So you think you want to start a blog???

Here's a link to a good article on being a blogger and whether it's a good way for you to promote your practice...cause once you start you have to do it regularly. Even someone as prolific as I am struggles with the requirement for regularity and consistency. This article is worth reading if you are sticking a toe in that water.
Enjoy

http://netprofitstoday.com/blog/is-blogging-right-for-you/

Hand Strength and Walking Speed Correlates to Fewer Strokes (and a stronger spleen?)

Surfing the internet health news is actually a pretty interesting way to spend a morning. Everything from how our culture sabotages children's health to a controversy over people taking anti-depressant drugs for grief to this gem of a research study that I found quite interesting from a Chinese medical point of view.

In this study, more than 2,400 men and women with an average age of 62 underwent tests for walking speed, hand grip strength and cognitive function. Brain imaging studies were also performed. During the follow-up period of up to 11 years, 34 people developed dementia and 70 people had a stroke. The study found people with a slower walking speed in middle age were one-and-a-half times more likely to develop dementia compared to people with faster walking speed.

Also, strength appears predictive among older individuals as stronger hand grip strength was associated with a 42 percent lower risk of stroke or transient ischemic attack (TIA) in people over age 65.

So how can we interpret these results from a Chinese medical point of view? I was immediately reminded of some statements of fact from Bob's book by that title, "...in the elderly, blame the spleen," and "when the qi is strong, it is able to control the blood and prevent its spillage externally from the blood vessels." If we remember the various functions of the spleen qi, these include the strength of the muscles and the ability to feel energetic, strong, and lively, manifesting as the benefits of healthy post-natal engenderment of qi and blood.

Here is a wonderful quote that describes exactly what this research showed from Aging and Blood Stasis: A New TCM Approach to Geriatics, a book by Dr. Yan De-xin, one of the most famous and effective geriatric medicine specialists in China.

The four limbs receive their qi from the stomach. Sometimes, the spleen qi does not reach the channels due to a disorder of the spleen. As a result,it cannot move the fluids and humors of the stomach. The four limbs thus do not obtain qi from water and grain. Hence, the qi is gradually weakened. The circulation of the [blood] vessels is not smooth, and the sinews, bones, and muscles all lack the qi to exist; so they cannot function well.

As a clinician, what this suggests to me is the importance of doing anything I can to help my patients maintain the strength and health of their spleens, whether this be through acupuncture, herbal supplementation, tuina, dietary therapy, and/or exercise suggestions. And now we have a Western medical research study that supports the importance of these efforts!

This research also corroborates the power of Miriam Lee's Great Ten Needles approach to treatment and her belief in Li Dong-yuan's idea that truly accurate five-phase theory would be visualized as a cross, with the spleen and stomach right in the middle of both health and disease in our many of our patients.

Have a great , everyone.

Chopping Wood and Carrying Water Amidst Mayans & Dragons

Many of us have seen and heard warnings and portents for this year…even a disaster movie called “2012” came out recently. But who of us can really know if the Mayans have their timing right? At the turn of the last millennium and many other times in history there were predictions about the end of the world as well, and yet here we are, still.

But if these were really end times, would you change what you are doing today or your plans are for the coming few months? Would you give everything away and go into a meditation retreat or get a non-stop party started? Would you take that trip with your spouse to Fiji that you’ve always dreamed of, embark on a quest, apologize to your worst enemy, start a non-profit foundation, or…would you simply keep treating patients, taking care of your family, doing your best to live well each day?

Since none of us know the day our own personal Armageddon will arrive, it’s probably not a bad idea to think about these things, Mayan predictions notwithstanding, and live accordingly as much as we are able.

Not to wax too philosophical or lose my sense of humor, here are some of my personal goals in 2012…and hopefully beyond.

• I will make a new friend and reach out to at least one person I’ve not heard from in years. Why not?
• I will deal with real problems that crop up as best I can, but not carry around worries and fears about imagined ones. It's usually hard enough to deal with what actually does happen much less what could happen!
• I will take time for some exercise each day. It makes a difference no matter what else is going on.
• I will start each day with the most important things that need to be done.
• I will try harder to be courteous to everyone…it costs nothing and makes people happy.
• I will take on at least one technological learning curve in 2012 (since many of them don't last more than a year anyway). Yikes!
• I will tithe regularly. What goes around does come around.
• I will be up early enough to greet the sunrise more days than not. I read somewhere that if you get up 1/2 hour earlier each day, you get an extra 7.5 days per year. I could use an extra week here and there, couldn't you?
• I will reduce my personal possessions/projects/clutter by 10% or more by the end of the year. Whoa!
• I will remember to be here now. If I’m not here now, sure as shootin’ I won’t be there then!

I’ll let you know how I did a year from now if we’re all still here!

Whenever the world ends for you, what do you want to know that you did-learned- shared-gave-loved-created-released to the best of your ability? Don’t wait! Don’t die wondering! I wish everyone a happy, productive, meaningful, fun and funny, lively, bubbly, zingy, roaring, powerful, and best-year-ever Year of the Dragon! Visit me on Facebook, too!

Solving the 5 Most Common Marketing Problems

1. “We’re a small new clinic and don’t have the budget to compete with the established practices…but we know that we’re good at what we do.”

Much of your best marketing can be done on a very low budget. Giving talks, writing articles and blogs, Tweeting and Facebooking, or simply volunteering with groups of people in your community cost you nothing but time, which at the beginning of your practice you probably have more of than you’d prefer! Brochures can be purchased cheaply or created and printed out on your color printer in small batches for a few cents apiece. Do spend the $50+ it costs for 1000 nice business cards and don’t go anywhere without them. Remember that the ability and willingness to talk to anyone and everyone about what you do and to hand them a card with a smile is some of the cheapest and most effective marketing you can do.

2. We’ve never done much marketing before…and now we need to implement some kind of marketing plan.

Regular marketing activities must be built into your schedule. In other words, make appointments with yourself, write them in pen (or digitally) in your calendar, and keep them no matter what. What will you do during those appointments? Start with creating a description of your perfect patient (musicians, climbers, golfers, lawyers, mothers with babies, people who want facelifts, etc.). Where do these people hang out? What publications do they read, what clubs to they join, what websites do they frequent, where do they volunteer? Whatever the answers to those questions are should suggest the first steps in your marketing plan. If you can speak or if you can write or if you like to play golf or play music or climb mountains, do those things for and with the people who are your “perfect patients.” Each appointment with yourself represents time to write those articles, participate in those clubs and volunteer activities, make phone calls to organizations needing speakers, create a blog and the subsequent required Twitter and Facebook and LinkedIn posts, find and sign up for a Health Fair booth (and create the plan for that event), or write a brochure about your specialty. Keep track of which activities actually produce patients and do more of them as much as possible.

3. We have more & more competitors popping up and grabbing our patients…and making it hard to distinguish our clinic from the competition.

Write down a list of all the ways in which your clinic, services, and skills are different from everyone in a 10-mile radius. Have you been in practice for many years? Do you have an easy-access parking situation? Are you on a bus line? Do you offer a specialty in your practice? Do you have a brilliant bedside manner? Do you have a children’s play area, great research files for your patients, offer classes, dietary counseling, reflexology before treatments? What else? If you cannot think of anything, write a list of how you’d like to distinguish yourself and what it would take to make that happen? Then, when you do public talks or write marketing copy for ads and brochures, emphasize these differences. If you want your current patients to know every way in which your clinic is different from others, make a small “Did You Know?” poster or flyer and post it in the bathroom.

4. We’re getting killed on price by new, young practitioners who are offering lower priced services.

Remember that many people don’t make decisions about their health care based on price! Studies done on almost any type of product show that people do not usually go for whatever is the cheapest; they go for what feels like the least risk. How do you lower people’s risk? First, by doing the best professional work that you can do, day in and day out. Second, by participating in your community because people like to buy products and services from those they know and trust. Third, by running your office like a well-oiled but human and humane operation. Fourth, make sure your patients know you want and appreciate their referrals. You can even put a short statement on the back of your card that says something like “The greatest compliment you can give me is the referral of your friends and colleagues. Thank you for your business.” Then charge what you need to charge to live your life both with integrity and with fairness to yourself.

5. We’ve spent a ton of money on advertising and marketing, but don’t seem to be getting much bang for the buck.

Remember that few of us choose our healthcare providers based upon ads in the paper. It is a far more effective strategy to give talks, teach classes, write articles, join organizations, be a volunteer, or even start a blog. Such activities make you a de facto “expert” and are far more likely to bring you patients than buying ads. If you want to spend money on marketing, web-based marketing on every health-provider listing service you can find and having a simple, easy to find website (with good Search Engine Optimization) is a better expenditure of your money.

For many more ideas on marketing your practice, see Points for Profit: The Essential Guide to Practice Success for Acupuncturists by Honora Lee Wolfe, Eric Strand, and Marilyn Allen, from Blue Poppy Press as well as lots of FREE articles on my blog at www.bluepoppy.com.

Shi Dou (Sp 17) Food Hole: A Forgotten Acupoint

Most Chinese-trained acupuncturists rarely use the point Shi Dou. It is not considered an important or particularly useful point according to current Chinese acupuncture education. In fact, it is probable that most Western acupuncturists promptly forget everything about this point after taking their licensure exams and would be more likely to use its neighbor, Da Bao (Sp 21) if a local point in this region were required.

However, according to the Bian Que Xin Shu (Bian Que’s Heart Writings), a Song dynasty text by Dou Cai as interpreted by Sung Baek in his book Classical Moxibustion Skills in Contemporary Clinical Practice,¹ direct moxibustion of this point with tiny threads of high grade mugwort moxa is singularly useful in many if not most cases of spleen qi vacuity, liver-spleen disharmony, spleen dampness, and especially where the qi mechanism (upbearing and downbearing) is impaired due to a combination of liver depression, qi vacuity, dampness, and heat existing all at the same time. In fact, when reading author Sung Baek’s description of this point’s uses, what he appears to be describing is Li Dong-yuan’s yin fire theory. There are several sites in his book that support this idea.

In one case, Baek states that moxa on this point is of vital importance in cases of edema with urinary retention and the inability to breath when lying down. This symptom picture suggests that treatment must downbear turbid counterflow qi and also supplement the lung qi (by supplementing the spleen qi) so that is can properly depurate and downbear both qi and body fluids.

In another case, he suggests using Shi Dou for the treatment of spleen stomach damage with dry heat above due to excessive consumption of cold food causing loss of communication between the three warmers. This again suggests that moxa on this point promotes qi rectification, clearing of heat, and spleen qi supplementation.

In a third case, the same author suggests applying 300-500 threads of moxa on Sp 17 in case of chronic malaria in order “to balance hot and cold within the body” by fortifying the spleen.

Finally, he suggests the use of moxibustion on this point for all types of edema due to inadequate engenderment of latter-heaven qi by the spleen, in cases of high fever but where the lower limbs are cold, in cases of diarrhea due to spleen qi vacuity, nue-type diseases with alternating fever and chills, vomiting and loss of appetite, yellow jaundice with red-colored urine and yellow eyes due to cold damage, and chest and rib-side pain due to poor digestion. Also, he insists that these complex disorders must be treated first by fortifying spleen qi. He further states that treating Shi Dou on the left is for specifically for supplementing the spleen, while, on the right, it is for soothing the liver.

In searching for other views on the use of this point, I found that Felix Mann’s The Treatment of Disease by Acupuncture, which is a translation of the treatment formulary section of the Zhen Jiu Da Cheng (Great Compendium of Acupuncture & Moxibustion), states that Shi Dou can be used to treat chest and limb heaviness, diaphragmatic pain, intermittent fever of the spleen, paralysis and numbness, ascites, and pulmonary congestion. Again, if we look at these symptoms, we see the disease mechanisms of spleen qi vacuity, blood vacuity, dampness, and liver depression qi stagnation with possible damp heat.

According to Li Dong-yuan, the disease mechanisms of yin fire include spleen qi vacuity, liver depression, damp heat, yin and/or blood vacuity with vacuity heat, and stirring of ministerial fire. If one analyzes his treat protocols, it becomes clear that, to treat this kind of complex disease mechanisms, one must, at the very least, supplement the spleen, rectify the qi, and clear heat, as well as doing whatever else is necessary in each patient’s case. Based on Baek’s and Mann’s description of this point’s effects, we see that it is exactly these disease mechanisms which are being treated. We also see that they are discussing difficult-to-treat, complicated conditions similarly to Li Dong-yuan.

As a final note, it is my own clinical experience that this point will be tender, often exquisitely so, when it is most needed. I also agree that it is necessary to burn many, but very tiny, moxa threads on the point, usually at least 50 and often as many as 200. Needling the point is not suggested as a replacement for moxibustion since the two types of therapy do not perform the same functions as well as the fact that it is just over the lateral lung in a very slender person. If time does not permit you to treat both sides with moxa, I suggest using the right side, since it is away from the heart and prevents the possiblity adding unwanted heat to that organ (although I have not had that happen in actual clinic practice). I have used this point with excellent results on many patients and hope you will consider it the next time you encounter a patient with a similar complex condition. Knowing the type of patients that most of us see every day, you may find yourself treating this point on a regular basis.

For more information about moxibustion, see Lorraine Wilcox’s Moxibustion: Modern Clinical Handbook and Moxibustion: The Power of Mugwort Fire. For more on yin fire theory, see Bob Flaws translation of The Treatise on the Spleen and Stomach and his one-hour online course, Li Dong-yuan’s Theories on Internal Damage Disorders.

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¹ Baek, Sung, Classical Moxibustion Skills in Contemporary Clinical Practice, Blue Poppy Press, 1990. Out of Print

Have Patients with Anxiety Attacks?

Q. Hi Honora, A few years ago I came to a seminar you taught. During that weekend, I remember you suggested an interesting treatment for anxiety disorder. A patient came in last week with anxiety attacks as a major complaint and I wondered if you could refresh my memory on that treatment. –Sarah in Chicago

A: Hi Sarah, There are several good treatments for anxiety disorder. In fact, acupuncture in general has an anti-stress, down-regulating effect on many patients. That said, however, there are several approaches that I suggest you consider as rotating treatments, using them in succession and then repeating from the beginning. Here you go:

1. Start with Four Bars (often called Four Gates) as an opening treatment. While these needles are in, do some simple massage on the head and neck, dragging across Yin Tang and doing small circles on Tai Yang, GB 20, along the cervical spine and occipital ridge.* (The only time this is inappropriate is if the person really is not comfortable being touched and we do, on the odd occasion, get patients like that.) If they don’t like to be touched, but a needle into Yin Tang.
2. The next time that patient comes in, hopefully within a few days, do the treatment that you saw me do, which is a cross treatment as follows.

a. Insert LI 4 and Sp 4 on the right

b. Insert Per 6 and Liv 3 on the left

c. If using Ion pumping cords, use black clips on the right and red clips on the left. Connect LI 4 to Liv 3 and connect Per 6 to Sp 4.

d. If using polarized needles, use Gold plated needles in place of the red clip and Stainless steel in place of the black clip.

e. Insert needles very shallowly, because electrical flow in the body is strongest on the surface.

f. No jewelry; don’t leave the room during tx; 15-20 mins or until they wake up.

3. As a third alternating treatment, you could do Miriam Lee’s Great 10 Needles adding points such as Liv 2 and LI 11 for excessive heat, Ht 7 and CV 17 for palpitations and severe fearfulness, or An Mian (extra point), Sp 6, and Ear Shen Men for insomnia.

4. In terms of self care, suggest that the patient use exercise, stretching or progressive muscle relaxation routines, calming music, aromatherapy oils, and an anti-inflammatory diet high in Omega-3a and plant-based protein and low in sugar and caffeine! While acupuncture can calm people down in the moment very quickly and effectively, in the long run the patient has to find ways to help him-or-herself as well.

5. I received a comment from a reader suggesting that, since most anxiety attacks are at least partially due to the qi and blood not nourishing and constructing the heart qi, herbal formulas that do this are vital for long term change in such patients. She is right about this, so if you have access to herbals, choose or create a formula appropriate for your patient to help rectify this pattern.

Hope that helps. If you want details of the theory that goes along with either Four Bars treatment, Miriam Lee Great 10 Needles Treatment, or ti Ion Pumping Cord treatment, check out my online CEU courses attached to these links. Thanks for your question and best wishes.

Lots of patients are anxious these days...

Q. Hi Honora, A few years ago I came to a seminar you taught. During that weekend, I remember you suggested an interesting treatment for anxiety disorder. A patient came in last week with anxiety attacks as a major complaint and I wondered if you could refresh my memory on that treatment. –Sarah in Chicago

A: Hi Sarah, There are several good treatments for anxiety disorder. In fact, acupuncture in general has an anti-stress, down-regulating effect on many patients. That said, however, there are several approaches that I suggest you consider as rotating treatments, using them in succession and then repeating from the beginning. Here you go:

1. Start with Four Bars (often called Four Gates) as an opening treatment. While these needles are in, do some simple massage on the head and neck, dragging across Yin Tang and doing small circles on Tai Yang, GB 20, along the cervical spine and occipital ridge.* (The only time this is inappropriate is if the person really is not comfortable being touched and we do, on the odd occasion, get patients like that.) If they don’t like to be touched, but a needle into Yin Tang.
2. The next time that patient comes in, hopefully within a few days, do the treatment that you saw me do, which is a cross treatment as follows.

a. Insert LI 4 and Sp 4 on the right

b. Insert Per 6 and Liv 3 on the left

c. If using Ion pumping cords, use black clips on the right and red clips on the left. Connect LI 4 to Liv 3 and connect Per 6 to Sp 4.

d. If using polarized needles, use Gold plated needles in place of the red clip and Stainless steel in place of the black clip.

e. Insert needles very shallowly, because electrical flow in the body is strongest on the surface.

f. No jewelry; don’t leave the room during tx; 15-20 mins or until they wake up.

3. As a third alternating treatment, you could do Miriam Lee’s Great 10 Needles adding points such as Liv 2 and LI 11 for excessive heat, Ht 7 and CV 17 for palpitations and severe fearfulness, or An Mian (extra point), Sp 6, and Ear Shen Men for insomnia.

4. In terms of self care, suggest that the patient use exercise, stretching or progressive muscle relaxation routines, calming music, aromatherapy oils, and an anti-inflammatory diet high in Omega-3a and plant-based protein and low in sugar and caffeine! While acupuncture can calm people down in the moment very quickly and effectively, in the long run the patient has to find ways to help him-or-herself as well.

Hope that helps. If you want details of the theory that goes along with either Four Bars treatment, Miriam Lee Great 10 Needles Treatment, or ti Ion Pumping Cord treatment, check out my online CEU courses attached to these links. Thanks for your question and best wishes.