Holistic Health Care Articles
The Economics of Treating Sickness
By Brendan Kelly, M. Ac., L. Ac., acupuncturist and herbalist
Published online December 2012
For several thousand years, Chinese medicine has emphasized the importance of looking below the surface. In the treatment room, acupuncturists and herbalists are trying to understand where symptoms are coming from rather than only treating the symptoms themselves. The clinical importance of this holistic perspective is that when the root causes of a condition are addressed not only can a wide variety of symptoms be resolved, but there is a much greater possibility of understanding the origins of the condition.
In addition to it’s effectiveness in treating individuals, Chinese medicine’s emphasis on looking for where symptoms are coming from can also provide insights into the condition of our health care system. Here in New England and nationally, a significant issue is the already expensive and rapidly increasing costs of health care. Here in Vermont, where I live and practice, the state is predicting that if the cost increases continue at their current rates, it will literally bankrupt the state in twenty years. Other states around the region and around the country are facing similar dire predictions. A basic question is why?
In looking at where the vast majority of the money we spend on health care is going, we can begin to see some of the deeper assumptions that are helping to create this economic unsustainability. For most of us, we think about seeing our practitioner when we are sick. We might have sometime more superficial like a cold or flu, or something more significant like cancer, but the overwhelming amount of time and money we spend on healthcare is for when we aren’t well. Of course, whether we have a low-grade fever and a lingering cough, or a potentially life-threatening tumor, hopefully we can find a treatment or a practitioner that can be of help.
However, from the view of Chinese medicine, treating sickness is only part of an effective healthcare system. The historical analogy is that waiting until you are sick to receive treatments is like waiting for your well to run dry before starting to dig. If the well is dry or you’re sick, there is nothing wrong with buying bottled water or getting treatments. But just as it’s expensive to continuously buy jugs of water for drinking, cooking, washing dishes and showering, it’s also expensive to wait until we’re sick before we get treatments.
We see the same pattern in looking at the majority of the dollars that we, and government agencies and private insurance companies, pay to our health care practitioners. Most practitioners, whether they are an MD prescribing pharmaceuticals or an herbalist prescribing herbs, are paid when people are sick. In most cases, when people are well they don’t make an appointment and therefore the practitioner is not compensated. Following the influence of our healthcare dollars, we are helping to create a system where almost all practitioners only receive money when we are not well—rather than creating a system that cares for health, we are creating a system that maintains sickness.
We are getting what we are paying for with healthcare. Most of the dollars we spend go towards treating sickness, and many practitioners, organizations and companies are following these dollars. At our clinic, most people make an initial appointment because of some physical, mental or emotional symptom, but many stay after these symptoms are gone. In addition to treating sickness and preventing disease, Chinese medicine offers deep-reaching and person-specific treatments to promote long-lasting health.
What are you paying for?
Brendan Kelly is an acupuncturist and herbalist at Jade Mountain Wellness in Burlington, VT—www.jademtwellness.com. He researches, writes and teaches about natural medicine at colleges, universities, schools and conferences nationwide. He is currently publishing his first book “The Yin and Yang of Climate Change.”
Treating Sickness and the Cost of Health Care
by Brendan Kelly, acupuncturist and herbalist at Jade Mountain Wellness, Burlington, VT
article published online, November 1, 2012
Around the country, there’s lots of talk about the cost of health care. Here in Vermont, where I live and practice Chinese medicine, the state is in the process of revamping the medical system partially for economic reasons. According to the Green Mountain Care Board, which was appointment by Governor Shumlin to oversee these changes, if the current increases in health care costs continue, it’s projected to bankrupt the state in 20 years. It’s not a question if the system will change, but rather a question of how and when.
While the finances of health care are somewhat different for other state here in New England and nationally, the trend is very clear—costs are increasing rapidly. While there’s lots of discussion about what this means for who receives health care and who pays for it, what’s lacking for the most part is an examination of the underlying causes. Historically, Chinese medicine has emphasized the importance in the treatment room of understanding symptoms and where they’re coming from. Treating symptoms alone without understanding their deeper causes is analogues to having your tomato plant wilting from a lack of moisture and not watering the roots. Even with the best of intentions, if the plant is dry and doesn’t get watered, pruning the dying leaves and stems will have little lasting benefit.
Similarly, it’s important to discuss the underlying reasons why our health care continues to become more and more expensive. A fundamental cause is that our health care system is none of these—is not a system and it doesn’t care for health. We have often confusing and sometimes contradictory reimbursement and treatment guidelines which overwhelming pay for the suppression of symptoms. Unfortunately modern western medicine, and the government agencies and insurance companies that pay for it, do not have a well-developed understanding of health and well-being, and as a result emphasize trying to make symptoms go away. But as with our tomato plants, what happens on the surface—physical, mental and emotional symptoms—is a reflection of what’s happening at deeper levels— a lack of internal balance and harmony.
With our health, symptoms often appear externally because something is out of balance internally. From several thousand years of clinical practice and refinement, Chinese medicine has developed deep-reaching diagnostic and treatment methods to address both the branch—the symptoms—as well as the deeper root causes. In addition to its very significant health benefits, Chinese medicine is also an extremely cost effective form of care.
In our clinic we routinely see patients able to reduce or eliminate many medications as well as avoid a wide range of surgeries. A few weeks ago, a patient told me that she had cancelled the foot surgery scheduled before coming in for treatments. Interestingly, she was not coming in primarily for foot pain and I was not focusing treatments on the discomfort in her toes. The significant reduction in her pain and resulting cancelation of the surgery were an ancillary benefit to a treatment process that was promoting internal well-being. The cost saving from cancelling the surgery would, in all likelihood, have paid for several decades of regular Chinese medicine treatments.
A major part of the rapidly increasing costs of health care is that it’s expensive to wait until people are sick before they receive treatments. While preventing disease and the need for invasive treatments is preferable to focusing only on treating symptoms, there is even more benefit, medically and economically, to promoting health.
Bio: Brendan Kelly is an acupuncturist and herbalist at Jade Mountain Wellness in Burlington, VT—www.jademtwellness.com. He researches, writes and teaches about natural medicine at colleges, universities, schools and conferences nationwide. He is currently in the processing of publishing his first book “The Yin and Yang of Climate Change.”
Ask the Acupuncturist and Herbalist
Published in the Vermont Winter 2012 issue of Green Living, a nationally published environmental magazine
By Liz Geran, Acupuncturist and Herbalist
What can a Chinese medical practitioner do for me?
Chinese Medicine offers individualized diagnosis, individual acupuncture treatments, and customized herbal Formulas. Chinese Medicine is based on treating the individual not just the symptoms or the diagnosis. People are very different and Chinese Medicine looks and treats each individual uniquely to promote balance and health. We treat the constitution or true nature of the individual (you could think of this as the season) as well as treating the symptoms (you can think of these as the weather the individual is experiencing). Additionally, Chinese Medicine treats the individual with the condition not just the condition itself.
Can Chinese medicinei increase vitality, performance and ease hormonal changes within men and women as they age?
Yes! Both Acupuncture and Herbal Formulas are used to ease the aging process, strengthen vitality and aid with the changing hormonal levels of both men and women. Chinese Medicine uses customized herbal formulas instead of single herbs. The strength of Chinese herbal formulations lie in the diagnostics of knowing the root cause of the weakness or imbalances of the individual. We customize a concentrated powdered herbal blend of between approximately 6-15 herbs. The powder is mixed with hot water and taken 2 times daily.
Simple lifestyle modifications to increase vitality will also be suggested to the client such as:
1. Warm cooked foods for every meal will help to increase the general Qi- -or energy– of the body. This is especially true during the cooler and cold seasons.
2. If the client has too much heat, warming and spicyfoods will be discussed and will be temporarily decreased from the diet.
3. Eat your largest meal towards the beginning of the day, a moderate sized lunch and a smaller, lighter dinner. Our food becomes our energy. Eat when hungry. We need many more calories earlier in the day to give us the energy we need and fewer calories before sleeping.
4. Approximately 2 liters of water for a normal size adult daily, increasing this amount if the individual is ingesting tea or coffee, as both have a diuretic affect. Drinking warm water during the cold months will help keep the body warmer and more energized. Cold drinks in any season are hard for the stomach.
5. In Chinese medicine every hour of sleep before midnight equals 2 hours of sleep after midnight. If you are feeling a lack of energy try adopting an earlier to bed and earlier to raise schedule (This is easier once the time has changed in the fall). It is also easier to go to sleep earlier if we turn off all electronics one hour before bedtime. The colder and darker months are the seasonal time in Chinese Medicine to get extra rest and to recharge your internal batteries for the busier seasons of spring, summer, and late summer.
6. Movement and fresh air will help to bring Qi or energy into the body and will increase your energy level. Qi Gong and Tai Qi are movement practices that directly build the energy. Yoga will also help build the energy as will walking or moderate exercise programs.
These are some of the general recommendations for most clients. Each client has a vastly different set of conditions that come into play to bring about health, balance, and vitality during all ages!
Liz Geran provides Acupuncture and customized herbal formulas at Jade Mountain Wellness in Burlington Vermont. She has a Masters of Acupuncturedegre with extensive herbal training. In December 2012 she completes a 2 year advanced Chinese Herbal Training. Liz was an Occupational Therapist for 18 years working in a wide range of western medical settings including: hospitals, acute care, intensive care units, outpatient services, nursing homes, public schools, preschools, neonatal care units, and home healthcare for adults and children. Liz teaches a wide range of Chinese health classes, as well as teaching Qi Gong and Tai Chi Easy in several community settings.
HEALTHY LIVING WITH THE SEASONS: WINTER in VERMONT
By Brendan Kelly, L. Ac., M. Ac., Herbalist
Jade Mountain Wellness, Burlington, VT
For millennia, Chinese culture has observed Nature and sought to understand the changes in the world around us, as well as within us. One of the primary models that was developed to understand these cycles is the Five Elements, with Wood representing Spring, Fire representing Summer, Earth representing late Summer, Metal representing Fall, and Water representing Winter.
It appears that the first well-developed written source about the Five Elements dates back about 4800 years, and describes them as phases of movement of energy within us and all of creation. As one of the seminal classical Chinese medicine texts, the Nei Jing or Yellow Emporer’s Classic of Internal Medicine is a detailed description of Chinese cosmology and human health, and comes from cultural and medical understandings that far predates its publication. Some estimates are that our current Five Element model draws on 10,000-12,000 years of continuous development.
From these thousands of years of refinement there are associations that are not only the basis of Five Element acupuncture and herbal medicine, but part of a medical system that offers important lessons on how to live a more balanced life. With the cold temperature and the predominance of darkness, we are now in Winter, which is associated with the Water element. To understand the season and the element itself, think about water as it appears in Nature.
Think of the ocean: deep, dark, and when viewed from the shore, it can seem to continue out onto the horizon forever. Also, think about when the waves are high and pounding the coast. The force with which they hit the beach can literally cause the ground to shake. The Water element is an embodiment of this vastness and tremendous power. My experiences from being thrown by waves while surfing during storms has shown me how small we are physically in relation to the forces of Water. And as with all the elements, we have this same power within us.
For us humans, this power of the Water element is housed in the Kidneys. Seated in our lower back, they provide a foundation on which our physical, emotional and spiritual strength rests. However, rather than being a deep reserve of fluids and power, the Kidneys can become dried out and depleted due to the way we live. Sometimes we even equate the hectic pace of our schedules with living a meaningful life. We sometimes consciously and unconsciously think “I’m busy all the time doing things, therefore my life means something.” Unfortunately, not only does “doing” not necessarily equal “meaning”, there can be an inverse relationship between the two: doing more can create less meaning. This is particularly true when our “doing” wears us down, making us less capable of living fully and appreciating life deeply.
One central aspect of health in Chinese medicine, which is particularly relevant at this time of the year, is rest. We as a culture can get caught up in “doing” to the extent that it can literally become pathological. Our sometimes excessively active lives can compromise the strength of our own internal foundation. When we regularly push beyond our daily allotment of energy, we will eventually begin to dip into our deep reserves, called jing, which are housed in the Kidney. It is traditionally understood that these energetic resources are better used to help us fulfill our unique individual purpose in life or help us in times of potentially life threatening illness.
This concentrated jing energy is also our source of deep internal wisdom. It is our ability to see our lives through the perspective of the passage of time and the process of growing older. It is both our ability to sense clearly the unique purpose of our lives, as well as the long-term energy to fulfill that purpose. With the magnitude of its importance, it’s clear why Chinese medicine places such an emphasis on protecting our jing and not squandering it carelessly.
Also called Ancestral Energy or Ancestral Qi, jing is understood to be passed along to us from our parents at conception. In a general physical sense, it can be seen as a very rough equivalent to our current understanding of DNA. A very important part of appreciating the significance of our jing is that once we have used them up, it is very difficult, if not impossible, to replace. And when it is used up, our life is over. With this traditional understanding in mind, the phrase “working ourselves to death” can take on real meaning.
Often related to being overly busy is our use of stimulants. What stimulants offer in the short term is the perception of having the energy to do things and stay awake. In continuing to work or be active after we are tired, we can dip into our jing to keep going because we don’t have the day-to-day energy to continue with the physical work or mental activity with which we are engaged. Over the long term, this not surprisingly leaves us in an even more depleted state.
Coffee in particular introduces the pathological influence of damp heat into the Kidneys and the lower part of our body in general. The stimulating aspects of coffee is part of the heat, and the oils in the coffee are part of the dampness. To understand damp heat, think about an infection that has reached the oozing, red, festering, inflamed stage. The redness and inflammation are the heat, and the oozing and festering is the dampness. Together, they combine to create an unhealthy, potentially serious condition. What coffee does is introduce (to various degrees) this very same condition to our Kidneys, which again is a foundation of our strength. By drinking coffee regularly (both with and without caffeine), we introduce this damp heat pathology into our own base of energy.
In looking to the local, wild plants as potential teachers, they have much to offer us in terms of living a balanced life more in harmony with Nature and the seasons. Look outside your window, or think about a natural area you know well. Are the plants there sending up new shoots now? Are they in a flowering stage, reaching up towards the sunlight? Is there an abundance of fruit or vegetables on their stems or branches, ready for harvest? The answer to all of these questions is, of course, no. The plants are in dormancy, with most of their energy stored underground in their roots. Similarly, Chinese medicine prescribes that we limit our physical and mental work, and general activity, this season so that our own essence can be stored and replenished. As with our plant friends, when we rest and sleep more in Winter, our reserves can build so that when the warmth and sunshine of Spring returns we can shoot forth into the season with the energy for new growth and activity.
Each season offers us unique opportunities. With Winter, it is the chance to replenish our root strength, just as the plants and trees and animals around us are doing. By slowing down, being still, and observing the world around us, we can learn to go more and more with the flow of Nature. That flow for us now in Vermont is a cold and dark one. It is a flow that moves slowly, that conserves energy by not doing more than what is needed. It is a flow, when listened to, that can help us build deep strength so that with the return of Spring we too can experience the resurrection of that season.
Some signs and symptoms commonly associated with Water imbalances:
- temperature regulation issues, particularly hot flashes and night sweats
- back (particularly lower back) and leg issues (in the hips, knees, ankles and feet), including weakness, stiffness, tendency towards injury and pain
- general fatigue and loss of energy
- graying and loss of head hair
- sleep issues, including difficulty falling and staying asleep and not sleeping deeply
Some suggestions on how to live more in balance with Winter:
• work and do less, and rest more. Sleeping 1-3 hours more nightly now helps build endurance for the remainder of the year.
• consider eliminating, or at least limiting significantly, stimulants, especially all coffee (including de-caf.)
• eat warm, cooked, nourishing foods, like soups and stews from locally and organically grown and vegetables, as well as natural and organically raised meat and wild game. Red meat helps build blood and lasting strength, as do root vegetables. Eating blue and black foods usually strengthens the Kidney, including blueberries, black beans, black sesame seeds etc.
• consider incorporating wild food into your diet. Burdock root, also known as Japanese gobo root, is nutrition packed and helps build strength in the Kidney, and is a common plant throughout Vermont and can easily be incorporated into soups and stews.
• visit natural and wild places, and observe what is happening and not happening, and follow Nature’s lead.
This article was first published in the Winter, 2008 edition of Tributary Magazine, a southeast Montana regional publication. It has been updated and applied to life here in Vermont.