The Truth About Coffee!

coffee cup

Every now and then someone says to me, “I heard that coffee is good for you,” or, “I heard that coffee has such and such nutrients.”  Let’s set things straight.  Coffee is a plant.  Of course it has nutrients in it.  More in the beans than after it is brewed.  All plants probably do.  On the other hand, health and healthy food has become a big, big market.  Companies and food industries are all anxious to convince you that their new product or their food is good for you.  So anxious, that the ones with money can even afford to pay for research.  I know that there is even “evidence” out there that coffee has nutrients and is “good” for you somehow. I’m not even going to look for it or point it out to you or try to tear it apart.

What they leave out is what ELSE is in coffee, or what else it does, basically the side effects.  This is where Chinese Medicine shines, so much so, that Western herbalists are realizing that all herbs should be classified according to Chinese Medicine principles.  Every food has certain properties, such as temperature and toxicity.   Through thousands of years of close observation that far surpasses any research that we have, Chinese herbalists have been able to classify plants based on what conditions they create in the body.

Coffee is hot and greasy.  It creates heat in the body, and, if you think about coffee beans, you can even see the oil.  This is not in and of itself bad.  If you are someone who is very cold and dry, you might need that.  The problem is most Americans are already hot and damp.  Heat and damp are basically inflammation.  All the stuff we love creates heat and damp and so inflammation.  Coffee, sugar, meat, dairy, alcohol, smoking, gluten……  We are mostly all a little bit inflamed due to growing up eating all of these.  More coffee is not going to help this problem, but only make it worse.

And don’t start thinking that just because you have cold hands and/or feet or feel a little cold sometimes that you are cold and need coffee.  This more often comes from stagnation, meaning basically poor circulation.  Exercise would be better.  Generally, only the very malnourished, the very old, or those working outdoors in the cold a lot are cold enough to need coffee.  So coffee isn’t  ALWAYS too hot, just wait until you are old, or save it for a cold day.

On top of that, caffeine is both toxic and draining.  It is a DRUG, and has to be eliminated through the liver and kidneys.  Constantly doing this every day is hard on them.  If feels like it gives you energy, but that is not coming from any root source of energy.  Ginseng or a good food gives you energy because it nourishes.  My herb teacher used to say, caffeine is like using a credit card with no money in the bank.  Keep doing it over a long period of time, and you’re going to go bankrupt.  That’s exactly what coffee can do to people.  Sorry, I know many will be unhappy to hear this, but that’s the truth about coffee.  Whatever benefits it’s said to have are probably best gotten another way.

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What I really meant to say …

What I really meant to say …

rhoda1I wanted to share with you something I wrote while I was on my Writer’s Retreat back in the end of February. You, my lovely and human patients, came to mind later when I read this, because I so often am faced with clients asking me if I can basically stop them from aging or make them young again, give them the same energy they had at 20, or the same body shape and abilities. We all wish for this, and I thought it might help to hear that I do, too.

In the workshop, we were given the prompt, “What I really meant to say…..”. I wrote:

What I really meant to say was lost in the gap of my missing teeth. Who knew that losing two upper molars would cause my tongue to slip and slide sideways and not continue to smoothly perform its’ talking function? Each time, it surprises me that the words are not coming out the way I intended, some kind of mishap between what forms in my brain and comes out of my mouth. It frustrates me, feels slightly embarrassing and freaks me out a little. It feels like a precursor of what’s to come as I age and things begin, well, continue, to not work as I expect. Teeth don’t stay put,  the back can no longer pick up four-year-old children, energy can no longer maintain me for twelve hour days. I realize my image of my–self had not included this falling apart stuff, aging. Don’t we all imagine ourselves as still 25 years old? Even my 86 year old mother says she imagines herself as 40. And yet it is normal, something that happens over and over again to everyone we know; I knew aging would happen, but I denied it. My mind playing tricks on me once again, funny to think about one part of my brain thinking it is amazed by how another part keeps playing these tricks. Delusions of stasis and forever-ness and when I get “there” it will be better, delusions that I guess bring me some kind of peace at the moment. Part of being human, I plod along, watching it, surprised, embarrassed, amazed and then amused. O Silly Me, silly us, people, just being people. Coming together, falling apart, and wishing we had said something else.

P1020531 rhoda2

Chaos, Where Great Dreams Begin

“Before a great vision can become reality, there may be difficulty. Before a person begins a great endeavor, they may encounter chaos. As a new plant breaks the ground with great difficulty, foreshadowing the huge tree, so must we sometimes push against difficulty in bringing forth dreams.”

chaos character

Wei, Chinese character for “chaos.”

When you enter my office, you’ll see a picture of the Chinese character for chaos, or difficulty, pronounced wei (way). It was left for me by the previous tenant, but seemes particularly a propos to me right now as I go through growing pains. It’s NOT exactly the one most of us have heard about by now, that within crisis there is opportunity. Those who know the Chinese language well point out that this crisis equals opportunity idea is an oversimplification or misconception that Westerners take to extremes. The character on my wall by itself means simply “chaos” or even “danger”. Put together with another character, ji, the two form a word that can mean “crisis”, and that other character, ji, is the one some say means “opportunity. However, that ji character by itself actually means something like “incipient moment; crucial point (when something begins or changes).”

Here, we are just talking about the single character wei, which is indeed chaos. I prefer to think of it in the way described above, of a small plant trying to push up out of the ground. Pushing up out of the ground is a strenuous and tumultuous affair. Anything could happen. In the right circumstances, yes, it could turn into a huge tree. But it could also get stepped on, eaten, or scorched. So it is also a delicate moment, when great care is needed. This character can be a particular reading of the I Ching, a Chinese method of divination. In the reading for this character, it mentions that it is important to act with reason, and ethically and honestly during such a time.

I can certainly identify, because taking on the whole clinic myself since the other practitioners have moved out has definitely felt like a strenuous and tumultuous affair. Much has gone well, but there have been daily struggles, technical difficulties, and just a lot to do. It also feels like the culmination of years of hard work, starting with when I began acupuncture school. So after years of “germination,” it feels like I am finally pushing through the ground toward my dream. It’s all felt alternately joyous and anxiety ridden.

This character reminds me that it is normal to feel some difficulty as I strive to grow toward my dream. Sometimes we feel like we are the only ones struggling, the only ones who feel like this, the only ones having this particular problem. The wisdom of those who came before us is that we all experience some difficulty of some sort or another, and someone else (probably millions of someones) is definitely feeling the same thing you are, somewhere. It helps to remind myself of this, and also to remind myself that this chaos of changing furniture, difficulties with voicemails and internet connections, cash flow, and the like, is part of the growing process toward a worthy end. The great dream of helping as many people as I can with Chinese Medicine, and of spreading the word about how it can help women in all phases of life, is blossoming.

Studying medicinal plants in the Anza-Borrego Desert

Ocotillo

Ocotillo

The sky has turned a gorgeous shade of blue, and there’s a blooming Ocotillo in front of me, flowers bright orange red against that deep blue sky. A light breeze blows; I am sitting wedged into a small “wind cave” of sandstone, high on a hill, several miles back through a canyon in the Anza-Borrego Desert. The cave provides some shade as the sun begins to go down on the other side of the sandstone outcropping. As I sit quietly, hummingbirds come to drink from the flowers of the Ocotillo.

An Ocotillo (Fouquieria splendens), if you haven’t seen one (which I hadn’t until a couple weeks ago), is a very tall cactus, probably 10-12 feet high, with many several inch thick branches curving gently up from the base. At this time of year, most of them have long arrays of these orange-red flowers at the top of each branch, wings of six inches in length, but each made up of a cluster of small flowers full of nectar. There are many here in this desert, and it is one of the 60 or more plants we learned about on my trip here, a trip to study the medicinal and edible uses of local plants.

Monkey Flower

Barrel Cactus

Barrel Cactus

Really, people, this was amazing. I’m so happy I had the opportunity to develop a closer relationship with local plants and learn about them in depth from an expert, Tellur Fenner of the Blue Wind Botanical Medicine Clinic in Oakland. While in acupuncture school, I memorized and had clinical experience in the medicinal properties and uses of over 300 Chinese species of plants, and had to be able to recognize them in dried form, but aside from a few live specimens we had growing in pots around the school, I rarely got to know the whole living plant. This is something I’ve always wanted to experience more fully.

That Ocotillo I was enjoying can be used medicinally for many ailments, according to Tellur, a student of the late, great herbalist, Michael Moore (no, not the film documentarian). Its primary use is in helping to clear lymph and fluid congestion in the pelvic region. I would translate this in Chinese Medicine terms to clearing dampness from the lower jiao. To most of us, that means it can help fat absorption in the intestines, and reduce hemorrhoids, urinary irritations, enlarged prostates, and more. Generally these days, a tea or tincture (herb extracted into alcohol) is made from the bark, although the roots have uses as well, and you can even make tea from the flowers!

Red Peony

Red Peony

All of the plants we met were fascinating and beautiful. It was especially exciting for me to get to see an herb I use frequently in Traditional Chinese Medicine, Red Peony, flourishing readily in the transverse hills adjacent to the desert. Here, we see the lovely leaves and flowers, but it is the root that is used for medicinal purposes. A white tuber with reddish skin, it can relax muscle spasms, like those of menstrual cramping, promote circulation, and from Chinese Medicine point of view, the most inner white root nourishes the blood and smoothes Liver Qi. Interestingly, Tellur was able to tell us that Peony has the same medicinal uses all over the world, which helps to validate it really does what we say it does!

Each day was jam packed with this kind of information (and even more details, including botany lessons). And at the same time, we got to just enjoy being outdoors, with night skies full of stars, surrounded by blooming cacti during the day, enjoying canyon streams with fan palms and campfires with good company in the evening. I’m always looking to expand my knowledge to better help my patients, and what a wonderful way to do it! Thanks to this opportunity that sprang up in my email inbox (Thanks, Isabelle!), I’m now able to learn firsthand about local medicinal plants. Tellur Fenner is a local ethnobotanist, with extensive experience and a great teaching style, who teaches all level of students, so if you’re interested, you could learn, too!

wind cave

wind cave

The Placebo Effect and the Effectiveness of Acupuncture

Recently, a patient sent me an article from the New Yorker by Michael Specter, “The Power of Nothing.” The article is largely about the placebo effect, but it refers to acupuncture in a way I think needs to be addressed. The patient who sent it to me is a longtime client who has benefited considerably from acupuncture and Chinese herbs. I thought this person also deserved a response, and this is what I wrote:

Thank you so much for alerting me to this article and for sending it to me. It’s an interesting article about placebo effect, but it concerns me considerably in the way the article treats Acupuncture and Chinese Medicine. It’s interesting in that Specter, the author, does give a very thorough review of what we know about the placebo effect and why and how people are studying it today. He gives a review of research, quotes researchers themselves, and gives summaries of research articles. The main interviewee, Ted Kaptchuk, an Acupuncturist and Herbalist, says he thinks there’s nothing “wrong” with the placebo effect, it does help people sometimes, and so he wants to understand it better.

I’m basically in agreement with that part. It’s obvious to just about any practitioner that a certain amount of benefit is derived for patients just from the practitioner-patient interaction. However, as one reader who commented on the article a month later points out, it is also known that the placebo effect can only go so far, and for so long. Deeper reaching changes and recoveries need more: “Experienced physicians know that sympathetic concern and reassurance can often allay subjective symptoms—at least temporarily—but only appropriate medical treatment has a chance of curing physical disease.”

The even more disturbing side of this article is that these same people, Specter and Kaptchuk, discount acupuncture in a harmful way, with just a few sentences, and with no proof or clarifications whatsoever! After such a careful elucidation of the placebo effect, why would they do this to acupuncture? At least one statement is not even true.

The article opens by saying that Ted Kaptchuk practiced acupuncture for many years, and then turned to research. There’s an implication that he thought acupuncture didn’t work, and yet later he’s quoted as saying he helped thousands of people. His quoted reasoning is that it wasn’t the needles, but something to do with him personally! This is a pretty big presumption to make without any reasonable evidence presented.

One example is given (the only example) of a patient Kaptchuk said he treated for chronic bronchitis, who then came back saying her ovaries were “cured” as well because of his treatments. Ted says there’s no way the acupuncture and herbs could have done this, but how does he know that? They give no facts, and leave things very vague. How many times did he treat her? Was the woman actually diagnosed with an ovarian disorder, or were they going only to investigate (they say she cancelled her surgery because the pain was gone). Perhaps she just had pain. If just pain, perhaps it was actually related to the chronic coughing, but referred, and clearing the bronchitis cleared that pain as well. If she did have an ovarian cyst, the most likely cause of ovarian pain, cysts are almost always due to what we call “dampness” (think of the fluid inside), and chronic bronchitis is, too (think of the phlegm and inflammation in the lungs). If he cleared this for the lungs, to me it is very likely that it cleared the ovaries as well. We even sometimes use some of the same herbs and points.

Later in the article, Specter states in just one partial sentence that clinical studies don’t demonstrate the effectiveness of acupuncture. Despite the thorough citing of sources elsewhere in the article, here there are no sources or references to research at all. And, in fact, the statement is not even true. A large number of studies have demonstrated the effectiveness of acupuncture, to the point that, ten years ago, the National Institute of Health (NIH) recommended acupuncture for a long list of conditions (PDF). The NIH doesn’t recommend things lightly, and in fact, they said they recommended acupuncture because enough evidence already existed at the time to show its effectiveness. Since then, even more studys have been completed that show the effectiveness of acupuncture.

What is also true is that a number of studies on acupuncture have not been able to show effectiveness, but if these are what Specter is referring to, here again, there is no questioning in his article of why the studies fail; whereas in examining the placebo effect, the article does question the formats of the studies. It has been my experience that many acupuncture studies are not drawn up in a way that can accurately measure the effectiveness of acupuncture and Chinese medicine. In order to fit the current research paradigm, many studies treat everyone with the same disorder with the exact same treatment. This is not how Chinese Medicine works, which is part of its beauty.

It is a statement of fact in Chinese Medicine that each symptom or disorder might be treated by a number of different point prescriptions or herbal prescriptions because every human body is unique. In TCM, we treat based on each individual’s pattern. One person may have menopausal symptoms for one reason, and another person might have a different imbalance that exhibits the same symptoms. Treating them both with the same points and herbs might make one better and the other not, or might even make them worse!Other difficulties in doing research on acupuncture is, in fact, having an effective “placebo” treatment to use as a control. To date, no one has come up with something that feels to all patients like they are getting acupuncture, but which is not acupuncture. No wonder some studies aren’t able to show anything! Add to this that acupuncture is just not a big money maker, so no one wants to put much money into research (a big problem with all research today), and you start to touch on the difficulties.  We need to come up with a new paradigm.

This is something I’ve thought a lot about, having a B.A. in Biochemistry, having worked in research in the biotech industry, and having taught research methodology at TCM schools. (But to go into depth about it is a subject for another article.) Unfortunately, however, I think Michael Specter’s article has some serious flaws that need to be addressed and I’m a bit surprised that Ted Kaptchuk allowed the article to be published; however, not really knowing the man, it’s hard to say. Coincidentally, I happened to just meet someone who is also involved at the Harvard Institute, an insider, who mentioned that several of Kaptchuk’s colleagues were also upset with him about this article. While I understand the need to study the placebo effect, and I also can understand changing from clinical practice after 40 years (it’s hard work) to something that gives more prestige and millions of dollars in grants, I don’t understand why Specter and Kaptchuk felt they had to discredit acupuncture in the process. The nature of the article belies the rigor they say they are trying to promote.