Welcome to Chinese Medicine Bristol's official blog! Here, Acupuncture and TCM pracitioner Sandra Arbelaez will share information about Acupuncture and Chinese Herbal Medicine, how they work, and the latest research and developments related to TCM. You will also find knowledge and ideas on how to enjoy a full, healthy life that she has picked up over the course of 15 years of exploring the world of natural health

Tuesday, 2 July 2019

My 15th year in practice

I cannot believe it has been 15 years since I started practising acupuncture!! It is such a privilege to be able to say this and to have met all the people I have met, each of whom has taught me something and helped me become a better practitioner in one way or another. I am often asked how I ended up doing what I do, and I always give the short answer. This is the full story of the personal journey that took me to discover all the wonderful things that Chinese medicine has taught me

This journey started many years ago while I was living in London. I was in my mid-twenties experiencing chronic Kidney disease which I had developed as a result of excess stress, excess work, excess exercise, excess alcohol, and not enough nutrition; all mixed in with PTSD (which I never identified at the time) that had resulted from the trauma of being followed by a stalker everywhere I went for a whole three years while I was still living in Colombia. My lack of awareness of my physical and emotional needs was at the base of my health issues, but this was something I was yet to discover.

After a few years of trying unsuccessfully to “get fixed” by the doctor and getting increasingly ill, weak, and scared, I finally decided to try acupuncture which I was convinced, for reasons unknown to me, would help. I had my first acupuncture session one afternoon after yet another kidney infection had hit me. After telling him about my symptoms, the practitioner looked calmly at me and told me I would probably be better off with herbal medicine, which he did not do. I would not take it; I was adamant acupuncture was what I needed and he reluctantly agreed to treat me. I remember him asking questions as if he knew exactly what I was feeling, I couldn’t believe he would ask me about my knees and my ears! Later I learnt how these parts of the body are closely related to the Kidney energy. 

That first treatment was the beginning of a long process, I seemed to be very responsive to it and felt completely different straight after. Although still unwell, I felt lighter and the uncontrollable fearful thinking and the anxiety constantly making my heart flutter and my stomach tighten were all gone for several days. While my physical energy continued to improve steadily for the years I was in treatment for my ailments, my mind and emotions were where the deepest transformation actually happened. I became increasingly aware of my body, my intuition and trust in it got stronger, and my interest in my own health grew to become a fascination with nutrition, herbalism, energy, and natural health. While my body was still too weak to be used in a normal way, I delved into every single library book I found about these subjects and started to apply all the necessary changes that still support my wellness now.  It was at this point that I realised it was not possible to continue living in the way that I have lived until then. Everything had to change, including my career as a classical musician. I was forced to rethink the life plan I had imagined for myself, which was incredibly confusing and made me feel lost for I don’t know how long. I started to do little jobs that my energy levels permitted, and waited for something to happen.

I heard of something called Reiki and became curious about it so I took a course, and then another one to help me get better. After this, I embarked on a massage course. My health had improved a lot and I felt elated to discover the whole new grateful and joyful me who had risen from the distraught and sickened old one. I wanted to give something to others and I loved giving massage to people and feeling the difference it made to their stress and tension. However, I began to encounter more people with deeper issues which could not be solved with massage and I got restless to take the next step. Finally, in 2001, I took courage and decided to learn more about the mysterious therapy that had helped me become aware of how my body worked and which had been at the centre of my return to health. I never looked back. It was the summer of 2004 when I started practising acupuncture, I had both excitement for what was to come and apprehension for my lack of experience but I remember feeling that I was finally on the right track after being forced to change direction in such a tumultuous way.

The day I received my MSc
Like most people’s, my journey into healing was a lonely and, at times, extremely painful one. I guess this was the way it had to be for me to learn what I did, but I came out the other side convinced that it didn’t have to be the same for everyone and wanting to help others on their own journey. Becoming an acupuncturist allowed me to do this. In the last fifteen years, I have tried to be for others that neutral person who can truly listen, and who can help them understand what is happening, reassure them, and make helpful suggestions so that they can feel empowered to heal their whole beings. This, and the constant need to learn more which has kept me studying and trying to deepen my understanding of Chinese medicine, have been my main driving force. In exchange, I get much more than I ever asked for: I get to make a living doing exactly what I feel I am here to do, and I get showered with love and gratitude every single day of my life.

With a neurology professor at Heilongjiang University, China
Volunteering in India with World medicine

with  amazing teacher Dr Suzanne Rubidoux in Dublin
Chinese medicine has taken me to many places in the last 15 years. It took me to Reading for three years to learn Chinese herbs,  to London for one year to do an MSc in Oriental medicine, to China for three months to learn about the amazing work that can be done with neurological conditions, to India to volunteer with World Medicine, and in the last two years to Dublin to be showered with knowledge by one of the most amazing practitioners I have met. I can never imagine getting to a point when I can sit back and think that I have learned everything there is to know about what I do. This is not only encompassing Chinese medicine. I feel that every year in practice I learn more about myself and about being human in these stormy times. This learning, and helping those who suffer, is what life is about for me, and I am grateful to be able to live this experience. I am filled with love and appreciation for all those who have shared different parts of this journey with me, for all those who have offered me their knowledge and wisdom, and for all those who have trusted me and allowed me to be part of their own journeys. All of you are my teachers and I thank you for that. 

With hope to continue growing as a human being and as a practitioner for at least another 15 years. Much love and healing to all,

Tuesday, 10 January 2017

TCM causes of disease

According to the philosophy behind Traditional Chinese Medicine (TCM), everything is interconnected and, as a result, one part of the whole can not only influence the whole, but the whole is also reflected in each one of its parts. This law applies to everything that exists. The definition of what constitutes the "whole" varies depending on the context. We could at various times consider the Universe, the solar system, our planet, our specific ecosystem, a species, or a single living being as whole entities. Thus, each of us may be thought of as a "whole" made up of every single part of the body, as well as the mind, emotions, and spirit. In terms of our health, this means that anything that produces changes in any part of us - i.e anything that happens in either our external or internal environments-  can have a definite effect on the whole of our beings and either support our health or cause illness. As a result of this way of thinking, TCM views on how our body works and what may cause disease are radically different to what we are used to and people are often surprised when they come for Chinese medicine treatment for a seemingly simple symptom and end up being questioned about unrelated parts of the body, as well as their relationships, sleep patterns, lifestyle, etc.

Our society is now riddled with highly complex chronic conditions such as diabetes, autoimmune diseases, neurological, mental, and emotional conditions, just to name a common few. Conditions such as these, are not the result of a single agent but are caused by a variety of factors that include our lifestyle, diet, and genetic make up. Nevertheless, we are still stuck trying to find a single cause and a single solution to everything, including disease. Chinese medicine has a unique understanding of the  interconnection between all the systems of the body, between the body, mind and emotions, and of the relationship between us and our environment which enables practitioners to see more clearly how a chronic disease was developed in a particular individual. Thus, the climate we live in, our emotions, our relationships, specific aspects of our lifestyle and diet, and our exposure to pollutants may become important parts of the puzzle of chronic illness.

TCM causes of disease
Traditional Chinese Medicine classifies the causes of disease in this way:
External Causes, which refer to a variety of climatic and environmental factors
Internal Causes, which are specific emotional and mental factors
Miscellaneous Causes, which mostly refer to lifestyle  and infectious and polluting agents

External causes of disease

In this category, we find six climatic and environmental factors that can turn into pathogenic influences as they "invade" the body.  Each of these factors is predominant
Climatic and environmental factors can cause disease
during a specific season although they may also be present at other times of the year depending on the latitude and altitude we live in or because of unusual climatic changes. They can also be created artificially in our heated and air conditioned homes. The six external pathogens or "evils" are listed below:
  • Wind: Predominant in spring, and also produced by fans, airconditioning and drafts, Wind tends to cause a sudden onset of symptoms and affect the upper parts of the body. Wind often combines with other pathogens such as Heat, Cold and Damp, helping them penetrate the body. Sneezing, itching, headaches, twitching, and symptoms that rapidly change location can all be caused by Wind invasion.
  • Cold: Predominant in winter, and also easily contracted diving into cold water, Cold makes the body chilly and produce excessive watery discharges. Symptoms that can result include watery eyes, a runny nose, and frequent copious urination. As cold contracts matter, this pathogen can also cause pain and stiffness in different locations of the body.
  • Damp: Predominant in late summer - a humid season in some parts of China -, Dampness tends to affect the lower parts of the body more than the upper parts and, amongst other things, can cause a sensation of heaviness, aching joints, swellings, thick and sticky discharges, and sluggishness in the digestive system. In the SW of the UK where I live and work, this pathogen is prevalent throughout the year.
  • Heat: Predominant in summer, Heat can cause symptoms such as sensations of heat , fever, dryness in different parts of the body, thirst. inflammation, constipation, sweating, and dry skin.
  • Summerheat:  This pathogenic factor is like Heat but much stronger in its effect, and can also occur in summer. Summerheat can also easily combine with Damp pathogens causing symptoms such as nausea, vomiting, diarrhoea, heaviness and sticky discharges as well as severe fever, sweating, and thirst.
  • Dryness: Predominant in the autumn - although not where I live!-, Dryness can affect bodily fluids resulting in symptoms such as dry eyes, dry nose, dry mouth, dry cough, dry stools, and thirst. This pathogen can easily be caused by different types of heaters and air conditioning systems.

External pathogenic factors invade the body either singly or in combination. They start on the superficial layers of the body where, depending on the strength of the pathogen and of our defensive energy, they may be expelled back out or move inwards causing further symptoms and damage. Symptoms like chills and fever, skin rashes, body aches, sudden swelling of the joints, and headaches can be caused by external invasions.

Internal causes of disease
 In Chinese medicine, it is understood that the body, mind, emotions, and spirit are but different manifestations of Qi. Rather than being separate from each other, these different aspects of ourselves constitute a fluid continuum of energy that goes from the density of the physical body to the lightest, more ethereal Spirit. TCM explains that when Qi, or any of its manifestations, does not flow smoothly or its flow is impaired, this can result in the development of symptoms. It is in this way that an imbalance in our emotions can transfer into a denser form of our Qi and cause physical symptoms. The internal causes of disease consist of seven specific emotions that can turn into pathogenic factors because of our failure to healthily express or otherwise deal with them,  or because of the emotions being so sudden and excessive that we cannot protect ourselves from their effect.

Emotional imbalances are Internal causes of disease
- Suppressed emotions -  for example, unexpressed anger, frustration, or grief - can cause Qi to stagnate. This can in turn cause a myriad of symptoms which may include pain in any part of the body.
- Chronic emotional states - such as constant worry, stress, anxiety, and sadness that are not addressed or resolved- not only disturb our mind and general wellbeing but can also consume our energy which may result in a gradual decline in the functioning of the whole body.
- Sudden, strong emotions - such as fright, trauma, and euphoric or elated states like those artificially caused by chemical substances - can scatter Qi and may interrupt and disrupt its flow to such an extent that it may be hard for it to be restored again. This can result in ongoing mental, emotional and physical disturbances.

The close relationship between each of the seven emotions and a specific organ of the body means that when a particular emotion is out of balance its related organ will be affected first. As all TCM relationships are reciprocal, this also means that when an organ is out of balance its corresponding emotion will be exacerbated. In addition to this, all types of emotional imbalances affect the Heart which, in TCM theory, is the seat of consciousness and of the spirit, and whose energy is involved in any type of emotion we experience.

These are the seven emotions and their corresponding organs:

  • Anger and related emotions such as rage, annoyance, frustration, jealousy, etc; affect the Liver and its functions causing Qi to ascend and go the "wrong way". This can result in a variety of symptoms ranging from headaches and digestive difficulties, to pain and disturbances in the menstrual cycle
  • Joy, as well as elation, euphoria, overexcitement, etc; affect the Heart and may cause the Qi to slow down and scatter around as well as produce excessive heat that can result in sleep disturbances, nightmares, agigation, and an inability to concentrate or relax.
  • Sadness - which includes gloom, despair, etc- affects the energy of the Lungs and tends to deplete the Qi resulting in lack of energy, weakness and weak immunity
  • Grief affects the  Lungs and Heart and has a similar effect on the energy as Sadness, weakening the Qi.
  • Pensiveness, which manifests as overthinking, circular thinking, and worry, affects the Spleen, causing Qi to get knotted and stuck,often resulting in digestive difficulties
  • Fear affects the Kidneys and causes the Qi to descend. This is the reason why in times of extreme fear there may be incontinence of urination or defecation.
  • Fright (shock) also affects the Kidneys, causing Qi to become chaotic. It then may take a long time for Qi to recover its normal course as it happens in some cases of PTSD

Miscelaneous causes of disease
Our constitutional weaknesses, what we eat and how we eat it, the amount and type of exercise that we do, and our exposure to chemicals, pollutants, and to parasitic or infectious agents, can all be factors involved in the development of disease and are classified in TCM as miscelaneous causes of disease.

Having healthy parents greatly contributes to our health
Our constitutional strength is a direct result of the health of our parents at the time they conceived us, and the health of our mothers during pregnancy. When we are born, this constitutional strength is further shaped by the appropriateness of the nourishment we are given as well as the environment we live in. Just as we may end up with a weak or strong immune systems, we may be more or less able to cope with certain activities, foods, or environmental factors. It is common in the West to be oblivious of this. We instead tend to believe in the "once-size-fits-all" approach to lifestyle, exercise, and diet and often unwittingly cause harm to our bodies by doing and eating things that are detrimental to our individual health. Becoming aware of our own constitutional strengths and weaknesses and honouring them by adopting a lifestyle that promotes our wellness is one of the keys to good health and it is something that Chinese medicine is particularly good at because of its deep understanding of how the body works and how it relates to the outside environment. I consider this the most important part of my work as a TCM practitioner as I believe it is not enough to alleviate symptoms but it is also necessary to find ways to prevent their recurrence so that each person has control of their own health.

Although in TCM identifying infectious agents is not important per se, treating infections and intoxication from different types of chemical pollutants is possible through identifying the manifestation of their toxicity in a particular individual and treating them accordingly. Preventing the development of diseases caused by toxicity from infections and chemicals is essential in our modern world where we are subjected to increased pollution and to a chemical overload in our food and many household products, and where our immune systems have been bombarded with antibiotics while we are exposed to increasingly strong infectious agents. Fortunately, it is possible to reduce our exposure to toxins by choosing more natural products and we can also strengthen our immune system through our diet and lifestyle. TCM treatment for this kind of condition consists of aiding the detoxification of the body while strengthening the body's resistance to disease. This is done with a combined strategy that would include diet and lifestyle changes as well as herbal remedies and acupucture.

In contrast with the simplistic view of disease we have in the West, where we think that a complex chronic disease can result from a single cause (sugar- diabetes, cholesterol- heart disease/stroke, depression- chemical imbalance in the brain, and so on); in TCM, disease - particulary when chronic - results from a distorsion or diruption of the equally complex relationships between internal and external factors. As a result, prevention and treatment of disease are processes that involve identifying and addressing the pathogenic factors that have caused the symptoms so that there is relief, as well as harmonising the relationships both between the internal organs and between the individual and the environment so that the symptoms are corrected in the long term.

Tuesday, 26 January 2016

An acupuncture journey: volunteering as acupuncturist in rural India

This December just  gone, I spent two busy weeks in Chaparda, a tiny rural place in the Indian Western province of Gujarat, with a team of volunteer acupuncturists from the UK. We went as part of a project run by UK-based charity World Medicine which organises projects such as this in different parts of the world. Our aim was to offer free acupuncture to the nearby villagers, mostly poor farmers unable to access healthcare,  and also to give basic ear acupuncture training to members of the local charitable hospital set up to serve the community.

Our team of UK acupuncturist at Jay Ambe Hospital
The most exciting thing about this project was not that I’m totally in love with India and its people and I’m always up to visiting the country, it was the fact that the project didn’t only consist of giving treatments but it contained that magic element of teaching simple techniques that would allow the local hospital to continue offering some kind of treatment after we left. “Teaching the man to fish” is definitely the only way in which we can truly help anybody.

It took me a few days to grasp the extent of the work of our host organisation which not only comprised the charitable hospital we were to give treatments from – the Jay Ambe hospital-  but also several schools and homes for disadvantaged children and adults in need. Our accommodation was next door to the homes for elderly men and women who were often happily sitting in the sun to get the early morning chill out of their bones and would greet us as we walked past to get our breakfast. Every morning when I saw them, I thought to myself that if it weren't for this local charity, they would all have been living in the streets without any shelter or food. 

The work in the hospital started the day after our arrival.  The project consisted of two body acupuncture multi-bed clinics – one for men and one for women - , an ear clinic which would provide pain relief ear acupuncture in group sessions that run throughout the day (up to 6 per day) and, during the first few days, the ear acupuncture teaching clinic in which 4 or 5 members of the hospital staff would be taught the 5 point protocol that was being used in the ear clinic.

After some unsurprising hiccoughs that made us start relatively slowly, by the fourth day we were up and running at full capacity at the body and ear acupuncture clinics. Several ear acupuncture sessions were offered through the day, each time treating over 20 people, while the body clinics had queues outside their door at all times. The final countdown of treatments came up to over 700 given in the body clinics. By the time of writing we were waiting for the Ear clinic numbers

People awaiting treatment outside our treatment rooms
Ear acupuncture group session

We mostly treated farmers from the nearby villages that had been summoned by people sent out by our host organisation to give the news of our arrival. Quite a lot of them were visibly in pain and discomfort. The men tended to be very skinny and sinewy while the women were larger but could hardly walk from the stiffness in their backs and legs.  I was mostly at the ladies clinic but also spent some time at the male and ear acupuncture clinics and saw that, on the whole, the bulk of the people we treated was made up of over 50’s with quite severe joint and lower back pain resulting from working hard in the fields, crouching over the fire to cook, and generally a life full of hardships.

What struck me the most was to see so many people well under 60 not only toothless but also with signs of aging that made them look closer to 80 than 50. I spent the first day or two convinced that the people at the reception desk who were filling in the forms were mistaking people’s age, but then I realised that, in fact, most people I treated looked at least 20 years older than they actually were. I suppose this is a result not just of a lifetime of hard work but also of lack of nourishment and, most probably, of having being conceived by parents who were themselves undernourished.  On the other hand, these people living in obvious poverty and suffering from - sometimes quite extreme- physical discomfort would most of the time come in with a smile on their faces even when they reported no improvement in their symptoms. This is the beauty of Indian people, what makes their eyes so alive and their smiles so bright, they can see joy and a reason to be grateful where most people I know in the West could not.

Giving a treatment for knee pain at the ladies clinic

Giving free acupuncture to people who can’t afford it has always been something that appeals to me. I did it for many years in Bristol, where I gave weekly acupuncture treatments at a drugs project down the road from where I live. This was one of the most gratifying experiences I have ever had, not because of what I did but because of what I received from the people I came across who lavished me with gratitude and taught my na├»ve self so much about life, about being human, and about acupuncture itself!  Doing this in a faraway country is a completely different thing though, I wondered for some time if offering free treatments for a limited period of time was not going to be even worse for the people we were trying to help. What if soon after we left their symptoms came back and then they could find no relief in anything else? I realised I was wrong when a few of the people we treated in India, some of whom had arrived in severe pain which they had had for anything up to 20 years, after the 4th or 5th daily treatment came in all relaxed and smiling saying that they were pain free. I could see then how selfish my thinking had been, if even one person could get this much benefit then we were definitely doing the right thing for them.

I have rarely felt as exhausted as I did at the end of this trip, but it felt great that we had made a difference –even if small- to the lives of some of these villagers not only because our treatments brought relief to some of their symptoms, but because we left everything in place for our work to continue in the ear acupuncture group clinic now run by the people trained during our stay.  The latest news we received from them was that the ear clinic was up and running again after receiving new needle supplies from Delhi – they had gone through the incredible amount of needles we took we us and run out on our very last day in India! – and hundreds of villagers are still turning up for treatment.

Most of our hard-working hospital team
There is of course much to be learnt from this project to improve on future ones that any of us may be taking part of but, on the whole, we can say it is mission accomplished and everyone who got involved and gave their good will, time, money, and work, should feel proud of their contribution. Above all, this work is testimony that we can create a global family of people who care about each other... where there is a will there is definitely a way!!

Deep gratitude to each of those who made this experience possible: to those who donated money to help me get there, to the project organisers, my colleagues and fellow travellers, our lovely committed interpreters and helpers, the members of staff at the hospital who worked extremely hard, the staff in our host organisation who fed us and put up with our requests, and of course to all those who used our services in Chaparda for it could not have happened without them!