Skin cancer can be deadly if you let it manifest, and Washington has one of the highest rates of skin cancer in the country, followed closely by Oregon. In our overcast Pacific NW climate, we often forget to take basic precautions, but even in overcast weather the sun still shines! The leading cause of skin cancer is overexposure to the sun. Fortunately, there are a lot of ways we can prevent against skin cancer. Start up these healthy habits in the Summer and keep them going all year long to beat the statistics - you can do it!

1. Sunscreen. Sunscreen is integral to preventing skin cancer. When you are going outside in the sun for extended periods of time you should make sure to apply a good sunscreen. Avoid spray types of sunscreen and use lotion types, also, make sure to use a sunscreen at least 40 SPF or above. 

2. Dermatology check-ups. Schedule annual dermatology check-ups just to ensure you do not have skin cancer or another problem with your skin. 

3. Avoid sunbathing. I know, I know, this may be one of the sole reasons you go to the beach. But, it has been proven that sunbathing is bad for you...even if you have applied sunscreen! Ultraviolet rays are harmful to the skin and it is important to protect against them however possible. 

4. Say bye-bye to the tanning salon. Radiation is terrible for our skin, and radiation is found aplenty at tanning salons, it has even been shown that some tanning beds produce radiation stronger than the sun! So think about that the next time you decide to go into a tanning bed...just don’t do it!

5. Wear protective clothing. It is one thing to apply sunscreen, but you should also combo that with protective clothing. Wear hats, sunglasses and garments with a ultraviolet protection factor rating. 

6. Use essential oils. Use lemon, sappan wood and mate leaf essential oils in order to encourage healing and repair of damaged skin in order to prevent potential patterns of skin cancer. 

7. Detoxify your liver and kidneys. Your liver and kidneys are major players in converting vitamin D from the sunlight and the food you eat. One way to guarantee you are consuming enough vitamin D is to drink milk thistle tea or taking a milk thistle tea supplement. OR get Acupuncture! Acupuncture provides excellent support for detoxification, cleansing and decreasing inflammation.

Pain is a multifaceted and deeply personal experience that can be very difficult to describe and communicate.  Pain itself is a very functional experience that warns us to be careful when we might be injuring ourselves.  We can see how important pain is in the rare occurrences in which a person is born without the capacity to experience it.  This condition is known as congenital analgesia and these individuals have a very high mortality rate as they struggle with repeated broken bones and poor healing rates due to tissue re-injury when they can’t feel that they are hurting themselves.  

It is important to consciously acknowledge that pain is a functional sensation and that when properly manifested and interpreted can be very beneficial to our health and self-care.  Especially when we know what the pain signals we experience mean.  When it becomes too prolific, though, it can be impossible to negotiate recovery on your own.  

Most people are very good at pushing through their symptoms so that they can be functional throughout the day.  Unfortunately, they commonly do this by categorizing unpleasant pain impulses into a single amorphous uniculture they relate to as “my pain”.  Everything from a skinned elbow to headache to stomach cramping gets thrown into the same classification schema with little thought about what each individual signal might mean.  

Though this can be very useful in the short-term, this strategy tends to inhibit long-term recovery because they get re-injured over and over.  Just like in the congenital analgesia population, utilizing this strategy to ignore pain tends to worsen symptoms and pain levels over time because it doesn’t allow healing.  

Unaddressed injuries start to pile up on top of each other and it gets very hard to determine what the pain you are feeling means.  This is similar to driving your car with a flat tire; you will make it a little further and might even make it home, but you will have destroyed your wheel, axel and engine by the time you do.  If you don’t address the underlying problem (your tire is flat) you can’t take care of the other problems (your speed has slowed down, the ride is bumpy and there is a horrible smell from your car starting to burn).  

The original centrally driven model of pain is usually attributed to Descartes and was a simple circuit-like reaction where pain was stimulated at the site of injury and went directly to the brain with no control for grading or interpretation.  We now know that this is inaccurate.  Pain is an experience that our brains create.  This was detailed in the neuromatrix theory described by Ronald Melzack in the 1960s and expanded upon by many highly insightful researchers like Lorimer Mosely and David Butler.  

Our brains absorb all the thousands of input signals coming in to them at one time; the sensation of that needle poking our arm, the comforting smells of cookies baking, the angry, stern looks of our employer speaking to us, the full, satiated feeling in our stomach, the sound of breaking glass.  After that the brain filters these inputs through our previous learned experiences (the last time I saw a heavy hammer falling it landed on my foot or I was brutally spanked after I heard that crashing sound as a child and I broke the dishes).   It then decides what it should bring from the unconscious experience into our conscious awareness.  If the brain decides that the input isn’t relevant to our survival it won’t tell us about the pain stimuli.  We commonly see this in imaging studies where 60-70% of the healthy population have a hip or spine injury that they are not impacted by or aware of it in the slightest.

Sometimes the brain and sensory neurons become over-responsive at interpreting inputs as pain.  What was previously benign and safe (like light touch or a gentle walk) can become very painful.  Even when there isn’t any tissue damage.  This is termed a Central Pain Processing Dysfunction and recovery requires treatment to desensitize the central nervous system and remind it of what good and bad stimuli should feel like when determining whether you should hurt or not.  

There has been a swing in pain medicine to treating centrally driven pain with a technique that some psychologists utilize to treat fear and anxiety known as Acceptance and Commitment Theory (ACT).  This approach emphasizes focusing on goals and accepting that pain is an inevitable consequence to reaching them.  For instance, I know that walking two miles is going to make my back hurt worse afterwards, but I enjoy walking and need to get to the store. So I am going to accept that I will be pushing myself beyond what my body is telling me it is capable of and commit to walking anyway (or you could have been more insightful to what your body was saying and walked one mile, rested and then finished with no increase in pain and a progressively stronger body).

 This approach however ignores that at the root of central pain processing dysfunctions, are usually initial and subsequent injuries that stimulated the brain to become hypervigilant in the first place.  This is particularly true in the Ehlers-Danlos Syndrome (EDS) population who always have underlying musculoskeletal dysfunction contributing if there is a central pain processing dysfunction.   ACT based treatments for addressing pain are similar to driving home with that flat tire.  Sure, you can accept that your tire is flat and that you are damaging your car driving it home instead of addressing the flat tire, but your car isn’t going to benefit from it.  In the same way your body won’t benefit from ignoring your pain instead of analyzing what the pain means.  

Cognitive Behavior Theory (CBT) is a psychological technique that works very well with pain medicine and particularly well with the EDS population.  This theory suggests that you cognitively assess and investigate what you are feeling. You then decide on an action based on the logical conclusions you make from what the pain is trying to communicate to you.  

 Very often when we cognitively assess our pain we can tell that this is a very short term and temporary complaint that probably won’t be there tomorrow, such as a sharp, brief stab in the shoulder or a sore thigh muscle.  These are things that we can consciously let go of as they are not serious and are unlikely to affect us long-term.  In effect, we are performing on a conscious level the duties that our unconscious pain processing centers should be performing unconsciously.  This has very strong benefits to reducing stress and anxiety because we know these pain experiences will be temporary and are not threatening to our wellbeing.  

Other times, when we utilize CBT, we recognize that a pain is either more severe, or has been a consistent problem that might indicate damage to our tissue in some way. In this case we are in a position to cognitively assess what kind of pain we are feeling and what that might indicate.  Is this a tendon pain that indicates we aren’t stabilizing our shoulder with our scapular muscles and our rotator cuff is irritated?  Do we see less pain (and by default less tissue damage) when we lift a little less? Or engage our low traps before lifting the arm?  When our rotator cuff is more active and strong, is this pain consistently less?  Or instead of the shoulder is this a burning, nervy pain around our skin and fascia that indicates small fiber neuropathy (as seen in fibromyalgia and very strongly in the recent EDS research)?  

In that case we could benefit from talking to our doctors about a neurogenic pain medication and lowering our baseline inflammation levels.  Is this the headache that starts at the back of our skull and rolls over the skull to sit behind our eyes?  In that case we are probably scrunching the circulation of our greater occipital nerve and need to relax our neck muscles and change our posture, or strengthen our core and shoulder muscles to improve our ergonomics.

CBT-based approaches gives back to you the control to manage your symptoms instead of being placed in the position of a passive victim.  There will be some pains that are unresponsive or have so much complicated noise going on that you will need a good PT, MD or body worker to help with them, but commonly you can have a lot of control over your daily experiences.  It is just important to know what the different “flavors” of pain signals suggest.  Be cognitively aware and assess your symptoms as they come up.  Some will be transitory and unimportant.  Others will be more important to listen to and adjust the intensity of how you’re moving and working at in order to allow your body to heal.  Your physical therapist can help you negotiate what different pains mean and how to manage them successfully. ​

Brian Kitzerow is a Doctor of Physical Therapy at Good Health Physical Therapy with offices in both SW and NE Portland. Interested in learning more about your own pain? Consider seeing Brian at Good Health or coming in for Acupuncture at All Ways Well today!

Most people have heard of the field of acupuncture by now, but did you realize the scope of the practice encompasses Chinese medicine, which includes so much more than needles? Let’s explore this ancient therapy.

First of all, the practice of Chinese medicine starts with a diagnosis. The practitioner asks many questions to build a history; this includes the answers to digestion, appetite, diet, sleep patterns, bowel movement urination, pain, lifestyle, and stress level, for example. The acupuncturist will also be noting the voice pitch, hair luster, skin color and tone, as well as posture and mood of the patient and any significant odor. After that, there is a pulse and tongue analysis to determine where the pattern and root are, primarily. Finally, blood pressure is measured and other applicable tests done, including palpation of the body. After this history, a diagnosis and treatment plan is determined. What might be included in this plan?

Needles: Acupuncture needles are very fine, sterile, painless and safe. They are, of course, the main component of the treatment plan. They are placed into certain acupuncture points on the body, either locally (at the pain site) or distally (away from the pain). The needles are retained anywhere from 20 to 40 minutes and most find the treatment to be relaxing and calming.

Herbal formulas: Chinese medicine includes herbal formulas for the most part. The herbs and acupuncture needles work together to bring the body into harmony naturally. Herbal formulas come in either patent formulas, or the practitioner will make you your own formula. What is special about formulas is that they are designed to not overdo the amount of one herb that might cause harm in another part of the body; for example, if you are trying to get rid of heat, there will be herbs to clear heat (by promoting urination perhaps) but also herbs to mitigate the strong effects a heat-clearing herb might have on other organs. In this way, there is always a balance. Herbal formulas treat not only the symptoms but also the root cause.

Nutritional counseling: In Chinese medicine, food is medicine, and if you don’t get an herbal remedy, you will probably get dietary advice tailored to your specific constitution. For example, if someone has a pale tongue with a white coating, and it is puffy with teeth marks on the side, this might indicate this person has too much cold in the stomach, which is hampering the digestive fire. Chinese medicine rates food according to its temperature, season, color, shape and whether it’s right for your individual body. Cold foods include too many cold, raw vegetables, iced drinks and smoothies. A food such as ginger might be a nice addition to one’s diet in this case.

Cupping and Gua Sha: Cupping uses glass cups heated with a small flame to create a suction on the skin. This dissipates stagnation of blood and lymph fluid, promotes blood flow, eases stiffness, encourages better circulation to muscles and tissues, and feels great. It leaves a purple bruise and “cup” mark, only temporarily.

Gua sha uses a flat edged tool that is scraped in one direction on the skin, usually on large areas such as the back. Gua sha is used for many ailments, but especially for pain and stiffness. It removes blood stagnation and promotes the smooth flow of oxygen and blood. Waste and toxins are removed, and the scraping helps circulate fluid and nutrients, encouraging microcirculation in soft tissue. Gua sha can be used on the face for health and beauty, as well.

Moxibustion: Moxibustion is heated mugwort and comes in many forms. Usually this smoky herb is held over an area of the body to warm and circulate. It’s great for menstrual cramps and chronic pain. Smoky moxibustion is used less nowadays due to shared office space and its smoky quality, but there are plenty of practitioners who still use it; find one and you’ll be happy you did. Alternatives to the smoke are smokeless moxa sticks and oil moxa.

As you can see, the wide practice of acupuncture is much more than just needles. In addition to the above mentioned supplements to treatment, some practitioners use massage techniques, a form of manipulation called Tui Na, or acupressure.

In my practice I utilize a little bit of all of these different modalities on a case by case basis. In particular I always add some gua sha, cupping, Tuina or Foot Reflexology. In my personal philosophy, a little bit of bodywork goes a long way to help integrate the energetic work we do into the physical body so I always include a little bit to help the body along.

Interested in more? contact me or book now!

​~Rebecca

One of the best gifts you can give your mother this Mother’s Day is the gift of acupuncture. Acupuncture can help with an abundance of health problems and get you feeling one hundred percent again. Mom’s make the world work, it’s a known fact. So this holiday season you should give your mother the gift of acupuncture, here are seven reasons why.

1. Acupuncture is great for pregnancy. In the first trimester of pregnancy, many women turn to acupuncture when they are looking for a non-medicated way to treat what ails them. The number one reason women seek acupuncture in their first trimester of pregnancy is morning sickness.

2. Acupuncture can help cure and alleviate stress. Mom’s have to deal with a lot of stress, so what is better than getting a cure for that this mother’s day? Send your mom to an acupuncturist so she can reap the benefits of calming stress relief. 

3. Acupuncture is a great cure and preventative measure for anxiety. There are many acupuncture points on the body to calm the mind and bring us down from our stresses and anxieties. Such as Pericardium 6, Liver 3 and Stomach 6.

4. Acupuncture is very beneficial for those experiencing arthritis. There are different types of arthritis and different treatment plans which include acupuncture, herbs, changes in diet and exercise. Traditional Chinese Medicine  just might be able to help you move better and find relief. 

5. Kiss migraines goodbye. Acupuncture is a great cure for migraines, it also can help prevent them from happening too. It is possible to stop a migraine in its tracks if one is able to see an acupuncturist during the acute stage of migraine.

6. Acupuncture can alleviate insomnia. We all know that mom’s have to put up with so much throughout the day, by being overworked and overstressed it may cause them to get insomnia. Acupuncture needles are strategically placed on points that will calm the mind, balance hormones and settle the nervous system. Most people will notice some change after just one treatment, but to get the full effect and truly eliminate insomnia, you should commit to several treatments.
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7. It improves digestive function. Acupuncture is effective in improving the digestive function within individuals. There are numerous acupuncture points on the body that can help with digestion. Two of the best are located on the stomach energetic meridian, Stomach 25 and Stomach 36 (that means specific acupoints on the belly and the shin! Ask, I'll show ya sometime...).

Having children was the BEST decision of my life. All the excitements, joys, sorrows and everything in between that go with it are worth every minute. That doesn't mean every minute is magical or easy. Moms are some of the hardest working women in the world and it is my privilege both to be part of that community and to have tools in my Acupuncture toolbox to help those of us who are mothers to be the best that we can be.

Interested in learning more? Email me or book online any time and allow me to be part of your mommy support group!

​~Rebecca