TRADITIONAL CHINESE MEDICINE AND ENDOMETRIOSIS - MY TAKE FOR ENDOMARCH →

In honor of EndoMarch (March is Endometriosis awareness month), I wanted to share my own experiences, both in and out of my acupuncture practice with endometriosis, a gynecological disorder that affects one in ten women.

I think I should have been diagnosed with endometriosis. At one point, about 20 years ago, while I was living in Los Angeles, a doctor told me I “probably had it” but never followed that up with any useful information. Not exactly the solution I had hoped for.

Why would she tell me this? Well, I had excruciating pre-menstrual and menstrual cramps and low back pain – but no other abnormalities that they knew of. Bad cramps shouldn’t be overlooked as “normal”; they indicate an imbalance in the body.

The official diagnosis of endometriosis must come from a thorough pelvic exam, MRI, ultrasound or laparoscopy. The western medicine approach towards endometriosis will mostly involve medication or surgery. 

I was given strong pain medication. I used the pills they gave me for the pain and moved on with my life as best I could. I would call off work and social engagements when it was that time. Wrapping up in a fetal position with a heating pad on my abdomen once a month. 

I had it much better than some of the people I’ve treated since. Endometriosis can allow cells to spread through the body tissue, causing cyclical pain in many body parts. It can cause pain with bowel movements, excessive bleeding, fatigue, digestive issues, and even infertility. It can affect all organ systems negatively.

It wasn’t until I started learning about different forms of medicine – including diet and lifestyle, traditional Chinese medicine and Ayurvedic medicine – that I realized there was an alternate route for potentially alleviating pain.

There are many different non-Western medicine methods to help with endometriosis. You can reset your nervous system and help relieve the symptoms. Sometimes these treatments can be combined with Western medicine in an integrative approach. I will focus on acupuncture and traditional Chinese herbal medicine. 

When I started to see acupuncturist Dr. Wen of Hua Bing Wen Acupuncture Center (who has 35 years of experience, now practicing in Beverly Hills), he told me he was going to focus on yin. Dr. Wen later became a teacher and mentor to me. He is an acupuncturist who specializes in fertility and oncology. (Interesting combo, I know, but somehow poetic)

Yin is so important when treating female patients with most gynecological disorders. Yin is a nourishing part of physiology that represents fluids of the body, including blood and lymph. These fluids help us maintain a healthy state. Blood carries hormones through our body, allowing the body to heal and thrive. An imbalance of yin can account for the development of disease. 

When hormones become imbalanced, it can result in a disharmony of fluids in the body. This disruption can be caused by a number of influences – both internal and external. These disruptions can cause things like stagnation or heat in the body, leading to pain.

Acupuncture and herbs can be used to help correct imbalances and create a smooth flow of qi, yin and blood throughout the body. The result is less pain and also less emotional dysregulation. I have witnessed it help so many suffering people firsthand.

If you suffer from endometriosis, dysmenorrhea or another gynecological disorder resulting from hormone imbalances, drop me a line. I would love to help. 

REFERENCES:
wenacupuncture.com

https://www.yalemedicine.org/conditions/endometriosis

https://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656?mc_id=us&utm_source=newsnetwork&utm_medium=l&utm_content=content&utm_campaign=mayoclinic&geo=national&placementsite=enterprise&invsrc=other&cauid=100721 

SHOULDERING THE BURDEN

I’ve had shoulders on my mind lately. My mom recently had surgery for the first time – an operation on her shoulder. The recovery process has been difficult to witness, as I have a visceral feeling whenever I experience anyone in pain, but with family it’s 10 times harder. I drove her to PT, and saw her wince and groan during therapy. I’ve chopped vegetables and prepared nourishing meals to help improve her strength. I even washed her beautiful hair once. For better or worse, I’ve inherited her proclivity for caretaking. Honestly, I take joy in it.  

It should be mentioned that my mom is otherwise in great shape. Prior to surgery, she was still running three miles at 5 AM. Not long ago, she was a compassionate nurse. Growing up, she was our homemaker; cooking nearly every meal and cleaning up after all of us constantly. (See notes on repetitive movements below, ugh)...

My husband and I recently moved to be closer to my mom and dad, where I’ve relaunched my acupuncture practice. A month later after opening, I realized I was now having intense neck/shoulder pain on one side. Was this because I have more responsibility placed on my shoulders? (financially and emotionally). Personally, I do feel there’s a connection, but we’ll get to that, and how stress can be connected to shoulder issues in Traditional Chinese Medicine (TCM). 

Nowadays, I’m pondering questions like why do women generally suffer from shoulder pain more than men? Why is frozen shoulder (adhesive capsultitis) most common in menopausal women? Has the weight of the “invisible (or mental) load” finally started to take its toll? That’s my own personal theory. There isn’t a clear link or any scientific evidence to support this, but it’s true that frozen shoulder occurs more often in women in menopause. In Asian countries, it’s often called the 50-years-old shoulder. It’s theorized that this is due to the post-menopausal decline of estrogen, which helps lubricate joints. In TCM, we call this Yin Deficiency, and it’s a natural part of aging.

Let’s take a closer look at the shoulder from a mechanical (some might say Western) perspective. The shoulder is the most mobile joint in the entire human body. It’s connected to both the front and back of the body, as well as (of course) the arm. This can make it difficult to identify the cause of pain without medical imaging. The following are the most common diagnoses and causes of chronic shoulder pain:

Mostly drawn from this blog by Beacon Orthopaedics and Sports Medicine

Rotator Cuff Tear - Most frequently caused by repetitive overhead motions

Shoulder Impingement - Also most frequently caused by repetitive overhead motions

Labral Tear - Caused by injury, or … you guessed it – repetitive overhead motions

Frozen Shoulder - Unknown, seen most in menopausal women

Shoulder Joint Arthritis (Called Bi-Syndrome in TAM) - Arthritis is most frequent later in life, and more common in women and people who use repetitive overhead shoulder movements

From a TCM  perspective, shoulder tension can be associated with Liver Qi stagnation.The liver governs the movement of QI in the body. The free flow of Qi in the body ensures the free flow of blood. More specifically, liver blood nourishes and moistens the sinews that attach to joints and allow for movement. A common TCM saying: If there is free flow, there is no pain; if there is no free flow, there is pain.

So, why does my shoulder hurt? This is a question that has a complicated answer with many factors involved. In my mom’s case, her imaging showed arthritis of the joint (Bi-Syndrome). No doubt this was due to repetitive movements throughout her life, and of course getting older (Yin Deficiency). My shoulder pain is most likely caused by a combination of hypermobility, stress (Liver Qi Stagnation), work-related posture and repetitive movements. So what can we do to prevent or help shoulder pain?

Here are 6  ways to prevent, or improve shoulder pain:

(NOTE: We are focusing on chronic shoulder pain, not shoulder pain due to an injury)

Be mindful of your posture - During periods of high stress, it’s common to unconsciously hold tension in our shoulders. For example, being hunched over a computer screen. Or in my case, over a treatment table. 

Be conscious of repetitive movements - Which if done enough, can cause arthritis later in life. Repetitive movements could be work or life-circumstance related. Digging, throwing something over and over, cleaning/chopping/lifting with the same dominant arm. Try switching it up, decreasing your weight load or taking small breaks to rest or stretch. Which brings me to…

Stretch - Yoga has many effective shoulder-opening poses (to balance out those hunched shoulders). Shoulder “flossing” with a yoga strap, thread the needle. Even holding your arms out in a “T” shape and rotating your palms so one is up, and the other is down, and switching a few times, is a great thing to do daily. 

Ditch the heavy purse or bag - Don’t fill up your purse and then mindlessly sling it over the same shoulder again and again, ok?. When you have a phone, keys, laptop, books, etc. all on one shoulder, it can be a lot of weight to bear! So don’t fill it up, Mary Poppins. Better yet, carry a backpack! Here’s the one I recently bought for a trip: LINK 

Get acupuncture! If you catch frozen shoulder in the early stages (First 1-3 months), you can actually prevent it from getting worse. You can even keep your shoulder mobile – no freeze!! This would be a fantastic time to follow all of these tips, but also to get acupuncture and other body work. Acupuncture can utilize points that are local (where you feel the pain), and distal to the area of pain (and stagnation). Acupuncture also addresses the root of your imbalance – whether it’s Liver Qi Stagnation, Bi-syndrome, Kidney Yin Deficiency or something else. 

Sleep on your back. No cozy side-sleeper likes this one, but it can’t be denied that you’re putting strain on your joints when you sleep on your side. Both the joint you’re sleeping on and the joint on top of your body are stretched out of alignment for long periods of time during sleep. A good way to train yourself to sleep on your back is to buffer yourself with pillows on both sides (sorry partners, snuggling will need to happen before you nod off). You can also try using a pillow propped under your knees to prevent you from turning onto your side.

OUT OF TIME? TRY THE WORKOUT THAT'S DESIGNED FOR THE BUSIEST SCHEDULE!

By Thomas Najar

Key to any fitness program is consistency. It's far more beneficial to do a small amount of exercise every day than a big chunk every few days. Regularity turns into habit. When an activity is done habitually, it requires less willpower to get off the couch and go do the thing.

People often think change requires big innovation. The bigger the change, the more drastic and dramatic the plan of action required. This isn’t always true. Small actions, repeated day after day, can yield substantial results in the long run.

Thankfully, there's an approach to fitness that makes it easy to do a small amount of highly effective exercise in a ridiculously short amount of time. High-Intensity Circuit Training (HICT) combines aerobic and resistance training to burn fat, lose weight, and improve strength and endurance. The best part is you can do a full workout in only 7 minutes!

HICT was originally designed to offer busy professionals an exercise program that could improve their energy. Lack of exercise leads to fatigue and disengagement. Aerobic and resistance training were prioritized for their ability to improve energy, but traditional approaches are time-consuming and require special facilities and equipment. HICT can be done quickly and easily; busy travelers can work out in a hotel room without having to search for a gym.

Eight to twelve exercises are performed for 30 seconds each, enough time to complete 12 to 20 reps. The exercises alternate between upper and lower body muscle groups, and between high and low heart-rate/intensity. 30 seconds or less of rest time in between exercises maximizes metabolic impact and efficiency by minimizing total time taken for the entire routine. The goal with rest is incomplete recovery. All of this combines to provide a full body workout that includes both resistance and aerobic training for maximum benefit in the shortest amount of time.

Several years ago, the New York Times published an example routine of HICT and provided a companion app. The app walks you through 12 exercises with a timer and voice prompts that guide you the whole way. The full routine runs seven minutes and can be done once or repeated 2-3 times depending on your needs and fitness level.

Though HICT may not deliver the absolute strength and endurance of more traditional aerobic and resistance training, it's hard to top the value from this approach. Plus, at only seven minutes, the excuse of not having enough time to exercise gets thrown out the window! It's also a great place to start for beginners, though you should always consult your physician before starting any new exercise program. If you’re looking for an exercise program you can do at home that yields a ton of benefit in a short amount of time, and is backed by science, a 7-minute High-intensity Circuit Training program may be just right for you!

Check out the links below for details on sample workouts and the science behind HICT.

The Scientific 7-Minute Workout

For a 7-Minute Workout, Try Our New App

HIGH-INTENSITY CIRCUIT TRAINING USING BODY WEIGHT: Maximum Results With Minimal Investment

3 AT-HOME YOGA + ACUPRESSURE POSES

Managing stress is always important, but never more so than during emotionally challenging times like these. Whether you are quarantined alone, with three kids, or with your new love interest, all kinds of emotions and worries can pop up; we are dealing with an unprecedented circumstance (and a novel virus!). This is human nature. Of course, we all know that heightened stress can challenge your immune system. This is why it’s essential to manage your stress in healthy ways and be gentle with yourself.

I’ve composed a short list of some of my favorite acupuncture points combined with yoga poses that you can stimulate on your own with acupressure. Acupressure is an extension of acupuncture; you can use acupuncture points, and their energetic qualities to achieve similar results by using your own finger pressure, without puncturing the skin. Combining two of my favorite stress relievers, yoga and acupuncture, achieves a deep sense of calm and balance.

Once you find the pose and the acupressure point, stimulate the point lightly using pressure from your finger or thumb. Again, the pressure does not have to be hard. This stimulation can be done as a constant pressure or pulsation - listen to your body and how it responds best.

Here are three acupressure/yoga pose combinations. You can do these pose/pressure combos on their own, or together. You may want yoga blocks (thick books work, too!), a blanket, towel or pillows to help you comfortably get into the poses.

#1: Will-Power Bolstering Acupressure Point + Bound Angle to Release and Calm Fearful Thoughts

Here is a guide for correctly entering the pose:

https://www.yogajournal.com/poses/bound-angle-pose

If your knees are above your hips in this pose, you can support them with blocks or pillows. Bound Angle, or Baddha Konasana, is a hip opener. Many yogis believe emotions are stored in the hips, so there may be some emotional release with this yoga + acupressure combination.

Once you are in the pose, instead of grasping the big toe, wrap your four fingers around the front of your ankle, and use your thumb to stimulate the sixth acupuncture point on the kidney channel, (KD6). This point is also known as Shining Sea (English name) and Zhaohai (Chinese translation). Other useful applications of KD 6 are treatment of sore throat, insomnia, balancing hormones and calming the mind.

KD 6 is located a little below the tip of the medial malleolus (the round knob on the inside of your ankle). You can feel around this area to see where it is most sensitive. If you are feeling comfortable, you can also fold forward to deepen the pose. Take 10 full, even (not forceful), breaths here through your nose, in and out.

Visualize fear leaving your body with every exhale, and your will power growing stronger with every inhale.

#2 Immunity and Energy Boosting Acupressure Point + Reclined Figure 4

Again, I defer to another site to enter this pose: https://www.pharmaca.com/projectwellness/yoga-pose-of-the-week-figure-4/

In this pose, you will hold your legs by grasping underneath the bottom leg. The top leg will be the leg you use for acupressure. I find it easiest to use my pointer finger to stimulate ST36 in this pose. Make sure both shoulder blades are still contacting the floor, and flex (or flex and point), your feet for more active stretch and stimulation. 

ST 36 is also known as Leg Three Miles (English name), and Zu San Li (Chinese translation). Leg Three Miles refers to the ability of this point to increase your energy, allowing you to literally walk another three miles even though you are tired. It is helpful in treating fatigue, and also easing digestive issues, such as constipation or loose stool.

ST 36 is located on the lower leg, three body inches (the width of your four fingers without the thumb), below the base of the kneecap, one finger’s width to the outside of the ridge of the tibia bone.

If you are feeling comfortable, take 10 full and even (not forceful), breaths here through your nose, in and out.

Imagine your whole body building strength and resiliency with every breath!

#3 Lung Strengthening Acupressure Point + Seated Twist for Grief and Release.

Twists in yoga are a great way to open up the chest and back, relieve anxiety and even stimulate digestion in the lower intestines. (Coincidentally Large intestine is the organ system Lungs are paired with in Chinese medicine!)

Here is the proper way to enter a seated twist: https://www.yogajournal.com/poses/half-lord-of-the-fishes-pose

Instead of extending your hand out (the one that’s not on the ground), use your thumb to find the first point on the Lung acupuncture meridian, LU 1. This point is also known as Central Treasury (English name) and Zhong Fu (Chinese translation).

LU1 is located on the front of the chest. It is just below the clavicle in the 1st intercostal space, in front of the deltoid muscle. From the midline of the body to the nipple is a measurement of 4 “cun” (body inches), and this point is six from the center, so around a couple of inches beyond that. Again, you can push around the area to find the sensitive point. When you find it, stimulate this point using your thumb and wrapping your other four fingers around the upper arm to allow good pressure.

The lung channel can help strengthen breathing function, and the lung organs are affected negatively by grief. Because it is so important to keep the lungs healthy, it is beneficial to process any grief that comes up during this time in a healthy way. Twists, intentional breathing and acupressure in combination are a great way to do this.

When you’re feeling comfortable in the pose, and have found the point, take 10 even breaths in this pose on each side. The opposite emotion of grief in Chinese medicine is courage.

With each breath, you may breathe out your grief and sadness and breath in courage and strength.

- Jennifer Best L.Ac, CYT (Yogaworks Center for Yoga)