Sleep Positioning for Back and Shoulder Pain

Struggle to get comfortable in bed at night?  Here is one of my hot tips for sleep positioning. It keeps the spine aligned as well as taking pressure off of the shoulder and hips. My patients dealing with injury or late stage pregnancy swear this supported sidelying position has changed their life, but it's great for anyone to try. You'll need four pillows. One under the head, one under the ribs, one between knees and an optional "hug" pillow to keep your torso in position and your arms comfy.

The key is to get the torso pillow right up against the bottom shoulder, creating a sort of "groove" for the shoulder to sit in, almost weightlessly. Be sure to get a big enough pillow between the knees so that the hips stack up evenly. Alternatively, you can have one leg stretched out behind you and the top knee on a big pillow. Comfortable sleep positioning is important to promote healing and the deep sleep crucial to our nervous and immune systems. Happy snoozing!

Moxibustion for Turning Breech Babies

Most babies are born in a vertex or head down position, allowing for an easier passage out of the uterus and through the pelvis. Babies will typically turn head down between 28-32 weeks.

Breech describes a pregnancy in which the baby is not positioned head down.  Often a breech baby will be bottom down, while others are feet first or transverse. 3-4% of babies are breech at 37 weeks. Often a breech presentation can lead to a C-section. If your baby is breech there are non-invasive techniques to help your baby turn head down.

Acupuncture along with moxibustion is well known for success in turning breech babies. Moxibustion is a warming technique using an herb called mugwort- often compressed into a smokeless stick for ease of use. We have helped scores of women turn breech babies at DHH and want to share with you what you can do for yourself at home.

This protocol is known to encourage the baby to move into - and stay in- the best possible position for birth. It is recommended to do the whole ten-day protocol even if you discover baby is in position when you see your OBGYN or midwife. This will help baby stay in position. One of my patients calls this “smoking her toes” and used it successfully to turn breech babies in both pregnancies after week 36.

Protocol:

Best to use smokeless moxa. It would be deal to have your partner or a friend do the moxibustion for you. The protocol is to moxa the following points bilaterally twenty minutes for ten days.

If you are certain baby has moved into head down position you can reduce the moxa time from twenty to ten minutes per day till the ten days are up.

Make yourself comfortable on a bed or chair and wear loose, comfortable clothing. Light the tips of two moxa sticks until the ends are glowing. Careful not to burn yourself or anything else! The lit moxa sticks are held bilaterally about a thumbs width from UB67 (outer proximal corner of pinky toe nail) until woman feels the skin is comfortably hot, the sticks removed for 2-3 seconds then re-applied. This "pecking" action repeated for 20 minutes.

UB 67 is the point where Urinary Bladder meridian meets the Kidney meridian. Stimulating this point strengthens the Kidney Qi, important for maintaining the fetus in the correct position. Extinguish moxa by stubbing out and keep in a sealed glass jar or use a jar of sand or rice to extinguish. Be sure to have enough moxa sticks to get through the ten days. - 6 sticks should do it.  It is always best to have acupuncture in conjunction with your home moxa protocol if at all possible. Give us a call and we will get you right in for support!

Sleep: Your Superpower

I have often bragged over the years that sleeping was my superpower. As I have gotten a little older, I have a little less swagger in my step when it comes to my sleeping prowess. With hormonal fluctuations, stress surges and a noisier neighborhood, I have had to work at it to make sure I am getting the solid 8 hours that give me the energy and joie de vivre I depend on. With a few tweaks I have gotten my sleep groove back. The National Sleep Foundation says that 30-40% of American adults have reported trouble sleeping in the past 12 months, while 15% report chronic insomnia. Insomnia tends to affect more women than men overall. Its effects are insidious and profound: causing weight gain, brain fog, anxiety and depression, disrupting hormonal balance and impairing our body’s ability to fend off pathogens and to detoxify.

Common treatment for insomnia in the US consists of pharmaceutical drugs that often have side effects, are addictive and worse yet, can stop working when used long term. Fortunately, in a 2009 systematic review of RCT’s, acupuncture was shown to provide safe, effective treatment for insomnia. At DHH we don’t use a one size-fits-all approach to treating insomnia. We will get to the source of the problem and provide a tailored solution that restores balance naturally.  That means when acupuncture alone isn’t enough, we also utilize nutritional strategies and high quality herbal medicine or supplements to help get you snoozing like a champ.

Insomnia is described by traditional Chinese medicine in four categories: difficulty falling asleep, light or restless sleep, early waking and dream disturbed sleep. Yin deficient fire often accounts for the “light sleep” and “early waking” types of insomnia. Qi stagnation from prolonged stress transforms into fire, which flares up and disturbs the mind. This pattern relates to trouble falling asleep easily and may be marked by vivid and distressing dreams. Other patterns exist as well and an experienced DHH acupuncturist can help with a correct diagnosis and customized treatment plan.

Causes of insomnia:

• Poor sleep environment- inadequate darkness, too much sound or stimulation.

• Medications that contain stimulants such as: corticosteroids, some antidepressants and heart medications, among others.

• Medical conditions that are not properly managed for example GERD, chronic pain, and hyperthyroidism.

• Schedule changes in work or sleep.

• Excess eating, caffeine or alcohol use.

• Stress, depression and anxiety.

• Hormonal: PMS, perimenopause and menopause.

Tips on improving your sleep:

• Get to bed before 11pm- like diving under a wave, you will get to sleep before liver energy surges and gives you a ”second wind”. Your nervous system will thank you.

• Keeping a regular sleep schedule- allows your body to set an optimal circadian rhythm, which is critical for the symphony of physiological processes; tissue repair, hormonal balance, metabolism, immunity.

• Black out- not you, your bedroom windows! And power off those devices at least 30 minutes before bed. The blue light emitted from devices disrupts your body’s production of the hormone melatonin, important for sleep.

• Eliminate- the issue of excess alcohol or caffeine. If you aren’t sure try, reducing or eliminating those elements. If it’s keeping you awake, it’s not worth it.

• Stress busting- be sure you are getting enough exercise. 30 minutes of breaking a sweat most days should help a lot. Try to make it fun when you can, such as an urban hike or a personal dance party.

• Acupuncture- let us give you some care and create a plan to get you bragging that sleep is your superpower!

What is PCOS?

This is the first in a series of blogs about PCOS. Polycystic Ovarian Syndrome is a complex syndrome with varied presentations, so there is much to discuss. It is one of the most common endocrine disorders affecting women. In PCOS, dysregulated blood sugar causes an excess production of testosterone, leading to a disruption of normal ovulation.  The hallmark symptoms are lack of ovulation with irregular or long menstrual cycles, infertility, acne and abnormal hair growth patterns. Although not seen in all patients, there is a link between PCOS and obesity.

A leading cause of infertility in the United States, 5-10% of women are affected by PCOS with less than 50% diagnosed. That means PCOS is responsible for 70% of infertility in women who have difficulty ovulating.  PCOS also increases the risk of metabolic syndrome in women.  The good news is that with nutritional and lifestyle changes, supplementation and acupuncture support, women can greatly reduce the risks associated with PCOS.

Generally, a diagnosis is made when two of the following symptoms are found: excess androgens, menstrual irregularity and polycystic ovaries- where multiple follicles are seen, often looking like a “string of pearls”.  Clinically patients with PCOS can present with at least two types from a western perspective: lean patients with a tendency toward hypoglycemia, and overweight patients that tend toward insulin resistance. The treatment strategy would be different depending on the type. In order to determine if you have PCOS and what type, work with a trained DHH practitioner or your OBGYN to get a serum lab work up and a vaginal ultrasound to help identify and categorize, or rule out PCOS.

Wondering what you can do if you have PCOS? In general, focusing your nutrition on blood sugar stabilization is a perfect place to start. A fantastic resource for nutritional guidance is “The Blood Sugar Solution”, by Mark Hyman, MD. Always begin the day with a protein-based breakfast. Eat something every 3 hours. Dominating your meals with a rainbow of vegetables, healthy fats and proteins, while avoiding refined carbohydrates and sugars is the first step. Increasing your exercise to at least 30 minutes per day of cardio is also very helpful in optimizing blood sugar and hormonal balance. Finally, at DHH we will customize a treatment plan to address your unique health picture. Well-researched supplements are prescribed as needed and evidence-based acupuncture is performed to help get you ovulating regularly again.  Stay tuned for more on the topic of PCOS.

Electroacupuncture For Pain

Electroacupuncture is much like it sounds- a treatment technique in which a tiny electric current is passed to pairs of acupuncture needles.  Why the heck would I want to do that, say you? Well, as it turns out, it’s a safe and highly effective treatment for pain with a long history. Ancient Egyptians actually used electric fish to treat pain in 2000 BCE. Fast-forward to Italian physician Galvani, who discovered the muscle twitch response in dead frog legs back in 1780. You may remember this rather macabre experiment from your high school biology class. The science of neurology further developed in the 1800’s to discover the uses of electric current in muscular contraction. Electro-acupuncture is a fairly modern application in traditional acupuncture-practiced since 1934 and it’s become ever more popular due to its efficacy.

How does it work? A rhythmic, non-painful muscle twitch is produced beneath the needle via a very small milliamp current. This electric stimulation to needles (called PENS, percutaneous electric stimulation) is shown to produce natural painkillers- also known as endogenous opioids; the most well known of which are endorphins. The treatment also elicits perfusion of blood flow locally, carrying with it essential nutrients promoting muscle regeneration. Microamp current is even smaller- often barely perceptible to the patient. This current does not cause muscular contractions; rather it’s been shown in some studies to produce ATP, critical for cellular energy and is also thought to promote tissue healing.

Electroacupuncture helps to break vicious pain cycles, deal with chronic pain disorders and facilitate patients own pain relief mechanism.  As well as the analgesic effect, electro acupuncture stimulates muscle relaxation, normalized muscle length and overall stress reduction. Consider giving it a try next time you are contending with pain. You will be slightly shocked at how well it works!

Optimize your chances of getting pregnant

Most of us spend our youth trying NOT to get pregnant. It’s quite a shock to our cultural conditioning to realize we might not get pregnant as soon as we feel ready, even though many of us have delayed that moment to anchor other important aspects of our lives. Turns out that difficulty conceiving is really common. One in eight couples in the US has trouble getting or staying pregnant. More than nine million American women seek fertility treatment each year and many men need treatment too. In our clinic we see women struggling with fertility every day, both with and without western a diagnosis. Men usually come in when they get the unexpected news that they have a poor sperm analysis. Challenge with fertility can be quite frustrating and emotionally painful. It is possible for the women and men who work at naturally optimizing fertility to end up more grounded and healthier in the process. Best of all, Chinese medicine can give very tangible help to enhance fertility.  Among its research supported benefits, acupuncture can help regulate ovulation, improve blood flow to ovaries, support the hypothalamus-pituitary-ovarian axis and lower stress hormones. While at Double Happiness Health we carefully evaluate and customize each client’s treatment plan to get the best results, here are five tips on diet and lifestyle changes you can make to start optimizing your chances of conceiving right away and feel better in the process:

1. Reducing stress might sound cliche these days, but figuring out what works for you personally, and actually creating simple habits that change your stress level on a daily basis really does help couples get pregnant. A 2011 study published in Fertility and Sterility showed women that attended a mind/body program had greatly increased pregnancy rates. Try incorporating one thing: breathing, yoga, meditation or even a walk after work.

2. Clear inflammation. Inflammation is at the root of many fertility issues; go for an anti-inflammatory diet. The Chinese have it right when they suggest mostly eating deliciously cooked veggies, healthy fats, power packed whole grains and yummy proteins. This basically cuts out wheat, dairy, sugar and processed foods. If you aim for this most of the time, you will absolutely optimize your egg and sperm quality.

3. Detox. I know you love your morning americano. Me too. But you don’t want to rely upon caffeine for energy. Try to limit coffee to one cup per day unless you are having trouble, then give it a break altogether. Too much caffeine can reduce sperm motility, decrease blood flow to the uterus and possibly cause problems with implantation. A large Kaiser Permanante study in Oakland study showed drinking ½ cup of green tea or even black tea instead produced twice the pregnancy rates than in coffee drinkers. Alcohol is best avoided while trying to conceive.

4. Timing is everything. If you are having a natural cycle, get to know when ovulation is occurring for you by using an over-the-counter ovulation predictor kit, or, better yet, learn your body’s signs of ovulation by tracking your BBT. Once you know when you are ovulating, the key is to have sex a little ahead of time. Sperm generally live for up to 72 hours, but an egg only has a 24-hour window to be fertilized. Try to conceive the day before and day of ovulation.

5. Read “Making Babies” by Sami David M.D. and Jill Blakeway L.Ac., my current fav of all the fertility self help books out there, it’s a balanced east/west view and provides truly helpful information for men and women to prepare you for your 3 month “pre-mester” of fertility enhancement.

Getting a clue about your digestion

Was it Ms. Scarlett in the kitchen with a candlestick?

Solving the mystery of our digestive issues can sometimes feel like a game that has gotten very old- a daily cycle of bloating, poor elimination, rashes, fatigue and worse. In fact, food sensitivities and other GI disturbances have been linked to allergies, arthritis, autoimmune disorders, dementia, infertility, insomnia, mood disorders, and migraines.
Our gastrointestinal system is a wondrously complex system that does much more than digest, absorb and eliminate- it’s an independently working nervous system (the enteric nervous system)- replete with neurotransmitters, hormones, chemical messengers, enzymes and a diverse colony of beneficial bacteria. In fact, the gastrointestinal system represents almost 70% of our entire immune system.
Imagine your gut like an overlooked precious natural habitat that your very life depends on, and you’ve got the picture!
Many things can go awry in our gut: inflammation, intestinal permeability, enzyme depletion, microbial imbalance, detoxification dysfunction, motility problems. Each one of these factors can be impacted by food sensitivities.
Determining the source of your digestive issue sometimes requires acting like a detective, carefully noting symptoms and triggers. A great tool for this process is doing an elimination diet. While the idea might be a bit daunting initially, with the right support this tool can become the most profound self-experiment you have ever done. It is inexpensive, fairly simple to do and empowering. Elimination diets are not flawless, but continue to be the gold standard for identifying food sensitivities. Food allergy testing does exist, however it tends to be pricey and not very reliable.

An elimination diet is just like it sounds- a process by which foods are eliminated for a period of three to four weeks for adults and then deliberately re-introduced one at a time to determine if symptoms are observed. Almost anyone with digestion problems can benefit from an elimination diet.
Who should not do an elimination diet? Individuals with respiratory reactions (asthma, chronic pulmonary disease or emphysema). Anyone with a personal or family history of anaphylaxis (a severe whole-body allergic reaction) should not do an elimination diet, as it could be life threatening. People who suspect celiac disease or gluten sensitivity, have anemia or a family history of celiac should be screened for it first, as it is hard to diagnose this autoimmune condition after a long-term elimination.
At Double Happiness Health we tailor elimination diets for the individual, taking into consideration many factors guided by research, clinical experience, patient symptoms and history and what the patient is willing and able to do. One size does not fit all but the more suspected food groups you take out the better, although it is admittedly more challenging. Often it is the foods we eat every day that we have become sensitive to without realizing it. The basic foods to exclude in an elimination diet are gluten, dairy, egg, soy, corn, smoked or processed meats and smoked fish, shellfish, nuts, lentils and most beans, alcohol, coffee, citrus and nightshade vegetables.
Mon Dios, what CAN you eat!? Actually, that leaves enough for a pretty satisfying diet. You should not go hungry- this isn’t meant to be like fasting and there is no need to micromanage your diet except to eliminate the suspected items. Be sure to drink plenty of water- about 60-70 ounces per day. Include fresh meat, fresh fish, brown rice, wild rice, quinoa, most veggies and fruits, adzuki and mung beans, unsweetened rice milk, coconut milk, avocado, seed and seed butters, olive oil and coconut oil. Get our shopping list here.
No one is expecting you to eat like this forever- that wouldn’t be very fun. I liken the process to tossing pebbles into still waters- we can see the ripples, whereas toss a boulder into a choppy lake and you’d hardly notice. This temporary diet allows the gut to become very calm and easier to observe.
After about three weeks of the elimination phase, you begin to re-introduce a single food for a single day. You would not introduce both gluten and dairy on the same day or on subsequent days. Say you reintroduce gluten on a Monday- you can have a slice of toast at breakfast and wheat pasta at dinner. Then you will resume your elimination diet, looking out for reactive symptoms Tuesday and Wednesday. If you have not observed any symptoms, you can try reintroducing another food such as dairy on Thursday. It’s a good idea to keep a food/symptom journal during this time. Symptoms or reactions you might notice: bloating, bowel changes, headaches, brain fog, sinus or respiratory issues, breakouts or rash, fatigue and inflammation or joint pain. If you note symptoms, keep that food out of your diet for the rest of the re-introduction period. The whole process is completed within 5-6 weeks.

It’s not an easy process, but it is very do-able and can be very rewarding. Some tips:
• Planning ahead for your meals is critical to success.
• Prepare by having the foods you will need in advance.
• Toss or hide foods (really well) that might tempt you.
• Cook bigger portions that can last over several meals.
• Try some recipes out before you begin so they are familiar and easy.
• Calendar the elimination diet when you do not have big social events or travel plans.
• Make sure your family and friends know that you are doing it so they can support you.
• Make social plans like going to the movies or a hike so that you don’t feel isolated.

Be sure to seek out some cookbooks and blogs as inspiration, and work with DHH practitioners before and during your process. Acupuncture support helps to balance your qi and optimize the healing of your gastrointestinal and immune system. We can also help guide you regarding tailoring your elimination diet just for you and to create a treatment plan to optimize your health.

Autumn and the Metal Element

Cool, crisp autumn has decidedly arrived in San Francisco. Days are shorter, shadows are longer, summer is in our rear-view and the holidays are right around the corner.

A recent lively conversation with friend and gifted coach Simone Janssen of Salt Leadership got me thinking about late autumn and it’s associated element of metal in Traditional Chinese Medicine. Autumn is a time for turning inward, self-reflection and gratitude for the harvest. Just as trees let go of their dry leaves to be recycled into rich mulch, the metal element within us helps us to discard what we no longer need and to store only what is necessary for winter.

I tend to see trends in my own body and in my acupuncture clinic this time of year. As in nature, issues of dryness, especially related to lung, sinus, skin and large intestine tend to arise physically. Emotionally, we may contend with some grief. Whether it’s the letting go associated with aging, expectations, relationships or aspects of our identity, sadness is often part of the experience. Not surprisingly, when we are out of balance, this stuff might cause us to react with a metal-like rigidity or desire to control. Try to breathe and just roll with it. This too shall pass-
Chinese Medicine holds that grief and sadness must be felt and processed, or it will manifest into disease. Take extra good care of yourself with plenty of rest, fluids and a balanced, seasonal diet.  Eat plenty of soups, stews and healthy fats.

Diaphragmatic breathing is one of my favorite tools for staying present and getting grounded. Here is a simple breathing exercise I like to teach my patients:
Lie on your back with knees bent and feet planted. Place one hand on your chest and one on your abdomen. First notice where you tend to breath. When anxious or tense, most of us breathe into our chest.
Now place both hands on the lower abdomen below your navel. Send your breath into the belly, feeling your hands rise with inhalation and fall with exhalation. Taking your time, practice ten breaths in this way. Try practicing this in the morning before starting your day- I find it invigorating and it helps me be available to enjoy the fresh day, starting over and finding that it feels good to let go.

Finding the Best Acupuncturist in San Francisco

After denouncing them for years, the world is finally returning to ancient healing methods, backed by hundreds or thousands of years of practice and empirical evidence. Acupuncture is one of them. The centuries-old healing practice is a part of traditional Chinese medicine (TCM) and has been gaining immense popularity in the west lately. But what it really is, how it works, and how to find the best acupuncturist in San Francisco? Let’s talk about it all to help you develop a better understanding of this traditional method of treatment.

What is Acupuncture, and How Does It Work?

Acupuncture is a traditional Chinese method of healing that involves stimulating sensory nerves and pressure points under the skin by inserting very thin, sterile needles at specific points on the body. The needles gently and strategically activate peripheral nerves to trigger the body’s natural healing mechanisms.

This is how we understand acupuncture in the west. TCM experts have a different explanation of how acupuncture works. They consider it a technique to re-balance the flow of energy (chi or qi) in the body, which then helps improve overall health and wellness.

What is Acupuncture Used For?

Acupuncture can offer many benefits but is best known for the relief of pain and discomfort, including those associated with different diseases. Some of the conditions, and pains, acupuncture can help offer relief from include:

• Headaches, including migraines

• Neck pain

• Dental pain

• Lower back pain

• Menstrual cramps

• Labor pain

• Myofascial pain

• Osteoarthritis

• Tennis elbow

• Carpel Tunnel Syndrome

• Fibromyalgia

• Post-operative and chemotherapy-induced nausea and vomiting

• Respiratory disorders, such as asthma

• Digestive issues, such as gastritis and IBS

• Stress, anxiety, and depression

• Addiction

How to Find the Best Acupuncturist?

Whether you’re searching for the best acupuncturist in San Francisco or somewhere else, the process will be the same as choosing a doctor.

Start by asking for recommendations from people you know and trust. Check each of the recommended acupuncturist’s credentials, training, and certifications. Read reviews online and then finally reach out to the practitioners for a quick one-on-one session to inquire about if and how they can help with your condition. Ask if they have experience dealing with your specific issues, what results you can expect, and how long it will likely take. Choose the one that best satisfies your concerns.

One thing to remember when choosing an acupuncturist is to always choose a licensed practitioner.

Christine Friel L.Ac. and her team of powerful, talented women at Double Happiness Health meet all of these conditions. They are all licensed to practice acupuncture in California and have extensive experience in the field of acupuncture and TCM at large. They have treated thousands of patients over the past two decades, helping them improve their health and quality of life by relieving a wide range of uncomfortable symptoms, hormonal challenges and systemic disorders. Reach out to this incredible team for acupuncture in San Francisco. You will be so glad you chose Double Happiness Health!