Love in the Time of Coronavirus

by | Mar 12, 2020 | Acupuncture, General Wellness

Love in the Time of Coronavirus

It’s the new C-word of 2020: “coronavirus.” Amidst the hyper-vigilance that has begun to dominate most aspects of our daily lives, the COVID-19 virus has, in a matter of months, catapulted itself to a common household name. Although the widespread knowledge of the disease’s existence is as infectious as the disease itself, knowledge that goes beyond the fact that the disease, in fact, exists… may be limited. In the name of due diligence, we’ve conducted both a high-level overview of COVID-19, including verifying facts and dispelling some myths of this hottest of hot topics, as well as a deep dive into the nitty-gritty of how Traditional Chinese Medicine (TCM) can go above and beyond to help us understand what is at stake, and how Chinese herbal formulas as well as acupuncture treatments may be a huge benefit to combatting the illness. And, at the core, we hope to shed some light onto the most important question of all: how do we avoid contraction?

We begin by addressing some Frequently Asked Questions (FAQ):

What is a coronavirus? Are there more than one?

Coronaviruses are a large family of viruses which may cause illness in animals and/or humans. Typically, in humans, a coronavirus may cause respiratory infections ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).

What is COVID-19?

COVID-19 is the name given to the infectious disease that is caused by the most recently discovered coronavirus, which began in Wuhan, China, in December 2019.

What are the Symptoms of COVID-19?

Although other symptoms of the disease have been documented, the most common symptoms of COVID-19 are elevated body temperature, dry cough, fatigue, and shortness of breath. Some other symptoms include runny nose, nasal congestion, sore throat, and diarrhea, although no evidence has surfaced that most, let alone all, symptoms must be present in positive cases of COVID-19.

Can a person without symptoms spread COVID-19?

Some people with COVID-19 become infected but do NOT develop outward symptoms of the disease and may not even feel unwell. That said, the primary method of spread for COVID-19 is through respiratory droplets expelled through coughing and/or sneezing. Because the vast majority (approximately 89%) of COVID-19 cases present with mild symptoms, it is reasonable to assume even those with a mild cough may be capable of spreading the disease.

Where in the world is COVID-19 currently located?

At this point, the diseases is fairly widespread across the globe. There are currently more than 122,000 cases of coronavirus across the world, with the biggest countries infected being China, the country of origin, Italy, Iran, South Korea, Spain, Germany, France, and the United States. As of March 11, 2020, over 1000 cases of coronavirus have been identified within the United States. At least 32 people have died due to the disease nationwide. Over 4,300 COVID-19 deaths have occurred across the globe thus far.

Who are the people highest at risk of developing severe symptoms of COVID-19?

While studies are ongoing to determine how COVID-19 may affect different groups of individuals, at present, it seems people who are elderly, people with pre-existing medical conditions (such as high blood pressure, lung disease, heart disease, diabetes, or cancer), and people with compromised immune systems are those most at risk to develop severe symptoms of the disease.

Do antibiotics work against COVID-19?

No, COVID-19 is a viral infection. Antibiotics do not work against viruses, only against bacterial infections.

Is there a vaccine or pharmaceutical treatment for COVID-19?

Not at present. To date, there is no vaccine available, and no pharmaceutical prescription that has proven to be affective at treating symptoms of or preventing contraction of COVID-19. However, just as with other diseases, patients should seek care in order to aid in recovery from the disease with as little complications as possible. Those whose symptoms progress to severe illness should be hospitalized.

Is COVID-19 more dangerous than the flu?

That remains to be seen. Yes, we currently know the flu, or influenza, is “deadlier” than COVID-19 insofar as the mortality count, but there are other factors at play that may change those statistics in the long-run. In this season alone, the influenza virus has caused an estimated 34 million illnesses, 350,000 hospitalizations, and 20,000 deaths, according to the Centers for Disease Control and Prevention (CDC). But scientists have known about, and studied, the flu for several decades and thus know what to expect each season. In contrast, we currently know very little about what COVID-19 can do in terms of damage. And we know, with a good amount of certainly, that as we end March and enter April, the number of flu cases are going to decrease, as they do nearly every year. With COVID-19, there are still a lot of unknowns, so only time will tell how the population fares with the coronavirus as we end the spring months and enter into summer.

Can a face mask protect me from contracting COVID-19?

Only wear a face mask if you yourself have already contracted COVID-19 and are coughing, or are currently caring for someone who may have the disease. A disposable face mask can only be worn once. If you are not ill or looking after someone who is ill, it is likely the face mask, which is in high demand, may be wasted. With the current world-wide shortage of masks, it’s important to allow resources to remain for those truly in need. Please see the most effective methods to prevent spread and contraction of COVID-19 below.

What are effective methods to prevent the spread and contamination of COVID-19?

  • Regularly and thoroughly clean your hands with an alcohol-based hand sanitizer or wash them for at least 20 seconds with soap and warm water.
  • Maintain at least 3 feet distance between yourself and anyone who is visibly coughing and/or sneezing.
  • Avoid regularly touching your face — especially your nose, mouth, and eyes.
  • Clean all of your commonly handled items, including your tech equipment (i.e., smart phone, computer keyboard, headphones, etc.) and your car (steering wheel, gear stick, seatbelt hardware, etc.).
  • Follow good respiratory hygiene: cover your mouth and nose when you cough (ideally, with your sleeve/bent elbow or a tissue, rather than your hands). If using a tissue, dispose of it immediately in an appropriate receptacle.
  • Avoid hoarding N95 respirator masks — they are not one-size-fits-all, and without proper training, it’s likely the mask will allow for some permeation of the disease, which renders them useless. Leave them for the hospital staff and healthcare workers who really need (and know how to use) them.
  • Stay home if you feel ill, if you have a fever, cough, or difficulty breathing. Seek medical attention if symptoms multiply or worsen.
  • Avoid traveling if at all possible. This advice is especially pertinent if you are elderly, immune-compromised, or have pre-existing diabetes, lung or heart disease.

Now that we’ve concluded our FAQ, we take a look at the Traditional Chinese Medicine (TCM) perspective of COVID-19:

The TCM and integrated perspective of COVID-19

The TCM strategy for COVID-19 involves two parts: prevention and treatment.  It’s important to remember that TCM treats syndromes or types of diseases rather than generic diseases.  Furthermore, as disease develops in the body, it can change in characteristic and type, and the treatment must also change accordingly. Although available information about causes, symptoms, transmission and severity is still lacking, we can analyze what we know so far to come to a TCM understanding of this new disease.

The first major symptom is fever, but some patients with mild cases can present without fever.  In general, fever is highly indicative of an exterior condition, such as a Tai Yang disorder.  However, for it to truly fit a Tai Yang pattern, the patient should present with fever and chills.  Furthermore, that some infected patients exhibit no fever at all is indicative that this pathogen can bypass the Tai Yang level and strike deeper into the body.

There are two reasons why pathogenic factors would be able to bypass the Tai Yang level: either the patient’s Tai Yang level is deficient, or the pathogenic factor is particularly strong.  If we look at how contagious COVID-19 is, we can examine its transmissibility compared to other viruses.  In epidemiology, R0  is used to quantify how contagious a pathogen is; the higher the R value the more contagious it is.  For scale, a common flu has an R value of around 1.3, and SARS, a much more virulent virus, had an R value of about 3.0.  COVID-19 is currently thought to have an R value of about 2.2.  This suggests that COVID-19 is moderately contagious, and therefore according to TCM should generally only tend to infect those with weaker immune systems.

The second symptom is dry cough, which gradually leads to the third major symptom: difficulty breathing. A dry cough means that Dampness is not a major factor for most patients.  However, without further symptoms it is difficult to assess which pathogenic factor is responsible, since Heat, Cold, Dryness and Wind can all lead to a dry cough. Furthermore, for severe cases, this can lead to pneumonia and potentially acute respiratory distress syndrome. Post-mortem samples taken from a 50-year old male patient from Wuhan were extracted from the lung, and examination showed bilateral diffuse alveolar damage.  Alveolar damage suggests the body wasn’t able to get enough oxygen into the bloodstream, which leads to hypoxemia and weakness.  This emphasizes that in addition to fighting off the virus, it is also imperative to strengthen the lungs.

Lastly, in addition to hypoxemia, some severe cases present with other complications related to the blood.  Some severe patients show problems with septic shock and dysfunction with bleeding and clotting.  From the TCM perspective these blood conditions can be categorized as Blood Deficiency, Blood Stagnation and Toxic Heat.  These all need to be considered when formulating prevention or treatment plans.

Prevention

Considering that the virus attacks the lungs and immune system, it is essential to bolster the lung function and the immune system in general.  In order to do this, TCM tonifies the Lungs and Spleen with a well-known formula called Yu Ping Feng San.  The three herbs in this formula are Huang Qi (Astragalus), Bai Zhu (Atractylodis Rhizome), and Fang Feng (Saposhnikoviae Root).  Together, these herbs boost the immune system and digestion, thus warding off external pathogens.  From a western perspective, evidence has shown that astragalus inhibits avian infectious bronchitis caused by avian coronavirus.

Secondly, because some cases point to weakness in or attacks at the Shao Yang level, the second arm of this TCM prevention strategy is to proactively clear the shao yang level with a classic formula called Xiao Chai Hu Tang.  This formula can clear any pathogenic factors from the Shao Yang level, and in smaller doses can do so preventatively.  The two primary herbs in this formula are Chai Hu (Bupleurum Root) and Huang Qin (Scutellaria); while one clears the exterior the other clears the interior, particularly clearing the upper torso and chest. From a western perspective, Chai Hu and other plants in the same genus have been shown to inhibit flu viruses, Hepatis C virus, and others.  Furthermore, current research from Cell Research has shown that in vitro treatments of chloroquine have been effective at treating COVID-19.  Chloroquine is traditionally an antimalarial drug, and Xiao Chai Hu Tang is a common TCM treatment for malaria.

Treatment

If patients have already contracted the disease, the above two formulas are not sufficient; Xiao Chai Hu Tang can be continued, but it is necessary to combine it with other herbs.  Since the primary complication of COVID-19 is pneumonia, which usually manifests as a form of heat, it is important to clear the lungs either preventatively or curatively.  Some common syndromes that more serious COVID-19 patients at this stage could present with include heat aggregating in the lungs (邪热壅肺), heat closing off the lungs (邪热闭肺), internally closed while externally failing (内闭外脱). However, this diagnosis would have to be done on a case-to-case basis due to individual symptoms and signs, such as pulse, tongue and other secondary symptoms.  But as an example, one could include herbs like Sang Bai Pi and Di Gu Pi if the patient presented with Lung Heat symptoms, especially since Di Gu Pi also clears Heat at the Blood level.  TCM often treats patients with the same disease differently based on their individual symptoms, progression of the disease and the patient’s constitution.  And of course dosage would need to be adjusted accordingly as well.

To learn more about TCM prevention and treatment strategies, or about how TCM can help you improve your health in other ways, feel free to contact the authors of this article: Dr. Steven Wong (steven@yellowmountainclinic.com) and Dr. Melati Stevens (drmelati@herb-and-legend.com).

References:

  1. https://www.healthline.com/health/r-nought-reproduction-number
  2. https://www.who.int/csr/sars/en/WHOconsensus.pdf (p.27)
  3. https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (p.10)
  4. https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf (p.5)
  5. http://www.chinanews.com/sh/2020/01-20/9065162.shtml
  6. https://www.ncbi.nlm.nih.gov/pubmed/29170045
  7. https://www.ncbi.nlm.nih.gov/pubmed/30203768
  8. https://www.ncbi.nlm.nih.gov/pubmed/29039946
  9. https://www.ncbi.nlm.nih.gov/pubmed/28314599
  10. https://www.ncbi.nlm.nih.gov/pubmed/30920421
  11. https://www.nature.com/articles/s41422-020-0282-0.pdf
  12. https://www.zhihu.com/question/367393092?from=groupmessage

Migraines, Headaches, and Nonpharmacologic Treatment Options

by | Jun 18, 2019 | Acupuncture

Migraines, Headaches, and Nonpharmacologic Treatment Options

June is Migraine and Headache Awareness Month, providing an opportunity to increase awareness around the invisible disease that plagues so much of our population. This month we explore this topic and delve into the symptoms, causes, and treatment methods for individuals who suffer from these disorders.

Headaches are defined as pain or “aching” in any region of the head. The pain may be dull or sharp, localized to one spot or traveling from place to place on the head, and may be subtle in pressure or feel extremely vice-like. While many of us may be familiar with the irritating presence of a headache, migraines are less common but still quite prevalent. There are more than 3 million cases of migraines each year in the United States alone. Migraines are a recurring type of headache that can cause moderate to severe pain that is typically experienced as “pulsing” or “throbbing.” They may be accompanied by extreme sensitivity to light and sounds, and may render the victim of the migraine unable to function normally in their day-to-day routine.

While a dull headache may be something that is able to be ignored and “worked around” in order to continue doing one’s job, studying in school, or enjoying dinner with the family, some types of headaches, as well as most types of migraines, can be utterly debilitating, leaving the individual feeling weak or dizzy, perhaps curled in a ball on the couch or in bed, and feeling helpless. With symptoms this severe, it is easy to understand the tendency to completely detach from the world, avoiding light, noise, and excessive external stimulation.

So what is causing these terrible symptoms of pain, and what can we do to decrease them, or better yet, avoid them entirely?

There are several factors that may cause headaches or migraines. Here is a brief list of some of the more common causes:

 

  • Weather changes – extreme changes in barometric pressure, such as going from a bright and sunny day to suddenly having heavy cloud cover with strong rains or hail approaching, does a number on our bodies.
  • Changes in light – exposure to bright or fluorescent lighting
  • Stress – high stress situations raise our blood pressure, which can lead to excessive pressure in the brain, which can cause pain.
  • Hormonal changes, such as those accompanying menstruation (common), pregnancy, and ovulation
  • Oral contraceptives – just as hormone changes can cause headaches, so too can ingesting oral contraceptives, which contain hormones and must travel through the entire digestive systems of the bodies, which can have adverse effects.
  • Pharmaceuticals – some forms of medications, such as vasodilators, may cause changes in our blood pressure that can result in aching in the head.
  • Strong odors (eg, perfumes, colognes, petroleum distillates)
  • Smoking – smoking, as well as the inhalation of second-hand smoke, can cause headaches and migraines, as nicotine is a vastactive substance, which means it can change the size of blood vessels, which can trigger headaches just like changes in blood pressure.
  • Head trauma – perhaps obviously, trauma to our brains or skulls can have lingering effects on our health, including causing chronic headaches or migraines.
  • Too little, or too much sleep – new findings have shown that lack of sleep triggers ‘migraine proteins’ — key proteins that arouse the nervous system and can either trigger or suppress pain; likewise, too much sleep may throw off the body’s natural circadian rhythms, which create similar results.
  • Motion sickness – migraine sufferers are likely to have heightened sensitivity to motion sickness, as motion sickness involves reflexes that relay in the brainstem, and may share the same neural circuitry as migraine triggers.
  • Cold temperature exposure – cold stimulus, such as is experienced in a “brain freeze,” or ice cream-induced headache, is a classic example of a cold-caused headache.
  • Lack of exercise – while there is little evidence to show that no exercise directly results in headaches or migraines, the reverse affect of exercise reducing headaches and migraines, especially in frequency, is ample
  • Fasting or skipping meals
  • Red wine

Now that we have a clearer perspective on some of the most common triggers for headaches and migraines, we can consider some ways to treat the symptoms if and when they do arise.

There are certainly precedents for using pharmaceuticals to treat severe and debilitating migraines. However, whenever that form of treatment can be avoided in lieu of a nonpharmacologic option, that choice tends to be better for the both the subtle nature of the body’s defenses, as well as for its overall long-term health.

Studies have shown that nonpharmacological options for managing headaches and migraines have generally produced comparable average reductions in migraines compared with pharmacologic prevention.

From Dr. J. Chawla’s 2019 article published on Medscape on the treatment of migraines without pharmaceuticals:

Trials of nonpharmacologic management have produced average reduction in migraines of 40%-50%, closely paralleling results obtained in trials of preventive drugs; however, the evidence base for nonpharmacologic and pharmacologic prevention remains limited. Biofeedback, cognitive-behavioral therapy, and relaxation therapy are frequently effective against migraine headaches and may be used adjunctively with pharmacologic treatments. Occipital nerve stimulators may be helpful in patients whose headaches are refractory to other forms of treatment. For more on nonpharmacologic treatment of migraine, read here.

Another study L. Nie et al. published 2019 showed that acupuncture, in combination with Chinese Medical Massage (or Tui Na), was effective at significantly reducing the attack frequency, severity of pain, duration of pain, and associated symptoms of migraine as compared to a control group. More info on that study here

Other studies, such as this one show that repeated acupuncture treatments may decrease the severity of headaches and migraines for months for chronic migraine sufferers.

Lots of opportunities exist for pharmaceutical-free treatment options. Talk to your healthcare provider, of feel free to give us a call to schedule a consultation if migraines are something that has plagued your life for far too long. It’s time to find some relief.

April Showers Bring Earth Day Flowers… and Allergies

by | Apr 18, 2019 | Acupuncture, General Wellness

April Showers Bring Earth Day Flowers… and Allergies

The month of April derives it’s name from thе Latin wоrd ‘aperit,’ meaning, “to open.” Aрrіl may therefore be thought of the month when things begin to open – tree’s leaves and flowers’ buds come out from their winter hiatus, and spring begins to bloom! It is fitting, thus, that April is the month wherein “Earth Day” lies. This year, on Monday, April 22nd, Earth Day will be celebrated around the globe for the 49th year since its inception in 1970.

The initial spark to honor our Earth and environment with a national day came to Earth Day founder Gaylord Nelson, a U.S. Senator from Wisconsin. After seeing the gruesome aftermath of the colossal 1969 Santa Barbara oil spill, the senator was inspired by the emerging anti-Vietnam-war movement in which thousands of college students were participating. He hoped to unite the activism of these passionate individuals towards a newly awakening consciousness about the environment and air and water pollution. By connecting activism and the environment, he aspired to drive environmental protection onto the national political agenda. The rest, as they say, became history.

The following excerpt is taken from the Earth Day Network ( www.earthday.org) –

On April 22,1970, 20 million Americans took to the streets, parks, and auditoriums to demonstrate for a healthy, sustainable environment in massive coast-to-coast rallies. Thousands of colleges and universities organized protests against the deterioration of the environment. Groups that had been fighting against oil spills, polluting factories and power plants, raw sewage, toxic dumps, pesticides, freeways, the loss of wilderness, and the extinction of wildlife suddenly realized they shared common values.

 

 

Earth Day 1970 achieved a rare political alignment, enlisting support from Republicans and Democrats, rich and poor, city slickers and farmers, tycoons and labor leaders. By the end of that year, the first Earth Day had led to the creation of the United States Environmental Protection Agency and the passage of the Clean Air, Clean Water, and Endangered Species Acts. “It was a gamble,” Gaylord recalled, “but it worked.”

As we approach Earth Day next week, consider your own impact on the environment, and how you might be able to decrease your carbon “footprint.” Ride your bike to work, or take a scooter. Carpool with friends, or in an Uber or Lyft. Pick up trash that you see on the side of the road or while walking through a park. Pick up after your pets. Eat seasonally, locally, and from restaurants that source their ingredients these ways. Turn off the water when you brush your teeth. Take shorter showers. Switch to sustainable, clean energy if at all possible. Avoid single use plastics such as plastic bottled water, plastic straws, and non-compostable plastic silverware. Set up a compost heap for food scraps somewhere on your property or see if your community already has one accessible such as in a community garden. Properly recycle plastic, paper, glass, or metal that you can’t refuse, reduce, or reuse!

Now that we’ve taken a moment to honor the planet, let’s think about what all those Earth flowers, along with pollens, grasses, weeds, and mold can do to our sensitive sinus systems. Many people suffer from seasonal allergies, and if you’re one of them you’re in good company! The pollen and mold count in Denver can multiply on a massive scale during the month of April due to rising temperatures. Allergic rhinitis generates more than 12 million doctor visits each year, with the majority of those visits being during the spring months! About 35 million Americans are allergic to pollen and mold spores. To make matters worse, climate change has created a more severe spring allergies environment, with earlier days of warmth extending “Ragweed Season” an additional 27 days each year in North America.

Acupuncture has had a long history of battling allergies. While sneezing, stuffy sinuses and itchy eyes typically drive patients to turn to antihistamines for relief, acupuncture also has a high track record of successfully combating these symptoms. Several studies, such as this one published in the Annals of Internal Medicine, reveal acupuncture’s potential power in providing alleviation of bothersome allergy symptoms. Regular treatments over the spring months may be able to not only reduce recurring symptoms, but also aid in reduction of the use of antihistamines and other allergy medications.

In addition to acupuncture, maintaining a ritual of balanced nutrition can help to alleviate the symptoms caused by allergies. If JUICING is your thing, you may really dig the allergy-combating recipe below:

Ingredients

  • 3 celery ribs
  • 1/2 cup pineapple
  • 1 green apple
  • 1 lemon, peeled
  • 1/4 cup fennel (chopped)

Celery juice can help combat H. pylori, streptococcus, mold, and more that may be lingering in your body’s digestive tract. Apples house an important flavenoid called quercitin, which can help reduce and control allergic inflammation. Pineapples contain bromelain, which can help speed the recovery of acute sinusitis. The bromelain has strong anti-inflammatory and immune-modulating effects, thus reducing allergic reactions and speed up recovery. Lemons aid in reducing mast cells from releasing excess histamines, which cause the immune system to be over-reactive to pollens and allergens in the environment. The selenium found in fennel stimulates the production of killer T-cells, which may improve the immune response (PLEASE NOTE – if you are not a fan of fennel’s subtle licorice flavor, you may want to substitute with parsley instead).

If allergies play a part of your spring season on a regular basis, consider mentioning it to your acupuncturist during your next clinic visit. We have both herbs and acupuncture treatment protocols to help bring you back to a place where you can stop suffering, and maybe even literally stop to smell the roses. 🌹🌹🌹

Traditional Chinese Medicine and the Treatment of Pain

by | Sep 5, 2018 | Acupuncture

Traditional Chinese Medicine and the Treatment of Pain

Traditional Chinese Medicine (TCM) treats a wide variety of ailments and disorders, but amongst the vast array of complaints TCM practitioners encounter, there is one that comes up perhaps more than any other… PAIN. Luckily for the patients who come in seeking relief from their bodily pain, TCM is one of the most effective methods of reducing and relieving pain symptoms without pharmaceuticals or opioids. In the wake of America’s opioid epidemic, the country’s leading medical facilities are recognizing a need for non-pharmacologic strategies able to be employed to decrease the public’s opioid dependence. Acupuncture has gained popularity as a powerful, evidence-based, safe, and cost-effective treatment modality able to meeting this need. Acupuncture and TCM are effective in the treatment of numerous types of pain conditions, including back pain, shoulder pain, knee pain, migraines and headaches, jaw pain, stomach aches, muscle strain, and plantar fasciitis. Furthermore, acupuncture’s cost-effectiveness can dramatically decrease health care expenditures, especially in a community setting.

Pain is a subjective, first-person experience. Each individual’s perception of and tolerance to pain differs, and each experience relies on several factors — how long has the individual been dealing with pain? What is the cause of the pain? What methods have been used to cope with the pain? And in what ways, if any, has the pain affected the individual’s quality of life? Sometimes pain can make sleep difficult, which can dramatically reduce the body’s abilities to tolerate pain. Sometimes a pain, that starts off as somewhat tolerable, persists for a long enough time, and causes enough constant grief for the individual, that the pain begins to affect the individual’s emotional health. Sometimes, the methods an individual utilizes in order to cope with the pain (pharmaceuticals, opioids, alcohol, over-eating, under-eating, etc.) can cause other problems that need to be addressed.

The treatment of pain in a TCM setting will analyze all aspects of an individual’s situation. We will examine the cause, the constitution, and the characteristics of the pain to create a thorough plan for alleviation, as well as best steps to prevent recurrence. Pain management treatments may include acupuncture, Chinese herbal medicine, Chinese Medical Massage, cupping therapy, electro-stimulation therapy or “e-stim” (the application of a pulsating electrical current to the acupuncture needles to further stimulate the acupuncture points), and/or GuaSha (skin scraping with massage tools to stimulate microcirculation of the soft tissue and increase blood flow). The combination of treatment modalities maximizes the ways in which the individual’s pain becomes manageable, if not reduced completely.