Happy Hour Hiatus

I have had numerous people ask me about the status of my Acupuncture Happy Hours that I was holding weekly on Wednesdays at Casa de Tree during the latter 6 months of 2009. I was going to resume in late February/early March of this year once the days became slightly longer, allowing for more light in the cafe which tended to have a darker mood lighting at night. Unfortunately, I found out that Casa de Tree has shut down operations as the owners are returning to Japan this year.

So for now, I'm sorry fans, my Acupuncture Happy Hour is going to be on indefinite hiatus until I can find a new location. Come back periodically to the Iyashi Wellness website for updates on this.

Good insurance news - for now

A moment of reprieve for Anthem Blue Cross insurance holders here in California. The State Insurance Commissioner has been able to secure a delay in the spike of premium increases until May 1st. This will allow outside health-insurance actuarial experts to investigate whether Anthem has violated any California law with its implementation of increases rates.

Let's hope the Commission can come to a long term agreement based on this analysis to minimize future insurance rate increases.

39% insurance premium increase

Several news agencies have written about premium increases being placed on policyholders of Anthem Blue Cross here in California. The purported increase can be as high as 39% for some holders, even with Blue Cross' parent company, Well Point, seeing profits soaring at $2.7 billion just in the last quarter of 2009. Nonetheless, the company is citing increases in health care costs as their reason for rate increases. (An ironic note made by my colleage Dr. Kevin McNamee: Even with all these profits, Blue Cross has paid the same out of network rates to healthcare providers since the 1990s.)

Unfortunately, there's not much we as insurance holders can do, because it was Congress who in the early 1990s allowed health insurance providers to become For Profit. So even though the Obama administration is looking into this, until Congress and the Senate require insurance providers to become not for profit, there's very little we policy holders can do about these insurance hikes.

I encourage you, especially if you are an Anthem Blue Cross member, to speak to your insurance broker to see if moving to a different insurance company would be a smarter choice. Also, speak to your Congressional representative and Senator to require insurance companies to become non-profit again. Power in numbers

Foods You Should Be Eating

There was recently a wonderful article in Well, a New York Times Healthblog. It talks about 11 foods people should be eating but most likely aren't. Luckily, all of the listed foods are easy to find at your local markets, and especially farmers markets.

Since the article already lists what the foods are good for and how to prepare it, I decided to do a twist on those foods from a Chinese Medicine perspective. So here it goes:

Beets: these pee-staining (and you know what I mean if you've eaten them!!) roots nourish the blood, strengthen the heart, calm the mind, lubricate the intestines and cleanse the liver. What does that mean? It's excellent for anemia, restlessness, constipation and for liver intoxification from drugs or alcohol. I like to eat it by boiling the beets in water until tender, peel skin and then eat as is with no seasoning. It comes out so sweet, you don't need any seasoning! I also like to cook the beet greens in a sauté, whether stir fried, or water fried with other hardy greens. Caution when consuming it raw. I one time drank a cup of raw beet juice with nothing else, and I immediately threw it up! Its detoxing abilities are so strong, you have to consume it mixed with other fruits and veggies juices.

Cabbage: it's excellent in clearing heat, lubricating the intestines and stopping cough. When we say clearing heat in Chinese Medicine, it means heat symptoms present in the body, from constipation (you're all dried up, right?), thirst, fever, acne (it's usually red like fire, right?), body odor (fetid food has smell, right? so if you're consuming heat-producing foods, you're more likely to have B.O. than not), hypertension, hot flashes, to anger (that's a form of emotion rising up onto the surface, exploding, like a volcano, right?), and so forth. I like to eat it by julienning it and then sprinkling a little bit of vinegar and salt to it. I then mix it really well until it become a little like pickles. In Japan, there was a craze for a while of the Cabbage Diet. All people ate was cabbage to help them lose weight because of it's high fiber content and aid in promoting bowel movements.

Swiss Chard: Like all dark green leafy vegetables, it has a cooling ability, so like the cabbage, and similar to spinach, it can clear heat. It also nourishes the blood. So it's excellent for anemia, blood disorders, constipation and detoxing. I like to water-fry it with a little bit of garlic and salt, or mix it into some quinoa with kale and salt. Simple but delicious!

Cinnamon: Cinnamon, or rou gui, is used extensively as a medicinal herb in Chinese herbology. It is a warming herb, so we use it for conditions like the common cold, abdominal pain that gets better if you put warmth to it, PMS cramping and low back pain. Think about it, when do you usually use cinnamon in your cooking? During the Fall and Winter right, for that yummy pumpkin pie, in soups, in hot cocoa or hot coffee. Why? Because it's warming, and for Americans, it reminds them of feeling all cozy on a cold winter day. I like to throw a whole cinnamon twig into the boiling water that I use to prepare steel cut oatmeal. Not only does it make it fragrant, but it sure adds that punch of core-warming heat to my oatmeal. For PMS cramping or stomach pain, drink cinnamon tea.

Pomegranate Juice: pomegranates promote urination, reduce inflammation (especially of the throat, mouth and urinary tract), and is mildly nourishing to the blood. It's good for urinary tract infections, like cranberry juice, because its sour and cooling, and like aforementioned, promotes urination and reduces inflammation in the urinary tract. I like to drink pomegranate juice, but like with any fruit juices, because of its high sugar content, I usually dilute it with water. It's best, like with any juices, to eat the real fruit, so if you can find it in your market, buy the real fruit. It's time consuming to get to the seeds, but well worth the effort. Just be careful staining your clothes.

Dried Plums: ok, I don't eat dried fruits, again, because like fruit juices, they are high in sugar content. So if I'm going to eat dried plums, I'm going to choose the real fruit. They are the yummiest during the summer. It's excellent at supporting the healthy functioning of the liver, and helps to keep the qi ("energy source" in Chinese medicine) flowing smoothly throughout your body. Some expressions of stuck qi is irritability, moodiness, PMS, easy to anger, and menstrual problems. Plums are also a digestive aid and relieves thirst.

Pumpkin seeds: it's an anti-parasitic and diuretic, so it's excellent for intestinal worms, diabetes and prostate problems. The raw seeds are excellent at calming nausea and bloatingduring pregnancy.

Sardines: like with fruit juices and dried fruit, I like my fish fresh. In Japan, we eat sardines all the time, broiled. Because it can be quite bitter, we like to eat it with some grated daikon and soy sauce to cut the bitterness. Sardines are wonderful qi tonics and yin tonics. What is yin?, you might ask. It encompasses the notion of body fluids, cooling energy, female energy, night, sleep, calmness and so forth (as opposed to yang energy, which is aggressive, explosive, muscles, male energy, and day). It also nourishes the tendons and bones. So sardines are great for menopause, thirst, bone fractures, osteoporosis, tendonitis.

Tumeric: like cinnamon, this is an herb we use extensively in Chinese herbology. Known as jiang huang, we primarily use it for menstrual disorders like amenorrhea, dysmenorrhea, cramps, and for arthritic conditions.

Frozen Blueberries: ok, frozen fruits and vegetables are my exceptions. I do keep frozen blueberries in my freezer to use in my smoothies or oatmeal -- if I can't get access to fresh ones, or if it's not summer. Blueberries nourish the blood and tonify the qi, so it's good for anemic conditions, amenorrhea, and fatigue. Like with cranberries, it also aids in relieving urinary tract infections. I love to eat fresh, sweet blueberries also with some home-made whipped cream! Mmmm!

If you want to learn more about food from a Chinese Medicine perspective, a wonderful book to own is called The Tao of Nutrition by Maoshing Ni and Cathy McNease. Much of the information in this particular post came from this book.

And one last thing I'd like to say about eating these and other foods is to choose organic, locally grown foods as much as possible.

Enjoy healthy eating!!

Overuse of CT scans will lead to new cancer deaths, a study shows -- latimes.com

I just read this article in the Los Angeles Times and wanted to share with my readers.

Overuse of CT scans will lead to new cancer deaths, a study shows -- latimes.com

The overuse of CT scans, like the overprescription of antibiotics, is I believe emblematic of a medical system that is under increasing pressure to perform, and perform fast and effectively, with less and less infrastructure to support the healthcare providers to provide the best care to their patients. HMOs are requiring doctors to see more and more patients an hour, cutting down the quality time both doctors and patients want to give and receive. Patients want results right away. Doctors want results right away. Insurance companies want patients in and out of hospitals as quickly as possible yet be making lucrative money.

It is also the scare - the fear - that patients have. As the article says, many patients get the CT scans, even if they seem perfectly healthy, because they are afraid of some lurking tumor or disease in them. And it really is the irony that by exposing themselves to these unnecessary levels of radiation that may ultimate cause the cancer they were hoping to prevent.

While our healthcare system is currently going through major upheavals, the one thing patients have in their control is to be completely aware and educated about every test and procedure that are going to be done to them and for what reason. If it's invasive, find possible less invasive or non-invasive alternatives. I believe the more educated, empowered and in control patients are of their health and healthcare, the better they can prevent diseases, and should they need to receive medical services, that it would allow them optimal, effective healthcare.

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My experience in the Dominican Republic - 4

(To read Parts 1, 2, and 3 of this trip, click here)

Day 6 - YASICA

This location was the farthest we would go from our hotel, about a 50 minute ride up into the mountains, passing Camú. As became the case in every location we visited, I saw mostly adults and senior citizens, but because our mission today was inside a school, I had more school-aged children and teenagers. It was great, they all came in still with their uniforms during what I imagine was their class times.

(Simon, John the photographer and Tomoko, prepared to face the rain to walk back to the school after our lunch break.) This was also the very first day that we had rain while in DR. And rain it rained! As the day progressed, the clouds started to take cover, and all of a sudden, around 1pm, we started getting pouring thunderous rain. It rained for a good hour or so. It then stopped completely. Typical tropical storm, I was told. Later in the evening, it started to rain again, and the rain came down pouring by the time we arrived to the hotel.

We got to enjoy fresh sugar cane! Delicioso!

Dusk before the next thunderstorm

By the way, acupuncture is not known in Puerto Plata, the third largest city in DR, so it was the first time for every patient to get acupuncture from me. (Acupuncture is known in other parts of DR. For example, in Santiago, the second largest city in DR, and from where Omar and Mirla the sibling assistants are from, acupuncture is very well known.) Even though they had never had acup. before, most Dominicans who were complaining of some sort of pain in their body (headache, back ache, knee pain, shoulder pain, etc), colds, allergies, fatigue, high blood pressure, anemia, and/or diabetes readily agreed to be treated by me.

The wise and experienced crewmember, Jae, who was our traffic controller of patients within the medical dept, always directed any patient whose registration form indicated any of the aforementioned conditions and complaints. Sure, some patients were afraid and nervous, asking the ubiquitous question, “Do the needles hurt?,” but for the most part, most patients just let me treat them without any questions. There were surprisingly very few people who flat out rejected my treatments. Once they started feeling their pains going away with my treatment, they were impressed and quietly sat in their chairs for about 20 minutes. Not that it was quiet. There was always a long line of people as well as children and infants waiting inside and outside to be treated by us three doctors, and curious people just watching, so there was always a lot of chaos and noise and people milling around. Jae and the other aides were always trying to keep order and some semblance of peace in our stations.

Because I know my students and fellow acupuncturists are reading this, I want to write a little more on the clinical aspect of what I saw. So I will write this part primarily addressed to this group, making the following few paragraphs layreader-unfriendly. I apologize in advance.

As I wrote earlier, the bulk of the conditions I treated were fatigue, pain, allergies, colds, anemia, diabetes, and high blood pressure. From a TCM perspective, there was a lot of Bi syndrome, Spleen Qi xu + Damp, and Qi and Blood xu conditions.

Of the hundreds and hundreds of patients that I saw, I can literally count, in my fingers, maybe 4 or 5 patients who had wiry, forceful, strong pulses. Most of the patients had slippery but thin, feeble, weak, deep pulses. Some rapid, but mostly not. This was a big difference from many of the patients I treat privately. Most of my private patients have excess pulses, often wiry or surging and rapid. The majority of the tongues I observed in DR were wide, flabby, scalloped, pale with slight or significant yellow coating. Very few thin, red, yin xu tongues or dusky or red stagnation/excess heat tongues. Physically, most were overweight, though there was a fare share of healthy weight individuals. (There was one young, slender mother who came in complaining of how she had no appetite. She looked at me and said “See, look how skinny I am!” in a complaining tone. If you saw this same woman here in Los Angeles, everyone would be envious of how skinny she was! Hearing her complaint was such a refreshing change!)

So, without being able to do a full intake or even a 15-minute consultation which is the minimum I’d do with my private first-consult patients, based just on the tongue and pulse, I can say from this experience that the majority of underprivileged Dominicans I treated suffer from deficient conditions most likely due to their suboptimal diet. Weather plays a key role here as well, with constant hot tropical weather (i.e. high humidity/rain fall) engendering mass damp-bi conditions.

In terms of needling, I used no more than 10 needles, making it easy to track how many I was using per patient. I combined primarily the 5 transporting points, Master Tung points, and ear points. If I was treating only pain, I often needed only 2 or 3 points, and to that I might have added couple supporting points to address the root of the problem, but often times just those 2 or 3 points were all that was needed to significantly reduce the pain or resolve it all together. It was fascinating to watch how quickly the treatments took effect.

Day 7 - CANTABRIA

What with all that work, heat, and sweating, it finally all got to me. By Day 7, I was so exhausted, I could barely eat breakfast nor sit up. My back was starting to give out. I knew if I didn’t rest that morning, I wouldn’t be able to make it on the flight the next morning to Los Angeles, so I decided to rest-in that morning. I felt guilty letting my teammates down, but I’m glad I did so nonetheless. I slept an extra couple hours and that helped tremendously, b/c by the time the crew came back to eat lunch at the hotel, I was feeling a lot better, ate lunch with them, and joined them in the afternoon medical mission. But acupuncture was not to be given.

It turned out that the location did not have enough space for me to set up my acupuncture station, so I ended up helping to translate for Dr. Karen, as she spoke no Spanish. It worked to my advantage, as I was able to stay seated the whole afternoon, which helped to prevent my back from getting worse. If I had to do my acupuncture treatments, there would’ve been a lot of sitting, getting up, bending over and moving from patient to patient, which would’ve definitely regressed my weak back to a worse state.

My vantage point as I helped Dr. Karen with translation

OK taking a breather from her pharmacist duties

Dr. Tomoko palpating a patient

This community was different from the other 4 communities we treated in that there was a significant number of Haitians residing there. Because of the dire economic state in Haiti, many Haitians emigrate next door to DR to try and eek out a living. Their native language is Creole and French. As a result, often through the consultation that day, we'd have a Haitian translator who spoke Creole and Spanish who would translate for the Creole-only speaking Haitian, and then I'd translate the Spanish to English for Dr. Karen. Three languages going on at one time was fascinating to watch.

I heard from Omar and Mirla that there is a lot of discrimination from Dominicans against Haitians, but in this community, from what I could observe, people seemed to coexist respectfully and harmoniously.

In addition to the usual ministry work and handing out of photographs, we finished our last mission that night by providing free sandwiches and drinks to all the community members. We hired a local lady to make the sandwiches and punch. She made over 300 sandwiches and they went fast!

DAY 8 - LAST DAY

On our last day, we had the morning off, so couple of us crew members went to the beach to read, swim and relax. It was a beautiful morning. After finishing lunch, we convened with all of our luggage at the hotel lobby, and like when we came 8 days ago, Pastor Aaron and Omar helped put all of the luggage back on our Little Truck That Could and took us back to the airport. As happy as I was to go back home because I was exhausted, I definitely got wistful realizing that this intense experience and the resulting comraderie that came about with everyone was slowly coming to an end.

The beautiful beach the morning of our departure

The Little Truck That Could. We were always packed to the rim wherever we travelled in this truck.

Dr. Lee goofing off, "I'll be back!" a la Terminator

The local crew members

I met really nice local people, young men and women willing to help and always ready with a smile. Dominicans are very hard working. They are also a deeply religious people, and like in most latin countries, their faith keeps them going through all obstacles. It was inspiring to watch this, realizing they have so much less than most of us (at least the majority who's reading my blog), and yet they keep their chin up, smile and don't complain much. When one has less, one really doesn't take things for granted.

I am really happy I was able to experience this. I made new friends both in the DR and with the Korean church crew. Having experienced what I experienced, I'd like to begin volunteering my services in Los Angeles helping the underserved community. Now that I know I can see 100 patients a day and know how to set up the logistics, it’s easy peasy Japanesey! ☺ Instead of going far and getting exhausted from an intense mission trip, I can just look in my backyard and help people in need.

I’d like to give a special shout out here to Torrance First Presbyterian Church for organizing and funding this mission, as well as to K.S. Choi (GoAcuzone.com) for providing the acupuncture supplies at a discount to the mission. I know there were also several people at the church who did all the behind-the-scenes planning that made this mission possible. I’d also like to thank Pastor Aaron, Omar and Mirla for taking such good care of us and working so hard to bring basic medical and dental care to hundreds of needy Dominicans. I'd like to give another special shout out to Laraine Crampton, L.Ac., for being such an invaluable resource and help in preparing me for the trip. And lastly, I’d like to thank the 10 crew members for letting me come on board this mission and giving me the opportunity of a lifetime.

Our "official" portrait

My experience in the Dominican Republic - 3

(To read Part 1 & 2 of this journey, click here.)

Day 4 - CAMU

On this day, we visited Camú, an area inland, with small houses dotted along a single mountainous road. It was about a 30-minute ride from the hotel. Like in Playa Oeste, initially there were very few people waiting, but within 20 minutes or so, there was a crowd of people eagerly waiting to receive free medical care from us.

We all quickly went about setting up our designated stations. Having devised a new set-up for the acupuncture station, I was armed and ready to treat another 100 patients today! My station was the first to be set up, as would always be the case the rest of the week -- in about 10 minutes -- because all I needed were a few chairs, a table, my needles, sharps container, alcohol swabs and cotton. General medicine - and our newcomers, the Dental team - would take about 30 minutes because of the slew of drugs (for the pharmacy) and tools and equipment required (for dentistry). The paraphanelia required to do dental work was mind boggling. Thank goodness these two departments had extra local assistants helping.

In terms of doing acupuncture, I can now see why acupuncturists were called Barefoot Doctors in China and why this medicine grew out of China, a country with a population of well over 1 billion. Once armed with the proper training, all an acupuncturist fundamentally needs are needles. (Plus of course the sharps container, cotton, and alcohol swabs for safety and sanitary reason.) Just with needles, we can effectively treat a multitude of people and conditions. Imagine had I brought my other tools found in Traditional Chinese Medicine, such as moxa, cups, e-stim, and herbs, the greater degree of relief I could've provided the Dominicans!

The acupuncture station before the chaos

Dental tools

Local assistants Stephanie, Amelfi, and two Korean national assistants, Penelope and Eunju

Other scenes from Camú:

Tragedy had befallen this woman, and our staff was praying for her.

(This little girl was so cute. All through this consultation, she sat on her mother's? grandmother's? lap, quietly, sucking her pacifier, intently watching every move that Dr. Tomoko made.)

(This little boy was also adorable. While his mother got treated with acupuncture, the boy sat quietly the whole time next to his sister, and was constantly mindful of having his hand on his mother's body. He would get distracted by all the commotion, and then realize that his hand wasn't touching his mother, and would quickly go back to touching her belly or arm, or somewhere, as long as he was touching his mother.)

I don’t know which was more tiring – the huge numbers of people I was treating, or the heat and humidity without any air-conditioning. I had constant trickles of sweat dripping down my face, neck and back every day. I was basically bathing myself in my own sweat every day. By the second day of doing these intense medical missions, I got a heat rash on my abdomen. It was so darn hot and humid!! (But I came back with beautiful, supple skin from all that moisture! LOL!) Mirla and the other aides had to frequently change the wet, cold towel around my neck to try and keep me cool.

I couldn't live without these towels!

Day 5 - LOS RIELES DE SAN MARCOS

This was another location about 20 minutes from the hotel. We conducted our work inside a local church. Acupuncture was stationed up by what I suppose was the altar as it was elevated from the rest. Boy was it hot in there. We had fans going, but it was just blowing the hot air over and over. At one point, the electricity went dead because so much electricity was being used by the dental department, haircutting department, fans and printer. Thank goodness for our reliable generator, which allowed Dr. Lee the dentist to keep working!

Scenes from San Marcos:

That's the acupuncture station, in the back. Dentistry to the left, and general medicine to the right.

I think the recirculating hot, humid air plus being elevated from others (making the air even hotter) got to me that day because I started to get dizzy part way through my morning stint. I had to stop about 2 hours into it. I had to step outside and rest in our little truck for a while until I could feel normal again. After a good lunch, I was thankfully back to working.

Patients resting as they got their acupuncture treatment.

This family (the girl on the left was a friend) was so adorable. The mother was very shy and soft spoken but very sweet and loving to her daughters. The children were very well behaved all throughout the day. Later in the evening, while Christian work was going on, the little girl in the light blue dress was meandering around the crowd and came upon Assistant Eunju and I. When we asked her for a kiss, she readily and without hesitation came up to us and planted both of us a cute, sweet kiss on our cheeks!! I just melted there! All the hard work was so worth this little kiss :-)

Pharmacy busily dispensing medication

Dr Karen trying to cool off

These boys were great, always eager to talk to us in their limited English. They came up to me to say hello in English, and introduced themselves. I introduced myself, but realized one English etiquette was missing in our dialogue: I taught them to say "Nice to meet you" which is "un placer conocerte" in Spanish. When they learned what "nice to meet you" meant, they scurried back to the other English staff they had introduced themselves to earlier and finished their introductions properly. Later in the evening, couple of the boys came back to ask me again how to say "un placer conocerte" in English. When we were leaving for the night, the boy in the black pants came by our truck and thanked me in Spanish for the English lesson and our work. Again, all the hard work was so worth it with these kinds of exchanges.

Doc, how does my new teeth look?

Children doing song and dance along to the Christian missionary work

This day was also John the photographer's birthday. We were able to celebrate with cake and serenading. Fun times.

The last of these chronicles coming real soon...