After a lot of research and discernment, we have made significant updates to our cancellation and no-show policy, and as of February 1, 2021, we will be making a concerted effort to enforce it. This marks a big change for us because, while we've always had a cancellation policy, we've frankly struggled to know when and how to enforce it. After a lot of discernment and research, we feel ready to move forward.
Because change is hard, and we're all amid a whirlwind of change in other ways, we wanted to lay out the reasons behind the change in hopes it will ease the transition. If, after reading this, you still have questions or concerns – please don't hesitate to reach out to us.
The basics of the new policy
- AS ALWAYS – We ask for notification of your intent to cancel or reschedule 24 hours or more before your appointment. If you cancel/reschedule within 24 hours, that's a late cancellation. If you just don't show up, that's a no-show.
- Always always call to cancel as soon as you can if you believe you are sick with a viral illness. Particularly during this era of the pandemic's ongoing spread, we want to give a wide latitude to cancellation due to illness. You will not be charged even if this is within 24 hours of your appointment.
- Likewise, if a close contact has been diagnosed with COVID-19, please call to cancel as soon as you can, and you will not be charged if this is within the 24 hour cancellation window.
- You will be charged $50 for violations of our late cancellation policy. There are additional penalties for repeated violations.
- You can read all the details on our cancellation policy page.
The purpose of the cancellation policy
We have a cancellation and no-show policy in place because we have limited resources, and want to use them to best help the community. When a person cancels late, it is often impossible to fill the slot they vacated. This creates a chain reaction of lost opportunities that have real impacts on real people's lives. Our intent is NOT to make others' lives more difficult or to create a punitive environment. Our concerns about finding the right balance are why we've taken a while to craft our approach.
When there is an appointment on the books, our practitioners and staff are here, ready to serve you. The
clinic has been prepared for your arrival and the flow of practitioners through rooms and other resources is determined. Usually, your practitioner will have done some preliminary research appropriate for the upcoming appointment, and their understanding of how their day will unfold includes your appointment.
Repeated interruptions here cause a lack of easy flow through the day and week, as practitioners scramble to figure out what to do with a new window of time. Further, of course, the practitioner loses income when the appointment fee is not paid. Like anybody, practitioners need reliable income to live. The stress of frequent income loss impacts practitioners the same way it would impact anyone.
Our primary purpose in enforcing our policy is to ensure that practitioner time, skill and energy is respected.
Respecting other patients' needs
In Clatsop county, as in many rural counties, healthcare resources are limited. This, combined with the high skill level of our practitioners and our robust in-house insurance billing, means that our practitioners are very busy. In the case of our massage therapists, they are often booked months out. It's unfortunate, but there's just not enough supply to meet the demand.
When a person late cancels or doesn't show up, that potential appointment is lost. For some patients, massage is critical to their regular functioning, and it's hard for them to not be able to get in regularly. By not showing up for an appointment, a late canceller misuses a limited resource that could have been used by someone else. Nobody wants that!
The precariousness of small business
The last year has been hard on everyone. Small businesses like ours have been hit on multiple levels, and the fun isn't over yet. We've been very lucky to have ongoing growth and support from our patients as well as grant and loan funding from several sources – keeping us afloat during a rough time. But the expenses and challenges of operating under these circumstances are real, and every little loss takes us closer to having to reduce services or even close.
Recovering some money when a person cancels isn't going to restore that appointment lost, but it will help to ensure that the practitioner gets some of what they would have made and that the clinic can continue to pay its bills. And, hopefully, the accountability structure the fee creates will just help motivate all of us to pay a bit closer attention to our calendars and communications.
We'll be monitoring how the policy works, listening to your feedback, and adjusting as needed. Thanks for your ongoing support and your help in keeping our doors open and our practitioners happy.
The rumors are true! We are adding a location to better serve the North Coast and Southwest Washington.
Within six months of our opening in January 2017, it was apparent that we were going to quickly outgrow the space on 14th & Commercial. The demand for services has been so high that many are dismayed to learn that our first available appointments can be months away. This is largely due to space considerations – with only two rooms we can only do so much. We’ve done our best juggling shifts to maximize the number of people we can accommodate, but the time has come to take a big step forward.
We are expanding in Astoria by keeping our location and adding a new one just down the Riverwalk!
Starting Monday, December 2, 2019, all acupuncture and massage therapy appointments with Watershed Wellness practitioners will be taking place at our new Pier 1 location.
Esthetics (facials) and yoga will be remaining at the Downtown location.
The address is : 10 Pier One, Suite 308, Astoria, OR 97103 (map link).
Some mapping systems do not render the address correctly. For a time, the location will show as the “Port of Astoria administrative offices” until that all gets switched over with Google.
Map & Further Location Instructions
The building, which until very recently hosted the Port of Astoria administrative offices, is three stories, red and blue, just to the West of the Megler bridge and the marina in the West Mooring Basin. The road leading to Pier 1 is Portway Street, which turns off 101 at the light next to the Portway Tavern. There are several counselors in the building, as well as forest product companies and several Port / marine traffic related businesses you may have visited in the past.
As you go down Portway street, you will cross the Riverwalk and trolley tracks (be careful!) and pass the Astoria Riverwalk Inn on the right. You will feel like you are driving into an industrial region. Depending on time of year and economic conditions, you may see stacks of logs, cruise ships, fishing boats and trucks. But, continue down Portway St and you will come to the entrance of the parking lot and see the red and blue building. You made it.
Park in the parking lot, paying attention to any signage or striping. There are multiple wheelchair accessible spaces and a spacious elevator at the Pier 1 space, so everyone should be able to access the space with no problem. Please contact us if you have any special needs that you want to be sure we can accommodate.
Contact information and scheduling
Our phone number, email addresses and website address are all staying the same. You can find this information, an online contact form and more information about both of our locations on the locations page.
All the same touches and all the same customer service support will be available to you at the new location. We are working very hard to make sure that all you experience are improvements and ongoing healing as we make this transition.
Our scheduling system will remain the same and if you have appointments scheduled for acupuncture or massage, they will be switched over to reflect the Pier 1 Location. You may receive rescheduling emails about this change. If you have any questions, do not hesitate to reach out to verify your appointments from your calendar.
More about what's great about the new Pier 1 location
We will be releasing more articles with information about what's to come for both the Downtown and the Pier 1 locations on the blog. To stay updated, be sure you're either a subscriber to the newsletter or that you follow us on Facebook or Instagram.
For now, a little rundown of five things we're most excited about with the expansion…
- Increased space means existing practitioners can potentially take on more patients – meaning shorter wait time for appointments. Yes, expanding staff will be coming, and we have plenty of room to grow.
- Increased space also means the ability to provide a post-treatment relaxation area, expanded medicinary services and eventually classes and events in the space.
- The clinic location is quieter being far from the main roads. There are new sounds to experience, like battling seagulls and boat traffic. But overall, a more peaceful treatment experience.
- The views are fantastic, and we have new businesses and neighbors to connect with.
- Much better parking experience, while still maintaining the connection to the convenient and iconic Riverwalk!
From a Chinese medicine perspective, it is essential that we learn to live in harmony with the seasons. There is, of course, no monolithic “Chinese medicine perspective” but all lineages and even more modern interpretations of Chinese medicine theory discuss the health benefits of seasonal awareness.
The recent movement around local and seasonal foods is a nod to the importance of this timeless principle. People are recognizing that living in accordance with their immediate spatial and temporal environment is not just for hippies (although, for them too). Food tastes better, is more healthful, is less expensive and somehow just FEELS better when it is eaten at the right time for the place that one is in.
But the Chinese philosophy on living in balance with seasonal energy goes farther than food choices. In fact, most of what I have found in the Classical texts of Chinese medicine has nothing to do with food.
1. Physical/mental/spiritual activity levels and types
The guidelines regarding activity go into every realm of life, just as the seasonal energy touches us everywhere – all the time. In the Neijing one of the first practical recommendations concerning seasonal living involves activity.
“During this season [spring] it is advisable to retire early. Arise early also and go walking in order to absorb the fresh, invigorating energy” (From Maoshing Ni's translation)
2. Social activity levels
This is perhaps simply an outgrowth of #1 – but I think it is easy to overlook. We naturally gather together in the summer – although in the United States, some of our most “together” holidays are in the winter. Just as we should limit excessive physical activity in the winter, so should we ramp down our social activity.
3. The color, smell and feeling of the surrounding environment
Paying close attention to the seasonal changes is important in resonating with their energy. All of our senses should be engaged in the study of our environment. It makes sense to similarly alter our internal environment to some degree. Letting your decorations follow the ebb and flow of nature will help you to become closely in tune with seasonal energy. Of course, you will want to keep balance as well – so surrounding yourself with emblems of Metal during the Fall is not necessarily the best way to go, but there are simple, effective and gentle ways to remind yourself of the seasonal energy even when you must be inside.
All of this and much more is included in the kind of lifestyle counseling that naturally grows out of Chinese medicine theory on the energy of the seasons. We’ll be discussing more specifics about each season on the blog in articles to come.
Do you have a favorite season? Which one and why?
In this episode, I sat down with Amanda to talk about judgment, and non-judgment, in the holistic healthcare environment.
In particular, we examine some of the things that commonly hold people back from getting care due to worries about judgment around:
- Body image, such as body hair, body odor or weight gain
- Social factors, such as identification as gay or trans, or having low income and so being unable to wear “fancy” clothes
- Political and intellectual factors, such as having a very conservative viewpoint when you believe your practitioner to be quite liberal
It's just a quick 20 minutes, and we hope it will provoke questions – check out the form on the main podcast page to share your thoughts.
Occasionally a patient won’t be able to come to an appointment for one reason or another, because life is complicated. However, there is one kind of cancellation that I find really strange: a patient cancels their appointment because they are sick.
Now, obviously, if someone is too sick to leave their house, then this is completely reasonable. But the prevalence of this phenomenon makes me think that I have neglected to educate my patients about how effective our medicine is at treating acute illness.
So here, dear reader, is the scoop on Chinese Medicine and common bugs.
Chinese Medicine, like all medicine, grew out of daily necessity. Over thousands of years, practitioners have learned to treat the maladies that their communities and families have suffered from. This certainly includes chronic and terminal conditions, like arthritis and cancer, but the most common afflictions that affect us are illness and injury.
While we think of illness in the modern industrialized world as mostly uncomfortable and annoying, epidemic illness was the leading cause of death in much of the ancient world. The flu virus continues to kill thousands of people a year in the US alone, even with our modern medical systems in place. Imagine the destruction it would have wrought without these systems.
Ancient physicians, then, were spending most of their time treating and curing epidemic illnesses.
In fact the vast majority of the herbal texts that have been passed down to us through the ages concern the stages that exogenous (coming from outside the body) illness pass through in the human body, and how to treat every presentation at every stage. Treating an illness early is always best, but we can’t control when a patient will come to see us, so we have intricate systems for treatment regardless of the timeline.
We also understand, based on these systems, that every person’s presentation is different, and requires a different approach.
One person’s cold may start in their chest as a hot and dry cough, while another’s manifests as profuse clear runny nose and a mild fever. Treating these two presentations differently results in a faster recovery in each case. By carefully observing your specific symptoms, we can craft an acupuncture treatment and an herbal formula that will be tailored to your exact experiences and completely resolve all of them.
We also know that proper treatment of acute problems prevents chronic ones.
This is a key concept to understand. A lingering cough from a simple cold can become a long term problem as the lungs’ ability to regulate themselves becomes more and more compromised. Such a process can predispose a person to chronic bouts of bronchitis, asthma attacks, or lung infections.
By completely treating the issue the first time, we never have to deal with any of those problems down the line. For those who already have a chronic health condition, this is doubly true. Autoimmune disease, chronic pain and depression all sap our body’s immune systems and create increased openings for acute illness to become chronic.
With this in mind, my advice is to seek out care when you first feel sick.
That woozy feeling in your head, the tickle in your throat, and the snot you woke up with this morning are telling you that you are already mounting an immune response to something. This is our opening to set you up for the shortest and least painful illness possible, and maybe even a complete avoidance of further symptoms.
And don’t worry about getting me sick; this is my job!
My Chinese herbal lineage focuses on deep understanding of the most venerated text of Chinese herbal medicine, the Shanghan za bing lun.
The first, and most well known, part of this text (often referred to simply as the Shanghan lun) contains information about treating diseases that are caused by factors outside the body. In particular, the vast majority of the formulas in the text treat the common cold, other viral respiratory infections & the secondary infections and complications that come from them. So, you could say that I spend a lot of time thinking about the topic of colds & flus!
Different types of colds?
Chinese medicine (CM) discusses various types of colds – which we call “external invasions,” to differentiate them from diseases caused by food, drink & strongly disordered emotional states. The symptoms of the external invasion, and the method for treating those symptoms, varies based on the character of each type of cold. In the simplest way of looking at it in CM, there are colds that are more “hot type” (with higher fever, yellower phlegm) versus those that are more “cold type” (with lower fever, runnier nose).
But further differentiations exist, based on the origin of the pathogen, the health status of the person invaded, and so on. The Shanghan lun differentiates the varieties of symptoms of exterior invasion into six stages, called Conformations. The conformations are a complex theoretical construct, so we can only sketch the outlines here. If you're interested in getting a bit more information, you might want to read about it on my website for students and practitioners of CM.
The conformations relate to the way a cold develops, and also helps us to see the difference between “regular colds” and more virulent & severe epidemic type invasions. The conformations themselves include physical structures, various bodily functions, acupuncture channels and other diverse parts of the human body. In other words, each conformation is not a single structure, but a mixture several structures and functions.
In a way, each conformation is like a landscape – and as a cold travels through each of the six landscapes, the way it manifests, and the way we treat it, changes.
I list and briefly describe the conformations below in order from the most superficial / exterior layer of the body all the way into the Jueyin which is the deepest level, the most interior to the body. As disease travels through the conformations, it changes character. The more exterior layers (yang layers) look more like typical cold & flu symptoms, and so it is from the chapters describing these disorders that most of my formulas come from when I treat this type of disorder.
- Taiyang – Taiyang contains the Bladder and Small Intestine channels & organ networks, as well as aspects of our immunity, our water metabolism and more. This is the most surface layer, and when struck, the typical symptoms of a mild cold are the result. Runny nose, mild congestion, an often lower grade fever, body aches, frontal headaches and low energy can all be the result. We treat this stage of cold by forcing the pathogen out & strengthening the surface to prevent reinvasion.
- Yangming – Yangming contains the Large Intestine and Stomach channels & organ networks, and thus has a lot to do with digestion, but dysfunction here can also impact mental state (anxiety, mania) and temperature regulation, among other things. We are proceeding more deeply into the body here, and if a cold or flu reaches here, the symptoms tend to be more severe. Very high fevers, even leading to bleeding, severe headaches, sinus trouble including congestion, and certain types of hot lung conditions can all be the result. We treat this stage by cooling down the body and allowing the body to release as much built up matter and energy as possible.
- Shaoyang – Shaoyang contains of the Gallbladder and mysterious Triple Burner channels & organ networks. The impacts of this conformation can be VERY diverse as befits the layer of the body that is getting so much closer to the interior (yin). As cold or flu symptoms, Shaoyang symptoms tend to be back and forth (fever AND chills), less acute and can also hang on for much longer. People who are repeatedly getting sick within one season, but never really having a fever or serious acute symptoms are often trapped in the Shaoyang stage. This can be harder to treat, and we do so by helping to “harmonize” the yin and yang aspects of this stage.
- Taiyin, Shaoyin & Jueyin – The Shanghan lun text I have been discussing goes into detail about the treatment of deeper layers of the body as they are impacted by the consequences of external invasions. However, because these look less like what we call “cold” or “flu,” I'll not discuss them here. The same goes for the next two layers..
I hope to talk more about the conformations and how understanding them can help you respond better to cold-season illnesses. But, for now, with that general idea explained – a word on customization of cold treatment.
Different types of people, different treatments – right?
So, there are different types of colds to begin with, but there are also different types of people having those colds! One of the most important things about Chinese medicine as a distinct profession in healthcare is how we focus on the customization of treatment to the uniqueness of the individual patient. If a person is very weak, with a thin and deep pulse, not having much of a fever and the cold lingers for weeks, we will treat them much differently than a person who comes in with a big fever, big pulse and very rapidly moving illness. Doesn’t that just make sense?
You may have a different herbal formula than your partner with a similar cold!
That's the outcome of true customization of treatment. But, of course, sometimes I find myself prescribing very similar formulas to a large group of people. While customization is important, it’s also true that many people react similarly to particular colds traveling through their town. And there are some types of treatment or supplementation that help most people feel better. This is why we see standardized over-the-counter remedies on the shelves in the first place – they are a convenient way to help large groups of people. So, as a practitioner, or for you as a member of the public, we have to find the best way to balance customization and convenience.
Over-the-counter remedies and Chinese herbal medicine – the case of Yin Qiao (or Yin Chiao)
For many of my patients, the first Chinese herbal formula they ever took was in the form of several small tablets called Yin Qiao San – said to be great for the common cold. Many people swear by the remedy and keep it on hand just in case. In fact, there are some Chinese medicine practitioners who ask their patients to keep it on hand for just this reason. This formula was formally written down in a book published in 1798 devoted to exploring “Warm diseases,” so those types of illnesses that are either caused by warming factors, or expresses itself through heat type symptoms, or both.
It contains cooling, lightweight herbs like honeysuckle flower and forsythia seed pod.
This formula is appropriate for people who have hotter cold symptoms such as : fever, burning sore throat and a tendency to a more rapid pulse & yellowing tongue coat (especially as the cold progresses). In the basic CM way of looking at things, a warm or hot pathogen creates these symptoms. Warm and hot pathogens are traditionally more likely to be encountered in warm climates. If a cold came from a more cold type pathogen – such as those typical in my home in Oregon – then this formula would most likely NOT be appropriate. Further, when the cold goes into the interior, causing a phlegmy cough or profuse nasal discharge, this formula wouldn’t be appropriate regardless of the nature of the exterior invasion.
In other words, Yin Qiao San can indeed be effective – for certain types of colds and not others.
What are the potential consequences of using a formula that isn’t appropriate for the type of cold or other disorder you’re experiencing? Fortunately, Chinese herbal medicine is powerful – but also very gentle. Yin Qiao San is quite cooling, but it is also relatively easy on the body and the dose typically taken is too small to do much damage. So while there are Chinese herbs that can cause serious complications if you take them when they are not indicated for your condition, this particular example is not one of those.
That said, if you need warming treatment and take cooling herbs instead, there are undoubtedly consequences for the yang of the body. Long term, a person who inappropriately takes Yin Qiao San may find lowered surface immunity or mild digestive problems. That the consequences may not be severe in this case, though, doesn't mean we shouldn't attend to always taking the right herbal formula for our situation.
How do you avoid taking the “wrong Chinese herbal formula?”
Does the highly customized nature of Chinese herbal medicine mean that there can be no on-hand remedies a patient could self prescribe? Of course not. There are general treatment strategies that assist nearly anyone who is experiencing the symptoms of a cold or flu. For instance: increasing fruits and vegetables, decreasing sugar and strenuous physical activity and staying warm and hydrated will help virtually anyone have a better time with a cold or the flu.
But, if you would like to take a more active role to treat future colds and flus, or you have developed complications from one – like a chronic painful cough – seeking out treatment from a licensed Chinese medicine practitioner may well be part of an answer. If you come in for a visit, I will use CM diagnostic techniques, including a wide ranging discussion with you, to help determine the best treatment for an existing cold – or the prevention of one in the future. While I would be unlikely to prescribe Yin Qiao San, it being outside of my lineage and climate, I could certainly recommend a group of herbal formulas to have on hand for potential situations that would be appropriate for your constitution.
This is just a brief overview of the issues involved in treating colds and flus with Chinese herbal medicine. Questions? Get in touch – maybe I’ll write a future article about your question!
Hormone supplementation can be a very helpful tool for some transgender people to live full and authentic lives. There is also a great deal of fear-mongering about the side effects of hormones, usually from non-transgender doctors. While more long-range study is needed, a large-scale recent long-term trial found no elevated risk for mortality, either broadly or specifically, for transgender people taking hormones. (1)
Care providers who try to scare trans people away from hormones are not standing on firm evidence in doing so.
That being said, the lack of mortal danger does not mean that there are never annoying or difficult side effects from hormones. Any medication, taken over a long period, can cause some unwanted experiences to occur. In the next two articles in this series, I’m going to break down some of the most common side effects of testosterone and estrogen supplementation, and explain how Chinese Medicine can help resolve them.
Testosterone, as we’ve discussed in the past, is primarily a hot and yang substance. What this means in practice is that it makes this growth, move faster, and makes people feel warmer. What it can also mean is that it can cause some people to get too hot, and develop unpleasant symptoms as a result. In Chinese Medical thinking, the yin of the body, or the cooling and moistening substances, need to be able to balance out the yang.
Over time if the yin is taxed by something, whether it’s a stressful life event or something we are consuming, the heat can overwhelm the system.
Some signs that this may be happening include; night sweats, anxiety, heart palpitations, changes in hunger, hot flashes, acne and pain in the legs. These are mostly symptoms that are associated with puberty or menopause, and there is a very good reason for that: people who are taking testosterone are inducing puberty and menopause, concurrently. This is not a bad thing; it’s just a life process.
But it can be a lot for the body to deal with.
In addition to heat, sometimes testosterone can lead to reduced blood flow in the lower abdomen, or what we call “blood stagnation” in Chinese Medicine. Blood stagnation can manifest as frank tissue changes, like polyps or tumors, but most often it shows up as pain from impaired microcirculation.
This can result from muscular changes in the pelvis bowl (particularly that pesky psoas muscle), the cessation of menses, or from the surgical removal of reproductive organs. Some trans people who take testosterone find that they develop mysterious wandering pain in the lower abdomen after several years on testosterone.
The fact that some people experience these unpleasant effects can feed back into the medical world’s desire to pathologize transgender people and say that taking hormones is just bad and dangerous.
This is rarely said, of course, for most other medications. Very few people say “metformin can cause diarrhea in some people, so no one should ever take it”, because it is seen as a life-saving drug. Hormones are also life-saving, and deserve the same medical care and respect as therapies. The correct way to think about this situation is not to say that testosterone is bad, but rather that we need to help the body integrate the changes from hormone supplementation in a more efficient way.
Acupuncture and Chinese herbs to do this, along with dietary changes in some cases.
The body is intelligent, and can learn how to self-regulate under new conditions. We can help it to vent excess heat, supplement yin, move blood, and adapt. Acne can be treated, night sweats disappear, hunger cues return to normal, and the body changes in a normal and healthy way. Instead of yelling at people about the “dangers” of the medications they take, we can work with people and make their experience be the smoothest it can possibly be.
Note: Not all people will have unpleasant side effects from testosterone, and not all side effects will look like what is described above. Each person in unique, both in their constitution and in their life experiences and circumstances.
If you are taking hormones and experiencing any difficulties, feel free to schedule an appointment with me so we can talk through what classical Chinese medicine might be able to do for you.
(1) Largest Study to Date: Transgender Hormone Treatment Safe. Kathleen Louden. July 02, 2017 http://www.medscape.com/viewarticle/827713
Acupuncture treatment is one of the foundations of the clinical work we do at Watershed Wellness
This form of medicine treats a huge variety of conditions, is safe and effective, and also is great combined with massage and yoga. This makes it a natural choice to be one of our primary modalities. I am excited to share this medicine with you, including the special way we approach acupuncture treatment at Watershed Wellness.
Our acupuncture department is united by a set of principles that make our treatments safe, enjoyable and most importantly, profoundly effective for an astonishing variety of conditions
At Watershed Wellness, we’re not just an assembly of unrelated healthcare practitioners. We work hard to function as an interconnected whole as much as we can – particularly when it comes to the energy and intention we bring to the work we do. While each practitioner brings important and unique attributes to the table, where we are most united is in the vision and values behind how we practice.
Over the next months, we will discuss more about this vision and these values and how they improve your experience as a Watershed client
I think this will help you get a good feeling of what you can expect when you come in for an appointment – this one is a special bonus because it allows me to discuss one of my favorite Chinese medicine topics, the five phase elements. That's right – we're going to dive into a little bit of Chinese medicine theory – the intricate and fascinating body of information that guides every acupuncture treatment I do.
The five phase elements (also just called the five elements) are one of the more recognizable theories within Chinese medical science.
The ancient scholars who developed Chinese medicine initially had a habit of categorizing many things according to number. There are five phase elements, six conformations, twelve organ systems, and so on. This makes things easier to learn and understand and, according to the scholars of these theories, help our work as human beings to resonate with what they understood to be the fundamental laws of the universe.
The five phase elements we use so frequently in Chinese medicine are 水 water, 木wood, 土 earth, 火 fire and 金 metal (other traditions typically would add air or void instead of metal). These are connected through a generation or creation cycle (in the order written above, with metal feeding into the water) as well as cycles of control or regulation. Nearly anything can be categorized according to the five phase elements and their interrelationships, from acupuncture points to grains to stars to organ systems.
Side note : I'm going to be doing a lot more education on the basics of Chinese medicine and how this information can help you to get and maintain vibrant health – if you want to get all the latest information please do sign up for our newsletter if you haven't already.
I've articulated five basic principles that lie at the heart of Watershed Wellness acupuncture as resonating with each of the five phase elements
I think doing it this way makes it easier to understand. But, even if you don't fully grasp how the five phase elements fit into this thing, I believe you'll recognize the importance of the principles we use to guide our acupuncture practice.
Water – Deep knowledge
Water is about the depths. It is about the storage of all that is valuable, keeping it still with winter’s cold. It is about connection to ancestors and others that have come before. When it comes to Watershed acupuncture treatment, water reminds us of our commitment to constantly refresh and expand our knowledge of the world and the human body so that we practitioners can be of maximum service to our patients.
The education that American acupuncturists receive is extensive. At NUNM, where I went to school there is a strong emphasis on scholarship, independent research and adherence to the ancient, basic principles of the medicine. We are taught, early on, that lifetime study is part of our commitment as practitioners. I take this very seriously and regularly engage in all kinds of continuing education, both formally and on my own.
I utilize this knowledge every day in work with my patients, and I believe it makes the work we will do together much more effective.
Wood – Responsiveness
Wood is the springtime element. It is all change and youth and movement, like new blackberry canes emerging from disturbed soil, or like a 8 week old puppy’s constant exploration, mouthing and noise making. Wood gives us the ability to start new things, but also to respond appropriately when a situation is in progress.
Above all, at Watershed, we want to be responsive to your needs – and wood reminds us to do this. Your acupuncture treatment will be 100% created just for you – we don’t use the same treatment for everybody, and we don’t impose our will on you as the patient when something about the treatment is clearly not working.
Every time you come into the treatment room, I will reevaluate your situation, discuss your experience during the last treatment, and do careful diagnostic work to ensure that your treatment is exactly what you need in that moment.
Fire – Connection
Fire, the phase element of the Heart, is the ruler of intimacy, of connection between people, and of building community. Fire is warmth, brightness, life giving. It’s also associated with the summer solstice – that high time of joy, experiencing and flourishing.
Watershed acupuncturists pay special attention to the fire element when we engage in our work. We believe that the swiftest and most long lasting healing comes when patient and practitioner work together to address whatever needs to be addressed.
We connect with you, get to know you as a person, and hope to become trusted advisors. We make sure that you understand the treatment, and are OK with what’s to come and respect your boundaries at every step. That connection and Heart is part of what makes treatment at Watershed special.
Earth – Comfort
Earth is about nurturance, solidity, safety and comfort. Earth is at the center of our digestion, and is injured whenever we have to worry about ourselves or other people. When we pay attention to Earth in our acupuncture treatment at Watershed Wellness, we are putting your comfort at the forefront of what we do. You can see this in our waiting room, in the softness and warmth of our treatment tables, and more. This comfort allows you to feel more relaxed and safe, which in turn seems to make treatment more effective.
A note about comfort, here. Sometimes, you will have sensations during needling that can be uncomfortable. While I always seek to make sure we don’t push you beyond a tolerable level, some discomfort is usually necessary in order to treat disease. The principle of Earth doesn’t guide me to avoid that. It simply means that we will always be checking in, always making sure that you’re still OK with what’s happening, and doing everything in our power to make your total experience comfortable and relaxing.
Metal – Safety
Metal, of course, has the most direct resonance with acupuncture given the material of acupuncture needles. Metal otherwise is about letting go, about autumn, about balance and justice. Metal calls us to be precise, to make clean breaks, to keep everything in its place – and as such becomes a primary arbiter of safety. At Watershed, we take acupuncture safety very seriously.
We abide by all state regulations and professional commitments, of course, but go above and beyond that to ensure that you never have to worry that acupuncture treatment will create problems that weren’t there in the first place.
Another way that metal comes into our clinical work is in the simplicity and precision that lies at the heart of classical acupuncture treatment. While some traditions use large numbers of needles, the acupuncture we practice uses only as many needles as absolutely necessary to ensure a positive outcome. This minimalism means that we have to diagnose very carefully and be extremely precise with our creation of the point prescription. This care increases the safety of your treatment while also making it far more powerful.
We look forward to discussing these principles with you more in person – you can get on the schedule any time.
As spring comes into full bloom with the approach of May, people are flocking outside to run, jump, play… and get injured. Such is life! So now is the perfect time to discuss the most common varieties of common exercise-induced injuries: the sprain and its sibling the strain. When you pull a muscle or roll your ankle, it’s likely that you have sprained or strained something.
The broad definition of this painful condition is that you have stretched or torn a ligament (sprain) or a muscle or tendon (strain) without the joint popping out and becoming dislocated. Any time that something pulls or pushes on tissue with more force than it can resist, a sprain or strain is likely to occur.
Once a force is exerted on tissue and something tears, Qi and blood rush in to clear away the damaged tissues and bring nutrients in for the process of repair.
As this process gets under way, the area swells and will often become red, hot and painful. If the injury is severe enough, the joint may become too tender and swollen to bear weight or to use. Over a few days or weeks, the intensity of the repair process will decline, and so the swelling and pain will subside gradually until all is well again. This is the ideal circumstance, in which very little intervention from the outside is needed.
Unfortunately, this happy progression is not always what occurs.
One reason sprains and strains in the limbs are more often discussed is that the tendons and ligaments in our limbs don’t have excellent blood flow through them (fancy medical words: they are not well-vascularized). This means that the process of inflammation and repair has less resources to work with, a bit like the difference between a car crash in a city center and one in a remote area. The ambulance will get there as fast as it can in both cases, but it might be a while if you are far out in the wilderness.
The other tricky variable to consider in how quickly an injury will heal is the underlying physiology if the individual person. Here is a very zoomed-out overview of the organ systems that could be involved in healing a musculoskeletal injury from a Chinese medicine perspective:
- Liver feeds blood to the tendons and ligaments
- Spleen feed nutrients to muscles
- Lung ensures that Qi is circulated to the whole body
- Gallbladder moves fluid in the joint spaces
- Heart is in charge of moving and controlling blood in the whole body
- Sanjiao (Triple Burner) moves fluid in every space between organs and body cavities
- Kidney builds and maintains the bones
You can see that many organ systems are involved in the repair of injuries!
But which organs are impacted and to what degree is often best explained as an outgrowth of your constitutional tendencies. If you have digestive issues that your spleen is already dealing with, then its ability to repair your muscles will be compromised.
If you have liver Qi stagnation from a stressful job, the liver will have a harder time getting blood to the tendons or ligaments to repair them. When people are blood-deficient the liver doesn’t have much to work with in the first place.
“This is why treatment for an injury in Chinese Medicine is so individually tailored; it’s often a matter of treating underlying problems that are preventing the healing process from perfectly unfolding.”
What can you do the next time you roll your ankle or throw out your back?
Acupuncture, Chinese herbs, and especially topical herbs are very important for healing injuries quickly and completely. In addition, here are some home remedies based on prior imbalances that you can try out yourself:
- For Liver Qi stagnation (depression, stuck anger, frequent sighing, discomfort in the ribs): journaling, nature walks, talk therapy, exercise
- For blood deficiency (frequent waking from sleep, anxiety, abnormal-for-you pale complexion, forgetfulness) eating organ meats, leafy green veggies, possibly iron and b vitamin supplementation
- For Spleen Qi deficiency (fatigue, loose stools, feeling tired after meals, poor appetite) simple foods (grains, sweet potatoes, congee), regular meals (as in at a similar time every day), medicinal vinegars before meals (check out your local Asian market for delicious drinking vinegars), eating meals while focused on the food rather than in front of a screen or in the car.
- For Sanjiao stagnation (swollen lymph nodes, frequent itching of the skin, swollen and red areas in the neck and ears, chronic illness such as Lyme): proper hydration, gently detoxifying foods like citrus, fresh herbs, and burdock root
- For Kidney Qi or Yang deficiency (deep exhaustion, low back ache, chronic pain made worse by cold, frequent urination at night): rest, meditation, foods from the sea, quiet spaces, warm compresses
Have fun, take care, and drop us a line if you take a spill!
One day as a medical intern during my schooling, a faculty member came in for a treatment for acute pain. He had just rolled his ankle outward, which is the harder and more painful way, and it was swollen almost to the same size as his knee. He wanted to know if I knew how to do acupuncture for acute pain, because he was leaving for a vacation the next day, and wanted relief! I said yes, and did what I considered to be a fairly simple acupuncture treatment to drain heat (inflammation) and move blood. We also applied a poultice of Chinese herbs guided by the same principles.
I've seen countless successes with acupuncture for acute pain since that time as an intern. Classical Chinese medicine, as I have written before, is designed to treat the most common maladies that people experience. However, because of the relatively recent introduction of Chinese medicine to the American system, combined with some structural problems in our healthcare system itself, means that people rarely consider an acupuncturist when they are injured. The way that injuries are approached from a Chinese medicine context is quite different from how they are approached in biomedicine (also called Western medicine).
Biomedicine, let's be clear, is responsible for incredible recoveries – seeming miracles in many cases. For treatment of trauma, and enacting life saving measures in the face of poor prognosis, biomedicine is incredible. However, some have found that full treatment of those injuries to a pain free state, or overall treatment of chronic pain, seems not to be as well developed in this system. Could this be because the approach to acute injuries in biomedicine comes from work in extreme circumstances, such as battlefield medicine & high performance sports contexts?
If you consider this possibility, it does make sense, because people dealing with extreme circumstances tend to innovate and create useful technologies. Many pioneering approaches have come out of battlefield medicine, such as ready-made tourniquets and quick-clot. There is a dark side here, though: both sports and battlefield situations have different aims than regular civilian life. They both require people to be ready to exert themselves again as quickly as possible. This is not the same thing as healing an injury as fully as possible.
In fact, sometimes healing as quickly as possible can impede fullest recovery over the longer term
A simple illustration of this can be seen in the RICE protocol. RICE stands for rest, ice, compression and elevation. It has long been the standard approach to sprains and strains, and it comes from sports medicine. Icing an injury certainly does cause the swelling to go down. It allows someone to put weight on the joint again sooner, and get back on the field.
After the first day or two however, as the intense heat of swelling recedes, it begins to introduce cold in the site. Cold tends to slow biological activity, and can kill cells. From a perspective in Chinese medicine theory, cold injuries Yang, Qi and blood. In my clinical experience, and that of my teachers, this can lead to instability in the joint as it heals, and increased scar tissue. In extreme cases, it can an acute injury and creates a chronic one. Using acupuncture for acute pain – before it becomes a chronic condition – may be part of the answer!
How do acupuncturists look at acute injuries differently?
We’ll return to sprains in later posts, but for now let’s examine how Chinese medicine theory relates to acute injuries. There are various types of acute injuries, of course: breaks, cuts, punctures, dislocations, crush injuries, and endless variations and combinations of those types. From a CM perspective, what all of these types of injury share is that they cause Qi and blood stagnation. Wait – blood stagnation? You may wonder “how can a bleeding cut or similar be blood STAGNATION?” There's a lot to say about that, but let's summarize by saying that we define blood stagnation as any situation where blood is not flowing properly inside of the vessels. Being outside of the vessel, and pooling between layers of tissue, qualifies.
This becomes more clear if you imagine the process of wound healing with clotting, scabbing over and then scarring. Qi stagnation happens anytime that the body’s abilities to communicate is compromised, even at a cellular level. As cells are destroyed by an injury, dead zones of communication are created.
Stages of injury in Chinese medical theory
Acupuncturists treating acute pain recognize three stages that all acute injuries move through.
- Stage 1: The site of the injury becomes hot and swollen, and dead tissue builds up, which was think of as heat toxins. The body sends Qi and blood to the site to repair the damage.
- Stage 2: Some of the acute heat swelling recedes, and stagnation of Qi and blood due to tissue damage begins to create pockets of cold
- Stage 3: All acute heat and swelling are gone and only stagnation remains, largely as scar tissue, which leaves the area vulnerable to wind and cold becoming trapped.
Our acupuncture for acute pain treatment strategies flow naturally and rationally from these stages of healing.
- Stage 1: We drain heat toxins, stop bleeding and move Qi and blood
- Stage 2: Some draining and moving and some warming methods are used
- Stage 3: Warming and nourishing methods used, some moving Qi and blood but more gently
When treated properly with the above methods, injuries tend to resolve more completely. We accompany the patient through all of the stages of healing, giving them support every step of the way. This leads to a much more stable joint/limb/body cavity, with less scarring and often less pain. Simply put : acupuncture for acute pain helps avoid needing treatment for chronic pain down the road. While acupuncturists absolutely can, and do, treat old injuries – preventing them is much more satisfying.
What you can do on your own for acute injuries
You can always come see me if you get hurt, I specialize in acupuncture for acute pain! But, sometimes treatment isn't feasible – or not feasible soon enough! In that case, here are some take-home strategies for self-treatment!
- Sanhuang San (pronounced Sahn Hwahng Sahn): known as herbal ice, this external herbal formula clears heat and moves Qi and blood, thus reducing swelling and pain. It works with the body to improve circulation, rather than shutting it down. You can mix the powdered herb with any ointment and apply thickly to the site of the injury, like icing on a cake. Do not use on open wounds! You can find the powder here, among other places.
- Warm/cool hydrotherapy: you can improve circulation in and out of the area by alternating warm and cool soaks or washcloths. Shoot for 10 minutes of one and 10 minutes of the other, for no more than an hour at a time. This will help flush toxins out of the area and then assist the body in bringing the circulation back.
- Don’t ice after the first two days! Really, please don’t. Use warm/cool hydrotherapy instead – protect that yang qi!
- Massage out bruises. Be gentle, of course, but from a Chinese medicine theory perspective, bruises are stagnant blood that needs to be broken up – moved. A little goes a long way here!
Use your injured body part gently and stretch. Circulation of Qi and blood is vital to the healing process, and needs to be balanced with rest. Listen to your body as you learn your limits during your healing process.