chronic pain

The long, frustrating road to healing chronic disease

“Am I ever going to feel better?”

If you’ve struggled with a long-term illness, you may have asked yourself this question.

Maybe you’ve suffered with chronic pain, or a challenging digestive disorder, or a recurrent skin problem or some other ailment for so long, you’ve forgotten what it feels like to be well. To be ‘normal.' Maybe somebody has told you your condition is permanent. Perhaps you’ve been given a diagnosis and told it will be with you for life. Maybe you’ve even stopped asking yourself the question if you can be well again.

There is a lot I could say about Chinese Medicine’s perspective on chronic illness. I could tell stories of miraculous cures I’ve heard from my teachers and mentors, or discuss my own successes as an acupuncturist and herbalist in treating complex diseases.

I could even talk about my own experiences as a patient, suffering from disorders that were never supposed to get better, but which did with regular treatment. But I’m not going to do any of that here.

Instead, I would like to let the tradition of this medicine speak for itself.

I am going to quote a passage from one of the world’s oldest medical texts1, a work that has guided the practice of Chinese Medicine for over two thousand years.

Here is what it says on the subject of chronic illness:

“Now, when any of the five major organ systems has an illness, it’s as if one was pierced by a thorn, or soiled by dirt, as if there were a knot, or something closed. A thorn may have pierced one for long, and yet it can be pulled out. A stain may have existed for long, ad yet it can be cleansed. A knot may have been tied for long, and yet it can be untied. A closure may have lasted for long, and yet it can be opened. If someone says an illness with a long duration cannot be removed, then that is an erroneous statement.

“Now, those who are experts in the use of acupuncture needles, when they remove an illness, that is as if they pulled out a thorn, as if they cleansed a stain, as if they untied a knot, as if they opened a closure. The illness may have lasted for long, and still it can be brought to an end. Those who state that it cannot be cured, they simply have not acquired the necessary skill.” 2

If you’re feeling hopeless about your health problems, I want you to take a minute and read those paragraphs again. Really let them sink in.

If you are suffering from a chronic illness, I want you to save that passage, and take it out and read it whenever you feel like things will never get better. Health is a journey, and sometimes, it is a long and winding one. The terrain can be rough. It may seem you are moving backwards. There may be moments when you feel lost. But progress is always possible.

As a practitioner of Chinese Medicine, I am here to walk that journey with you, every step of the way. I am completely committed to restoring your well-being, and I invite you to commit to the possibility of your own recovery yourself.

1 This text is called the Ling Shu (靈樞). It’s the second half of a medical treatise called the Huang Di Nei Jing (黃帝內經 ), or the Yellow Emperor’s Classic of Internal Medicine.

2  This is a paraphrased version of Paul Unschuld’s translation of the Ling Shu. The original text in Classical Chinese is:

今夫五藏之有疾也,譬猶刺也,猶污也,猶結也,猶閉也。刺雖久猶可拔也,污雖久猶可雪也,結雖久猶可解也,閉雖久猶可決也。或言久疾之不可取者,非其說也. 夫善用鍼者,取其疾也,猶拔刺也,猶雪污也,猶解結也,猶決閉也。疾雖久,猶可畢也。言不可治者,未得其術也。

The Effects of Compression: Binding, Chinese Medicine, and You

acupuncture transgender

It’s a dilemma that trans-masculine people know all too well: the need to reduce the painful experience of dysphoria on the one hand, and concerns about longterm health on the other. At first, the decision is easy; we strap down our breast tissue somehow some way, whether with ace bangs, commercially-made binders or compression shirts. The internal alarm bell that goes off when we look into the mirror or down at ourselves quiets, and we finally get some relief. All seems well for weeks, maybe months.

Unavoidably though, a new problem arises: pain.

Where the pain resides exactly depends on the person and the binding method, but it will arise. Compression of our rib case, and the soft tissues beneath, can lead to a wide variety of problems. Rib pain, shortness of breath, dizziness, and even scary chest pain can all becomes staples of daily life during binding.

Let’s examine how to think about this situation using the tools & science of Chinese Medicine. In this way of thinking, the trunk of the body is divided into three compartments, or Jiao. The upper Jiao contains the lungs, heart and pericardium. The middle houses in the liver, gallbladder, stomach and spleen, while the lower is the home of the kidney, bladder and both intestines. The final organ, the Sanjiao or Triple Burner, is a network of water passages that connects all three for the purposes of transport and communication.

In addition to the organs, we also have meridians or Chanels associated with each organs, as well as larger channels that connect all twelve.

The most-often-used metaphor for this system is a watershed that runs through the deepest parts of our bodies, which then consolidates and emerges into broad rivers between the muscles and fascia, finally concluding as small streams at our surface. What a nice metaphor – and it has broad utility. This network, according to Chinese medical theory, carries information, regulates water metabolism, and ensures that homeostasis (the balance inside our body that enables health) is maintained by subtly responding to all of the weird things that happen us throughout our lives.

Given this system’s intricate levels of communication through different kinds of tissues, imagine what might happen if we took the entire thing in the upper and middle Jiao, and squeezed. Not just once, but constantly, every day, during every waking hour and sometimes sleeping hours as well. One can imagine that all sorts of processes could be negatively impacted!

Here are a few of the potential consequences, on this view:

Blood flow: blood is hugely important process that our bodies use to transport nutrients, gasses and yang (life force) from place to place, and its functions are especially associated with the heart, pericardium and liver. If blood flow is impeded, these organs can become either too full of blood (stagnation) or have their blood supply be subtly reduced (deficiency).

Symptoms can include chest pain, pain in the ribs and abdomen, anxiety and depression.

Water metabolism: The spleen, lung and kidney are all important organs that ensure the proper flow of moisture around the body. The kidney is said to seam water up into the upper Jiao, the spleen to transform and transport it from food and drink into the other organs, and the lung to accumulate moisture and then rain it back down to the rest of the body. If the lung becomes physically compressed, moisture can accumulate and build up as phlegm.

Over time, the heat of the body can cook this immobilized phlegm into a hot goo that results in chronic congestion, hot chest pain, cough and anxiety.

Qi transformation: the work of the organs is done around the body by their associated channels, through a process called Qi Hua or Qi transformation. To give one example; the stomach channel carries the hot and drying Qi of the stomach organ up the front of the body to assist with digestion, heat distribution and immune functions.

Cutting down the size of its pathway through the chest can impede its flow, resulting in stomach organ issues like reflux, nausea or vomiting. It can also have implications for our immune systems.

All of the issues that can arise from binding can be treated through acupuncture, herbs, bodywork, and targeted exercise, but their cause is the practice itself. I want to be careful here not to engage in victim-blaming. Many healthcare providers think about this issue and say “yes, my patients should certainly stop binding if it’s causing so many problems!” But that ignores the entire reason that we do it in the first place. Dysphoria is a very real health problem with severe mental health implications.

Binding is often a life-saving act of harm reduction that allows us to life our lives without the constant mental anguish that dysphoria creates.

Surveys of people who bind find that the vast majority of people are doing it while they await the ability to access a surgical solution. Until very recently, top surgery was not covered by insurance and pain from chest bindingwas only available to those who could pay out of pocket. This has begun to change in some states, but remains the case for most people. Therefore we should remember that binding is a self-preserving response to a societally-imposed scarcity of medically-necessary healthcare.

While we engage in the activism needed to change this, here are some harm reduction strategies to consider:

  • Stretch it out: engage in stretching poses that open the chest and ribs, for at least five minutes a day
  • Build strength: strengthening the muscles of the back and chest may help hold the body of your ribcage in place and protect them from the longterm effects of compression
  • Move your body: qi and blood move when we do, and exercise of any kind helps prevent stagnation. Depending on how you bind, running may not be a great plan, but walking is wonderful for both our bodies and our moods.
  • Get some acupuncture: we can reduce stagnation and pain by unblocking channels and moving qi and blood in targeted ways
  • Take some herbs: chest stagnation and digestive issue in particular respond well to Chinese herbals formulas
  • Listen to your body: only you can know what is right for you in terms of when to bind, how to move, and how to balance all of the considerations in your life.

Above all, be gentle with yourself as you navigate the complexities of trans experience. If you want support in your journey, schedule an appointment and let's see how we can work together.