Monday, January 11, 2010

When is Enough, Enough?

We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable rights, that among these are life, liberty,

and the pursuit of happiness.

The United States Declaration of Independence

The pursuit of happiness.

When you are in pursuit of something, you either do not have that which you seek or you feel you do not have enough. Some things you can measure and count, like money. But does having enough of that stop us from pursuing more? While other things you may pursue cannot be measured, like happiness.

Our country was founded on this principle and we even have successfully exported it the world over; it is engrained in the very fabric of our modern culture. We seek; we strive. To be fair, without this indomitable spirit, this country would not have progressed and advanced as quickly as it has. It is part of what makes us unique and special as a people. But there is balance in all things. We strive to put food on the table, clothes on our backs, a roof over our heads, and a few bucks in the bank for rainy days and retirement. Yet along the way, we get conditioned to believe that more is better: more food, more clothes, a bigger house, and a larger pot of cash in the bank. Happiness in the present moment and contentment for all we do have get lost in the pursuit for more; enough is no longer enough. We continue to seek to fill the void in our hearts with things that don’t have a chance at fitting.

Stop reading this for a moment and tune in to your breath. Notice… we inhale… for more; we exhale… for less. And right there in the middle is a space of stillness, of contentment. It is the sweet spot between more and less. It is enough.

In my office, I sit and listen intently to my patients. I piece together their stories with their symptoms and work to find a path toward relief. And when they lay down on my table and rest with the acupuncture needles in, they get an all too unique opportunity to lie still during their busy, seeking day. And no matter the message I am communicating with my point selection, one theme is always present: you have everything you need right in your own body. You heart beats by itself, your breath flows in and out by itself. Much of your body processes occur without your intervention. Yet, something gets in the way. Something pulls us out of balance.

The longer I am in practice, the more I see my role as helping to remove obstruction. When given the chance, the body, the mind and the spirit know what to do. When I can encourage stillness, when I can encourage my patients to simplify, to do less, to sit still more, greater health can be recovered and balance can be found. One of my teachers told me that when his patients ask him what they should do, he replies, “Do less.”

Sure there are many among us that truly lack for the basic necessities of life. But even for them, enough can be found in the love they have for their family and friends, the breath they have in their bodies, and the joy they have in their hearts for what they do have. And there are those of us that are fortunate to not be suffering for material needs. Yet we suffer still. It is the suffering that comes with the never-ending pursuit for more.

Take a moment. Sit down, close your eyes and take a deep breath.

Pause and listen…
Pause and listen.

Enough is actually enough.

When Enough is No Longer Enough

So, we’ve established when enough is actually enough. But when is it not enough? When do we need to strive for something more? When do we challenge ourselves to get out of our stagnant rut and reach for change?

Enough is no longer enough when it represents old patterns that no longer serve us. It is easy to default into familiar habits out of laziness or apathy in making the changes we need to make in our lives because change takes hard work and effort. Is that something we are up to?

In the realm of health, many of us get so comfortable with what has been usual for us that we mistake it for being normal. (See my 2009 post called “Usual vs. Normal”). For example, we have had this low back pain for months now that we “just deal with.” Either we pop an Advil and go about our day, or we let it handicap us to the point of keeping us from living the life we want to live. It becomes our excuse for not engaging with joy in our lives. We let issues like these linger. And the longer they go unaddressed the harder they become to treat and the more daunting the task seems to be. Do we deserve to feel better? Does hobbling around reinforce a low self-image? Have we had enough yet?

Whether it is low back pain or something as complex as many varied forms of addiction, when we perpetuate old destructive patterns, we often do so because we are not yet ready to break out of those old routines, that albatross of old self-definition. Who would I be if I no longer drank? We become complacent enough to believe “I’ll change tomorrow.” Yet what does it take for that tomorrow to actually come? When have we had enough? When do we embody the change we deserve and need?

The answer to these questions is completely individual. My role with my patients is to see where they are at, where they wish to get to, work within those confines and at the same time challenge them with just enough of a stretch to see the task ahead as attainable and doable. It takes patience and time to change old patterns.

Let’s take another example. When I advise patients on diet and nutrition, the only goal I know I can realistically achieve is to help my patients develop awareness around their food choices. How do the foods they eat affect their health? If they have allergies and chronic sinus infections, how does dairy affect them? If they do not know or have a hard time believing me and the mountains of research pointing to the connection between the two, then I ask them to eliminate it from their diet for 3 weeks and then reintroduce it by itself. They can then tell me how it makes their sinuses feel. No amount of external preaching or research can make someone change until they experience it for themselves. Once that awareness hits, they now have an empowered choice to make: continue eating dairy despite the obvious sinus congesting effects, or realize that it is not worth it, that they have had enough. Feeling better becomes worth changing an old habit.

The arc of change is sometimes long and slow, and sometimes dramatic and sudden. What pushes someone over the edge of change, only they can determine. But one day, one bright and sunny day, they wake up and realize that enough is no longer enough—they do in fact deserve more.

Wednesday, January 6, 2010

Resonance in Healing

One of the most stable geometric structures is the equilateral triangle. All three angles provide equal support. Turned on any of its sides, it is equally stable.

I see healing and the practice of medicine the same way. There are three angles that all have equal input, equal responsibility, and equal importance.

Angle 1: The Doctor

Who are they? Do they have a passion for their work? Do they come recommended? Are they insatiable in their desire to learn and educate themselves? Do they themselves look healthy? Are they willing and able to say the most important statement a doctor can say: “I don’t know, but I’ll find out for you?” We are talking about the quality and integrity of the person here. Choosing someone who you feel comfortable with in guiding you toward greater health is a challenging decision. But when you find the right fit for you, you know it without question. And you are excited about beginning a relationship that might see you through a health crisis, one that can adapt and blend with the ups and downs you may experience in your health through the course of your life.

Angle 2: The Medicine

Knowing what medicine to choose for what condition is not easy. Increasingly scarce are the General Practitioners, the Family Physicians. Increasingly, Western Medicine is moving toward greater specialization. The body is a complex thing and does require deep and profound understanding of each system to begin to grasp the entire being. But lost in this is the ability to see the person as a whole, to see how all the parts connect. This is where doctors practicing complementary medicine have stepped in. These include acupuncturists, naturopaths, homeopaths, and more and more Western physicians breaking outside of the mold.

Know your audience. When consulting a surgeon, expect surgery to be their advice. If that is not something you are interested in, seek a second opinion. Yet, if surgery is ultimately what you need, then that is what you need. Some people come to me expecting me to nay say all things Western. But if you need your hip replaced, acupuncture is not going to offer you much help other than to prep for the surgery and recover faster from it. Know what each discipline’s strengths and weaknesses are. When you have an acute condition that has a proven Western treatment, that is an excellent way to go. But when you have a chronic condition that involves lifestyle, diet, and nutrition, a more complementary approach is often better.

Angle 3: You, the Patient

There is no excuse for getting a bad haircut! You are sitting there awake, examining in the mirror the work being done. Did putting on the smock make you lose your voice?

For some reason, when people seek help they default into a subservient role. I want my relationship with patients to be 50-50. I encourage them to be educated, knowledgeable, and ask as many questions as they can. Never simply take my word for it, or anyone else’s for that matter. You are your own best physician. We have at our finger tips these days immense amounts of information. Yes, it can be dizzying and hard to know what to believe. That is where your doctor comes in. Let them respond to you. Let them answer your questions and help you make sense of what you have read and heard. An empowered patient makes the doctor step up their game. I wouldn’t have it any other way.

With all that information, how do you choose the right approach for the condition you have?

Resonance in Healing

There are lots of ways to fix someone. You have recurrent headaches and come to me with one full boar. I needle a point in your foot and it goes away. Done. Fixed. But has healing taken place?

Healing occurs when there is resonance between all three angles of the Healing Triangle; it is when You find the right Doctor using the right Medicine. When the Doctor resonates with their Medicine, the Medicine resonates with You, and You resonate with the Doctor, healing can occur. So long as there is resonance between all three, I honestly believe that it does not matter what the remedy is. It could be something as benign and unpredictable as a rock for all we know.

Ahh, but how do you find that resonance?
  • Trust your own innate intelligence and ability to make the right health decisions for yourself.
  • Do you homework and choose the Medicine that makes the most sense to you;
  • Choose the Doctor that listens well, empowers you, and offers a treatment plan that is consistent with your vision for your own health path; 
  • Get second opinions;
  • When your questions are answered and you feel confident proceeding, trust in the choices you have made; 
  • Allow yourself to receive the help you have asked for;
  • When you feel it is time to change course, let your Doctor respond to your needs and adapt. If the resonance continues, you will know. If it does, it may be time to find someone new.
Health can be defined as the ability to adapt to your environment. It requires flexibility, knowledge and a desire to heal. All around you are choices for treatment. Only you can decide what is the best course for you, what resonates with your body, your mind and your spirit.

You are your own best physician.

Which Style is Right for You?

Someone recently asked me which style of acupuncture—Chinese, Korean, or Japanese—yields the best results. Good question.

Styles do not make results, acupuncturists do.

In general, there are a few very broad-stroke differences between Japanese, Korean and Chinese needling styles. Japanese style acupuncture tends to be non-invasive with only very mild stimulation; very outwardly gentle. Korean styles tend to be more vigorous in stimulation. They also have a unique system of hand acupuncture that I understand to be very effective. Though needling the hand can be a bit uncomfortable for patients. And Chinese styles seem to be everything in between.

What we learn in school is called “Traditional Chinese Medicine” and is an amalgam, a distilled version of the 4000 years of medical history that can vary with every geographic area in China. The Chinese government in the 1950s realized they could not care for their population using only Western physicians, so they re-introduced Chinese medicine in a pared down, well-defined and teachable program that is now taught in schools around the world. We all start with this basic foundation in the medicine, but once we graduate, many of us begin to explore the innumerable traditions in search of styles that we most resonate with and that we find most effective for our patients. Once I, as the acupuncturist, find a system that makes sense to me, then I stand a better chance of having it work for my patients.

From the patient’s perspective, the most obvious way that they may feel a difference in style is in how vigorously their acupuncturist seeks to elicit the “Qi” (pronounced chee, which means energy) sensation—that dull, heavy achy feeling at the site of the needle. That sensation means that the point has been well-stimulated. Clarifying for the patient what they are experiencing or should expect to feel is of the utmost importance. They need to understand that the qi sensation is an okay feeling to have. But a sharp, shooting, burning sensation is not. When that occurs, it simply means that we have gotten too close to a blood vessel or nerve and we need to relocate the needle. Some patients love that qi sensation and others simply do not. I never want a patient lying on my table in a state of anxiety—it is counter-productive. I always work within my patients’ comfort level. Always. The only time I am aggressive with needling is when someone is in acute pain and I need to strongly off-set that pain. And when you find the right point, acupuncture works 100% of the time. To see the look on a patient’s face when needling a point in their foot gets rid of their migraine within seconds is priceless!!!

The bottom line is always about getting results. Liking the acupuncturist is wonderful, but if they do not get results, then you are paying them for stimulating conversation! As much as my patients may like me, if I am not addressing their chief complaints effectively enough in a timely manner, then my rapport with them can only go so far.

There are of course other reasons why one might choose one style over another, but that is where we get a bit technical. Some styles are better suited for acute issues, some are better for constitutional balancing, while others are best for more psycho-emotional issues. Chinese Medicine is an enormous world and it is as varied as the acupuncturists are who practice it.

In the end, be assured that none of us do what we do in the style we do it if it did not work most of the time. My role is to continue to be insatiable in my quest for better skills and deeper knowledge to get more reliable and consistent results. Your role is to decide whether or not you connect with me, the style I practice, and get the results you are looking for.

Friday, November 13, 2009

Immunity: Self vs. Non-Self

Immunity is a hot topic in the news these days. In addition to it being cold and flu season, the H1N1 Virus has more people asking me how they can support their immune systems. To answer those questions and more, see my recent article entitled Colds & the Flu.

In the very real sense, our immune system defends us against microbial attackers like bacteria and viruses. It does so through our intact skin, our nasal passages, and our digestive system. When working properly, it is incredibly effective and efficient. Throughout the year, how many days are you actually sick? If your answer is the vast minority, then your immune system is quite strong. And when you do get sick, like in the case of food poisoning, observe how quickly it responds to rid your body of the toxins.

Now, I am the first person to admit that sometimes a cold is just a cold. But when faced with on-going immune challenges like food and air allergies, asthma, frequent colds and the flu, respiratory problems, and auto-immune conditions, we must begin to ask the same question we ask for any chronic condition: why is my body not repairing itself? The answer can lie not just in the physical body but at deeper levels as well.

Immunity is about discerning Self from Non-Self. What is mine? And what is not mine? What do I allow in? And what do I appropriately keep out? In fact every cell in our bodies including the organ of our skin, is comprised of a semi-permeable membrane which functions to allow a very fluid exchange with our environment, the strength of which is within our control.

This is about having healthy boundaries. Are mine so rigid I allow no outside influence? Do I not allow myself to receive the love of friends and family? Have I so disconnected from my immune system that it takes a serious health condition to get my attention? Or perhaps my boundaries are so porous that I take on the world’s problems as my own. Perhaps I am constantly asking my immune system to work over time fending off invaders that I allow in.

Discovering clarity about this begins by establishing a clear sense of Self. If I know who I am, I know who I am in reference to someone else. If I know what my issues are, I know what issues are not mine.

Let’s take the example of allergies. Allergies are a hyper-reactivity to our environment. They reflect confusion within your immune system about how to respond to a perceived attacker. That no matter how common place this “invader” may be, like dust, your system kicks into high gear. Even the mildest trigger elicits a severe response. When did this hyper-sensitivity begin? Was there a time when as a child you were consistently under attack? This could have been due to a chronic illness, over-prescribing of medications before your immune system was intact, or even from a lack of physical safety at home. Perhaps these “attacks” occurred so subtly over time that all you experience on a daily basis today is a curious hyper-vigilance to your surroundings; perhaps you experience an under-current of fear even in the most familiar places; perhaps you have not felt comfortable in your own skin; perhaps you have allergies.

The road to recovery from a chronically compromised immune system is shaped by addressing both the physical body—controlling symptoms and rebalancing the system to prevent further recurrences—and the psycho-emotional body—disentangling your sense of Self from Non-Self. Through the use of acupuncture and Chinese medicinal herbs, we can work at both levels to finally help you regain what you deserve to have, a healthy and vital immune system.

Tuesday, October 27, 2009

Usual vs. Normal

We often mistake what is usual for what is normal.

There have been times when I have asked my patients, “How is your digestion?” And they will say, “Fine.” Yet, they burp with each meal or no matter what they eat, they have gas. And upon further questioning I will find out that they will have bowel movements every other day. And that, believe it or not, they consider that “fine.” We should move our bowels with every meal… like dogs!

The other area of health I find this disconnect in is with PMS. PMS is so usual for so many women that we just right it off as normal. “Oh, it’s just PMS!” Just pop a Midol and go on with your day. But just because you and every woman you know have some form of PMS, does that make it normal?

When I sit down with my new patients to begin my thorough history and intake, there are very few areas of their health that we do not cover in great detail. From the seemingly minor and trivial, to the bothersome and acute, it is all important. What we will invariably find is that the things they have been living with for years, the things that are so usual for them, have fallen off the radar of concern and become normal. I see two reasons for this.

First, we are conditioned to only see our doctors when “something is wrong.” And given that our culture preaches that we can rest when we are dead, many of us would rather push aside those nagging health issues and soldier on, than acknowledge that anything is actually wrong. Until of course, something actually becomes wrong. Until what we are experiencing is clearly no longer usual or normal. Then it is time to “fight the disease.” And since our medical system is set up and is best suited to take up this fight, it positively reinforces this approach to health.

But today you are beginning to hear, even in mainstream areas, talk of prevention and wellness. This brings me to the second reason for mistaking usual for normal. We have had this confusion because we have been conditioned in the West to see health as the absence of disease. That we are either healthy or we are sick. That if your labs don’t show it, or it can’t be seen on an MRI, then we do not know what to treat or worse we think whatever you do ave does not exist. But any wise doctor of any discipline will tell you that health is not black or white; it is grey; that there is an entire continuum between “healthy” and “sick.” And it is in this place that usual is never considered normal.

If you have headaches during PMS, that is something to treat. If you bloat when eating fruit, that is something to treat. If you only go to the bathroom every other day, that is something to treat. You may have been living with these issues for a long time, and other people you know may have them too, but they are signs of an imbalance in your health and are not normal. Welcoming wellness and disease prevention into your life involves shifting your perspective about what is worth treating, about how much better you can feel. Is it enough to just feel “fine?” Or do you believe that you deserve to feel great? How about feeling that way all the time? Why settle for anything less?

Embrace wellness and optimal health!

Monday, October 19, 2009

Going Barefoot

Chinese Medicine began as a medicine by the people and for the people. In our lore, there is the image of the barefoot doctor traveling to local villages to give care to those in need. People would come from all around when word got out. The doctor would tirelessly treat any and all who came. For many, this was their only access to the health care they needed.

Last year, I saw a piece on 60 Minutes about Remote Area Medical (RAM), a non-profit organization founded by Stan Brock, well-known as the co-host of the popular 1970’s TV show Wild Kingdom. RAM has been delivering health care services to remote areas around the world for the last 25 years. The piece was done in large part as a reflection of the current health care system in this country. No longer were only “other” places considered “remote areas.” Now, right here at home, right here next door is where the need can be just as great. So when I heard that RAM was coming to LA for their first foray into a large urban environment, I had to go barefoot and volunteer.

For 8 days, from August 11th to the 18th, RAM took over the Forum in Inglewood. That Thursday in the pre-dawn light, as I pulled into the parking lot for the first of my two 6am to noon shifts, there was a long line of people waiting to get in. Many had camped out in front the night before. And many would come back later in the week for more care. I had flash backs to when, as a child, I had come here to see the Lakers play, to see U2 perform, and I even saw rodeos. This is a building that at one time represented the flash of LA, the glitz and glam of Hollywood, it was new and fresh, exciting and jubilant; it was the “Fabulous Forum.” Now, it felt like a creaky old dinosaur, antiquated, functional but not well-suited to meet a new demand in a new time. It felt like our health care system.

With all the talk today in the media about health care reform, there are those that say we have the best health care system in the world. If this is true, then the definition I am choosing to use is the one I saw on display all last week: dedicated medical professionals, sincerely and earnestly caring for those in great need. By the people, for the people. Physicians, dentists, ophthalmologists, OB/GYN’s, hundreds of support volunteers, and now acupuncturists teamed up to offer free care to all those who came—most being uninsured or under-insured. According to Jean Jolly, in total 14,561 services worth $2.8 million were given by 3,827 volunteers to 6,344 patients. That’s almost 800 people a day!! And more could have been treated had there been enough medical volunteers. It is hardly surprising that the demand was far greater than the supply.

From the start of my shift, I had a steady flow of patients. Many came for pain-related conditions. And many had a long list of lifestyle-related health issues common in an underserved population: high blood pressure, obesity, diabetes, coronary artery disease, and high cholesterol. But one thing was uniformly present in all the patients I treated: a lack of options. Much of what these hard-working people suffer from is preventable through better food choices and nutrition and lifestyle education. But they are surrounded by fast food as the least expensive way to feed their families; they have income that is too low to afford their own private primary care physician so they instead use the local ER for such needs, where doctors are so overwhelmed by the volume that they have no time to educate their patients about prevention of disease. Something must change. Though I am not sure what that “something” is, I do know a few things:

  • Education is the silver bullet. With education, come options. With options, comes choice. And an empowered and knowledgeable patient is their own best judge of how to care for themselves and their family.
  • As the saying goes, “An ounce of prevention is worth a pound of cure.” So much of what we, as a population, from the wealthy to the poor, walk around suffering from is preventable with a good diet and exercise. With even the smallest changes, over time, our medical needs will decrease along with our costs. And we will begin to transform our disease care system into an actual health care system.
  • We, as a nation, are only as healthy as our sickest neighbor. To see homeless people sleeping on the street amidst all the wealth in this city is saddening. That RAM could have stayed open for another 8 days and still not met the demand is shocking.
  • Health and wealth are inextricably intertwined. Health is not merely the absence of disease; but rather it is the ability to adapt to new environments. The health of our country is today being challenged to adapt to the profound need to change how we care for our citizens. Yet, taking the first step does not require monetary wealth. Rather, it requires a wealth of spirit. Do I feel compassion for those who are in need? Do I see myself as their kin? Do I want to help?

In my time with RAM, I’d like to think I helped a few people in need. Perhaps I planted a few seeds of change in some of my patients’ minds. And perhaps, if only for a moment, for as long as their pain subsided, I was able to introduce another possibility to them, that there is another choice, another option. That they are not alone in their struggle to live without pain. That for at least those 8 days, they had someone to lend a helping hand.

May you be happy.
May you be healthy.
May you live with ease.
And may you help those in need.