Categories
mental health social-justice stress-v-stressor

Life is full of stressors. Come resolve some stress!

Wow, it’s autumn in 2020. Back in 2017, I was thinking about social determinants of health and mental health and I’m still thinking about them, endlessly.

While I focus my post- licensure self-guided education on learning about them and how we respond to them and mitigate the risks on a public and on a personal level, I know my acupuncture practice is about that personal level.

We are all under a lot of stress, even if sometimes it blends so seamlessly into ambiance that we no longer notice. (Ever think you’re feeling fine until someone touches your shoulders and exclaims, Whoa! You’re shoulders are as tight as boulders! and you realize that um maybe you are stressed after all.)

Lucky for us, treating the stress in our body is a separate process than treating the stressor that is triggering the stress. And if you can lower your body’s stress levels you can become more resourceful and responsive to your environment, participating more fully and seeing more broadly and engaging more with mutuality and care for your family, friends and community.

There’s lots of ways to complete a stress response cycle, and I think that getting a great acupuncture treatment with some aromatherapy is one of them.

Come and get a treatment!

blossoms in fall backlit by sun
photo credit Electra Allenton 2020
Categories
mental health

National Mental Health Awareness Month 2017

May is National Mental Health Awareness month.

For most of my life (2/3rds) I experienced undiagnosed social anxiety and general anxiety, which would often collapse into occasional depression when it was too overwhelming. I missed out on a lot –grades of school, trips, extracurricular classes, friendships, healthy romantic relationships, sometimes even food, and definitely developing social skills– until I realized what was going on and sought treatment. And even now I am still undergoing treatment and self-improvement and deeper understanding.
Many folks in my family have experiences and symptoms and challenges that can be categorized under mental health diagnoses. Many friends have them as well.

Some people don’t like labels and official diagnoses because those words are stigmatized, have very severe negative connotations. That is true; in this society, it’s very true. In other societies, it’s even more true. Having a mental health diagnosis can change the health care you receive, the jobs you can get or keep, the relationships you are invited into… It’s a sign of weakness, of imperfection and possibly moral failing.

On the other hand, having a schema (a word or phrase that is an anchor for a large amount of qualities/descriptions) that is a launching point, an explanation, a rationale, a self-description, and a thing that insurance or schools will deal with to help you get help, can be incredibly freeing. Having two words that encapsulate the sense that you don’t deserve to take up space because your needs would discommode others, that people despise and scorn and resent you as soon as you’re out of their presence, that making eye contact with strangers on the street or making phone calls is certain to result in you attacked or ostracized when you inevitably make the wrong facial expression or wrong stammered phrase, when you don’t go to your class or your dining hall because you’re taking up someone else’s deserved place in line or in the conversation by existing and so you eat nothing but oranges bought from the convenience store for a month… It is freeing to have two words to start to disentangle that bundle of sensation and experience from your self identity and daily behavior. It’s relieving to have words to describe the people you grew up with that shaped these responses.

And I’ve treated this social anxiety with CBT and internal family systems and Jungian dream work and homeopathic remedies and pharmaceuticals and acupuncture and vitamins and Western herbs East Asian herbs and targeted amino acids and elimination diets and they have all of them helped. All of them.

The experience of living with the amorphous dread of some unnamed wrongness for most of my life and then the upward climb of self-understanding and then understanding of my family and friends has been so enriching.

In July I’m officially starting a residency where I primarily treat mental health and it’s interlaced presentation with physical experience, by way of Naturopathic medicine and East Asian medicine, and I am so excited because this is the calling, this is what I want to do with my life. I want to help people who are going through the Wrongness to find understanding and progress and ease and relief, that I am still seeking myself.

Categories
Uncategorized

I am an ND, LAc!

This shows my ND license. You can check yourself by following the link!
Look, it’s me!

Hey look, it’s me!

It’s a culmination of a dream/goal/ I have had since I was 17 years old! And it allows me to serve you with more robust healthcare!

I still have my LAc as well. As a “dual degree” ND, LAc I am still focusing predominantly on East Asian medicine at my location at Bridge To Becoming.

You can check this one, too.
from the Oregon Medical Board’s Licensee Search

Basically, this means that in addition to the care I already provide with acupuncture, East Asian herbal medicine prescriptions, aromatherapy, Shiatsu and Sotai massage, I am able to prescribe some medications, prescribe a lot of Western Botanical Medicines, do physical exams and diagnose some conditions, and also provide some additional services.

In a few months, I will also be providing more robust Naturopathic and East Asian medical care at Amenda Clinic, but not yet.

Categories
biomarkers-vs-outcomes rants

Bio-markers and Bio-plausible not bio-promoting

Sometimes when my patients and I discuss a treatment option, I might get a little rant going about how researchers and health professionals and also patients are confusing bio-markers with actual health outcomes. This is especially significant when trying to evaluate whether a treatment is (1) evidence-based medicine and (2) whether the evidence is actually useful evidence.

There is a long but very interesting article co-published by ProPublica and The Atlantic, which everyone interested in health should read:
When Evidence Says No, But Doctors Say Yes, by David Epstein, published 2/22/2017. This article is primarily about how bio-plausible (it just makes sense!) treatments keep getting recommended to patients despite in-depth quality evidence showing that they aren’t useful.

I am very interested in this in general, but considering my particular pet peeve of biomarkers being confused for outcomes, this paragraph stuck out:

In 1997, a Swedish hospital began a trial of more than 9,000 patients with high blood pressure who were randomly assigned to take either atenolol or a competitor drug that was designed to lower blood pressure for at least four years. The competitor-drug group had fewer deaths (204) than the atenolol group (234) and fewer strokes (232 compared with 309). But the study also found that both drugs lowered blood pressure by the exact same amount, so why wasn’t the vaunted atenolol saving more people? That odd result prompted a subsequent study, which compared atenolol with sugar pills. It found that atenolol didn’t prevent heart attacks or extend life at all; it just lowered blood pressure. A 2004 analysis of clinical trials — including eight randomized controlled trials comprising more than 24,000 patients — concluded that atenolol did not reduce heart attacks or deaths compared with using no treatment whatsoever; patients on atenolol just had better blood-pressure numbers when they died.

I’m diverging from the topic of the article to point this out, because it is very important when weighing your options.

A colleague asked the Facebook hivemind what questions she, as an accompanying advocate, should ask the physician/surgeon of a friend who had debilitating back pain about a proposed surgery. Many people chimed in that in addition to her already proposed “risks, alternatives, and physician experience” and etc., she should absolutely ask about the expected result of the surgery. This goes for medications and nutritional changes and physical therapies as well. What are you trying to achieve? What can you expect to achieve?

A lot of interventions (medications, nutritional changes, exercises and physical therapy… anything you change in order to make a difference) have been tested against whether they make a difference in bio-markers because it is too costly and risky to see if they make a difference in actually important things like quality of life, mobility and individual agency, and duration of life. They’ll therefore conflate a biomarker known to be involved in the outcome, such as LDL cholesterol or blood pressure, with the outcome of Not Dying Suddenly From A Heart Attack or Permanent Disability After A Stroke. Again, the reason is that it’s often too costly or too difficult/unethical to get permission to run a study long enough to find out; but that means that there’s lots and lots and lots of treatments out there that make your numbers look pretty without addressing the cause for those numbers to be “off.” They also confuse people as to whether the biomarker is the cause of an outcome, or just related to the outcome. Things like LDL cholesterol can be a predictor of cardiovascular disease but don’t necessarily cause CVD!

This doesn’t even get into the difficulty of studying one particular outcome, like cardiovascular disease or skin cancer, while ignoring all other outcomes, like autoimmune disease, diabetes, other types of cancers, infection, and all sorts of other things that can make life difficult or make life end. Or being so focused on reducing the biomarkers of one disease (blood pressure as an indicator of CVD) that you take risks with other diseases (blood pressure medications making diabetes mellitus type II more common) which can increase mortality or reduce quality of life.

It’s a very tricky balance. It’s not something that you can just figure out by finding the one right study.

That’s why it’s important to find clinicians who will work with you holistically –as a whole complex person– to figure out which risks are the real risks, which biomarkers are worth chasing down into pretty, non-threatening ranges, and which interventions are actually helpful versus which ones are just to cover everyone’s behind.

Categories
social-justice Uncategorized

Social Determinants of Health

Need justice, have umbrella, willing to march!
Coming together to ensure mutual security and wellbeing, rain or shine!

The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. The social determinants of health are mostly responsible for health inequities – the unfair and avoidable differences in health status seen within and between countries.

As a part of my education in East Asian medicine and Naturopathic medicine, we looked at not only individual determinants of health (your behavior, your choices, your genes and your upbringing) but the social determinants of health (Are you persecuted by your government or by fellow citizens? Do you have freedom of movement, of the ability to better yourself, to accumulate wealth for security?)

This political climate calls upon us to clarify our values and to look at how our actions influence others, and our role in upholding, ignoring, or resisting our social norms and government codes.

To that effect, I want to share these documents about how we can make sure our Representatives in government truly represent our interests, and how to resist without undermining your cause.

Indivisible Guide: A PRACTICAL GUIDE FOR RESISTING THE TRUMP AGENDA, Former congressional staffers reveal best practices for making Congress listen.  This is both a guide translated into many languages and in both written and audio format, and a community for support.

198 Methods of Nonviolent Action: Practitioners of nonviolent struggle have an entire arsenal of “nonviolent weapons” at their disposal. Listed below are 198 of them, classified into three broad categories: nonviolent protest and persuasion, noncooperation (social, economic, and political), and nonviolent intervention.