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!

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?

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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.

Breathing into Pain

If you are experiencing pain that is either chronic or has come "out of nowhere," take a moment to breathe into it. Find a quiet spot away from any distractions. Lay down or sit in a comfortable position with your back straight, and take a few deep breaths. On the inhale, breathe in through the soles of your feet up to the top of your head. And on the exhale, breathe back down and out your soles. Breathe in comfort, space and warmth. Breathe out tightness and pain. Inhale. Exhale.

Once you have established a good relaxed rhythm, pause your attention at the site of your pain and introduce yourself to that long-lost friend. What does the pain want you to know? What is it trying to tell you? It could be as simple as needing to adjust your chair at work or as insightful as realizing that your back pain comes on when you are not feeling supported in your own life. Inhale. Exhale.

One reason the breath is used in so many forms of meditation, is that it is a bridge between the unconscious and the conscious mind. While we do have conscious control over it, i.e. we breathe, when we are sleeping you might say, we are being breathed. It is an unconscious involuntary mechanism. And it is in this interplay that great self-awareness can be explored. When we tune into pain in our bodies, mind or spirit, even if the message is buried deep within our unconscious Selves, with enough time, compassion and patience, we can learn to bring it to the surface so we may finally listen to what it has been trying to tell us for so long.

When we become more accustomed to tuning in to these messages in real time, we can actually prevent painful experiences from burying deep within us; we can undo those long-standing triggers so they simply become benign events. We have an experience; we step fully into it; we feel it with all our spirit; and we let it go. We get what we need to get, we get it now, and we move on.

We inhale. We exhale. The space in between is what we call Life.

Pain as a Messenger

We often get plenty of chances to hear the messages our body and our spirit is telling us.

I am reminded of the story of the man with flood that is coming to town. One man decided that since he was a religious man, God would save him. Soon the water started rising and coming into his house. But when a neighbor came by with a car to offer to take him to safety, he refused help by saying, “I am a religious man. God will save me!” The water kept rising and by now the man was standing on his roof. Just then a boat came by to take him to safety. But once again he refused by saying, “I am a religious man and God will save me!” By the time the water was up to his neck, helicopter came by to pick him and take him to safety. But once again, he refused by saying, “I am a religious man and God will save me!” Well, unfortunately that man drowned. When he got to heaven and saw God, in a huff, he demanded to hear from God. “God, I am a religious man. I thought you were going to save me! What happened?” God replied, “What do you mean? I sent you a car, a boat and a helicopter!”

When we live with chronic pain, we are ignoring our body’s message. Something is wrong. Something needs to be fixed. How long are you willing to let that pain exist and speak to you before you finally get the point? Do you kill the messenger by simply taking a pain reliever?

Whether it is with physical pain, repetitive behavioral patterns, or poor relationship choices, when we are making choices to ignore messages of the body, the mind, or the spirit; we are choosing not to learn now what we need to learn to grow. We are like a hamster stuck on the wheel. At some point, at some time, we will be ready to step off, learn the lesson, and start a new path of growth.

Striving Toward Wellness

What role does your doctor play in your daily life?

Do you see them only when “something is wrong?”

Is it time for a new perspective?

This is an exciting time! With healthcare as a hot topic in the news today, people at all levels of society are asking similar questions. And, thankfully, here in this modern city of Los Angeles, we are blessed with a wide array of health care choices. You can build quite a diverse team of experts who span the full spectrum of disciplines from the East to the West, from clinical to spiritual, to support you and your health. At the root of this freedom of choice comes the primary question to ask yourself: “What role do I want my doctors to play in my health care?” And as an Acupuncturist interested in being part of the larger discussion, I ask myself “What role do I wish to play in the care of my patients?”

Let’s explore the answers to these questions in three progressive stages of health care:

1. Curative

Here, you have something you need treated: a cough, headaches, pain, indigestion, etc. We have all been in this category and will most likely be here again at some point in our lives. And because of this very real-world need, we have been conditioned to regard our doctors as people we see ONLY when we are sick. And-- chicken or the egg?-- Western medicine is well-suited in its tools to be a reactive style of medicine. When a patient’s condition can be clearly identified with a pathogen to fight or a diagnosable condition to treat through medication, surgery or other western therapies, it can be efficient and effective. How far we have come in such a short period of time is staggering to consider. But when there is no definitive diagnosis or no proven course of treatment, if these big guns are used, they are done so at a price. As more and more of you, the patient and healthcare consumer, express dissatisfaction with the side effects of medication or the, at times, extreme response of surgery, you begin to look for other approaches to address your every day health concerns.

Eastern medicine, and Chinese medicine in particular, have proven over the more than 3000 years of medical history that it too can be effective in treating most every health condition that can commonly arise in a population. It is in this place that I see most every patient that walks in my door. They come for a chief complaint, something that they need treated or “fixed.” If the issue is recent and acute in nature, resolution can be found quickly and effectively. If the issue has been chronic or has lingered, then I need to balance treating the condition with treating the underlying internal imbalance that supports the continuation of the condition. This can take a bit longer to address as we begin to explore the reasons why the body has not yet corrected itself. Once we can have such clarity, we can progress to the next stage of treatment.

2. Preventive

It is here that a new type of relationship can be forged with patients. This is where Chinese medicine excels even more. It sees connections and relationships between the various body systems and organs that allow that patient to understand how their lifestyle and food choices, their posture and emotional state of mind, can contribute to the recurrence of their chief complaint. What changes must they make to keep their condition from returning? In answering such a question, the patient learns to fish. The goal here is to see your condition return with less and less frequency and severity coupled with a growing self-awareness around the triggers that invite the condition to return. Perhaps you know, after all your experience tuning into your own body through your acupuncture treatments, when you are in the early stages of imbalance and wish to head things off at the pass. I want to empower you to make better choices in your life, to understand that you are indeed your own best physician. If I need to see you weekly forever, then clearly I am not doing my job. The further away you get from that initial chief complaint, the closer we get to the ultimate stage of treatment.

3. Wellness

By now, your chief complaint is long gone. You have made and embraced those necessary lifestyle changes to ensure that it will not return. The next question I routinely get is: “So why do I need to keep coming? I feel well.” I respond somewhat tongue-in-cheek with “Well, can’t we always feel even better?” The means of diagnosis in Chinese medicine are so subtle that we can pick up even the slightest degree of imbalance. Perhaps you come in once a month or even just seasonally for a “tune-up.” This is about a commitment you make to yourself to see health not just as the absence of disease, but health as a dynamic state of being. One in which you have control. In many ways, this is the pinnacle of all treatment. To achieve Wellness, you have welcomed a new type of relationship with your doctor, they have responded to your desires for greater vitality, and you have worked together to not only successfully address your health concerns but to thrive and live a more optimal and engaged life, recognizing that if you don’t take care of your body, mind and spirit, where will you live.

May you be happy.

May you be healthy.

And may you live with ease.