have to become certified in what’s known as “clean needle technique,” which means that we observe very strict rules to make the acupuncture procedure as safe and hygienic as possible.

There's actually a whole bunch of rules that dictate how we work with this little needle.
There’s actually a whole bunch of rules that dictate how we work with this little needle.

I know I’m verging on beating a dead horse with how many times I’ve talked about our training on this blog already but it’s the number one misconception that people have about our profession. As more people learn more about acupuncture, it’s becoming less of a concern, but there are still a lot of people out there who think we just completed a series of weekend seminars.

Stereotype #2: Acupuncture is only good for pain.

Acupuncture is indeed wonderful for treating pain, but we can do so much more! Pain is the number one thing that gets patients through my door, but I am always excited to explore with them what other conditions we might be able to treat. Many acupuncturists are general practitioners but many of us also have specialized training in fields such as fertility, emotional issues, allergies/asthma, autoimmune diseases, and much more. I consider myself a general practitioner in that I feel comfortable treating pretty much anything that comes through the door, but, as an example, I also have a special interest in treating women’s health and infertility issues. In order to work with these patients more effectively, I took extra classes while in school, interned under practitioners who specialized in this field, and have continued to learn more through continuing education classes.

There is a vast array of conditions that acupuncture and Chinese medicine can effectively treat. In 2003, the World Health Organization (WHO) released a lengthy list of conditions that acupuncture can treat. This ranges from neurological issues (including Bell’s palsy, disc issues, migraines, etc) to musculoskeletal issues (such as joint pain, arthritis, sciatica) to mental health concerns (depression, anxiety, PTSD, and more) to digestive concerns (IBS, acid reflux, ulcers, etc.), and many many more. Pain may be the common thing we see in practice, but it’s just the tip of the iceberg!

Stereotype #3: Acupuncture hurts. I mean, it’s needles, right?

Almost always, when I put the first needle in people who have never had acupuncture before, the response is “Oh wow, I didn’t even feel that. What was I worried about?!” As I’ve mentioned before, acupuncture needles are very small. Sometimes, especially in areas where there’s not as much fat/muscle under the skin (such as hands, feet, or ears), you can feel a little prick when the needle goes in, but that usually goes away after a second or two. Sometimes people can feel a dull or achy sensation where the needle is. This is referred to as “de qi” and means that qi is being influenced at the acupuncture point. Usually when I ask patients if the sensation bothers them, they respond that it feels good and that they feel like the session is working already.

Ed's not making any promises about acupuncture being pain-free
Ed’s not making any promises about acupuncture being pain-free

Stereotype #4: It’s expensive.

Sometimes, this is true. Depending on your area, acupuncture sessions can be kind of pricey. This is a due to a number of reasons- it’s a personalized treatment, and in most cases, you are getting a one-on-one treatment for a full hour. This rarely happens anywhere else in medicine. There are also a lot of expenses in being a self-employed acupuncturist- rent/overhead, staff, taxes, malpractice and premise insurance, supplies, and more. However, many of us try to keep costs down as much as possible. I charge $75 for an initial appointment (90 minutes) and $50 for a follow-up (45-60 minutes), which I feel is extremely reasonable for an individually tailored treatment session. I keep prices down to make acupuncture available to as many people as possible- my goal is to make this system of medicine within the financial grasp of most people.

There are also some acupuncturists out there who also do what is known as community-style acupuncture. This means that you can get treated in a group setting in which points are used on the arms, legs, and head. Because this type of treatment facility gets people in and out more quickly and the acupuncturist doesn’t have to have a private room for each patient, costs are often lower and are even done on a sliding-scale in some places.

Acupuncture can sometimes be covered by insurance as well. I’m a provider for Anthem Blue Cross Blue Shield of Connecticut. This means that if your policy covers acupuncture, I will submit a claim to your insurance company and they will reimburse you for your treatment (I have people pay at the time of service for reasons that are far too boring to get into here). Every insurance company and every policy is different, so I encourage people to inquire with their company if acupuncture is a covered service.

Other random stereotypes/myths I’ve come across:

There’s a religious aspect to acupuncture. 

Nope! Although acupuncture is definitely a big part of Chinese historical culture and identity, there’s nothing you have to believe in for it to work. We’re not all Buddhist or Daoist and we don’t preach or promote a system of beliefs. Just like I discussed with the first stereotype, we come from many different paths and religions- the only thing we’ve really got in common is that we firmly believe acupuncture works.

We’re going to make you completely change your diet and become vegetarian.

I talk with my patients a lot about lifestyle and diet, and many of them almost apologize that they eat meat! No problems with meat consumption on  my end. I was a quasi-vegetarian/pescatarian for a long time, and my Chinese professors would tell me “You need meat. Look at how pale you are!” While it’s true my natural complexion is that of a vampire’s ghost, I was extra pale back then because I wasn’t eating much of any animal protein (I now eat poultry as well as fish). Chinese dietary emphasis that all tastes and flavors should be eaten in balance, including meats. Of course, too much of anything is a bad thing so if you’re grilling a 24 oz. porterhouse every night, you can bet I’m going to let you know my feelings on that. But don’t worry that I’m going to condemn you to a life of steamed broccoli and tofu in the name of health.

That about wraps this up, folks! Ever hear any other stereotypes about acupuncture you want busted? Leave ’em in the comments and I’ll address them in a future post! I’ll have one more short post up before the holidays and then I’ll take a break from blathering at you until after Christmas. As always, feel free to share this point with anyone you think might be interested. Be well!

Living Mindfully During the Holidays

Hi all! So I know this blog is about Chinese medicine and acupuncture, but part of what I do with my patients is work on lifestyle issues as well. If you’ve seen me in practice, I can almost guarantee that I’ve given you some variant on the phrase “I see you for around one hour a week. The work I’ve done here in my office is important, but what you do during the other six days and twenty three hours of the week is just as (if not more) important.” I’m good at my job and know I can help people make real changes in their life, but let’s face it folks- I’m not a miracle worker. This is where you come in. Your environment, lifestyle, emotions, work schedule, family, etc. all have huge impacts on your health and well-being. I can give you a great treatment to help reduce stress and to help you sleep better, but if you leave my office and get a greasy burger that you eat quickly while simultaneously checking your work email and answering text messages about what to get your dad for Christmas, guess what? You are instantly back where you started. By making some positive changes in your own life, you can change the course of your health and well-being.

Taking care of these lifestyle factors is incredibly important during the holiday season. In the fine tradition of Festivus, I’d like to start with the airing of grievances. I have a big problem with the commercialization and general attitude of stress that seems to accompany the time between Thanksgiving and New Years. Complaining about all you have to do becomes our de facto method of communication about the season. We’re made to feel bad if we don’t spend a ton of money on presents while also managing to make Pinterest-worthy cookies and decorating to the lofty standards of Martha Stewart. This turns what should be joyful time into a stressful marathon filled with tedious trips to the mall, tension headaches, and a secret desire to hide in your kitchen cramming Christmas cookies in your mouth.

So what can you do to turn this time of year back into a joyful one? Here are some helpful ideas.

Put yourself on the priority list.

Without fail, since I have been in practice, my business slows down after Thanksgiving and picks back up in January when everyone comes in feeling terrible. Why is this? People feel weird about spending money or time on themselves when the message all around is that this is the time for buying things for other people. However, it’s important not to neglect your own health and well-being during this time. The holidays will still come and everyone will still be merry even if you take an hour to get an acupuncture treatment, watch a fun movie, or  go for a walk. Taking care of yourself also means getting exercise, eating well-balanced meals, and getting enough sleep. Small daily measures add up to a create a larger picture of health. Don’t push aside your own needs- taking care of yourself now ensures that you will have a happier holiday and that you won’t bring in the new year feeling exhausted, emotionally spent, and beat up.

Practice gratitude.

It’s easy during the frenzy of the season to focus on what you need to get, rather than focusing on what you already have. Press pause on that train of thought. At the mall frantically trying to find the perfect gift? You had a car to get you to the mall, you’re dressed in warm and comfortable clothes, and you have enough disposable income to buy a present. That’s pretty darn good. I don’t like to play the suffering Olympics (in which worse suffering somewhere in the world renders your discomfort void) but it’s easy to lose sight of the basics. My mom shared with me a TedX talk the other day that she had seen during an in-service at her school. The speaker, Shawn Achor, was a really cool guy who talked about how positive thinking engenders positive performance. This inspired her to start working on a gratitude journal where she finds three things (big or little) that she is grateful for that day. I’m not a journal person, but I’ve been thinking more about this and really like the idea. When you focus on what you’re grateful for, it redirects the focus away from what you don’t have. In this season where everyone is trying to sell you something, take a couple of minutes to reflect on some of the blessings you already have in your life.

Move away from the commercial aspect of the holidays.

The “thanks” part of Thanksgiving seems to have gotten lost recently and replaced with “nonsensical shopping madness that prevents employees from spending the day with their families.” Starting right after Thanksgiving, it seems everything around us screams BUY BUY BUY.  Now, I love getting gifts for people- I love to think about what they want or to find something that they would love and would never buy for themselves. However, I was at the mall for a really long time one day this week and found myself getting increasingly grumpy. I wasn’t finding what I wanted and my hands hurt from carrying bags and I really wanted a soft pretzel (despite the fact that I always feel terrible after I eat them). Then I stopped myself and redirected my attitude. One of my very favorite quotes about Christmas is from the very wise Dr. Seuss:

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It’s so true! The holidays aren’t just about stuff. It’s about spending time with loved ones and enjoying the company of those around you. Make some memories this year that aren’t revolving around material things! Bake some cookies, attend a tree lighting, visit a neighbor, or have a glass of champagne and make everyone listen to your best rendition of “All I Want for Christmas Is You.”

Recognize other people’s journeys.

The holidays aren’t a great time for everyone. It’s pretty easy to lose sight of this when all the ads we see show happy families and smiling faces. Some people miss those they have lost, others may not have a family or friends that they feel they can celebrate with, and for some people, the expense of the holidays and the energy required for all the festivities puts a huge damper over the whole thing. So what does understanding that not everyone loves December do for your health? It’s pretty simple- having compassion for others helps you be better. Caring for others enriches your spirit and fills your heart. Doing some shopping? Grab a toy for one of the many toy drives that help all kids have a happy holiday. Have a friend with a chronic illness who struggles to power through and get everything done? Offer to help them do some wrapping or shopping. Got kids who love to color? Have them make cards for residents in long-term care facilities who might not get some holiday love.

So I know all these suggestions seem like things that aren’t necessarily related to Chinese medicine. However, remember what I said earlier about your life outside the treatment room. By reframing your mindset about the holidays, you can approach the holiday season with a renewed outlook. This can help you reduce stress and avoid burn-out. I’ll have at least one more post up before Christmas, but I hope this helps to introduce some ideas about how to more fully enjoy this wonderful time of year. Be well!

A new holiday tradition this year- wreath making at a local nature preserve
A new holiday tradition this year- wreath making at a local nature preserve

Stick Out Your Tongue!

Hi there everyone! I hope you all are enjoying this first weekend in December (and our unseasonably lovely weather if you’re based in New England). Today I’m going to talk a little bit about the tongue in Traditional Chinese Medicine (TCM) and why it is such an important diagnostic tool.

In addition to asking lots of questions during an intake, I also take the pulse on both wrists and ask patients to stick out their tongue for me. I’ll talk about the pulse and Chinese medicine in a future post, so today we’re just going to focus on why I want to take a peek at your tongue. It’s always pretty funny to request that someone sticks out their tongue at me, especially if they aren’t familiar with Chinese medicine at all. Reactions range from curiosity to amusement to a particular look on people’s faces I like to interpret as ‘Welp, this one is clearly a nutter. Time to ease on out of this treatment room.”

So why do I ask to look at the tongue? Using the tongue as a diagnostic tool has a very long history in TCM. The tongue is the only muscle that we can see outside of the body, so it gives us sort of a sneak peek into the general state of things. When we look at the tongue, we take note of a number of things but generally are paying attention to three major things: the tongue body, the tongue color, and the tongue coating.

The tongue body refers to the general shape, texture and geography of the tongue itself. We look to see if the tongue is long, short, thick, thin, swollen/puffy, cracked, crooked/deviated to one side, or if it has indentations on the sides, among other things. The tongue body gives us a great deal of information about the general condition of the body, including the state of qi of the body (see last week’s post if you missed my discussion on qi).

With the tongue color, we look to see if the tongue body is red, pink, pale pink, purplish, or any combination of those colors. This tells us a lot about if there is enough qi and nutritive substances in the body, as well as if qi is not flowing as smoothly as it should.

The tongue coat refers to the very thin covering that rests on top of the tongue muscle. Often dentists now encourage brushing of the tongue coat because it eliminates bacteria that can cause dental cavities and bad breath. However, do your friendly neighborhood acupuncturist a favor and refrain from brushing your tongue coat on the morning of your next acupuncture appointment. A good and healthy tongue coat should be thin and “white” (meaning not yellowish in color, not actually. a true bright white). It should be slightly wet, but not thick, greasy, or overly wet. We also check to see if the tongue coating is cracked or peeled, which means there isn’t enough of the proper coating or that it is missing in spots. Additionally, we look for yellowish, grey, or even black discoloration of the tongue coat (Here’s a fun fact- next time you take Pepto-Bismal, take a peek at your tongue a little while after you drink it. The active ingredient makes your tongue coating turn temporarily black-ish). Tongue coating tells us a lot about the presence of fluids in the body and if there is too much heat or cold in the body. Many times if I see a yellow tongue coating on a patient, I will ask if they have recently had coffee. 80% of the time, they will say yes and ask how I earth I knew that. While I like to keep up the illusion that I am some sort of Harry Potter-esque Chinese medical wizard, it’s pretty simple. The tongue coat changes quickly and is easily affected by things we eat or drink. A yellow tongue coat indicates the presence of heat in the body. Coffee is a beverage this is hot both physically (i.e. the temperature of coffee is high) and energetically (in that it strongly affects the energy and movement of the qi). If the patient had a yellow tongue coating but doesn’t have many other heat signs (such as reddish complexion, fever, constipation, infection, etc.), it’s a pretty good guess they’ve recently had a cup of coffee (Try this at your next holiday party! Amaze and astound your friends!)

We basically take all the information we get from your tongue and combine it with the questions we ask you, what your pulse feels like, and a physical exam to arrive at a diagnosis. This picture goes into some diagnostic details that we haven’t touched on yet in this blog, but you can get an idea of some of the very different tongue presentations and what they can mean.

 

Pretty cool, huh?
Pretty cool, huh?

 

There is also the idea that different parts of the tongue reflect different areas of the body. It is thought that each region of the tongue refers to a specific organ system and can indicate problems in this area. Important note before we continue: organs in Chinese medicine do not necessarily coordinate to their actual anatomical location and function in the body. Organs tend to refer more to a conceptual and functional idea (i.e. the “spleen” in TCM can mean many things, including referring to process of digestion). I’ll return to this idea in a later post, but just keep in mind that if there’s something weird on the spleen area of your tongue, it doesn’t indicate that you have something crazy happening in your actual spleen.

tongue

So what are we looking for in a nice, healthy tongue? It should be neither especially long or short. It should be a medium thickness (meaning the tongue doesn’t look puffed up or swollen). It should be evenly formed (no indentations on the sides, no deviating to one side of the mouth or the other). A healthy tongue is pinkish-red with a thin coating. There should be no spots, purplish discolorations, or noticeable paleness. The coat shouldn’t be yellow, grey, patchy, or missing entirely, but rather should be white/clear and cover the whole tongue evenly.

Guess how many tongues I see that match the description above? Spoiler alert: not a lot. Most people have at least one or two abnormalities of the tongue. I do see beautifully healthy tongues from time to time, but if I’m seeing patients, they’re usually in my office for a reason so their tongue has some outward indication that something’s not quite right somewhere in the body.

One of the best things about tongue diagnosis in my opinion is that it’s pretty straightforward and relatively easy to interpret. Pulse-taking in TCM is a true art that takes decades to master- it’s much more open to interpretation than tongue diagnosis. A puffy tongue is a puffy tongue no matter who you ask. The tongue also changes pretty fast- it’s a good indicator of how effective the treatments are.

Here’s a hypothetical example of how I would use the tongue to help me diagnose and evaluate how treatments are going. Say you come see me for constipation- lately, you’ve been feeling like you’re just not pooping with the sweet freedom that you used to. Your only other symptom is some lower abdominal discomfort, especially if you haven’t had a bowel movement in a couple days. When I take a look at your tongue, it’s pretty red with a thin and dry yellow coat. This indicates that you’ve got heat in the intestines that is drying up the fluids of the the body that help move things along. Treatment is going to focus on clearing heat, generating fluids, and moving the bowels. I’ll also recommend that you increase your intake of fruits and veggies, to make sure you drink plenty of fluids, and to do some daily abdominal massage to get the qi of the intestines moving. The next treatment, when you come in, you are excited because you’ve been having bowel movements a little more regularly. Your tongue is still reddish but the coat looks lighter and not as yellow as the previous visit. It also looks less dry. Treatments would continue to focus on those principles mentioned above until the tongue is pinkish-red with a nice thin white coat, indicating that the heat and dryness in the intestines has been resolved and things are flowing like they should.

So take a peek at your tongue today! What does it look like? It’s always fun to take pictures and see how it changes over the course of a week or two. As always, feel free to leave questions in the comment section, and please share with anyone who might be interested! Be well!