"Mommy Thumb", or Why do I have so much pain postpartum?

If you found your way to this post, you may have already heard about “mommy thumb”.  But there is also mommy back, mommy shoulders, mommy neck.  Luckily I do not normally suffer from much pain, After giving birth to our daughter, I had the opportunity to suddenly experience what it is like to have your back go out, and to have excruciating pain in your neck/ shoulder that has you moving gingerly, because the slightest wrong movement causes severe spasming.  I also got to experience the relief of visiting an acupuncturist and postpartum chiropractor and letting them help me.  I have to say, when you are on the receiving end it feels incredible and seems magical.

If I had known then what I know now, I could have prevented this pain.  I, and everyone else who has given birth within the past year (or four), and especially if also combined with breast feeding, is prone to fluid and blood deficiency.  It is the liquids of our body that keep our muscles like a moistened and wrung-out sponge – able to bend, be squished, change position.  During the gestation of a child, we become filled with extra blood and fluids to support the growth of our baby.  This is why your skin looks younger, and your hair gets extra full like any fertility idol ever dug up.  

When we give birth, we lose a lot of this.  This is why just following the birth we can have nightsweats, and why our lush hair starts to fall out, leaving us with our usual thickness.  Now of course, our bodies were made to do this, but we have lost a lot of the traditional social and dietary supports that help replenish these fluids postpartum.

Some people continue to have nightsweats long after giving birth, or leak milk in their sleep and can fill a whole other bottle from the opposite breast while feeding their child.  I fit the second of these categories.  I found myself waking up in puddles of milk. I asked my midwives about “oversupply”, and they told me there is no such thing.  Perhaps I did not describe what was happening completely, in part because I also didn’t really think it was an issue. I was just surprised that breastfeeding was so messy because I hadn’t heard anyone talk about it.  Now I know that this is a kind of “leakage” according to East Asian medicine, a sign of deep deficiency, and should absolutely be treated to prevent further issues and deficiency (which in my case, did come).  Luckily, it is not hard to treat this situation, or the more mild version of relative postpartum deficiency.

When these fluids are lost, our muscles become dried out.  They can feel stiff, almost like cardboard, or a dried out sponge, or feel spasmodic.  This is often accompanied by strong thirst in the postpartum person.  If left untreated, it can lead to fatigue, low grade frequent nausea, achey joints, and other kinds of malaise.  If you visit a postpartum acupuncturist and herbalist, they will treat the branch (the pain), and the root (the fluid deficiency).  Not only will this ensure that the problem does not return, but it also prepares you to be in full health for the next step in your reproductive journey, whether that is another conception and pregnancy or perimenopause.

Why do I have pain since using Spironolactone?

Do you have neck, back or shoulder pain while using Spironolactone for acne?  Read on to understand why and learn about other ways to get rid of acne while improving your overall health.

Here in Los Angeles I see a lot of adult patients taking Spironolactone for acne.  These patients are pleased with the results of this medicine, and have only come to see me because they have some sort of upper body pain or stiffness.  They may also mention incessant urination.  Often they do not associate these common side effects with their medication.  Spironolactone is an aldosterone antagonist and used to treat high blood pressure.  Aldosterone regulates how much water your kidneys filter out of the blood for discharge, acting as a diuretic. 

Traditional East Asian medicine has a very sophisticated lens for assessing fluid metabolism and the health of the blood.  Blood should not move too quickly nor be too static, and it should contain the right amount of “water” (fluids).  Healthy blood both nourishes muscles and contains the functional energy of the body, distributing it through the entire body the way sap distributes life function throughout a tree.  When the blood is deficient or dry, muscles can become stiff and dry.  The blood can no longer contain the life force so it no longer spreads healthily through the body but rather flares up into the upper body, causing headaches, pain, even hair loss!

Your local skilled acupuncturist and herbalist can address these imbalances.  More importantly, we can treat the acne so that you don’t need to go on the Spironolactone in the first place!  It is common to use beautiful flowers to treat acne because they are cooling and clear toxic heat.  Some common flowers we use are honey suckle (shown above), forsythia, and violet.  Beauty to beget beauty, what could be more magical?

Not only will you feel more radiant and be in less pain by using Traditional East Asian medicine to treat your illness, your long term health will benefit.  The health of the blood determines so much, even emotional wellbeing!  Issues with blood may go unnoticed until there are important hormonal shifts in the body, such as a viral illness or perimenopause.  

For someone who is considering a future pregnancy, this is also extremely important.  We prepare people for pregnancy by promoting healthy fluid metabolism and harmonized blood.  Diuretics disrupt these mechanisms. Acupuncture and herbs regulate these symptoms so that your symptoms resolve, and your body is at peak fertility.

What is a BBT (basal body temperature) chart, should I do it, and how do I do it?

A basal body temperature (BBT) chart is quite simply a graph showing your basal body temperature (your temperature at the very moment you wake up in the morning after at least 4 hours of sleep) throughout the month.  It shows slight differences in a temperature and as such gives a snapshot of menstrual hormonal health.

It is done for a variety of reasons.  It is just one aspect of the Fertility Awareness Method (FAM), and can be used to avoid pregnancy or to enhance chances of conception.  The idea is that if one knows their fertile window, they can optimize it and/ or keep sperm away during that time, depending on what your goals are at this time in your life.  In my practice I consult my patients’ BBT charts for the purposes of enhancing fertility, and this is where I get the most questions.  This blog post will be most helpful to those of you trying to conceive.

It can come as a shock after years of scrupulously avoiding pregnancy to discover that it does not happen as easily as one might have been led to think in high school.  (Although to be fair, the youthfulness of high school bodies may make conception a lot easier, so good that you were so careful.). After a few months of failed attempts, couples often begin to wonder if they should take a closer look at what they are doing.  Conception in the best of situations can take many months; it is good to shift lifestyle habits towards optimal health and begin gentle investigation early while also resting in the knowledge that bodies and nature do things in their own time.  There is a delicate balance to be struck between optimizing your odds and being relaxed.  

A BBT chart can confirm something very important — whether or not the ovaries are ovulating.  The only other way to know this is by carefully tracking with imaging what the ovaries are up to throughout the cycle.  “But wait!” You say, “my OPK strips tell me that I am ovulating!”  Actually, they measure your luteinizing hormone (LH).  This is your body’s messenger that tells the growing egg it is time to pop out of the ovary.  Your body can send this message, but the ovaries do not always respond.  A BBT chart is a great way to see if the eggs are leaving the ovary, and also to give a general picture of hormonal health.

BBT charts, like egg white cervical mucus (EWCM) and ovulation strips, can also tell a couple when the sperm should be trying to meet the sperm.  Whether this is through intercourse or through the insertion of donated semen, the timing is important.  BBT charts can only tell you you have ovulated after the fact (more on this below), but after a few months of tracking you can come to see when your fertile window falls. I personally do not think this is the best way to time sperm meets egg, as the EWCM is much more important for timing – the fertile mucus both keeps the sperm safe and helps it to get where it’s going at the right time.  (Read more about this here.). 

Finally, one more use of a BBT chart is to be able to see changes in hormonal health.  A BBT chart is absolutely unnecessary to know if  hormonal health is improving.  There are always other indicators to track, such as quality of sleep, abundance of EWCM, bowels, urination, and most obviously, menstrual symptoms.  However, it can be fun and satisfying for the patient (and your herbalist and acupuncturist, if you have one) to see the chart become more and more textbook each month.  This is not for everyone.  Some people find it fun, some find it stressful, so once you have confirmed that indeed you do ovulate, do as you please.

Okay, I’m ready to try it, how do I do it?

Go to the pharmacy and get yourself a thermometer with two decimal points.  The tenths of a degree is where you will see the temperature fluctuation.  The moment you wake up, before you speak, get up, go pee, sip water, stick the thermometer in your mouth and let it sit there a few minutes so that it is your temperature. Then push the button, wait for it to beep, read the temperature and record it.  You can record it in an online fertility tracker or on a good old fashioned spreadsheet.  (If you like the paper versions I have one free for download here.)  Typically these spreadsheets and apps also have a line to track cervical mucus (CM), when there was sex or insemination, and other data.  (This is highly personal data…this data will also show pregnancies and miscarriages.  If you prefer not to share this with a third party, use Google to find which apps are available currently that commit to storing your data locally only.)  All of these signs together show a complete picture of your fertile window.

But what am I looking for?

Okay, so you’ve done the work, you have a cool graph, but how do you interpret it?  You want to see a “biphasic” chart, which means a clear delineation from a more or less steady line at a lower temperature from the first day of your period (cycle day one) to midcycle, when you should see a clear and distinct stair step of half a degree.  After the temperature rises, it should stay up until right before you start bleeding.  It is the hormone progesterone that increases your body temperature just after ovulation, and it is the withdrawal of this hormone that causes the uterine lining to shed.  If right before your period your temperature does not drop, but instead goes up and stays up another half a degree, this is called a triphasic chart.  Triphasic charts can often indicate pregnancy!

Let’s take a look at a real live charts pulled from public forums on the internet to see what this can look like and how it might change.  

The first one is example of why it is helpful to temp.  The LH surge is occurring (the red line) but the blue line never goes up and stays up about half a degree.

Here is another chart.  I think this one is great to see because it shows both an anovulatory chart at the beginning, and then ovulation. The ovulation is weak in that there is not a clear stair step change that stays well elevated, but still the chart is biphasic.  Someone with an anovulatory chart will see a line that looks like what this chart looks like up until cycle day 32.  This kind of pattern could go on for weeks, even months.  It is not uncommon with a chart like this to periodically get EWCM.  The body is trying to ovulate but cannot.  A skilled herbalist can determine how to help your body and also give you herbs specifically for when you see the EWCM to help the egg release.  

People with long cycles will typically have a chart like this.  There is no reason to be too concerned about a long cycle if everything else is going well (EWCM at ovulation, easy periods, good poops, energy, mood).  A person with a long cycle can still be ovulating and have a healthy luteal phase temperature-wise.  This chart shows that there is more going on than a long cycle.  The temperatures in the luteal phase go up quickly (steeply), which is very positive.  However, the temperature does not go as high as we would like (ideally the temperature goes up half a degree) and has some trouble staying up.  An acupuncturist and herbalist can help regulate your cycle so that you both have more opportunities a year to try for pregnancy and better chances for success.

Here’s another cycle that could use a boost from Traditional East Asian medicine.  The chart is biphasic, but it kind of swoops down into the proliferative phase, and swoops up into the luteal phase, without a strong and steep rise.  The temperature is still dropping into the proliferative phase after the person is done bleeding.  

With treatment, we often see a chart that looks like this turn into a chart that looks more like this:

Textbook BBT chart

This is a textbook chart, clearly biphasic.  The chart is in Celsius, and shows more than half a degree rise.  Assuming there are no issues with the sperm, when charts look like this, people get pregnant!

Patients often ask about random spikes up or down.  If they are one-offs, check to see if they indicate sleep disruption, alcohol use, travel, or illness.  If it is as simple as you got up to pee, mark that and consider it an outlier.  Tracking your temperature can show you how easily a couple of drinks, lack of sleep, or a cold can affect your cycle.

I hope these charts are helpful to you as you deepen your understanding of your own body’s cycles.   Please feel free to share any questions below.

Why I Love to Treat Uterine Bleeding

My favorite things to treat are those that

• Make a big difference to someone's quality of life and healthcare

• Have limited treatment options in conventional medicine

• Leave no doubt about whether or not treatment has been successful

Uterine bleeding checks all those boxes.  I have had people come into my office who have been bleeding non stop for months.  This is serious cause for concern and can lead to the need for blood transfusions.  Even without meeting that criteria, that much blood loss leads to such a deficiency that it can be difficult to work and go about one’s life.  The extreme deficiency in turn can exacerbate the bleeding.

Sometimes the excessive uterine bleeding is within the menstrual period.  Some people bleed so heavily that they cannot leave the house during certain parts of their cycle.  This, too, can lead to anemia, as well as worsening symptoms after the cycle, such as headache, nausea, anxiety, etc.

Sometimes it is heavy bleeding interchanged with incessant spotting. 

Sometimes it is bleeding, light or heavy, during pregnancy, also called a threatened-miscarriage. (I had this kind of bleeding at week 14 with our daughter, and it was treated quickly and successfully by my gynecology professor with herbs.)

All of these patterns require treatment.

According to Traditional East Asian medicine, inappropriate bleeding comes from heat, stagnation, deficiency, or blood that is not moving well (blood stasis).  In practice, these patterns are combined.  The beauty of our herbal medicine is that there are many many plants and minerals that stop bleeding, and we distinguish between how they stop bleeding.  Some herbs stop bleeding by cooling the blood, others by shoring up the body and making it more absorptive so that blood and fluids can’t leak out.  Some herbs even stop bleeding by moving stagnant blood, because quite commonly blood will push it’s way around blockages, causing wreckless bleeding where there should be none.

Nothing is more satisfying than seeing a patient who has been suffering respond to treatment.  Once the bleeding has stopped, our task is to replenish their blood.  As color comes back their faces, symptoms of blood deficiency improve.

If you or a loved one has been suffering from this issue, send them to their nearest acupuncturist and herbalist for treatment.

Pediatric Tuina You Can Try at Home

In Chinese medicine there are many microcosms, reflections of the entire body and/ or universe in the smaller parts.  It's understood that in pediatrics, the channels are not fully formed yet, and for up to the age 7 there are these special areas and points.  I say up to the age 7 (females mature in periods of 7, males in periods of 8), but this is an approximation.  Developmental or emotional ages are sometimes younger, and often we find that in these situation these special child tuina (massage) techniques can work for longer. 

The hand is a great place to start, because it is the least invasive. Here are reflected all of the solid (zang) organs, and some of the hollow (fu) ones.  To tonify one moves towards the body, to sedate one moves away.  So for example, if you're little one is a picky eater, or is colicky, or sleepy and chubby, or tends towards runny noses more than is normal (which is already a lot), you can tonify the spleen by stroking the outer edge of the thumb from the tip to the 2nd knuckle.  Do this at a brisk pace, with a firm and gentle touch, 20-30x.  Or perhaps your child has difficulty going number 2 and has a full round belly.  Then you could stroke the outside of the first finger from the base to the tip, also at a brisk pace, 20-30x.  

Perhaps your child has pink eye, or a tendency towards a dry sore throat, or gets especially frustrated easily.  You can sedate the liver, but stroking the palm side of the first finger from the base to the tip in the same manner.  For an acute cough, sedate the lungs by stroking from the base of the ring finger to the tip on the palmar side.  Try these strategies daily for a week and see what you notice.  If your child is constitutionally weak, you may try tonifying both the kidneys and the spleen, but stroking the first and last finger from the tip to the base.

Make these concepts your own by integrating them into your daily parenting and see how the simplicity and wisdom of East Asian medicine can benefit you.

For those of you who already know East Asian medicine, you may be surprised that the zang organs do not follow the sheng or the generating cycle.  If you imagine a fetal fist, with the thumb folded into the middle, you will see that Earth is in the right position in the center.  Perhaps the thumb leaves that position for the baby to suck its thumb, but even then it is exercising the prenatal spleen.  The zang organs after that start in the spring and follow the order around the circle.

Delicious Dish Rich in Plant Protein for Pregnant People, Non Pregnant People, Vegans, and Omnivores

Hi everyone!  I’ve had a few pregnant people describe to me their aversion to meat, even in the 2nd and 3rd trimesters when I become more concerned about their appetite.  I also have quite a few vegetarians (including myself) who run out of ideas for yummy, easy plant protein rich eats.  Here is a recipe that is in heavy rotation in our household.  For those of you who might not know, I lived in Spain for 6 years.  This is a dish I learned there, and the way of cooking rice is central to many Spanish dishes, including paella. 

Ingredients:

Butternut squash

Red/ orange/ yellow pepper

Onion

Canned tomato (I usually use the peeled whole tomato that I break up when I add it, but I used what I had on hand which is pictured here)

Cooked garbanzo beans

Extra virgin olive oil

Short grain rice like Arborio or Calrose

Salt to taste

Lemon and mayonnaise to garnish according to taste

Start by cutting the butternut squash into uniform thin slices.  I use about ⅓ of the squash.   Add more olive oil than you think is respectable to a large round frying pan, and when it is heated but not smoking, add the slices of squash and stir it around, coating them and then letting them sauté in the oil.

Begin cutting your next vegetable.  In general you start with the longer to cook vegetables and end with the ones that cook more quickly, so the red pepper can go next.  I used one whole pepper.  When the butternut squash as started to soften, push it to the edges of the pan and put the pepper into the pool of hot oil in the center.  Then start dicing your onion.  I use half an onion here.

When the pepper is starting to soften and fry, mix it in with the butternut squash, push that all to the edges, and add the onion to the hot oil in the center.  Let that cook and soften, and then integrate with the other veggies, push to the edges, and add the can of garbanzo beans.  You can salt the veggies as you go along.  Once the garbanzo beans are warmed and getting slightly toasted, integrate them and make room for the tomatoes.  Let the tomatoes cook down in the oil enough that they start to get the rich caramelized flavor.  At this point you can add the rice.  I used one cup of rice that will become 2 cups of rice once cooked.  You can make a well for the rice, which I forgot to do, but basically you add the uncooked rice and let it get a bit sauteed in the oil so that it is soaking up the flavors of the dish.  After about 5 minutes, you can add 2x the water as the rice that you put in, plus a little bit more.  So I added 2 cups of water plus a smidge.  Add salt for the amount of rice and water you added.  Mix it all together until it is evenly combined, bring to a boil, and then turn the heat down to a very low simmer.  Do NOT move the rice again.  You may need to move the pan on the burner if it is bubbling unevenly (in other words your pan is bigger than the flame) so that all the parts get heat.  Slowly, the rice will grow.  You can take a fork to pick out a couple of grains to test for doneness.  If the ones on top are still a bit dry and the ones in the center well cooked, you can add a lid and keep the heat very low to let the steam cook the grains on top.  This is considered a less skillful way to do it, but I do it all the time and won’t tell anyone.  If the ones on top are mostly done, you can just turn off the heat and cover with a lid (or newspaper, as I commonly saw done).

Push the already softened to the edges of the pan to make a well of hot oil for each new ingredient.

This technique of toasting the rice in oil and maybe other ingredients, adding 2x plus a bit of liquid, stirring to mix and then not touching again, bringing to a simmer and then turning down the heat is the technique that is common to many Spanish rice dishes.  As you can see, it is quite versatile, and you can sub the vegetables and legumes of your choice.

Serve with lemon to squeeze on top, and a dollop of mayonnaise on the side.  You can graze each forkful by the dollop of mayonnaise on the way to your mouth and enjoy.  Our 6 year old is a huge fan of this dish, so it is kid tested and proven.

Joy and Ease in Your Postpartum Phase

I was hanging by a thread, and then I fell.”  —A real live patient describing her last postpartum experience

“I didn’t even realize I was depressed until 5 months went by and I looked back.  I remember sitting in the dark, alone, scared to move because I didn’t want my baby to wake up and start crying again.”  —Another real life postpartum experience described to me by a loved one. 

In our contemporary American culture, so much effort is put into getting the egg to meet the sperm. Yet precious little energy goes into surrounding the new parents and their little as they navigate formidable new territory.  Indigenous medicines all around the world are rich with wisdom on how to transition mothers through the portal and to the other side, how to nurse their wounds and refill their empty belly that no longer contains the warmth of another life.  I am lucky to practice one of these ancient medicines.  My skill set comes from the traditional medicine of ancient China and it’s contemporary diaspora.  It is my passion to treat as many people as I can during this rite of passage. 

Families are stronger when supported with proper postpartum care.  EAM practitioners know what to look for to minimize the common postpartum symptoms of depression, anxiety (just as common as depression, by the way), insomnia, and feeding difficulties.  We can also help you recover from the amazing physical, emotional, and spiritual feat that is birthing a child.

In a typical postpartum visit, I make sure to assess the state of the person’s blood. It will be relatively weak compared to before giving birth, but is it also stagnant, or especially deficient, and do body fluids also need to be replenished?  When the blood is weak, yang can flare, making it hard to sleep at night even when you are off duty.  Insufficient blood or fluids can also cause low milk supply as well as tingling in the extremities, a surprisingly common postpartum symptom.  I remember one mother who felt tingling in the stomach channel of her leg whenever her baby latched further up the stomach channel on the breast, a clear manifestation of how emptying the channel left room for wind to get in and cause tingling.  Stagnant blood can cause pain in the lower abdomen, but even a stagnation that goes unnoticed by the patient can keep the body from making new blood, causing feeding difficulties and mood changes.  One of my obstetrics teachers says that she has found blood stagnation to be the most common cause of postpartum depression, and I have to agree.  I would add that postpartum blood deficiency is the most common cause of postpartum anxiety, an adrenalized sensation of being on hyper-alert, unable to drift into sleep and easily rattled by the new child’s cries and communications.

The best news is that these way too common ailments are treatable, even avoidable, and the treatment is soothing and nourishing.  As you consider carefully the support networks you want after your baby has arrived, please look in your area to find a qualified obstetrics and gynecological East Asian medical physician to be on your team.  If you are in Los Angeles and want to see how I can help you, whether it is months before your baby arrives or years after, please reach out or schedule below.

Why Chronic Leakage of Breast Milk is Debilitating

I remember my midwives saying that there is no such thing as oversupply.  At the time, that made sense to me, but if I had known then what I know now, I could have saved myself years of feeling unwell and likely have prevented a few miscarriages.  Let me explain.  While the idea of milk oversupply may be debatable, from our Chinese medical lens we know that if the milk is falling out, this is leakage, and a loss of precious vitality.  Leakage looks like waking up in puddles of milk, soaking through your milk pads, or losing 4-6 ozs out of the breast your child is not feeding on while you are feeding on the other breast.  Regular loss of this amount of breast milk is extremely taxing.  Why?  

Because:  it is our bodies’ job to take in food and turn it into ourselves, which includes our blood, and eliminate the waste.  In menstruating bodies, the blood that is made goes to the uterus.  This precious substance either grows another new human body or it is shed monthly.  In a postpartum body, the blood is redirected to the breasts, where it becomes a very precious substance that grows a child.  In the same way that losing too much blood out of your uterus is taxing, even debilitating, losing too much milk out of your breasts is also very debilitating.  A body that is prone to leaking breast milk is often the same body, because of its constitution, that will take a long time to stop bleeding after birth, continuing to have a light flow 4, 6, or more weeks after childbirth.  Even if the amount of bleeding is light, this is a huge loss of qi, blood, and yang, and can cause a self-perpetuating loop.  Down the road, leakage can cause things like fatigue, weakness, dry tight muscles, scanty periods, insomnia, or poor hormonal health, even constipation.  Dry tight muscles might look like chronically aching neck and upper back, or an upper back that is especially tight before your period, or stomach muscles that are so tight that you chronically feel slightly or very queasy.  The same weakness that can cause you to leak things can become exacerbated, so that you begin to leak out of your lower orifices (pee and poop) or out of your uterus (heavy bleeding) or out of your pores (too much sweating).  

This sort of postpartum illness is insidious.  You may have had an easy time right after birth, only to look up 1 to 2 years later and realize that you really don’t feel well, and that it has been a while since you have.  I monitor for this kind of leakage in my postpartum patients in order to stop it before it becomes a problem.  When new patients come in two to three years after having a child and they tell me that their bodies are not what they used to be, often our intake reveals that they too have been leaking breast milk or other precious body fluids (sweat or blood) over a long period of time.

Traditional medicines provide excellent postpartum care because they can both identify issues before they are an issue, and more importantly, they have effective treatments that firm the edges of your body so that it can contain what should not be lost.  We also have ways of replenishing fluids and blood.  

Years after finishing breastfeeding, I slowly but very surely got better thanks to long term herbal medicine.  Had I known what to look for in the moment, and what treatment to use, I could have avoided years of feeling weak and other symptoms.  This would have meant more abundant healthier blood, and a much better chance for my later pregnancies to have taken.  It also means feeling strong and more like yourself.  If you relate to any part of what is described above, please find a skilled postpartum herbalist to help you start healing now. If you would like to schedule a free 15 minute phone consult, send me a message through the email form below.

Acupuncture and Chinese Herbal Medicine are Uniquely Suited to Treating Chronic Illness

Do you feel somehow cursed because, unlike your loved ones, you can’t eat a slice of pizza without debilitating pain or running to the toilet?  Is your internal thermostat off, to the point that you are sweating and wanting to rip your clothes off and stand in front of a fan while others seem perfectly unbothered?  Do you have to budget your energy expenditures, knowing that a normal friend outing will require half a day or more of recuperation time, or that a typical work day even at a job you love leaves you without the energy to fix and eat a meal?  Does a normal sized meal sit uncomfortably on your belly, so that you eat less than everyone else at the table, and yet mysteriously still gain weight?  Do you track public restrooms or a tried and true way to ask to use the employee restroom because you can’t run an errand or watch a movie without getting up to pee?  These are all symptoms that drive my patients to multiple doctors, where they sometimes get a diagnosis and sometimes do not, because despite something clearly being wrong, their ailment does not show up on blood work or imaging.  Or their abnormal bloodwork does not turn up a diagnosis.  Or their diagnosis in conventional medicine has no treatment.  Sometimes frustrated patients are told to lose weight or exercise more, two things that their body has long ago declined to do despite dedicated and sustained efforts.

The medicine that originated in ancient China and spread throughout Asia, now referred to as East Asian Medicine (EAM) is uniquely suited to treat chronic illness.  When you explain your bizarre conglomeration of symptoms, we hear things that were described in ancient texts, and are excited to begin an effective treatment that will restore confidence in your own body’s ability to interact with this world and experience joy.

We ask a lot of follow up questions in order to determine whether your body has not enough or too much of certain substances and to find out where things are getting stuck or are falling out.  We then, in very basic ways, get to work.  If something is stuck, we open through; if blood or cooling fluids are missing, we help the body make more; if there is too much heat, we cool it; too much cold, we warm it.  If an organ’s function is going in the wrong direction, say stomach qi is going up when it should go down causing nausea, vomiting, or regurgitation, we help it find the right direction.  If something (like urine) is falling out too frequently, we help it to stay in.  Persistent symptoms become less frequent, and less intense.  Slowly, being chronically unwell becomes a memory, a hard thing that someone went through and came out of on the other side, stronger, more confident, and, for having suffered deeply, more compassionate.

Your mysterious illness is not mysterious to us. If you are tired of seeking a solution to feeling unwell and are ready to get off of the sick train, call (626) 817-3556 for a free consultation or book an appointment below.

Is the Stomach Bug Flying Around your House Trying to Get In?

There's at least one point every year where patients start coming in telling me that they ate a [insert here the last thing they ate before getting sick] and got food poisoning.  Everyone is listing a different innocuous food because in fact it is a stomach flu circulating through the community.  Traditional medicine has many ways to avoid the bug getting into your digestive system or to make it unwelcome if it is already there.  Firstly, stay warm.  Keep your feet warm, your belly warm, your back warm.  Keeping your belly warm can look like drinking ginger tea, eating cooked vegetables over raw vegetables, or sitting on the sofa under the covers with a heating pad or hot water belly on your stomach.  Avoid iced beverages (including your coffees and lattes and waters) except in the hottest hours of the hottest days in order to keep your digestive cooking pot (your belly) appropriately warm.  This helps food to go down at the right speed and come out at the right speed.

A hand is holding the base of an orange butternut squash cut in half. The seeds inside are sprouting. This squash was used to make a medicinal congee.

To prevent or recover from a stomach bug, make a pot of congee with short grained rice.  Instead of the typical 2:1 water:rice ratio, add 8 to 10 times as much water to the rice.  If you have butternut squash or any other sort of orange pumpkin, add some peeled cubes to the mix, along with grated ginger and bay leaf.  The orange root vegetable will help to tonify your digestive system, ginger will warm your digestive fire, and the bay leaf is anti-diarrheal.  The thick rice water that is generated is absorptive, and will help redistribute fluids in your digestive system to where they should go.  Serve with a drizzle of sesame oil and soy sauce to taste; if someone is already feeling queasy they may prefer it without condiments.

Butternut ginger congee, drizzled with sesame oil and soy sauce. A medicinal and delicious porridge that strengthens the digestive system.

Another handy tool for your household's medicine cabinet is the Chinese medical formula 'huo xiang zheng qi san".  It is for "sudden turmoil disorder".  Sudden turmoil is when you are suddenly vomiting or diarrhea-ing or both at the same time.  You can use it at the onset of disease, or use it prophylactically if others in your household or in your community are sick.  While there are other formulas that very effectively treat sudden turmoil disease, this is a kind of generic formula that can be applied easily without need of diagnosis by a practitioner.  We were recently travelling abroad and I brought some.  We only used it once, after finding out friends that we had spent the week with were severely ill with a stomach bug.  It is excellent for foreign travel, when it can sometimes take longer to navigate a different health care system in a different language.  If you want to pick some up from the clinic to have at home or for travel, feel free to get in touch and let me know when you can stop by to pick it up.

Another very effective folk medicine technique comes to me via my Argentinian mother-in-law, and is practiced by women throughout Central and South America.  El empacho means blockage and can refer to just about any digestive upset.  Tirar el empacho is a technique of pulling quickly and sharply on the skin of the low back with the aim of producing a cracking sound.  I have learned it this way:  first apply talcum powder or corn starch to the low back to make it easier to grip.  Beginning just above the sacrum, and just on either side of the spine, grasp a roll of skin and tug upward quickly and firmly.  Repeat, going up the rest of the low back.  The more cracking sounds and the louder they are, the more needed the technique was and the more effective it will be.  Repeat 3 days in a row (although I confess to forgetting to repeat and the technique has still been very effective).  My mother-in-law used this recently on our daughter when she was home sick with no appetite.  Within an hour she announced she was hungry and wanted to eat.  Another example:  an elderly family member had diarrhea for one month, which was attributed to having eaten a chocolate (despite having eaten chocolates her entire life).  She visited her doctors several times but nothing could stop this diarrhea.  Long term diarrhea is quite serious in anyone, but especially in the elderly and in babies.  It wasn't until her caretaker, who grew up in Mexico and is also familiar with the technique, thought to "tirarle el empacho", that it stopped.

I hope that these techniques and remedies help your household stay healthy and free of acute digestive disorders.  If your digestion issues are long standing, East Asian medicine can also help.  If you have trouble going to the bathroom, or go to much, or have pain with digestion, these are all signs that you could benefit from a more personalized treatment. Always feel free to reach out with any questions, or book an appointment with the booking button below.

Recurring or Persistent Urinary Tract Infections

Most people with a vagina have experienced a urinary tract infection at some point in their lives.  But some of us have had wayyyy more than our fair share, and fall into a very frustrating cycle of UTI followed by antibiotics (possibly followed by yeast infection) followed by UTI followed by antibiotics, etc., etc.  If a person’s trigger is sex, this become an even bigger quality of life issue.  Many, many women struggle with this, and all the wiping from front to back and urinating immediately after sex is not enough to prevent some of these chronic cases.  This is on my list of things that should be shouted from the rooftop about East Asian medicine:  Chinese herbal medicine and acupuncture can put chronic UTIs into remission.  Please spread the word.

There are many ways that bladder infections can manifest.  In the same way that Western medicine chooses the appropriate antibiotic for the appropriate bacteria, we choose our formulas based on exactly what your particular body is doing.  Do you get your UTI at a particular time in your menstrual cycle?  Do you get strong burning pain and discomfort, or are you more the type to just go more frequently even though nothing comes out and have a bloated sensation at the pubic bone?  Or maybe you go straight to blood in the urine, which can look pretty scary but the herbal solution to this problem, like the others above, was described thousands of years ago and is effective.

Some women, after a spate of infections, will have all the sensations of UTI, yet their urine shows no bacteria.  This may be due to previous infections creating irritating scar tissue in the wall of the bladder, or due to biofilms that shelter the bacteria as it makes its life within little biofilm apartments, inside of you but separate.  People in this category usually receive the diagnosis of interstitial cystitis, which is considered a bladder pain syndrome.  In these cases, antibiotics are no longer appropriate or effective.  Fortunately, this does not matter for Chinese medicine.  There were no labs to culture your urine when our treatment principles were developed, so we are always treating “difficult urination”.  And we can treat difficult urination whether or not it is interstitial cystitis or an actual UTI.

Antibiotics are an incredible, life saving medicine, and will treat an acute UTI effectively and prevent you from dying a very ugly death due to a simple bladder infection traveling to your kidneys.  It is my personal experience that antibiotics are far superior in treating one-off, acute infections than our herbs.  But if you or someone you love fall into this other category of frequent, chronic, or resistant urinary tract infections, please get in touch.  There is so much we can do to return your body to full health.

Foods for Anemia, Including my Mother's Chicken Liver Recipe

If you've ever been anemic and then come out of it, you know what a gift of health and life it is to have healthy blood. Even lab ranges that are technically borderline can show up with strong feelings of fatigue, sleepiness, difficulty going uphill/ upstairs, and stars that cloud your vision. Symptomatic anemia is just as important to treat.

Once you are anemic enough to feel it, it is hard to correct with diet alone; be sure to take the iron supplements your doctor recommends, or to get your hands on this syrup.

Schedule an appointment with your local acupuncturist and herbalist to determine and correct the digestive or menstrual issues that are causing you to become anemic in the first place. This can easily become a loop of chronic illness, and East Asian medicine can treat it effectively.

This is the protocol I share with my patients, which includes my mother's recipe for chicken livers with sour cream (delicious!). There are other tasty recipes out there for chicken liver pate. This very diet is the one that increased my hemoglobin 2 points in 2 weeks when I was 5 months pregnant and anemic.

Eating for Anemia

Eat wild-caught salmon regularly. Frozen or smoked is probably the most affordable way to do this. Salmon salad is a great way to have a little bit every day.

Eat small amounts of chicken liver regularly. It's important to buy high quality organic ones. The way animals are raised and processed impacts us all in mundane and spiritual ways. On a very physical level, when you eat an animal’s liver you are eating the organ that processes everything that animal ate. The same way you wouldn’t want a farm worker, the soil, or our creaturely kin tp be exposed to toxins, you don't want to ingest an organ that filtered pesticides or herbicides.

My mom’s chicken liver with bacon and sour cream recipe:

Ingredients

• 1 pound organic chicken livers.

• 1-2 onions
  
  

• high quality sour cream (here in California I like Strauss’)
  
  

• few slices pasture raised bacon

Cooking Instructions

• Fry bacon to your liking, take out and break into pieces
  
  

• Fry onions in the bacon fat until soft and transparent
  
  

• Fry livers (that you have cleaned, trimming any connective tissue or tiny gallbladders that sometimes get left on) in the onions. Stop when they are just pink in the middle. If you over cook they get grainy and have an unpleasant texture. Add back the bacon
  
  

• Stir in spoonfuls of high quality sour cream to your liking
  
  

• Eat over short grain rice

Drink nettle tea, one a day if you can

Eat steamed dark green veggies and beets. Eat roasted sweet potatoes without added sugar.

Avoid smoothies and yogurts. These cold foods make it difficult for your digestive system to assimilate vitamins and minerals from your food and turn them into flesh and blood.

My colleague Jacqueline’s post with bone broth recipe.

If you are chronically anemic, or easily become anemic after getting better, there is a larger imbalance at play. Come in for an appointment so that we can treat the root cause of your illness.

Acupuncture for Chemotherapy Side Effects

As anyone who has been through chemotherapy knows, it is a rollercoaster.  Just as the body is showing its ability to heal from the last dose, it is time for the next.  Often it is the first day or two after an infusion that the patient feels best; the body has had the longest time to heal since the last infusion and the effects of the most recent infusion have yet to kick in.

The side effects indicate that the chemotherapy is working as desired.  The rollercoaster of the symptoms are a manifestation of our bodies’ incredible capacity for resilience and repair.  Still, no one enjoys the feelings of sickness that come with treating the wayward cancer cells.  Fortunately, acupuncture works quickly and effectively to mitigate the effects.

Let’s talk about the chemo-induced symptoms that I have treated in my office.

Tongue Pain  Chemotherapy causes the epithelial cells of the body, which then regrow. This includes the epithelial cells of the tongue.  Pain is probably not the right word to describe the sensation this causes, as the feeling ranges from dry, painful, sore, to other neurological symptoms such as a strange metallic taste and tingling.  I would say for most of my patients this is one of the most difficult to tolerate symptoms, because we use our mouths to ingest everything we need as well as to speak.

Fortunately, acupuncture can provide instant relief.  By working with channels that pass through the tongue, we can mitigate the discomfort of these sensations.  Patients usually report that they notice increased salivation during the treatment.  By the end of the treatment they notice less discomfort.  The relief provided by acupuncture can go a long way in making it possible to eat the amount needed to stay strong.

Nausea  You do not have to have experienced chemotherapy to know that the sensation of even mild nausea can make it difficult to inhabit your body.  Acupuncture is well known for being able to treat this condition.  In fact, there are some health insurances that will only cover acupuncture for “chemo-induced nausea”.

Gritty eyes, styes, and other eye symptoms  Because chemo attacks the fast growing epithelial cells, the glands we all have behind our eyebrows can sometimes stop working and no longer produce enough tears to moisten the eyes.  Acupuncture helps to reduce the inflammation and to promote healing of the tear glands.  Patients often comment that their eyes feel less filmy, less gritty, or less swollen by the end of the treatment, and the improvements continue to develop over the next 24 hours.  I will also send patients home with ju hua, or chrysanthemum, a most amazing flower for any sort of eye troubles.

Anemia  Chemotherapy impairs the body’s ability to make blood and can often result in low grade to severe anemia, or, depending on the chemo, even neutropenia.  Unlike the other symptoms in this post, a patient cannot report during the course of the treatment if their body has created more red or white blood cells or more hemoglobin.  However, my patients consistently report that their bloodwork is better than average.

Neuropathy  Some of the strongest chemotherapies, such as oxaliplatin (often used to treat pancreatic cancer), cause neuropathy.  This side effect sometimes becomes so severe that the course of treatment has to be discontinued, and the effects are sometimes permanent.  What I have found is that patients respond immediately to acupuncture in the first several rounds.  After that, while it continues to help, there is more variability between patients and the results are less complete and may not last as long.  

Painful nailbeds  Tender to painful nailbeds are due to visible damage to the blood vessels in the nail bed.  At its worst, the nails can fall out (but they grow back).  It has been described to me as a feeling of someone squeezing your finger tips.  Acupuncture also provides much welcome relief to this sensation.

Having born witness to this process, I am always so happy to be able to provide some relief during an emotionally and physically trying time. . If you or a loved one are facing the prospect of chemotherapy treatment, please consult with an East Asian medical physician like myself so that you can have the most support during the process.

Why Did My Acupuncture Treatment Make Me Cry?

You may just as easily be asking: make me laugh, make me feel antsy, make my limbs move involuntarily, make me burp, or make my abdominal muscles move in a comfortable, wave-like fashion?  OR, make me remember something unexpected from a long time ago, significant or insignificant?  These are all common responses to a treatment, and all are signs that the needles are working.

Everything that has ever happened to us is stored in our soma (body).  This is not a metaphor, but, as body-workers, Vipassana meditators, yoga teachers, somatic therapists and trauma therapists can tell you, quite literal.  Not only can muscle tissue and fascia contain memories, but even hormones and even gasses that you have become sequestered safely away.  When releasing large muscle groups, it is not uncommon for the room to smell like chemicals that the patient has been exposed to earlier in her lifetime.  When a patient comes in, their symptoms and life history suggest areas to work in, and when these areas are released, emotions, memories, and sensations can come to the surface.  The body’s memory is fascinating and precise.  If you have ever experienced a big shock, or lost an important person in your life, you may notice that your body remembers the event on its anniversary even when your conscious mind does not.  Some examples are a 9/11 first responder who experiences a severe chest cold every year around early to mid September.  (The lungs are associated with grief in East Asian Medicine.)  Or someone who was assaulted unexpectedly by a stranger, only to feel pain at the same time of year the following years in the same areas of her body where she hit the ground.  When someone has a seemingly unrelated symptom out of the blue, I make sure to ask, what happened in this month in other years of your life. If the symptom is related to a somatic memory, that question will prompt an answer.  

This is especially true with scar work.  Scars are a rich area to work in, as they invariably block the fascial planes and tissue beds that make up the meridians.  Over time this can cause an imbalance.  Sometimes when taking a life history I will notice that an injury to a channel is followed one or more years later with problems in the associated organ.  This is an example of how constricted tissue in one part of the body can affect another area.  I continue to be surprised by the responses elicited by scar work.  I have seen several instances where releasing scar tissue prompted the patient to have a pre-lingual memory.  That is a very, very early memory, yet the body knows.  (This is especially interesting, as scientists theorize that it is the syntax of language that allows us to form memories.  These clinical experiences, however, suggest that the body’s memory functions differently.)  I have had patients feel very specific phantom sensations; after working around a decades old C-section scar, one patient had to check her lower belly repeatedly because she kept feeling the same sensation of leaking fluid that had alerted her many, many years ago that some stitches had ruptured.  Of course, there was no leaking fluid, but this sensation persisted on and off for a week. 

And so it is with emotions.  Whether or not we are working on a visible scar, there are sections of our bodies that become stuck by strong emotion.  Acupuncture works to course the qi through all the riverbeds of the body.  As stuck areas begin to flow again, whatever was in the stagnant areas comes to the surface to be experienced and pass away.  The emotional release that happens on the table helps your body to work more completely, which means symptoms will resolve and you will feel lighter.  

If you suspect you have some stuck emotions or stuck tissues, book a session with me and we’ll do a complete life history to see how I can best go about unsticking your tissue planes.

Photo by Amanda Flavell

Chrysanthemum, chamomile, eyes, and herbal safety

I picked my daughter up from daycare the other day and found myself studying the face of the lovely woman who makes her home a second home to my daughter and others. She looked different to me, in a way that I couldn’t identify but made me wonder why her features weren’t matching the image of her in my mind’s eye.  The next day I understood what I was seeing differently-- she had a red rash around her eyes and the area was puffy. “Tita Annie,” I asked “what’s going on with your eyes? Do they itch?” and she explained to me how she has eye rashes that come and go, that they are uncomfortable and last for a few days.  She was gesturing to them while she was explaining, and her husband, standing near-by, chided her not to touch them. Clearly they were both very familiar with this annoying rash. I told her I would be back shortly with some ju hua that would fix her problem.  

I dropped my daughter home and biked back with a mason jar of some ju hua, chrysanthemum flowers.  In the parts of America that have winters we know chrysanthemum morifolium as the multi-colored annuals that are put out around Halloween time.  In East Asian medicine, it is the yellow or white flowers that are used. I instructed her to boil a few for 10-15 minutes, drink the infusion, and put the steeped flowers, once cooled, on her eyes.  This was a Friday. I didn’t see her again until the following Monday, where she reported exactly what I was expecting: in about a day her eyes were fine. I have yet to see ju hua not work its magic.  In our medicine, it is known for being the number one choice for any type of eye irritation or discomfort. It also expels wind, which was indicated in this example because Tita Annie’s eyes itch and the condition comes and goes.  I used it when my daughter caught pink-eye at 9 months from her older cousins (in addition to breast milk; lactating mothers have the most superior treatment in this situation), and it worked like a charm. I was surprised that my daughter even ate the steamed and cooled flowers off of her high chair tray.  Though to be fair, she was also trying to eat rocks at that phase in her life.  

It is important to know that you should only get ju hua from the most reputable source. An executive of one of the most-trusted herbal companies shared with me that they reject many ju hua suppliers as this is an herb that tends to test positive for heavy metals.  Spring Wind is very rigorous with their testing and sourcing, as is Mountain Rose, who has not carried ju hua for some time now.

Here in Southern California, there is an alternative from the same family that can be picked up at the farmer’s market: chamomile.  One of my Mexican patients tipped me off to the traditional use of manzanilla in her home country.  It is also a member of the Astaracea family, family of origin to so many flower medicinals.  I have yet to use this clinically, so cannot report back. But maybe you have used chamomile for eye problems and can share your experience in the comments below?