Tendervine Health

Kyutoshin for knee pain - In general when someone comes in with joint pain my first thought is ‘moxa moxa moxa’! I prefer this needle-head moxa technique when the pain is deep in the knee as it helps to generate fluid deep within the joint. While I usually use charcoal moxa for kyutoshin, because of the position of the needles on the knee the charcoal is too heavy so we have to use the smokey kind. Makes for a great photo though especially in this Bay Area spring light 😉🌻

Inspired by the incredibly clinically relevant teachings of and , here is a breakdown of my approach to managing Hashimoto’s as an East-Asian medicine practitioner. Most of the article is focused on the advice I give to patients to help them make the most of the 167 hours per week they’re not in clinic, with some background on Chinese medicine diagnostics and treatment although as we know each person comes in with their own ‘flavor of Hashi’s’ so there’s only so much guidance you can give in a blogpost! I hope this helps patients and practitioners alike navigate Hashimoto’s in a pragmatic, customized, and effective way

Felt on fire this week in clinic (literally - lots of kyutoshin (needle head moxa)) after getting to accompany in her Japanese Acupuncture Remix course this weekend. Seriously Barbara is a magical sage who makes sure to dose everyone with acupuncture, moxa, and laughter in all her treatments. Her wardrobe says it all 😂 🌮 Her courses blow my mind every time - so grateful to have her as a magical unicorn mentor in this medicine ❤️🙌✨

It has happened - the practice has grown beyond my capacity and in order to provide the level of care my patients deserve, it has to grow. Over the next few months I will be training a team of talented practitioners who are equally as passionate about providing thoughtful, gentle, well-informed care for people dealing with complex health conditions. So as the practice evolves beyond me, so must our name. We will now be known as Tendervine Health! Tendervine Health will have the same focus on Japanese acupuncture, classical herbal medicine, and integrative medicine. The major differences are the breadth of conditions we will be able to treat and the increase in available appointment slots as our patients will have a full team to care for them. This is a huge milestone for my practice that I’m hitting about 3 years earlier than I expected. I’m both excited about the opportunity and terrified of the risks it entails, and in the end it’s worth it so that more people living with complex disorders that interfere with their daily lives can receive the thoughtful, ‘slow medicine’ care I value as a practitioner and a patient. Here’s to the next phase of practice and all the benefits and challenges it brings!

Been waiting for this for 4 years! And it was well worth the wait.

As part of my doctoral thesis I started getting really into analyzing blood tests from a Chinese medical perspective thanks to the encouragement of and referencing the incredible work of Clare Pyers]. And I can tell you there is no going back - there is so much valuable information and perspective you can get from such objective data points that can only make you a better practitioner. It can help you corroborate a diagnosis, determine which pattern is most pressing to treat in a complex case, and determine if your treatments are working or if you may need to pivot your approach. This here is a snapshot of blood work from one of my patients with post viral fatigue since 2020 that I’ve diagnosed as Kd and Sp yang deficiency with Kd Jing deficiency and this blood work corroborates that AND shows there is an element of pathogenic/constrained heat that needs to be addressed which is something I wouldn’t have necessarily picked up from pulse, tongue, and palpation diagnosis only. This lead me down the yin fire scenario thought process and has only enhanced the treatment I have given with pretty significant positive outcomes! I’m waiting until we get to the end of her treatment plan before writing a case but wanted to share this PSA with other EAM practitioners to buy Clare Pyers] book and start analyzing some blood tests!!! (Big shoutout to for coding the database that allows me to input and analyze the data in 5 minutes rather than look up each test in the book over the span of 3 hours!!)

I bought a bottle of Empirical Health] Gui Zhi Fu Ling Wan honey pills and I can honestly say this stuff is the real deal! One of my teachers in my master’s program said that taken in small doses over a long period of time this formula helps those with a uterus have less clots during me**es and lowers the chance of fibroids forming. In higher therapeutic doses this formula helps with menstrual pain accompanied by clotty me**es, constipation, and skin issues that come on in the luteal phase of the menstrual cycle (think acne, psoriasis, etc) along with helping to slow the growth of fibroids if the pattern matches (fibroids can form due to multiple patterns of disharmony, but that’s for a different post 😉). I usually make this formula for myself by blending raw herbs and mixing in honey, but I understand that not all patients have the time or will to do this and with this formula in particular nothing compares to taking it raw. Thanks to Empirical Health] now being sold by in the US I was able to get a one bottle sample to try and I’m SOLD! Just put in an order to stock up in clinic along with some other goodies to try from them 🙌

Insomnia is a common issue brought up in clinic. Whether it's a short bout or a long struggle, insomnia affects almost everyone at some point in their lives. The past few months my patients have been presenting with some extremely complex insomnia cases in the clinic. Some have been super responsive to treatment while others have been more resistant, and when I'm faced with a clinical challenge I always go back to basics through the teachings of great masters and thought leaders of East-Asian Medicine. My first stop is almost always the books and lecture notes of Ikeda sensei, and I found his take extremely eye-opening and compelling for what my patients are going through so I wanted to share some of his perspective here. Link in bio.

Today the US government made at-home tests available for free - if you haven’t already you should order them now through covidtests.gov - they allow for 4 tests per household. Unfortunately if you live in shared housing or a duplex situation or are required to test more regularly, 4 tests aren’t going to be enough. Tests are in short supply, so many healthcare practitioners such as me have stocked up to be able to make testing more widely available to our patients and our community. Ask your provider or if you’re in the East Bay and need a test kit please reach out to me - I’m providing them at-cost (not looking to profit from pandemic panic!) whether it be because you have been exposed or want to test to re-enter the community post-infection. 🙏🏼

Just wanting to share this view from my clinic window. This is actually my favorite time to give treatment - when the day starts to quiet down and we start to transfer our attention inward. In this very yang-focused society where we value production and movement these yin moments of stillness are the medicine we need.

I just got off a call with (who graciously agreed to be my thesis advisor for the doctorate program even though I full on fangirled hard during our first call 😂) and I’m sitting here reflecting on something she said that really hit home - ‘once you see it you can’t unsee it.’ We were talking about seeing yin fire in clinic as practitioners but I realize now that it also applies to the patient experience. Once you recognize and see the signs of disharmony in your body you can’t unsee it - the low grade digestive discomfort or the slight fatigue that sticks around all day or the skin rash that just won’t get better. Embarking on a health journey is embarking on a quest that will never lead you back to where you are now because the information and insight you acquire along the way cannot be unlearned. It takes courage to take that first step, and I sit here reflecting on my patients’ journeys and am in awe of their courage. And not just my patients but every person who decides decides it’s ok to be vulnerable in pursuit of harmony - the process will test you while also bringing meaning and perspective to your human experience.

Let’s talk about yin fire and it’s role in autoimmune disease. For my doctoral thesis project I’ve be doing a deep dive into the pathomechanism of chronic inflammation from all points of view and here is what I’m learning: Chronic inflammation occurs when the body cannot return to homeostasis but is constantly trying to anyway, and in turn healthy tissue suffers which is what we have labeled an autoimmune response. From the perspective of Chinese and East-Asian medicine Li D**g Yuan described this phenomenon in the Pi Wei Lun through the concept of ‘yin fire’, a disharmony of ministerial fire due to deficiency stemming from pathomechanical qi movement from the Spleen and Stomach. This article (linked in comments) is a primer to what I’ve been learning about yin fire and chronic inflammation based on the writings of the thought leaders who have been kind enough to translate and relay this vital information in English. Read through it and I’d love to hear your thoughts!

Flu season is upon us - with the rain has come the sniffles! While in conventional medicine diagnosis and treatment focuses on the pathogen that is attacking you, in Chinese Medicine the focus of diagnosis and treatment is on your body's response to the pathogen. This means that it doesn't matter if you've contracted rhinovirus or norovirus, if you have a fever, chills and bodyaches your treatment will be different than if you have fever, chills and a sore throat.

Read more about Chinese medicine's approach to treating upper respiratory illness to prep yourself with knowledge during this change of seasons! https://www.sydneymalawer.com/blog/treating-the-common-cold-flu-in-chinese-medicine

Treating the Common Cold & Flu in Chinese Medicine For millenia Chinese medicine has been used to treat upper respiratory diseases from the common cold to pneumonia. Classical Chinese medicine views externally-contracted disease as

Just your Friday reminder. I wrote this down for myself as a reminder after a patient had a profoundly transformational experience the week post-treatment and made immense progress in a week on a condition that’s been affecting them for almost 30 years. The reason why I needed to write it down was because if I had done the treatment based mostly on symptoms (which I almost did) it would have been a very different treatment and I’m not sure it would have had the same effect. The pulse I had felt was strikingly different from the pulses from the weeks prior, so I almost didn’t trust my pulse-taking skills but in the end went with it. This note reminds me not to come in with pre-conceived notions but rather to allow each person’s pulse patterns to slowly unfold week to week. As your relationship with your patient builds the pulse reveals its layers - the comfort they feel with you helps them relax, the positive outcomes they feel from your treatments helps them trust, and the care they feel from you helps them surrender. All of this reveals new layers to the pulse that help you find the real root to their condition. And that is your responsibility and honor as a practitioner - to treat the root - the physical, the emotional, the spiritual root.

P**p is fascinating! My fellow Chinese medicine practitioners understand this way too well. In Ikeda Sensei’s book ‘Integration of Acupuncture and Herbal Medicine’ on page 7 he detailed how subtle differences in diarrhea presentations give you big clues as to the different patterns and therefore formulas used. The main takeaways are that diarrhea can be cause by cold OR heat, and that it can result from Kidney, Lung, Liver, or Spleen Deficiency. So depending on the other symptoms, if you feel better or worse after diarrhea, and if you experience abdominal pain or not you pattern may be different. For example, in chronic diarrhea when the patient feels better after going to the bathroom it is considered heat in the stomach and intestines due to Spleen Deficiency with the appropriate formula being Da Chai Hu Tang. If you get diarrhea during your period, it is considered Liver deficiency leading to cold, so the appropriate formulas are Wen Jing Tang or Dang Gui Si Ni Jia Wu Zhi Yu Sheng Jiang Tang. If you tend to get diarrhea after drinking too many cold drinks but with very little abdominal pain, this is a constitutional Lung Deficiency pattern and the appropriate formula is Ge Gen Tang. These are just a few examples of what your p**p is telling you! 💩

Sometimes when a condition is outrageously stubborn to treat it’s actually because of an autonomic nervous system imbalance, which is a fancy way of saying a fight between your ‘fight or flight’ and ‘rest and digest’ response. I’m currently in the midst of an AIP coaching program put on by & .alt and learning an immense amount behind the science of not only food but also lifestyle such as stress and sleep. My big takeaway from last week’s coursework was that regulating your hormones through nutrient dense food, sleep, and navigating stress appropriately is absolutely vital to any healing process. For some of us it’s difficult to navigate stress and sleep through the above because LIFE, so learning how to support patients with herbal medicine is necessary in order to help others living with autoimmunity improve quality of life. Here is a custom formula to help regular cortisol and CRH levels in the body (Rhodiola) as well as boost progesterone in order to elongate the menstrual cycle (Vitex).

Many who come to see me in my practice are suffering from GERD and gastritis (aka heartburn & reflux). Their symptoms vary from mild irritation of the throat and burping to severe stabbing pain in the epigastrium and inability to lie flat due to the pain. Many of them feel that their condition is not under control even though they are taking proton-pump inhibitors such as omeprazole. While regular acupuncture and herbal medicine has helped many of them control their symptoms, the best results I have gotten with patients have been those who have adopted a GERD-friendly diet based on Chinese dietary therapy along with herbal medicine and occasional acupuncture. Check out this article for an overview of GERD as seen through the lens of 🍲
https://www.sydneymalawer.com/blog/treating-gastroesophageal-reflux-disease-gerd-gastritis-with-chinese

As of today I am fully immunized. I received my second dose of the Moderna vaccine on Feb 11th (which also happens to by my half birthday!). According to the studies on Moderna you are considered fully immunized 12 days after your second dose. My experience with the vaccine was fascinating - I had super mild symptoms the day after the second dose, and then 6 days later I had a strong reaction - chills, fatigue, and a strong skin reaction on my face that has since subsided. I understand concerns about the vaccine as it was quick to market (for good reason) and there’s so much we don’t know about long-term effects, but for me what’s more important is that we as a society can be safe and healthy which is why I immediately signed up when they extended the vaccine to specialty clinic healthcare workers. It is our responsibility as primary care providers to ensure the health and safety of those who seek our help. A question I’ve been getting is how my behavior is going to change now that I’m fully vaccinated. The truth? Not at all - in fact my behavior will stay exactly the same both in and outside the clinic. The only difference this makes is that I have a little less anxiety now about my weekly trip to the grocery store and might actually get my hair cut. Want to know when and where you can get your vaccine? Check out the link in my bio for up to date information on vaccine distribution in the Bay Area

These have been my tools of choice lately. I use the thinnest 10 packs of Balance needles with their octagonal metal guide tube (which I have many of that I autoclave between patients). I also use their copper enshin especially for working on releasing the scalenes and SCM that one of my patients calls the ‘lucky penny’ 😂 The Ontake Warm Bamboo moxa is most people’s tool of choice with Wakakusa moxa that you can find at . And last but certainly not least the trust premium gold moxa for tonetskyu.

Hey everyone - I have been getting a lot of questions around the COVID vaccine lately, specifically on where and when to get the first dose and how to manage afterwards. Since the regional distribution effort is a moving target, here is a link to an update on Bay Area vaccine distribution and a resource to track pop-up vaccination and testing sites.

https://www.sydneymalawer.com/covid-19-bay-area-resources

Repost from
•
The Westbrae herbal pharmacy has gotten a facelift! Thanks to Connor () and Sydney () for putting this together and making our space even more lovely.

Shallow vs Deep Needling :: As a practitioner of Japanese Meridian Therapy, I use very thin needles and tend to insert needles no more than 5mm into the skin (with a few exceptions of course). So how is it that shallow needling gets results? When I was in my Techniques II class in acupuncture school with Koki Sensei he described to us two concepts: 得氣 ‘de qi‘ or obtaining the qi, and 氣至 ‘qi zhi‘, the arrival of the qi. In school we are taught to focus on de qi, which requires deeper needling and more stimulation in order to find and feel the qi grab onto the needle. On the other hand, qi zhi is a more patient approach - it's more about sending the body a gentle message through touch and needling and then waiting for it to respond by bringing the qi to that point. Throughout my training with Koki and Barbara I learned (and continue to learn) to refine my senses and techniques so that I could achieve qi zhi with minimal manipulation. As someone who hates being told what to do, this approach is much more in line with my personality and philosophy as it feels more like I am guiding qi and therefore the patient into homeostasis.

First dose of vaccine done. No reactions, just some soreness a few hours later. Berkeley’s vaccine dissemination procedure is constantly evolving, so for the latest information email [email protected] or download the app because they are also administering vaccines. You can call your primary care provider but it’s a shot in the dark - some are in the know and some are now. The resources above will let you know when you are eligible. Stay safe ❤️❤️🙏🏼🙏🏼

So much has happened in the past few months I’m still wrapping my head around it. The best way to describe it is as a transformation. Transformation is a beautifully pleasure-full AND painful process, and this one is no exception. As many of you know I was licensed in February and started my practice during a pandemic, which was terrifying and confusing and felt impossible. Before shelter-in-place my colleague and I had this grand idea of opening a 3-room co-working clinic in Berkeley where new and established practitioners could work side-by-side and have a space to host community events and offer community-style acupuncture monthly in addition to private practice. Instead we wound up renting one room to share in someone else’s clinic in North Berkeley as we navigated a pandemic and I also rented an addition afternoon in San Francisco. Flash forward to now, my clinical practice has gone from 0 to 60 and evolved into a supportive, caring respite for my patients from the everyday stress of the pandemic. It has expanded so much that I had to leave the space in San Francisco (no worries though because and Carla are still there to take care of SF folx 🙏🏼) and was able to accept an amazing opportunity when the practitioner who was the main tenant of our current clinic space decided to retire and offered for us to take over the lease! So here is a photo of what we now call Westbrae Acupuncture, a co-op of practitioners in the Westbrae neighborhood of North Berkeley here to support the health of our community. It’ll take some time before we can host all of the community events we dream to (including community Acupuncture), but I am so grateful that Connor and I have taken the first step towards our dream of supporting our community of patients and practitioners through a healing environment 🙏🏼🙏🏼🙏🏼

It’s that time of year again when we retreat inward and seek warmth and comfort. Just stocked the Berkeley clinic with some essential winter and flu season formulas and even started giving them memorable names because I realize the Pin Yin can be difficult to keep track of when you have an herbal medicine cabinet full of formulas (which most of my patients do at this point shrug 🤷‍♀️) and haven’t studied them for 5 years! (I still put the Pin Yin in the label to make sure those who want to learn can!) So grateful for and from and their quality liquid concentrate/ lines 🙏🏼🧪 🌿

Been making a lot of raw formulas lately - this one is for a patient that involves taking about a pound of herbs a day for one month! Thanks goodness for right down the 880 in so that we can go grab herbs quickly when running low!

Backyard home visit view 🍁 ☀️ 🙏🏼 I never thought I’d be doing home visits regularly when I first started practicing, but it has actually been a joy to be able to bring the healing power of acupuncture and moxibustion right to people who otherwise wouldn’t get the consistent care they need. It’s also been a great way for families and health-conservative pod-ed communities to get access without having to venture outside of their property. Grateful for the opportunity to learn about alternative ways to bring care to others during these trying times ❤️

Just pre-ordered two sets (one for Berkeley Clinic and one for SF!). I’m super stoked - thank you for making such an awesome product! If you’re interested in ordering a set or two check out the link in comments