Since 1986, I’ve used acupuncture as my main source of health care. Despite the many practitioners I’ve seen, and conditions for which I sought treatment, I understand that each practice is unique. Still, I have found acupuncture helpful. When I moved to Kansas, I met Julie Bear Don’t Walk, an acupuncturist based in Lawrence, Kansas. Julie received her master’s degree from Pacific College of Oriental Medicine, Chicago. When Julie was younger, she sought Traditional Chinese Medicine (TCM) for PMS, anxiety and depression, and had profound results with both acupuncture and herbal medicines.
Julie’s last name, Bear Don’t Walk, comes from her husband, Scott Bear Don’t Walk. Scott is a member of the Crow Tribe of Montana and is a descendent of the Salish and Chippewa Cree. His name represents sacred healing and lifelong well-being, which is believed to be embodied by bears. By taking this name, Julie has accepted the responsibility that comes with partnering with people to find a path toward health.
I sat and chatted with Julie about her practice, herbs, and what a typical patient might anticipate during a visit with a TCM practitioner. –Jean Denney
Q. As one of your patients, I know that a feature of your practice is herbs. What is the efficacy of herbs in conjunction with acupuncture, and why do you use both?
A. First, the term TCM is a comprehensive holder, and acupuncture is one piece of Chinese medicine. I am equally trained in Chinese herbs as I am (in) acupuncture. So, Chinese herbs play a huge role in the holistic health picture of Chinese medicine. The way I describe it to my patients: We’ll do acupuncture – typically on a weekly basis – but in between that, the herbs do the heavy lifting. I also see some patients who only (use) herbs. They don’t do acupuncture. Some people are afraid of needles. We can get a lot done with Chinese herbs, particularly with an emphasis on internal disorders…for pain and in terms of regulating the cycles of life, regulating hormonal cycles for men and women, regulating digestion, getting to the root of why certain muscles tighten, and giving the body the substance it needs via Chinese herbs to create a new pattern of health.
Q. How often do you prescribe Chinese herbs?
A. About 75 percent of my patients take herbs, but it is not a requirement. It just gets results faster. When we have more tools in our toolbox, we can get the job done more efficiently and more effectively.
Q. Please describe a typical scenario for a patient who first comes to visit.
A. When patients first come in, we will discuss their top three health goals and identify their landscape: If they’re taking a lot of Western medications, we might wait to use Chinese herbs while I do some cross references to be sure there are no negative herb/drug interactions. I collaborate with my patients and we come up with the best treatment plan that will fit their lifestyle and their goals. If patients want to throw everything at it, we definitely will incorporate Chinese herbs into their treatment plan. I also send them home with a few simple, doable activities such as a 10-minute qi gong video from YouTube, a very simple modification to their diets, or instructions for improving sleep. At subsequent visits, we check in and make necessary adjustments to the treatment plan to continue meeting the patient’s goals.
When I first started, I (recommended) powdered herbs for most people. Powdered herbs – herbs that have been cooked then granulated – produce strong results; having an herbal pharmacy, I can customize formulas to each individual. But over the years I realized that compliance is more important than perfection. Now, I prescribe a lot of herbal patents, herbs in pill form. I explain to my patients the power of Chinese herbs, and (as a result) I’ve seen patients go off certain Western herbs after taking Chinese herbs. This, of course, is in collaboration with their doctor.
Q. Please talk a little about the efficacy of Chinese herbal remedies?
A. Some people will ask when they should notice a difference. Typically within 24 hours you should start to feel something. It depends on what the patient’s underlying pattern is: Sometimes it will take a few weeks, but by and large you start to notice a difference within 12 to 24 hours. The herbs are working internally to change a pattern that’s already been well-established, and the beautiful thing about Chinese herbs is that you only take them for a (short) period of time – you are not on them indefinitely. There are certain Chinese herbs that you do take long term – longevity herbs, if you will – but the herbs you only take for a short period of time correct the imbalance and then you’re done!
Q. What exactly is a pattern in TCM, for example?
A. When a patient comes in and they say, for example, “I have these three health issues I want to work on: I have an irregular menstrual cycle, I get headaches, and I’m tired all the time,” I go through a battery of questions with them. I call it a review of systems to see what is causing these patterns. What is causing the menstrual irregularity, what is causing headaches, and what is causing the fatigue? Another person may come in with those same three complaints, but they may involve different etiologies or causes. So the battery of questions helps me hone in on which (organ) systems are out of balance (and in what specific ways). Then I look at the tongue, which gives me a snapshot of how things are working internally: the digestive system, blood, fluids and metabolism. Then I also check the pulse on both wrists, which gives me a snapshot of how the organ systems are working from a Chinese medicine perspective. They have similar names as they do in Western medicine such as liver, spleen, lungs and kidneys, but we look at them through a slightly different lens.
Q. Can you help me understand that lens a little bit?
A. In Western medicine, the kidneys are involved with fluid metabolism, urination and healthy urination. In Chinese medicine, we actually extrapolate that and say the kidneys are responsible for fluid metabolizing, but they are also responsible for deep energy such as the adrenals. In Chinese medicine, the kidneys and adrenals are synonymous. For example, if fatigue is a pattern (in a patient), we ask if the fatigue is coming from insufficiency of kidney qi or energy, or if it is coming from too much water in the system. Then, if we get rid of the water, the energy is there for the body to use to find balance. We look at the relationship between the organ systems: For example, if someone has a lot of water retention and fatigue, we look at the organ systems for both the spleen and the kidneys because both have a role in fluid metabolizing. This is what we call pattern differentiation.
Q. Pattern differentiation helps the patient grow in awareness, too. You suggest paying attention to health changes that come with seasonal shifts and, accordingly, you suggest nurturing foods, meditations and exercises as a way for patients to regulate wellness on their own away from treatments.
A. Living in harmony with the energy of the seasons is the foundation of health. With our lifestyle, this is not always easy or even familiar. Living in harmony with the seasons and (participating in activities) appropriate to the seasons is the first step. So is eating in harmony with the seasons. For example, right now we are talking during the earth season: a short season at the end of summer and beginning of fall. It’s typically marked by dampness, and we are seeing a lot of rain right now as well as a lot of humidity. Also, everything is coming into harvest right now so we’re starting to see the fruits of the fall harvest. The earth element includes foods associated directly with the earth such as root vegetables and grains such as barley, quinoa and wheat. These are foods that have an affinity for the digestive system. Simple dietary shifts often make a radical difference in people as well. That said, I am a pragmatist, not a perfectionist.
Q. If there are foods that correlate to the seasons, are there herbs as well?
A. There are. I see certain patterns of disharmony show up more during different times of the year. For example, we’re moving into the metal season, which is fall. The organs associated with the fall elements are the lungs and large intestines. What I start to see during this time of year is a lot of fall allergies because that has to do with the lung system. Sometimes I’ll see more diverticulitis, things going on with the large intestine, constipation issues and depression. The lungs have a role in regulating depression and low energy. So I will need to stock up on fall herbs for the upcoming season. Astragalus, for example, is a really good fall herb because it helps with fluid metabolism, helps with energy, opens up the lungs and helps with allergies.
As it gets colder, diseases of cold become more common. You’ll see cold in the digestion, cold in the uterus, cold as a lack of vitality, for instance, adrenal fatigue. We use moxibustion (a heat therapy that uses the herb artemisia, or mugwort) as a way to build the fire from within and warm things up and get them moving. There are also a lot of topical formulas that use Chinese herbs and are used to help reduce pain associated with cold such as muscle pain, joint pain and arthritic pain. The classic formula Tiger Balm, for example, is a very common Chinese herbal topical for sore muscles.
Q. For the person who is about to experience TCM for the first time – anticipating acupuncture, herbs or both – what would you share about their first visit?
A. The most important thing to know is that bodies are wise – they want to be balanced, efficient and healthy. It requires less energy and resources to function that way. When illness or pain presents, it’s the body’s way of saying “Something is out of whack here and I want you to know about it.” Acupuncture and Chinese medicine can help remind the body that it can work efficiently – in harmony and in health. It corrects problem-causing imbalances, and at a certain point the body takes over. What I let patients know is that it has taken your body time to develop a pattern of imbalance, so it’s going to take a bit of time and commitment to change that pattern. If digestive issues have been going on for nearly 10 years, they aren’t just going to go away after one treatment. I let my patients know healing is collaboration – the more they work on with me, the faster we will get results. There is also a level of commitment – showing up for acupuncture; taking their herbs; doing their practical, fits-well-into-their life homework. During our time working together, I help my patients develop a personalized toolbox they can use for the rest of their lives.
Q. So the goal is consistency, and a chief ingredient is time. I also know from my own experience that sometimes symptoms that brought me in for treatment can worsen before they get better.
A. That can happen, especially with pain because the body is still learning to regulate itself. If you are rearranging your living room, you may want to move this over here and that over there – it’s going to get messy as it gets rearranged. You may have to make a bit of a mess.
Q. Yes, and I think when you have a skilled acupuncturist, especially one who is facile with herbs, you get a much better plan of treatment. You are coming at the root problem from several angles.
A. Right. We’re saying we’re going to change this pattern using this tool and this tool, and then I’m going to give you a little self-care advice. The body has the power to heal. Anything is possible! The herbs and the acupuncture wake up the patient’s body to that healing. The body is smart and it wants to be healthy; it wants to be balanced. Herbs and acupuncture just remind the body how to accomplish that.
The Mystery of TCM Pulses
In Chinese Medicine, there are 28 different pulse types that indicate different types of pathology. Pulses are taken at the wrist, using the index, middle and ring finger to get a reading at three different points. Each point reveals a different piece of information.
On the right, the pulse read with the index finger (closest to the wrist crease) provides information about the lung and large intestine; the pulse read with the middle finger correlates to the spleen and stomach; and the pulse read with the ring finger reads the specific type of kidney pulse, called kidney yang.
On the left, the top pulse reveals information about the heart and small intestine; the middle pulse reveals issues with the liver and gall bladder; and the bottom pulse (farthest from the wrist crease) tells us about the kidney yin pulse.
Some practitioners who specialize in pulse taking have very detailed methods for gleaning information from the pulses – it’s truly an art form that is perfected over a lifetime. The qualities I look for are the pulses that are floating or deep; full or empty; relaxed or tight; slippery or choppy. These differences indicate specifically where the imbalances in the body lie, and significantly inform how I develop a treatment plan. For example, a wiry pulse feels like a guitar string – the tightness indicates that qi is not flowing in the body. The position of the wiry pulse indicates which organ system has the stuck qi. Often, a wiry pulse is felt in the middle left pulse of the wrist, indicating a stuck liver qi pattern (which shows up as irritability, stress and impatience).
Traditional Chinese Herbs for Every Season
Fall
Astragalus (Huang Qi)
Balloon flower root (Jie Geng)
Honeysuckle flower (Jin Yin Hua)
Forsythia fruit (Lian Qiao)
Tricosanthes fruit (Gua Lou)
Kudzu root (Ge Gen)
Licorice root (Gan Cao)
Winter
Cinnamon twig (Gui Zhi)
Eucommia bark (Du Zhong)
Chinese foxglove root (Sheng Di Huang)
Water plantain rhizome (Ze Xie)
Japanese teasel root (Xu Duan)
Achyranthes root (Niu Xi)
Americang ginseng root (Xi Yang Shen)
Korean or Chinese ginseng (Ren Shen)
Goji berries (Gou Qi Zi)
Spring
Chinese white peony root (Bai Shao)
Angelica (Dang Gui)
Thorowax root (Chai Hu)
Bacial skullcap root (Huang Qin)
Red sage (Dan Shen)
Magnolia flower (the unopened buds) (Xin Yi Hua)
Chinese rosebud (Mi Gui Hua)
Chrysanthemum (Ju Hua)
Summer
Asiatic cornelian cherry fruit (Shan Zhu Yu)
Hawthorn fruit (Shan Zha)
Schisandra fruit (Wu Wei Zi)
Field mint (Bo He)
Mung bean (Lu Dou)
Sweet wormwood (Qing Hao)
Watermelon (Xi Gua)
Lily bulb (Bai He)
Late summer
Poria or Ful Ling
White atractylodes rhizome (Bai Zhu)
Codonopsis root (Dang Shen)
Chinese yam rhizome (Shan Yao)
Ginger rhizome (Sheng Jiang)
Magnolia bark (Hou Po)
