Digestive Issues Galore

Welcome back to Health Watch, San Diego Health News you can use.

I recently made some revisions to my marketing campaigns for my website and decided to include some material specific to Digestive issues since we have had such a great success treating chronic digestive issues at the clinic.   After only 5 days, there have been over 20,000 inquiries just in San Diego County, and they estimate traffic to be over a million over a year.  Wow, that is a lot of upset tummies and a whole lot of meds.  I have decided to answer the most recent questions via blog to cut down on correspondence time.

What types of conditions do I see regularly in the clinic which respond to acupuncture and oriental medicine?
Almost every kind of digestive problem responds, and the wonderful thing about Integrative Medicine is that we actually work toward the cure as opposed to managing or suppressing symptoms.  Western meds will frequently use pharmaceutical medication to suppress a symptom which to us, is one part of an entire pattern of disharmony.  Proton pump inhibitors cause permanent damage to the lining of the stomach and their use should be avoided where possible.

Do you treat acid reflux?

• Yes, and I have never yet seen a case that is due to excess stomach acid.  In Chinese Medicine, there are literally dozens of reasons why a patient has reflux symptoms, such as food allergies, weak stomach acid, or my personal favorite (and most often misdiagnosed) which is chronic biliary disease, aka gallbladder problems.  Sometimes a patient will have a vertebrae out of alignment, which we can tell during the back treatment.  For this, I will refer out to a chiropractor to have the vertebra adjusted, and then we finish up with a few treatments after to help them hold the adjustment.  Sometimes patients are actually eating foods which trigger their symptoms or they need herbal medicine to help strengthen their digestion.

What about Constipation/Diarrhea/ Abdominal pain? 

• Again, there are many causes of either, and sometimes the treatment is very straightforward.  I have several cases of sub-clinical celiac patients (often diagnosed as IBS or Crohn's) - this is a slowly growing diagnosis in gastroenterology and can be diagnosed with a simple blood test, although the dietary cheanges will confirm it in about 4 days.  Dietary changes, along with acupuncture and herbs, and many patients are great in about 6 weeks.  Medications such as statin drugs or BP medication can also cause these symptoms and cannot be ruled out.  OB-GYN issues are common in women, post partum or even beyond and many times we need to clear up those issues.  Simple nutritional issues are common too such as Magnesium deficiency, which is much more common in women.

Stay tuned as we explore this further.

Qi Cultivation (3/3): Pray/Play

Qi Cultivation (Tai Qi, qi gong, yoga, martial arts), Play/Pray, Exercise
 I include the all of the above as Qi cultivation because in different ways they all help balance the cellular effects from certain physical and emotional states, and to help maintain the patency or ‘free-flowing’ nature of qi. Some of you who read my article on bodywork now understand that the nature of qi is like a river, and it needs to flow freely and evenly. Chronic pain and disease are signs that the qi has gotten diminished or stuck in some way. This category includes ways to help ensure that qi moves freely and smoothly, and also helps bring a level of self awareness into your body to help prevent recurrences in the future.

What types of qi cultivation you choose depend on your personality and taste, and I don’t find one to be more beneficial than the other. It should be something in which you find immediate gratification (or you won’t continue doing it). I have experimented with almost everything – sadly I lack the temperament to do tai ji – gave it my best shot for over a year – do not have the patience for it. But found immediate results when I started doing yoga for my back. So to each his own. In general I find there is a need for something with movement and stretching (frees up the qi in the large muscle groups and maintains flexibility and strength) and something which allows for quiet time and contemplation (relieves stress and allows the body to mentally and physically recharge the batteries. Sometime they can be combined like long solitary walks on the beach, so again, search out ones that are pleasing.

In addition to the physical benefits of clearing out stress, improving flexibility, freeing up stuck qi from the large muscle groups, the process of qi cultivation for me personally has brought with it a greater level of awareness of how I hold myself during the day, where my qi gets stuck, how my emotions affect me physically. This is very liberating because I am much less at the mercy of them – I am more aware that when I haven’t taken the time to stretch or have quiet time for inner contemplation, I am a little too tightly wrapped, both mentally and physically. And I have learned over time, that when this gets really out of balance, then I get grumpy, my back goes out, and the cycle begins again. The great news is that I have the practices to go back to, and within a fairly short period of time, the qi is flowing, and my body and mind are in better shape.

I also find that ‘play’ is one of the most important aspects of self-care, and one that seems to get left behind after childhood. Dogs and kids remember already know this. Play can be anything, but it should be something that genuinely is joyful, makes you glad to be alive, and renews the heart. Dinner parties with friends, tennis, golf, singing, salsa dancing, church choir. It doesn’t matter what. 

  Let’s be honest, martyrs are boring – remembering to play makes us more enjoyable to be around, and it provides a reserve of good feelings so that on bad days I am less likely to go home and kick the dog or yell at my spouse.  (All Work and No Play... remember the Shining? Not good).  It gives us a cushion – which again is partly biochemical! If we go back to the idea of cellular chemistry, play has a powerful affect chemically on the body in terms of the pleasure receptors in the brain, and stimulates the immune system. From the TCM perspective, it helps to stimulate the heart energetic (joy), and relieves mental and physical stagnation. Seriousness of mind leads to seriousness (or stuck- ness) of the body, and we now know what happens now when the qi gets stuck.

In the oriental classic, The Great Dao (6) (a great read by the way), great attention is given to qi cultivation and self- care – meaning right diet, right action, right thought, bodywork like tui na, etc. Acupuncture was considered crude and invasive – it was only used when the other aspects had been neglected. For the practitioner who was skilled in therapeutic massage and offering wise counsel in terms of diet, exercise, and mindfulness, there was no need to resort to something as crude as needles…. While I am not yet ready to give up my weekly acupuncture visits, this brought me to a renewed respect for all the elements of self-care, including qi cultivation. Truth be told, there are not enough hours in the day for me to do everything I need to to maintain myself so that I don’t need to rely on bodywork to help balance the equation. I would rather go horseback riding….

Contact me directly at jmoffitt@acunut.com.

1. Pert CB. Molecules of Emotion: The Science Behind Mind-Body Medicine. New York, N.Y.: Touchstone, 1997, p. 9.
2. Psychoneuroimmunology: Body-spirit-mind medicine (http://www.journeyofhearts.org/jofh/transition/pni_p)
3. The American Heritage Dictionary of the English Language: Fourth Edition. Houghton Mifflin Company: 2000. Available at: http://www.bartleby.com/61/59/P0635950.html.
4. Maier SF, Watkins LR, Fleshner M. Psychoneuroimmunology: The Interface between Behavior, Brain and Immunity. American Psychologist. 1994;49;1004-17.
5. http://www.what-is-cancer.com/index.html
6. The Great Dao Doctrine was founded by Liu Deren, who declared that an old man had taught him the mysterious Dao in the second Huangtong year (AD 1142) of the Jin dynasty (1115-1234), leading to the birth of the Great Dao Doctrine. (http://www.eng.taoism.org.hk/general-daoism/major-daoist-sects/pg1-3-18.asp)


© Copyright 2003 - 2009 Jennifer Moffitt, Healing Arts Center Press, and AcuNut.com. All rights reserved.

Qi Cultivation (2/3): The New Paradigm of Body and Mind

Ok so in our last letter I mentioned PNI - becasue the medical effects of the mind and emotions are much deeper than just stress, or depression. In order to illustrate this I am going to introduce a fairly new field of medicine:  
Psychoneuro-immunology (PNI)… a mouthful to say the least, and it is helpful to break up the word into it’s component parts:

• Psyche - the mind component or study of psychology, the cognitive and emotional processes involving mood states.
• Neuro - the neurological connections e.g. neurotransmitters and neuroendocrine secretions, or study of neurology
• Immunology - how the immune system e.g. the cellular and humeral components are impacted, or the study of immunology.

The study of the interaction of behavioral, neural, and endocrine factors and the functioning of the immune system. (3) 

 The study of interactions, bidirectional communication occurring between behavior, brain, the immune and endocrine systems. (4)

 My personal favorite was from Dr. Kirsti Dyer’s website on Transitional Medicine: PNI is an interdisciplinary science that studies the interrelationships between psychological, behavioral, neuroendocrine processes and immunology. (2) 

PNI includes the effect of the mind and emotions on the immune system. We have Dr. Candice Pert to thank for her discovery of the opiate receptor in cell biology (a basic receptor responsible for the pleasure principle and my lingering addiction to chocolate). Basically PNI is extremely new, looking to discover how the body-mind-emotions affect cell repair, regulation, communication, protein synthesis – all things which we now understand affect qi production. Finally! A Medical paradigm that includes what Traditional Chinese Medicine has observed for several thousand years.

Cells are repaired and regulated at different rates depending upon the type of cell - epithelia in the digestive lining live a couple of days, skin cells, three weeks; red blood cells 120 days, and bone cells, several years. Dying cells are replaced with newly formed cells, a process known as cell turnover. (5) As you may have already guessed, the strength and speed by which cells are repaired depend upon the raw materials that we provide for it (diet, cellular nutition, sleep), and how effectively the body is able to make that repair (bodywork, sleep). However, what you may not know is that the cells are bathed in neuropeptides, hormones, protein fragments, and enzymes that all dictate how well we metabolize our food, the strength of our immune system, inflammatory processes in the body. They are dramatically affected by our emotions because of the chemical messengers released during certain emotional states (e.g. prostaglandins, cortisol, adrenaline). Someone who lives in chronic fear, worry, or stress bathes their cells in a very different chemical environment than someone who meditates every day in a cave, or who gets to run and play on a daily basis; they have a different cellular environment to show for it. Added up over time, these micro-changes play a much larger role for things like cell-to-cell communication, fertility, metabolism.

The time needed for cell reproduction and repair is one of the fundamental reasons that chronic disease and pain are not healed quickly – this is something I have to explain constantly to patients. It takes time for the cells to repair themselves, and a long period of proper nutrients, rest, exercise, bodywork to support the healing process. As we have stated before, even if it seems like it happened overnight, unless you were in an accident, it didn’t. And it takes time for the body to heal. The hardest part of my job is when a patient leaves before the miracle happens, or who absolutely won’t take any action to help support this process on their own. For them, at most all I can do is make them comfortable a few days a week.

Not surprisingly then, our emotions are a reflection of our cellular health and well-being. At some point in the not too distant future, they will be able to predict with some certainty the chemical effects that the various emotions have on the immune system.

  In future columns we will cover more about the TCM approach to the mind and emotions and how they affect the physical organs. For now I want to make a pitch to include some of the following activities in your self-care routine and briefly explain why.  (See 3/3)

 © Copyright 2003 - 2009 Jennifer Moffitt, Healing Arts Center Press, and AcuNut.com. All rights reserved.

Back to Basics: Qi Cultivation

For those of you who have been following this series of articles, we are exploring the “Basics” in our approach to maintaining and restoring health.  We will be covering diet and cellular nutrition, sleep, and the use of bodywork in Integrative medicine, all with an eye to qi cultivation, preservation, and patency (smooth flow). As you already know, qi is the body’s vital energy – sort of like gasoline to a car – although it can seem more elusive in concept. I have tried to show that there is a lot to maintaining our engine - the physical body. At every level, if something is neglected there is potential for us to ‘spring a leak.’


I find it helpful to think of healing and health in terms of a pie chart – we can even give it a title. In our “Pie Chart of Self Care” every aspect must be present in order for the chart to be complete. Let’s consider the ideal first…

A Perfect World (sigh):












In our idealized view, as you can see, all the elements of self care are pretty evenly represented, with a category I like to refer to as “Sheer Luck” being the smallest of all the values at around 5 %. By ‘luck’ I mean that margin of error (or grace for the more optimistically inclined), by which we can use and abuse this balance and avoid health pitfalls or injury. You know – all those near misses on the freeway, too many Frappacino’s in the summer, not enough veggies – they draw from the ‘luck’ category.

Unfortunately, the ‘Pie Chart of Self-Care’ in the folks I see clinically usually looks more like this:

Hmmm, not enough of several elements, and far too much reliance on ‘luck.’ 

For the patients who come in with a chronic illness or acute injury, often it seems like luck has run out. And then we have an added category which I like to call “Meds’ which has with it pros and cons as well.

The reason I bring out visual aides this month is to drive home the point that all the elements of self-care are important. Far too frequently we rely on one or another and hope it is enough. Then we go to the physician (of whatever modality) and expect them to fix the deficits in our self care, preferably as quickly as possible.

For chronic conditions which have been around a long time, whether pain or internal medicine – many times there are been aspects of self-care which may have been neglected for months or years. I find this is true even with an injury that is sudden onset – an accident or a pulled muscle that is very painful and which refuses to heal. How entrenched an injury becomes is often a reflection of the care and maintenance that was given to the body prior to the onset of the problem. So even if you never had a chronic backache before, if it suddenly shows up over night, and you have not been including bodywork, nutrition, exercise, play, etc. realize that you were primed for a condition to develop.
Realize there is no blame here – these are aspects which have been ignored and minimized by western medicine for far too long. I may be dating myself here by mentioning that the sayings my grandmother used to quote (while sneaking last night’s peas into my pancakes) were true more often than not, I just had to go through 10 years of school to realize it. The good news is that the word is out – now you know too and you can use all these tools to help restore and maintain your health.

Now there are a few slices on the chart which I have not covered yet – qi cultivation, play/pray, and exercise. We will cover these as a unit because they have a common theme.  Lest we relegate this column to the realm of the ‘touchy-feely,’ let me assure you there is a medical basis to include these items in our “Chart of Self-Care.”

In our next installement:  Psycho Neuro Immunology (PNI)

Back to Basics

Welcome to another issue of AcuNut's Health Watch.  I had the good fortune last night after work to go for a walk out in the canyons near my home. It was a cooler than usual fall day, and it felt like fall for the first time.  (Living in San Diego, sometimes we have to hunt for changes of season).    While pondering the onset of winter, aka the loss of my flip flops, I started to think more specifically about yin-yang balance and how that changes the treatment principle for my patients. 

Yin and Yang are the basis of Oriental medicine, a fundamental subdivision that the early Chinese scholars used to try and describe the nature of the universe.  Yin is everything that is cool, and moist, water, black, night, winter, nourishing, calm, and immobile. Yang, on the other hand, is the pure fire element: warm, moving, summer, upward, vibrant, and energetic. Everything in the universe breaks down into the balance between yin and yang. Nothing is firmly one or the other - there is always a small element of yin within the yang, and a small element of yang within the yin.

While Oriental medicine can seem foreign in the beginning, the basis of the medicine is really about restoring this intrinsic balance within the body.  For those who suffer from chronic pain or illness, the change of seasons is a great time to work on resolving their conditions. Spring and summer are about nature's increasing yang: flowers begin to bloom, gardens grow, and there are more daylight hours. The yang energy is moving up and out as growth and development. In winter, the yang energy dives deep into the body, the plants go to sleep (hopefully not in our winter garden though), and there is a hunkering down, a turning inward to rest and rejuvenate.  We are not separate from this process - this eb and flow happens in us as well, and a skilled practitioner knows how to use this flow to reinforce the healing process.


What is the Flow?
In my practice, it seems like returning patient to the flow includes a lot of the basics, things like your breath, sleep, food, poop (OK no laughing matter when you have a client who has been constipated for 10 years, or diarrhea for 20).   The flow is simple, simple, simple.

For many of us, going "back to basics"  is too simple. We like things complex and multi-layered. Our lifestyles move at a hectic pace, supported by technology so fast we can barely keep up. We are used to having the world at our fingertips - all the answers to our problems merely a "Google-click" away, even on the phone.  Somehow, it feels like we have lost touch with the process, the quality of the journey itself.  Something to consider:  Perhaps that techonology that allows us to blast off to the moon via our smartphones isn't so great if we are constipated when we get there. 

We want medicine to be magical.  Our over-reliance on pharmaceuticals and technology has created a false picture about the body and the healing process in general. Everything should be quick and easily diagnosed.  Hollywood shows like ER and Grey's have only reinforced this notion, luring us to think everything should be neatly resolved in a one-hour segment, (and that we should look good while doing it).

Interesting that no one on these shows ever has a chronic degenerative problem that is difficult to diagnose or smelly - intractable diarrhea or bloating. It's always the cool flashy stuff, multiple organ transplants, racing with the little refrigerated lunchbox through the hospital in the nick of time…

But the advances in science and medicine have not translated to better health or a better quality of life; in fact, many of us feel worse than ever before. We are a nation struggling with obesity. Endocrine, autoimmune, and cardiovascular disorders are widespread. Chronic degenerative conditions like Alzheimer's are on the rise, and almost 10% of our children have been diagnosed with attention deficit or behavioral disorders.  The US ranks 30th in the world for infant mortality, largely due to high rates of pre-term babies.  MAny many people drowning under the weight of poly-pharmacy, taking meds that supress a symptom but do nothing to cure them.  Why has science failed us?

What if it hasn't?   What if we have just forgotten the basics, the abc's of good health?  I think the dazzling power of emergency medicine has blinded us to the subtle (and even obvious) signs of a body moving out of balance, of impending illness or injury.  Then, when we fail to overcome that bad cold, or the back pain becomes chronic,  it's a mystery.  


Stay tuned as we start to explore the Basics of Preventive Medicine and good health.  Yours in health, Jen

Acunut's Heath Watch, San Diego's Health News You Can Use. 
 In our last chapter we discussed the current Flu epidemic and introduced ways to build up your immune system naturally to prevent getting sick in the first place.  Be aware, these are not sexy, nor are they shortcuts.  And they are going to sound a lot like stuff your grandmother used to yell at you (ok mine did).  While I know in the US it has become normal to expect a cool high tech approach to wellness, I have to tell you that there really are no short cuts when it comes to the body.

Get enough sleep! 
The body needs at least 8 hours and in the US we average about 5. (For a more detailed explanation on the importance of sleep, you can read my article Back To Basics: A Good Night's Sleep). This is one of the most important ways to restore the wei qi (pronounced Way - chee) of the body, so don't overlook this.

Clean up your diet.
This is helpful in so many regards, and we have been beaten over the head with all the different weight loss options available. There are many to choose from, my personal favorites are the South Beach Diet for those who have a few pounds to lose and are Blood Type O.  Alternatively, as a former research biochemist, I like The Blood Type Diet by Peter d'Adamo for those who are already at goal or have immune issues. I particularly like the Blood-type Diet to help provide a cushion of vital energy so that if there is a hit to the system in the form of a virus, there are more resources available to defend it. (You can download food lists for each blood type here).

Mild to Moderate Exercise
Seems pretty straight forward, doesn't it? But there are deeper reasons biochemically as to why this is so important for the immune system. Elevated levels of stress create elevated levels of certain chemicals which, when unchecked, have a damaging effect on the immune system. Add to it the benefits of more restful sleep, and an elevated metabolism to help strengthen the body against external attack and maintain weight, you have a pretty important addition to the package.

Supplementation:
The judicious use of herbs or supplements to help strengthen the immune system is a time-honored tradition in many cultures and ours is no exception. There are no magic herbs to recommend - what you need is as individual the color of your hair. If you are really concerned or more prone to exposure (from the kids, for example), cut to the chase and have an herbal consult with a licensed practitioner (such as an acupuncturist or naturopathic physician). You will save money over the long run by targeting herbs and supplements to your condition - and you prevent that pile of pill bottles in the kitchen with herbs you don't neeed. A competent professional should be able to help you prioritise which are the most important for you now, and will be able to advise you if your condition changes and new ones are needed. The body is not static - it changes over time, and your needs for supplementation will change with it. Also, you have the benefit of working with professional grade products, and can be assured of their quality.
A caveat: Beware of any practitioner who wants to charge hundreds of dollars for 'diagnostic testing' or herbs/supplements. Even my most physically challenged patients don't spend usually spend more than $25 per week. It is my job to help them prioritise so that this is a long term affordable addition to their health care.

Bodywork:  In addition to supplements, I think that bodywork is hugely important in preventive medicine.  By Bodywork I mean acupuncture, massage work, or chiropractic / Osteopathic adjustments.  While I may be biased as an acupuncturist, we have had the cure for the common cold for over 2,000 years.  A well timed visit when you become symptomatic may mean you are down for a day instead of coughing for a month.  For many of my patient's who come in at the start of a cold, they are usually better within 36 hours.

Some of this may be disappointing for those of you used to Grey's Anatomy and ER, and it is hard to admit that Gran was right.  You can read more about the benefits of acupuncture and alternative medicine on my website at http://www.acunut.com/.
Until next time, yours in health!

© Copyright 2003 - 2009 Jennifer Moffitt, Healing Arts Center Press, and AcuNut.com. All rights reserved.