Self-Care
These Longest Days of the Year
Welcome to the Tai Yang time of year. Say that three times fast, and maybe add “Thank You,” to complete the trifecta, TYTYTY! “Tai Yang” means the most yang, as we enter the longest days of the year, leading up to the summer solstice next week, at which time days will begin to very gradually, grow shorter.
Until that time we might be more vulnerable to “yang pathogens,” exemplified by inflammatory heat and/or “external invasions,” which is probably why we see a minor uptick in Covid cases around this time each year, despite the warm weather which should mitigate such spread. More common are the former, symptoms of “heat rising,” a la insomnia, anxiety, palpitations, acid reflux, constipation, headaches, and ANGER!!! If you’ve noticed an exacerbation in any such signs within yourself, rest assured, it is normal for the time of year and relatively wane after June 21st. If it doesn’t, see a doctor, and/or myself.
Some of the things we can do to cool excessive yang rising include green tea in the mornings (after breakfast), then peppermint or chrysanthemum teas at night, snacking on watermelon, cucumbers, and celery, and minimizing spicy foods and alcohol. Most importantly, sweat!
In Chinese medicine we treat most “Tai Yang disease,” or viral pathogens through moderate sweating—underscore moderate for you high intensity athletes—and as the weather now is increasingly humid to begin with, it is important to sweat, just a bit every day.
The Tai Yang time of day is mid-day, around noon, which makes that window optimum for exercise—although as I often advise my busy patients, the truly best time to exercise is whenever you have time. ‘Tis better to do imperfectly than not do at all.
Although I am admittedly a slave to air conditioning for sleep, it is obviously manmade, unnatural, and ultimately not physiologically (or environmentally) beneficial. In the humid climate of summer, the contrived cold air traps pathogenic fluids at the exterior, or “Tai Yang layer” of the body, thereby exacerbating local inflammation, often inducing skin/joint conditions, and compromising immune function. I recommend using it as minimally as possible and/or wearing a scarf or long-sleeves while in offices or public transportation that insist on killing us slowly. And spend as much time outdoors as possible. We are all too deprived of it these days.
Happy Father’s Day!
Chinese Medicine on Fainting, Dizziness
A friend of mine recently expressed having experienced great bouts of dizziness and fainting during the third trimester of her last pregnancy, which was in the dead of summer and was thus not surprising. I felt bad to hear of her struggles, but grateful that it inspired an idea for a new entry, on how Chinese medicine views fainting and dizziness, whether in pregnancy or not, and how we can treat or prevent it.
As with any Chinese medical diagnosis, the specifics get complicated, but we can still relatively easy to simplify into a couple of broad strokes. With any manifestation of dizziness, whether orthostatic, vertigo, passing out, or anything else, we are considering patterns of either blood deficiency, dampness, or a combination of the two, the latter of which obviously being the most difficult to treat. The final one is where your toddler at home forces you to “dance” with her around the house by spinning endlessly, for which there is no cure.
Blood Deficiency: More common in vegans, vegetarians, and pescatarians (most likely descending order), more common in women (especially while pregnant), the elderly, or anyone on long-term medications, which compromise the body’s absorption and capacity to produce blood. There is either a lack of cerebrovascular fluid or its flow and the head becomes faint.
Recommended treatment is herbs and moxibustion (acupuncture not as effective here), red meat or eggs, and earlier bedtimes.
Dampness: More common with obesity, more common in men, and/or people who consume a lot of alcohol, sugar, dairy, or raw foods. The microbiome grows congested with fluid retention, so the pathway by which our cellular energy carries healthy fluids to the brain is obstructed. “The clear yang qi cannot rise,” as we say, and our clarity or stability suffer.
Recommended treatment is minimizing all of the aforementioned foods, herbal medicine for 1-3 weeks to purge fluid retention, and acupuncture, especially along the vertigo line along the scalp located directly above the top of the ears. Note, this point will not be as effective on blood deficiency patterns, who are suffering a pattern of “deficiency,” not “excessive damp,” which responds better to aggressive manual treatment. As for self-care, drink hot ginger tea and black teas until symptoms subside.
Combination Blood Deficiency/Dampness: This is most common in pregnant women and very difficult to treat, because to nourish blood we must generate fluids, but to resolve dampness we must purge it. Not to mention the fact that we must be careful with purging fluid retention in pregnant women, since the fetus is ultimately a form of fluid retention—albeit an adorably magical one.
Dizziness and vertigo are serious conditions, not generally life threatening, although potentially dangerous when leading to the physical risks that accompany fainting. As always, Chinese Medicine can have much to offer in the way of hands-on treatment, internal medicine, and recommended self-care.
When in doubt: red meat, eggs, ginger tea, good rest, and steamed vegetables for the dampness.
Spring is “Shao Yang” Season!
As I made my way this Monday through my ten-block, 2 ½ avenue walk from Penn Station to the office, the 41-degree winds whipping into my face, masquerading as 30 degrees, that lovely sweatshirt-only, spring day of the previous weekend felt like ancient history, only to return like an overdue hug on Tuesday.
Even on these open-air, warm days, I’m cynically aware of what they ares. A tease, a mere foreshadowing of the still relatively distant future, a glimpse into a climate we may or may not experience each year, and for the next several weeks one that will rear its head only sporadically, thereby confusing our wardrobes and forcing us to check the weather app daily.
Spring corresponds with the wood element in Chinese medicine, which corresponds with the gallbladder meridian, or shao yang layer of health and disease.
At their root, “shao yang pathologies,” which can be anything from gastrointestinal to neurological, emotional, autoimmune, or otherwise, are said to be caused by “dry,” or weak guts. Vulnerability in metabolism leads to inflammation that flares upwards, commonly manifesting in symptoms such as chest tightness, throat dryness, eye dryness, most dryness, headaches, etc.
“Heat above, Cold below,” as we call it, which really just means the “cold” or weak microbiome has caused substances that should have descended as stool or urine to rise in the form of inflammation and harass upper portions of the body. One of the most signature symptoms of a shao yang pathology is the experience some have of alternating heat and cold sensations. So, while we can probably blame much of spring’s recently more chaotic, unpredictable nature on global warming, there is systemic logic to it. We might even acknowledge that in spite of our ongoing environmental crisis, spring is still the only season that consistently behaves so erratically. And erratic… is shao yang. Even the “shao yang pulse,” is signified by being ever-changing. One minute it feels wiry and rapid under the clinician’s finger—the next it’s like a slippery little ball. As my teacher would say: “This person is ‘shao yang’.”
How to temper our internal and external shao yang challenges? Simple and same as always really: Warm, easily digestible foods, and early bedtimes.
Soups and stews, congees, eggs, and steamed vegetables are light on the gut. They should generate healthy metabolic fluids and are less likely to create inflammation. This will address the “cold below.” As for the “heat above,” early bedtimes will modulate neurotransmitters and maximize the kind of organ recovery that can be attained only through a good night’s sleep (and/or Chinese herbs).
Err on wardrobe for the calendar more than the forecast, obviously within reason. Our bodies are still considered “cold” from the half year of cold, so all the youthful “heat pathologies” walking around outside in cut-off belly shirts cut low again on top will be more vulnerable to viruses.
Exercise should be consistent, but moderate. Regular enough to quell the heat above, but mindful to not sweat so much as to weaken the cold below. If you’re aiming to have the beach body ready for summer, the best way is by avoiding gluten, dairy, sugar, and raw foods, along with mild core workouts.
Finally, the wood element of spring is most supported by the sour flavor, so this is a good time of year to add foods like lemon and vinegar to your daily intake. Although they are uncooked, pickled foods, such as sauerkraut or kimchi are good to have alongside your warm meal, as they help to prevent the “shao yang stomach.”
Happy Shao Yang Season, everyone!
When is Stress Actually to Blame?
I feel like in the 20th century no one was talking about stress as an etiology for disease. Possibly I am guilty of generational egocentricity, having barely reached the drinking age by 2000. Thankfully, I had very few young friends discussing ailments and how they came about.
Still, I think it is more referenced, even over-diagnosed nowadays, especially by western doctors any time they cannot explain a symptom or its etiology, shrugging shoulders and throwing their arms up, citing the most probable suspect. “Might just be stress,” they say, which for its listener might feel an implication that their complaint is a fabrication of the mind, if not something that can only be resolved or improved once everything in life is good, or they achieve spiritual enlightenment, neither of which are in the cards for most of us this go around.
While I’m all for patients having agency over their own health, things happen that are out of our control—an accident, post-viral symptoms, genetic predispositions, or just life—when it helps to have a knowledgeable clinician to provide valuable insight and hopefully effective treatment.
In Chinese Medicine stress is said to have a drying effect on the body. This is why when people “stress eat” they crave “damp-causing foods,” such as cheese, bread, and sugar.
Unfortunately, such foods do not generate healthy fluids, nor is stress-induced dryness the kind that will drain pathogenic dampness. Instead, the drying effect of stress refers to the depletion of mucosal organ fluids, beneficial stomach fluids (anyone get acid reflux or diarrhea when over-stressed?), and/or those that lubricate our orifices, gyri and sulci of the brain. Although hydration is advisable, drinking water cannot replace these fluids.
In early stages or mild cases, the best way I know to restore such fluids is through rest, sleep, and the consumption of eggs, bone broths, or red meats. For the rest of us herbal medicine is necessary. Herbs such as ginseng or licorice for the gut, puerariae root for the head and neck, ophiopogonis for the intestines, atractylodes for the intestines, trichosanthis for the orifices, or rehmanniae for the brain and blood. Always consult a (real) herbalist before taking.
Although extensive periods of stress are never helpful, it is important clinically, to thoughtfully discern between when stress is, and when it is not the primary cause of a particular symptom. Almost everyone in modern society has at least moderate degrees of stress, yet everyone is walking around in enormously different stages of health or discomfort.
From our perspective, when stress directly brings up a symptom, it informs us that dryness is probably at its root of imbalance. The body couldn’t tolerate any further depletion of fluids. Then, and only then, is when stress is to blame—not to mention the fact that most disease is multi-factorial. Systemic dryness is likely only part of the picture, which is why many people “do all the right things”—exercise, meditation, good sleep hygiene—but still experience symptoms. Because it is almost never “just stress.”
3 Tips for Winter Self-Care
With the shorter days and longer, colder nights of winter upon us, it is in our best interest to follow nature to best support well-being. Of course, to some degree it is relatively impossible for most of us to alter most things about our lifestyle based on the seasons. Modern society does not follow, nor concern itself with the Tao. The Tao does not make money nor promise love, and even if it could we are not learned enough in it to follow with much accuracy. Nevertheless, we can still do what we can when we can, make minor modifications, certain mindful choices whenever possible, as I would be remiss to not share.
- Stay warm… but not too warm! While Chinese Medicine is all about warmth, encouraging vasodilation over constriction, if you live in a climate that has the four seasons it does not benefit your “wei qi” (immune system) to never experience the conditions and elements at all. This does not mean go out wearing belly t-shirts, short sleeves, or no socks at the first weather report above 40 degrees. On the contrary, hats and scarves are highly recommended, as is not being overly sedentary or sheltered. A sheltered existence, whether literally or figuratively, creates a weaker shell. For our purposes we might think of our immune system as our shell. Even if just for a commute or walk around the neighborhood, it is important to get outside on most days, bundle up, and not fall too victim to the privilege of modern climate control.
- Sleep earlier. While the recommended bedtime in Summer is 11pm, in Winter it is 10pm. This doesn’t mean get into bed at 10pm, watch a movie until 12, and fall asleep around 12:20. It means to be unconscious at 10:00. For those of us this presents a challenge for, the earlier you can do the better. There is a biomedical belief that for healthy sleep habits, consistency of bedtimes is most important. If one goes to sleep at 1am a few nights out of the week, one should do so every night. From a Chinese Medical perspective, this is a bit like recommending if you eat pizza once a week you should do so daily, so that it is never able to shock your microbiome. Instead, we recommend making the healthiest possible choice as often as possible. Also, don’t eat pizza every week. I love pizza too, but let’s be honest. It’s fast food.
- More (red) meat), less raw food. I know it feels like Chinese Medicine doctors are always trying to get people to eat more red meat and less raw food, but that really is not the case. The summer is a time for both raw foods and red meat in moderation. There can be more days of veganism or pescatarianism in Summer, as excessive beef is too warm for most bodies on hot days. By contrast, Winter is the coldest, most yin time of year. It is the time to protect our bodies’ “yang qi,” or metabolic fire, as we observe in so many other animals as a time to store fat (you can begin your South Beach diet in April). The oppressive cold of yin requires balance in the form of yang-warming ingredients—think steak cooked with garlic, onions, or ginger. If you cannot consume red meat it is advisable to accentuate the warming spices. Please note, this does not mean hot sauce or red pepper, which is a bit to healthy spices what coffee is to much needed rest. It will give a temporary surge of warmth, but in the long run will dry out the healthy stomach fluids, which will make it more difficult to absorb nutrients and generate natural yang inside the body. Spicy food is not “yang,” any more than yelling or shouting is “strong.”
For my part what I can offer for the next few months is more moxibustion, heat lamps, and heated tables when indicated. Burning the mugwort herb on acupuncture points generates healthy warmth and organ fluids in a way that no other modality can, in my opinion. In biomedical terms, it reduces cartilage damage from inflammation by modulating the NF-κB signaling pathway. It also drops pain via the suppression of Cox-2, which is an inductible enzyme that is highly expressed with pain. Recall, one of the oldest Chinese Medicine maxims: Where there is pain there is stagnation. Where there is stagnation there is cold. This is why my office smells like an incense store in winter.
