This is the fourth part of a series of articles about pregnancy by YinOva Acupuncturist and Obstetric Nurse, Laura Scheurer, You can read other articles in this series by clicking here.

Even very early in pregnancy your body begins to transform to accommodate and prepare for childbirth. Your pelvic girdle shifts to support a growing fetus and as pregnancy advances, weight is redistributed sometimes stressing musculoskeletal structures as they shift, adjust, and realign. This causes a change in your center of gravity.

Some of the hormones of pregnancy, such as progesterone and relaxin, soften ligaments and cartilaginous attachments stretching the connections between the joints and muscle to the bone. It’s no wonder that one of the most common complaints our pregnant patients have is muscular pain. OB’s generally regarded mild aches and pains as ‘normal’, reflecting the way your body changes to accommodate your growing baby. However the experience can vary, with some women experiencing a time-limited, inconvenience, whilst for other women, it can be a debilitating experience.

Depending on your particular problem area and severity, your doctor or midwife may advise rest, specific exercises, physical therapy, medication, complete bed rest, or, on occasion, hospitalization.

From a traditional Chinese medicine point of view, musculoskeletal pain is seen as a disruption to the flow of Qi and Blood through the channels passing through a specific area. A disruption can occur due to trauma, overuse, poor body mechanics, the invasion of a pathogenic factor (wind, cold, damp and heat), or an internal imbalance, expressed through a channel pathway. During pregnancy, there is an adjustment in the flow of Qi and Blood in preference to supporting pregnancy, sometimes depriving sufficient flow to tendons, ligaments, muscle and bone.

Practitioners of Chinese medicine look for patterns of disharmony as we create a plan of treatment tailored to your needs. We often see a mix of both pain along the channel pathway indicating a stagnation of Qi and Blood, and an internal disharmony expressing itself along a channel. The most common channel appears along the midline of the body, affecting the neck, mid to low back and pelvic structures, or the sides of the body affecting hips, ribs and shoulders.

The two most common internal disharmonies involve the Liver and the Kidneys. The role of the Liver is to direct and provide for the flow of  Qi which in turn, leads the flow of Blood. When there is an interruption or blockage in this flow, there is pain. The tendons and ligaments are nourished by Liver blood. The sides of the body are the channels for the Gallbladder meridian, which is related to the physical and energetic activity of the Liver.

On a very deep level, the Kidney is intimately related to fertility, conception, and passing on constitutional information to the next generation. The bone and marrow are also under the influence of the Kidney. The Kidneys, located in the mid-back region, are paired with the Bladder organ and its channel pathway, which covers the entire rear aspect of the body.

Using this knowledge, as well as the information we collect from you about your specific condition, we select acupuncture points to free the flow of Qi and Blood to relieve your pain. Together, we can identify areas in your daily activity that may require some modification.

As a former labor and delivery nurse, I am so rewarded by the fact that we, at the YinOva Center, can offer a safe, effective intervention to relieve pain in all its manifestations, particularly for those who cannot take medication, or for whom medication is not effective or ill-advised. The beauty of Chinese medicine is that there are 5 branches: acupuncture, herbal remedies, massage, food as medicine, and meditation. Within this paradigm we can formulate a treatment plan that is most effective and realistic for you.

The segment that follows, addresses specific musculoskeletal discomforts associated with pregnancy, some self-help suggestions to help relieve your discomfort, prevent exacerbation of symptoms and limit their duration.

Pain affecting the Neck, Mid and Lower Back

Neck and upper back pain are often conditions that already exists. Some of us hold all our tension in our neck and shoulder area or we work long hours at a computer. Carrying backpacks, laptops, children or any unevenly distributed weight, can cause musculoskeletal misalignments. Add to these preexisting conditions increasing breast weight and postural adjustments from the added belly weight, and it is no wonder we see a rise of aches and pains.

Low back pain, and sometimes sciatica, is common during the last few months of pregnancy. These can be caused by the extra weight of your baby and the fact that joints and ligaments soften in pregnancy. Sometimes a sharp pain traveling down the back and leg can indicate pressure on the sciatic nerve.

It is important to address your neck and upper back pain early on, especially if you are planning on breastfeeding. A minor discomfort can turn into a major pain if ignored. Acupuncture is effective in treating musculoskeletal pain because it interrupts the pain pathway to the brain; it also stimulates the release of endorphins, the body’s natural pain killers.

Self Help

• Develop an awareness of those activities triggering muscle tension and pain. Pay attention to your body mechanics when sitting, using a keyboard, bending, or lifting.
• Redesign your work area to be more ergonomic and accommodating.
• Take frequent breaks, stretch, breathe, rotate all your joints to improve circulation and move areas of stagnation.
• Use support pillows for your low-back, neck, shoulders and between your knees when you are in a side lying position.
• To encourage good posture when seated, try sitting on a birthing ball.
• Comfort measures include warm baths and warm compresses to the low back, neck or shoulders.
• Prevention include keeping your neck and back out of drafts, especially if your acupuncturist identifies cold lodged in your channels.
• Regular gentle exercise (with the permission of your doctor or midwife), such as prenatal yoga or warm water aerobics, may be helpful in stretching and strengthening back muscles.
• Maternity girdles or support belts are useful to some women.

Pelvic Pain

Symphysis pubis pain presents around the pubic bone and can radiate into the lower back or the groin area. The symphisis pubis is an area of tough fibrous cartilage that joins two pubis bones together forming the pubic arch. This cartilage is softened and stretched by relaxin, a hormone of pregnancy produced by the ovaries and  placenta, increasing the flexibility of the pubic symphysis to ease delivery of your baby.

Pain often appears around the 24^th – 26^th week of pregnancy. Sudden pain and weakness is often noticeable when you are shifting your weight, for example putting on your pants, climbing stairs, getting up from a seated position or out of your car. Rest and wearing a supporting belt may be recommended to help relieve pain and stabilize the pelvis. Acupuncture can reduce your level of discomfort and prevent the pain from becoming more intense.

Self Help

• Minimize the mobilization of your pelvis. When rising from a seated position, keep your knees and ankles together as you pivot on your bottom to shift your position. Stand slowly, two feet flat on the ground, rise slowly, supporting your weight.
• Wear comfortable flat shoes.
• Rest frequently.
• Realize this condition is temporary and symptoms will resolve after the birth of your baby.

Rib Pain

Often pain is described as radiating from the upper/mid back, traveling around to the front ribs, involving one or both sides. The pain can be dull and achy or a stabbing, sharp pain, taking your breath away. Pain is attributed to the uterus rising out of the pelvic cavity, displacing internal structures, pressuring confining bony structures.

Receiving acupuncture while comfortably lying on your left side, supported by some well placed pillows can be quite helpful. Your acupuncturist may also offer ear press needles or seeds  for you to apply to appropriate points at home, enhancing your treatments between visits.

Self Help

• Rest may be your best ally during these episodes of rib pain. Finding a comfortable reclined or semi-reclined position, elevate the right side of your body slightly, prop with an adequate number of pillows, this will enhance an unobstructed flow of blood returning to the heart and lungs for oxygenation.
• Pace yourself. Don’t overdo anything. Moderation in all things rule.
• Try some gentle breathing exercises. Rib pain sometimes makes it difficult to take a deep breath but oxygenation is really important. Obstruct one nostril, inhale slowly, as deeply as is comfortable, briefly hold, then, switch nostrils, slowly and gently exhale.
• Recognize that there is competition for space in your abdomen. Try eating smaller, more frequent meals. Light broths, especially those starting with a stock of bones and marrow, are high in protein, easily digested, can be sipped throughout the day and nourishes the energy of the Kidney and Liver Blood.
• Weightless exercise, such as floating and gently stretching in a heated pool, can be therapeutic. For a more aerobic exercise try walking in the pool – it’s low impact, provides gentle resistance to improve muscle tone, and it will increase your heart rate and lung capacity. There is something quite therapeutic about water energy.

Hand Pain Numbness and Tingling

Usually occurring later in pregnancy, pain, numbness, burning and tingling of the hands and fingers, is thought to be due to an accumulation of fluid (edema), locally affecting the joint spaces of the wrist and placing pressure on the median nerve. The small bones of the wrist form a very small tunnel through which the median nerve and blood vessels pass to supply the small bones of the hand (metacarpals) and fingers (carpals) with innervation, blood and oxygen. This process allows for the fine, precise, coordinated motor movement of the hand. Symptoms vary, from mild, transient episodes to severe. If symptoms are more pronounced and prolonged, impairing your ability to turn a door knob, hold your tooth-brush or make a fist, your doctor may give a diagnosis of Carpal Tunnel Syndrome.

Acupuncture can help by relieving both local and systemic fluid accumulation and inflammation (Stagnation; Dampness; Heat). Certainly a trial of acupuncture (4-8 treatments) is preferred especially since pharmaceutical analgesics and non-steroidal anti-inflammatories are ill-advised at this time.

Self Help

• Body mechanics and ergonomic design are important in your work environment to minimize undue and prolonged stress on your neck, upper back and shoulders.
• While working at a keyboard, provide for right angle support to your shoulders and elbows, so your wrists and fingers are in alignment. Wrist rests while typing are sometimes very helpful.
• Hand braces and over the counter wrist supports are available at a variety of commercial pharmacies. When applied, they provide a resting support for those numerous fine bones.
• Support forearms, wrist and hand on pillows when in bed,  as close to the level of your heart as possible. This encourages a free flow of Qi and Blood – you will feel the difference.
• A warm compress is helpful and comforting.

Leg Cramps

Leg cramps where the leg muscles go into painful spasms, are common in pregnancy, particularly at night and may be due to the pressure of the uterus on pelvic nerves. This usually resolves once you are out of bed using the muscles. However, if the pain does not recede, and there is any reddening or swelling of the leg, you need to  promptly notify your doctor or midwife to rule out any clot formation.

Self Help

• Make sure you are drinking enough water.
• Get the blood moving in your lower extremities. Try gentle leg and ankle stretches, circling your feet and wiggling your toes before you go to bed.
• Daily gentle exercise like walking or swimming can help.
• Ask your partner to massage your feet and lower legs.
• Make sure your diet includes calcium, magnesium and potassium rich foods  like green leafy vegetables, bananas, apricot, avocado and whole grain.

Feel free to call our center and talk to an acupuncturist if you would like more information about using Chinese medicine to treat pain in pregnancy.

You can schedule an appointment at the YinOva Center by clicking here

Birds do it… bees do it…. sometimes my patients feel as if the only person who isn’t doing it is them. Time and time again women confide in me that they rarely feel in the mood for sex. They miss the connection that sex gives them and feel guilty that they have let this part of their life go, but they also feel tired and unmotivated about their sex lives.

In Chinese medicine sex, in the context of a supportive relationship, is important. The old Taoist sages would say that having sex connects us energetically to our partners. This is known as He Qi which literally means “joining energy” and refers to the way, in a good sexual relationship, both partners contribute energy to each other. By doing this the Taoists believed that it was possible to use sex to increase lifespan and heal the body. I believe that it’s vital for the emotional and physical health of our relationships that we connect with our partners in this way.

Chinese medicine has a long tradition of using acupuncture, herbs and nutrition to enhance libido. Our YinOva Center patients are pleasantly surprised to find that six sessions of weekly acupuncture can make a tangible difference to both sexual desire and responsiveness. This is because lack of desire in Chinese medicine can be caused by two things. Firstly, stagnation of qi leading to poor flow of energy and blood which mutes sexual response and secondly, lack of qi which means that we are too depleted to be able to get in the mood for sex. A combination of herbs that boost qi along with acupuncture to help qi and blood flow is a great way to get your mojo back. In this article from Cookie Magazine a journalist who came to our center to work on her flagging libido describes how acupuncture affected her sex drive.

Issues that inhibit sex drive can vary. Some people are too tired to have sex and some are bored with their sex lives. Some women find that medications that they are taking make them less sexually responsive and some women feel bad about their bodies. Some of my patients have unhealed psychological wounds around the subject of sex either from abuse or from negative experiences in the past. Some of our patients have medical conditions that make them feel less inclined to be sexual. Whatever the cause, a reduced sex drive is a warning that all is not well and I always advise my patients to seek the advice of their medical doctor as well as coming in to our center for Chinese medical treatment.

Here are some of the tips we give our patients to help them revive a flagging libido -

1. Come and see us for regular acupuncture.

Acupuncture moves qi in the channels around the genitals and so can help with issues related to orgasm. Acupuncture can also gently balance hormones and can increase desire and arousal.

2. Exercise.

Regular exercise moves qi in Chinese medicine and so alleviates the qi stagnation associated with poor sexual response. Exercise also reduces stress and improves your body image, both of which will help you feel sexier. A study of women ages 45 to 55 found that sexual satisfaction is directly linked to fitness. According to the study author Judith Gerber, a psychologist at the University of Vermont College of Medicine “The less exercise they got, the lower their desire and sexual satisfaction”. Because exercise makes the blood flow and the nervous system fire women often tell me that they have more energy for sex immediately after exercising. Bearing this in mind it makes sense to do half an hour of yoga or qi gong before bed time to give your sexual energy a boost.

3. Relax and be mindful.

Feeling sexual requires focus. Many of my patients have described to me how their minds wander during sex. If we are busy thinking about our work, the bills or our shopping list it’s hard to be in the moment and enjoy sex. Meditation can be a great way of training your mind to stay present. Personally, I find yoga to be very meditational and it has the added bonus of being great exercise and increasing flexibility, all of which make it easier to enjoy sex. This article from the Mayo Clinic has some great suggestions about ways to relax.

4. Strengthen your pelvic muscles.

Pelvic floor exercises called Kegel exercises can help you become more aware of which muscles give you sexual pleasure. To perform these exercises, tighten your pelvic muscles as if you’re stopping a stream of urine. Hold for a count of five, relax and repeat. Do this several times a day.

5. Don’t over-complicate sex.

Many of my patients are relieved when I instruct them to go home and have low key sex. Movies, the internet and books all show us sexual images that may seem unattainable and make us feel inferior. Remember that sex is first and foremost about energetic connection. Although sometimes it’s great to swing from the rafters, quiet gentle sexual connection can be just as rewarding and less daunting. While we’re on the subject it’s good to bear in mind that sex doesn’t have to be a marathon. Researchers at Pennsylvania State University found that most couples found lovemaking sessions of between 7 to 13 minutes to be optimal.

6. Chinese herbs can help if properly prescribed.

A specially tailored herbal formula can be really helpful. Many of our patients have reported great success from taking Chinese herbs for their particular condition. Chinese medicine has a long tradition of using safe, gentle aphrodisiacs such as ginseng which may be all you need to get your sex life back on track.

7. Consult your doctor.

There can be structural and hormonal issues affecting your libido and your doctor will be able to help with these. Your doctor can also tell you if any of the medicine you are taking is lowering your libido and may be able to suggest alternatives. She can also check for undiagnosed medical conditions such as diabetes, high blood pressure and hypothyroid – all of which can affect your sexual response.

8. Nutritional supplements that may help.

L-Arginine often works for both men and women. It boosts blood flow through the genitals. For men this increased blood flow can enhance erection, while for the woman it can lead to heightened stimulation. Men can take L-Arginine in pill form, while many women report the best results are achieved by applying a cream directly on the genitals. We always advise our patients to take a good multivitamin because low libido can sometimes be associated with nutritional deficiencies. Low levels of iron or folate can make you too tired for sex whilst low levels of vitamin E can lead to hormone imbalances which also affect sex drive.

9. The importance of touch.

Skin on skin contact stimulates the release of a hormone called oxytocin which in turn results in a desire to touch and be touched. The release of oxytocin makes us feel good about the person who caused the hormone to be released so allowing your partner to massage or gently stroke your skin creates an emotional and hormonal connection. Oxytocin has been shown to increase both sexual desire and sexual response and thus receiving and giving touch throughout the day is a great way to increase levels of this hormone and in turn makes you more likely top want to be sexual. Sex itself increases oxytocin levels and thus makes libido stronger which leads us to our final bit of advice.

10. Have sex.

Even if you don’t feel completely in the mood. Just do it. Having sex creates energetic connection, bonds you to your partner and causes hormones to be released which in turn make it more likely that you’ll want to have more sex. So as the saying goes “fake it till you make it”. Have sex even if you don’t feel in the mood, stay present, enjoy the connection, relax and don’t have too many expectations. Before you know it your body will be back in the groove and you’ll find your desire creeping back.

For most of us the New Year is a time to think about the changes we want to make in our lives. Many of us resolve to drop some bad habits or pick up some good ones. Here at The YinOva Center we often hear from people who are trying to give up smoking especially at this time of year. We understand that quitting smoking can be really tough and we want to support you in whatever way we can.

So can acupuncture help? The answer according to clinical research is mixed. This study compared acupuncture to sham acupuncture in a group of smokers who wanted to quit and found that acupuncture increased the likelihood they would be successful. Some other research studies were less conclusive.

The mixed results in clinical trials reflect our experience here at The YinOva Center. Many, but not all, of our patients find acupuncture very helpful in that it gives them the extra boost they need to finally kick the habit once and for all. They find it takes the edge off their nicotine cravings and gives them enough support to resist temptation. Other patients enjoy their relaxing treatment but find it isn’t enough on it’s own to stop them from smoking. I always tell my patients that when it comes to stopping smoking, acupuncture can be supportive but it isn’t the whole story. It can help you with cravings but it won’t replace will power.

So if you’ve made up your mind to stop smoking and want some extra support we’d love to see you here at the YinOva Center. We have found that 2 treatments a week for three weeks seems to work best. We focus on points that calm cravings as well as those that calm anxiety. We also address any symptoms that come up. For example many smokers who quit to protect their lungs are disappointed to find that initially they develop a cough as their lungs expel years of accumulated gunk.

Here is the advice we give our YinOva patients who come to us for help as they give up cigarettes:-

• We love these people who run a 1/2 day stop smoking course in New York City and all over the world. Founded in the UK they use a combination of cognitive and behavioral therapy and hypnosis and have great success rates. They also have an online course that many of our patients have found really helpful.

• From the same people comes a book, The Easy Way to Stop Smoking: Join the Millions Who Have Become Non-Smokers Using Allen Carr’s Easyway Method. Both Ashton Kutcher and Ellen DeGeneres claim to have quit smoking having read the book. One of my patients skimmed through the book standing up in Barnes and Noble and quit there and then!

• In our experience the best way to quit is cold turkey. Patients who try to cut down their cigarette consumption usually find that it creeps up again.

• Quitting to make someone else happy almost never works. You need to find a reason to do this for you. Talk to us and let us help you get in touch with all the reasons why you are worth taking care of.

• Note that cravings last only a few minutes so ignoring them uses less will power than you think. Distract yourself for a couple of minutes and you should feel much better. We asked some of our patients what they did when they were experiencing a craving and here are some of their suggestions. Chew gum, eat a carrot, light a candle, focus on taking 10 full breaths, wash your hands or have a shower.

• The worst cravings only last a week. Take it one day at a time and know that by the time you have reached day 7 you are over the worst.

• Many of our patients have found that drinking alcohol weakens their resolve. In fact in studies 50% of relapse is related to alcohol use. Its best to avoid situations where you are drinking and other people are smoking, especially for the first few weeks.

• Find ways to calm your mind. Take up yoga, adopt a regular meditation practice, have an acupuncture treatment or go for a run.

• Don’t skip meals. When you were smoking you may have replaced a meal with a cigarette. It allowed you to avoid the feelings associated with low blood sugar. Now if you miss a meal you may feel irritable and unable to concentrate and your mind may trick you into having a cigarette to make you feel better.

• Convince yourself that there is no excuse for a relapse. Nicotine never makes anything any better so no matter what life throws at you don’t use it as an excuse to start smoking again.

• Acupuncture, whilst not replacing your own will power, can help you manage cravings so feel free to come in and see us for a course of 6 treatments.

• If you do slip up and have a cigarette, simply start again. Don’t beat yourself up or decide it’s impossible. Just get back on track. Many of our patients who have successfully given up smoking made several attempts before they finally quit for good.

Good luck!

This is the second part in a series of articles about pregnancy by YinOva Acupuncturist and Obstetric Nurse, Laura Scheurer.You can read other articles in this series by clicking here.

Morning sickness, one of the most common of complaints in pregnancy, can vary widely from person to person.  One might experience a mild aversion to aromas that previously were perceived as pleasant and not much more.  In another, the mere thought of food can induce a wave of nausea accompanied by dry retching and or vomiting.  It may not come as a surprise to hear that “morning sickness” can occur at any time of the day.  For some it is first thing in the morning only, for others it may be present constantly, even waking some women during the night.

Although no one is really clear as to the cause of nausea during pregnancy, it is thought to be due in part to an increase in estrogen levels and human chorionic gonadotropin (hCG), a hormone produced by the developing embryo after conception and later by the placenta.  Theories about other contributing factors include high stress levels and fatigue before conception and in early pregnancy.  Some believe emotional factors play a part as well.

Regardless of the cause, it is considered a “normal” side effect of pregnancy that is generally time-limited and will pass by the 12^th to 14^th week.  Conventional treatment usually involves reassurance and possibly an anti-emetic (medicine to stop the nausea and vomiting).

From a Chinese medicine perspective, there are very dramatic and profound changes occurring  during pregnancy as the Conception Vessel and the Penetrating Vessel are now redirected from supporting a menstrual cycle to nourishing a growing fetus.  These extraordinary vessels traverse the front and center of the body.  The Penetrating Vessel (the sea of Blood) communicates with both the uterus and the Stomach.  It is said that when the Penetrating Vessel is disordered, it interferes with the descending action of the Stomach, causing a rebellious rising of Qi, leading to nausea and vomiting.

Acupuncture has been used effectively offering great results in the treatment of morning sickness, providing a real alternative to just putting up with feeling sick all the time.

Treatment with Chinese medicine recognizes nausea and vomiting to be caused by one of a number of imbalances.  Some may sound familiar to you such as Stomach Qi deficiency, or Stomach cold, Spleen Qi deficiency, accumulation of phlegm or Liver Qi stagnation invading the Stomach.  These differential diagnosis, assist your acupuncturist in devising a treatment plan specific to your particular imbalance.

Once you have received acupuncture and are on the road to recovery, we have some very helpful self-care suggestions that will help keep those nauseating episodes at bay.

Fluids

• Avoid dehydration, even mild dehydration can make any nausea worse.  Dry lips, feeling thirsty, and decreased urinary output with dark concentrated urine are signs that your fluid intake is inadequate.
• Suitable fluids start with water, water, water.
• Teas, such a chamomile, peppermint or ginger tea are settling to the stomach.  For ginger tea, shave a thumbnail size of ginger into your cup, pour hot water over the ginger, add honey to taste, let steep for 10 minutes.  Limit the ginger tea to no more than 2 cups a day so as to not create heat in the Stomach.
• Ginger ale, is helpful for those who feel some relief after burping.
• Mineral water with lemon is refreshing and hydrating.
• Some women find that a teaspoon of apple cider vinegar in a cup of hot water with a bit of honey to taste, settles an upset stomach.
• If there are no symptoms of cold, ice pops and watery fruits like watermelon will keep you hydrated, and may be all you can tolerate for the time being.
• Soups and broths are a great way to maintain hydration and supply some nutrients.  Potato soup, miso soup, chicken broth are all nourishing, in addition to providing hydration.

Foods

• When thinking about what you can eat, think of what you would feed a 9-month old baby – bland, easy to digest foods.
• Baby rice, porridge, potato, pasta, yogurt, peaches and pears, go down easily and are not difficult to digest.
• Frequent, small meals encourage blood sugar levels to remain stable.
• Avoid sweet, sugary treats as they will cause blood sugar levels to fluctuate contributing to nausea.
• High protein snacks throughout the day and before bed, and a carb based breakfast may be helpful during this time.

Smells

• Sometimes just a whiff of an odor or an aroma that was previously inoffensive, now triggers a wave of nausea.
• A little essential oil on a hankie can save the day.  Try peppermint, lemon, or vanilla.

Acupressure Bands

• Worn on both wrists, pressure is applied to an acupuncture point known as PC-6 or Neiguan (inner gate) as it is the empirical point for the treatment of nausea.

Heartburn

It is thought that the rising hormone levels of estrogen and progesterone during pregnancy, relax the smooth muscle of the sphincter between the esophagus and the stomach causing acid to counter-flow from the stomach into the esophagus.  Acid reflux, or heartburn can occur at any time during pregnancy, but most often at the end, in the last trimester when the gravid uterus rises up into the diaphragm.  The degree of discomfort can vary from very mild to severe pain with vomiting.  It is usually worse when in a reclined position and better when sitting upright.

A Chinese medicine differential diagnosis may include Stomach Fire Blazing with strong thirst for cold drinks, or Food Stagnation, with a sensation of abdominal distention and belching.

Acupuncture points on the foot, lower leg, wrist or mid-abdomen can be helpful to redirect the flow of digestive juices to their proper place.  Sometimes we can send our patients home with ear press needles to be applied to the webbed area between the 2^nd and 3^rd toe as an adjunct to weekly treatments.

Self-help suggestions

• Small frequent meals as opposed to fewer larger meals makes more sense for you now.  As your baby grows, your internal organs are displaced smaller meals are processed easier than a large meal, especially when space is limited.

• Learn to recognize and avoid the foods that trigger heartburn.  Some common culprits are highly seasoned rich foods, fried or fatty foods, processed meats, chocolate, coffee, alcohol and often times commercially prepared yeast containing products.

• Antacids are generally safe to take, but avoid sodium bicarbonate since the sodium is absorbed into the blood stream causing a potential for other issues.

• A safer alternative is an herbal antacid, hai piao xiao, or cuttlefish bone is a simple formula that also contains gan cao (licorice).

• Read our blog for more detail on what foods to eat and what to avoid during pregnancy.

We think you will find these suggestions easy to incorporate into your daily routine and quite effective.

Please see Part I of Laura’s series, Conquering Pregnancy Fatigue.

This is the first in a series of articles about pregnancy by YinOva Acupuncturist and Obstetric Nurse, Laura Scheurer.

What an exciting time it is anticipating the birth of your baby, whether it is your first or a new addition to your growing family.  We can say with confidence, there are few experiences in life that top the moment your pregnancy is confirmed.

At the YinOva Center we offer acupuncture, herbal remedies, massage and holistic support for you as you prepare for a healthy pregnancy.  Happily we see many of you transition from this “premester” preparatory phase, to your first trimester.  When that time comes, we often hear, “We’re pregnant, now what?”  We can continue to work together as your body adjusts to the various changes of pregnancy.  Guided by the principles of Chinese medicine and our philosophy of “traditional wisdom for modern families,”  I have been inspired to start a blog series offering safe, simple self-help suggestions for the common side-effects of pregnancy.  Topics will include everything from the first trimester through to preparing for labor and finally, the postpartum period.

“Why am I always so tired?”

Fatigue is a common complaint in the early stages of pregnancy, with a sudden loss of energy as your body gets used to the all the changes.  Your body is adjusting to the extra workload of the developing placenta as well as hormonal changes.  This fatigue often lasts throughout the first trimester, with a sense of renewed energy starting at about week 13.  Toward the end of your pregnancy, in your last trimester, fatigue is often linked to the additional 20 – 30 lbs. gained, lack of sleep due to frequent bathroom visits or the station of the baby, making it hard to find a comfortable sleeping position.

Your Doctor or midwife may suggest an iron supplement early in your pregnancy to improve your hemoglobin levels, which will improve overall oxygenation to your cells and thereby improving your energy.

Based on the result of an involved questionnaire, we can find different patterns that emerge.  Your acupuncturist will then select a course of treatment best suited for you particular presentation.  You may recognize the names of some of the more common patterns if you have been receiving acupuncture for a while, if not, this may be an introduction.  Either way, I’d love to explore the Chinese perspective with you.  They include:

• Qi deficiency: fatigue that is worse after exertion and better with rest.

• Yang deficiency: includes some of the signs of Qi deficiency plus sensations of feeling cold.

• Yin deficiency: fatigue, restlessness and heat signs, like warm flushes or night sweats.

• Liver Qi stagnation: fatigue that is worse with inactivity and stress.

• Liver Blood deficiency: fatigue, weakness, dry skin, pale lips and poor memory.

Acupuncture is useful at any stage of your pregnancy.  If there are obvious reasons for your fatigue, like nausea, anemia or musculoskeletal pain, those issues will be addressed first.  We would advise you to listen to your body and slow down if needed.  This is not the time to push the envelope on your energy reserves.  Small, simple lifestyle or nutritional changes will correspond to increased energy.

Self help suggestions:

• For those of you taking an iron supplement, choose an easily absorbed liquid formula, like Floradix.

• Incorporate iron rich foods into your diet, like organic eggs, grass-fed red meats, spinach, blackstrap molasses and dried fruits.

For those presenting with patterns such as Qi deficiency or Yang deficiency:

• Think about how you can reduce your workload.
• Dress warmly.
• Start work later in the morning if possible.
• Go to bed earlier.
• Pay attention to your sleep hygiene: keep your room dark; remove electronics like TV’s and laptops from your bedroom; if outside noise is an issue, use a white noise device.
• Your diet should incorporate Qi and Yang tonifying foods and preparations: limit the consumption of cold and raw foods; lightly steam or roast veggies with rosemary, add a little garlic or ginger to stir-fry;  add cinnamon, or cloves to fruit compotes or rice congee.

Yin deficient women need to support and conserve their Yin energy:

• Seek out activities that are calming as opposed to stimulating, i.e., gentle moving meditations, Tai Chi or prenatal yoga help to center and ground your energy reserves.
• Avoid foods that are too stimulating like caffeinated drinks, pick-me-up snacks with too much sugar.
• Incorporate Yin nourishing foods like banana, mango, dairy, legumes, fish and pork.
• Small frequent meals, rather than less frequent, large meals, keep blood sugar levels stable, minimizing those after meal or mid-day energy slumps.
• Try different kinds of milk to make fruit smoothies, such as almond, rice, hemp or coconut milk as these are less mucus producing, and nourish the Yin energy.

Liver Qi stagnation fatigue requires us to focus our attention on promoting the smooth flow of Qi.  Possibly you are one of those ladies, who, prior to your pregnancy found regular, strenuous work-outs like running suited you best.  Now that you are pregnant those work-outs may not be advisable.  If you feel the need to release some of that pent up energy and doing nothing makes you feel more tired a brisk daily walk and/or lane swimming  are good alternatives.  They are both gentle enough and active enough to move the energetic Qi of the Liver, calm irritability, and energize you at the same time!

Liver Blood deficiency ladies need to build Blood (of course we are primarily speaking of the energetics of Blood, through the eyes of Chinese medicine, we are not suggesting there is anything wrong with your blood – using upper case ‘B’ for Chinese medicine and lower case ’b’ for what is commonly thought of as blood).

• Dietary suggestions include already mentioned iron rich foods.
• Other suggestions: beetroot, avocado, dark leafy green vegetables, kidney beans.
• Smaller, more frequent meals.
• Include plenty of plant based proteins, like quinoa or whole grain buckwheat.
• Wheat grass shots are a nice addition to your routine.
• Don’t forget your fluid intake.  Always start with water, water, water.
• Another option, pure, clear and clean broths to sip on throughout the day.

Daily waking activities need to include some down time.  Most likely you will find it is after lunch between 1 and 3 pm, you may feel,  as my mother would say, “too pooped to pop.”  Energetically, in terms of Chinese medicine, this is the time when the Liver energy is at its weakest (peak time is 1 – 3 am while you’re body is resting & rebuilding Liver Blood).  A nap would be ideal, but often not possible for many working women.  Please listen to your body’s needs.  Put yourself first for now.  Schedule a daily 20 minute catnap.  Close the eyes, get into a no fly zone space to replenish your energy reserves.

Remember how incredible your body is.  Enjoy, marvel and embrace the changes your body is going through and bringing forth!

Stay tuned for the next topic in our series: ‘Morning Sickness.’

Ovarian cysts are small fluid-filled sacs that develop in a woman’s ovaries.  Most cysts are harmless, but some may cause problems such as rupturing, bleeding, or pain; and surgery may be required to remove the cyst(s).

In Traditional Chinese Medicine cysts are considered an accumulation of phlegm and/or blood stagnation.  This is predominantly a Yin Pathology where fluid is accumulates due to an overabundance of water and phlegm.  In treating cysts, the main treatment goal is to tonify the kidneys, transform dampness and phlegm and move blood stasis.

Yang energy is required to encourage the break up of cysts.  Yang is the warming and moving aspect of life.  To boost Yang energy and decrease the sinking, heaviness of Yin energy, acupuncture, herbs and dietary therapy are employed.

Acupuncture Therapy

Certain points along the meridians tonify Yang.  There are many ways to do this.  Many treatments are aimed at nourishing the Kidneys especially when the person is susceptible to cold, has back problems, weight gain, phlegm and fatigue.  Others treatments are geared towards raising the Spleen Qi especially if the person has digestive issues, insomnia, bruises easily and feels fatigue.  Additionally, it is important to move blood in order to disperse stagnation.  I often use a heat lamp and castor oil packs on the abdomen to facilitate movement.

Herbal Therapy

Traditional Chinese Herbal formulas are a synergistic interplay of 5-20 herbs.  Some warming herbs include Cinnamon bark and spices such as Tumeric, Cardamom, Cayenne Pepper and Saffron. Some herbs that help eliminate phlegm and dampness include Barley and Orange Peel.

Dietary Therapy

Dietary therapy is an intrinsic element to Traditional Chinese Medicine.  If you are trying to reduce the growth of cysts it is imperative to reduce or eliminate phlegm producing foods such as:

* cheese
* ice cream
* soy
* wheat
* sugar

There are many different types of cysts.  The following list is from the Mayo Clinic:

• Follicular cyst: This type of simple cyst can form when ovulation does not occur or when a mature follicle involutes (collapses on itself).  A follicular cyst usually forms at the time of ovulation and can grow to about 2.3 inches in diameter.  The rupture of this type of cyst can create sharp severe pain on the side of the ovary on which the cyst appears.  This sharp pain occurs in the middle of the menstrual cycle, during ovulation.

• Corpus luteum cyst: This type of functional ovarian cyst occurs after an egg has been released from a follicle.  After this happens, the follicle becomes what is known as a corpus luteum.  If a pregnancy doesn’t occur, the corpus luteum usually breaks down and disappears.  It may, however, fill with fluid or blood and persist on the ovary.  Usually, this cyst is found on only one side and produces no symptoms.

• Hemorrhagic cyst: This type of functional cyst occurs when bleeding occurs within a cyst.

• Dermoid cyst: This is a type of benign tumor sometimes referred to as mature cystic teratoma.  It is an abnormal cyst that usually affects younger women and may grow to 6 inches in diameter.   A dermoid cyst can contain other types of growths of body tissues such as fat and occasionally bone, hair, and cartilage.

• Endometriomas or endometrioid cysts: Part of the condition known as endometriosis, this type of cyst is formed when endometrial tissue (the lining tissue of the uterus) is present on the ovaries.  It affects women during the reproductive years and may cause chronic pelvic pain associated with menstruation.

• Polycystic-appearing ovary: Polycystic-appearing ovary is diagnosed based on its enlarged size – usually twice that of normal – with small cysts present around the outside of the ovary.

Although Traditional Chinese Medicine is highly effective you need to allow time for the treatments to work.  Even if you see an immediate improvement in energy, sleep, mood, etc. it often takes at least three months of regular treatments to change existing patterns of disharmony.

Jan was a 35 year old woman who came to see me because her periods were so heavy that she had been diagnosed with anemia.

Carla was a 45 year old woman whose abdomen protruded so much that her friend had mistakenly thought she was pregnant.

Lauren was a 39 year old woman who was having difficulty conceiving.

All the above names have been changed to protect the privacy of our patients.

What all these women had in common were uterine fibroids which are benign tumors of the uterus which can cause pelvic pain, abdominal swelling, abnormal uterine bleeding and infertility. They are made of smooth muscle and fibrous tissue. They can be located either outside or inside the uterus. They range in size from a pea to a melon, but they are usually between the size of an orange and a grapefruit.

In my practice I see them very regularly which is not surprising as an estimated 20 – 30% of women aged between 35 and 50 suffer from fibroids making them the most common structural abnormality of the uterus. Some women have them and never know but for many women, such as the one’s described above, they do cause problems.

Herbs and acupuncture can help reduce the size of fibroids but in my experience are unlikely to make them magically disappear altogether. With this in mind its important to consult your GYN and use Chinese medicine as an adjunct to what she recommends. That having been said, I have had very good results using Chinese herbal formulas such as Gui Zhi Fu Ling Wan to reduce the size and unpleasant side effects of uterine fibroids.

Fibroids grow in response to excess estrogen in the system which means that you need to reduce your exposure to external sources of estrogen and support your liver whose job it is to process estrogen for you. In Chinese medicine fibroids are related to blood stagnation and so promoting the circulation of blood in the pelvic area is recommended. There is often an emotional element to fibroids and it can be helpful to explore and address that. So when developing your self-help regimen you should focus on these areas.

1. Limiting your exposure to eternal estrogens
2. Supporting your liver
3. Moving blood in the pelvic area.
4. Exploring the emotions associated with your fibroids

1. Limiting Your Exposure to Exogenous Estrogens

Controlling how much estrogen you take in is difficult in our estrogen-laden environment. The problem is that chemical estrogens have ways of entering our food and water supply. Agricultural chemicals and pesticides mimic the activity of estrogen, provoking heightened estrogen receptivity on estrogen receptor sites. Urine, contaminated with high levels of residual estrogen from birth control pills, can seep back into water supplies through inadequate sewage treatment procedures. Plastic wrap can leach estrogen-like compounds into our food. Obviously, estrogen replacement therapy at menopause or the contraceptive pill can worsen uterine fibroids due to increased levels of circulating estrogen.

What to do:

• Many women find that adopting a low fat, high fiber, mostly vegetarian diet is helpful.
• If you are overweight, lose a few pounds – excess fat increases the amount of estrogen in your system.
• Avoid hormonally treated meat and dairy
• Eat as much organic produce as you can
• Avoid refined and hydrogenated oils
• Eat cruciferous vegetables, such as broccoli, cabbage, cauliflour, kale and brussels sprouts. These contain a phytonutrient called diindolylmethane (DIM) which supports the activity of enzymes that improve estrogen metabolism. Scientific research shows diindolylmethane increases the level of “good” estrogens (2-hydroxyestrogen) while reducing the level of “bad” estrogens (16-hydroxyestrogen).
• Soy and soy products are a controversial issue. Many alternative practitioners suggest that phytoestrogens (from plants) bond with receptor sites in the body and stop the uptake of more harmful xeonestrogen (from chemicals). This theory makes sense intuitively but over the years I have seen enough women whose fibroids have grown under the influence of phytoestrogens in herbs and foods to suggest avoiding these foods especially processed soy products. Flax seeds, which are also phytoestrogens, seem to be much gentler and I have never seen them produce an adverse effect

2. Supporting your liver

One of your liver’s many jobs is to break down estrogens. It has a much harder time doing this if it is detoxifying all the other substances that it is expected to tackle on a daily basis.

What to do:

• Avoid alcohol.
• Avoid coffee.
• To stimulate the liver you can use lemon juice, and put bitter greens such as dandelion greens, endive and raddichio in your salad.
• You can take liver-supporting herbs including dandelion root, milk thistle, burdock, artichoke and turmeric.
• B vitamins also aid the liver and are recommended. They can be added in the form of whole foods (such as lentils, rice bran, and blackstrap molasses) or supplements. Vitamin B6, in particular, enhances the breakdown and removal of estrogen from the body.
• At the YinOva Center we sell a month long herbal detox made by Blessed Herbs which we find to be very helpful as part of a detoxification strategy .
• Flax seed oil improves liver function and although it contains phytoestrogens does not seem to cause the same problems as processed soy products.

3. Moving blood in the pelvic area.

In Chinese medicine impeded blood circulation in the pelvic area over time can lead to denser and denser tissue eventually resulting in fibroids.

What to do:

• Make sure to include omega 3 fatty acids in your diet which prevent abnormal blood clotting. You can do this by eating fatty fish and if you want to learn more about beneficial fats please see my blog entry on the subject.
• Apply a caster oil pack to the lower abdomen during the 5 days before your period and during the period itself. The only exception to this is if you are trying to get pregnant when you should only use the caster oil pack during your period. The pack invigorates the blood and helps the lymphatic system move debris. Apply caster oil to your abdomen, cover the area with plastic wrap them place a heating pack or hot water bottle on top. This should be warm not scalding. If it is too hot place a towel between the hot pack and the plastic wrap. Do this twice a day.
• Regular moderate exercise – helps improve circulation.
• Regular warm baths can be helpful especially if you add essential oils such as frankincense and lavender.
• Regular acupuncture can promote blood flow in the pelvic area and thus help reduce fibroids.

4. Exploring the emotions associated with your fibroids

Over the years I have noticed that women with certain emotional issues are more prone to fibroids. For instance women whose fibroids bleed profusely are often overwhelmed and unable to cope with their workload. Dr. Christiane Northrup says that fibroids represent creativity that was never birthed. She talks about dead-end jobs and relationships, and conflicts about reproduction and motherhood. Although not always the case I have noticed this enough to flag it up with my patients and urge them to address their overwhelming lives and explore areas where they feel unfulfilled.

What to do:

• Learn to meditate
• Take up yoga
• Hire a therapist or life coach and explore the ways in which you feel blocked
• Learn to say NO

For more information about how we can help you with your fibroids please feel free to contact us at The YinOva Center.

Do you suffer from brain fog or a cloudy mind? Are you forgetful and absent minded? Do you sometimes feel detached or unfocused? If you do, you’re not alone. Here at the YinOva Center a lot of our patients tell us that they worry about their brain power and ask if Chinese medicine can help improve focus and memory.

In Chinese medicine the kidney system is related to brain function, so many of the herbs used to improve concentration are also kidney tonics. However Chinese medicine differentiates forgetfulness from a cloudy mind. If you feel foggy and heavy headed your Chinese diagnosis would more likely be related to damp which is a Chinese way of discussing poor fluid metabolism and mucus accumulation.

We use acupuncture and Chinese herbs to treat all sorts of issues related to mental function and because everyone is different we recommend getting a proper Chinese medical diagnosis from an experienced practitioner who is able to prescribe you a formula specially tailored to your circumstances. Most of our YinOva formulas for brain fog are adapted from these formulas.

• Bu Nao Wan (Cerebral Tonic Pills) - is a common formula used for memory problems related to weakness in the kidney system.  Several herbs in the formula such as Wu Wei Zi (Schizandra) and Suan Zao Ren (Zizyphus) have been used for hundreds of years to calm the mind and help with focus.

• Gui Pi Tang (Restore the Spleen Tea) – This is a formula that is commonly given to patients for whom anxiety or over-thinking leads to memory problems.

• Shen Ling Bai Zhu Wan (Ginseng, Poria and Atracylodis Pills) – This is a good choice for people who suffer from cloudy mind due to poor fluid metabolism and damp.

Here is the advice we give our YinOva Patients who want to be more focused

• Drop some bad habits – Smoking, drinking alcohol and taking recreational drugs all affect memory. We’re happy to help you with cravings as you drop your bad habits.

• Acupuncture activates the brain - Studies show that acupuncture can have an effect on brain function. Some of our patients find that a course of 6 treatments is all they need to find their focus.

• Find some fish oil – Omega-3 is found in the brain in the form of DHA and works with a number of enzymes used for coordinating brain mechanisms.

• Hydrate - The brain like the rest of your body is mostly made up of water so dehydration is an often overlooked cause of poor brain function.

• Herbs for a healthy mind – as well as the formulas we discussed above the following herbs can help memory and focus.
  • Ginko Biloba – Over the past decade there have been 125 studies into the effects of ginko and most of them conclude that it increases blood flow to the brain and so improves memory and mental clarity.
  • Salvia – this herb, which is part of the sage family, has been used in Chinese medicine for centuries to increase blood flow. Modern research bears this out and according to a 2003 UK study conducted by the Human Cognitive Neuroscience Unit at Northumbria University, young people who received an extract of Salvia essential oil showed improvement in word recall.
  • Acorus - known as Shi Chang Pu in Chinese herbology this herb transforms damp is works well for people suffering from a heavy head and a cloudy mind.
  • Reishi mushrooms are a powerful adaptogen and have been prized for thousands of years throughout Asia for their ability to bring calm and help concentration.

How do you tell when spring has arrived? For some it’s when the birds start singing, or the trees start budding. For others it’s when the crocuses emerge from hibernation and peek through the ground. Here at the YinOva Center in New York City we can tell spring is in the air when our patients come in with red eyes and stuffy noses. Seasonal allergies affect one third of Americans and according to a study published in the September 2004 issue of Allergy Magazine, a combination of Chinese herbs and weekly acupuncture sessions is a useful way of alleviating the symptoms and may help prevent allergies all together.

Allergies happen when your immune system misidentifies something harmless, such as pollen, and mounts a defense against it by becoming inflamed and producing mucus. As practitioners of Chinese medicine we’re taught to diagnose each patient’s allergies individually, looking for a pattern of disharmony that has resulted in symptoms. We start by dividing up the root of the problem from its branch. The branch is the allergy symptom whereas the root is the situation in the body that led to the allergy happening. Once we have a clear picture of a patient’s unique combination of symptoms, we create a treatment plan that is specifically tailored to their situation. At the YinOva Center, this plan usually involves a weekly acupuncture treatment, a daily herbal formula and some diet and lifestyle changes.

Western medicine has several ways of tackling allergy symptoms. Doctors can stop your body’s overreaction by prescribing antihistamines such as Benadryl or drugs that act on the nervous system such as Albuterol. They can address inflammation by giving you cortico-steroids such as Prednisone, and they can relieve sinus pressure by prescribing decongestants such as Sudafed. All of these drugs can address the branch of the problem, the allergy symptoms, however many of them have side effects including drowsiness, fatigue, anxiety and an over-suppression of the immune system. Western medicine can be really helpful and we certainly encourage people to listen to their doctor’s advice, however our patients tell us that they are frustrated because the drugs only work whilst they are taking them and do little to solve the underlying problem.

So what is the underlying problem? Why do some people overreact to everyday irritants? In our practice the most common pattern we see is weak lung and spleen qi. Lung qi is how we describe the function of the entire respiratory tract, including the nasal passages. So weak lung qi refers to a respiratory tract that is under performing. Spleen qi is a way of describing how the digestive system is involved with the metabolism of fluids, so weak spleen qi refers to poor digestive function, which can lead to an overproduction of mucus, which tends to collect in the lungs. This is not the only root diagnosis we see so consulting a trained acupuncturist and herbalist will really help you identify your own unique pattern.

As for the branch, the allergy symptoms themselves, Chinese medicine sees this as related to wind and damp. Wind is Chinese medicine’s way of describing our susceptibility to outside influences such as an allergen and damp describes mucus buildup in the sinuses, the lungs and the digestive tract. A good herbalist will take everything into account and design an herbal formula that addresses all aspects of the allergy from the underlying weakness that made you susceptible to the irritating symptoms such as itchy eyes and runny nose.

For many of our patients, the acupuncture brings immediate relief. By inserting small hair-like needles around the nose and sinuses we are able to stop sneezing and relieve congestion. There are points on the feet that can soothe red, itchy eyes and other points to calm down an overactive immune system.

So what can you do to help yourself? At the YinOva Center we give our patients the following advice.

• A weekly acupuncture treatment from an experienced acupuncturist can help. Try to start before allergy season to treat the root of the allergies before they kick in.

• A specially tailored Chinese herbal formula can address both the root of the allergies in your particular case as well as the specific symptoms that you suffer from.

• If your sinuses are congested, try cutting back on dairy products, which can cause mucus build up in some people.

• Wheat can make inflammation worse, so it’s worth limiting it if you are having an allergy attack.

• Eat foods that are rich in Vitamin C. This is a natural antihistamine and can be found in citrus fruits, kiwi fruit, broccoli, spinach, strawberries, melon and cabbage.

• Beta-carotene is an anti-oxidant that supports the respiratory system. You should increase your intake of beta-carotene by eating yellow and orange fruits, such as mangoes and papayas, orange root vegetables such as carrots and yams and green leafy vegetables such as spinach and kale.

• Low magnesium has been linked to allergies in clinical research. Increase your magnesium by including sunflower seeds, spinach, chard, salmon and sesame seeds in your diet.

• Quercetin is an antioxidant that is high in bioflavonoids. It too has an antihistamine effect and also decreases inflammation. Get more quercetin by eating onions, red grapes, apples (with the skin on), tomatoes and leafy green vegetables.

Today our Clinic Director Noah Rubinstein is blogging about a common foot problem that comes from overdoing it just a bit.

The NYC Marathon is next week!

Predictably, this is the time of year in my practice when I see a lot  more people with foot pain.  But even if you aren’t a long distance runner or an actor on stage every night,  foot pain can quietly creep into you life and just be taken for granted.  When it gets bad enough and the podiatrist gets their hands on you, a common diagnosis is Plantar fasciitis.

Plantar fasciitis is the thickening or inflammation of a band of connective tissue between your heel and toes. This band protects the muscles and  acts as a shock absorber and helps to provide stability to the foot. Excessive stress on it can lead to swelling, micro-tears and pain.

Common causes of plantar fasciitis include:

• sudden increases in running mileage
• bad exercise habits
• shoes that don’t offer proper support
• work that involves being on your feet for long periods
• being overweight

The discomfort associated with plantar fasciitis tends to develop gradually. The pain is typically sharp and tends to be focused around the heel, which is why it is often confused with heel spurs. One of the tell-tale signs of plantar fasciitis is that it is much worse first thing in the morning. This is definitely the case with my dancers who feel okay onstage at night, but then get inflamed and tight in their sleep and wake up in a lot of pain.

What we can do

Treatment for plantar fasciitis is aimed at reducing inflammation and allowing tissue to heal. We do this in the same ways that we address inflammation in many orthopedic conditions.

Acupuncture and Chinese herbs are used to promote circulation of vital energy and support optimal function of the area by encouraging tissue repair, reducing swelling, and reducing pain.  With centuries of treating injury and pain from overuse and abuse in the martial arts, we have many tools for addressing these problems.

Conventional medicine first line treatment includes over-the-counter NSAIDs (non-steroidal analgesic) such as advil or motrin. These can provide temporary relief however they do not address the cause of the pain.  Your doctor may prescribe cortico-sterioids but this treatment cannot be repeated as it can actually weaken the fascia and thin the shock absorbing pad of your heel.

Physical therapy, splints and night braces may also be recommended as may orthotic inserts for your shoes.

What you can do

With plantar fasciitis, as with so many other conditions, I believe that the best therapies are the ones you can do for yourself. Better that you work on yourself for 10 minutes every day than for an hour with a specialist on Mondays. Right?

Predictably, the number one recommendation is rest. For many, this advice is like rubbing salt in a wound. In the spirit of the message though, if your feet are acting up, try to take care of them and give them a break between shifts, shows, marathons, or whatever you do. Here are some other tips for taking care of your paws:

Stretching – a few times a day, loosen up everything from the knee down with calf stretches, heel and arch stretches and toe curls using a towel.

Ice vs. Heat – generally I discourage the use of cold. It constricts, it slows local circulation and sets you up for injury. With plantar fasciitis, when it feels really lit up and painful though, it’s okay to cool it down. Sometimes alternating with heat. Don’t ice before working out though and don’t forget to keep the surrounding muscles warm and limber.

Footware – this can be the source of all that ails you. Make sure you are wearing supportive shoes for work and play.

For runners, properly fitted sneakers can make all the difference. To find your perfect pair I highly recommend Jack Rabbit Sports. No matter what level you are at, they have the gear and the knowledge base to keep you on the road.

If you are onstage every night, make sure your shoes feel as good as you make them look. If they are tearing up your feet, ask about getting them customized. Whether you are a performer or not, remember that if your body mechanics are off because of you shoes, it can lead to all kinds of problems, not just with your feet.

Overnight one of my patients “facebooked” me to let me know she’d had her baby – a happy reminder of all the reasons I love my job. Helping couples to conceive is rewarding and interesting work.

When a patient first consults me I ask lots of questions, some of which may seem off-topic, but together they give me a picture of their internal landscape and from there the detective work begins. Sometimes I manage to spot something very simple that may be getting in the way of conceiving and an example of this is a luteal phase defect.

Your luteal phase is the time from ovulation until your period starts. A normal luteal phase should be 14 days which gives a fertilized egg enough time to implant and start to signal to your body that it’s there. A luteal phase lasting less than 12 days is too short for this to happen and the uterine lining begins to slough off before a fertilized egg has had a chance to implant and initiate the hormonal changes necessary to sustain a pregnancy. This is a common endocrine disorder and is present in many of the women I see who are having trouble conceiving. Researchers estimate that more than 1/3 of women who are suffering from early pregnancy loss have a luteal phase disorder.

Another indicator of a luteal phase defect is low progesterone in the second half of the cycle. It’s possible to have a completely normal 14 day luteal phase and still have low progesterone levels which mean that the endometrium can’t develop and function properly and a fertilized egg will have problems implanting and being sustained. A short luteal phase or spotting before your period could be a sign of low progesterone and it is a good idea to contact your doctor for further testing.

In our book Making Babies: A Proven 3-Month Program for Maximum Fertility Dr. David suggested the following tests for women who think they may be suffering from luteal phase defect.

• Testing serial progesterone levels during a single cycle – 7, 9 and 11 days after ovulation.
• Testing prolactin levels – elevated prolactin can lead to inadequate progesterone
• Testing thyroid function – hypothyroidism can lead to low progesterone
• Checking for polycystic ovarian syndrome – low progesterone levels commonly occur in women with PCOS

If progesterone levels are low your doctor may prescribe supplemental progesterone or a follicle stimulating drug in the follicular phase on the grounds that a strong follicular phase can lead to higher progesterone in the luteal phase.

In Chinese medicine we interpret luteal phase defect as an imbalance of the whole cycle, not just the luteal phase. Western medicine recognizes this too which is why doctors sometimes combine intervention in the luteal phase (progesterone supplementation) with support in the follicular phase (clomid). The luteal phase is governed by yang energy, which develops from yin energy which is dominant in the follicular phase. The transformation of yin to yang happens through the movement of qi and blood at ovulation. An interruption in the flow at any point in the cycle can show up as a luteal phase defect. This is where the detective work comes in and as an acupuncturist I try to identify the root cause of the problem as I make my Chinese diagnosis.

• Too little yin in the first half of the cycle can lead to too little yang in the second half of the cycle. This would be termed yin and/or blood deficiency in Chinese medicine.
• Stagnation at ovulation can affect the hormonal transition and thus the transition of yin to yang. This would be termed qi and/or blood stagnation in Chinese medicine
• Too little yang can affect both the hormone transition at ovulation and the quality of the luteal phase. this would be termed yang and/or qi deficiency in Chinese medicine.

Based on these different diagnoses I adapt my acupuncture treatments and create a specially tailored herbal formula for each patient, which along with any treatment suggested by the patient’s doctor can significantly improve or correct a luteal phase defect.

Often all it takes for conception to occur is bit of detective work combined with Eastern and Western medicine working together to correct a small but significant imbalance. Then before I know it I’m waking up to baby pictures on Facebook and the satisfaction of seeing another patient become a Mom.

Whilst studying Chinese medicine I was introduced to the the idea that our bodies are in tune with nature and that we can and should adapt our behavior in response to nature. At the time this was news to me but over the years I have appreciated the wisdom of taking my cues from the seasons. At the YinOva Center we encourage our patients to celebrate transitions and to acknowledge the effect life’s rhythms have on us. As one season transitions into another it is traditional for acupuncturists to use this time of energetic movement to positively effect our patient’s health and well being.

I love the fall and feel its energy distinctly in my own life. It’s a time where the warming, yang energy of summer dissipates and we transition into the more yin, cooler energy of the fall and winter. Summers being yang are supposed to be frenetic with travel and movement a priority. Winters being yin should be more slow and nourishing.  Autumn is a time of transition when according to Chinese medicine we should begin to slow down and store energy for the winter months ahead. It’s a time to boost the immune system to ward of colds and flu and to switch from cooling summer foods to warming winter ones.

The movement of autumn in Chinese philosophy is downward and this is reflected in the root vegetables that are available at this time. Unlike summer vegetables that get their energy by soaking up the sun’s rays, winter vegetable reach down into the ground to get their sustenance and we in turn are nourished and sustained when we eat them. Also in season are tree fruits such as apples and pears which have used the summer sun to ripen. In Chinese medicine they are said to have stored the energy of the sun and that we benefit from this energy by eating them in the run up to winter.

Here is the advice we give our YinOva patients to help them enjoy the beautiful fall season.

• Carry a sweater with you. People are often still wearing their summer clothes but temperatures fluctuate in the fall and in Chinese medicine it’s important to avoid subjecting yourself to changes in temperature which are considered bad for the immune system. So to avoid an autumn cold dress in layers so that you can wrap up easily if the weather changes.

• Transition from cooling summer salads to warming soups that are rich in root veggies and nourishing meats. Nourishing yourself with warming foods is considered a great way to build up energy for the long winter ahead. Likewise apple pie and baked apples or poached pears contain the energy of summer and we can use them to nourish our bodies as we transition into winter.

• Drink plenty of warm liquids such as green tea. After the humidity of summer, the fall is often dry and dryness in Chinese medicine can weaken yin energy and lead to coughs and allergies.

• Visit your acupuncturist for a series of immune boosting treatments ahead of winter’s cold and flu season and if you are prone to catching colds ask about the formula Jade Windscreen. This herbal combination has been used for hundreds of years in China to ward off viral infections.

Everyone feels anxious sometimes but if you find yourself feeling anxious a lot of the time or are generally anxious without reason you may find it helpful to tell your doctor and enlist the help of an acupuncturist. The NIH (National Institute of Health) has supported acupuncture as a treatment for anxiety since 1997 and here at the YinOva Center we see many busy New Yorkers who seek our help to deal with feelings of anxiety and overwhelm.

Chinese medicine has a long tradition of combining acupuncture, herbs, nutritional advice and exercise to treat a wide variety of anxiety disorders from phobias to panic attacks and generalized anxiety. In my experience it can be really effective especially when combined with talk therapy and conventional medical treatment. Acupuncture, itself, has come under some scrutiny by the medical community recently and studies have shown that an acupuncture treatment can have a positive effect on serotonin levels and that regular acupuncture can relieve anxiety and depression.

When treating anxiety I always encourage my patients to take a holistic approach involving conventional medical advice, regular acupuncture, herbs, dietary changes and exercise.

Here is the advice we give our YinOva Center patients about dealing with anxiety.

• Regular acupuncture really does help. There is scientific research that shows that it has a positive effect on levels of both serotonin and norepinephrine.

• A carefully crafted herbal formula tailored to suit your specific pattern can be really useful. There are Chinese herbs that treat palpitations, over-thinking, insomnia, poor appetite, depression and anxiety.

• Make sure you’re getting enough B-Vitamins. Premier Research Labs make a product called Max Stress B Nanoplex which contains a highly accessible form of B complex which has an almost instant calming effect for most people.

• Calcium and Magnesium taken at night can support restful sleep as can a Chinese formula called An Mian Wan

• Regular massage can help with muscle tension and relaxation

• Even if you’re tired after a restless night you should resist the temptation to have a cup of coffee which only makes the symptoms of stress worse. Replace it with a calming cup of chamomile tea.

• Some of us don’t feel hungry when we’re anxious and some of us crave sweets. Either way it’s important to eat a varied, healthy diet to support your body. My patients are always surprised how much less anxious they are when they are eating well so make sure you are getting some whole grain carbs, plenty of colorful veggies and some lean protein. Not only does this restore a sense of control but a healthy body has a profound effect on your emotional health and resilience.

• There’s a reason why we crave carbohydrates when we are anxious. They raise serotonin levels so it’s possible to use some healthy carbs medicinally to help with mood. Try a baked potato or a small bowl of whole grains.

• Omega 3 Fatty Acids have been shown to help with mood. You can take them as a supplement or even better get them from fatty fish such as salmon, tuna and mackerel as well as in nuts, flax seeds and leafy green veggies.

• Don’t use alcohol to take the edge off your anxiety. It’s tempting to have a drink or two when you feel stressed but long term the effects of alcohol cause more anxiety. In Chinese medicine it is said that the liver heat the alcohol produces makes people irritable and stressed.

• Get some exercise. In Chinese medicine anxiety can be attributed to stagnation so moving qi and blood can help some people as much as an anti-depressant. Take a small amount of regular exercise each day and slowly increase the amount and intensity as you feel healthier. Even 20 minute walk can change the way you feel.

• Let the sunshine in. We get Vitamin D from the sun and recent research has shown that some forms of anxiety can be caused by a vitamin D deficiency. You can also take a Vitamin D supplement.

• Learn to meditate. See this YinOva Blog Article for more information about how to meditate.

Blogging today – YinOva Acupuncturist and Herbalist Laurel Axen Carol. Laurel specializes in using Chinese medicine to treat female reproductive issues, a subject she currently teaches at graduate level.

Laurel says – Getting a diagnosis of a breech presentation is not fun. I have had two myself, one frank and one transverse, so I am no stranger to the news. I have done everything under the sun to get a baby to turn and both did ultimately-but with two totally different births.

It’s healthy to encourage a baby to turn but there is a point when we need to TRUST that some things are beyond our understanding.

There are so many suggestions for turning a breech baby:

• Laying inverted on an ironing board (this can become really uncomfortable fast)
• Hanging around the house on all fours doing continuous cat/cows (yoga moves where you gently rock your pelvis)
• Frozen peas on the top of your abdomen or wherever the babies head is.
• Playing music into your pubic bone with head phones etc.
• Moxibustion, otherwise known as mugwort, burned over the mother’s small toe.
• Chiropractic -namely the Webtser technique.
• Clothes pins on the baby toes.
• Handstands in the pool.
• Visualization.
• Meditation.
• Homeopathic remedy pulsatilla
• External cephalic version.

As an acupuncturist I use moxibustion and acupuncture to help turn babies. I am always honest when dealing with a woman with a breech. Sometimes there are reasons way beyond our understanding that lead to a baby’s postion.

My treatment usually consists of a systemic treatment to help address what is going on with mom. This could include; stress (obviously), reflux, back pain, sciatica, tight muscles, insomnia. I often open the Dai Mai which is a meridian called “the Girdle Vessel”. This extraordinary meridian runs transverse across the belly and its main function is to hold up the other meridians. Opening the Dai Mai can often help the baby find a little room to flip drop down.

A lot of times I find that babies are breech because the hip-flexors and pelvic floor needs to loosen up. Some tight ladies include runners, pilates aficionados, athletes etc suffer from this. Other times babies are breech because the mom has too much water or the uterus is stretched and weak and isn’t holding the baby as tightly at term. In this case I use treatments to help strengthen her Qi.

I do burn the moxa of the little toe in a few different ways. Occasionally I use warming needle (moxa attached to a needle) and other times direct moxa placed on cream and other times I use pole moxa. I provide mom with moxa sticks and tell her to go home and continue treatment for ten consecutive days. If baby has not turned by then to come back for another treatment. No one really understands why moxa over the little toe works? One Western explanation may be that the little toe is the dermatome for the sacrum. One thing is for sure moms report (and I experienced) a lot of fetal movement during the moxa treatments.

The one thing I feel that I must urge continuously is that you must TRUST that the baby and your body know what to do. Let go, relax and try not to become obsessive. This may be your first interaction with the will of your little one!

I have found the greatest success is before 36 weeks but many babies still turn past then. I have even seen a baby flip at 41 weeks.

A good online resource is Spinning Babies

Other YinOva Blog articles on this subject
Can Acupuncture Help to Turn a Breech Baby
Turning a Breech Baby – A Patient’s Story

“It started with a few extra strands on my hair brush and before I knew it there were patches so thin you could see my scalp” Diana is a beautiful woman in her mid-thirties who was understandably devastated when her hair began to fall out. She had tried a variety of medicines before coming to see us at the YinOva Center on the advice of a friend who had used Chinese medicine successfully to treat alopecia.

More and more women are suffering from hair loss according to the American Academy of Dermatology who estimate that at any given time 30 million women in the USA are affected by alopecia. Certainly at the YinOva Center we are seeing an increasing number of women who are struggling with this issue and seek our help. Chinese medicine has a long history of treating hair loss in both sexes and can often be very helpful both for stopping further hair loss and for supporting regrowth.

In Chinese medicine healthy hair relies on a good flow of qi and blood to nourish the scalp. This flow and be interrupted by either a deficiency of qi and blood or a stagnation of qi and blood either of which can mean that insufficient nourishment reaches the scalp. Blood and qi deficiency are often caused by either poor diet or poor assimilation of nutrients where as qi and blood stagnation is often caused by stress or a hormone imbalance.

Acupuncture can improve the flow of qi and blood in the scalp and can help hair to regrow and Chinese herbs can nourish qi and blood to stop more hair from falling out. At the YinOva Center we usually use both acupuncture and herbs together along with nutritional suggestions and lifestyle changes to help our patients who are suffering from hair loss.

Here is the advice we give our YinOva patients who are suffering from hair loss

• Regular acupuncture can stimulate hair regrowth by encouraging the flow of qi and blood to the scalp.

• Chinese herbs have been used for hundreds of years to stop hair loss. One herb in particular is known for it’s ability to treat alopecia. He shou wu (Polygonium Multiflorum) is included in almost all the formulas we write for women who are losing hair. It is a blood tonic in Chinese medicine. In several studies over 60% of people who had hair loss experienced hair regrowth within 3 months after taking He Shou Wu.

• Make sure you have a broad diet and are not missing out on important nutrients. Omega 3 fatty acids are particularly important for a healthy scalp and can be found in salmon, walnuts, flax seeds or taken as a supplement. Iron deficiency can often contribute to hair loss. At the YinOva Center we are particularly impressed by the iron supplement Floradix which comes in an easy to absorb liquid form. Vitamin B12 is essential to healthy hair and is found in eggs, poultry and meat. If you are a vegetarian it may be helpful to take B12 as a supplement. Biotin is another B vitamin that helps hair to regrow. It’s hard to get enough of it from food so here at the YinOva Center we usually suggest people take it as a supplement.

• A daily scalp massage can help stimulate the scalp to aid with hair regrowth. We usually suggest rubbing the scalp gently for 5 minutes morning and night.

• In 1999 a team of researchers at Aberdeen university discovered that an essential oil blend applied to the scalp can help with hair regrowth.  86 patients were divided into two groups and over a seven-month period one group massaged an essential oil blend onto their scalps daily for two minutes while another group did the same thing with only the carrier oils jojoba and grapeseed. At the end of the study, 19 of the 43 patients in the active group demonstrated significantly improved hair growth while only six of the 41 patients in the control group showed improvement. One man in the active group grew a full head of hair after being completely bald. The recipe used in the study is as follows.
  • atlas cedarwood essential oil – 2 drops
  • thyme essential oil – 2 drops
  • rosemary essential oil – 3 drops
  • lavender essential oil – 3 drops
  • jojoba carrier oil – ½ teaspoon
  • grapeseed carrier oil – 4 teaspoons

Using a small glass jar mix the jojoba and grapeseed oils together first. Then add the essential oils one at a time and place the lid on the jar. Shake the oils together to mix them together.