The Hot Flash: How I Treat Menopausal Transition in the Clinic

This information is interesting and valuable for both acupuncturists and for the general public.

Dr. Grosam’s free one-hour lecture on perimenopause diagnosis and treatment strategies.


What Every Acupuncturist Needs To Know

Before You Begin

Understand your patient.
Understand the symptoms.
Understand the severity.
Understand the possible effectiveness of your treatments.

“50% – 20% – 20% – 10%” Rule

50%: Patients will naturally respond to acupuncture treatments with full efficacy results.
20%: Patients will respond slower and more gradual and will need acupuncture prescription modifications.
20%: Patients will need long treatment courses, herbs, and lifestyle changes.
10%: Patients will not respond to Chinese medicine.

Build Effective Treatment Protocols
“Mild – Moderate – Severe” Rule
1.) Quantity: Based on severity and duration of symptoms:

Mild Conditions: (3-6 Tx).
Moderate Conditions: (6-12 Tx).
Severe Conditions: (12-24+ Tx).
Short Duration/Acute Conditions: (3-12 Tx).
Long Duration/Chronic Conditions: (12-24+ Tx).

2.) Frequency: Based on severity and duration of symptoms:

Mild Conditions: (1 Tx/wk).
Moderate Conditions: (1-2 Tx/wk).
Severe Conditions: (2 Tx/wk).
Short Duration/Acute Conditions: (2 Tx/wk).
Long Duration/Chronic Conditions: (1 Tx/wk).

3.) Every individual person is different.

Every individual will respond uniquely to acupuncture based on your particular lifestyle, diet, exercise, work, and sleep habits.
Emotional, environmental and genetic factors will also play a role and are a necessary consideration.

Treatment Schedule
1.) Set up acupuncture protocol based on diagnosis.

2.) Give the patient a predetermined set amount of treatments based on severity.

3.) Continue treatments if there are changes in: Severity, Duration, or Frequency of symptoms.

4.) If there are no changes, modify acupuncture prescription and repeat.

5.) Once the patient’s symptoms are manageable and controlled (within quality of life parameters), start spacing out the treatments or start maintenance treatments.

6.) If there are no changes after set amount of treatments, add herbal prescriptions and suggest lifestyle modifications.
“Constant changing of acupuncture prescriptions, herbal prescriptions, and lifestyle modifications, may lead to the increased difficulty of knowing which therapy is the key to the patient’s symptom alleviation.”

Sample Protocol
1.) Regulate zang-fu organs, harmonize digestion, and calm shen. (“The Oil Change”)

2.) Regulate qi, clear/drain […]

Courage, Direction, Expression, Bonding, Separation and Transformation

Have you wondered why is it that one person is full of life and may set out to achieve amazing goals while another person is dull and does not set out to achieve anything? I often wondered why particular people were predisposed to be a certain way. After reading “Dragon Rises, Red Bird Flies” I realized there was more underlying factors to the human character than the usual emotions covered in so many texts. It is true, that some of our make-up develops from our emotions and these emotions, being fear, anger, joy, worry and sadness, are very important in the clinic. Patients will, in fact, have one of these emotional imbalances as a chief complaint. The emotions will too, bear weight in the clinic as a classic manifestation of a particular pattern and diagnosis. However, TCM psychology is far more exhilarating to study and far more useful in the clinic when you can look beyond the emotional state of the patient. This is the ability to recognize that each individual has a defined primal disposition. This quality or makeup of the individual shapes the person’s entire life from the day they are born. Based on five-element, yin-yang, deficiency/excess and Zang-Fu theory, I will summarize these individual traits into fundamental explanations, so they can be useful in the clinic.
Kidneys “Courage”
Bronze statue of Bruce Lee on “Walk of Stars” Hong Kong, 2007
1.) Kidney Yin: Influences learning, nutrition, growth and cultural development.

Kidney yin deficiency:

Will not identify with human values or ethics, will tend to be crude or savage like, indifferent for aesthetics, make poor judgments, will have increased irritability, egocentricity, cheerlessness, paranoia and depression. They will suffer from fear but will mask it with aggressive pose. […]

Living & Studying in China

I ran across a short article I wrote for the AAAOM acupuncture college newsletter back in 2006 while we were living in China. I thought you all may enjoy this fun little read.

Me, my wife and two boys have been living in Jinan, China for six months and it is nothing like we imagined.  So far, it has been the most difficult and exhilarating experience of our lives. I think I speak for my entire family, that if we had had a “Plan B,” an opportunity to quit, move back to the states and have our old house, work and life, we would have done so in the blink of an eye.  Every day here, we have challenges, realizations, problems, or obstacles that needs full attention.  For example, there is the culture shock and the great trouble of ordering food in a restaurant without speaking the language or being able to read a menu.  There are also a great many reasons why I am happy to have had my hepatitis shots, I won’t say anymore. Another one is the day and a half traveling back and forth from different governments buildings to secure our family’s visas.  Dr. Lu asked me to share my thoughts and experiences of living in China.  I thought you would enjoy it most if I shared with you the perfect day of what it is like to live and study in China.

I wake at 5 AM every morning, tired from late-night studying and prepare for my day.  I pack my bag with books, a Chinese-English dictionary and daily necessities.  I grab my travel mug filled with green tea and hike off to the mountain by 5:30. The streets are empty […]

Top 25 Herbal Formulas

Many patients have inquired about what we can treat with our herbal formulas, so I decided to put together a quick list of the top 25 symptoms we see in the clinic and the common herbal formulas used to treat them.

1. Boost Immunity Yu Ping Feng Wan
2. Sleep Well An Mian Wan
3. Stress Tamer Jia Wei Xiao Yao Wan
4. Menses Ease Shao Fu Zhu Yu Wan
5. Increase Fertility Ba Zhen Wan
6. Fatigue Rescue Liu Wei Di Huang Wan
7. Strengthen Digestion Xiang Sha Liu Jun Zi Wan
8. Cold & Flu Fighter Yin Qiao Jie Du Wan
9. Sinus Power Bi Yan Wan
10. Anxiety Plus Gui Pi Wan
11. Depression Reliever Xue Fu Zhu Yu Wan
12. Bowel Plus Huo Xiang Zheng Qi Wan
13. Headache Relief Tian Ma Gou Teng Wan
14. Fibromyalgia Aid  Shen Tong Zhu Yu Wan
15. Endurance Enhance Jin Gui Shen Qi Wan
16. Constipation Mover Xiao Yao Wan
17. Infection Fighter Huang Lian Jie Du Wan
18. Arthritis Relief Du Huo Ji Sheng Wan
19. Acid Reflux Tamer Wen Dan Wan
20. Diarrhea Control Bu Zhong Yi Qi Wan
21. UTI Control  Ba Zheng Wan
22. Cough Ease Qing Qi Huan Tan Wan
23. Asthma Calm Ding Chuan Wan
24. Hives Stopper Xiao Feng Wan
25. Hot Flashes Zhi Bai Di Huang Wan

Final Note: These formulas should only be prescribed by a professional trained in Chinese medicine and only after a formal diagnostic intake has been performed.

Acupuncture: What You Need To Know

Acupuncture is Effective

A comprehensive study commissioned by the Department of Veterans Affairs found acupuncture to have a positive effect in the treatment of chronic pain, migraine and tension headache. The same study found a potentially positive effect in dysmenorrhea, cancer pain, labor pain, insomnia, post-operative nausea and vomit, depression, and smoking cessation.
Acupuncture outperforms placebo in relieving the most common types of chronic pain: headache, low back, neck, shoulder and knee pain.
Acupuncture significantly outperforms standard care in headache, low back, neck, and knee pain.
Acupuncture is superior to most forms of physical therapy in the treatment of knee osteoarthritis.
Systematic reviews published by the Cochrane Collaboration found acupuncture  to  be effective for nausea caused by chemotherapy and surgery.
The American College of Physicians and American Pain Society recommend acupuncture as a second-line therapy for chronic low back pain.
The American College of Chest Physicians recommends acupuncture for cancer patients when pain, nausea, vomiting, or other side effects of chemotherapy are poorly controlled.

 Acupuncture is Safe

A prospective study of 2.2 million acupuncture treatments found that serious adverse events were rare.

Acupuncture Is Popular

The Number of Acupuncture Visits Per 1,000 Adults Nearly Tripled Between 1997 and 2007
The Percentage of Americans Who Have Ever Used Acupuncture Increased by 33% and those who received acupuncture  in the in the last year increased 21% Between 2002 and 2007.
53% of recent users reported that a medical doctor was the resource from whom they were informed about acupuncture.

Acupuncture is Cost-Effective 

According to international cost-effectiveness threshold values, acupuncture is a cost-effective treatment strategy for patients with chronic neck pain,

Acupuncture Is  Increasingly Covered by Insurance

As of 2004, 47% of private insurance plans included acupuncture coverage.
Fifty-four million Americans have acupuncture coverage as an essential benefit […]

Top 10 Cold & Flu Herbal Formulas For Your Family

1. Isatis Root Granule (Ban Lan Gen) Tea
“Preventative For Exposure to the Common Cold and Flu Tea”
Use: Take as prevention and during the initial onset of the cold & flu.

2. Yin Qiao Jie Du Wan Pills
“Initial Onset of Cold and Flu Symptoms Formula”
Use: Body aches, cough, fever, headache and sore throat due to colds, flu and respiratory infections.

3. Huo Xiang Zheng Qi Wan Pills
“Stomach Flu Formula”
Use: Abdominal pain, constipation, diarrhea, food poisoning, nausea and vomiting.

4. Golden Jin Sang Zi Hou Pian Lozenges
“Golden Throat Lozenges”
Use: For sore throat with pain, dry throat, or for weak voice due to overuse.

5. Viola Clear Fire Formula
“Infection Formula”
Use: Strep throat, pneumonia, respiratory infection, tonsillitis, laryngitis, etc.

6. Xanthium Nasal Formula
“Sinus Infection Formula”
Use: Nasal pressure, congestion, yellow or green discharge and pain due to acute sinus infection.

7. Jade Screen and Xanthium Formula
“Chronic Allergies Formula”
Use: Chronic allergies, sinus congestion, nasal discharge, sinus pain and sore throat.

8. Children’s Ear Formula
“Ear Infection Formula”
Use: Ear infections in both infants and children under 6 years old. This is an alternative to antibiotics.

9. Fritillaria and Pinellia Syrup
“Sore Throat and Cough Syrup”
Use: Cough, chest fullness, phlegm and sore throat.

10. Silver Bee Rinse
“Throat and Mouth Rinse”
Use: Take for sore throats and mouth sores.

Pam and Brian

2014-15 Wellness Kits

This year’s wellness kits will be ready for purchase by mid-October!!!

Individual herbal formulas are already here. For a list of formulas, please look below!

While living and studying in China, Pam and myself were amazed that health and preventive medicine was deeply rooted in the Chinese culture. In fact, many of our friends and colleagues were intimately familiar with many common herbal remedies to treat the common cold and flu. It seemed like everyone knew that when they felt the “gan mao” or “common cold” coming on, they know exactly what to take and what to do. It was just normal part of life. We often heard simple recommendations that we even pass on today in our clinic like: have a sore throat, drink lots of water, or have body aches, chills and fever, go sleep. And all over the city, grocery stores and pharmacies would have large bins of various herbs and teas for sale specifically for the season. This was our inspiration to provide wellness kits for our patients and the public. It is to provide everyone the necessary herbs and information to fight and prevent colds and flu at home and before it becomes a problem.

Our Wellness Kits contain many common teas and formulas to help fight and prevent illness during the upcoming cold and flu months.

1. Isatis Root Granule (Ban Lan Gen) Tea
“Preventative For Exposure to the Common Cold and Flu Tea”
Use: Take as prevention and during the initial onset of the cold & flu.
2. Yin Qiao Jie Du Wan Pills
“Initial Onset of Cold and Flu Symptoms Formula”
Use: Body aches, cough, fever, headache and sore throat due to colds, flu and respiratory infections.
3. Huo Xiang Zheng Qi Wan Pills
“Stomach Flu Formula”
Use: […]

Treating Lyme Disease with Acupuncture and Chinese Medicine

Mission Statement:
The Chinese Medicine Lyme Study is an ongoing clinical research project investigating the effects of Traditional Chinese Medicine (TCM), Chinese herbal formulas and acupuncture for the treatment of Lyme Disease.

We are developing the best acupuncture and herbal prescriptions, not only to relieve the symptoms, but also ones that will have the best curative effect on the disease.

The CM Lyme Study’s treatments consist of strengthening the immune system, eliminating pathogenic factors, relieving aches and pain, boosting energy, clearing toxicity, promoting circulation, and calming the mind.

The research and use of TCM, Chinese herbal formulas and acupuncture is safe, natural, effective and may hold the most viable and alternative treatment for Lyme Disease.
Herb Treatments
The Chinese Medicine Lyme Study Chinese herbs clinical research is quite easy. Every week, you will set up a weekly appointment. At each visit you will fill out the required Lyme Disease Rating Sale (LDRS) paperwork, have a meeting with Dr. Grosam and be given your herbal formula. Each visit should take about 15-20 minutes. The herbs prescribed to you will be in a powdered form. You are required to take 4 grams of powdered herbs 3 times per day, preferably 1-2 hours before or after meals. To prepare the herbs, put the required 4 grams of herbs into a cup and add 6-8oz. of hot water, stir to dissolve, and drink. Some people enjoy the taste of Chinese herbs, while others will grow accustomed to them. You cannot add sweeteners or other additives to the tea.
Acupuncture Treatments
The Chinese Medicine Lyme Study Chinese acupuncture clinical research is quite easy. Every week, you will set up a weekly appointment. At each visit you will fill out the required Lyme Disease Rating Sale (LDRS) paperwork, […]

Summer Cold Prevention

We’ve been seeing many cases of summer colds popping up in the clinic and around town. Some of the common symptoms include: cough, congestion, stuffy or runny nose, headache, sinus problems, nausea, stomach pain, or diarrhea. Here are some simple preventative measures to beat the summer cold:

1.) Drink plenty of water: Keeping hydrated is the #1 measure you can take towards better health. More water benefits your lungs, digestion, and helps maintain proper temperature control of your body. If the lungs are not hydrated, if your digestion is dry, or if you cannot cool down and regulate your body temperature, you leave your body and its immune system vulnerable to cold and flu bugs.

2.) Eat less: Our digestive tract runs lean and mean during the hot months of summer and cannot take large and heavy meals. If the digestion gets bogged down from food, it will slow down and will start generating phlegm. This leaves a ripe environment for viruses to proliferate. The best rule of thumb is to eat small and frequent meals throughout the summer. Eat more vegetables and fruits that are in season. They are rich in water and nutrients that help fight off colds and flu.

3.) Moderate exercise: It is good to sweat some in the summer and to get your blood circulation flowing. Try exercising earlier in the morning or later in the evening to prevent heat stroke. Too much sweating is not a good idea because we loose energy along with the sweat. Again, keep hydrated.

4.) Rest: Do not extend yourself too much. Exhaustion leaves us more vulnerable to colds and flu viruses. Enjoy yourself, slow down and enjoy what summer has to offer.

5.) Avoid direct air conditioning […]