I am always on the lookout for good music to play in the treatment room. When I first started learning tai chi in Hong Kong many years ago, my teacher Alex used to play opera and reggae to accompany our rounds of t'ai chi. So before long I started associating these genres with relaxation and Chinese medicine (tai chi being one modality of Chinese medicine, along with acupuncture, herbs, food and tuina massage). So when I started my acupuncture practice some years ago, I automatically played classical music or reggae in the treatment room.

These days I tend to favour playing "non-music" in the treatment room so  patients have something to listen to while I leave the needles to do their work. Tibetan singing bowls or the sound of water are my favourites. Not everyone likes opera, but most people  appreciate the soothing sound of chimes being gently caressed by the breeze.

Imagine my delight when a patient gave us a CD recording of her playing the piano while being accompanied by a blackbird in her garden. This patient is a piano teacher and said she first noticed the blackbird singing in her garden two years ago, especially while she played the piano. So one day she recorded the blackbird while she was playing. Later on when she was playing back the recording, she realised that the blackbird seemed to be accompanying her piano-playing. And this magical CD is often what I play when I'm treating these days because the sound of nature is deeply relaxing. 

This isn't the first time I've heard of birds accompanying musicians playing. A famous recording from 1924 captured cellist Beatrice Harrison dueting with nightingales at her home near the  woods in Surrey, England. She received 50,000 fan letters from this time!

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.