The medicine of east Asia is based on a science that does not hold itself separate from the phenomenon that it seeks to understand our medicine did not grow out of Petri dish experimentation, or double blind studies. It arose from observing nature and our part in it. East Asian medicine evolves not from the examination of dead structures, but rather from living systems with their complex mutually entangled interactions. Welcome to qiological. I'm Michael max, the host of this podcast that goes in depth on issues, pertinent to practitioners and students of east Asian medicine, dialogue and discussion have always been elemental to Chinese and other east Asian medicines. Listen into these conversations with experienced practitioners that go deep into how this ancient medicine is alive and unfolding in the modern clinic. Have you ever had the experience in clinic when a patient says something and it just stops you in your tracks, there's a kind of gravity and brilliance about what they just said. That completely resonates with you. The feeling in the room changes I had that happen the other day, when a patient of mine said a listening heart perceives me. It really got me thinking about the importance of listening and it reminded me how ting, the Chinese character for listen. At least the traditional form of it actually tells you what's involved in deeply listening. I'll be back a little later in the show to unpack that character for you. There are occurrence in our medicine that say we should be very cautious around the heart. In fact, it's best not to treat it directly. And even in our modern world, treating cardiac issues is something that I suspect most of us feel some uncertainty and anxiousness about. You know, we don't really get this kind of training here in the west. So I'm looking forward to this conversation with as he's going to deep into Chinese medicine cardiology. And as you pointed out to me in our pre-interview conversation, ischemic heart events are only a small part of a cardiologist practice. Most issues with the heart are issues of a chronic nature. And you know, Chinese medicine has options that conventional medicine doesn't, let's get into this. Ammas welcome to GLI.

Hi there. Thanks for inviting me.

Yeah, it's uh, it's pretty fun. You know, we get to connect across time zones and oceans and all this stuff. And talk about Chinese medicine. Wonderful. Looking

forward today.

Our topic is Chinese medicine cardiology. I'm curious. I mean, we don't hear many people that do Chinese medicine cardiology. What are the influences that drew you to doing this? Yeah,

it's a, it's an interesting story. I, uh, uh, 30 Chinese, Minnesota and San Francisco and California back in, uh, 98 and in my second year of school, in the American college of TCM ACDC, um, there was a Chinese delegation from Chengdu that came to the school. And gave a couple of lectures and sessions. And now the head with delegation was a professor who was head of the department of cardiology in one of the major hospitals in Chengdu. And he was giving a lecture on Chinese herbs and heart failure and instantly bam, wham. You know, 30 minutes, I knew that this is what I wanted to do. And then from that, from then on, I pursued that and it actually made things pretty easy for me in school because everything was geared toward cardiology, you know? So

you knew what you wanted, you were focused.

Yeah, I was, I was really focused and again, studying from the second year, uh, I'll tell you later on more about this, but you know, all the way to the end of the school, that was my focus. And then after that, of course, I went to China and I spent almost eight months in a department cardiology, but that was the kind of the initial thing that kind of drew me into it. But there was also another thing. There was actually a Harvard, uh, cardiac. Um, my brother-in-law introduced me to who was very holistic in his approach, any, he was saying, you know, I, I, I see Chinese medicine really working in cardiology. So that was kind of, it was a, it was a

support saw Chinese medicine working in cardiology. How did he come across that?

I, well, I did some of that. I only met like briefly, but I remember as a student, that was, that was a great influence at the time. It was also interesting because most of these things happened kind of around that same month. I was thinking, God, this is the first of cardiology says that he sees this working and I get this gut-wrenching too. And yeah, kind of connecting the dots was the next thing to do.

You know, it's curious sometimes how we pick up these bits of inspiration and it totally changes the direction that we take in our life.

Definitely. It was something like, like dawned on me instantly. It was like crystal clear that this is it. This is, this is, this is what I'm going to do. So, and you know, over the year, it kind of even developed in our develop that also from a personal point of view, philosophical point of view, you know, the heart being the emperor, the connection of the heart and the Shen and the soul and everything comes together. But, but the initial, the initial incentives were, were these, these, these two, these, the meeting of these two people,

actually, I want to get into that. Actually. I want to get into it right now since you brought it up, heart, soul, Ember blood. For that matter. I know in my life I've had a few experiences. It's really, it's just a handful of experiences, but something comes along. And I'll hear something where something is presented to me much like you with cardiology. I don't have to think about it. I don't have to like, do the pro and con list. I don't have to like use my spleen rumination to work it through. I hear it. And I go, yup. That's what's happening.

Yep. Yeah. Well, definitely. I, I, you know, the, the, the Western term for that is intuition. I think it's, uh, the Chinese view of that is more broad and actually more accurate, uh, these decision-making these decisions that we make and these, these moments that we realize things. And then after the first we realized that then we know, I think that's kind of, that's kind of how

I see. And then we know that. Yeah, that's true. Isn't it? Yeah,

it's a realization first. And then you kind of analyze it with logical, uh, analytics. Uh, and then you say, yeah, yeah, this is what it is in there. Then it becomes like knowledge and then, uh, or, and then you follow it. And then actually one of the things that drew me into Chinese medicine is, is actually, uh, an angelical, uh, uh, color, uh, medicine. I didn't stay chia. You, I used to do since I was like 13 or 14 years to do martial arts, that was Japanese martial as the karate and stuff. And I switched to title each one when I was about 20. And at the same time, I didn't say my background is, is, is sciences. My, I did my bachelor's and master's in biology and life sciences. And during that time, switching from the external martial arts to the internal martial arts and starting to feel the sensations that achieved, this was kind of what drew me in to Chinese medicine in general. Uh, coming back to what we just said, these, these realizations or these, um, notions or this knowledge, you know, there's a saying in, in, in, in Chicago and imagination leads the mind, the mind leads to the cheat and, you know, and then fall, but she leads the blood leaves, the blood in the blood leads the shin. So where there's this kind of like a circle. I really think the process of, of making decisions is based on number of things. Uh, one of them, and, you know, sometimes we call it intuition, but this intuition is based on our cognitive knowledge on the one hand subconscious knowledge on the other hand experience, and then something greater, which is just like a hook, a hook up to, to, to, you know, to a higher knowledge and this triad as what kind of gets us to it to a point saying, aha, this is, this is it. This is what's going on. And this, and luckily off often, this is what I'm going to do.

Yeah. It's, it's, it's, it's an undeniable. And often unsettling feeling. Yes. Yeah. The Chinese have a phrase it's often translated as fate. They call it UN fun, but I don't think it's quite fate in the same way that we think in Western terms like, oh yeah, this is what's going to happen regardless. You're kind of doomed to something. It's more like opportunity meets willingness.

I agree. That's a nice, nice way of saying that. Yeah. Opportunity meets willing. Yes. I, you know, I consider myself really lucky and all of us, I think, to, to, to do something that we really love clinic for me, especially treating conditions of the heart or cardiology is something that I enjoy. I enjoy a lot. I enjoy of course the influence. And then I guess we'll talk about this sooner Chinese medicine is unbelievably effective for, for, uh, several cardiovascular disorders of the P people are not aware of that. Um, I guess we'll get to that later on, but there's a lot of, there's a sensation of fulfillment, I guess. You know, we, we have that also with treating any condition, but there's something about, for me, there's something about treating someone's heart, which, you know, you, you kind of need to have so much respect to even. Approaching someone's heart and cardiovascular, uh, in cardiology. So, so yeah, over the, over the years when you get that and when you find that avenue that has to be in, there has to be so respectful. And then when you do influence the, the, the fulfillment and the sensation is this it's great. It's great.

Yeah. I hear you use this phrase, respect and approaching the heart. And it just, I mean, it sends a total tingle through my spine cause it's true. And I know for myself, because I'm not trained in this. And when you think about issues, especially cardiological issues, at least for me, and maybe some of our listeners can relate to this. One of the first things that comes up for me is fear and talk about the heart kidney access, because someone's got a heart condition. It's like, this could be, you know, it's usually serious stuff. Yeah. And what if I do something wrong? What if they have a heart attack? What do you know? What if. Yeah, there's all that stuff there. And it occurs to me as I hear you say this. It's really not that I've got fear. I mean, there is some fear, but it's more that, oh yes. I want to be very respectful of what I'm doing here. That's that's a really helpful

piece. Yes. And I see that and I S I would approach this notion of being respectful from two directions. Be. Careful is one, but also like, uh, you know, we'll talk about, about, you know, things that you need to do, things that you can do, things that you need to learn to avoid. I guess we'll talk about that. But, um, being careful caring before careful, but also respect because you know, when you approach the emperor, you must be humble. So from that, from that aspect as well, it's common. And I see that with many practitioners that people are drawn to the field of cardiology, but at the same time, Because of the potential, let's say at least the potential for, for harm. I don't see many practitioners doing Chinese cardiology and that's a shame because I think apart from the fact that it's very effective, there are several, let's say levels of even, you can start with cardiovascular risk factors that, that everybody know that we, you know, if it's a high blood pressure or if it's lipids or if it's a blood sugar, this is a good way. It would be a good way to start. But, uh, and build your guests, I guess, your confidence. But if you ask, I hear that I encounter that also I teach, you know, when I teach in conferences or, or an workshops on cardiology, uh, this comes up often. And I, I, I do, I have to say that it is true that the fact that I have, you know, a scientific Western background. Helps a little bit. It's still, I'm not, I'm not a physician and I'm not a trained in cardiology. It does help. But I think once you go, like, for example, if you, if you, if you're fortunate enough to be able to see a cardiology ward in China, that's a huge confidence builder. It's a huge confidence builder because you see these, these patients getting at the same time, getting drugs, getting herbs, getting acupuncture, and you see this, this, this, this for me was, it was, it was. Uh, let's say, uh, apprehension breaker, because once you see it and you experience it, then, then it becomes, you know, a more approachable.

Yeah. You know, it's possible. You've seen it. It's not, it's not an idea. It's not in a book. It's not a theory. There's a whole war to people that are being helped in you're seeing how it's working. Right. Right.

Exactly. And, and even, and another, another thing is it's always nice to go back to the classics. You know, if you go back to the classics in terms of specific diseases that we have, uh, going all the way back to, you know, 300, uh, VCE chest pain or shaoyang B, so there's a, there's a, or you are with me as in heart attacks is something that Chinese medicine has been treating for 3000. Even before Western diagnostics. So that's also something to remember. Do you have very specific syndrome, differentiation and analysis on chest pain and on palpitations and you have two types of palpitations, the more ShaoYin related palpitations and the more, the more organ related palpitations, this is very much like the Western view. You have, you have arrhythmias, which originates for, uh, more, uh, uh, let's say, stressful or psychological conditions. And you have arrhythmias which originate from like changes, organic changes in the heart. So keeping in mind or bearing in mind the Chinese medicine, uh, was. And has developed treating cardiovascular disorders for centuries. That also kind of helps to get cardiology more approachable. Yeah.

Well, you know, what is it that they like to say these days? We are using evidence based medicine. Yeah, yeah, yeah. We got 3000 years of

it.

Yeah. And even, and even if you take a look, you know, take a look at the, um, uh, the herb categories. I don't know how many of our listeners are due to herbs or not, but if you open any of the, of the new textbooks, uh, even, even, uh, the classical textbooks, like, you know, like, uh, Ben skis and, and you look at, uh, symptoms of cardiology, uh, there are so many herbs and herbs categories that cover different aspects of, of, of, uh, cardiovascular conditions, which is amazing. For example, the blood moving herbs sections, which is one of the biggest sections, almost each and every one of these herbs. We know for a fact, even from a Western perspective, these days that they have, they have, uh, functions or from a qiological functions that affect blood circulation and cardiovascular function, so and so forth. So, so like, like we have all the tools, why not use them?

Why not use it? Well, let's, let's get into some of that. What are some. Some basics that people should know about. I mean, maybe they're not going to become Chinese medicine cardiologists, although it sounds like you've got some learning resources that will help people with that. We can get into that later, which is someone in their regular practice. Maybe someone comes in, they've got they're on statins, or they've got some kind of cardiovascular issues about arrhythmias or something. How can we begin to at least think about and start to cozy up and approach some of these issues. So we, so we can learn and build our confidence and maybe learn a few more things after that.

So I would say a good start would be cardiovascular risk factors. So when you treat patients like you, patients that suffer from hyperlipidemia or, uh, or imbalances of lipid profile, these patients don't evolve any, any. And the immediate risk treating them that doesn't involve any immediate risks. So treating these patients with acupuncture and herbs is a good start treating high blood pressure, which we've all even learned in school is a good start. Mind you treating blood pressure is, is tough. It's not, it's a tough cookie. It's not an easy cookie to crack. And of course the worst meds work much faster, but, uh, but still we get good results. If we integrate. Uh, our patients with lifestyle modifications and acupuncture and herbs. So that's, that's, that's another one. And I think one of the most surprising things for me over the years, how effective acupuncture, acupuncture, specifically acupuncture is for treating palpitations and arrhythmias. It's, it's fantastic. And even if you do the, you know, simple things like, like removing excess, uh, accumulation of chiefs, technician from the liver, which is affecting the pericardium and is causing palpitations, something really simple, like using a, you know, specific, simple tools, you know, like in PC six and global 34 and liver 14 and stuff like that, CV 17, you get actually really, really interesting and good. Again, if, if, if your central analysis and then your diagnosis is correct, then, you know, starting with a simple things, you know, like high blood pressure, like lipid profiles, like sugar and balances, the, these are good things to start with. Then later on, you can, you know, you can, as you accumulate more experience, you can move into things like Hartford. You know, the holy grail is heart failure because we were able to help patients with heart failure, which is, which is, which is amazing. Um, yeah. I

want to get into that in just a moment, but I want to come back first to the arrhythmias and palpitations, because I mean, I see a fair amount of patients who have had arrhythmias and many of them opt for this ablation surgery where they sneak a wire up and they find the part of the heart that. Misbehaving from their point of view and they just, you know, Carter eyes it, right. What do we have to offer to those kinds of patients that have this kind of an organic. Arrhythmia.

Okay. That's a great question. The ablation procedure, where they actually enter with a catheter and they tried to either burn or freeze tissue that the suspect is causing the problem. This procedure normally is, is conducted for patients that have a February atrial fibrillation, which is a very common, uh, which is a very common arrhythmia. Um, they do that also for people who have multiple premature heartbeats, if they have more than 20,024 hour ECG. And they also do it for several others, but most commonly and the most common arrhythmia, in fact, from a Western perspective is called a February atrial fibrillation. And I see many of these patients. I see quite often, I see quite a lot of these patients because this is like the most common arrhythmia. So definitely we can help. Now this depends on the stage or phase of, of this patient, for example, cause atrial fibrillation has three distinct stages. The first thing is called paroxysmal or it used to be called. They changed the name now, but it Parak, SysML where it actually comes and goes spontaneously. And the second phase, when it's good, it's called like a persistent airfare, but it comes and doesn't leave unless you go to the hospitals and get either an IV drug or a electrical shock to the heart. That's the second phase as persistent. And the last part last phase or the worst one is called chronic patients actually live with their atrial fibrillation. Obviously like everything, I'm Chinese medicine, we can be most helpful. The first group, the group that has, um, perks as more atrial fibrillation, they have these bouts of, of, of arrhythmia, of heart high and irregular heart rates, which can go up to 160 and even more. And, uh, depending on how long they've had it, some patients, we can almost completely eradicated if the, if they came in early enough saying let's say within a year from diagnosis. And even with the patients, patients that have had this more than a year, we can, if not completely cure this, we can definitely put them into remission or long, long remissions or reduce what is called the AFM. If a burden is how many bouts they have each week, how long is each one? Um, and how severe are the symptoms? So often what we do and what we see is once we start treating these patients, they have initially where you see that they have less a AFib attacks or bouts, and they have, um, the duration is less, instead of being 12 hours, it's only like two hours. And then, and then the symptoms get so much, but if they don't, they don't feel a symptom as much. And this is a good indication that you're in the right direction. Having said that it's still a tough condition to treat. And I think, you know, most patients come in and they say, I want to get rid of this. Can you get rid of the risk completely? And this is kind of what they're expecting would the ablation as well, which

sometimes they can't. Sometimes they can't write

ablation success rates go anything from 50% to 90%, depending on the person on the condition, on the location of the, of the it's called the ectopic area where the, or those beats are, and also on the, on the skills of the surgeons. So definitely there's, there's success rates are varied and it's, it's, it's also the same for us. I mean, some patients we get, you know, uh, we completely stop their AFE belts. Some patients we reduced their AFL burden, uh, quite significantly, you know, to the fact that they have maybe one episode for like an hour or so every few months, which is something, a bear I'm still bearable. And, uh, with some patients we don't succeed, uh, I would say so an aging population is just one, one condition, but there's another very common condition, which a lot of people suffer and that's premature heartbeats. Premature heartbeats or they're called PVCs or APCs, depending on their origin. And the heart are very common. It's like, um, you know, the commonly called skipping, skipping heartbeats or skipping beats where people actually feel it either like a skipping beer or like a pause or like a, several, just for a few seconds, they feel like three or four or five or 10, uh, fast beats. And they come and go. And this, this is a condition where we, we actually are extremely helpful and, and, and the success rates are very high. Like, oh, I'd say more than 90%. And the condition by itself, uh, is not a life-threatening condition. If you want to start with treating arrhythmias and then then premature heartbeats is something which, which is, it's a very good start because the results are excellent with acupuncture and herbs. It's not a, it's not a life threatening condition. And, uh, many, many of these things are triggered by things that we know how to treat in terms of, you know, stress and sleep and food. And so on. Maybe one more thing I want to say is, is, is, is, is, is a strategy of how we treat arrhythmias and the strategy. Tweeting. It's like a root Bernan bureau. It's a root and branch strategy. You want to eat the differential diagnosis exactly. As you see it, but you also want to want to treat triggers the many things that actually trigger arrhythmias, for example, a big meal in the evening, triggers arrhythmia, for example, a blood deficiency or anemia of the tendencies is higher of obviously stressed as though, but there's also things like pasture patients that have arrhythmias when they lie on the left side, have more with me. And we find areas like gallbladder 24 and liver 14 to be tender there. And once you desensitize those areas with acupuncture, then, then you eliminate those triggers and they can lie on the side. So there's often we, we look at triggers and we looked also at the root cause. Wow.

Can we just a moment to collect my thoughts here? This is a lot of information, you

know, I can go on for days of cardiac.

Well, you know, it's just going to comment on the, uh, premature heartbeats. This is something we see a lot in clinic because we've just got to take someone's pulse and we go, oh yeah, kind of intermittence. Yep. Yeah. We, I mean, we see this a lot. Right. You can probably see it several times in a week. Yes. Is my suspicion. And quite often, just whatever you're treating, whatever they've come in for and you're treating with acupuncture. Yeah. I mean, generally that's going to go away in treatment. Right, right. Often, cause it's got our attention and we're looking, you know, can we get this pulse to even out? Exactly. So that, yeah, it, it responds really well to acupuncture. And in terms of the arrhythmias, you know, maybe in between the premature heartbeat in, in sort of that first stage of, uh, of AFib, any herbs. In particular, any formulas in particular that you find yourself using a lot and again, any acupuncture points or combinations that seem to show up on a regular basis for these?

Well, th the, the nice thing about this is this is cardiology treatments with Chinese medicine is not rocket science, Chinese. It's more simple that people think, okay, if you follow your and uh, you know, I'll, I'll, I I'll apply it in the second, like major differential diagnosis, but basically if you follow your TCM syndrome, differential, differentiation, then you're, then you're on the right track. But still yes, there are different. I would say this, the arrhythmias that respond very quickly to our treatments are the arrhythmias that involve things that have to do with emotions, Liberty stagnation, invading the pericardium Liberty stagnation, evading the prerecording and moving to the shaoyang. For instance, also, uh, with, with, you know, with tension in the neck and headaches and migrants, liver, blood deficiency, uh, with women, especially more palpitations are more with me as after the menstrual period, for example. So, so these are things that respond very well. I often use for these things. I use really simple things like, you know, Goldblum the 30 fours, CV 17, and, and that'd be liver 14. And, and I guess the key sign symptom would be. Uh, we used to call this hypercarbic pain, but it's not necessarily that I see that on a paper where people sign a lot when they do this.

Oh yeah. Oh yeah.

That repeated sighing. Right. And then immediately I checked for tenderness on these points on the money and all liver 14 global at 24 and often these points and tender. And when we release that, basically the sighing is, is just basically what this is. You know, some people come in and they say, I'm short of breath. Is this, my heart was going on. We have a heart condition. It's no it's. And, and, and I tell them, listen, you are aware of the fact that when you have stress, sometimes it goes through your shoulders and shoulder blades. Right. And they say, yes. And I say, well, but there's also muscles between, between your ribs, the call, the intercostal muscles. And you can take, you can take stress. Many of us get stressed in that area. And what that does, is it congested? It could just your rib cage and when a congest, your rib cage. You find it difficult to get air in and you do this, these, this attempt to get air inside and that, and when people realize that, first of all, they come down, they said, okay, so I'm okay. It's not my heart. Right. I'm not going

to die of a heart attack. Right. It's

it's just, yeah, it's just a, it's just tension and something as simple as Goldberg 34, number 14 for this kind of condition within one or two treatments, it gets you 50% of the way there. So yeah. Always look for these people, that site a lot.

Yeah. Yeah. I've, I've, I've seen that so many times. I often see it as a liver condition and it's really congesting the diaphragm as well. Yes. Yes. You get that. All of them open up and, and then the cheek has flows in both directions and it's so much better.

And I do want to say one more thing. I don't know if this is the time to say it, or, but I can say that for me personally, the breakthrough, in my understanding that my treatments are very effective in terms of treating arrhythmias as when I bought from Amazon or eBay, a handheld ECG, which is something that you can buy for under, under a hundred dollars can held handheld ECG as what handheld one lead ECG. What that does is, you know, when you feel the patient's pose and you see the arrhythmia, you say, you will let me, let me, let me, let me record this for a second. And you can record that and you can count how, how many VPCs they have in, in a sub 32nd stretch, uh, stretch or two minutes. And, and then you actually see that the, the before and after the treatment, the improvement, and it's totally

measurable. And people love that. People love to see that kind of thing. Oh yeah,

yeah, yeah. You print it out to them. You still here's the before here's the, after you had, you had 25 VPCs before you have eight now after then they see how from week to week, it kind of decreases. So, you know, people in the Western world, they love them, you know, the measurements. So you know that for me, that was like the best investment in my cardiac cardiovascular. And by the way, now I use like, uh, monitors and ECG, and I have a bunch of other things that I'm using, but this is how I started that. It was kind of show me, man. I'm not just, you know, I can measure the success that's, which is something which is, you know, with dermatology, you see it with cardiology is often very elusive, right?

A hundred bucks on Amazon. That sounds like a great investment

at the

time. Now for a quick break earlier, I promised you I'd explained how the Chinese character for this. Actually instructs you and what's involved in listening. The characters pronounced ting in the traditional form is made up of the characters for ear eyes and ready for the. Heart makes sense. Doesn't it to listen to really listen. It involves all of these senses. I hope that you find listening to qiological stimulate your mind and heart and helps you to better help your patients. If you feel inclined to help support the show. I've created a Patriot on page. So you can contribute to this endeavor by becoming a contributing subscriber. In addition to feeling the satisfaction of knowing you're helping to support a podcast that you love. There are a few special goodies available for those contributing subscribers. For those details, head over to chia, logical.com and click on the Patrion button to help keep a little inspiration in the teacup. And now let's get back to the rest of today's show. I want to come back to another one of these common risk factors and that has to do with lipids cholesterol. No, there's a lot of talk these days. That cholesterol is not the demon that we used to think it was. I mean, yes. Yes. You will find it in occluded artery. But yeah, there's some talk these days that will, cholesterol is not the issue. There's something that's causing the cholesterol to form there and to collapse, but you know, every single cell membrane of our body needs cholesterol, all the sex hormones need cholesterol. I mean, there's a lot of body processes. Cholesterol is not the enemy. Right. When you're thinking about working with lipids and cholesterol and all that stuff, statin drugs. What are your thoughts these days? How do you work with, because this is something a lot of people come in with it again, it's like the beginning of the cardiological journey for a lot of folks cardiological. I think that's a new word. Yeah. What do you do with this? How do you work with this stuff? Okay.

So I think the first thing I would want to emphasize is. Relative risk. And let me, let me say what I mean, there are two models from Western perception perspective, there are two models of, of, of how you should treat lipids in the us. It's very simple and it's often industry driven. Uh, if your cholesterol is above a certain threshold level, you should take your steps to reduce it. Okay. Regardless of other conditions in Europe and specifically in the UK, they follow a different, a little bit of a different model where they actually calculate the overall risk for a person to develop, uh, cardiovascular conditions. So meaning that if you have high cholesterol and you have high blood pressure and your sugar is out of balance, and you have a family history and you have a set of lifestyle and you're a smart. Okay, then your risk factor is much higher to developing cardiovascular or coronary artery disease. And then they give you a score and they say, okay, according to the score, we need to reduce your lipids to a certain degree. So this is something to keep in mind. So this is kind of like in general. So that's the first thing I want to say. The other thing is, which is even more important is kind of what, the point that you mentioned. What's the story with cholesterol? Well, obviously cholesterol is, is a huge, uh, necessity for the body, for the, you know, for the sex hormones, for the cell membranes, for the glial cells in the brain. So in the body is producing cholesterol because it needs it. So. Killing LDL to levels, which they try to do now and be below a hundred or below 70. And even they tried to do this primary prevention. Now let's say to giving kids Statens to prevent like aspirin to reduce it's horrible. This is like a horrible thought. And I would go get into my take and how I deal with this in a second. But I'm kind of doing like a whole overview stat. Is the holy grail drug of, uh, of the 21st, 2020. And, uh, and, and early 21st century, that's, well, that's a blockbuster drug and they're making a lot of money on that. So obviously that influences the policies. Having said that they have shown in mega clinical trials that reducing cholesterol levels does save lives. You can't argue with that, but I guess the key would be the overall assessment of risk. So let's say, uh, your total cholesterol should be up to 200 and the patient comes in and they have 240 or something, 240, but they don't have any other risk factors. You know, I tell them. Hmm, this is cool. This is okay. And I'm not feeling that I'm taking a risk there, so they may go back to their family physician and he would say, no, no, no, no, no. We need to get you closer. But below 200, it's their decision and, and research, like you've said, recent research is showing that, uh, maybe it's. Exactly what they thought before and taking it in mind that the side effects of these drugs. And I'm seeing that because I see so many, I see patients right after they have a heart attack because they come to me as part of the rehab, a rehab program. That's where they're on high dosage of since the 80 milligrams a day, a hundred milligrams a day. And that's when you see all these side effects and the side effects go, anything from, you know, the muscle pains are just the common ones and the simple ones, but increased risk of diabetes. There's the increased risk of damage and memory, memory loss, a transmitted memory loss. I just, you know, I just had a patient, um, 48 years old had a heart attack. He was on these, uh, stands of, I think it was 80 milligrams with day. He runs FA plant or a factory where they actually produce this algae for four. And he couldn't remember the name of the LG that he was producing. And the plant there was that it was that bad. And once he got off. So, so definitely there's the side effects. But on the other hand, if you do have a patients that have had, you know, one or two heart attacks before, and they have other risk factors and their total cholesterol is a hundred, 280 and their LDL bad cholesterol so-called Belcrest is as high. Yeah, definitely. These patients do need to take steps to reduce, or maybe not started, do need to reduce their cholesterol levels. Right.

They need to do, and they need to reduce the risk factors. What I'm hearing you say is like here in the states, you get a test, oh, it's above this mark that equals a stat and deficient. I mean, of course there was no such thing as a statin deficiency, but, but they act as if it is what you're saying, what I'm hearing you say, there's the levels of cholesterol. There is your blood sugar. There's your hereditary factors, your lifestyle. I mean, there's, there's a whole three dimensional picture. Yes. That if you take that into consideration than a number on a test, it has a different meaning. Yes,

definitely. Yeah. And one more thing I want to say about that is, and I have to say I'm contemplating this on, on my, uh, myself. I don't, I'm not sure I have a hundred percent. My take is not a hundred percent on that yet. I'm still developing that, but on the one hand, Obviously we do need, uh, leopards and cholesterol on the body. But on the other hand, I, I've definitely seen that patients that undergo, for example, a very stressful period, especially young period, all of a sudden, and we see from a Chinese perspective, it's very obvious, like it's a joy in the repair cardiac issue or, or liver gallbladder issue. All of a sudden they have increased cholesterol. So that indicates to me, this is a patient that, uh, despite the fact that his cholesterol is not very high, I still want to, because it's presenting as, as a whole, as part of a bigger disharmony with these patients. Yes. I would treat them even because I'm, cause it happened just recently or in conjunction to when they had a very stressful period and you see all these other symptoms of liver, pericardium and Goleta. And so you say, okay, so this is a patient that we do need to rebalance. And we see that, you know, we treat them for two, three months and the closer goes, Google goes back down and everything comes back to.

I want to come back to this thing about statins and memory loss for just a moment. I'm familiar with the muscle pain that people can get from statins, because sometimes people come in because of body aches and pain. And what we discover is, well, they're actually, their statin drug is causing that. So how do we treat your muscle pain? Well, let's treat the reason why you're on a statin drug. I mean, that's a very common side effect. I think all of us see it, this thing with your memory loss, this is the first that I've heard of this. And it makes me wonder about people that have been on statins for years. What might this do to memory, you know, over the course of a decade or two, have you got any thoughts about.

It's an interesting point. Um, okay. I started to notice this, I'd say years ago, 5, 6, 7 years ago. I started to notice this location. I, and I, I, I'm constantly on top of research on that because I'm, you know, I'm because of my scientific background, I, you know, I get alerts on studies and so on and so forth. And I started looking into seeing if the ears are any indications from a Western research, uh, perspective that, that, that there are indications of this is true. And I didn't find anything. However, and the past two or three years, this starts to come up and you see, initially it was just initial case studies and just, you know, six months ago, I actually saw a study that actually showed that, uh, there's there's. They still call it transient short-term memory loss with high dosages of stents. So they, they, and I remember it. I was, you know, I was talking to the cardiologists that I work with years ago and say, do you guys see this? And they were saying, no, no, this does not happen. I said, but I see this with patients maybe because we ask more questions. Really. We see these things that they don't. Right. Uh, and there was saying, and even, and now, recently I started hearing, even from cardiologists, you know what we've heard about this, it's still not established there's this isn't research research. They haven't shared anything that goes, but we've heard about this. So it's kind of like a new thing or they're that they're kind of looking at, but I do want to say that again, from what I've seen, patients that are. On high dosages once they reduce their dosages, this, this goes away. But coming back to what you're asking, that's a great question. I don't have an answer for that, but that's obviously intuitively I would say if someone is on a statin for a long time, I would like to see a research on the link between dementia and Alzheimer's and Stanton's, uh, and you know, a retrospective study going, going like 20 years back. And see, I would definitely like to see that. I dunno if anything anyone's doing that, but, uh, I'd say the risk is there. The risk is there, but you know, again, it's not established. Are you

familiar with David Perlmutter's work?

I'm familiar with his name, but no, not as

often. Jewish boy from Florida, he's a, he's a neurologist and he's, he's kind of, he's one of these popular docs in a way. And he's written a book. What was the name of his. The name of the book escapes me, but he's been looking at Alzheimer's and dementia and that sort of thing. He's big on controlling blood sugar. He's big on, he thinks of all the timers and dementia is kind of a diabetes type, three long-term issues. And one of the things that he's seen is the increase in statin prescriptions. It seemed to correlate with increases in Alzheimer's over the past couple of decades. Now, whether there's actually a connection or it's coincidence or, you know, what's actually going on, we don't, you know, I think it's. Ground for inquiry, but he's done some work in that area,

you know, as you, as you were speaking, I just Googled Statens and memory loss and I didn't even have to complete the sentence. You know how Google it already knows what you're

thinking.

Yeah. So it was doing, it was doing stuff. And I just go in, I see this study from 2015 standard therapy and risk of acute memory impairment. I'll go jump down all the way down to the conclusions and I'll just read it to you. It just two lines. It says this both Statens and non Statens LDLs were strongly associated with acute memory loss in the first 30 days following exposures to use. So obviously there's research on this now, too. So it's not, it's not it's, it's, it's, it's more, it's becoming more and more established. And,

and what's interesting to me about this. We're talking about the heart. We're talking about the blood, the emperor. Yep. Yep, yep. And, you know, memory. It's part of the domain of the heart.

Definitely, definitely is a part of the domain of the heart and the blood. And then in the ShaoYin. Exactly. So normally when we look at poor memory or memory loss or poor concentration, we'd look at liver, heart liver, blood deficiency, uh, heart liver, blood deficiency. Now again, if we're trying to see what the status do from a Chinese perspective, well, they cool and they reduce dampness InflammaDry. What they're doing is a kind of drying up the blood a little bit from, uh, again, uh, causing some, but I can't say that I've seen classical symptoms of blood deficiency with people that are on high doses of stem. So I, I really don't know. I really don't know there is a mechanism that we can explain that, but I, you know, I guess I'd have to kind of further inquire

that. Yeah. We were talking earlier about. Something that is sort of the next phase of cardiac cardiologic risk factors. And you know, one of the big reasons that people go to cardiologists and that's heart failure. Yep. What can we do about this?

Okay. Let me start with just a recent case. Study, a case example. I have a patient she's a nurse she's 48 years old. No, sorry. She's 58 years old. She has cardiomyopathy, which is basically an enlargement of the heart muscle, which is causing third degree, heart failure. Uh, Hartford is also divided into classes, class one, class two, class three, it's called the New York heart association classification. And it basically had to do with how much dyspnea on exertion you have, if it's. You know, if you just, when you walk up the hill or if we walk a straight or if you, and if you just sit there and have this one, then it's the higher class and so on and so forth. And the gold standard measurements for that, or, uh, they do the echo echocardiogram where they actually see how strong the heart is pumping. It's called ejection fraction, how strong the heart muscles working. And they also use other blood markers. One of them is called BMP. So we started working with this patient. So maybe like four months ago. And on top of our heart failure, she also had. Multiple premature heartbeats. And when she came in and she said, do you think you can help me? And the first thing I told her is, listen, you have a severe heart condition due to your heart failure, but it's aggravated to do something that I think we can easily treat. And the first thing that I started working with her, she had, she had heart and lung cheat deficiency with, uh, or the inefficiency in, uh, uh, lung Cheney and deficiency. And she had lived, she said she was a sole parent. She's a sole parents. She has a OneCare to tons of stress in her life. Um, also, um, so we started working in, you know, first reducing the, the, the, the excesses or, you know, it was, again, it was the liver pericardium goal, better access and. And within three or four weeks, she started reporting. She has less and less palpitations. And as her heart pounding and less of these sightings that we mentioned before, and, and in, uh, in my clinic, I use those ECG as routine. Now, as soon as they come in before, uh, the, the secretary takes the ECG before the treatment and as they go out, we do it again. So, and we started seeing the reduction in the BPCs and she started reporting feeling better, but surprisingly after three or four months, She did another echocardiogram and she comes back really happy. And she says, I look at this hat of an improvement in my it's called ejection fraction or E F it's the degree of strength. And there was like more than a 45% increase in their F and she was blown away. Everybody was blown away because she had like a two, two or two between two or three degree, heart failure. And she was back to, you know, back to like 1 0 1 to two.

Wow. Now, is that something that Western medicine can do? Is that something that like regular cardiologists can.

Actually no, the best drug that they have now, it's called Entresto. It's a combination of two drugs. Uh it's it's it's gives some relief, but I would say in her case it was the integrated therapy because she got this drug. Well, she was on this drug anyway for six months, we didn't, but we added what we did. And I think the combination did, did, did the effect, but the, the degree of change is something that they, they, I was told actually I was invited to, to her hospital to, to talk to a physician and they were saying, yeah,

so there's some, they got curious about why is she getting better when it's impossible to get better?

But I was lucky in this case because, because her physician, I used herbs as well. Okay. And we'll talk about herbs in a second. Her physician was, was one of them. Younger physicians and her, uh, heart failure, specialty ward. And he was the first one to say, listen, this is very, there's not a lot we can do for you, you know, go for acupuncture, go for herbs. And he was saying herbs, normally I don't, I don't see that. And, and, you know, uh, and being a nurse, he said, you know, there's no way I have to ask my physician if I can do herbs first. And I said, yeah, go ahead. And so we were able to use acupuncture, herbs, and acupuncture in conjunction to herbs, the 4 million, the two formulas, the main formula. Worked with her where the first one was like, uh, that, uh, sandwiches, a simple formula for liver, uh, in conjunction with shaoyang my son, which is tonifies the heart, the heart and lung and chest. She, that was kind of like in general, the formula. And we had some blood tonifying herbs. So I would say that the, you know, the treatment principles were, were those really simple, you know, work on the, again, uh, liver pericardium, Goldberg access for the excesses and tonify the heart, chest and lung for the deficiencies that it was cheesy and UN and, and the results were great. Amazing.

Wow. That, and it makes sense. I mean, I've heard as we've had this conversation, you've been talking about the liver pericardium gallbladder axis, and here's a great case of you calm the liver down, you strengthen the heart a bit. Yep. And things can dramatically change. This is, this is such. Encouraging news.

Yes. To hear it. I think so. And I've seen these things or when I was in China back, you know, back in, or what is it almost 18 years ago, I've seen, I've seen it there. So, you know, it doesn't come as a, it didn't come as a surprise over the years, but, but I have to say, you know, again, it depends, definitely. Let me give you another example. I have an elderly patient he's 84 years old. He has both heart failure and AFib, uh, which is a nasty combination, but he's, uh, he's too old to get ablation surgery or any other surgery. And he, he was actually quite fragile and weak. And I started doing, I, you know, initially I just did just at PC six for him, for like that, just one point bilaterally for three tweets. And we're getting, we're getting great progress. Um, he's getting less bouts of Bethenny's dyspnea. So sometimes really simple things can work really great sometimes. Yeah, you need the more comprehensive, all included herbs, acupuncture, formulas approach. Uh, again, this is a, this is a new patient. I've only had them for three weeks. So I don't know. We'll see as time will tell, but, but definitely I'm seeing changes.

Can I ask you a question about PC six? Yeah, this is, this is such a beginner question, but in some ways, PC six is a point that sometimes really eludes me. And the reason being is I, I go to, it depends on a person's physiology. There's often veins running through there. There's lots of tendons sometimes where I think PCs six should be. There's no way to get a needle in there. Cause there's all this, there's all this, you know, heart, you know, not hardware, but you know, there's all this stuff that's in the way. What do you do about that?

Well, first of all, are you, all the time I almost have to. And I'll reference you to, uh, uh, I dunno if you've heard of Robert Jones, Robert Jones used to teach acupuncture techniques here at my school back in again in 1998. And he has a book on acupuncture, needling techniques. And in this book, uh, he has a chapter which is called the wild card, the wild card, the wildcard. I like that. PC six explains why PC six? Yeah. It's like a jackpot, a acupuncture point. Okay. So, uh, of course in cardiology I use a lot. I always find a way to get to two inserted. Sometimes it definitely, you need to kind of press the separate the tendons. Sometimes you have to move aside the vein. Uh, if it's there, sometimes you have the kind of, I would say this, if there's a vein crossing and normally they cross, they don't necessarily go with the, the, you know, uh, this is, this is teachings of Dr. Wong, Joey. He always says go, uh, proximal to the vein immediately proximate to the vein and needle the point. And if you can't move it aside. So I would say the jackpot is worth the effort of trying to get in there for the wildcard. And I'm sorry.

So sometimes you got to go move stuff around a little bit, a little bit. Yeah. So it's, you know, I mean, so often with points, it, it's not a textbook location. It's, you know, it's in this area and you got to see what's actually there. Yep. Okay. Anything else that we should know in getting started with Chinese medicine, cardiology,

gold standard. If you do have a chance to visit a cardiology award in China, obviously this would be the best way. Of course not. Everybody can do that, but if you can do that. Don't hesitate. If you thinking about cardiology, go and see what they do over there. So that's the first thing. Next thing, there are some books, there's a Phillips in oil and Bob floss book on cardiology, uh, which is a nice book. There are several Chinese translated books, those paperbacks on, on Chinese herbal cardiology, which, which you can pick up, which are not ultra inexpensive, you know, books or books. You never find the right formula in the book, but it gives you yeah. But, but they, they do kind of give you a nice direction. They remember for me as a starting point, there was, these was really, these were really good starting points. There's always the notion of, of drugs and herbs and drug herbs interactions, which is, oh, yes, that's huge. Yeah. And I would say this it's, it's not as. As we think it is, it's definitely an issue, but at the end of the road, there's like a bunch maybe turn herbs that are the troublemakers. So-called on the one side and there's like 10 drugs on the, on the Western side. Maybe, maybe later on we can attach something to the podcast. I can give you like a list of, of, uh, what I see as the big troublemakers. But in general, the thing to take a look at is. As you know, blood, blood thinning drugs, and, uh, uh, and, and on blood moving herbs. Okay. So big ones are like Don ShaoYin and, uh, and way, and, uh, by go get, go. Those are the big ones. Again. It's not that I don't use them. I use them, I use them all the time, but these are the things that kind of to, to, to take a look at. And that's one thing you want

to be cautious

when you're using those, because when you use those, and of course, obviously also the blood, the blood telling, uh, w when your patients are on blood thinning drugs, and, you know, patients that are. Longterm for me. I always like if I have patients going on herbs for a year or six months or eight months, I always have them do blood checks every two, three months, you know, to check their kidney function. Liver functions is to assist nevermind what the condition is. So it's something to take a look at. Uh, it doesn't matter if you're treating lipids or if you're dating. Heart-failure. I mean, if you're giving patients herbs for a long period of time, you know, take a look at their, their liver functions and kidney functions. And I also do it like the six, one thing I have patients always take herbs for six days and then one day off. So they only take, uh, six days a week. They don't take it

seven days a week. So a day after the Sabbath.

Exactly, exactly. I think one of the most important. In terms of starting a starting point is also trying to establish some kind of a communication skills with Western physicians. If you want to have referrals, you know, go into pub med or Google, get some research on Chinese, on acupuncture and, you know, show physicians this, and then this has, this, does the stuff supporting this and you, you know, can kind of establish a relation with, you know, open-minded cardiologists. And I have to say that that. I see, uh, that the new generation cardiologists, the younger ones are actually more open-minded it's, it's either there or the end of many of the really harm. Now the professors that have been out there and like the key opinion leaders, which have nothing to fear anymore, and they are aware of the limits on the answer on the one hand, which are open. And on the other hand, you have the young guys, which are, you know, I've been brought up on a holistic medicine as well. And the, and their opener, every, every, everyone in the middle is kind of more difficult.

Right? And if you use research, that's speaking in their language, it shows respect for how they work and how they think. And, and you've got a common way of communicating about how, you know, both of you can work together to, to help the patient. And really that's why we're in medicine. Yes,

definitely.

Ammas thank you so much for making the time. This has been really eyeopening for me and hopefully for the listeners as well. Thank you. Anything that you'd like to send me in the way of lists or links or documents like you were talking about? I'll make sure it all shows up on the show notes page. So folks, just head over to the show notes page, you'll get all that good

stuff. I'll send you some links and some notes. Definitely. That sounds great. All right. And I would encourage everybody to do now take a look at the opportunity of Chinese medicine cardiology and treating, treating the heart emperor. Yeah.

If there's one takeaway that I've gotten from this is that in many ways we already are too, because some of these early risk factors, these are things that people come to us. They've got other issues that they've come to us with, but it falls within that wheelhouse. It falls within what we do. And so, even though we may not think we're working with their heart, In some ways we are we're at the, you know, especially at the early stages.

That's very true. That's very true.

Yeah. And I love the way here you are Chinese medicine cardiologist. And when I hear you say, we're working with the emperor and I, and I hear the respect in your voice, I'd love to get a closing thought on just how we approach and sit and work with the

emperor. I think in the old days, first of all, you came in to the hall of the entrance hall and you could see the upper from a distance before you could approach him. And then there was a, I think, you know, at least from what I'm imagining you would approach and you would, uh, maybe bow or maybe show some other gesture, physical gesture of respect. And so putting that into practice, I would say that offer, I don't jump straight into treating. Hard points. I may treat the liver, try to influence the pericarp by the liver. Maybe get some excess out of the gallbladder to reduce the liver from invading into the pericardium and affecting the heart and kind of slowly cover that distance of, uh, in the entrance hall to, until you get to the heart. Uh, there are some practitioners that say that you should not be needling hard points at all. There are some books that say that I don't use that approach, but I definitely take time conveying this respect by kind of slowly moving closer. So I was

like, great. Before. I'm ask again. Thanks for being here on qiological

today. Thanks for inviting me. It was a pleasure. That was great.