Staying Healthy (& Sane) During the Pandemic

There is a lot of interesting news coming out of China currently about how Traditional Chinese herbal medicine and acupuncture are being used to support the treatment of COVID-19. For example, this article just showed up in my inbox today. I'm trying to wade through articles like this and learn as much as I can.

Art Credit: Ricardo Levins Morales

But before saying more about how Chinese medicine is being used to address COVID-19, it makes sense for me to take a step back and write out some general holistic health advice that might help folks stay healthy during this challenging time.

One thing I love about holistic medicine traditions, be they Traditional Chinese Medicine, western herbalism, etc., is the recognition that pharmaceutical medicine and even herbal medicine are heroic interventions.

Of course we should utilize medical interventions when we need to. They are often life-saving. And of course we are all eager for wider availability of diagnostic testing, the development of a vaccine, advancement in the medical treatment of COVID-19, and a better public health response than we are currently seeing.

Art Credit: Ricardo Levins Morales

But, while we wait for these medical & public health developments, there are things we can do to bolster our immune health so that our bodies can mount a stronger general response if and when we do come into contact with the virus. Because there is no vaccine, and because none of us have been exposed to the novel coronavirus before, we are relying on our immune systems to overcome the virus and hoping that our immune response will overpower the virus before the illness enters more advanced stages.

Holistic medicine traditions teach us that lifestyle choices are more fundamental to our baseline health than medical or herbal intervention. And we might say that the pillars of this foundation are: 1) rest, 2) movement, and 3) nourishment.

So, let’s talk about some ways we might boost our immune-health during the current viral pandemic by ensuring we’re getting some quality rest, movement & nourishment every day.

Under the shelter-in-place mandates, many of us have some more time on our hands. Despite the sheer difficulty of this moment, perhaps we can integrate a few health-supporting practices into our daily routines. Remember, though, change is hard, and we’re all going through massive amounts of adjustment and information-overload during these pandemic weeks. So, be gentle with yourselves. Baby steps are ok.

____________________________

First, a few quick words of disclaimer: There have been no human trials for any integrative approaches to reducing the risk of contracting COVID-19 or for reducing symptoms once a person is infected.

Art Credit: Ricardo Levins Morales

Please follow CDC Guidelines for protecting yourself against infection, such as frequent handwashing, social and physical distancing, staying home when sick, and daily cleaning and disinfecting of frequently-touched surfaces. And for what to do if you think you're sick.

Also, please realize that the following are tips you can try at home, but don't constitute medical advice. For complex medical conditions, please consult with a credentialed practitioner.

Next, here are a few theoretical ideas from Traditional Chinese Medicine to guide our consideration of immune health:

From a Traditional Chinese Medicine perspective, wei Qi, or defensive Qi, is what prevents disease processes from entering our bodies and taking hold. Wei Qi is produced by a combination of the air we breathe and the nutrients we absorb from food. To have strong immunity, we want to optimize lung function, oxygen circulation, digestion and nutrition.

Most of the information coming from Traditional Chinese Medicine practitioners treating COVID-19 patients in Chinese hospitals points to the coronavirus being a damp pathogen. In Chinese medicine, dampness is a by-product of weak digestion. In Chinese medicine, digestion is governed by the Spleen. The Spleen is weakened by cold and dampness and loves warmth. So we want to avoid cold food at this time, as well as dampness-producing foods like sweets.

Finally, the respiratory system needs a healthy amount of moisture to be able to resist infection. When our airways are dry, we’re more vulnerable to infection. One of the ways we become dry is if our Yin is depleted, for example by stress, busy-ness, or heat generated from eating too much junk food.

From a Chinese medicine perspective, all of the advice that follows, supports healthy Spleen, Lung, and wei Qi function and abundannce of Yin.

For anyone interested in going deeper into Traditional Chinese Medicine physiological concepts, here are some links to articles I wrote in the past on the Lung in Chinese Medicine, the Spleen in Chinese Medicine, and immune health.

_________________________

Rest:

Art Credit: Ricardo Levins Morales

Let’s talk first about rest. Rest might really be the most important factor in maintaining a strong immune system and/or fighting off infection. During this time, please give yourself permission to rest. It’s really important. 

Please try to sleep 7-8 hours per night or more if you can. It’s better to go to bed early. Try to be in bed by at least 10:00pm. All natural health systems say that staying up late is taxing and depleting to our bodies and minds. Additionally, eat your final meal of the day several hours before going to bed. Try eating dinner at 4:00 or 5:00pm and even taking a mellow walk after dinner. Your sleep-quality will improve if your body is not working on digesting a complex meal while you are lying down to sleep at night.

If you feel yourself getting sick, going to bed may be the most helpful thing you can do to allow your body to fight off the virus, and hopefully prevent it from progressing to more advanced stages.

If you’re working from home, maybe you have time to take a nap in the afternoon. Allow yourself this time. Rest will also help you process the intense emotions that will emerge for all of us as we watch the pandemic unfold. 

If you have trouble sleeping, allow yourself to lie down, close your eyes and rest, even if you can’t sleep.

Art Credit: Ricardo Levins Morales

Of course, limiting ourselves to only a healthy dose screen time and news media may help us to rest and relax more deeply.

Meditation can be a form of rest and a tool for managing anxiety. Headspace is one great online source that  provides simple, non-intimidating, instruction in basic meditation techniques. The website offers a free two-week trial. You can set the app to do as little as five or ten minutes a day.

Doing crafts, handiwork, cooking, working on puzzles, playing a musical instrument, singing. These are also forms of meditation. Keeping our hands busy helps refocus that energy that tends to get caught up in worry, rumination, repetitive thoughts, etc. Allow yourself some time to enjoy some of these kinds of activities.

Art Credit: Ricardo Levins Morales

If you have trouble sleeping, try drinking some herbal tea at bedtime. Herbs like chamomile, lemon balm, skullcap, passionflower, California poppy, or oat tops belong to a category of western herbs called nervines. They help relax the body and calm the nervous system, and are generally quite safe and mild-tasting. Some of these herbs can be found in packaged herbal tea blends or in bulk in local grocery stores.

If you need additional support, please consult with me regarding additional support for sleep in the form of Chinese herbal formulas, supplements, etc.

For more information on sleep, here are some links to article I wrote several years ago on improving sleep and treating insomnia with Traditional Chinese Medicine.

Movement:

If you’re stuck at home under the shelter-in-place mandate, if you’re overwhelmed by news and emotions, it can be hard to find motivation to move. It has, at times, been difficult for me to make myself move in the past couple of weeks.

Movement is important. One of the fundamental ideas in Traditional Chinese Medicine is that where there is stagnation in the body, we are more vulnerable to disease, pain or injury. We need to move our Qi & Blood. That means circulation of air through our lungs, circulation of fluid and lymph, movement of blood through all our microcapillaries. Oxygenation and waste-removal to and from all our tissues is essential to providing an optimal environment for all of our cells.

Additionally, from a Chinese Medicine perspective, Spring is the season where the Liver organ is considered dominant. The Liver, in Chinese medicine thinking, suffers from stagnation, and needs movement to thrive. Movement is especially important at this time of year, as nature emerges from the stillness of winter and begins blossoming and growing. (For further reading, here's a link to an article on the Liver in Traditional Chinese Medicine.)

Movement doesn’t mean you need to start a rigorous exercise routine. You do not need to lift weights or run five miles, although some of you already have those practices in place. Just make sure you move your body every day.

Art Credit: Ricardo Levins Morales

For me, it has been helpful to make myself go outside and take a walk every day during the pandemic. You don’t necessarily have to go to a nature area or regional parks. In fact, we need to avoid crowding into public parks and parking lots. I have gotten solace simply from walking around my neighborhood. Fresh air, sunshine, spring flowers, a change of scenery, appreciating nature even  if it’s just the weeds that poke out between the sidewalk cracks, checking in on neighbors, getting a sense of how local businesses are faring. All of these have been healthy parts of my daily walks.

Art Credit: Ricardo Levins Morales

Movement can also take the form of gentle at-home yoga, tai qi, or qi gong practices. Here is a link to a nice set of qi gong exercises specifically geared toward lung health that British acupuncturist Peter Deadman put online in response to the COVID-19 pandemic.

Aside from exercise, there are other ways to promote circulatory movement. You can take a hot bath or alternate hot and cold water in the shower. You can briskly massage the surface of your skin with a dry brush (available in health food stores) or a wash cloth. You can gua sha your skin, which means using a tool to scrape along with the meridian pathways of the body. (Some of your are familiar with gua sha from my clinic.) You can utilize the edge of a spoon to perform gua sha on yourself. Ideally, you scrape in an upward direction (in the direction of the heart) along the insides of your arms & legs and in a downward direction (away from the heart) along the outside surfaces. Don’t forget to gua sha your chest where the lymph vessels drain into the subclavian veins. Bathing and self-massage of the skin will improve circulation of lymph in your body.

Another Chinese medicine practice you can do at home is to apply moxibustion (moxa) to the acupuncture point "Leg Three Miles" or Stomach 36 on your lower leg to strengthen your defensive Qi. If interested, ask me. I'll supply you moxa stick & instructions.

Finally, returning to the Chinese Medicine theme of Liver, in connection with Springtime & movement: Sour is the flavor that corresponds with Springtime and Liver. To get things moving, to get your lymph, your bile and digestive juices moving, it’s a good time to add a little sour to your diet. Garnish your food with a little sauerkraut. Add a squirt of lemon to your drinking water every day. Drink a small amount of warm water with a squirt of lemon before each meal.

Nourishment:

Finally, let’s talk about healthy eating. Again, those of us who are sheltering place may have a little extra time to prepare healthier food for ourselves, presuming we’ve figured out how to navigate grocery shopping in the context of pandemic.

First, there’s a basic list of do’s and don’t’s, or maximize these & minimize those:

Try to minimize intake of foods & drinks that tend to dry you out. That includes caffeine, alcohol and carbonated beverages. Also minimize foods that produce phlegm and dampness or promote inflammation in the body, like dairy, refined grains/gluten/flour, fried food and sugar.

Eat regular meals to keep your energy and mood up. But try not to overeat. Give yourself a few hours to digest between your last meal of the day and going to bed. In order to function optimally, your digestive system needs ample time to rest.

The best things to eat for immune health are warm, cooked foods. Think soups and stews. Our digestive systems struggle when we load them with cold food. So avoid excessive raw food. Avoid ice cream. Try to eat lots of fresh vegetables. Eat a range of colors: beets, radishes, carrots, squash, greens, berries, etc. Fresh vegetables are full of bioflavenoids and anti-oxidants that reduce inflammation in our body and improve our immune response to viruses. Additionally, Spring is a great time to eat young leafy greens and sprouts. Consider garnishing your vegetables with fresh culinary herbs like thyme, oregano, sage, basil, garlic, scallions, parsley, cinantro and fresh ginger. Make pesto by blending fresh basil or other culinary herbs, olive oil and garlic. All of these herbs stimulate the digestive system and are strongly anti-microbial.

Take some time to make bone broth or buy some from a local market. Drink a bit daily and keep some frozen on hand. It will come in handy if you get sick. You can also make broth from mushrooms, seaweeds, or tomatoes. Mushrooms are great for reducing excess mucous in the respiratory system. Many types of mushrooms effectively bolster our immune systems to fight bacteria and viruses. In Chinese medicine, we say mushrooms help rid the body of heat toxins. You can easily make mushroom broth by placing (any type of) mushrooms in a large pot, covering them with an ample amount of water, bring the water to a boil and allowing it to simmer until half of the water is gone. At that point, I use an immersion blender to blend the mushrooms into a thick, delicious base for soup.

You can make really delicious meals be lightly steaming or pan-frying almost any type of vegetable. Eat your veggies with some type of grain (rice, buckwheat, barley, quinoa, etc.), some broth, a bit of protein like beans, fish, poultry, etc. Garnish your food with fresh culinary herbs. Here's an article I wrote several years ago. Still relevant: Spring Food & Cooking Tips from Traditional Chinese Medicine.  And here’s a link to an article on ginger.

If you begin to get sick, you can consume a small amount of fresh, spicy foods every 2-4 hours. These foods include ginger, green onions, horseradish, radish. You can eat these raw, blended into a slurry with olive oil and apple cider vinegar, or boil them for 15 minutes and drink the broth. These fresh spicy foods with help mobilize your immune response. It’s best to take a dose of spicy food, and then go to bed, cover yourself with warm blankets and let yourself sweat.

I hope these tips are helpful to you. Remember, consult with a medical professional if you experience symptoms of illness or if you have a complex underlying medical condition. Feel free to get in touch with me if you have questions about using food and herbs to stay healthy at this time.

Art Credit: Ricardo Levins Morales

I'll close with this lovely prose poem by Kitty O'Meara, who expresses what's important much better than I do:

And the people stayed home. And read books, and listened, and rested, and exercised, and made art, and played games, and learned new ways of being, and were still. And listened more deeply. Some meditated, some prayed, some danced. Some met their shadows. And the people began to think differently.

And the people healed. And, in the absence of people living in ignorant, dangerous, mindless, and heartless ways, the earth began to heal.

And when the danger passed, and the people joined together again, they grieved their losses, and made new choices, and dreamed new images, and created new ways to live and heal the earth fully, as they had been healed.

Art Credit: Ricardo Levins Morales

Wishing you health.

Take care, stay safe.

Stephanie

Musings of an Acupuncturist in the Time of Coronavirus

Art Credit: Ricardo Levins Morales

Dear Acupuncture Patients,

It’s Monday, March 23, 2020. Here in the Bay Area, we have been under a government-mandated shelter-in-place order for nearly ten days. My acupuncture practice ground to a halt just as the shelter-in-place orders came into effect. Given the data on how the COVID-19 virus spreads, it became increasingly unethical for me to maintain a hands-on health practice during this time. In order to slow the rate of virus transmission through our community, to reduce the imminent overwhelm of our medical system, and to save lives, the most important thing for us (who could possibly do it), was to socially-distance ourselves by STAYING AT HOME. 

Art Credit: Ricardo Levins Morales

This is a really intense time that we are all going through. The spread of COVID-19 against our like-never-before-globally-interconnected backdrop, its social and economic effects, its health impacts including what's looking more and more like inevitable loss of loved ones--these are unprecedented in our lifetimes. The time we’re living through right now will rank up there with major historic world events like world wars, etc.

How are you doing? I’m thinking of all my acupuncture patients, and wondering how things are going in your lives. I hope you are staying healthy and safe. I hope you are finding ways to deal with the emotions and overwhelm that will arise as this situation intensifies. I care about you all, miss our interactions, and hope you are managing to navigate this strange time.

Art Credit: Ricardo Levins Morales

It has been strange for me to suddenly, in the course of a day or two, stop having face-to-face interactions with my patients. Not to mention, to stop driving my kid around to all her various activities, to stop exchanging chit chat with my kid’s teachers, coaches, friends and their parents. I imagine all of you have experienced similar mammoth shifts in your routines during the past week.

I’ve been at home with my daughter, leaving the house only for short walks. I’ve been learning some new things, like how to attend an online Zoom meeting or order grocery delivery service through my computer. But mostly, I’ve been re-calibrating. It’s been a time of cozy & sweet moments with my daughter, of rest and reflection, but also a time of sharp emotions: grief, fear, anxiety, confusion… to name a few. It has been something like an unplanned meditation retreat.

Art Credit: Ricardo Levins Morales

All of us are re-calibrating now. Nothing is *normal* at the moment.

My friend says it is like forty days in the desert, like Ramadan or Lent. 

In this context, I remind you, as I am constantly trying to remind myself, take it easy. Be gentle with yourselves. Stay safe. Take care.

____________________

As a healthcare professional with a hands-on practice, this is an uncertain time for me. A strange time. Illness is raging through and threatening my community. And the best thing I can do is to sit at home.

Among my colleagues, there is talk of transforming our practices to encompass tele-health. Honestly, it all seems quite overwhelming to me. It’s all I can do to keep up on a fraction of the COVID-19 newstreams: the latest scientific findings on the new virus, the ever-evolving public health guidelines. Transitioning my acupuncture practice to some sort of online format is quite another challenge. 

In this context, I’ve wondered what I can do to keep somewhat professionally active at this time, and perhaps to be helpful to some of you. For me, it is most natural to start with writing. Ten years ago, before my acupuncture practice got busy, I wrote regular electronic newsletters with articles on topics in Traditional Chinese Medicine. Perhaps I can go back to something like that.

Art Credit: Ricardo Levins Morales

I have been slowly digesting some interesting information coming from China about how Traditional Chinese Medicine, or TCM, (acupuncture and herbs, in particular) have been used during the past few months to support conventional/western medical treatment of COVID-19 patients. As one teacher puts it, there have been over 320 large-scale epidemics in China between the time of the Eastern Han Dynasty and the Qing Dynasty (approximately 2,000 years.) Some of the most important traditional Chinese medical texts that TCM practitioners draw on today were written in the context of these epidemics. They are studies of diagnosis and herbal treatment of infectious disease processes moving, stage-by-stage, through human populations. These works are highly relevant to modern-day viral epidemics, such as the one we are experiencing right now. The knowledge in these texts is being used with good effect in the current pandemic.

I’m hoping to write a series of blog posts on ideas from Traditional Chinese Medicine and herbology relevant to the COVID-19 pandemic.

But before I launch into a bunch of essays and theories, it seems important to take a deep breath, and acknowledge this unprecedented moment that we are all in.

Art Credit: Ricardo Levins Morales

A viral pandemic is at our doorsteps. Our roads and tourist-centers are suddenly quiet. No one is taking plane trips or crossing borders. Most of our schools and many of our workplaces are suddenly empty. Doctors and hospital staff are heroically preparing for the flood. Many of us are on lock-down, sheltering at home.

Art Credit: Ricardo Levins Morales

This is a potentially transformative time, for us as individuals and as a society. No doubt things won’t be the same after we get through this pandemic.

In any case, this is a time when much-needed deep rest and re-calibration will be available to many of us, even as we grieve. Maybe tomorrow I’ll write out some suggestions on staying healthy during the pandemic. Maybe the next day I’ll spell out some ideas from Traditional Chinese Medicine. But today I need to rest.

________________________

There have been so many lovely poems & images floating around the internet as we go into this pandemic time apart-together. I’ll close by sharing one of my favorites. Artist/activist Ricardo Levins Morales created this beautiful "What To Do in a Pandemic" poster & has made the images available for free download from his website:

Ricardo Levins Morales Art Studio: What to Do in a Pandemic (Animals)

In moments of discouragement and overwhelm, I keep conjuring these images.

Especially "Accept Your Feelings."

And "Rest."

I can't possibly leave you with a better message.

Warmly,

Stephanie

Sources:

Chen, John, PhD, PharmD, OMC, LAc. "How Coronavirus is Currently Treated in China." Webinar, March 17, 2020.

Ricardo Levins Morales Art Studio.