How Can Physical Therapy Help You? Feat. Guest Author, Amber Hayes, DPT

Hi everyone! We have Amber Hayes, DPT, as our guest author here today who is going to be talking about physical therapy, her practice in Watertown, and how physical therapy might be of benefit to you. Amber Hayes and Maryann Mancini are local Doctors of Physical Therapy and co-owners of Connect Physical Therapy in Watertown, CT. They are a dynamic team committed to providing educational, patient-centered, and multi-faceted solutions for their clients. I recently had the opportunity to write a guest post for their blog, and I was thrilled to have Amber write one for me as well. So enough from me, and I’ll let Amber take it away! Enjoy! -SP

The amount of pain in America is astonishing. The amount of people who believe pain is “normal” is even more shocking to me. My name is Dr. Amber Hayes, DPT, ITPT, CKTP. I am a physical therapist who co-owns and practices at Connect Physical Therapy LLC, located in Watertown, CT. My business partner, Dr. Maryann Mancini, DPT, OCS, ITPT and I believe physical therapy is a very viable treatment option for reducing pain, improving function, and increasing quality of life. With that being said you may ask:

  • Who are physical therapists and how can physical therapy really help me feel better?
  • What conditions can a physical therapist treat me for?
  • How do I get referred to a physical therapist?

Physical therapists are movement specialists, and we are well educated. Both Maryann and I have a post baccalaureate degree and Maryann even has an advanced certification, as an Orthopedic Certified Specialist. Both Maryann and I graduated from Quinnipiac University, academically excelling at the top of our class. We are both Impact Trained Physical Therapists, and I have a certification as a Certified Kinesiotape Practitioner. Maryann assists with teaching a graduate course in Quinnipiac’s Physician Assistant Program and both of us strive to stay current with evidence-based research and have taken multiple continuing education courses over the years.

Drs. Mancini & Hayes

As physical therapists, we are able to evaluate you specifically. A physical therapist will take you through a thorough examination of joint movements, strength testing, and balance assessments that are specific to your complaints in order to determine the root of your symptoms. Once examined, we are able to progress forward with treatment to start reducing pain and improving the impairments which were found during the initial evaluation. Maryann and I prescribe exercises (i.e. stretches and strengthening activities) which are right for you. Correct intensity, correct movements, correct stress level on the body.

Not only do we have you exercise, but equally important is that we use manual therapy skills to aid in pain reduction and progressing you towards improved function. We are able to use our hands to do things like: mobilize a joint, decrease limited joint mobility, improve postural alignment, or provide appropriate cuing during exercise performance to allow for completion without compensation. In less fancy words, our manual intervention can aid in decreasing pain and improving your function.

Maryann and I work to then educate our patients. Provide home exercise programs, explain anatomy and the possible reasons for a patient’s pain, and have a discussion of goals and expectations for physical therapy. We want our patients to feel better. We want them to feel at ease. We want them to move better and feel listened to and thoroughly care for. We want an open line of communication and a positive patient-therapist relationship.

Now to answer what conditions that we specially treat. Physical therapy is not just for people who have undergone surgical intervention. In the outpatient physical therapy setting we can see patients with a wide variety of chief complaints. As specialists in orthopedics, we assess, manage and treat injuries of the musculoskeletal system. We provide rehabilitation for surgery, acute and chronic injuries and injuries or disorders of the spine or joints of the body. You may think, “Wow, that’s a lot!” And you would be right.

As a few examples, we can treat: low back pain, neck pain, shoulder pain, knee pain, ankle pain, headaches, scoliosis…basically any type of joint or muscle related pain. And remember, we thoroughly screen and examine you, so should we feel physical therapy is not the best treatment option we will refer you in the right direction. We truly believe in an interdisciplinary approach to healthcare for maximum outcomes.

Sometimes medical doctors may even send you for physical therapy prior to undergoing surgical intervention. This helps to optimize your mobility and strength prior to surgery in order to improve your post-surgical outcomes. Post-surgically, physical therapy is helpful. We educate you on your surgical precautions, progress you according to the stages of healing, and allow you to achieve your goals. We are always in direct contact with your surgeon, ensuring proper progression of their surgical protocol and updating them on your progress.

We also see sports related injuries and treat patients for impairments after sustaining concussion. Vertigo is also likely treatable with physical therapy intervention.

If you think your balance is off, but there is nothing you can do about it…you are wrong. Especially in the older patient population, we help to treat gait and balance dysfunction. Numerous factors can affect your ability to walk and maintain balance. We can assess where your impairments are and work towards improving them. We want you to remain safe and independent with your functional mobility!

Physical therapy can also be used to help manage acute and chronic pain through the use of manual therapy, modalities, and guided/appropriate exercise.

I firmly believe that physical therapy intervention is something that almost all, if not everyone, can benefit from. With that being said, how do you get referred? You can have a discussion with your medical doctor about the benefits of physical therapy, or you can even come to physical therapy through DIRECT ACCESS!

Direct access means that you are able to seek treatment from a physical therapist without first receiving a referral from a medical doctor. Most insurance plans allow this! After coming in for a full evaluation we will be able to determine if PT would be beneficial for you. Starting physical therapy through direct access can allow you to efficiently use your time and more quickly see improvement in your symptoms. We want you to view us as a lifelong provider for your musculoskeletal needs, not as single course of care providers.

We want to see you be happy and healthy. We believe this begins with building a relationship with your physical therapist to reduce pain and improve overall function.

Should you be interested in learning more about our practice you can email: ah@connectphysicaltherapyllc.com or visit our website: www.connectphysicaltherapyllc.com

We offer free consultations and also have a Facebook Page: www.facebook.com/connectphysicaltherapyllc/  

Thank you, Sarah for this wonderful opportunity to spread the word about the physical therapy profession!

Talking With Your Doctor About Acupuncture

Hello out there, internet! I hope that you all have been doing well and are enjoying your summer. Today’s topic is an important one- we are going to be talking about how to discuss acupuncture and Traditional Chinese Medicine with your medical providers who aren’t acupuncturists.

It’s estimated that about 1/3 of Americans have tried some form of alternative medicine. This encompasses a wide variety of things including acupuncture, naturopathic medicine, homeopathy, energy work like Reiki, and more. It has become increasingly common for Americans to explore non-traditional methods to address their health concerns. As more and and more people explore these alternative treatments, it is a given that there will be some discourse with regular medical providers (doctors, nurses, surgeons, etc.) about if those modalities are helpful/harmful/useless.

While I can’t speak to other non-TCM therapies, I want to help you figure out how to navigate those conversations about acupuncture and TCM that you might encounter with your regular medical team. Some Western medical providers are very much fans of acupuncture, some don’t know much about it, and some think it is a pointless procedure and a placebo effect at best.

It is part of my job to educate other medical professionals about TCM, and I try to communicate with any healthcare professional that I encounter what I do and and how it works. I have found that the vast majority of medical providers that I talk to about acupuncture are very interested in learning about TCM and what it can treat. I’ve literally had conversations about acupuncture during almost every medical procedure I’ve had in the last decade (only my dentist escapes my blabbering through the silencing power of Novocaine). Because my job is somewhat unusual, I am used to having these discussions and don’t get my feathers ruffled when someone might not have a positive view of acupuncture. That’s on me to explain TCM to those who don’t know much about it, and I like to think I do that pretty well.

But I (and my big mouth) won’t always be there to do that for you and your doctors! It can be intimidating to tell your doctor that you want to try exploring acupuncture. From my patients who have had these discussions with their doctors, I’ve found that the conversation tends to go three different ways:

  1. The doctor gives the patient a high-five and a hell yes! (These are often the same doctors who refer patients to me because they know acupuncture is effective…these are obviously my favorites) More and more doctors are realizing (especially in light of the opioid addiction epidemic sweeping our country) that there is real value to exploring non-medicinal therapies, especially for treating pain. Recent recommendations from the American College of Physicians and the Joint Commission reflect this- these institutions are recommending that doctors learn about acupuncture and possibly recommend it to their patients as a treatment for pain. Indeed, the American College of Physicians now recommends acupuncture as a first-line treatment for both acute and chronic low back pain.
  2. The doctor gives the patient a “meh.” Basically this a neutral response- either they don’t know a lot about acupuncture and/or they aren’t convinced it will help patients. These are the conversations I want to help you feel more confident expressing your opinion in.
  3. The doctor says acupuncture is useless and/or a placebo effect. To be honest, I have heard of very few of these reactions…most doctors are good people who want to do right by their patients, and very few of them would actively discourage their patients from seeking relief from a low-risk procedure like acupuncture. These folks can be tough to convince, but hopefully some of the strategies I’ll discuss next can help.

Alright, so you know you want to get acupuncture or you’re already having it and you want to let your doctor know. Ultimately having this conversation is for your benefit- you want to make sure all members of your healthcare team are on the same page, and everyone is aware of who is doing what to help you, the patient, feel your best.  And, again, most doctors are wonderful people who want to help their patients…very few of them are going to be anything but supportive of your decision, so hopefully these conversations will always be stress-free. It also helps increase the visibility and acceptance of acupuncture and TCM within the medical community when doctors know that their patients are receiving (and benefiting from) acupuncture.

So here are the most important things to do in this conversation:

  • Be confident. It is your health and ultimately your decision to pursue acupuncture, no matter what your doctor personally thinks about it. This is the most important one. There’s a reason you want to explore acupuncture, and you shouldn’t have to justify it to anyone. You’re the captain of the ship here, and you get to make choices involving your health.
  • If possible, have personal and specific stories/experiences to share quickly. Something like, “I have gone for two acupuncture sessions so far- I notice that my low back feels less achy and I am able to fall asleep without as much pain as I was experiencing before.” Or “My husband tried acupuncture for his tennis elbow, and I am going to try it to treat the arthritis in my knee since he had such good results.” This does two things: it provides an immediate example of a benefit or acupuncture, and it makes a more personal connection. You’d be hard pressed at this point to find someone who would say to you, “That’s stupid and your husband wasted his money. I don’t care that he feels better.”
  • Ask your acupuncturist for a quick way to explain what acupuncture does for your particular condition. The acupuncturist can then give you a brief idea of how they are treating your condition and how acupuncture can specifically benefit you (they can even give it you on a sticky note to take with you!). You can then share this information with your doctor.
  • If you feel like your doctor is going to be a hard sell, bring in an article or some examples of research that show the benefits of acupuncture. Feel free to ask your acupuncturist for this- that’s on us to keep up with the research and not something you should have to spend a lot of time exploring. However, if you have a quick article or study on hand, feel free to share it!
  • Ask your acupuncturist and doctor if they would like to discuss anything with each other. I welcome discussing my patients with their other healthcare providers…conversing and getting to know everyone involved in your care only benefits the patient. Ask your acupuncturist if you can share their contact information with your doctor- the doctor can then directly talk to the acupuncturist if they have any questions or concerns about your treatment or about TCM in general.

So hopefully you feel a little more prepared to have a conversation with your medical providers about adding acupuncture to your healthcare! I truly want patients to be able to be able to integrate acupuncture and TCM into their medical care- there’s no reason why patients can’t have their regular doctors and see me for acupuncture as well. Indeed, the needs of a patient are best served by both parties working together on behalf of the patient.

I hope this was helpful, and please share any experiences you’ve had with these types of conversations. And as always, please feel free to share with anyone you think might benefit from this article. Until next time, be well!

 

 

TCM and Infertility

Hello out there! I hope you all have been enjoying the week so far. I am going to be talking today about one of my favorite clinical specialities- fertility! This week is National Infertility Awareness Week (April 23-29), so I think it’s perfect timing to talk a little about infertility and what role Traditional Chinese Medicine can play in the fertility journey.

Although I am a primarily a general practitioner (meaning I see a little bit of everything in my practice), I do have a special place in my heart for working with fertility issues. Back when I was in school, I took additional classes on women’s health and infertility, and I also had the opportunity to work with a very well-known fertility expert as one of my clinical supervisors. Since being in practice, I have helped quite a few women with conceiving healthy babies, and it is always one of the most rewarding parts of my job.

Before we go any further, let’s talk about what I mean when I use the term “infertility.” This is generally defined in the medical world as a failure to conceive after 12 months of trying (this sometimes gets shortened to 6 months, depending on a number of factors, including age, relevant medical history, and how actively you are “trying” to conceive).

I work with women when they are still in this 6 or 12 month period of trying to conceive (I’ll use the abbreviation TTC for this phrase a lot), as well as with women for whom natural methods didn’t work. This means that they may be undergoing any number of medical interventions to help fertility, such as medication to stimulate ovulation, intrauterine insemination/IUI, or ARTs (Assisted Reproductive Technologies) such as IVF (In-Vitro Fertilization). Side note: the infertility world is bonkers for abbreviations…sometimes I look at my chart notes and basically see just a list of letters I’ve assembled. It takes a little while to become fluent in the fertility lingo, so I’ll try not to use too many more abbreviations than necessary.

The great thing about acupuncture is that we can help at pretty much any stage of the conception process. Sometimes if women have been trying but haven’t needed additional specialized support yet, I can do things like help regulate their menstrual cycle, monitor and assist in ovulation, and help them pinpoint the ideal time for sexual intercourse to maximize their chance of conception. This method is really fun because I get to help women become more aware of their cycles and become more in tune with their bodily rhythms. The sometimes odd part for people is that I’m going to talk to you a lot about your period, bodily fluids, and sex life. I am a professional and definitely keep things that way, but I also try and make this process not so scary and introduce a little light-hearted humor into the situation. One of the major stressors for women TTC is that the fun is taken out of your sex life- rather than just enjoying sex for the sake of sex, it often takes on this very clinical aspect (I’M OVULATING NOW, HONEY, SO WE’RE DOING THIS IN 5 MINUTES…THERE’S NO TIME FOR KISSING!!!). By helping increase awareness of what is going on in your body at any given point in your cycle, I can help women to feel a little more in control of the process and to get some support from an outside source in what can be a confusing and stressful time.

If a woman has any underlying condition like PCOS (polycystic ovarian syndrome), endometriosis, or hormone imbalances that might be causing difficulties conceiving, TCM can also help treat those conditions as well. Sometimes with these patients, I’ll ask that they stop TTC for a few months to focus on resolving some of the underlying issues to ensure that there is the best chance for success when active attempts at conception start up again.

If women are undergoing fertility treatments of any nature, there’s a lot that Chinese Medicine can do during that time as well. Depending on what medications/hormones/therapies the woman is undergoing, we can help to support that process along the way. This can mean things like helping to support ovulation for a healthy egg retrieval procedure, thickening the uterine lining for implantation, or helping to maintain an early pregnancy in a woman with a history of miscarriages.This can also mean helping to manage some of the unpleasant side effects the hormonal medications can induce and reducing stress/anxiety about the whole fertility process. The technology involved in the fertility process continues to absolutely astounds me- it’s an incredible advancement in medical science, but it can always be helped by additional support. Several of the fertility centers here in Connecticut recommend their patients get acupuncture because not only has it been shown to help increase success rates in IVF procedures, they have also seen the many benefits of TCM in their patients who get acupuncture. It’s also a really great insight into how acupuncture can work in ways that people don’t even realize. Sometimes acupuncture gets accused of only working through the placebo effect, but it’s hard to explain how the placebo effect can help make a woman’s endometrium thicker or help stimulate egg growth in an ovary that wasn’t working so well before (both are examples of things I have had patients report after acupuncture treatments).

I want to take a moment here and point out that I’ve been talking mostly about treating women for fertility issues. I want to make it very clear that women and men are just about equally affected by conditions that cause infertility. However, I largely only see women in clinical practice for fertility treatments…so I encourage all women to make sure their partners have been tested for any sperm issues (sometimes the little guys are terrible swimmers, there’s just not enough of them, or the sperm can be an abnormal shape that hinders their journey to the egg) and/or hormonal imbalances/deficiencies. The testing process for men is pretty simple, so it’s absolutely something that all couples struggling to conceive should make sure they investigate. Chinese Medicine can also help men with issues leading to infertility as well, although it can take a bit longer and usually involves herbal treatment in order to see positive changes in sperm counts and motility. I’ve also largely been talking about cis-gendered (meaning you identify as the biological sex you were born as) and heterosexual fertility issues here, simply because that it what I largely see in clinical practice. The LGBTQA fertility journey can also have some additional factors at play, and it is a topic I would definitely like to explore more for both my professional knowledge and patients’ benefit. I do encourage those couples to seek out a fertility center/doctor with experience helping this population to make sure you are getting the most supportive and comprehensive fertility care possible.

The last thing I want to talk about is how incredibly common fertility struggles are. 1 in 8 couples will struggle to conceive naturally. It is one of my eternal pet peeves how little infertility is addressed in the country. Women are often made to feel ashamed when they have trouble conceiving, and the physical/emotional/financial burden of the fertility journey is an incredibly tough one. Rarely do women feel they are able to talk freely about their struggles to get pregnant, express their frustration with family and friends around them who easily became pregnant, or share their experiences with miscarriages and failed fertility treatments. That’s part of the reason I write things like this- fertility struggles are very common, and couples undergoing these issues shouldn’t be afraid to discuss them. Additionally, I often recommend my fertility patients find some place where they can talk about what they are going through- either through individual or couples therapy, a support group, or an online community where they can freely express their emotions.

It can be difficult to know how to bring up and discuss fertility issues if you haven’t experienced them yourself. Many people sort of put their foot in their mouth, saying things like “Stop stressing about it and you’ll get pregnant- just relax,” or “Well, this miscarriage was meant to be, obviously there was something wrong,” or “Why don’t you just adopt?” I have never talked to a fertility patient who felt better after hearing one of these phrases, and often, they silently die a little inside due to comments like these. This is a really good list of 12 things not to say to someone trying to conceive and explains why some of those phrases might be really hurtful. Often, people say something just because they feel awkward or they want to “fix” a problem. We’ve all done it- I can guarantee even I have said something thoughtless at one point or another. It’s a learning process, but listening and asking what the person undergoing the fertility process needs is the best choice. Even saying “I don’t know what to say” is the best option sometimes. But don’t be afraid to hold space and support loved ones going through the fertility process- it can be a really isolating time for couples, and it makes a huge difference to know they have support coming from their family and friends.

So that about wraps things up on the baby-making front! Please feel free to ask any questions you might have about all of this, either in the comments or privately at acupoulin@gmail.com. And please don’t hesitate to share this post with anyone you think might be interested or might benefit from reading it. I hope you have found this helpful, and until next time, be well.

Eating Seasonally: Spring Edition

Hello everyone! I hope that you all have been having a good week and are enjoying this beautiful spring weather as much as I am.

I’ve talked about the importance of eating seasonally on this blog several times before (see the winter edition and the summer edition here for a discussion on eating for both of those seasons along with some recipes). Today, especially with this being a week that involves some special meals prepared either for Passover or Easter, I thought it might be the perfect time to share a spring edition.

Eating seasonally is an important part of maintaining health according to Traditional Chinese Medicine. It helps our bodies and our digestive systems function at peak performance, and it also prevents troublesome health conditions from developing.

Spring in Chinese Medicine is associated with the organ of the Liver (and remember when I talk about the Liver, it doesn’t mean there’s actually anything wrong with the physical organ itself). In Chinese Medicine, the Liver is responsible for keeping your qi moving as it should. Just like little plant sprouts reaching up to the sun, spring is a good time for people to participate in activities that keep things moving and grooving. This can include things like stretching (the Liver controls the sinews and tendons, so stretching is especially important at this time of year), tai chi, and yoga. And if you’d like to pretend you’re actually a little plant reaching for the sun while you stretch, you do you and be the best little plant you can be!

The Liver is associated with the color green as well…perfect for spring! So eating foods that are green helps to nourish the body and keeps your qi happy and free-flowing. This brings us to one of my very favorite spring recipes. This is frequently on the menu for holidays and regular meals alike in my house. It makes a good amount of food, so even if you want to make up a batch on Sunday, you’ll have lots of delicious leftovers for the week ahead.

The recipe is originally from Ina Garten, whose Hampton lifestyle, adoring husband, and subtle sassiness all combine to make up one of my most favorite celebrities. You can easily make this without the potatoes if you are cutting down on carbs or sensitive to nightshade veggies, but, honestly, these potatoes are so good I can’t imagine it without them. Her original recipe also adds fennel when you add the beans and asparagus, but I personally find fennel gross so I leave it out. If you like fennel, however, roasting it is a delicious way to enjoy it.

Roasted Potatoes, Haricots Verts, and Asparagus

  • 1 pound fingerling or small potatoes
  • ⅓ cup good olive oil
  • 2 teaspoons Kosher salt
  • 1 teaspoon pepper
  • 1 pound French string beans (haricots verts), trimmed (These can occasionally be a little tricky to find, but I always can find them at either Stop & Shop or Trader Joe’s…if you can’t find them at your local store, regular green beans will work just fine)
  • 1 bunch thin asparagus, ends removed, cut diagonally into 3-inch pieces
  • Optional: 2 large fennel bulbs, cut into quarters and then again into long pieces
  • ¼ cup freshly grated Parmesan cheese
  1. Preheat your oven to 425˚.
  2. Slice the potatoes in half lengthwise, and spread them out on a baking sheet. Pour the olive oil over the potatoes, sprinkle them with the salt and pepper, and then toss until the potatoes are coated.
  3. Roast the potatoes for about 25 to 30 minutes, tossing once about halfway through cooking.
  4. Add the string beans and asparagus (and fennel) to the baking sheet, and toss with the potatoes. Roast for an additional 10 to 15 minutes, until the green vegetables are tender. I usually toss everything about halfway through this additional cooking time as well.
  5. Sprinkle Parmesan over all the vegetables and put back into the oven for a minute or two more, just to melt the cheese.
  6. Take the vegetables out of the oven, add a bit more salt and pepper to taste, and serve.

In TCM, asparagus are considered a sweet, bitter, and cooling food. They help clear heat and drain dampness, as well as moisten dryness (this seems counter-intuitive but often foods and herbs can have several important functions at once…dampness is a pathological state and draining it often requires the addition of something slightly moistening to prevent too much drying out). Green beans are a sweet and neutral food that help to nourish the Spleen and the Kidney. Fennel is a an ideal food for this time of year, helping to move Liver qi and strengthen the digestive system. Potatoes are also neutral and sweet, helping to tonify Qi. Putting all of these foods together creates a satisfying and nourishing meal that also helps clear a bit of heat that can develop when we move into warmer weather.

I hope everyone has a wonderful week, and until next time, be well!

Recipe originally from “Barefoot Contessa: Back to Basics” by Ina Garten

All individual food properties sourced from “The Tao of Healthy Eating,” by Bob Flaws

Fall and Chinese Medicine (Plus an Announcement!)

Hi everyone! I hope you have all been having a happy and healthy week.

Before I get started on today’s topic, I wanted to make a quick announcement! As you may have noticed from the change in the name at the top of the blog, the doctor is now in! I have finally finished and received my diploma, so I am now officially a Doctor of Acupuncture and Chinese Medicine. While this title doesn’t fundamentally change anything about my practice (besides the fact that I now sound much fancier), it does represent a significant achievement in my field. The doctoral degree is still a relatively rare one among acupuncturists, and I’m pretty darn proud of myself for completing it. However, I wouldn’t have stood a chance of finishing without much help and support from my amazing family (bless my mother for withstanding months of a very stressed out and cranky daughter), my friends, and my work colleagues (who let me shadow them in clinic for one of my classes and listened to me whine about school work daily without complaint). Having a doctoral degree will eventually become standard for acupuncturists, as it does a much better job of adequately conveying the amount of training and education we undergo, but we aren’t there quite yet. So until then, I’m very happy to have had the opportunity to go back to my alma mater and get this degree.

But enough about me! Today I want to talk about the season of fall and Chinese Medicine. As I’ve mentioned in other blog posts, living in accordance with the seasons is of tremendous importance in Chinese Medicine. We want to make sure we do things like dress appropriately for the weather, eat the right foods for the right season, and so on. Doing things that counteract the normal flow of qi during the seasons (like wearing shorts in winter) can easily lead to pathologies and health problems.

Transitional seasons like spring and fall can be a little tricky, however. Especially in New England, temperatures can fluctuate wildly, and it’s hard to predict what the weather will be like from day to day. However, there are some general guidelines for fall that we can follow.

9070-red-and-yellow-autumn-leaves-pv

Each of the seasons is associated with an organ system (and remember, these aren’t the real anatomical organs, more like their functional roles in the body). The fall is associated with the Lungs, which means several things. The Lungs in Chinese medicine are responsible for our defense mechanisms, protecting us from getting sick. However, as the first line of defense, it means that the Lungs are especially vulnerable to pathogens. This can show up as coughs and colds (which we usually see a lot of as we head into the cooler months). Easy ways to avoid this are wearing seasonally appropriate clothing, making sure you get adequate rest and nutrition, washing your hands frequently, and getting regular acupuncture treatments. The Lungs are particularly vulnerable to dryness, which is a condition we tend to notice more now after the humidity of summer has faded. Drinking plenty of room-temperature or warm liquids and enjoying hydrating foods like soups can help to mitigate some of this dryness. You can also use a nasal rinse or humidifier if you are noticing particularly bothersome signs of dryness, like a bloody nose or dry cough.

The Lungs are also associated with the emotion of sadness. Sometimes people might feel a sense of sorrow or grief as fall arrives. With the end of long, sunny days and the arrival of the harvest and falling leaves comes a sense of things ending. This feeling is not abnormal, but you want to make sure that you work on not letting these emotions become overwhelming. Speak with a mental health professional if you are noticing abnormal or persistent symptoms of sorrow and grief.

As we move into winter, it becomes normal to want to expend less energy and turn inwards more. Winter is a yin time, and this means conserving energy and nourishing our bodies against the cold weather. We aren’t quite there yet (thank goodness!) but it’s perfectly normal to want to sleep a little longer, make some warm and comforting foods, and reflect a little more as we transition from the yang energy of summer to the yin time of winter.

Fall is my absolute favorite time of year. As much as I dread winter and being cold, I love the beauty of autumn, especially here in New England. And as long as you pay attention to living in accordance with the seasons, there is no reason why this fall can’t be your healthiest one yet! And let’s be real, eating a few cider doughnuts never hurt anyone- what fun is fall if you can’t enjoy all the season has to offer? Until next time, enjoy autumn’s beauty and be well.

Self-Care Tips for Chronic Pain

Hello everyone! I hope everyone had a happy and healthy end of their summer. Fall feels like it is officially on its way here in Connecticut, and I personally am looking forward to consuming as many pumpkin-spice flavored beverages as possible.

Today’s blog post is about how important self-care is for chronic pain patients. Pain is overwhelmingly the most common thing I see in clinical practice (mostly neck and back pain), and it’s also what brought me into the world of Chinese medicine. I know I’ve mentioned in some of my earliest blog posts about how my chronic headaches in high school first introduced me to this amazing medicine. For a long time, my headaches were well controlled, and then they weren’t again. This is pretty typical for chronic pain unfortunately- sometimes what worked for a long time suddenly no longer works. This spring, I found myself in a pretty bleak spot- I have chronic migraines, so when I get a headache, it doesn’t go away with some Advil. I had a migraine pretty much 24/7 from Christmas until July.

Chronic pain is not easy. I can’t emphasize that enough. Chronic pain patients often have to minimize or hide their problems- it’s one of those invisible illnesses that tend to be poorly treated and poorly understood. I also was very hesitant to let anyone know what was going on because I felt like acupuncture and Chinese medicine should have been able to fix me, and they weren’t. In retrospect, I know this is silly- not all treatments work for all people for all things, and I’m no exception to the rule. TCM does wonders for me in many other parts of my health, but chronic migraines just weren’t responding.

So, in April, I wound up going to an amazing headache clinic here in Connecticut and started the process to get approved for Botox for chronic migraine. I know this sounds like hippie blasphemy- injections! Neurotoxins! Insurance-mandated approval process! And I felt like a traitor to my medicine.

This is where I needed to step back, calm my ego down, and try something new. So I waited the two month approval process to get the shots covered, got 31 injections in my face, head, and neck and waited for the Botox shots to do their job (it takes up to two weeks for the shots to work).

And you know what? They did. They really worked. And this is not to recommend any specific medical procedure- that’s a discussion for you to have with your medical provider. But this worked for me. Plus, I had the smooth wrinkle-free forehead of a toddler. It was awesome.

This brings us to now. The shots only have about a three month life-span, and mine are wearing off. I have three more weeks until I can get my next round, and I’m finding myself getting a lot more regular migraines. I came home from a busy day at the office Friday and, although it was a great and productive day at work, I was fried. I had forgotten what it felt like to have to make it through a very full day while managing chronic pain. And, unfortunately, I may have a few more weeks of this ahead of me. But this time around, I’m ready. I have a plan for the next course of treatment and in the meantime, I’m going to do everything I can to help myself as much as possible.

So after enough babbling, this is what I want to share with you today. Self-care is instrumental for chronic pain patients. Regardless of whether you are waiting on a new treatment, trying to muddle through what might work for you, or have exhausted most options, you still need to make the effort to put your health, well-being, and sanity first. So here’s my list of things I know make me feel better. By sharing these with you, I’m going to hold myself accountable to following my own advice. I know these may seem simple, but sometimes it’s good to have a reminder of the simple things.

And one more note- I am fortunate that I am generally able to live my life as I want and function at a high level despite pain issues, but I know that is not the case for many others out there. I do not speak for all pain patients, nor am I intending to suggest that because I am out and about in the world that all chronic pain patients can and should do so freely. Everyone’s experience is extremely personal and varied. This is just my perspective.

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And without further ado, …here’s my favorite self-care tips!

  1. Learn to say “no.”

This is a tough one for many people. But you need to protect your health first. Constantly expanding your energy when you have precious little left after doing the very basics of daily living can be downright dangerous to your health. Don’t retreat from life if you can avoid it, but also don’t be afraid to say no. When I turn things down, I tend to be upfront about why I can’t make it- I say I have an especially bad migraine and can’t make it this time but please don’t hesitate to invite me next time! It can be stressful to always feel like you are turning people down, but I’ve found that honesty is usually the best policy. I wouldn’t want one of my loved ones to drag themselves somewhere when they weren’t feeling well, and I think most people would generally agree with that sentiment.

2. Fuel yourself with good things.

This means a number of things. Pain often dulls your body’s awareness of other things it needs. I usually am good about drinking water, but I often won’t eat enough because I simply am not aware of a hunger sensation when my head hurts badly enough. Make sure you are eating regular, nutrient-dense meals. I know it’s tempting to sink into a comfort food routine, but trust me, cheesy pasta does not solve all of life’s woes (although, once in a while, it sure does help). Cooking can seem overwhelming when you don’t feel well, but try to have easy things on hand- rotisserie chicken, pre-cooked beans, minute rice, eggs, frozen veggies, etc to whip up a quick meal. Drink plenty of water. Avoid processed foods, sugar, and alcohol. Get plenty of sleep. Take a nap if you need it during the day!

3. Find your refuge. 

Pain is exhausting, y’all. When I came home from work Friday, I literally stood in the shower in the dark for 15 minutes like a weirdo. I needed absolutely minimal sensory stimulation and to loosen up my tight muscles. The shower usually does it for me. Find your place- a favorite chair by the window, your bed, on the floor next to your dog, wherever. Find that place that makes you feel a little better and seek it out as needed. Take some time there, center yourself with deep breathing, and collect your qi for the next part of your day.

4. Treat yo self.

(Shout out to all my Parks & Rec fans with this tip!) Treating yourself can mean anything that feels good to you. Many times chronic pain patients suffer financial consequences- treatments (especially ones not covered by insurance) can be expensive and sometimes work is limited by pain levels. So treating yourself doesn’t have to be buying something (although it certainly can be!). Listen to a favorite CD, go for a walk, meet up with a friend for lunch, etc. And if you don’t have the energy or finances to do those things, just treat yourself with kindness. Don’t get mad at your body for experiencing pain- think of what you would say to a loved one suffering and then say those words to yourself.

This also means doing other things that make your body feel good- for me it’s also making sure I’m getting chiropractic adjustments, massage, and treating myself with acupuncture whenever possible. It can be helpful to manage pain symptoms through several routes, and obviously, I am a big fan of regularly receiving body work of whatever type floats your boat!

And that’s enough tips to start! I hope everyone has a wonderful weekend, and until next time, be well.

Eating Seasonally: Summer Edition

Hello everyone- it’s nice to be back! I’ve been busy with work and finishing up my doctorate program, which is rapidly reaching its conclusion. I’ll write another post when I am officially done to explain a little about what the new title means.

Today’s short and sweet post is about eating seasonally for the summer heat! A while back, I posted about eating seasonally in winter to talk a bit about the importance of eating in accordance with the seasons in Chinese medicine. Diet is a very important part of TCM and it can actually play a pretty important role in your general health.

Summer is obviously a time of heat. And this summer has been pretty hot indeed! We actually refer to this time of year in terms of “summer heat.” Summer heat shows up during the dog days of summer, and it can be considered a pathological factor. When the heat and humidity is very high, we can see symptoms like fatigue, excess sweating, digestive concerns, heavy sensations, joint pain, and more. Most of us have experienced this without even realizing it- think about how all you want to do on a hot summer day is sit in the shade with a cool drink. It’s easy to feel fatigued and uncomfortable if you try and do too much of anything,

Food can be a fun way to counteract some of this pathological heat and humidity. The recipe I’m going to share with you is a quick and easy one for a watermelon, mint, and feta salad. There are many versions of this recipe on the internet so feel free to research some options or make up your own version.

I like to make my salad with watermelon cubes (about 1″ each), crumbled feta cheese, chopped mint leaves, and arugula (or any other salad green you like!). I’ll sometimes add walnuts or another seed for a fun crunch aspect. You can make your own vinaigrette or use a high quality balsamic vinaigrette (I like to look for ones that don’t have any added sugar, corn syrup, or food coloring). Mix everything together and dress it as you like! Quick, easy, and delicious.watermelonandmint

Watermelon in Chinese medicine is considered cool and sweet. It also generates fluids and relieves thirst, which can help further cool down the body. In TCM, we actually use the white rind and the seeds of watermelon as well but for this salad, you’ll just want to use the fruit itself.

Mint is also cooling. It’s known as “Bo He” in Chinese, and we use it for a variety of things. It’s considered cool and acrid, which means that it is good at moving and dispersing things as well as resolving heat conditions. This herbal property can help with some of that stuck, bloated, heavy feeling that can happen in the summer. It can also help with things like heat rash or skin irritation that occurs during these sticky months.

As in all things Chinese medicine, everything should be in balance. So while this recipe is great to help cool you down in the summer, you shouldn’t consume a ton of it every day. Especially for people with problematic digestion, too much cooling and raw food can actually make digestive symptoms even worse. So enjoy in moderation!

I hope everyone is having a wonderful summer so far. Stay cool out there, and be well!

The Beauty of Chinese Herbs (Feat. A Guest Artist!)

Hello everyone! I’ve talked a little here about Chinese herbal medicine, but it is sometimes a hard topic to condense into a blog post. However, with this glorious summer weather and all the lovely flowers blooming and growing, I started thinking about the very real beauty of some of our Chinese herbs. Chinese herbs come in a variety of different materials. The most common is plant parts (flowers, roots, leaves, berries, etc.), but herbal medicine can also involve the use of animal parts, bones, minerals, and more. Today we are going to explore three of the very beautiful flowers that we use in Chinese medicine.

I’m very lucky to be featuring a guest artist on the blog today- Lauren Bartkus (maiden name Robinson for those of you who know her from Westover!) is a friend of mine whom I have known for a very long time. She is a very talented graphic designer based out of Seattle, WA.  She specializes in responsive websites, logos and branding, and marketing material design for small businesses. For more information and more about her work, please visit her website. She has graciously volunteered to illustrate for us some of the flowers we use in Chinese medicine, and I am so excited to share her work with you.

Many times when we see Chinese herbs, they are either dried (so they lose some of their color and vitality) or they are in pill form, so you can’t see what they look like at all. This is a great peek into what these plants look like in real life, so you can appreciate the beauty of these immensely helpful healing plants.

Today I’m going to introduce and explore three flowers used in TCM. As a friendly reminder, when I talk about herbal medicine on this blog, this is not intended for you to go out and start taking these herbs. You should only ever take herbs under the guidance of a licensed Chinese medical practitioner who better knows your personal health needs and history.

I’ll give the name of the flower in Pinyin (a way of translating Chinese characters into English lettering) as well as in Latin and English.

Huai Mi (sephorae flos) (Pagoda flower)

(sometimes also known as Huai Hua Mi)

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Huai Mi is part of the category of herbs that regulate the blood. Broadly, this means that herbs in this category affect the circulation of blood in the body, especially if there is an issue of stagnation (blood not moving as it should) or abnormal bleeding. This particular flower is very good at both clearing heat and stopping bleeding. Its particular blood regulating function especially applies to bleeding of the intestines or for bleeding hemorrhoids (bet you didn’t see what one coming, did you? Pretty flowers can do pretty crazy things!). It can also be very useful for redness and irritation of the eyes. It’s even used for hypertension (high blood pressure).

Hong Hua (carthami flos) (Safflower)

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Hong Hua is another herb that regulates the blood. This is a really great herb for moving blood and reducing pain. It’s very commonly used in gynecological disorders such as painful menstruation. Hong Hua also has a variety of minor functions including moistening dryness, in certain dosages nourishing the blood, and helping stubborn rashes like measles come to the surface so they can be expressed and resolved.

Zi Hua Di Ding (violae herba) (Viola flower)

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This herb is part of the category that clears heat. This herb also is said to resolve toxicity (this does not mean “toxins” in the nonsensical modern use of how juice cleanses are said to “clear toxins”- this means it resolves infections).

The viola flower is especially useful for treating deep-seated or infected sores and accesses (yet another instance of the surprising power of a little flower!). It does this by both clearing heat and reducing swelling. It can also treat less serious instances of heat and swelling, such as in the eyes or throat.

I hope you all enjoyed this exploration of how some flowers can be used in Chinese medicine to treat all sorts of conditions. A huge thank you to Lauren again- I love her pictures of these so much, and I am definitely going to frame them for my office. I hope everyone has a safe and fun Fourth of July weekend, and until next time- be well!

Look For the Helpers

I’m really sad tonight. And since the best way I know how to express myself is through writing, this is my small attempt to share my thoughts on the terrible events of this weekend (and this week in general). As a straight, cis-gendered woman (meaning I identify with the sex I was born as), I have the immense privilege of not being targeted for my sexual preferences or identity. I’ve never had to fight to see people like me represented in media or to be treated equally in the eyes of the law. But I am still heartbroken over the events in Orlando this weekend.

I am sad and I am tired and I am deeply worried for the future. I am sad that intolerance and hatred are allowed to flourish. I am sad that violence is used as a tool to spread that hatred. I worry where this country, a country that I love, is headed. I look around me and all I see is angry rhetoric and name-calling. Regardless of your political views (and this is not the place to share either mine or yours), I don’t think anyone feels like we are in a good place as a nation.

I am sad too about the sentencing given this week in the Stanford rape trial. While this is a situation not on par with the act of mass terrorism that happened in Orlando this weekend, the sentencing itself and the statements of the rapist’s parents only emphasize that rape culture is all too prevalent in this country. This particular case merely drew attention to the massive injustices that plague victims of sexual violence. We still live in a place where women are taught how not to get raped, not a place where people are told not to rape.

So I am sad tonight. This week brings heartbreaking news, unfathomable loss, and fears for the future. And I know this blog is supposed to be about Chinese medicine but tonight I needed to share this with you all.

Fred Rogers (known better to us all as Mr. Rogers of that beautiful neighborhood) once said:

When I was a boy and I would see scary things in the news, my mother would say to me, “Look for the helpers. You will always find people who are helping.” To this day, especially in times of disaster, I remember my mother’s words and I am comforted by realizing there are still so many helpers- so many caring people in this world.

So look for the helpers. Look past the anger and the hatred and the violence. Be a helper yourself. Spread kindness and love and tolerance. Fight for your beliefs and fight to make this a better, safer, and more caring world. Stand up for those who cannot. Show your support for the marginalized and for the underserved. Hug your loved ones a little closer this evening- some may not get that chance again.

Look for the helpers.

Understanding How Acupuncture Works (A Scientific Perspective)

Hello, friends! My sincere apologies for immediately breaking my promise in my last post to write more regularly. Once again, school and work have been very busy. I’m excited about today’s post, however. This post is actually part of an assignment for one of my classes. Many of the doctoral classes emphasize the importance of evidence-informed practice. This is a fancy way of saying that clinical research and trials should have an influence on how we practice Chinese medicine. This can sometimes be a controversial idea, especially since many in the TCM field feel that we don’t need clinical trials to prove that something that has been done for thousands of years works. However, I think using this type of scientific consideration is actually important. An assignment for one of my classes asked us to write an article or handout of some sort that uses evidence-based medicine to explore a topic in Chinese medicine. So here we are today!

Acupuncture is definitely an art, but there is a very real scientific aspect to it that is being explored more and more frequently. This is personally exciting to me, because the more research that is done in the field of acupuncture, the more information I have to give to patients and other medical professionals about how and why acupuncture should be considered a valid system of medicine. We’ve talked about qi and the meridians here before, and let’s face it- those concepts sound a little odd to most people. If we don’t have a scientific aspect involved, it doesn’t look great for us to say, “Hey, you should totally just trust me that this invisible substance that moves through these invisible channels and can be influenced at these tiny invisible points is super important to your health.” That’s a quick way to alienate people and, frankly, to make us look like a bunch of patchouli-ensconced weirdos within the medical community.

This is where research comes into play. One of the most interesting components I have found within the field of acupuncture research is studies explaining exactly what happens when the acupuncture needles themselves are inserted into the body. There is a doctor named Helene Langevin who is both an M.D. and an acupuncturist who has done a lot of fascinating work on connective tissue and the mechanism of acupuncture. Dr. Langevin has spent much of her career exploring these topics, and she has found that acupuncture has an effect on the cells involved in connective tissues.

Let’s talk about connective tissue for a minute before we go further. Connective tissue is a very broad term, but the most important thing to understand is that it is the most widely found tissue in the body, and it is responsible for holding aspects of the body together, insulating and protecting parts of the body, and moving substances everywhere they need to go. Connective tissue is very adaptable and varies a great deal depending on what it needs to do. The type of connective tissue most important to acupuncture research is what is referred to as “connective tissue proper,” which can be classified as loose or dense. Within the classification of loose connective tissue is the subclass of areolar connective tissue.

Areolar connective tissue

This type of tissue is mostly commonly made up of a type of cell called fibroblasts (this will be important to remember later). The main function of this type of tissue is essential for holding our bodies together- it sort of works like packing peanuts to keep our organs, etc. in place. It keeps our bodies together while simultaneously allowing us to move around freely. It surrounds everything within our body and keeps things safe and well nourished.[i]

“Ok,” (you might say here) “thanks for the science lesson, Sarah. Just what I was hoping for on a holiday weekend- a really fun reminder of high school bio.” Bear with me…understanding just how important connective tissue is makes understanding the mechanism of acupuncture much easier.

In her research, Dr. Langevin discusses the idea that acupuncture points are areas where connective tissue can be easily affected. She proposes the idea of understanding these points as intersections on highways that travel all over the body. This is supported by her findings that acupuncture points themselves seem to often be located at areas of the body where different sections of connective tissue either meet or cross.[ii]

When an acupuncture needle is inserted into the skin, an acupuncturist usually moves it around a little- either we move the needle up and down a bit or we twirl the needle around. Research has shown that this changes the structure of the connective tissue on a cellular level- a “whorl” is shown around the tip of the needle that sort of looks like a whirlpool. The idea then is that this change in the connective tissue around the tip of needle acts as a signal to the cells of other connective tissues.acupuncture110324104147-large

Remember the idea of acupuncture points as intersections; when you have something happen at one of those intersections (i.e. the insertion of an acupuncture needle), information can travel along the connective tissue highways and have an effect on different tissues all over the body. By influencing the connective tissue through a needle insertion, cells such as fibroblasts (see, I told you would see that word again) can potentially change their actions and send out signals to influence other types of cells around them, thus providing an explanation for how inserting a needle at one point can influence all different parts of the body. Because the cells of connective tissue are responsible for keeping everything together, they are also naturally responsible for sharing information between parts of the body. This can further explain how acupuncture might even influence the perception of pain in the body, as causing a change in these cells might influence how pain signals are received and sent.[iii]

Let’s break this down with a food-based analogy (my favorite type of analogy). Picture a delicious plate of spaghetti. That spaghetti is your connective tissue (metaphorically speaking of course, not Hannibal Lector-style). When you twirl a fork into that spaghetti (like an acupuncture needle going into an acupuncture point), more and more strands will start to wind around the tines of the fork. Twirl hard enough and the whole plate of pasta begins to change shape. You might even splatter sauce everywhere as you move the pasta around. This is what happens when you insert the needle and move it around- the connective tissue itself is changed by that mechanical stress and can send out signals to the surrounding areas.

For those science-minded types, you might notice that the research on this is a little old. There are still lots of studies being done to further explore Dr. Langevin’s theories for how acupuncture works. As you know, each small aspect of any biological mechanism must be thoroughly explored before any final conclusions can be made- it’s not as easy as designing one study to definitely confirm how acupuncture works (although that would be terrific). For example, one of her additional studies is really just to confirm that connective tissue, as opposed to muscle, is what is actually affected by needle insertion and manipulation. This study was able to show that needle manipulation does indeed affect the connective tissue, which means that it is very possible that acupuncture then influences the information sent along the connective tissue pathways. Because other research has shown that this sort of mechanical stress influences cellular communication, this experiment supports her earlier theory that by inserting a needle, something happens along that cellular pathway to make a change in the body.[iv] Also important to consider is that, although research done fifteen years ago may be considered “old” within most academic circles, it’s still pretty young for a system of medicine that’s been around for thousands of years. Distilling this much history into neat studies takes a whole lot of time and effort on the part of those researchers.

So research continues to be done in this field, but it takes time. You can check out the hyperlink on Dr. Langevin’s name to see her bio at the University of Vermont and check out some of her latest work in the field if you’re interested in learning more. This is intended to just be a little introduction into the research surrounding how acupuncture works. Thanks for hanging in there with me on this today- I know it’s a little different from my normal posts but I think it’s always a good thing to introduce the harder sciences into discussions about Chinese medicine and acupuncture. I hope everyone has a great rest of your weekend, and be well!

[i] Marieb, E. & Hoehn, K. (2007). Human Anatomy & Physiology (7th ed). San Francisco, CA: Pearson Benjamin Cummings.

[ii] Langevin, H. & Yandow, J. (2002). Relationship of acupuncture points and meridians to connective tissue planes. The Anatomical Record 269(6), 257-265. doi: 10.1002/ar.10185

[iii] Langevin, H., Churchill, D., & Cipolla, M. (2001). Mechanical signaling through connective tissue: A mechanism for the therapeutic affects of acupuncture. The FASEB Journal 15(12), 2275-2282. doi: 10.1096/fj.01-0015hyp

[iv] Langevin, H., Churchill, D., Wu, J., Badger, G., Yandow, A., Fox, J., & King, M. (2002). Evidence of connective tissue involvement in acupuncture. The FASEB Journal (published online). doi: 10.1096/fj.01-0925fje