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www.makuang.com.sg 马光保健集团 MA KUANG HEALTHCARE GROUP PTE LTDVol.21 2017

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Wong Yiu NamImportant Aspects Of Postpartum Confinement Care

TCMOsteoarthritis

(Protect your Joints)

HEALTHCARE How to improveyour liver healthTCM

5 ways to treat indigestion with TCMGreen DialysisHypothyroidism

CONTENT

Lifecare is published byMa Kuang Healthcare Group Pte Ltd.No. 1 Gateway Drive, #10-11/12 Westgate Tower, Singapore 608531FAX:+65 6250 0728 | TEL:+65 6884 4772 | www.makuang.com.sgAll rights reserved.

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美 好 生 活 志

VOL.21 2017

4: TCM ON 5 ways to treat indigestion with TCM

6: WONG YIU NAM Important Aspects Of Postpartum Confinement Care

8: TCM ON What’s hyperlipidemia?

10: TCM ON Hypothyroidism

12: TCM Green Dialysis

16: TCM Osteoarthritis (Protect your Joints)

18: TRAVEL TIPS

20: ASCENSIA ACADEMY Exam Tips

22: HEALTHCARE How to improve your liver health

24: NECK PAIN

14: TCM Excessive Sweating

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Physician Chen Shuang Xia graduated from Changchun University of TCM with a Bachelor Degree in TCM, and has been in clinical practice in ChangChun Angiopathy Faculty Hospital for more than 10 years. She subsequently graduated from Singapore College of TCM And China Guangzhou University of Chinese Medicine with a Bachelor Degree in TCM. Physician Chen provides general consultation, specializes in cerebrovascular diseases, chronic diseases and pain-related diseases. She is well versed in using Gao Fang to treat chronic disease and subhealth symptoms.

CHEN SHUANG XIA (PHYSICIAN)

New Physician

Licensed TCM Physician (Singapore)Bachelor of TCM (Changchun University of Chinese Medicine) Bachelor of TCM (Guangzhou University of Chinese Medicine)Bachelor of TCM (Singapore College of Traditional Chinese Medicine)

More than 9years of clinical message experience

HAN SONG YING (THERAPIST)

Graduated (Secondary Vocational Technical School of Chaoyang,China)

New Therapist

04 | LIFECARE TCM

5 ways to treat

Indigestion with TCM

DefinitionFunctional dyspepsia, or non-ulcer dyspepsia,

includes a number of gastrointestinal conditions. It presents as chronic or recurrent upper abdominal discomfort, pain, bloating, nausea, and vomiting. Functional dyspepsia is a modern term that was not documented in tcm literature. Clinically, tcm physicians recognize the disorder by its signs and symptoms and correlate it with existing traditional tcm diagnoses. Based on different clinical presentations, functional dyspepsia is the equivalent to “epigastric fullness”, “stomachache”, “gastric discomfort”, and “acid reflux” in tcm literature. The dysfunction primarily occurs in the stomach, but may involve the spleen and liver system.

It is not uncommon to experience upper abdominal bloating, pain or discomfort, fullness with the smallest amount of food intake, intolerance of food despite feeling hungry, belching, acid reflux or stool texture changes. It often baffles people when their abdominal ultrasound, upper gi endoscopy and blood tests come out normal. Why isn’t there a positive test result when i’m feeling such discomfort? In reality, what these “healthy people” are experiencing is functional dyspepsia.

LI BING MEISENIOR PHYSICIAN

Who is the most susceptible to having functional dyspepsia?1. Those with a fast-paced and high-stress occupations, such as drivers and white-collar workers, are particularly prone to having functional dyspepsia. In addition, many of these patients also experience symptoms of anxiety, insomnia and depression.

2. Pregnant women, heavy smokers, those with constipation, and obese people are also susceptible.

3. Clinically, we notice that women carry higher risks than men, especially around the ages of menopause. This may be attributed to hormonal disruption and a lower threshold for stress tolerance in the female population. (It’s worth bringing up the statistic that females have a longer life expectancy than males. It is reported that 95% of centenarians worldwide is female. Why do women live longer than men? There are a lot of reasons, but the bottom line is this: females care about their health more than men. They often seek care promptly as they feel that something is not right. 70% of my patients are female. Statistic show that 28% fewer men seek medical help compared to their female counterparts. Women are more compliant patients as well.)

How do TCM physicians diagnose and treat functional dyspepsia?Although functional dyspepsia does not involve structural changes, it should not be overlooked. It can be effectively treated with TCM. There are five clinical categories:

1

2 IndigestionPresentation: upper abdominal bloating, sour burps, food aversion, abdominal pain that’s worse with pressure, nausea and vomiting, symptoms relieved by vomiting, foul stool, thick white coating on the tongue, and taut and slippery pulse.

Treatment: improve indigestion, sooth the stomach and reduce reflux

Prescription: modified Bao He Wan

Liver and stomach disharmonyPresentation: abdominal bloating or chest pain,belching and acid reflux, sensation of object stuckin the throat, loss of appetite, frequent sighing,irritable and easily angered, red tip of the tongue,deep and taut pulses

Treatment: sooth the liver and regulate Qi

Prescription: modified ChaiHu ShuGan San

LIFECARE | 05TCM

TCM culinary medicine for functional dyspepsia1.Orange jujube tea

Ingredients: fresh orange peels 10g (equivalent of 3g dry), 10 jujubes

Directions: cook jujubes in a pan till brown, and then place both ingredients in a cup. Add boiling water and soak for 10 minutes. Drink as tea.

Benefits: soothes the stomach, strengthens the spleen and increases gastric emptying. Use it before meals to increase appetite, or use it after meals to aid digestion.

2. Hawthorn digestive aid

Ingredients: hawthorn and Chinese yam 250g each, sugar 100g

Directions: dry the first two ingredients and grind into powder, and mix well with sugar. Stir in the above mixture in heated honey, and mix well. Shape into small balls roughly 15g each. Use 3 times a day with warm water.

Benefits: nourish and strengthen the digestive system, and facilitate gastric emptying. It’s best used to treat functional dyspepsia caused by weak spleen and stomach.

3. Malt congee

Ingredients: roasted malt 30g, medicated leaven (Shen Qu) 30g, rice 50g

Directions: simmer the first two ingredients. Keep the liquid and dispose the rest. Make rice congee with herbal broth and serve warm.

Benefits: strengthen and improve digestion. This is best for those with food retention in the stomach due to weak spleen and stomach.

4. Slimming rose tea

Ingredients: rose 9g, hawthorn 9g, tangerine peel 6g

Directions: Cook all ingredients in 1600cc water and bring it to a boil, and then simmer for 15 minutes. Turn off the stove, and let it soak for another 15 minutes. Drink as tea.

Benefits: soothes the liver, regulate Qi, burn fat and dissolve phlegm. It’s best for those who have high cholesterol and love fatty and sugary food and heavy flavors.

Case StudyMr. Lin, 37, is a busy and stressed software engineer who

frequently stayed up late and was experiencing anxiety and insomnia. His didn’t maintain a regular diet and often overate. Recently, he started having abdominal bloating, belching, increased irritability, decreased appetite, dry mouth but no desire for water, and diarrhea. These symptoms had been recurring for over 6 months, and were significantly worsened in the last 2 weeks. His tongue appeared light red with white thick sticky coating and his pulse thin and weak.

Analysis: the patient was chronically stressed and anxious. On top of that, he had poor diet and sleep, and lack of exercise. His lifestyle resulted in dysfunction of the digestive system, such as slowing peristalsis and reduced digestive enzyme secretion. During history taking, I learned that this lifestyle he had started way back in college. Sometimes, he would study till late night, head home, have a big meal of spaghetti or fast food of some sort, and then head right to bed. Since he went to bed late, he would get up late, skip breakfast and have a big brunch instead. He always had a cold drink with meals. Meal irregularity, overeating and cold beverages are burdens to the digestive tract. These habits would eventually damage the Yang Qi of spleen and stomach, and lead to symptoms he was experiencing.

Differential diagnosis: stagnant liver Qi and weak spleen and stomach

Treatment: sooth the liver and strengthen the spleen. He was prescribed modified Xiao ChaiHu Tang and ShenLing BaiZhu San for 2 months, and no longer had bloating. His appetite returned. His stool was formed and bowel movements became regular. He also started sleeping well again.

Despite advanced technologies, physicians cannot cure conditions caused by poor habits. Health is a lifestyle, and you are your own doctor.

Weak spleen and stomach

Presentation: abdominal bloating worsened with food, decreased appetite, easily satiated, fatigue and weakness, nausea and vomiting, diarrhea, light-color tongue with white or white sticky coating, deep and thin, or thin and weak pulse

Treatment: strengthen spleen and increase Qi, sooth the stomach and reduce fluid retention

Prescription: modified ShenLing Baizhu San

3

4

Damp-heat in the spleen and stomach

Presentation: abdominal bloating, fullness and discomfort, vertigo, heaviness in the head and body, weakness, nausea and vomiting, loss of appetite, not thirsty, puffy tongue with teeth marks, white or yellow thick sticky coating on tongue, and deep and slippery pulse

Treatment: decrease inflammation and fluid retention; regulate Qi to ease the digestive system

Prescription: modified Xiao ChaiHu Tang and Er Chen Tang

Mixed cold and heat

Presentation: upper abdominal bloating, a burning sensation in the stomach, cold intolerance with cold limbs, stomach discomfort with acid reflux, a dry mouth with bitter taste, irritable, hot flashes, increased bowel sounds with loose stools, symptoms worsen with cold exposure, light-color tongue with yellow coating, and fast, deep and thin pulse

Treatment: use a mixed of herbs with cold and warm properties to sooth the stomach and facilitate gastric emptying

Prescription: modified BanXia XieXin Tang

5

06 | LIFECARE TCM

Do all moms need postpartum care? Regardless of the procedure, vaginal delivery or caesarean section, birthing is a traumatic process with blood loss and energy consumption. Mothers are commonly in a state of blood and Qi (vital energy) depletion. During the “month of confinement”, the reproductive organs are given the chance to recuperate. With the right methods, uterine and ovarian functions can be well recovered. Speaking from the Traditional Chinese Medicine (TCM) perspective, appropriate postpartum care can reduce the risk of postpartum depression, low milk supply, puerperal fever (childbed fever), persistent lochia (vaginal bleeding or discharge), and cold or flu. Thus, “postpartum confinement care” is crucial. When it’s carried out properly, it can greatly benefit mother’s mental and physical health, breastfeeding experience, and even mother’s general physical constitution.

Important Aspects Of Postpartum Confinement Care. BY CENTURY-OLD WONG YIU NAM MEDICAL HALL

LIFECARE | 07TCM

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Hyperlipidemia is common in the middle age and senior populations, and is affecting more and more young people. Cardiovascular diseases associated with hyperlipidemia have become the leading cause of mortality. Low-density lipoprotein (LDL) is the culprit for atherosclerosis. It builds up on artery walls and causes damage. It causes the platelets to aggregate and eventually form plaques, causing cardiovascular disease. Clinical presentation varies. Most common symptoms are dizziness, headaches, forgetfulness, numbness, chest pain, shortness of breath, and bloating, etc.

Associated conditions include fatty liver, gallstones, coronary artery disease, angina, stroke, and cerebral arteriosclerosis.

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08 | LIFECARE TCM

What’s

Hyperlipidemia?LU JI HONGSENIOR PHYSICIAN

How does hyperlipidemia happen?The level of your blood cholesterol largely depends on genetics and lifestyle. Over half of the blood cholesterol is

produced in the liver and intestine. This explains why some people, despite having an impeccable diet and exercising regularly, have high cholesterol simply due to faulty metabolism. Diet high in cholesterol, such as animal products and fried food, can be a factor as well. We only absorb about 40% of the cholesterol from food.

TCM theory believes that the genetic component of this equation is mainly related to the liver and kidney system, while the lifestyle component has to do with the stomach and spleen system. The job of the liver is detoxification. Qi blockage at the liver and gallbladder can lead to spleen dysfunction and inflammation. This results in accumulation of phlegm and stagnant blood, as well as symptoms of hyperactive liver and yin deficiency.

Poor diet and weak gastrointestinal function cause hyperlipidemia. A high-fat diet leads to inflammation in the body, so does Qi deficiency of the digestive system. TCM believes that there are many similarities between the signs and symptoms of liver/kidney deficiency and atherosclerosis associated with hyperlipidemia. Poor liver and kidney function affects absorption and fluid excretion, causing problems with fat metabolism and hyperlipidemia. On the other hand, hyperlipidemia is a digestive condition, related to the function of stomach and spleen. Stomach and spleen Qi deficiency is the cause of phlegm accumulation. The characteristic of cholesterol is similar to that of phlegm, except that it’s in the vessels. Therefore, TCM treatment of hyperlipidemia focuses on balancing the liver and strengthening the spleen to reduce phlegm and increase circulation.

STAR BUY: ANTRODIA KING

TCM prescriptions1. Spleen strengthening and Qi nourishing prescriptions: these include Si JunZi Tang and SenLing BaiZhu San. Commonly used herbs that fall into this category are ginseng, poorman’s ginseng (Dang Shen), black atractylodes rhizome (Cang Zhu), atractylodes rhizome (Bai Zhu), hawthorn, Chinese yam, poria (Fu Ling), and astragalus (Huang Qi).

2. Liver and stomach soothing prescriptions: Some of these prescriptions are intended to sooth the flow of Qi in the liver to improve fat metabolism, such as Si Ni San and Xiao Yao San. While others are meant for nourishing the liver and stomach, such as QiJu DiHuang Wan and Zuo Gui Wan. The commonly used herbs that fall into this category are capillary wormwood (Yin Chen), red thorowax root (Chai Hu), tuber fleeceflower (He Shou Wu), sickle senna seed (Cao Jue Ming/ Jue Ming Zi), turmeric root (Yu Jin), herba cistanche (Rou Cong Rong), processed rehmannia root (Shu Di Huang) and goji berry.

3. Prescriptions that improve circulation: As we have discussed, phlegm is an important factor in hyperlipidemia. Dissolving phlegm is the equivalent of reducing blood lipids. Since the specific phlegm being targeted is in the vessels, improving circulation would be the solution. Wen Dan Tang is commonly used for dissolving phlegm. Commonly used herbs to lower blood lipids are grassleaf sweelflag rhizome (Shi Chang Pu), pinellia tuber (Ban Xia), oriental waterplantain rhizome (Ze Xie), lotus leaf, lightyellow sophora root (Ku Shen), capillary wormwood (Yin Chen), seaweed, areca peel (Da Fu Pi), and winter melon seed. HuoXie ZhuYu Tang and TaoHong ZiWu Tang are used to improve circulation. Common herbs to improve circulation are pseudoginseng (Tian Qi), Danshen root, peach seed, Chinese angelica (Dang Gui), rhizome Chuanxiong, and stir-baked cattail pollen (Hei Pu huang).

LIFECARE | 09TCM

One can select a few herbs to prevent hyperlipidemia. It is simple and convenient. The herbs should be taken once a day for 3-6 months, typically 5-10g per use. Common herbs that are effective in reducing blood lipids are hawthorn, oriental waterplantain rhizome (Ze Xie), Danshen root, rhubarb (Da Huang), sickle senna seed (Jue Ming Zi), tuber fleeceflower (He Shou Wu), red thorowax root (Chai Hu), rhizome Chuanxiong, milkcetch root (Huang Qi), capillary wormwood (Yin Chen), Chinese angelica (Dang Gui), kudzuvine root (Ge Gen), atractylodes rhizome (Bai Zhu), lotus leaf, grassleaf sweelflag rhizome (Shi Chang Pu), Chinese taxillus twig (Sang Ji Sheng), cattail pollen (Pu huang), manyflower solomonseal rhizome (Huang Jing), sickle senna seed (Cao Jue Ming), peach seed, tumeric, evening primrose, Chinese caterpillar fungus (Chong Cao), fiveleaf gynostemma herb (Jiao Gu Lan), eleuthopower (Ci Wu Jia) and licorice root.

Besides herbal treatment, statins, dietary and lifestyl changes (stop smoking, get plenty of sleep, establish work life balance and regular routines, and maintain a positive outlook) may be appropriate for those with severe hyperlipidemia.

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JIANG XUEFENGSENIOR PHYSICIAN

Hypothyroidism

The thyroid gland is located in the middle of the lower neck, below the voice box and divided into two lobes that weigh less than 20g. It is one of the endocrine glands that produce hormones to regulate physiological functions in the body.

Hypothyroidism includes acute and chronic thyroiditis, hyperthyroidism, underactive thyroid, swelling of thyroid gland and thyroid cancer. Hyperthyroidism and swelling of thyroid gland are most common and they affect mostly women. The ratio of between affected men and women is 1:4, and is prevalent among those aged 20 to 40.

Symptoms• Symptoms of hyperthyroidism

Increased appetite, loss of weight, fatigue, intolerance to heat and heavy perspiration, increased bowel activity, irritability, trembling hands, palpitations, cardiac arrhythmia, osteoporosis, aching of bones, light or no menstruation, erectile dysfunction (for men). Some patients have also experienced enlargement of the thyroid gland and eyelid retraction.

• Swelling of thyroid gland (Goitre)

Swelling of the neck that is painless and poses no difficulty in swallowing. A small number of patients would experience tightness of the neck.

TreatmentChinese physicians categorize Hypothyroidism

as “neck tumours”; physicians of the past had also conducted detailed research into the causes and treatment of this ailment.

The treatment of “neck tumours” is mostly internal; physicians will administer treatment according to displayed symptoms.

• Depression of the liver and stagnation of Qi (energy) require treatment by Chaihu-shugan decoction.

• Vacuity of Qi and stagnation of blood require treatment by Taohong-siwu decoction.

• Conflict of Qi and phlegm requires treatment by Haizao-yuhu decoction.

• Debility of chong and ren channels requires treatment by Yougui pills.

• Depression of phlegm and heat requires treatment by Chaihu-qinggan decoction.

Prescriptions by Chinese PhysiciansChinese physicians of the past frequently use

seaweed, kelp, Huangyaozi and other plants which are rich in iodine to treat Hypothyroidism. However, this author noted that the main cause of Hypothyroidism in the past is mostly due to a lack of iodine. As Singapore is an island abundant with sea produce, lack of iodine is hardly the main cause of Hypothyroidism. Thus, below are two clinical prescriptions that can be used to treat hyperthyroidism and goitre to satisfactory results.

• Prescription for hyperthyroidism

Astragalus, radix scutellariae, radix bupleuri, Radix Ophiopogonis, curcuma aromatica, unripe tangerine, chinaberry fruit, danggui, rhizome of chuanxiong, red peony root, radix scrophulariae, Wuweizi, tortoiseshell, turtle shell, oysters and glycyrrhizae melle tosta.

• Prescription for goitre

Xiakucao, fabanxia, yunfuling, Niubangzi, Baijiezi, Chuanbeimu, salted tangerine skin, raw turtle shell and glycyrrhizae melle tosta.

10 | LIFECARE TCM

• Marinated kelp in red sugarPreparation: Appropriate amount of kelp with sand particles removed. Boil the kelp in water, cut them into pieces when cooked. Place them in a bowl and marinate in red sugar for two days before consuming.

Suitable for Goitre patients who lack iodine.

• Radish soup with seaweedPreparation: Boil 30g of seaweed, 1 tube of white radish, and 1 slice of tangerine peel in water. Consume the soup in replacement of tea drink.

Suitable for Goitre patients who lack iodine.

• Burdock soupPreparation: 150g of fresh burdock, adding 500ml of water and boil till 250ml. Directions: Consume in 2 servings.

Suitable for goitre patients who lack iodine.

• Stewed chicken with pomeloIngredients: 1 skinned pomelo, 1 whole chicken, ginger, onions and moderate amount of salt. Preparation: Stuff pomelo flesh into the chicken and place it in a stewing mug. Add ginger, onions, seasoning wine, salt and moderate amounts of water before putting the mug in another pot and stewing it in hot water for 1 hour. Directions: Consume once a day by eating the meat and drinking the soup.

Suitable for hyperthyroidism patients with the following symptoms: lumps in the neck that are soft to touch, reduced food intake, giddiness and tinnitus, tightness of the chest, aching of waist and knees.

• Stewed turtle shell with fritillary bulbIngredients: 30g of turtle shell, 5g of fritillary bulb, 100g of lean meat, and moderate amounts of seasoning wine, salt, ginger and onions. Preparation: Place turtle shell, fritillary bulb and lean meat in a stewing mug, add seasoning and stew it water for 1 hour. Directions: Consume once a day by eating the meat and drinking the soup.

Suitable for hyperthyroidism patients with the following symptoms: lumps in the neck that are soft to touch, dryness of mouth and tongue, intolerance to heat and heavy perspiration, palpitations and heavy phlegm.

• Braised soybeansIngredients: 500g of soybeans, 3 whole aniseeds, 1 small piece of Chinese cinnamon, and moderate amounts of soy sauce and white sugar. Preparation: Pre-fry soybeans and soak them in cold water for 5 minutes till they expand in size and display wrinkled skin. Scoop soybeans up and drip-dry before frying them in hot vegetable oil, adding Chinese cinnamon, aniseeds, soy sauce and white sugar; slow dry contents for 30 minutes to 1 hour, and drain the gravy with a strong fire. Directions: Consume the dish anytime.

Suitable for patients with various types of hyperthyroidism.

LIFECARE | 11TCM

Recuperating from Hyperthyroidism and Goitre• Maintain a cheerful spirit and avoid anger and anxiety, for it is said that hypothyroidism is closely related to one’s mental state.

• Smoking and alcohol can cause stimulation and agitation among patients, resulting in increased heartbeat and worsening of the ailment. Thus, refrain from smoking and alcohol, as well as consuming coffee, strong tea, sesame oil and other food with similar stimulating effects.

• Patients with hyperthyroidism have increased metabolism, so they should consume food that are high in carbohydrates, vitamins B and C, sufficient proteins and sugar. Daily protein intake should not be less than 1.5g per kilogramme. At the same time, consume more animal liver, fish, fowl and soy-based products.

• Hyperthyroidism can lead to calcium deficiency and dehydration, so calcium intake and drinking lots of water are essential. Drink between 1.5 to 2.5 litres of water daily. Consume more vegetables but control intake of food with increased fibre content to prevent diarrhea.

• Do not supplement iodine unnecessarily. Iodine is the source of growth of thyroid hormones. Therefore patients with hyperthyroidism should consume food that are low in iodine. They should also refrain from eating too much seafood such as kelp, seaweed, saltwater fish and prawns. Likewise, goitre is also characterized by high and low-iodine levels, so one should not supplement iodine blindly. For goitre that is caused by a lack of iodine, can consume foods that are high in iodine but in moderation.

• Raw radish, beans and vegetables such as red cabbage, Korean cabbage and cauliflower have goitre-inducing substances. Eating them over long periods may cause swelling of the thyroids. However, these substances will diminish if the vegetables are cooked. Similarly, eating raw radish with fruits and grapes may also induce swelling of the thyroid gland.

• Patients who experience eyelid retraction during hyperthyroidism must take care of their eyes. Do not drink too much water before sleep, avoid strong light and dust irritation. Slightly raise the height of the pillow when sleeping, and refrain from salty food.

• Women who contract hyperthyroidism during pregnancy, or conceive during the treatment of hyperthyroidism should seek medical treatment immediately.

DietotherapyIn the ancient Song Dynasty, physicians had

already been using thyroids of goats and pigs to treat hypothyroidism. The use of kelp for treating Goitre due to a lack of iodine was first recorded in the Jin Dynasty. Many Chinese medical herbs were also proven to be effective in treating hypothyroidism during long-term medical trials.

Chinese herbal dialysis facilitates detoxification through skin, as well as bowel and bladder movement. It maintains and improves the remaining function of the kidneys. This is a more sensible, natural and steady approach to treatment. Machine dialysis is effective and fast acting, which is not appropriate for early stage chronic kidney disease. The result is that most early stage patients do nothing for years, and simply wait till they are eligible for dialysis. Without detoxification treatment, their quality of life tends to be poor and their condition tends to progress rapidly. These patients should undergo Chinese herbal dialysis. The sooner they receive treatment, the more kidney function they can preserve. They may be very stable for a long time without needing dialysis. Their condition is a lot more stable and quality of life is much better than those who wait to receive dialysis.

Chinese herbal dialysis is a new concept that I gradually formed and defined over many years of treating kidney diseases. I firmly believe that this concept can work as I followed Professor Peng Jian Zhong in clinical rounds and saw the state of many patients with uremia.

I would like to formally introduce the concept to dispel many misconceptions from patients. Many of them believe that dialysis is a better choice, since herbal medicine does not cure kidney failure. To many people, lifelong dialysis is well accepted and unquestionable, while lifelong use of herbal medicine is received with resistance.

I often use the term “Chinese herbal dialysis” when communicating with patients. Yes, it is true that chronic kidney disease is incurable and the only management is dialysis. However, there are many ways to achieve that. Chinese herbal dialysis facilitates detoxification through skin, as well as bowel and bladder movement. It has the advantage of protecting the remaining function of the kidneys and maintaining adequate urine output. TCM treatment based on its unique differential diagnosis can also improve anemia and bone disorders associated with chronic kidney disease, and the overall quality of life of the patient. Education like this eradicates anxiety towards TCM treatment and the patients are more compliant due to their new understanding.

Obviously, a combination of dialysis and herbal medicine is recommended for severe and complicated cases. It reduces dialysis frequency and improves quality of life. Medicine has become mo¬re integrative. The way we look at medical treatment should be more inclusive as well. I hope the concept of Chinese herbal dialysis will be accepted by more people, so more patients with chronic kidney disease can benefit from TCM treatment.

12 | LIFECARE TCM

Chinese herbal dialysis, the sooner the better.

Green Dialysis

JIE JUN DONGSENIOR PHYSICIAN

Kidney disease-uremia

Kidney function gradually decreases in chronic kidney disease. When the function is lower than 30%, it cannot effectively excrete toxins and fluid from the body, which leads to increased creatinine in the blood to 3 times or more the normal level. The patient may experience dizziness, fatigue, back and leg weakness, facial and lower extremity edema, anemia, skin itchiness, proteinuria, and joint pain. We call this uremia.

The symptoms are due to the kidney failing to excrete toxins and fluid, maintain electrolyte balances, and participate in hematopoiesis.

To prevent uremia, one must proactively prevent the progression of chronic kidney diseases, such as nephrotic syndrome, hypertensive nephrosclerosis, diabetic nephropathy, and gouty kidney, etc. Once symptoms of early kidney dysfunction are detected, one should receive TCM treatment to reduce the burden of the kidneys and prevent progression.

The diet should be low in protein. Make sure to exercise regularly to prevent cold and flu. Do not overwork.

Case study:

Patient 1: Female, 74, presented to the clinic in 2005 with diabetic nephropathy. Her blood tests would return to normal after treatment. She has been treated on and off since. Although she is qualified for dialysis, she hasn’t had to receive any. She continues to be treated with Chinese herbal green dialysis.

Patient 2: Male, 70, with uremia. He was afraid of dialysis. He started Chinese herbal green dialysis 3 years ago, and has been stable.

Avoid “stimulating food”

TCM believes that high protein food, including chicken, duck, fish and red meat, increases the burden on the kidneys, causing the condition to progress. Patients with kidney diseases need to adhere to strict diets, avoiding beef, lamb, crab, and chili pepper, etc. Those with proteinuria should also limit the amount of plant protein, including soy products. Diet should contain beef, lean meat, fresh vegetables, and congee. Additionally, one should quit smoking and overexertion (including sexual activities). Increased metabolic byproducts in the body increase the workload of the kidneys.

Astragalus root job’s tear congee

Astragalus root 30g cook in water for 30 minutes. Add adequate amount of rice, lotus seeds 20g and Job’s tears 30g to make congee.

Eucommia bark chicken soup

Simmer eucommia (Du Zhong) 30g, goji berries 10g, 10 red dates and chicken for an hour. Add salt to taste.

Food Therapy STAR BUY:AMERICAN GINSENG

LIFECARE | 13TCM

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16 | LIFECARE14 | LIFECARE TCM

XU XIAO ZHEN SENIOR PHYSICIAN

Excessive Sweating

Perspiration, also known as sweating, is a physiological process to maintain normal body temperatures, and excrete water-soluble waste. Hyperhidrosis, or excessive sweating, can be an isolated symptom or a part of other complex conditions, such as hyperthyroidism, dysautonomia, rheumatic fever, and tuberculosis.

TCM physicians are able to make different diagnosis based on the timing, location, odor and color of sweat.

1. Timing:

“Yang-insufficiency hyperhidrosis” is abnormal and excessive sweating during the day; “Yin-insufficiency nocturnal hyperhidrosis” is abnormal and excessive sweating at night.

2. Location:

“Sweaty face and head” may be due to damp heat (different from the concept of “inflammation” in Western Medicine) of the digestive system. It can also be due to indigestion after binge eating. When it happens to elderly and postpartum women, it’s mostly because of “Qi insufficiency”.

“Sweaty palms and soles” are mostly due to “Yin insufficiency”, although it could also be damp heat of the digestive system, or febrile illnesses.

“Sweaty chest” is seen in “weakness of the heart and spleen system” caused by anxiety and distress.

3.Odor

Fishy odor of sweat is related to damp heat and febrile illnesses.

4. Color

Yellow sweat is a sign of poor health.

TCM wellness care can improve excessive sweating

Prior to treatment, TCM physicians will assess the condition based on the quantity, environment, timing and odor of sweat, as well as the individual’s habits, age, diet, and body constitution. Appropriate herbal formulas will be given. Patients with “insufficiency syndrome” need formulas to enhance Qi, nourish Yin, replenish blood, and balance the immune system. On the other hand, those with “excess syndrome” need formulas to reduce damp heat, soothe the liver, and reduce fluid retention. If it’s a mixture of both, then treat the dominant syndrome first. In addition, the common denominator for both daytime and nighttime sweating is sweat gland disorder. Thus, herbs with a drying effect (by consolidating exterior for arresting sweating) should be considered to increase treatment efficacy. These herbs are Ephedra root, blighted wheat, sticky rice root, five-flavor berry, and oyster shell.

Those who sweat easily should pay attention to:1. Consuming enough water and nutrient-rich foods.

2. Keeping the skin dry, changing often, and maintaining

hygiene of clothing and beddings.

3. Avoiding direct exposure to wind to avoid getting sick.

Osteoarthritis (OA), or degenerative joint disease, is a chronic joint disease affecting the cartilage of the joint and resulting in osteophytes. This process is directly related to aging.

SymptomsJoint pain: Movement activities make the pain

worse and relived by resting. Some patients notice pain and stiffness when the joint stays in the same position for a long time or first thing in the morning. The pain and stiffness typically dissipates with movements.

Osteophytes, or bone spurs can irritate nearby peripheral nerves causing radiating pain. Degeneration of the cervical spine may result in arm pain. Degeneration of the lumbar spine may result in leg pain. Hip OA may result in inguinal pain. Severe OA in the spine can compress the spinal cord and nerve roots, causing sensory or motor deficits, urinary or bowel incontinence, nerve irritation and even paralysis.

Early changes do not affect the outward appearance or movement of a joint. Advanced stage OA in the knees and hands, where there’s little soft tissue, is associated with swelling, muscle atrophy and joint distortion. There may be tenderness to palpation, limited range of motion and a grinding sensation in the affected joint.

Osteoarthritis (Protect your Joints)

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ZHOU LI PINGSENIOR PHYSICIAN

16 | LIFECARE TCM

A TCM physician’s take on causes of OA (Osteoarthritis)The development of OA is often related to Qi deficiency or aging. When exogenous pathogens enter the

body, they can block the normal flow of Qi and blood, and remain inside the joints. In case of aging, it’s a combination of liver and kidney deficiency, and micro-trauma over the years. The joints start breaking down as the soft tissues lack the nourishment they need, and blood and Qi flow are compromised.

A TCM physician’s take on treatment of OAAcupuncture: YangGuan (GV3), QuQuan (LR8), XiGuan (LR7), DuBi (ST35), and YangLingQuan (GB34)

Herbal Medicine: commonly use prescriptions that nourish the liver and kidneys, such as DuHuo JiSheng Tang, to strengthen the musculoskeletal system

A TCM physician’s take on prevention of OA• Avoid direct exposure to wind, especially from fans or AC

• Regularly exercise and stretch

• Eat gelatinous food, such as black and white fungus

If you are dealing with edema, Si Shen Tang, poria, gorgon fruit, Chinese yam and lotus seeds are all good diuretic options to help reduce fluid retention.

Case StudyA male patient, 60, presented with a chief complaint of knee pain, increased with going up and down the

stairs, for about a year. His x-rays were normal. He achieved pain reduction and increased joint mobility with acupuncture and herbal treatment that focused on relaxing the muscles, increasing blood flow, and strengthening the bone. Additionally, he started to exercise routinely, which also helped to keep his symptoms at bay.

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Self-care tips and prevention:1. Regular massages can strengthen the muscles and increase range of motion. It is best performed by a trained professional. Inappropriate techniques may worsen symptoms.

2. Make sure to protect the compromised joint when exercising. Many of these joint degenerations occur at the knee joint. Avoid sitting in the same position for long periods of time. Do not blindly perform range of motion exercises or self-massage.

3. To prevent biomechanical injury to joints, one should avoid activities that overload the joint. Those with knee and ankle OA should avoid the stairs as well as prolonged squatting, standing, sitting seiza-style, hiking and walking, especially when the joint is aggravated and swollen.

4. Swimming, biking and stretching are good exercises that reduce the load on joints.

5. Wear comfortable shoes.

6. Proper strength straining can increase neuromuscular control and strength, and in turn reduce loading on the joint. It is beneficial for recovery and symptom control. As an example, quadriceps strengthening is good for those with knee OA.

LIFECARE | 17TCM

Written by: Ms Pearlyn Wijaya (Maths Teacher from Ascensia Academy)

18 | LIFECARE“Have a Break, Have a Kit Kat!” is one of my

favourite quotes. We all need to take a break sometimes, some need to take short breaks, some need to take long breaks.

Travel Tips

Tip 2: Do your research and plan out your itinerary

Download the TripAdvisor app to your iPhone or Android, and read up on the activities and hotels recommended. Do a spreadsheet of daily activities. Do a simple day-to-day plan for your trip, i.e. activities for day 1, 2, 3, etc. As travelling to the U.S.A. will result in struggling with jet lag for the first few days, I usually prefer to book a local tour to scenic areas (You may sleep in the tour bus along the way). For example, local scenic tours for Seattle that I booked for the first two days were Snoqualmie Fall/Leavenworth tour and Mount Rainier tour.

Tip 3: Booking your stay

With Airbnb growing fast, we certainly have more choices when it comes to booking our stay when we travel. During my recent trip, the majority of my stay was in Seattle, so my hotel was around the downtown area, where it was a short walking distance to main attractions. like Pike’s Market, Seattle Aquarium, Seattle Art Museum, Seattle Centre. It is also very important to know where is the nearest Chinatown to your hotel, just in case you cannot eat the local food.

Tip 4: Reflection and Revelation

One of the most important part of my trip is to do self-reflection! Living in the 21st Century, we all use computers and therefore we certainly know who is Bill Gates. Well, Bill and Melinda Gates donate 95% of their wealth to support meaningful causes around the world. It was a great opportunity for me to be able to visit Bill and Melinda Gates Foundation right at the heart of Seattle Centre. Some of the wall quotes that I like are ‘Use your voice for good’ and ‘use your creativity to help’. Often, we forget that we do not live in our own solitary world. We have to help others if we can. Just like in Ascensia Academy, we always do our best within our capacity to help students to pass their examinations.

Tip 1: Buy the plane ticket

Before travelling, we need to do research, such as the routes we can take to go to Portland.

Here are a few tips to consider when choosing your routes:

1) Cost of plane tickets (sort out the ones that are within your budget)

2) Preferred airlines

3) Type of planes (you might prefer a bigger plane for the long-haul flights)

4) Flight departure time, transit time (either choose a very short one or long enough for a short city tour), and arrival time at the destination.

LIFECARE | 19

20 | LIFECARE ASCENSIA ACADEMY

BY WONG WAI KONG (SENIOR TEACHER, ASCENSIA ACADEMY PTE LTD)

Aiming to develop confidence can be difficult given the current climate of nerve-wrecking anxiety and close to ritual-like observances during exam preparation. It is a daunting period which strains to the limit the resources and energy of both students and their parents. Participants, spectators and commentators aptly name this period exam fever. Below is a condensed version of a strategy that might just get you the results you want. Do you really want to be truly confident? Complete this to-do list below to prepare yourself:

Exam Tips

Give yourself enough time to studyDon’t leave it till the last minute. All planning

and revision must be done, sometimes months in advance, as there are many subjects to cover. Plan how much time is to be spent on each subject depending on how good you are in it.

Use flow charts and diagrams Refer to them often and practise at how to

produce them as they train you to make more connections and even think across disciplines. Having a good understanding of how all the information falls in place alongside one another in those cranial cabinets allows you to withdraw and apply concepts more efficiently in an exam. Also, many exams nowadays require learners to produce a visual and graphic representation of the answers

Organise study groupsOrganise an interest group or study group with

the purpose of revising a certain topic or subject. You may set up different groups with different members to study different subjects so that you can get the maximum benefit out of it. Study groups also give you the chance to explain your answers to others.

Snack on ‘brain’ foodKeep your body and brain well-fuelled by

opting for nutritious foods which are known to aid concentration and memory. Avocados contain Vitamin K and folate which help improve cognitive function, especially memory and concentration. Beets rid your blood of toxins and have natural nitrates which blood flow to your brain. Blueberries provide many great health benefits and protect our brains from degeneration and stress. Pack your smoothies or pancakes with them or simply pop them like popcorn. Try out other foods recommended by seasoned practitioners. Draft the consumption of these wholesome foods into your preparation!

Following these proven strategies can help to build up your confidence levels. Thus, start early and design a comprehensive plan catered to suit yourself best. You would definitely find yourself becoming more and more confident the closer it draws to the exam date. Leave nothing to chance and prepare for every eventuality. Through these, you no longer have to dread exams but would actually look forward to testing your abilities against them!

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ASCENSIA ACADEMY LIFECARE | 21

In TCM, the liver is responsible for Qi mobilization. It’s also responsible for blood storage and regulates circulation. These two liver functions are closely related and need to be in a state of dynamic equilibrium. Without proper mobilization, Qi becomes static and so does the blood. If the liver is hyperactive, excessive Qi movement may negatively affect blood storage and lead to symptoms of bleeding. When we talk about ways to improve your liver health, achieving equilibrium between these two liver functions is the basic tenet. In modern medicine, the liver functions as the largest digestive gland in the body. It regulates metabolism, detoxification, and fluid and hormonal balance. Regardless of the differences between TCM’s and modern medicine’s definitions of the liver, we all agree that we need to take good care of it.

How to improve your liver health

1. A balanced dietQi mobilization carried out by the liver is a key

player in digestion. On the other hand, the nutrients, or essence, the liver requires are obtained through food. A balanced diet with proportional protein, carbohydrates, fat, vitamins and minerals is a must. Avoid spicy food. Increase high-fiber food, such as fruits and vegetables, to ensure regular bowel movements. A balanced diet promotes proper bile production and excretion, which is crucial in maintaining liver health. Overeating and starving can both hurt your liver by throwing off digestive enzyme secretion. To protect your liver, cut back on fat intake to prevent fatty liver disease.

4. Liver disease preventionProactively prevent hepatitis and avoid chronic

use of medications that may cause liver damage. If the medications are absolutely necessary, make sure to supplement them with liver protective agents and take other measures to protect the liver. Drink plenty of water to facilitate circulation, metabolism, glandular secretion, digestion and excretion. This will reduce burdens on the liver from metabolic byproducts and toxins.

5. Improve your liver health with exercise

Exercises that are expanding, flowing and slow are a good fit for the uplifting and mobilizing nature of the liver. These exercises include walking, hiking, sports, and traditional martial arts (TaChi, BaDuanJin and YiJinJing). They improve circulation, respiration and strengthen the musculoskeletal system. They also contribute to one’s peace of mind, which is liver protective.

3. Prevent anger and depressionOur emotions are closely related to the

liver’s ability to mobilize Qi. Recurring, chronic or overwhelming emotional triggers can have a direct effect on liver function. Liver is associated with the emotion anger. Anger negatively affects liver function. Depression and uncontrolled anger are the worse for liver health, and lead to symptoms associated with liver Qi blockage and excessive liver Yang, such as depression, increased irritability, breast fullness and tenderness, chest and rib pain, headaches, sensation of a foreign object in the throat, lumps in the neck, decreased appetite, burping, bloating, loose stools, diarrhea, breast lumps, menstrual cramps, or irregular menstruation. Therefore, learning ways to control one’s emotions and maintain a positive outlook are crucial in soothing the liver.

2. Curb alcohol consumptionThere is a limit to your liver’s ability to process

alcohol. Excessive alcohol consumption may reduce one’s appetite and hinder protein and vitamin B absorption. In more severe cases, it can lead to toxicity, fatty liver, cirrhosis, and death. Avoid excessive alcohol consumption to prevent liver damage.

22 | LIFECARE TCM

24 | LIFECARE

CauseThe bottom line is that neck pain has a lot to do

with our posture. Staring at the phone and computer for an extended period of time causes our head to move forward and our back to slouch. Ultimately, this posture leads to tightness and microtrauma of the muscles around our neck and shoulders. Circulation around these structures decreases and metabolic byproducts accumulate. Eventually, inflammation causes the symptoms people experience. On the other hand, tight muscles tend to be acutely injured during activities requiring large range of motion. Those with chronic neck and shoulder pain are more prone to acute injuries. Since circulation in the area tends to be reduced in this population, healing is relatively slower as well.

Those who have sustained an injury without proper care may experience worsening symptoms and become chronic pain suffers, which greatly reduces the chance of full recovery. Therefore, if you have not recovered from a small injury and your symptoms seem to be getting worse, please seek care immediately.

From the TCM perspective, cold exposure can be another cause of neck and shoulder pain. Singapore can get very warm, and many people can’t wait to get in a room with AC. Most people also prefer tops with wide neckline, which increases direct exposure of neck and shoulder area to cold air. TCM theory believes that cold reduces circulation and causes pain and tightness. This also explains why heat frequently relieves neck and shoulder discomfort.

Neck and shoulder pain may not seem like a big deal. However, when left unattended, it often leads to degeneration, resulting in compression of the nerves, spinal cord and blood vessels. Commons symptoms are numbness and tingling in the arms, weakness, dizziness, headaches, and palpitations, etc. Degeneration is irreversible. An ounce of prevention is worth a pound of cure. Take your neck and shoulder soreness seriously to prevent irreversible degenerative changes.

Neck Pain

Stress increases as the economy grows as well as our pace. We spend more time on our phone and the computer and sitting in front of the desk. People are complaining of neck and shoulder pain, tightness and numbness. Massage may help temporarily, but the problems never seem to really go away, and may appear to be worse over time. This is not only affecting our seniors, but it has also become increasingly common in young people.

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WONG HUI MEIPHYSICIAN

LIFECARE | 25

As poor circulation is the cause of neck and

shoulder pain, treatment should mainly focus on

improving circulation. Depending on the individual

situation, TCM treatment may consist of different

combinations of acupuncture, TuiNa, GuaSha, cupping,

and herbal medicine. Some people have an aversion

to needles and are afraid that acupuncture may be

painful. In fact, acupuncture needles are very thin, and

very different from the needles medical doctors use for

blood draw or injections. You may feel slight pain for

a brief second when the needle pierces the skin, and

some soreness and tingling during treatment.

All treatments have pros and cons. The combination

of treatment you receive will be determined based on

your clinical presentation to achieve the best results.

Patient compliance is also an important factor. One must

be relaxed during treatment to avoid adverse effects

from treatment. If you experience any discomfort during

treatment, you should inform your treating physician

immediately.

Prevention includes avoid direct exposure to cold air, use heat to increase circulation and relax the muscles, and exercise. Don’t stay on your phone for long periods of time. If it’s a work requirement, make sure to maintain good posture and take a break and stretch every 30 minutes. Pillows are another important factor. Pillows that are too stiff, too soft or too tall don’t provide proper neck support and cause the muscles to tighten up.

Do not over look neck and shoulder pain. It only gets worse with age. Without proper early interventions, you might get to a point where your only options are medication and surgery. Early intervention is key to all conditions.

Treatment and prevention

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