Last week I attended what I thought would be an ordinary case study day -- where acupuncturists present difficult or challenging cases and explain their clinical reasoning and acupuncture points used. Like other clinicians, acupuncturists have to do a certain number of continuing professional development (CPD) hours a year, and this case study day was free to members of the British Acupuncture Council. 

I enjoyed the interesting cases, but by far the most thought-provoking presentation came from Sheria Chan, an acupuncturist who helped organise free emergency acupuncture clinics for victims of the Grenfell Tower fire in June 2017 (a fire in a 24-storey block of flats in west London that claimed 72 lives and shocked the UK).

I always knew that this 2,000-year-old medicine is used in disaster situations. I have heard of acupuncture used to help people suffering from post 9/11 trauma in New York City. Battlefield acupuncture is used by the US military to give rapid pain relief, enabling medical personnel to get wounded soldiers away from the battlefield quickly. I regularly treat patients for symptoms of trauma in my clinic. But as I listened to Sheria talk about the the immense challenges of setting up emergency acupuncture clinics in a chaotic disaster environment, I was moved and inspired. 

In the Grenfell case,  volunteer acupuncturists used ear acupuncture to treat shock, trauma and anxiety at three clinics for more than a year. This is an emergency measure, to help people caught up in the chaos after the fire, to help them cope until they can get formal treatment. It is a reminder of the power and flexibility of this ancient medicine.

Everyday we hear about how sugar is bad for us, but for me that message didn't really hit home until January this year when I found out that my blood glucose (or sugar) level is in the pre-diabetic range. You see, type 2 diabetes runs in my family so although I am not overweight, I am genetically predisposed to insulin resistance. This is when the body's tissues become less sensitive to insulin, which is what enables the body to take up glucose from the bloodstream. This leads to uncontrolled high levels of blood glucose, which we know results in serious problems with the kidneys, eyes, skin and the nervous system. Diabetes is a huge problem: the National Health Service spends £2.3bn-2.5bn a year on inpatient care for people with diabetes. That is equivalent to 11% of its budget!

I remember what my favourite biomedicine teacher, Awais Mian, always used to say about diabetes - the lifestyle advice you're given is not just for those with diabetes, it's for everyone who wants good health. This includes a diet rich in fruit and vegetables, with lots of complex carbs and food with a low glycemic index (delivering sugar to the bloodstream slowly). It means saying no to cakes and biscuits. Vigorous exercise is key, and in my case it's fast walking - not the gentle walks that I used to do, but walking fast enough to really raise my heart beat - and swimming. It helps to have a husband who loves swimming and thinks nothing is more fun than an excursion to London Fields Lido on a Sunday morning.

And of course, I also went down the route of  acupuncture and Chinese herbs. This combination of Chinese medicine and lifestyle changes works - I just has a blood test a few weeks ago and my blood sugar level is back to normal. This is probably going to be a lifelong war with sugar, but at the moment the score is Sugar 0 - Tess 1.

My friend Lina and I (I'm on the left) spent a couple of hours this morning with a group of carers in north London to give a talk on complementary therapies. The event was organised by the Brent Carers Centre, which offers support and activities to carers in the local area. This is a very large group of people whose work often goes unrecognised in society. One in eight adults in the UK are carers, according to Carers UK. This really hit home a few years ago when my mother-in-law started caring for my father-in-law at home, which is effectively a 24-hour job.

I spoke about the benefits of acupuncture and Chinese medicine to address physical, psychological and mental conditions. This seems to have resonated deeply with the attendees and it was great to see such  level of interest, presumably because of the very high mental and physical toll on carers. Seventy-two percent of respondents to Carers UK's State of Caring survey said they suffered mental ill health as a result of caring, while 61% said they suffered physical ill health. Many of the attendees wanted to know what they can do to help themselves, whether that is getting treatment or learning tai chi or qi gong (Chinese exercises that are based on principles of relaxation, balance and breathing, among others). They had conditions such as migraines, sciatica and tinnitus that respond well to acupuncture.

Apart from anything else, it was great to team up with my friend Lina Ramchand, whom I first met in Hong Kong about 20 years ago when we were both copy editors at the South China Morning Post. She is now practising reflexology, Indian head massage and sekhem energy work, and I am now an acupuncturist so we can help patients and carers in so many ways.

Six weeks ago, I went to bed with an achey left shoulder, felt the pain getting more intense through the night, and woke up the next day to a frozen shoulder. Also known as adhesive capsulitis, frozen shoulder is exactly what it says on the tin — the shoulder gets stiffer and achier over a period of 2-9 months (freezing phase); the pain gradually subsides but the shoulder is stiff and movement is restricted, which lasts about 4-12 months (frozen phase); the shoulder becomes less stiff and range of movement increases, which takes 1-3 years (thawing phase).
 
No one knows why shoulders freeze, although previous shoulder injury or trauma plays a part. More women than men are afflicted. The incidence of frozen shoulder is 2 to 4 times higher in those with diabetes than in the general population. What I do know is: a) it is very painful, and b) everyday activities like washing your hair, putting on a shirt, and driving a manual car become impossible.
 
The irony is not lost on me that I spend a large part of my working day treating patients with painful necks, shoulders and backs, when I myself can hardly lift my left hand without grimacing!
 
But here is the upside (and because I am an inveterate optimist, there is ALWAYS an upside). I know that for me, regular acupuncture, osteopathic treatment, stretching/strengthening exercises, as well as my tai chi practice, are key to getting more movement and reducing pain and inflammation. I also have more empathy with patients in pain. Let’s face it, pain makes you grumpy. It has a way of reducing even the sunniest personality into a blubbering mess, I get that. 
 
I also understood that there is an emotional component to a frozen shoulder. When you are going through a difficult time — whether at work or at home — you might hold yourself tight and stiff without realising it. When this goes on for years and years, this means less blood and qi (energy) circulating, which means less nourishment for muscles, tendons, ligaments and joints. Over a period of time, a vulnerable shoulder freezes. 
 
During the very painful stage, my wise osteopath advised me to see my frozen shoulder not as a problem to be fixed but rather as a healing journey that I have to go on. I know now that it helps to have patience (it might takes years to resolve), be kinder to myself (what’s the use of asking what could have been done to prevent it), and rediscover my sense of humour (the advantages of not being able to do certain chores!).

After the excesses of the festive season, it’s natural to turn your focus on your state of health at this time of the year. Are you the type of person who resolves to go to the gym to lose weight, perhaps go alcohol-free for the month of January, or maybe eat more sensibly? All good things, of course. But for me, I realised a couple of things over the Christmas break.
 
My husband and I both stopped working between Christmas and New Year, so had nearly 10 days of rest and relaxation. After the Christmas celebration, there weren’t many demands on our time, so it was wonderful to wake up in the morning and think about what we felt like doing that day instead of being ruled by the diary’s schedule. In hindsight, what I enjoyed the most was the ability to go slow. And that feeling is what I want to take into the new year with me.
 
I realise that life is very different when things are back to “normal” and you have to go back to work. But there are lots of things we can do to slow things down. I don’t have to look at the phone all the time: I can put it aside when I’m eating, or can check emails at certain times of the day. When I’m eating, I can try to do just that - just eat and enjoy my meal without looking at TV or reading the news.
 
Slowness also resonates with winter, the season that represents the most Yin aspect in Chinese medicine. Yin is the dark, cold, slow, inward energy, which is the opposite of the Yang of summer (think warmth, long days full of light, activity). Chinese medicine encourages us to be in harmony with the seasons - this is believed to contribute to good health and longevity.
 
So this January, try to rest more by sleeping early and getting up later. Turn your attention inward by reading, writing, meditating or learning internal exercises like t’ai chi or qi gong. Fill your reserves of energy so that you are ready for the outburst of activity when spring comes.

Most days I go to work thankful that I earn my living by practicing acupuncture. But on some days like yesterday, when a pregnant patient presented with her baby in breech position, I am even more grateful at this effective and safe form of medicine.
 
The Chinese medicine answer to turning babies who are not in a head-down position (the best position for labour) does not even involve the insertion of needles. Instead we burn a moxa stick – made from the leaves of the Artemisia argyi (or Chinese mugwort) plant – and use it to warm up a point near the mum’s smallest toe. The warming action of the moxa stick reinvigorates the womb and encourages the baby to move into the best possible position for birth. Research* shows that this protocol is successful for turning 75.4% of babies in the moxibustion group (compared with 47.7% of babies in the control group).
 
It is also a much less expensive and less invasive way of moving the baby. The alternative is something called external cephalic version, when an obstetrician tries to turn the baby into a head down (cephalic) position by applying pressure on the mum’s abdomen.
 
I taught my patient’s partner how to administer this moxibustion treatment at home for the next 10 days. He was very excited to be going home to be a “Moxibuster”!
 
* Cardini, F. and Weixin, H. (1998) ‘Moxibustion for correction of breech presentation’, Journal of the American Medical Association, 280, pp. 1580-1584.

When I was a kid growing up in the Philippines, I adored my Lola Sion, my dad’s mum. She was a respected figure in the community, was a teacher in the local school, and brought up seven children single-handedly after the Second World War (my grandfather, Lolo Juan, died of tuberculosis in 1950). She also slipped coins under her grandchildren’s pillows at night while they slept, and when we showed her the coins in the morning, claimed there is a magic bullfrog that did the rounds at night (perhaps her version of the tooth fairy), but that is for another blog.
 
I’ve been thinking of Lola Sion recently as I read an article* about how tai chi may help prevent osteoporosis in post-menopausal women. Lola Sion was an active woman in her early 70s, but an accident caused her to fall and break her hip bone. I don’t know if she had osteoporosis (post-war diet in rural Philippines may not have been very rich in calcium), but she never recovered from her broken hip and was bed-ridden for two years before passing.
 
Nowadays of course we know that a balanced diet and regular exercise help slow the loss of bone density and delay or prevent osteoporosis (a bone disease that occurs when the body loses too much bone, makes too little bone, or both). Studies suggest that about one in two women and up to one in four men age 50 and older will break a bone due to osteoporosis.
 
Medications and hormone replacement may also be used to fight osteoporosis. But all medications have side effects. Why not try a form of exercise that is fun, relaxing and has many health benefits?
 
I am talking about tai chi, which according to the US National Institutes of Health*, may help maintain bone mineral density. T’ai chi places great emphasis on standing single-weighted (all the weight in one leg), which stimulates bone growth. One of the senior teachers in my school of tai chi, Margaret Matsumoto, had a bone density scan at age 60 and her hips showed the same bone density as a healthy 30-year-old!
 
The London School of T’ai Chi Chuan is offering free introductory sessions on September 19th and 20th in central London. Come along and see what tai chi and studying with us is like. We will tell you about the background of our school, some of the benefits of doing tai chi (not just for osteoporosis!), introduce you to its basic principles and have a taster class. Click here for details. All welcome!

I wonder what Lola Sion would have made of this ancient Chinese exercise? Now there’s a thought.
 
* Wayne, P.M., Kiel, D.P. and Krebs, D.E. (2007) ‘The effects of tai chi on bone mineral density in postmenopausal women: A systematic review’, Archives of Physical Medicine and Rehabilitation.

​A recent study by scientists at the Hebrew University of Jerusalem found that sperm counts among men in the west have fallen by around 50% in four decades. There is nothing new in this study, as it was an analysis of more than 100 previous studies in the field. But it certainly highlights what fertility experts have known for decades – that more and more couples worldwide are having problems conceiving.
 
According to the NHS, one in seven couples in the UK may have difficulty conceiving. The causes of fertility are myriad, from polycystic ovarian syndrome (PCOS), endometriosis and thyroid problems for women, to lower quality sperm and low sperm count for men. But for 25% of couples with fertility issues, a cause cannot be identified.
 
In vitro fertilisation (IVF) has gained wide acceptance since the world’s first baby was born through IVF in 1978 (remember Baby Louise?). In the UK, more than 250,000 babies were born through IVF. In the western world, 1% (and rising) of all babies are born through assisted reproductive technology.
 
However, IVF cannot help everyone, with its high emotional, social and financial burden. Fertility drugs have side effects, from bloating and mood swings, to ectopic pregnancy and ovarian hyperstimulation syndrome. The success rate of IVF is highly dependent on the age of the woman undergoing treatment, as well as the cause of infertility.
 
Unless couples have very specific reasons for going down the IVF route, it’s best to try boosting fertility the natural way first. Some of the suggestions are well-known - get healthy, lose weight, don’t leave it too late, have fun with sex. Less well known is the importance of keeping calm and relaxed and not getting too anxious.
 
In Chinese medicine, the Uterus Channel or Bao Mai is the channel which connects the Uterus to the Heart. The Heart is particularly susceptible to emotional stress such as anxiety, which in turn can affect the health and receptivity of the uterus. Trying to have a baby can be very stressful, and when the body is in an anxious state, many physiological reactions can adversely affect your ability to conceive. Hormones are released, blood vessels are constricted, and blood moves away from the torso to the limbs as your body gets ready to flee in a fight-or-flight response. This means that blood supply to the pelvic organs, the uterus and ovaries is reduced.
 
Acupuncture helps boost fertility by improving blood flow to the pelvic organs, therefore promoting the growth of endometrial tissue, optimising ovulation, and regulating menstruation. Acupuncture is safe and has very few adverse side effects, when done by properly trained practitioners. 
 
Click here to see research on how acupuncture can help with female infertility and male infertility.

​What if I were to tell you that there is an acupuncture point on the wrist that helps make cigarettes taste bad? Aha, now that I have your attention, let me add that acupuncture not only helps with quitting smoking but with other addictions as well.
 
I like to use points on the ears as well as on the body. Why the ears? In the mid-1970s an auricular (ear) acupuncture protocol was developed in New York to treat many common drug addictions. The protocol is now referred to as the NADA protocol (NADA stands for the National Acupuncture Detoxification Association) and calls for the insertion of small, stainless steel and disposable acupuncture needles into five points on the outer surface of the ears.
 
When the auricular points are combined with acupuncture points on the body, the treatment aims to relax the patient, relieve anxiety, regulate the autonomic nervous system, and strengthen the lungs and immune system, among other things. And, yes, to make cigarettes taste bad!

January 16th this year is dubbed Blue Monday, that dreaded day in January when credit card bills come to remind you of your Christmas bingeing, the weather remains gloomy, and not a bank holiday in sight until Good Friday on April 14th. And if you started the year with lots of good intentions about watching your alcohol intake, eating more healthily and getting more exercise, what's happening two weeks into the new year?

If you've already broken a resolution, don't despair. Setting goals is great, but it's also important to be kind to yourself. If we want to make a change, we need to realise that it takes time to create long-lasting, sustainable changes. A few days alone will not do it. I read somewhere that it takes a minimum of 21 days of doing something consistently to create a habit. 

So whether you are ditching alcohol, avoiding sugar, going back to the gym, or sticking to your budget, take into account that it takes at least three weeks for a habit to form. And ask yourself, what kind of support do you need?

Chinese medicine is a great ally when it comes to supporting you with your health objectives. As an acupuncturist, I see my role not so much as a healer as much as an enabler or a supporter. 

Because Chinese medicine is such a flexible medicine, it can help with myriad conditions such as relieving stress, improving sleep, optimising your digestive functions (thus helping with weight loss), boosting immunity. This beautiful medicine treats the whole person, not just an illness. A patient (whom I've been treating for stress relief) told me the other day that because he felt less bloated and more energetic (and more relaxed), he was more motivated to exercise more and eat better. What a lovely way to start the year!