When I was in graduate school, we spent a couple of TCM (Traditional Chinese Medicine) Theory classes learning about body/mind imbalances that are often influenced by the “energetics” of a particular season. I distinctly remember approaching this section of class with careful skepticism; the information seemed too dependent on folk medicine, a term that I was still trying to understand. The concept of folk medicine piqued my interest, but also filled my brain with questions.
At that point, I was still struggling to figure out my approach to medicine. In my earliest years of graduate school, I was hell-bent on a particular way of understanding the body. I’d been raised in a culture in which Western biomedicine and the scientific method reigned supreme. Everything about TCM, Daoism, and the concept of “slow medicine” (similar to the Slow Food movement) called strongly to me, yet all the information I learned was critiqued, quietly but obsessively.
Much of the information I absorbed in my early grad school years was relegated to what I considered the gray area. I’d carefully process the information, then place it in storage. In the future, I told myself, I’d incorporate this information into my practice only if it could be proven useful. My internship in the clinic would answer some questions, I believed. In the meantime, I’d focus heavily on the parts of TCM that seemed less abstract and more practical – like learning how to stop a headache in its tracks with accurate point location and correct needle technique.
Spring Weather and Your Health: Headaches, Insomnia, and Tempers, Oh My!
Fast forward a decade. I’ve been an acupuncturist in a community clinic for 5 years, and I’ve seen/needled over 10,000 people. I feel confident saying that if there are any “patterns” that show up in the health of my patient population that seem connected to seasonal changes – well, I’m in a good position to notice them!
And I’m only ever-so-slightly embarrassed to report that there is some serious legitimacy to this “folk medicine” that I learned in school (I say this knowing that it drips with the irony and presumptuousness of my younger years in school…in other words, I’ve been SPANKED by TCM, about a zillion times by now!). Actually, the term “folk medicine” deserves its own lengthy blog post.
Nevertheless, seasonal changes can/probably do affect the health of my patients, as well as my own. That being said, for most of us, Spring is the absolute worst!
The worst? Well, the worst in that this season is related to the wood element, and the liver. It’s the season of sudden, extreme shifts. You know, like spring weather…
So what are the common complaints that we see worsen (or arrive) in the spring? Insomnia, neck and shoulder pain, migraines/headaches, skin issues, anxiety, and irritability. If you already deal with one of these health issues – does it get worse in the spring?
I’d get into more detail, but a couple of people have already expertly written about this season and its accompanying health imbalances. They’ve also written about what to do about them!
I recently had a root canal and though it wasn’t painful, the experience absolutely sucked. I left the endodontist’s office two and a half hours later, $1300 less in my savings, feeling pretty dang defeated. After all was said and done, my debit card swiped by an ill-tempered front desk person, I sat in my 90 degree car and took a fit (cried). This was the 6th dental appointment that I’d had in 2 months for the same problematic tooth. Three nights previous to the root canal I dreamed that my teeth were falling out, one at a time. They looked like giant pieces of white coral. I’m used to experiencing dreams as tightly bundled metaphors; this was uncomfortably literal.
WHAT is going on with my teeth?
I asked my dentist and my endodontist this exact question.
“I’m so anal about my teeth!” I reported. “I brush and floss twice a day, sometimes three. Aside from a single cup of coffee in the morning, I drink water throughout the day. So why this dying tooth? Why the increase in cavities? Do you think that it could be related to changes in my diet?”
Though I asked these questions separately of my dentist and my endodontist, they had the same reaction: a shrug followed by silence. Though I might be wrong, I understood this body language to mean: Don’t know, don’t care, probably not. The only feedback I’d received from my dentist up to that point was that he attributed the problem to the location of the tooth and a history of grinding. But when I asked about the other two cavities that had been discovered, and wondered aloud why suddenly there was such an influx of problems in my pie hole, and mentioned again my regimented (read:anal) care of my teeth, and asked one more time about the potential role of nutrition since that was the only thing that had really changed for me, he shrugged again.
He didn’t even bother to answer why hedidn’t think nutrition could play a role.
I couldn’t help but be momentarily overcome by self-doubt. Perhaps I’m so grossly uninformed about dental health that I am coming off as a giant idiot? Maybe questions are annoying? Maybe I’m annoying for asking questions? (I answered my own questions quickly: No. No. No.)
I was told by my dentist that a root canal was the only option left, so I set up an appointment with the endodontist that he recommended. For whatever reason, extracting the tooth wasn’t mentioned. Three weeks later, I went in for the procedure. The first step was an x-ray of my tooth so the endodontist could examine the root. As soon as the image popped up on the screen, the assistant asked a question.
“Why are we giving her a root canal? Her tooth looks perfectly healthy.”
The endodontist cleared her throat and answered, irked, “I’m the doctor; you’re the assistant.” She then turned to me, rolled her eyes, and said “You’re getting a root canal because all the other signs point to a root canal.”
This exchange, as you can imagine, instilled a surge of confidence.
“Ohhhhh,crap!” I thought, and though my anxiety swelled and threatened to invade my body with a sickening heat, I stopped it in its tracks. I wasn’t the expert. Neither was the assistant. The endodontist had spent many years of her life studying how to care for teeth. Root canals are her thing! my rational brain exclaimed.
So, I opened my mouth, a meek pup, and 150 minutes later I was released to the wild. The endodontist and her assistant talked about many things while the insides of my tooth were filled with Gutta-percha – basically, the assistant asked decent questions and the doctor scolded her for being silly. Not my cup of tea, and 150 minutes of this was a bit much, but c’est la vie. Honestly, I just wanted to be able to chew food on the left side of my mouth again.
Before leaving the office, I asked my endodontist for her opinion about my tooth. I explained to her about my diligent care of my teeth, and told her that my dentist said that maybe the damage was due to the location of the tooth. I asked if she thought that diet could be a possible factor.
She shrugged and said nothing.
Then she turned around and went into another room, where she immediately started bickering with her dental assistant.
As soon as I was in my car, I began to cry out of pure frustration. $1300 was a big chunk of change for dental work, especially in addition to the $150 I’d spent first trying to fill it like a regular old cavity. And the whole damn experience would have been 70 percent less frustrating if those on the receiving end of my cheddah’ could have taken the time to talk to me. Taken a single minute to answer a single question.
Anyway, back to the pitiful sobbing. Two boogery minutes later, my inner warrior-pirate lifted my chin and said, Get it together, Lauren. Go home. Do some research. SAVE THE MOUTH OF THE WORLD, LAUREN!!!!
Once I got home, I sipped at a tall glass of water with my fat-lipped, half-numbed face and for the next 3 hours (which turned into the next month), I researched the subject of all-things-teeth.
Before I share what I found, here’s a bit of history. At age 36, I’ve had a total of 4 cavities (not counting the recent proliferation of problems with ma’ pearls). Since I’ve lived in various places, I’ve seen a handful of dentists and my experiences have been mostly consistent. Any time I’ve had to have a cavity filled, I’ve started the appointment with a request for information: What can I do – other than brush and floss – to keep my teeth healthy? With the exception of a recent Facebook exchange with a friend who’s a dentist, I’ve received little to no feedback or instruction. For instance, I did not know that you probably shouldn’t brush right after eating, especially if you’ve just eaten or sipped something acidic.
Historically, after a dental procedure, my tongue darting across some newly polished teeth or poking at a newly filled tooth, I’ve been reminded (as my debit card is being swiped) that dental insurance is inadequate. More than once, the priced-out sheet of what the dentist did that day and how much won’t be covered has made me cringe. Then my brain starts churning out concerns: What about people without insurance? What about the single moms, the students, the elderly, the working class, the kids, the poor? If regular cleanings are one of the most proactive things you can do to protect your teeth (get rid of that plaque!), and if any work done on your teeth quickly consumes your coverage, and if many people don’t even have the millimeter of padding that dental insurance affords, and if paying out-of-pocket is too expensive for many, and if the majority of dentists don’t accept Medicaid, then…well, we have an obvious problem.
“Lauren, that’s why the poor are associated with bad teeth,” my sister calmly explained. “And that’s why they show up to the ER with an abscessed tooth and leave with a prescription pain killer.”
Which is how an article titled “How to Avoid a Root Canal” turned into this post. (Yes, I do have practical suggestions in regards to dental care in the next posts; see here and here.)
But many people, and not just the poor, are unable to get the basic treatment they need. About 130 million Americans lack dental coverage, and the rest aren’t off the hook. Dental insurance rarely covers the full cost of treatment: In 2011, $39.2 billion—46 percent—of the $85.2 billion spent on dental care came directly out of patients’ pockets. Dentistry is expensive enough that many people postpone procedures they urgently need—even though an abscessed tooth is excruciatingly painful and potentially deadly if infection spreads to the bloodstream.Disrupting Dentistry, by June Thomas
According to The United States Department of Labor Occupation Employment Statistics, the annual mean wage of the general dentist is $166,810. Dental school is expensive (in 2013, dental school graduates had an average of $215,000 in educational debt), and most new dentists feel they have to embrace the for-profit model to pay back these loans. Because of this, many dentists end up serving a very specific population. As for dental “insurance?” Here’s some food for thought: In 1972, Delta Dental offered a maximum yearly benefit of $1,000, which bought a decent amount of dental care. Today, the average cap on dental plans is … $1,000. In over 40 years, the benefit has not gone up.
So, what exactly is going on here? Below is another except from a great article I came across in my maniacal consumption of all things dentistry. I’d highly recommend reading it if you’re interested in the complexity of the problem, including the problem that the dentists themselves have to face. One of the solutions suggested to confront the issue of accessibility is (somewhat) similar to…the community acupuncture model. Go figure!
When you hear how rare it is for private practice dentists to take on Medicaid patients, it’s easy to conclude that they’re selfish snobs prioritizing profit over the needs of poor kids. But it’s not that simple. There’s no question that Medicaid pays less than market rates, and as small-business owners, dentists can’t ignore financial considerations. Anyone with a limited number of billable hours each week would be sensible to fill them with the best-paying clients.
Dentists also have other reasons to be selective about the patients they serve. For people in good oral health, dentistry is an aesthetic pursuit. These people’s twice-yearly appointments typically consist of a cleaning by the hygienist and a thumbs-up from the dentist. Some dentists may prefer these quick and easy cleanings, with occasional elective procedures such as whitenings, over the complicated business of managing serious tooth decay and gum disease, which are more common among poor patients who may have missed out on good care as children. A dentist’s office has a lot in common with a fancy department store: The more expensive the clothes, the fancier the changing room, the more solicitous the saleswoman. Similarly, the higher a dentist’s fees, the more exclusive the waiting room. That’s why those dentists who do treat Medicaid patients often set aside a day just for them—it’s better for business to keep the two groups separate. –Disrupting Dentistry, by June Thomas
Before we move into the next blog post where I share my ideas on how we may practice preventative dental health through diet and other little tricks of the trade, below are a couple of resources, for those of you who might have found yourself stuck between a rock and a bad tooth. We have a serious dental crisis in Maine. Read about it here and here.
And please understand that my personal experiences around getting my tooth fixed are not representative of all visits to the dentist. When I started sharing my stories of dental woes, many, many people were happy to share the names of the dentists that they loved.
Though my tooth isn’t giving me acute pain any more, it’s still not resolved. I still can’t chew on that side of my mouth, and to complete the fix, it needs a crown – another $1300 out of pocket. It’s recommended that you get the tooth crowned ASAP in order to prevent complications, but many people have to wait for their insurance to ‘refill’ to complete the fix. Many never get it done because they simply can’t afford it.
If you’ve read Got Anxiety? and now you’re here – thanks for reading. Now let’s get visceral and talk about the ways in which anxiety can manifest from a purely symptomatic standpoint. The first thing to know is that anxiety is protean by nature – in other words, the subjective experience of anxiety can change quickly, and the symptoms can disappear as quickly as they arrived. Some describe their anxiety as a “hamster wheel thinking” or being “stuck in the brain” while others describe it as a Pu-pu platter of more physical symptoms that can include increased heart rate, tense muscles, shallow breathing, nausea, stomachache, headache, crab rangoon, beef teriyaki, and fried wontons. (What?! I said Pu-pu platter!)
Anxiety also varies in intensity. Some people have low-grade anxiety that they live with day to day, and some feel relatively fine until they experience what they call a panic attack. No matter how you define anxiety, the one thing that holds true is that no matter how it feels, anxiety sucks. It’s a state of being in which calmness and peace feel like they are hiding in a cave, 3000 miles from where you live, surrounded by thistle. Which, needless to say, yet worth saying – totally blows.
Anxiety According to Traditional Chinese Medicine
Anxiety, from a TCM perspective, always involves the Heart and the Shen. The word “Shen” is a keyword in TCM. It indicates the activity of thinking, consciousness, insight, emotional life, and memory. In English, the closest word to Shen would be “mind.” When someone comes into the clinic looking bright-eyed and bushy tailed (and is not a squirrel), I might say “Hey, Clyde, your Shen looks bright today!” In other words, Clyde seems like his mind is free and clear, and it manifests on his face, especially in the clarity in his eyes.
In TCM, it’s also acknowledged that anxiety can come from both a known cause (i.e. PTSD in a veteran or a survivor of abuse) or an unknown cause (I feel like a chandelier is going to drop on my head and kill me even though there is no chandelier in sight), and is usually aggravated by tiredness and/or general stress. The cool thing about the way TCM treats anxiety is that it always looks for a differential diagnosis. In other words, we know that anxiety looks different according to the individual, and it’s protean nature is acknowledged within TCM.
The kind of anxiety that you are experiencing is an important differentiation in TCM
The following are some basic examples of ‘types’ of anxiety, as well as their ‘energetic’ origins.
1.Heat: Agitation, restlessness, feelings of desperation, rapid movement and speech, red face, heat sensations, panic that moves in an upward direction. What it actually feels like: Some dudebag just threw kerosene on the already big bonfire that is my collective worries and now I’m off to the anxiety races – insert flaring of thoughts/obsessions/worries and occasionally, a panic attack.
2. Qi Deficiency: Preoccupation/rumination, obsessive worry, palpitations, insomnia, fatigue, poor appetite, all of things worse when tired. What it actually feels like: I am so tired. Life is too much. How can I handle this? How can I handle this? How can I handle this? I just need to sleep? I’m not sleeping. I’m not sleeping. I’m not sleeping.
3. Stagnant Qi: Feeling stuck on a thought, irritability and depression, moodiness, muscular tension, GI issues (constipation/loose stool), sensation of fullness or discomfort in heart and stomach. What it actually feels like: I want to crawl out of my skin or hop on a train to some tiny village in Mexico and never look back and I’m angry because I can’t do this and worried because I’m so angry and if I don’t go for a run tomorrow I might literally implode. And why is my neighbor blasting country music at 10pm? You know what I’m going to do – I will run him over when I leave for work tomorrow and I’ll never have to hear his stupid music again. Rahhhh!!!
4. Blood Deficiency: Insomnia, palpitations, fatigue, dizziness, poor memory, feelings of vulnerability and being overwhelmed by life. What it actually feels like: My brain is fuzzy, I need to sleep, there is just too much to do, why are people so mean, is a giant shoe going to drop down from the sky and squash me like a bug?
5. Yin Deficiency: Preoccupation/rumination, tired but restless, insomnia with sensations of heat, occasional night sweats. What it actually feels like: My kids are crazy, my partner is crazy, I’m crazy, when will I get a moment to myself, oh crap, I forgot to pay the electric bill, I need a glass of wine, oh crap, here comes a hot flash, I need to sleep, I’ll never sleep, the car needs an oil change, my parents are getting old, I need 2 glasses of wine.
A couple of years ago, if someone were to ask me to name the most common complaint that I treated in private practice, I’d have told them that fatigue and back pain were the two things that I saw most often. Then I’d begin preparing myself to field the question that naturally ensued (“So, does acupuncture actually work?”)
At the time, the majority of the patients I treated were insured, middle-income women and men between the ages of 40-70. Most of them had multiple children and were living the typical American lifestyle – they worked hard, played hard, slept little – and the insidious cultural expectation to be a smiling, agreeable Superperson despite their lifestyle had left many of them with a crappy back and some serious fatigue.
But I’ve since changed my answer. Now that I work in the community acupuncture clinic, where 100-150 people from diverse socioeconomic backgrounds come through our doors every week, an assessment of what plagues the average person was bound to be more accurate, and holy mother of Bob, a definite pattern emerged in regards to what people are looking to heal.
Anxiety, hands down, is the most common complaint that I see in the clinic.
Ya’ got some?
When I first noticed that anxiety was spreading through my chart notes like kudzu, I wrongly assumed that it was mostly women who were experiencing it, since they were the ones to actually state aloud that they were seeking help to deal with it. However, upon closer inspection, I quickly realized that almost everyone, regardless of sex, was checking off “anxiety” and “feeling overwhelmed by life” on our intake form. This was perhaps one of the biggest aha! moments I’ve had since working as an acupuncturist. It was also a moment of great connection for me – I thought, WHOA NELLY, everyone has anxiety! It made me feel connected, in a slightly sweet but uncomfortable way, to know that at times, we are all vibrating at the same frenetic frequency.
So – within the past year, I’ve become highly interested (a.k.a. obsessed) with learning more about anxiety. If anxiety is a problem that plagues my patients (and at times, myself), then I want to treat it to the best of my ability.
When I started looking more closely into ways to treat anxiety, I found that there were lots of people talking about it (on the web, at least, where you can remain anonymous). In person, most people don’t like to say that they have anxiety – especially men – since many fall prey to the inane expectation to act tough, yo. The conversations I found on the web were both revealing and problematic – the exchanges were mostly concerned with identifying the symptoms of anxiety, as opposed to how to deal with it. It seemed that individuals were relieved to find out that there are other individuals out there in the world experiencing the same awful physical/mental symptoms – connection was instantly made over the sentiment of “Ohhhhh, yeah! I feel sh*tty in those ways, too!”
In short, what I discovered was this – people were happy to find that they were not the only ones out there who suddenly FEEL LIKE THEY ARE DYING. Dialogue about panic attacks was rampant in the anxiety forums.
I was glad to see connection happening. Even if people were breaking bread over how they suffered, at least they were breaking bread. What was disheartening was the second phenomenon I ran into, which could be summarized like this: Are you experiencing these uncomfortable symptoms (insert long list of everything from heart palpitations to irrational catastrophic thinking to extreme nausea and dizziness)? You are? Well then, you’ve tested high for anxiety. You also may have a panic disorder – contact your physician or a licensed therapist.
Okay. Contact your physician and then what? Get some pills? (Note: I am not anti-anxiolytic, but many people I meet don’t want to start taking a medication for an issue they barely understand themselves). And what about those people without health insurance? Or those with insanely high deductibles who only have catastrophic coverage? Or those single moms with 3 kids and a full-time job and not a flippin’ moment to spare? We’re back to square one, folks, which is that anxiety is everywhere and it sucks and there isn’t a ton of (free/accessible) support in regards to how to deal with it. Some lucky people might have the resources – coverage that includes mental health and the free time to see a therapist regularly. But let’s be honest. Most don’t. So… now what?
Faire et se taire? Translates into shut up and get on with it. Admittedly, this is not always bad advice for some situations. But for anxiety? That’s about as effective as telling the Hungry Mouse to board the Starving Cat to the Island of Cheese. Ya’ like that? (I just made it up.)
Anxiety Has Always Been Around, Right?
Yup. Anxiety ain’t new. And if anxiety is as old as the upright monkey, then perhaps we should start asking old people more questions about how they deal with it! Karl Pillemer, a gerontologist and director of the Cornell Institute for Translational Research on Aging, did exactly that. He created the Legacy Project, a study of almost 1,500 people ranging from their 70s to over 100. The focus of the study was to ‘pick the brains’ of our elders. One of the questions in the study asked participants to name their biggest regret; Pillemer was shocked by the answers. He had expected to hear about secret love affairs, shady money exchanges, bar fights, crashing grandma’s car – but the participants almost unanimously answered: “I wish I had not spent so much time worrying.” So… our elders had anxiety when they were younger, and as they aged, calmed down enough to reflect upon the fact that they wished they didn’t have so much of it. Hmmm….
So, read on, because I’ve learned some interesting things about anxiety. And I am happy to share everything I come across if it helps people start dealing with this issue in a productive, creative way. We’ll start with they ways in which Traditional Chinese Medicine conceptualizes anxiety – because guess what? The TCM perspective on anxiety is non-judgey, accepting of difference, and offers some outstanding suggestions about how to deal with it.
Last Wednesday I walked down to Monument Square to check out the Farmer’s Market. The tables were literally spilling over with bounty – fruit, vegetables, flowers, bread, cheese, and millions of other things that delighted all the sensory organs on my face.
As I was perusing the produce of one local vendor, I noticed that she had put out a bowl for sampling – fresh corn and cherry tomatoes. I grabbed a quartered cob and bit in – I’d never tasted corn that hadn’t been boiled or grilled, and I was shocked when what I can only refer to as !CANDYWATER! exploded from the kernels. It was like…it was like…
“A vegetable!” sang my spirit, “A vegetable that tastes like dessert!!!”
And right at that moment, in the midst of my corngasm, the bluegrass band launched into an uptempo version of This Land is Your Land, vendors began leaping through the air, and customers set down their non-plastic bags to lock arms with strangers – Farmer’s Market Flash Mob!!!
Okay, okay, the Flash Mob didn’t happen. What actually happened was that my 10 month old reached up and snatched the corn right out of my paw. She gnawed on it for the next hour, obsessed with prying each candy-like kernel from the cob.
Late summer, earth, balanced, rounded, yellow, nourishment, sweetness, singing – these are all words associated with the spleen. The spleen, as I hope you’ve gathered by my slightly ridiculous anecdote, has everything to do with our relationship with food, pleasure, and nourishment.
The Spleen’s Physical Realm
According to TCM, the spleen is the organ in charge of transformation. It allows us to literally and figuratively digest and assimilate the world around us (in the form of food and life experiences).When you hear the word “spleen” in the context of TCM, don’t be tricked into thinking about the organ that sits in the upper part of your abdomen. Instead, when you hear the word spleen, think about your relationship with food. How nourished do you feel by the food you eat? Do you experience TBB (total bowel breakdown) when you get stressed? Do you often eat in a hurry, in the car, stuffing french fries down the gullet? Do you ever make time to eat carefully prepared meals with the people you love? Do you fart all the time, and avoid accountability. You do??? Shame on you!
Nourishment is a great word to describe the job of the spleen. It’s a great word because it not only describes the nourishment that we get from the food we eat, but the nourishment we get from life itself – which leads us into the equally important emotional aspect of the spleen. This organ is also directly related to our ability to love ourselves and be nurtured by others.
The Spleen’s Non-Physical Realm
Who is the most gentle and nurturing person you know? And by ‘nurturing’, I don’t mean the kind of person who takes care of others begrudgingly, and at the expense of their own energy. I mean the kind of person who is naturally friendly, a magician in the kitchen, and whose all-encompassing bear hugs make you feel momentarily safe and loved in this big unpredictable world. Is it your granddad? Your mom? Your neighbor or friend? Whomever that person is – they probably embody the earth element.
The Spleen governs our feelings of concern and love for ourselves and others. Now… I’m going to say something that might make ya’ wanna smack me – but we must first love ourselves. We all know this is true, yet is seems to be one of the hardest things to do when that nasty little voice inside your head acts up and starts calling you names. Alas, don’t be discouraged! Cultivating spleen energy will help you muzzle that self-deprecating pain-in-the-arse that lives inside your head!
The Spleen also houses the power of Thought, which includes the power to concentrate and absorb information. The thought process essentially mimics the digestive process (we take in information, extract what is useful, and discard the rest). Overthinking, no matter the quality of the thought (and this can include anxiety and rumination), can damage the Spleen. Complaints like “muddled thinking” or a “foggy head” are often imbalances with this organ/meridian. If you are reading this, and saying to yourself: “Hey, MY head feels like it’s stuffed with damp cotton balls!!! Well, then, it’s time to head on in to Wildwood Community Acupuncture for a visit.
In general, a balanced Spleen helps us to feel safe and comfortable in our own skin. The mind is clear and the digestion is efficient, and there is energy to last the day. Though we experience the ups and downs of the life, we continue to cultivate compassion for ourselves and others.
I know. I know. Of course this isn’t what every day looks like – and if it did, we’d be like the Cylons from Battlestar Galactica. We are human, which means we experience imbalance, and we experience it often. But remember – there are lots of ways to bring yourself back into balance when you feel off – and when it comes to the Spleen, the first thing you can do is to cultivate the Earth element, which means you can try to restart your day from a place of self-love. Or you can just think of me at the Farmer’s Market, my molars crashing down upon those round yellow kernels whose sweetness brings instant nourishment and happiness, while in the background, a Farmer’s Market turns flash mob.
And if imagining my corngasm doesn’t work for you, you could simply watch this and have a laugh. Because laughter is good for everything.