Vulnerability

    Why does Clint's knee bother him in cold weather but mine doesn't?   Why did a friend  throw up every time he fought with his girlfriend, but my husband never threw up once when we fought?   Why does my patient Louise get headaches every time she is stressed, but my patient Francis gets diarrhea?

    Dr. Leon Hammer (one of my professors and heroes!) used to preach to us about the concept of vulnerability.  It is a concept that is intrinsic to Chinese medicine.  Sometimes we fail to see the forest for the trees.  Vulnerability is such a basic paradigm of heath and sickness and it is becoming more and more  overlooked as we get more  and more specific and more and more segmented and more and more limited in our examination of the human response mechanism.

     First of all, what is vulnerability?  It is an area of weakness in a person - an area that when stressed, is likely to rear up and make ugly noises.   The three main root causes of vulnerability are trauma, lifestyle, and inborn. 

    Most everyone knows someone who injured their knee and every time the weather gets damp or cold, that knee acts up.  Dampness and cold often settle into an injured joint that hasn't been treated properly.  (Ice is for dead people in Chinese medicine.   There are herbal liniments that can alleviate swelling and pain and bring blood to the area without introducing cold and dampness at at the same time - but that's another story.) Trauma was the original insult.   Dampness and cold are the stressors, the knee is the vulnerable area.  I see this a lot in clinical practice.  The knee will always be vulnerable unless you drive out the dampness and the cold. (which we can often do).

     I also see a number of people who get severe headaches and if you quiz them carefully, at one time they suffered a head injury in the past.  Its surprising how many people were kicked in the head by a horse!  The injury was the initial insult, the stressor varies (it can be an emotion, a smell, etc) but the head is the vulnerable area, and it will always be, unless you can heal the energetic changes that occurred from the trauma.

    Vulnerable areas are often a result of lifestyle.  People who burn the midnight oil, work the night shift,  eat very little good-for-you fats in their diet, or are simply getting older, tend to be yin deficient. You can think of (at least one aspect of yin) as WD-40 (lubricant) for your internal organs.  If you are low on lubricant, and a stressor comes along to plunder your already deficient yin, watch out!  Heat from friction can cause a multitude of ills in all parts of the body.  Most likely, the part that screams out is the area that was the most yin deficient to begin with.  I need my sleep.  If I don't get my sleep, my tendency towards yin deficiency dry fries my brain.  

     There are very few, if any people, who don't have a constitutional area of vulnerability.  I once knew a guy who threw up every time he got nervous, or if he ate anything spicy, or if he missed a play in his football game.  He had always been this way, and so had his sister. Talk about  vulnerable stomachs!  My kids both had weak spleens and lungs as children.... any time the weather turned, or someone sneezed around them, watch out!  They were sneezing and coughing and sick shortly thereafter.   

    The bottom line is.... this is not something that should be delegated a Chinese medical concept and ignored by the rest of health care! A good place to use this concept would be in pharmaceutical research.  Its my hypothesis that people with weak spleens and stomachs are the ones who will suffer the most nausea and digestive issues from chemo.  It's my hypothesis that people who all already yin deficient will suffer more hot flashes from diuretics.  It's my hypothesis that people with energetically challenged livers and spleens will be the ones who have side effects from statins.  I could go on and on...... 

   A lot of vulnerabilities are obvious - like the injured knee, for example.  Many more are not obvious  to the layperson but glaring to the eyes of an acupuncturist.  An energetic workup should be done on every person once a year, along with a  physical exam.  Then everyone would be aware of their areas of vulnerability, even if they are not manifesting at at the time.

   

  Oh, how I would love love love to be involved in western research that includes the concept of vulnerability into its paradigm!  It would really be cutting edge science......

     

Why Chinese herbs are so effective

There is a trend in America towards the use of herbal medicine, and this should be applauded. People take echinacea for sore throats, milk thistle for the liver, horsetail for eye ailments.  The list goes on.
However, in China, where herbs have been a mainstay of treatment for thousands of years, single herbs are very rarely prescribed.  Herbal medicine is most effective when herbs are used in combination with other herbs.  The herbs are  then are able to work synergistically with others to increase their effectiveness.   Not only can they be used to increase their effectiveness, but this can decrease the side effects of a single herb.  No football team could win a game with just a quarterback.

One thing that is so great about  Chinese formulas is that they were developed by the brightest minds in Chinese medicine - those minds that had studied herbal therapy for decades.... and most formulas are hundreds or  even thousands of years old - so they have stood the test of time and been found to be highly effective, yet when prescribed correctly, quite safe.  Those formulas that caused problems were discarded and did not make it into the chinese medicine formulary.  Those that were ineffective didn't make the cut, either.

This is so different from western medicine, where prescription drugs may have only been in existence for at most, fifty or so years, and are constantly being pulled from the market because of side effects, some of which are deadly.  Most western drugs are based on the principle that if the quarterback is the best player on the team, then cloning him and making a whole team of just that quarterback should be more effective.  Crazy analogy, I know - but its the best way to describe it.

Let's take for example Ba Zheng San, which is an herbal formula for a urinary tract infection.  There are nine herbs in Ba Zheng San.  A lot of the functions of these herbs overlaps, so if it appears that I am talking about way more than 9 herbs, its because of their overlapping functions.  Six of them clear heat (which means they are anti-inflammatory, antibacterial and/or antiviral) and purge fire (even more strongly anti-inflammatory, antibacterial and antiviral).  Six of them also promote urination, so that when you do urinate, you get rid of the pathogen causing your symptoms.   (If you have a robber in your house, you don't want to shoot the robber and leave his dead body lying around in the kitchen to rot - for this same reason, pathogens that are destroyed need to be escorted out of the body - which is something Antibiotics Do Not Do).  One of the herbs not only clears heat but also guides the rest of the herbs to the bladder.    And yet another herb harmonizes the effects of the other herbs, which means two things: it helps them to work well together, and it protects the digestive tract from being harmed by the formula.

It is recommended that you take two days of probiotic therapy for every one day you are on an antibiotic.  Since Ba Zheng San is a harmonized formula, your intestinal flora should not be affected and the probiotic regimen is not necessarily indicated.

This is just one example.... there are literally hundreds of herbal formulas.   You should never try to self-treat, but rather see a qualified Chinese herbalist for advice.

Coffee Studies

Nothing is a bigger waste of money than studies on how much coffee is too much to drink.  If researchers ever start to take into account individual differences/strengths/vulnerabilities maybe they could make this kind of research valid but until then, its just ridiculous.

Salt

     I read an interesting article about salt yesterday and it reminded me of something Kathleen Leavy once said.... that throughout history, more people have died of too little salt than too much salt.  Salt has gotten such a bad rap in America that its almost socially unacceptable to pick up the salt shaker.  How many health articles say to put it down????  But sodium is an extremely necessary nutrient for muscle contraction and nervous impulses to work properly, among other things.  How did it get such a bad rap, anyway? Because salt in excess can contribute to health problems, especially in  those people that are salt-sensitive.  Often, these are people who are descendants of slaves that survived the slave ships... many slaves died on the ships because of salt deprivation from drenching sweats. Those that were genetically better at holding on to salt survived and passed this gene on to their offspring.  So those individuals don't need as much salt as others as they don't lose it as easily, and its easier for them to be in excess.
     Excess salt causes you to hang on to fluids, so excess salt is bad for people with high blood pressure, congestive heart disease or kidney disease or other diseases where fluid metabolism is a problem.  And because so many of the processed foods that Americans consume are chock full of salt, someone who eats a lot of processed foods doesn't usually need to add salt from the shaker.
     The problem arises when someone never eats processed foods, which thankfully, is becoming more and more common.  A person who never eats processed foods, or who eats very little processed foods, is in danger of sodium deficiency if they also never pick up the salt shaker.  And if when they do pick up the salt shaker, its not iodized salt that they eat, then they run this risk of iodine deficiency, also, unless they eat plenty of vegetables from the sea.  (and not many people do that).   There is a good reason Morton iodizes their salt....mental retardation and thyroid goiters were much more prevalent until iodine was regularly consumed.  Most of our soils are just not iodine-rich soils, so our vegetables aren't absorbing much.
     So especially you mothers of young children, if you refuse to buckle into the demands for french fries and chicken nuggets,  I applaud you.  If you never feed your kids processed foods, I applaud you even more loudly.  Just be sure your kids get their sodium and their iodine.  And you, too.  If you give up processed foods and find yourself craving salt, give in to the craving and know that you need it.

The Spice Doc: Food Noise : the Diet Post

The Spice Doc: Food Noise : the Diet Post

Yes, you CAN cure the common cold. And don't you forget it.

   If you or a loved one are prone to colds and flu and respiratory allergies, a really useful concept to get a grasp on is the way the Chinese look at contagious respiratory illnesses.  It is really much more complicated than what I am about to tell you - entire books have been written on "external pathogenic invasions" but in a nutshell:
   There are two temperatures of pathogens (viruses, bacteria, pollen, extremes of temperature, etc)  that invade the respiratory tract: hot and cold.  TCM calls these pathogens Wind Heat or Wind Cold, as they seem to enter "on the wind".
   When someone first contracts a wind cold, the  pathogen causes any combination of the following: a headache in the back of your head/neck, sneezing, a CLEAR runny nose, a cough with thin, watery mucus, body aches, simultaneous fever and chills with CHILLS more predominant,  and NO sweating.
If you have a sore throat, it is mild.
   In contrast, wind heat pathogens cause feverish feelings or true fever, sweating, sore, dry or scratchy throat, headache (usually frontal) thirst, cough with thick or sticky yellow mucus, and thick and yellow or green nasal discharge.
   Lots of people pop Echinacea at the first sign of a cold or flu, and sometimes it works, yet other times it doesn't.  Why does it work sometimes and not others?  Because Echinacea is a cooling herb.    So which type of pathogen do you think it would effectively treat?  That's right, a wind heat invasion.  It cools down a wind heat invasion and makes it more difficult for the pathogen to multiply.  If you take Echinacea when you have  a wind cold,  not only will it not help, but it could make your illness worse.
Use Echinacea only for signs of wind heat.
   For a wind-cold, cut about 2 inches of raw ginger into medallions about as thick as a quarter and put them into a quart of  water.  Boil and steep for 20 minutes.  Pour this ginger water into a tub of hot water and get yourself into the tub.  Soak until you work up a good sweat, and then soak some more. ( You can even bundle up really warm  and make yourself continue to sweat in bed, too if you can stand it. )  Ginger is very warm, so its good for wind cold invasions.  Wind colds tend to slam the pores shut, so you don't sweat, and you are therefore unable to "sweat it out."  Ginger effectively remedies this problem.
   So next time you feel that familiar scratchy throat, or those body aches, pay specific attention to those symptoms, and treat accordingly.
   And in case you don't know it, acupuncture can also help your body get rid of the bug.   Acupuncture and herbs was the only form of medicine in China for thousands of years, so they had plenty of time to figure that one out!
   That is it for now.  Tomorrow is another day.  Enter it well.

Phlegm Misting the Orifices (or PMO, as I call it)

   My brother thought that the concept of "Phlegm Misting the Orifices" (or "PMO" if you are like me and gravitate towards acronyms) was really good fodder for jokes.  I told him that people with PMO often have a "slippery left distal" and that "their windows of perception are muddy" and that set off a big round of guffaws.  I admit, it is pretty hilarious to throw the term around when people act flat-out crazy.  We used it to describe a couple of the residents in my Dad's neighborhood in a retirement village in Ocala, Florida, and actually, it really, really describes a cousin of mine...... she is as PMO as they come.  

   But what does PMO mean?  Well, if you have Phlegm misting the orifices...  your windows of perception are muddy.  Like everything else in Chinese medicine, your windows of perception can be physical or emotional.  If your physical windows of perception are muddy, you might be deaf.  You aren't perceiving sounds the right way. You might be blind.  You aren't perceiving sights the right way.  You might have Alzheimer's disease, and can't perceive what happened ten minutes ago. 

 

   If your emotional orifices are muddy, you don't process the emotional reality of what is going on around you. Maybe your spouse is staying out all night,  comes home smelling of cologne that isn't yours, yells out a name that  yours in the middle of sex... and you are blind to the fact that he or she is cheating on you.  Or maybe your drug-crazed child steals hundreds of thousands of dollars from your father on his deathbed, yet you continue to see her as "a good girl." Or maybe you just talk and talk and talk for 45 minutes to your friend on the phone, and then tell her how very much you enjoyed the conversation, and it never registers with you that she said just  "hello." and "good-bye" and you said absolutely everything in between.  Maybe you are just black-out drunk - in which case you are both physically and emotionally PMO.  No matter which way the ball bounces, you aren't picking up on physical or emotional cues going on around you.

   So what brings me to this topic tonight?  I think it had a lot to do with the way the day went.  I decided long ago that there is phlegm misting the orifices of the collective unconscious in America, and it was totally reinforced today when I tried to pick up my Dad's prescriptions at the pharmacy.

First, there was a (thankfully) short period of time when we thought he no longer had prescription drug coverage.  For someone who takes 17 prescription drugs a day, one of which is Plavix, two more of which are insulins,  this would have bankrupt him by the end of April, if not by the end of the week.  (Turns out he IS covered, so we only need to worry about bankrupting Medicare, instead.)  Secondly, I picked up a prescription for some kind of solution that was supposed to help his amputated toe wound heal.  $83.  Turns out it is a mild bleach solution -  had I known in advance, I could've mixed the same thing up for 83 cents.  Thirdly, everyone I told this story to just clucked.  No outrage, no desire to go to the picket lines, no boycotting the pharmaceutical companies, nothing.  Just clucks.  Cluck, cluck, cluck.

Clear Phlegm America!  Wipe clean the windows of perception!

  .  Our problem in America, is not that people don't have insurance.  It is that :

#1: Without insurance, you cannot afford western medication.  It shouldn't cost a month's wages to treat a case of strep throat. 

#2. People will dicker and bargain for days over the price of a car, but never even ask the price of a knee replacement.  The fact that someone else pays for our medical treatment eliminates the very best benefits  of capitalism  from our health care system. 

#3: There are very few pharmaceutical medications that you should have to take "for the rest of your life".  Yet the statistics on medications that people take every day with no exit strategy in sight are staggering, and nobody thinks twice about it!!! 

     When I was put on blood pressure medication 12 years ago, it was with no exit strategy in sight.  I questioned my doctor about it and he looked at me as if I had three heads.  "How long should I take this?" I asked.   "Forever." I was told.  Well, do the math.  I was 38 at the time.  If I died at the young age of 72, at a copay of $30/month - $360 per year - that is $11,520 over a lifetime in medication alone.  Not counting the doctor visits to renew the prescription, the $$$$ out of pocket I had to pay for investigative studies when the beta-blockers I was taking  caused a heart arrhythmia........  Criminy.  

So, here we are, with poor Daddy, taking 17 medications for the rest of his life.  Who knows if it was actually the diabetes that led to all of this, or if a lot of his problems aren't drug-related..... once you mix three or more pharmaceuticals, there is no way to know how they interact with each other.  But in the eyes of a lot of  Americans, that is all right - no cause for concern, as long as someone else PAYS the BILLS - because there is a rampant case of drug-induced PMO going on right now..... 

Bye for now.