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The Hot Flash That is Misunderstood

One of my prior patients with a history of early stage breast cancer from almost 20 years ago came to see me, asking the question - "Is hormone replacement with estrogen appropriate for me?" She has suffered from "hot flashes" for the past one and half years.

With pulse examination, it took me less than one minute to make the diagnosis - She has "big pulse", blood vessel wide and thick, pulse jumping with a strong amplitude. Her pulse is best described as "expansile", an indication of excess evil heat inside her body and the solution is to cool off her heat with herbs.

Listed below are my thoughts :
1. It can be dangerous to prescribe medications just based on patients' narrative, feeling hot after menopause does not equal to hot flashes.

2. "Heat vs Cold" is hardly addressed in western medicine, but is a very important concept in Chinese medicine.

3. Medicine should follow logical thinking. This lady had her menopause at age 55, or 6 years ago. She was initially fine until about one and half years ago. Why would she have intense "hot flashes" at 61, four years after menopause?

4. Upon further questioning, she admitted to have had many episodes of infections about 2 years ago, including UTI's, prior to her feeling very hot. My speculation is that her body condition/constitution changed then and there is residual inflammation in her body whcih made her feeing hot.

5. What is the definition of hot flashes? Hot flashes come and go, lasting for perhaps one minute at a time. Feeling excessively hot continuously is very unusual and it is not hot flashes.

6. There is definite risk of increased incidence of breast cancer and blood clots due to hormone replacement therapy with estrogen. As for the commom, real hormonal hot flashes, acupuncture and Chinese herbs can help and there have been a number of studies done to support its efficacy.
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Sadness, Anxiety, Depression (SAD)

A lot of people have mood disorders that originate from a weak heart. I see this problem over and over aging in clinical practice through pulse diagnosis. Pulse at the left Cun position (first position right proximal to the wrist area) is usually weak, deep and thin. In western medicine antidepressants (SSRIs) and anxiolytics are prescribed. In Chinese medicine, herbs used to boost heart energy (Hwang Qi, Ren Shen, Ren Shen Yang Ron Tang, Shi Quan Da Bu Tang), to invigorate blood (Dan Gui, Chuan Qiong), and to dilate coronary arteries (San Qi, Mao Dong Qing, Yu Jin, Dan Shen, etc.) are mixed with herbs to enhance the brain power (Yuang Zhi, Shi Chuang Pu, etc.) to be prescribed to patients.

The interesting difference is : in western medicine, different mood, memory, mental problems are attributed to the lack of or imbalance of chemicals in the brain called neurotransmitters, while in Chinese medicine, the theory is that the brain does not get enough blood (vital air and nutrients). By strengthening the heart, the brains get what they need and work better.

Give Chinese medicine a try!
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Recently I gave a talk at TriHealth on how to treat commonly seen allergic disorders, focusing on using acupuncture and Chinese herbs.

Some may ask : Who benefit from CAM (Complementary and alternative medicine)? The answer is those who don’t benefit enough from western medicine, those who have experienced side effects or those who are fearful of side effects from western medicine.

Over the years I have used acupuncture and/or Chinese herbs to treat a variety of allergic problems such as dermatitis, nasal allergy, bronchial asthma and bronchitis. Typically these patients came with a long history of suffering, have tried multiple medications with marginal benefits. They did get better under my care.

The current understanding is acupuncture works through multiple mechanisms : relaxation, balancing the autonomic nervous system, anti-inflammation, strengthening immune system, etc. Chinese herbal mix achieve multiple purposes : cooling the heat/fire, taking away inflammation, decreasing itching, etc.

I have treated a number of physicians with allergy and respiratory problems over the years. One female physician had persistent symptoms of sinus infection but failed getting better after three courses of antibiotics. Her symptoms subsided after two acupuncture sessions and one bottle of mixed herbs. Another pediatrician had seasonal asthma every spring. A few acupuncture sessions in early spring made her free of asthma attacks that year.

Western medicine is effective in many diseases treatments but it does not change one’s body constitution which may be a contributing factor to the suffering.
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Dr. Sheng is giving a speech on

“Complimentary and Alternative Medicine for Allergy, Eczema, Sinusitis and Asthma”. At

TriHealth Pavilion at I-71 & Pfeiffer Road on

9/12 Thursday at 6:30pm
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A middle aged gentleman asked me for help to get him off some of his regular medications.

He had diagnoses of type II diabetes, irritable bowel syndrome, hypertension, depression, anxiety, sleep apnea, low back pain and high cholesterol. He had seen many physicians and had been on a long list of prescription drugs. Despite of the care from multiple specialists and plenty of pills, he felt miserable and began to have numbness of his feet and noticed occasional imbalance.

In western medicine each symptom is treated separately by physicians in that specialized field of medicine. The prescriptions from all the specialists made his medication list very long. To get him off him his regular medications would be a long shot. First I needed to understand his constitutional type. Was there a common thread?

His hands were warm, he admitted to profuse sweating, his pulse was big and expansive. His pulse was easy to feel with my fingertips using minimal pressure to the radial artery. This was a case of excess heat which made his mind very active (interpreted as anxiety/depression), his appetite very good (eating too much made it difficult to control diabetes and to lose weight), and suffered constipation with abdominal pain (considered as IBS in western medicine).

In addition to acupuncture, herbal formulas were prepared to drain the excess heat from his stomach, intestine and liver. Returned one week later, he felt to be a different person and felt greater than 50% of relief of all his complaints. A correct pulse diagnosis guided me to the portal as to where to begin to sort out this complicated case. Of course this was only the beginning of the road to recovery.

The concept and treatment of “heat excess” is not in the western medicine. This case illustrated the fundamental differences in eastern and western medicine. I am not criticizing western medicine, instead, I am advocating integration of eastern and western medicine so that our patients would get the better results of medical care and higher quality of life.
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Can Traditional Chinese medicine (TCM) be used for emotional disorders such as anxiety, depression, or panic attacks? As a matter of fact that was all Chinese people had before the advent of modern day psycho or neuro-pharmacology, and it worked.

I saw two ladies in their mid 60s last week. The First Lady was a cancer survivor and I was her oncologist many years ago. She stated that she had always been anxious with a history of panic attacks in the past, controlled by Valium or other anxiolytics. She felt worse the past couple weeks.

The second lady had a fall six months ago while jogging. She hit her forehead, had a concussion, then never truly recovered. She has had headache, felt restless, unable to look at compute screen for more than ten minutes at a time. Extensive examination by several physicians and X-ray imaging showed completely normal.

They had similar pulse patterns: big, expansive, throughout the entire distal radial arteries bilaterally, the so called “big” pulse in TCM, suggesting inner heat excess, or fire. I can feel their anxiety, mental restlessness, and even anger.

Both ladies improved quickly with a combination of acupuncture and Chinese herbs, the second patient a mix designed to drain the excess heat and energy or cool off, particularly in the head.

What about western medicine then? The first patient had just started Lexapro, an antidepressant prescribed by her PCP. Is she depressed? I would worry about hyperserotonin syndrome (getting too excited) which occurs sometimes after taking antidepressants. I am not against medications, but I do believe many of my colleagues over prescribe.
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A young female baker working in a bakery store came for the third acupuncture visit for her left arm pain. She had received acupuncture from another practitioner but to no avail.

The patient did not appear to be cold on examination but she did give a history of cold aversion. Upon close questioning, the patient suspected that the arm pain might have been brought on from working in a walk-in refrigerator from her previous employment. She would get temporary improvement from the arm pain after a hot shower.

Chinese herbal mix was prepared to warm her extremities, to expel cold in order to relieve the pain. Her problem resolved almost completely rather quickly. She did not need any physical therapy, narcotics, antidepressants nor muscle relaxant.

There are different styles of acupuncture. If the local method does not work try another therapist who knows alternative method. In this case, a dismal approach was employed with needles inserted in her legs and feet.

The combination of acupuncture and herbs work very well in many cases. Find yourself an experienced herbalist can be very beneficial to your problems.
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A 50 years old lady was referred to me for neck pain. On initial visit, she told me she had not felt good for four months. Her systolic blood pressure was low, in the 80’s. She felt dizzy and sometimes felt she was to pass out. Several of her blood viral titers were very high, She was diagnosed with a post-viral syndrome. To raise her BP, she started Florine’s, a special type of steroid hormone.

Based on her initial pulse diagnosis, I can tell that the blood flow to her brain, heart and kidney was low, simply put, the blood circulation was not optimal. Therefore, there is venous stasis and water retention in her lower extremities and her cardiac output is reduced due to diminished venous return to the heart. This is a condition referred to as Fire (heart)-Water(kidney) disharmony in Chinese medicine. Indeed, her ankles were swollen and she had various veins.

In addition to treating her neck pain, a few extra acupuncture points were added to stimulate the heart and blood flow. Chinese herbs were prescribed to her condition. She felt better when returned for the second visit. She decided to discontinue her medicine. Her pulse was normal a week later on the third visit.

A correct pulse diagnosis provided valuable clues to the recovery of her condition.
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Dr. Sheng will be speaking at cincinnati Sharonville Convention Center on April 6, Saturday at 4:00pm on PULSE DIAGNOSIS. ...

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The Missing Common Thread

From time to time, I see patients seeking help from complementary and alternative medicine (CAM) practitioners like myself. They come with a list of problems, with many medications specific to their symptoms recommended by several specialists. They wonder how many pills they have to take.

Let me make it clear. I am not against use of prescriptions drugs. Physicians tend to “match the pills to the ill(illness)” while the illness is difficult to categorize or to define. The suggestions of taking a pill is based on off-label use, a stretch, or a physician’s intuition. The use of SSRIs or SNPIs (antidepressants) is just one of many examples, I don’t remember how many times I have heard from my patients “My doctor wants me to take antidepressant, but I don’t feel depressed. I don’t feel good because....” Any chronically illed person may feel depressed which is secondary to the disease.

I recently saw a 56 year old lady with digestive problems including acid reflux and constipation, mental irritability, poor sleep, lack of mental focus, hot flashes, and borderline hypertension. Her pulse was strong, bouncing, and was best characterized as “heat excess” or “fire” in Chinese medicine. With acupuncture and herbal formulas to drain the fire, she felt better with all her complaints quickly. The common thread is that excess heat or fire in her was missed in the western medicine.
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