Heartburn / Acid Reflux

What causes heartburn?

What causes heartburn?

Heartburn can be terrible. My patients often come in complaining of a string of miserable nights when nothing can calm the burning in their chests. The ache can extend to the throat and jaw.* Acid reflux is more than just annoying. If left untreated for years, you can develop Barret’s Esophagus and eventually cancer. Soothing the pain has become a mega-industry, but your reflux is not a symptom of a Prilosec deficiency, and in fact long term use may cause Vitamin B12 deficiencies** or heart attacks.

Basic reflux defense:

Avoid alcohol, spicy or greasy foods, tomatoes, citrus, chocolate, and mint.

Sleep on your left side, or with an extra pillow or bed wedge to keep your esophagus above your stomach (Note, sidesleeping requires a thicker pillow than backsleeping to support your neck).

Don’t eat large meals or late in the evening.

Most people report a big reduction in symptoms when they cut down on carbs & sugar.

Stimulate PC-6. You can do acupressure on yourself.

There are TWO types of acid dysfunction reflux:

Sometimes the stomach is making too much acid, or the lining is damaged with ulcers, cancer, etc. In these cases, reducing stomach acid via pharmaceuticals can help, particularly in the short term.

More commonly, the stomach isn’t making *enough* acid. This is because the body only bothers to promote acid when it’s in the parasympathetic / “rest and digest” mode. If you are stuck in the sympathetic / “fight or flight” mode due to stress & anxiety, your digestion will slow down.

Have you heard the old tip about using apple cider vinegar? It seems counter-intuitive to drink vinegar (acetic acid) when your throat is on fire, but it works. Here’s why: The sphincter between the esophagus and the stomach is signalled to close tight by the presence of acid. If it doesn’t cinch up, the weak acid you do have will escape upwards.

I can’t vouch for all the claimed “miracles” of apple cider vinegar (ACV), but it’s a powerful tool for fighting heartburn. In addition to providing the acidic signal, high quality ACV also contains probiotics that make your gut healthier. This is why you want the cloudy stuff in a glass bottle (Bragg’s) not the cheap clear supermarket brand in the plastic bottle.

Bragg-Organic-Apple-CIder-VinegarShake the bottle until the gross-looking glop becomes a uniform cloudiness. Pour a finger or two of the ACV into a glass, then dilute it to about 3-4 inches with water. Chug it down and follow with tooth brushing or at least a serious rinsing to protect your tooth enamel. Within seconds your heartburn should dissipate. Some just use it as needed – when symptoms appear. More diligent people drink it every day.

Protip: Pickle juice also works! Try a swig out of the jar of kosher spears in your fridge!

* Heart attack symptoms are sometimes confused for heartburn, which is why it’s important to get checked out by a doctor, especially if you are at risk or have heart disease in your family history.

**Vitamin B12 deficiency causes serious health consequences including anemia, osteoporosis, depression, memory loss, dementia, neuropathy and cardiovascular disease.

The Science of Acupuncture

I get asked all the time… “How does acupuncture work?” Modern science is catching up with 10,000 year old acupuncture. I’ve said for years that we just don’t have the method for seeing the structures yet – just as we didn’t understand the minute complexities of the human body – or imagine MRIs! – 200 years ago. It looks like we are slowly figuring it out! This brief guide lists physiological changes with studies cited. Below are a handful of recent articles exploring the science of acupuncture (if you scroll past them, there’s more of my thoughts on the science of acupuncture). These are just the ones that I stumbled across. If I had to time to do an exhaustive search this would be a much longer blog post. :)

From the 4th article below: Oxygen pressure is higher at acupuncture points!

p6oxygen

 Acupuncture Tops Sham for Easing PTSD in Combat Veterans (not a surprise to me- I’ve been volunteering for the Returning Veterans Project since 2010)

Acupuncture affects fascia and an explanation for non-scientists

A “new organ” that Acupuncturists have been calling the San Jiao for thousands of years! 

 Acupuncture Biochemically Reduces Pain and Inflammation

MRI Reveals Acupuncture Modulates Brain Activity

CT Scans Reveal Acupuncture Points

New Brain Study – Acupuncture Fights Depression

Acupuncture Holds Promise for Treating Inflammatory Disease

Acupuncture Beats Gabapentin for Hot Flashes in RCT

Acupuncture as effective as drugs in treating pain, trial shows

Biological Evidence for the Existence of Acupuncture Meridians inside lymphatic vessels

Curtin researchers unlock the scientific reasons why acupuncture works – C fibers (nerve branches)

But what about “all those studies” that show it’s not effective?

First of all, there are plenty of studies that prove it works. Insurance companies (even the conservative ones) now cover needles for neck and back pain, because studies have specifically proved it, although some deny claims for, say, shoulder pain, because it hasn’t specifically been studied. Makes me want to roll my eyes. Ug.

Secondly, many of the studies that “prove” it doesn’t work are deeply flawed. They have doctors doing a few recipe points they learned in a 20 – 300hr class, rather than an actual acupuncturist. Sometimes the points they choose are completely mystifying to me – not only do they leave out important ones, but there are always one or two that just make no sense at all.

Thirdly, TCM differentiates the cause of disease, but lots of studies don’t. You can have a headache due to Yang rising, or Heart xu (deficiency). When a study gives the same treatment to everyone with a headache, of course it’s not effective! The western medical equivalent is putting people with viruses, bacterial infections, and allergies in one group, giving them all an antibiotic, then declaring that drugs don’t work for runny noses.

There are other problems too, like “sham” acupuncture doing “too well” so there isn’t a statistically significant difference. In one study I read back in school, they basically compared acupressure to acupuncture… then declared nothing worked since they both did. That’s just bad study design. There should have been a third control group with no treatment.
equine acupuncture

Equine acupuncture points from the Bagyuiho (Chinese horse and cow acupuncture text), 1399

And that whole placebo thing? It may play a part, as it does with every medical procedure, but it’s not the whole story. In other states (where it was legal without a vet supervising) I have successfully treated animals – there’s no placebo effect there! When a dog, lying limply on the floor and moaning, after 15 min of needles is bouncing up and down, jumping to kiss her owner’s face… that’s not a placebo. Neither is a rabbit regaining bladder and bowel control after a spinal injury. Of course those are anecdotal evidence, but they’re pretty compelling when they repeatedly happen in front of you. Googling for animal studies quickly gave me a whole new batch of data: Horses are studied most often because they have money-making “careers.” Even penguins benefit!

I’ll be perfectly honest – I’m not sold on some of the more esoteric aspects of TCM (Traditional Chinese Medicine). I don’t twirl my needles in a specific direction, for example. Thousands of years ago, when it was developed, there was philosophy as well as medicine involved, and like all ancient sciences, it could use a little update. But acupuncture itself is amazing. It stimulates neuromuscular junctions, which resets neurons (nerves control muscles, which in turn pull on bones). This helps break the cycle of spasms, or activate a non-firing muscle bundle. It reduces inflammation. It distracts nerve receptors and blocks transmission of pain signals. It helps break up fascial adhesions. With older, chronic problems it creates a microtrauma and alerts the body to a “cold case,” which restarts healing. It’s tremendous for nerve repair – check out my paper on stroke recovery. I’ve seen some truly stunning results from people who were locked inside their bodies, long after Western medical science said there would be no more improvement.

“Yang rising headaches,” is just a term for a diagnosis. It’s no more mysterious than “orthostatic hypotension’” for example, if you understand the language of TCM. The articles above show that we are just starting to understand how points work anatomically. I am confident that science will catch up and we’ll have a clear understanding of this system within my lifetime.

The good news is that it doesn’t really matter whether you believe acupuncture works… because it’s medicine, not voodoo, and it will anyway. :) The science of acupuncture is still evolving, but its effectiveness is clear.

Easy Advanced Massage class 2/21: NO exp req


Saturday, Feb 21st, 10am-1pm and 2-5pm (two identical classes – pick one), I’m holding another session of my intensive, 3 hr hands-on medical massage class. The concepts are easy to understand, but you’ll get advanced results. Learn how to ease tight muscles and relax your loved ones with a gentle, intelligent touch. NO massage or anatomy experience required! I’ll show you how to use the neurological system into tricking muscles into behaving, and how to erase scar tissue.

This class is appropriate for every body, since I will show you how to tailor your work to your partner’s needs. Please note that you will be learning Osteopathic techniques, NOT traditional massage. Techniques include myofascial release, exhaustion release, counterstrain, and percussion. Handouts will be provided. If the class goes smashingly well, we may have time for a 6th bonus technique. Bring a partner or come alone: We will practice on each other.

The class is limited to 8 people to ensure that I can provide lots of hands-on feedback and instruction: Make your payment now to reserve your spot! $75 per person, or $130 for a pair. Please call 503-964-3422 if you have any questions! I hold this massage class once or twice a year. You can always swing by the office, or I take Paypal (sharon@rosecityacupuncture.com), using the friends & family option is best. You can also mail a check or I can send you a credit card invoice email. :)

This will be the last time I can hold this class until I get into a new venue, so I encourage you to come if you can!

NOTE: as of 1/29 I have 3 spaces left for 10-1, and one left for 2-5.

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The sacroiliac joint, sciatica, and unexplained lower back pain

I often have patients come in with a “mysterious” chronic lower back pain. Sometimes it’s described as lumbar or hip pain. They’ve been to doctors and chiropractors, but it still persists. As soon as they put their hand on it (low and to the side, where the buttocks meet the back) it’s pretty clear that the problem is the SI – the sacroiliac joint.

Pelvis

The SI joint – where the sacrum meets the ilium – is a long vertical area on the sides of the lower back. Back pain is often centered at the top of the SI joint.

At the bottom of your spine is a triangular bone, the sacrum. Attached to that is your pelvis (made up of the ilium, ischium, and pubis). Your femurs, the long bones of your thighs, settle into a socket on the side of the pelvis. A complex set of ligaments and lots of muscles join all these bones. If one or more of these muscles is tight, weak, or spastic, it can throw the balance of the entire pelvic system off. A few of the major players are Iliopsoas, piriformis, and quadratus lumborum. These muscles keep us upright and help us walk, but when they go bad… I call them the Holy Trinity of Lower Back Pain.

Quadratus Lumborum runs from the lower ribs to the top of the ilium. There are also connections to the spine. This is your "hip hiking" muscle - imagine a "belly dance" sort of motion - but if course it's essential in walking and other daily movements.

Quadratus Lumborum runs from the lower ribs to the top of the ilium. There are also connections to the spine. This is your “hip hiking” muscle – imagine a “belly dance” sort of motion – but if course it’s essential in walking and other daily movements.

Iliopsoas starts at the front of the spine and the ilium, goes through the pelvic cavity, and attaches to the femur. It gets tight on people who sit a lot, particularly if you are tense while sitting (motorcylists and people who hate their jobs).

Iliopsoas starts at the front of the spine and the ilium, goes through the pelvic cavity, and attaches to the femur. It gets tight on people who sit a lot, particularly if you are tense while sitting (motorcylists and people who hate their jobs). When tight, it jams the bones together and creates stress on the joints.

 

Piriformis

This is a back view. The piriformis muscle attaches at the sacrum, and goes across the butt to the femur. The sciatic nerve passes under it or through it, depending on your personal anatomy. When the piriformis gets tight, it squishes the sciatic nerve and can cause electric shocks or pain running down the leg.

With every step you take, the sacrum “nutates” – it tilts back and forth in relation to the ilium. If the bones are jammed together and can’t glide properly, it causes pain. Sitting can also be a painful prospect: If the joint is inflammed, the altered pressure of a seated position can be excruciating. I understand this very well because I developed lower back pain and SI problems along with a L4-L5 disc herniation after my car accident in 2001. I wasn’t able to sit at all for the 6 months before I discovered acupuncture and Osteopathy.

There’s rarely only one muscle involved. Usually a primary dysfuction causes a cascade of compensation with other muscles. Nerves can be pinched by either tight muscles directly or by a bone pulled out of place by a tight muscle (bones don’t move by themselves).  Nerve impingement can lead to pain radiating down the leg or into the genital area. Motor control as well as sensation may be affected. The leg may go weak, or a patient may experience bladder or bowel incontinence (If this happens, get to the ER immediately – they will take steps to relieve pressure on the nerve and prevent permanent damage).

In most cases, the first thing we have to do is reset the tension on the muscles. Acupuncture and medical massage will work wonders here. Once the soft tissue is corrected, I can generally realign the bones with fingertip pressure. They just slide back home with no drama or fuss. Now it’s a matter of allowing the irritated nerve to calm down, which can take 20 minutes to months (or never, in worst-case scenario), depending on the extent of the damage. Whenever you are dealing with entrapped nerves, it’s important to get care immediately. Releasing them quickly gives you the best shot at a full recovery like mine. Getting the pain knocked down allows you to rebuild. Rehabilition exercises and stretches (plus some myofascial release) will make your muscles strong and supple again, so they work properly, which will keep your bones in the right places. I no longer have any back pain, and I’m back in the gym doing heavy workouts including Romanian deadlifts!

Headache & migraine treatment options

Got a headache? The biggest cause is dehydration, so first, have a drink of water. Other common causes are caffeine withdrawal, high blood pressure, stress, low blood sugar, and tight neck muscles. If you have persistent or severe headaches, you should get them checked out by a healthcare professional (If only so they can say “It’s not a tumah!”), but for minor annoyances you can treat it yourself with acupressure (points listed below).

Human skull bonesI usually find that migraines are caused by hormonal imbalances, or by neck muscle tension pulling on cranial bones. Our skulls are not a giant fixed globe: There are lots of different plates and oddly shaped bones that make up our brain protection. The joints (called “sutures”) are shaped like jigsaw puzzles.

My favorite cranial bone, the sphenoid. It barely shows at the side of the head, but inside it makes a gorgeous butterfly shape. When torqued, it also gave me a monstrous migraine headache!

My favorite cranial bone, the sphenoid. It barely shows at the side of the head (it’s pink in the other picture), but inside it makes a gorgeous butterfly shape. When torqued, it also gives me a monstrous migraine headache! I keep my sphenoid happy by getting care for my neck, and using the acupressure points below when one threatens to attack…

Our bones move with a subtle pulsing called the craniosacral rhythm. If the neck muscles attached to the skull get too tight, they can jam up those joints and cause migraines. The fix: Acupuncture and medical massage for the muscles involved. Craniosacral therapy by a skilled practitioner is also wonderful, but be sure to see someone who’s thoroughly trained. A weekend seminar is not enough! If there are hormonal causes, acupuncture is superb for that as well.

We can also discuss some lifestyle changes that may help, like dietary changes, or glasses that mute florescent lights to reduce migraine occurence.

Here’s a handy acupressure point for any headache, including a migraine: It’s in that “second piercing” spot, below the anti-tragus. Press firmly for a few seconds. If you have an earring in, you should remove it if possible, at least until your headache passes. For more information on ear points, check out this article. Also, look at LI-4KD-1, and GB-21 and TB-5  if you have neck tension. There’s another point on the side of the lower leg than can be helpful for migraines: Run your fingertip up and down the outside of the shin to find a tender spot. And definitely read this if you’re considering a Daith piercing. 

Press firmly with a fingertip or fingernail. It will hurt, but it'll be worth it!
Press firmly with a fingertip or fingernail to stop a headache or migraine. It will hurt, but it’ll be worth it!

Ear seeds – Radishes for reflexology!

If you ever attend an event with me, soon you’ll notice people walking around with funny little stickers on their ears. Ear seeds are my mobile acupressure strategy. When people come up to me and ask what I can do about their back pain in the middle of a party… BAM! On go the ear seeds. These are radish seeds on a tiny piece of band-aid tape. There’s nothing magical about the radish – they are just the right size and shape to apply acupressure to any of the 100 points on your ear (map below).

You’re familiar with reflexology, right? You know how your entire body is reflected on your hands and feet? Same deal with the ears. I can treat pain or dysfunction anywhere in the body, emotional upheaval, anxiety, etc. This is why I’m not a huge fan of lots of piercings. It’s also why ear massages are like getting a full body massage, and terrific for immediately calming someone down. Try it the next time your migraines act up, your dog is freaked out, or your sweetheart has road rage. :) Just gently rub the entire ear – don’t worry about hitting specific points for this purpose.

Once the seeds are on, they are working. They will last 3-4 days, and you can shower normally. If you want to give the treatment a boost, and can’t feel them on your ears, give them a gentle squeeze to wake them up. If you are already aware of them, leave them alone… they will probably be pretty tender to the touch! Sometimes people find the ear seeds annoying or sore, particularly if they are side-sleepers or they are working superhard (the more active a point is, the more it can hurt). In that case, just take them off. The point is to make you feel better!

I never charge for ear seeds. Ask me for them anytime – I always have them in my purse, and you are welcome to drop by the clinic for a quick installation.

Note: Some people use ear staples for quitting smoking, weight loss, etc. I prefer earseeds, since sending someone out with an open wound is an invitation to infection. Acupressure is hugely powerful and hurts less, too!

There are about 100 points on the ear, so I can treat nearly anything. Ear seeds are quick, portable, and give you a few days of acupressure.

There are about 100 points on the ear, so I can treat nearly anything. Ear seeds are quick, portable, and give you a few days of acupressure.

Healthy Boots – that look great!

I got rid of 95% of my old shoes once I made the switch to minimal, wide-toed, unheeled footwear. Wearing my old collection just felt awful after my toes were liberated. Like children, once they are educated, there’s no going back. :) So I was left with my new shoes… and NO healthy boots. With our cold, damp winters, and as much time as I like to spend outside, that was no good at all. So I went on a mission. I visited Shoe Mill (their selection was disappointingly high-heeled and rigid-soled) and Footwise (just didn’t see anything that appealed to me). I would have liked to hit Cobbler Bill’s and the rest of my list, but I’m a busy girl!

I checked out both Imelda’s (Update: closed in Dec 2022) and Clogs & More on Hawthorne about a month back – all I found was the rain boots mentioned in the shoe shopping post. They may have some new stock now. After Nordstrom’s and Macy’s at the mall, I went online. Zappos was uncharacteristically empty of options, but the Nordstrom’s website was terrific.

Here’s what my quest brought me. I didn’t buy all of these, but I did “borrow” a few on my credit card, since they all have free shipping & returns, and I can wear them inside for a while to see how they really feel before I pick which one(s) to keep. Much better than a 30-second try in a store, right?

The Finds:

Keen Delancy

The Keen “Delancy” is close, but I couldn’t get it zipped. This is a common problem for me, since I am 4’10” and my calf muscles start lower. If you have longer / slimmer legs, try them out. I have been distressed by Keen’s new line, which is both stiff and narrow. These are a rare, and welcome, throwback.

phoenixside

Soft Star makes this boot, the “Phoenix,” but it doesn’t meet my aesthetic standards so I haven’t tested it. I’m not fond of the “Ugg” shape and I don’t do brown. If you do, give them a go!

Born Lecia

Børn “Lecia” – These made me very, very sad. Born is a great company, and I was SO excited about having red lace-up boots! Sadly, the tops were too long for me, and pushed up under my knees. They were fine for standing, but when I moved and bent my legs they were no good. If you are a normal-sized human this will not be an issue. Note – these would be fine for even bigger calves than mine: The tongue has a big overlap. Worse than the height is the heel. It has a pointed bottom, and a soft sole, so the net effect felt like a point poking up into my heel. Immediately very uncomfortable, and it got worse over 20 minutes.

Merrel Haven (Nordies)

Merrell “Haven” is no oasis.

My first impression: The Havens are the least comfortable Merrell’s I’ve ever worn. They are far too narrow. By the time I sized up to a decent width, they were crazy long… Like, clown shoe long. Try again, Merrell. Plus, the look isn’t really my style. Note: The Captiva (not shown) is wider and better looking, but I couldn’t zip it. Besides, it has a small heel lift.

Born Kaila (Macys) healthy boots

THE WINNER! I was Born to wear these healthy boots! :)

Børn “Kaila,”  at Macy’s 

Love these! They do have about a half inch net heel – the most heel I’ve worn in months – but it’s not bothering me. Initially the top of the calf was snug on me, but it quickly stretched sufficiently that I don’t feel it anymore. Bonus: There is an adjustable buckle at the top. Mine are matte black. This glossy pic is the “mahogany.”

Verdict: YES! There was even room for my Correct Toes inside these gorgeous things!

Romika Fiona

Romika,  please make a quieter, taller version!

Romika “Fiona” at Nordie’s. 

Also in black. These look narrow, but feel huge inside! I swear they are made of Tardis! Unfortunately the zippers jingle when I walk (I’d have to swap the tab out), and the height of the calf is awkward and unflattering. They would be good under pants or jeans, but I pretty much only wear skirts.

NF JaneyNorth Face “Janey II Luxe” (Ordered from Nordstrom’s website)

I very much liked the short zipper at the inner ankle, which allowed for easy on-off. However, the toebox was narrow and stiffly structured. That’s a no.

Sorel Yaquina

Sorel “Yaquina”  (Ordered from Nordstrom’s website)

So close! The toebox is just a little too snug. I could feel it pressing against my big toe. If you have narrow feet, these will work beautifully for you. But not for me.

Final verdict:

The only pair that really worked for me 100% was the Born Kaila. I’m wearing the black ones right now, and I’m ordering a second pair of “mahogany.” The Keen “Delancy” and Sorel’s “Yaquina” were close… try them if you are, respectively, slim-calved and narrow-footed.

Hopefully this little review has helped you find some healthy boots, and more importantly, reminded you of what to look for when shopping. Please let me know if you find any other good candidates!

NOTE: For rainboots, I love my Bogs! They have a nice wide toebox and are zero drop, unlike most wellies.

Anti-inflammatory HTPT – Smell like pancakes *and* feel better!

Last month I mentioned that I was having some trouble with my Arnica distributer (problem resolved – it’s in stock and ideal for bruises, sprains, and strains). I found a fantastic solution: Hai Tong Pi Tang. This is an ancient Chinese anti-inflammatory formula, containing frankincense, myrrh*, saffron, and a number of other herbs. The tincture is in an alcohol base, and made by a local acupuncturist. It comes in a spray bottle, so you can easily apply to any injured or inflamed area. External use only, and not on broken skin, please!

Here’s a fun bonus: The aromatic herbs combine to create a “pancake” scent. Much nicer than Ben-Gay or the usual herbal stinkiness! Watch out, though, you might get nibbled on by fans of maple syrup. :) 2oz bottle for $25.

frankincense resin

Frankincense resin – anti-inflamatory, anti-bacterial, and calming.

*Frankincense and myrrh have been “Moving” herbs in the Chinese pharmacopia for thousands of years. They are used to treat “stagnation,” which translates to muscular stiffness and pain, among other things. I was once on a cross-country flight when my back seized up. This was early in my acupuncture schooling, while I was still recovering from a traumatic car accident. Somehow I had neglected to pack any anti-inflammatory medication, and the flight attendants weren’t allowed to give me any. I was in so much pain, and I had hours left in that horrible seat! Then I remembered that I had brought along my herb samples to study for an identification test the next Monday. I ate the frankincense and myrrh samples – something I DON’T recommend, as they taste terrible! – and within 20 minutes my pain was gone. I’ve been a big fan ever since.

Human Touch

I shared a link on Facebook last week about the importance of human touch, and there was an immediate pile of private messages thanking me. One person shared that just that day a co-worker had touched her shoulder as she scooted past her in a tight space, and it made her realize how much she needed a hug. Although the article focuses on men, it’s true for women, too.

Some cowboys have to resort to other species to get their snuggles!

Some cowboys have to resort to other species to get their snuggles!

 

I’m so grateful that Robert is physically affectionate. But then, that’s one of the many reasons I chose him. I’m a hugger, and I couldn’t be partners with someone who wasn’t.

 

 

 

 

aaport3

Men as friends, enjoying comfortable physical affection. It’s a beautiful thing.

In our current American society, man aren’t really allowed to touch each other platonically. They shake hands, or slap each other butts to celebrate a touchdown, but they don’t hug the way women do. In European nations, it’s not unusual see male friends walking arm-in-arm. We used to do that here, too, but homophobia and general isolation have reduced common touch to a rarity. Look at these pictures. The intimacy of these pals is heartwarming. Let’s spread a little of that around here… grab a friend and give them a squeeze! Have some buddies over for movies and make a puppy pile on the couch!

 

 

friendssnapshots7

World peace though HUGS!

 

Human touch is important to generate oxytocin, a hormone linked to social bonding and happiness. The people in Richard Renaldi’s “Touching Strangers” project reported that they actually felt themselves caring for their fellow models, more than they expected. I know some of my massage patients come to see me more for the touch than for the therapeutics. It’s why they keep coming back long after I’ve fixed them. And I’m fine with that – it’s my job to help in any way I can – but if we all just touched a friend’s shoulder now and then we could reduce everyone’s stress quite a bit.