Acupuncture: Treatment of Postoperative Pain

I was excited to find an article from the Journal of American Society of Anestheiologists regarding reduction of postoperative pain for both upper and lower abdominal surgeries. The study showed a reduction in incisional and visceral pain, reduced analgesic requirements, and diminished incident of postoperative nausea and vomiting. There was also a reduction in pain-induced activation of the sympathetic nervous system that normally accompanies surgery.

I can personally relate to what patients go through from being a patient myself. To this day I remember the taste of the anesthetic Ether, waking up nauseated and enduring pain once the anesthetic wore off.

Today with advancements made in the field of anesthesia, both post-op pain and nausea are better managed but not completely resolved. As both a registered nurse in preoperative care and an acupuncturist I can help people decrease the effects associated with surgeries. If you are having surgery I invite you to talk to your surgeon regarding acupuncture treatments. My suggestion would be to have an appointment the day before surgery and a couple days post surgery. Of course this depends on the type of surgery and the overall outcome.

I encourage you to read the article and take a copy to your surgeon : Anesthesiology: August 2001-Volume 95-Issue 2- pp 349-356.

Sleepless Nights

Sleep is extremely important in order to maintain good health. Getting the restorative sleep that we need helps us to repair damage done to our bodies during the day. It does so by allowing the body to replenish every cell, boost the immune system, regulate metabolism, improve cognitive function, eliminate toxins and free radicals, balance hormones, maintain cardiovascular health and create neurotransmitters.

Causes of insomnia and sleep disorders are:

Drugs: Prescribed drugs for blood pressure, cholesterol, weight loss, hormone replacement therapy, oral contraceptives, steroids, bronchodilators, over-the-counter pain and cold relievers, and decongestants.

Physical problems: Sleep apnea, asthma, COPD, congestive heart, pain-related disorders such as arthritis, nerve disorders such as Parkinson's, MS and restless leg syndrome.

Hormonal Imbalances: A high level of thyroid hormone to adrenal hormone imbalances as well as fluctuating female hormones during peri-menopause or menopause all can have their cause on a sleepless night.

Hypoglycemia: Drop in blood sugar below 50 can cause levels of adrenaline, glucagon, cortisol and growth hormones to rise, all of which can stimulate your brain and keep you awake. A good rule of thumb is to finish your dinner at least 3 hours before bedtime, refrain from overeating and keep bedtime snacks small. Stick with the low glycemic index foods such as eggs, meats, poultry, fish and non-starchy vegetables to help hormone levels low especially cortisol. It has been found that cortisol levels respond to our food intake and depending on the glycemic index of a meal, our cortisol levels can remain elevated into the night disrupting REM (rapid eye movement) causing one to wake up non-refreshed.

Caffeine: Coffee, tea, chocolate and colas, especially in the evening, can be too stimulating. Also alcohol and smoking can affect your sleep later during the night.

Nutrient Deficiencies: Lack of B vitamins, protein and magnesium as well as other mineral imbalances can affect sleep. Studies have found that thiamin, riboflavin, niacinamide, folate, pyroxidin (B6, one of the nutrients that enhances the body's conversion of tryptophan to melatonin) and B12 play a role in healthy sleep pattern.

Allergies: Certain foods and chemical exposures can affect sleep quality. These include anything from mercury, chemical solvents, pesticides and household cleaning agents to refined sugars, pasteurized milk, peanuts and gluten.

Persistent Stress: Persistent stress is the most common cause of insomnia and it all depends on how you handle the stress. Your brain maintains a "circadian clock" which regulates levels of adrenal hormones such as cortisol and adrenaline of which control patterns of body temperature,brainwave activity and hormone production. Normally, these circadian rhythms and your adrenal glands work together to keep cortisol- a wake up hormone low at bedtime so you can sleep. Cortisol should rise to it's daily high for you to wake up. But this internal clock can be easily upset with ongoing stress of almost any kind. Even perceived stress can be detrimental to your sleep cycle because your body interprets it as an emergency and will operate on survival mode keeping you alert, prepared and wide awake.

Erratic Hours, Rotating Shift Work and Jet Lag: All disrupts your circadian rhythm and disturbs the secretion of melatonin- a hormone produced by the pineal gland that helps regulate sleep. Unfortunately, modern society has TV, computers and artificial light which keeps us working and stimulated at night.

Inactivity: Regular exercise can help release tension and stress thus promotes better sleep. But do not overdue it on the training and or exercising at night which can lead to sleep disorders. For this reason, it is best to exercise early in the day.

These are just a few possible causes to insomnia and sleep disorders of which is a serious concern due to a range of physical symptoms from potential disruption of metabolism, cognitive and neurotransmitter function, immunity and overall hormone balance.

Nourishing Digestion with Fermented Foods

Traditional foods have been fermented for ages for both preservation and health benefits. Research clearly shows that fermented foods aid digestion and support immune function. Consuming these foods creates an environment against harmful pathogenic microorganisms in a number of ways.By eating these beneficial bacteria or "probiotics" such as Lactobacilli and Bifidobacteria studies have shown positve effects such as:

*Maintaining health intestinal flora and prevent colonization of pathogenic organisms.

*Preserve nutrients and break them down into easily digestible form, increasing the nutritive value of foods.

*Create new cultures that increase B vitamins.

*Enhance the absorption of minerals,particularly calcium,iron,zinc,magnesium,phosphorus and copper.

*Neutralize toxins, such as phytic acid, that block mineral absorption.

Sandor Ellix Katz has written an excellent book called"Wild Fermentation:the Flavor,Nutrition, and Craft of Live-Culture Foods"(Chelsea Green, 2003). I concur with his philosophy on eating a variety of live fermented foods to promote a biodiversity of microbial cultures. The list of foods and drinks range from well known dishes such as kimchi,sauerkraut,yogurt to Sonnenblumenkernbrot(German sunflower Seed Bread,and chang(Nepalese rice beer). I encourage all to check out his book.

With my recent trip to Tawain via Korea I was fortunate to have kimchi, best known as fermented Korean food with each meal. Here's a favorite of mine:Cauliflower Kimchi

1 head of cauliflower

2 carrots, peeled and diced

2 stalks celery,sliced

garlic, ginger,and red pepper powder(cayenne pepper)

The stems of the cauliflower are torn apart and sliced flat. Chop carrots into small pieces. Pickle both

vegetables with salt and let set for 10 minutes. Save the brine for later use. Thinly slice celery.

Add the celery,garlic,ginger and red pepper powder to the pickled cauliflower and carrot pieces. Adjust taste with salt and sugar. Put mix into a airtight container(quart size jar), pressing down to remove any air pockets.

Rinse the mixing bowl with the brine saved and pore it into the container.Weigh the veggies down with a zip-loc bag filled with some brine. Allow a week or so to ferment properly in a warm place located in your kitchen. Once it starts tasting ripe move the Kimchi to your refrigerator. Bon App'tite

Blog #5 Allergies

This information can be found at: http://acujan.blogspot.com/

To all of my clients and friends:

Ah-Choo, ooooh those Allergies that range from mold spores,pet dander and other irritants that tend to lurk in the spring breeze. Symptoms such as itchy eyes,runny noses,serial sneezes and congestion can be eliminated or reduced by taking  steps now to minimize the frequency and severity of seasonal allergy symptoms. Here are a few antidotes: 

1)Eliminate Food allergies and intolerances 

Eighty percent of our immune system is in our gut. If we unwittingly eat foods every day that triggers the body into an inflammatory reaction we create a cycle that puts a burden on our immune system. Common culprits are dairy, wheat,corn,soy,yeast and nuts.Try avoiding these common offenders for a couple of weeks and then gradually reintroduce them one by one over several weeks, watching for ill effects. 

2)Recharge Immunity

Now is the time for a tune up to balance your immune system. Acupuncture can help give a boost in many ways either by stress reduction, improved sleep cycles or balancing hormones. Under stress, the body releases too much cortisol that eventually will wreak havoc with the immune system. Frequent sessions of moderate exercise and other stress reduction activities are also good to commit to . 

3)Nasal Wash

A simple and effective way of cleaning our the mucus that tends to collect allergens, is to gently irrigate your nasal passages using a neti pot.Others find relief with nasal sprays that contain xylitol. Research shows that this natural sugar may enhance the killing of bacteria in the nasal passages. Acupuncture can also assist with nasal flow and congestion.

4)Herbs and Supplements

Try some natural substances that contain antihistamine and antiallergenic compounds such as Butterbur,Nettle,Quercetin and Tumeric. Eat fruits and veggies such as red onions,capers and apples that are rich in  bioflavonoids. Drink lots of great and black teas. Inquire about Chinese herbal formulas to help with immune boosting and or alleviating allergy symptoms. 

5)Manage your Environment

Minimize common allergens such as dust mites,pet dander and chemicals with frequent vacuuming,dusting and pet-grooming.Avoid artifical fragrances that can trigger immune responses. For cleaner air inside, change your furnance’s air filter once a month and consider buying a HEPA air filter for the bedroom. 

HAPPY SPRING!!

Blog #4: Eye See U

Nearsightedness is on the rise, partly because we're squinting at our computers instead of scanning the horizon. A large study published recently in the Archives of Opthalmology show that nearsightedness, or trouble seeing objects at a distance, rose by 66 percent over a 30 year period. An increase that seems to dove-tail all the close work we do like using computers, smart phones, e-book readers and other electronic devices.

Here's what you can do to maintain good vision throughout your life.

1) Eat Well: General rule of thumb: if it comes from your garden and is brightly colored, it's good for eye health. That means dark leafy vegetables, tomatoes, peppers, carrots, beets, etc. Data also suggest that people who consume more of the omega-3 fatty acids found in fish and nuts are less likely to experience dry eyes.

2) Stay Healthy: Preventing the development of high blood pressure, high cholesterol and obesity helps with keeping your eyes healthy. First, don't smoke because nicotine has an effect on blood vessels in the eyes. Second, good old fashion aerobic activity can help deliver oxygen to the eyes. Aim to move for at least an hour on most days.

3) Get Checked: Diseases like macular degeneration and glaucoma often are not noticeable until damage has already been done. That's why it's crucial to have your eyes checked at age 40 and regularly thereafter based on your doctor's advice.

4) Prevent Infections: Contact lens safety is critical for good vision. Contacts can slightly alter the surface of the eye and increase the risk for infection, which can lead to vision loss. Clean your contacts, wash your hands before touching them, and never sleep in them.

5) Protect your Eyes: Sun damage is cumulative all year round. Look for glasses that block both UVA and UVB rays. Wear goggles or safety glasses to prevent potential injuries. 

Other Stuff:

-20/20/20 rule: Every 20 minutes stare about 20 feet away for 20 seconds.

-Since we tend to blink less when working close us, use natural tear drops before a long session on the computer.

-Apply cool compresses to closed eyes a few times a day. Using soak and cooled tea bags such as chrysanthemum can help with sore, bloodshot eyes.

-Be aware that dry eyes can be a side effect of some drugs used to treat things such as high blood pressure, pain and allergies.

-Qi Gong Exercises for eyes: Ask me for a copy.

-Herbal supplements: Ming Mu Qi Huang can be helpful depending on what is going on.

Jan Evraets RN LAc

Acupuncture

Scenar

Herbal Medicine

Blog #3 Bone Broth

Bone Broth: a tasty healthful soup and easily digested medicinal food

Winter is an ideal time to make nourishing soups and a good base to start with is making your own bone broth. To make this broth involves prolong cooking of bones and cartilage of which most meats can be used, including poultry ,beef ,lamb or fish. The prolong cooking of bones in water will result in a broth rich in nutritional constituents that promote strength ,nourishment in times of sickness and rehabilitation , help to tonify blood and prevent bone and connective tissue disorders.

The broth is easy to make with the main drawback that it takes time to cook. Once made, it can be consumed as a snack or quick meal, or used as a base for more complex soup by adding steamed or sautéed vegetables, meat, and or beans.

Jan’s Bone Broth

2 onions,halved

4 inch nub of ginger,halved lengthwise

5-6 lbs of good bones,preferably leg and knuckle

6 quarts of water

3 garlic cloves,peeled

1 tsp. black peppercorn

2-3 tablespoons balsamic vinegar

1 packet of Pho Spices(1 cinnamon stick,1tblsp coriander seeds, 1 tblsp fennel seeds,5 star anise,1 cardamom pod,6 whole cloves- in mesh bag)

1. Preheat oven to 400*F
2. Rinse bones that are ideally 2-3 inches long with the fat and most of the meat removed placed on a foil-lined tray.
3. Roast bones, uncovered,until brown on all sides,turning every 20 minutes.
4. Add bones to stockpot with enough cold water to cover the bones.
5. Parboil the bones vigorously for 10 minutes. Drain, rinse the bones and rinse out the pot. Refill pot with bones and 6 quarts of water. Bring to boil over high heat and lower to a simmer. Using a ladle to remove any scum that rises to the top.
6. For extra flavor I char my onions and ginger. Place ginger and onions on baking sheet and brush with olive oil. Broil on high until ginger and onions begin to char.
7. Once onions and ginger are charred, add to the stock along with peppercorns,garlic,Pho spices and 2-3 talblespoons of balsamic vinegar
8. Cook half-covered for 4+hours. Add more boiling water if necessary when simmering, in order to keep bones covered.
9. Skim surface to remove scum and impurities- do not stir!
10. Cool the broth removing any fat that comes to the surface. At this point you can reheat the broth and add 2 carrots, 2 celery, 2 tomatoes and potatoes and simmer for an additional hour. This adds more flavor and depth to the broth.

Adding Chinese herbs to broth

Chinese herbs such as Astragalus and Codonopsis may be added to increase the medicinal properties ie. Increase energy,support digestion, and strengthen immune function of the broth. Theses herbs not only enhance the nutritional status of the broth, but are flavorful and add to the sweet taste. 

  

Blog #2 - Staying Healthy with the Seasons

To all of my clients and friends:

"Autumn is a season of gathering nature’s gifts before winter’s rest. It also marks the beginning of a cycle of personal turning within when the night’s darkness finally equals the length of the day. This transition may be difficult for some but if you choose to adapt yourself to the changes that come with the season; you will maintain health.

In Chinese Medicine, the organs associated with Autumn are the Lung and Large Intestine. Some of the associations with these organs are the breath and the ability to let go. Our bodies are kept alive by the breath we take, supplying us with vital oxygen. But what many of us don’t realize is that the manner in which we take in those breaths has the power to alter our conscious and affect our emotional well-being. Slow and conscious breathing benefits not only our physical selves such as activating the lymphatic system to help us flush toxins but also our mental and spiritual sides. Deep breathing promotes relaxation and awareness that can help facilitate the release of negative emotions.

The following are a list of different breathing exercises you can try:

Wu Breathing: This Chinese technique can be used in the morning and at night

1. Lie down in a relaxed position with your head on a small pillow and your arms resting at your sides. Your feet should be a bit more than hip-width apart.
2. Place the tip of your tongue on the roof of your mouth, resting it just behind the front teeth and the gums.
3. Begin to breathe naturally through the nose. Imagine the breath coming through the nose to the top of the head and then down to the center of the belly.
4. Continue breathing and visualizing in this manner for 20 to 30 minutes. Concentrate on the breath coming in through your head.

The 20-cycle Breath

1.Take four short, continuous breaths. Do not pause between the inhalation and exhalation.

2. Follow with one extended long breath.

3.Repeat this process five times.

Pulse Breathing: This exercise combines diaphragmatic breathing and a pulsed, hard exhalation to remove carbon dioxide. Perform this exercise anytime you find yourself under stress.

1.Take a deep breath and exhale.

2.Inhale and exhale forcefully.(This is a pulse breath)

3.Take two deep-breathing cycles and a pulse breath.

4.Take three deep-breathing cycles and a pulse breath.

5.Take four deep-breathing cycles and a pulse breath.

6.Take five deep-breathing cycles and a pulse breath.