May 2018

May 2018

    The Office: 2018 Update – MPD & Cardiovascular Diseases

  • The Left Cun reveals different heart problems.
    • Blocked pulses stage 1-3
    • Vasospasm pulses
    • Atherosclerotic pulses
  • Patients may experience insomnia, fatigue, anxiety, tightness in the chest, palpitations, which is most often a heart problem from an MPD/ TCM perspective.
  • There needs to be a 70% narrowing of the coronary arteries to fail a stress test.
  • Usually sympathetic dominant patients (or high stress situations) are the patient group experiencing coronary artery vasospasm.
  • During an angiogram, the vasospasm are usually not detected, because during the procedure they are usually not spasming and the artery’s problem is not of atherosclerotic nature. Chinese medicine appears to be a great treatment option for this patient group.
  • When treated correctly, the insomnia, anxiety, fatigue as well as the pulse go away (improve 70-100%).
  • If the pulse does not improve during the course of treatment, send the patient for cardiovascular testing (severe coronary artery blockage)!
  • For vasospasm as well as other heart problems we use herbs:
    • Base-formula:
      • Dang Gui and Chuang Xiong or Gui Zhi 15 each
    • Dan Shen 15
    • Mi Yu Cao 15
    • Shui Zhi (10g)
    • Xue Fu Zhu Yu Tang (20g)
  • Add-ons:
    • Jiang Huang or Yu Jin (cooling blood movers for the heart)
    • San Qi or Shan Zha (cleaning the blood)
    • Yan Hu Suo and/or Ye Jiao Teng (for sleeping issues)
    • He Huan Pi and Yan Hu Suo for anxiety
    • Ru Xiang, Mo Yao, Yan Hu Suo with body pain
    • San Qi, Jiang Huang, Pu Huang, Hong Hua with chest pain
  • Acupuncture Tx:
    • Wrist and ankles are loaded with proprioceptive receptors, so we needle there: LV, KD, HT (ashi points)
    • Front Mu for PC and HT (Ren 14,15,17)
    • Heat-lamp on the chest
  • Overtime the heart will become weak due to the vascular problem, so the weakness (subclinical heart failure) needs to be addressed after the heart pulse has cleared up:
    • Rx
      • Tian Wang Bu Xin Dan (calms the spirit)
      • Yang Xin Tang
      • Ren Shen Yang Yin Tang
      • in combination with the blood movers, only if the heart is weak and if the other pulses are not in excess (pounding), especially the liver

 
 
 

    The Office: MPD- The New & Improved Heart Base Formula

  • Herbs for a blocked heart pulse are altered according to the symptoms the patient has
    • Depression, mania, anxiety, insomnia, panic attacks, palpitations, water retention, hypertension, sweating, low libido, fatigue etc.
  • Base formula for blocked left Cun
    • Xue Fu Zhu Yu Tang 20
      • has Dang Gui + Chuan Xiong – strong vasodialator, so no need to add them again in this formula
    • San Leng 10
    • Shui zhi 10
      • both are cleansers for atherosclerosis
    • Dan Shen 10
    • Yi Mu Cao 10
      • all 4 single herbs above are neutral-cooling, so it is a balanced formula due to the warming nature of Xue Fu Zhu Yu Tang
      • but don’t cool the heart off too much, bc the heart likes warmth, unless they got the pericarditis type heart heat pulse
      • this base formula takes 60% which leaves you 40% to address symptoms they experience with their blocked heart
      • pay attention if px takes warfarin based drugs because the herbs may interfere with their INR; px needs to check INR weekly if on warfarin and Chinese herbs
    • If accompanied with insomina
      • Hu Po10 (if Liver heat)
      • Ci Shi 10 (if Liver heat)
      • Dang Gui 10
      • Yan Hu Suo 10
      • (Huang Lian, if heart heat pulse)
      • (Ji Xue Teng) – we are still in the formula of blood movers for the most part
    • If accompanied with anxiety
      • Yan Hu Suo 10
      • He Huan Pi 10
      • Yuan Zhi 10
      • Ji Xue Teng 10
    • If accompanied with anger
      • decide to go for liver or heart; only go for heart first, if they are not super-angry
      • watch the patient, if they are very grumpy, always for the liver
      • Half the medicine is how to handle the patient 😉
        • Be honest. Be yourself. Be authentic and be sharp and patient will trust you.
        • If you are exhausted at the end of the day, you are doing something wrong!
          • Don’t get involved into people’s problems.
          • Practice with certanty. Even if you have to fake it first.
          • Don’t dace with the patient.
          • Don’t take anyting serious. Nothing is what it seems anyways.
          • Tell them to cheer up and to take their herbs.
          • At the end of the day, you should be physically tired, but mentally stimulated.
      • Add 20% Long Dan Xie Gan Tang if they are angry (or Liver DTX)
    • If accompanied with depression
      • mushy, deep liver pulses, add
        • Yin Chen Hao Tang (if constipated) 20
        • or Long Dan Xie Gan Tang 20
        • or Liver DTX 20

 
 
 

    The Office: How To Determine The Length Of TCM Care

  • 20 years ago we used to do 1 year plans, then we got better and did 6 months, then we could do the same in 4 months, which we stuck with ever since.
  • It is better and more streamlined to do set-plans than doing individualized plans. If the “job is not done” at the end of the 4 or 5 month plan, then just roll these patients into a “prevention plan” and keep fixing their problems, as if they are still in corrective care.
  • For example, if a patient is coming from a long distance or if their problems are best addressed with herbs, then we lay out a 5 month herb plan.
    • 95cents/ gram = $400/month for herbs for 5 months = $2000
    • $65/ herbal visit, 1 herbal visit per week for 1 month, then 1 visit every 2 weeks for 4 months = 12 visits = $780
    • Nutritional counseling = $90
    • = $2870 total, if you pay as you go
    • Payment options:
      • Pay at once and save $600 (20% discount on the herbs and 3 free herbal visits)
      • Finance option: over 6 months or 12 months (for 12 months we charge 8% interest); they still save about $400
  • We expect them to feel 50% better in 3 months, otherwise we cancel their plan and refund what they have not spent.
  • At the end of 5 months and they are “only” 60-70% better and not 90% and if they are over 50 years old, we suggest a prevention plan.
  • Prevention plan
    • All (10-12) visits over another 5 months are free.
    • They also get 20% discount on herbs, so they pay $1600 for 5 months of care.
    • We offer a prevention plan especially if we see, that there is still something wrong with their heart.
  • We sell the plans through enthusiasm, we do not coerce people into buying a plan.
  • Especially millennials don’t want to be sold anything, so we tell them basically that we are very busy and that we want them to think about it carefully, if they really want to do a plan.
  • We take in over $250k/month and it really is not stressful at all. It’s a lot of fun and you get to help people.
  • People who don’t join us get a coupon card so they can come anytime to get 10% off acupuncture.
  • The plans are presented in an official manner, so patients take them seriously.
  • We address all complaints all at once, including weight loss. We take on all their health problems through long-term use of TCM.
  • The average patient visits 40 times. In 40 visits, you can change lives!

 
 
 

    The Office: Osteoporosis & Multiple Sclerosis

  • Osteoporosis:
    • Treating osteoporosis will take a long time (at least a good 12 months).
    • I simply give Evergreen’s Osteo 8 as an additional formula, 4 spoons once a day, regardless of pulse or other signs.
    • I use the patient’s “other formula” to treat the symptoms/ pulses they have besides the osteoporosis, mostly treating their heart, liver and digestive organs.
    • I have them retested after 6 months. Most patients show improvement.
    • Patients usually come because they want an alternative to Fosamax (bisphosphonate).
  • Multiple Sclerosis:
    • One cannot feel Multiple Sclerosis in the pulse.
    • Most patients will have high (and thin) pulses in all positions. I call this a “nervous system pulse”.
    • I treat them by strongly moving the blood and calming down their liver.
    • Rx:
      • Ge Xia Zhu Yu Tang 50 (move the blood, widen the pulses)
      • Long Dan Xie Gan Tang or Chai Hu Qing Gan Tang 50 (take away inflammation, calming the liver)
    • The pulses begin to widen out and settle into their home.
    • If they have low pulses with MS, then I might change the formula to 100% blood movers or also use above formula.
    • Why do I use blood movers, if the pulses are high? Answer – to widen the pulses out!
    • Often MS is accompanied with anxiety, then add:
      • Yan Hu Suo
      • Ji Xue Tang
      • He Huan Pi
    • Keep the formula very simple so it is strongly moving in one direction and only add in other herbs to treat additional symptoms, that are strongly bothering the patient.

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