124 - Dr Elizabeth So - East Asian Medicine & Acupuncture

Episode 124 of the Long Covid Podcast is a chat with Dr Elizabeth So about East Asian Medicine. We take a deep dive into what EAM is and some of the background to it, as well as how it can help with conditions such as Long Covid - and why!

This was such a fascinating discussion - we could have carried on for hours - and one of the biggest takeaways for me was the need to work together. That, and I've basically committed myself to trying Acupuncture now...

Elizabeth's website: www.awakenacupuncturenyc.com

For more information about Long Covid Breathing, their courses, workshops & other shorter sessions, please check out this link

(music - Brock Hewitt, Rule of Life)

Transcript

Jackie Baxter  
Hello, and welcome to this episode of the long COVID Podcast. I am absolutely delighted to welcome my guest this evening, Dr. Elizabeth So. And we are going to be diving into the mystical, magical world, that actually isn't so mystical and magical, of Chinese Eastern medicine. So a very warm welcome to the podcast. I'm really excited to have you here tonight. 

Elizabeth So  
Thank you so much. I really appreciate you having me. I have listened to your podcast and absolutely love it and have been so inspired with the work that you've done to raise awareness for long COVID. It's something that I am personally, maybe obviously, very passionate about. So thank you so much for your work. And thank you for having me. 

Jackie Baxter  
Well, it's my pleasure. So to kick off with maybe can you just say a little bit about yourself and what it is that you do? 

Elizabeth So  
Yeah, absolutely. So my name is Dr. Elizabeth So, my title is a DACM, which is Doctor of acupuncture and Chinese medicine. I'm also a licensed acupuncturist in the state of New York in the US. And I am also what is known as an NCCAOM diplomat, which is lots of letters behind my name, which basically just means I'm a Doctor of acupuncture and Chinese medicine. And I specialize in a lot of complex chronic idiopathic diseases that have very, very stubborn responses and are very treatment resistant to Western modalities. 

Jackie Baxter  
Yeah, I mean, my next question, like, what is Eastern medicine? So that's probably a good starting point?

Elizabeth So  
Yeah, great question. Yeah, it's a good starting point. I feel like that's the question I get every single time I start working with someone new. And it's almost like people don't necessarily know how to ask that, because they're like, what exactly do you do? What does that mean? And it's a very hard to understand answer if you've never worked with an acupuncturist or a Chinese medical doctor before. 

So definitely happy to explain. In terms of what people know me to be for, if you are going to go to somebody with a DACM or an LAC license in the States, they would be someone who would probably be focusing predominantly on acupuncture and Chinese herbalism, potentially. But really, it's the entire umbrella of East Asian medicine. Some people will tout the letters TCM, which is traditional Chinese medicine.

But I refer to it and what I do as EAM, which is East Asian medicine, because my training is not only in Chinese medicine, I also have some background in Japanese techniques, Taiwanese techniques, Korean techniques. So saying East Asian medicine is a little bit more inclusive, at least for what I do. And some people stick more to the just the TCM route, but I am an EAM practitioner. 

And so East Asian medicine includes acupuncture, herbalism, using the Chinese formulary, which is usually not just single herbs, like you would take St. John's Wort for example, or Ecchinacea, it would be a combination of a bunch of different herbs that are meant to be really balanced. So Chinese herbal formulas. 

And it also includes things like moxibustion if you've ever heard of that. Cupping, which most people know about guasha, which is sort of a scraping technique, medical versions of massage or physical manipulation, as well as nutritional guidance, Eastern nutritional sort of customized profiles, things like that. 

So it's sort of this very, very well rounded, what I like to refer to as spherical medicine, that incorporates all aspects of a person. And what people mostly know is acupuncture and herbalism. But it's actually very, very in depth with other aspects of health as well.

Jackie Baxter  
Wow. I mean, it's, in fact, when you messaged me, I was like, I'm interested. But I also have no idea what you're talking about, which was kind of why I really wanted to do this, because I thought this is going to be absolutely fascinating. 

So you know, we've all, Well, I think most people have heard of acupuncture, and most people have heard of, even if they don't really understand what it means, when you say things like Chinese herbs. But kind of all the other things you just mentioned, were much more of a surprise to me, which is pretty cool. Because it means that we can take a bit of a deeper dive into all of this. 

What I would love to know is like, what brought you into working in East Asian medicine. What was your kind of route into it?

Elizabeth So  
That's a really great question. I always when I was younger, you know, when you're a child and you're like, oh, I want to be a doctor when I grow up. I always thought that I wanted to be a doctor, but I pictured the kind of medicine that I would practice to be more like what I do now, you know, being understanding health as not just times where you do need medications, of which there are many occasions where that is appropriate. But to also work with people on health guidance, like nutritional guidance, or maybe mental wellness as well. 

So I started out my undergrad program as a pre med student with a major in psychology because I thought I wanted to be a psychiatrist, who would work with people on maybe even art therapy or things like that. Something that really incorporated the whole person. Maybe working with people on like, exercise, but also art therapy and talk therapy, and then also working through somatic body issues as well, or having a medical, Western medical background to understand what their, like physical maladies might be. 

And so I had this very clear understanding of how I wanted to practice medicine. But as I went through my program, it started to become clear to me that that wasn't really the route to do it. And so I sort of dropped it. And I did other things. And I went on a self exploration journey, and I thought I would drop medicine forever, because there wasn't a version of medicine that I had come across that I felt like really resonated with how I felt medicine should be practiced. 

And after several years post grad, I realized that what I was really looking for was Chinese medicine or East Asian medicine, because of how rounded out it was, and that it doesn't sort of isolate any one particular body system, any one particular aspect of health. There really is all of this room under the umbrella of East Asian medicine for everything, you know, the mind and the body are one, and you can't kind of divorce one from the other. And I think the mind body connection is very emphasized in our practice, but also, you know, environment, right, or like food, or all these other things that make up a person's general sense of wellness. 

And I was so invigorated by that. And the more I sort of started turning over that rock, I was turning over another rock and another rock, and it was just such a beautiful discovery process. And ever since then, I've just been absolutely in love with it, it has so much to offer so many people in so many ways. And it's a field in which you get to be this perpetual student, because there's always more to learn, there's always more to discover, always more iterations of how it can manifest in people's bodies. And so yeah, ever since then, it's very clear that this is like what I personally feel I was born to do, it's my life's vocation. And I'm very, very passionate about it. 

Jackie Baxter  
I love this. Because I think, you know, during my own journey, I've kind of realized that health and wellness, wellbeing, health care, all of these things. It's not just a traditional doctor in a doctor's office handing out pills. You know, that is an important part of it. And you know, there are lots of conditions that do benefit from medications. Absolutely. But that is just a small part of a much bigger picture. So there's all sorts of other things that are equally important, many of which, in fact, maybe even most of which, you've just kind of mentioned. So it's this kind of Yeah, much wider picture of health care, you know, that really is important to to everybody. 

And, you know, I think maybe for some people going through an experience such as long COVID, kind of opens your eyes to that. That was certainly the case for me. You kind of alluded to your own experiences with long COVID. And did you find a lot of benefit from East Asian medicine yourself in your own experience?

Elizabeth So  
Absolutely, absolutely. And this was something that, it actually took me a little bit of time. And I guess it also took the world a bit of time, to realize that that was what was going on with me. And really, East Asian medicine was the only thing. Well, I don't want to say the only thing because there were, I suppose a lot of lifestyle factors that I adopted after my diagnosis, and then working through all of the long COVID stuff. 

But East Asian medicine is particularly applicable specifically to the biomechanics of how long COVID presents. And it was only when I recognized long COVID for what it was, and then started using East Asian medical principles to resolve it that I started getting lasting results. And it was also relatively quick compared to other things that I've either heard other people talk about, or I myself had tried. So yeah, absolutely. Absolutely. 

And one of the reasons why I feel it's so important to talk about specifically East Asian medicine is because number one, I think a lot of people just don't really know what it is, how it works, what it can even offer them. Again, like we said in the very beginning, it's this very opaque field. It's just like, Oh, could it be good? I think most people know it's good for stress and it's good for pain, but don't really know much about it beyond that. 

But if you dig around even in the western side of the research that's been done for East Asian medicine, there's so much evidence that shows it has a really, really amazing effect on immune function, for example, and immune regulation specifically, which obviously, you know, is a really, really huge part of a long COVID presentation. It has a really strong effect on the ability to regulate emotions, your autonomic nervous system, which dysautonomia is a big part of long COVID. It has a really strong effect on things like your blood circulation, which is a big part of long COVID, as well. 

So it has all of these, even if you were just to strip it down to its sort of biomedical functions, it is still just in that isolated way, like point by point really, really effective for the systems of the body that are affected by long COVID. And then that's also not even taking into account any of this sort of East Asian medical theory that really understands long COVID really, really well. 

And one of the things that I like to talk about with people is that I think one of the frustrating aspects for certain medical providers, I want to say that use more - invasive is maybe not quite the word, but more intense interventions that require a lot of study before you can implement an intervention, which is good, we need that, you know, you're not just going to go around doling out meds and being like we think this might work. You do need to go through a nice rigorous process and have really good testing and all of that before you can release something to the public. 

One really amazing thing about East Asian medicine is that we don't need to wait for verification that a person is feeling the way that they're feeling. Someone can come in the door and the day that they come in the door, we can say, Okay, I see that you have this array of symptoms, I know that within our system of medicine, these array of symptoms fall under this particular physiological pattern. And this is the treatment protocol that will help that pattern to resolve. 

And, you know, I think another confusing thing people come up against is, well, How does long COVID which didn't exist during a time when Chinese medicine was originating, you know, obviously, that wasn't around when the system of medical theory was being formed. How does it respond to East Asian medical practices if it didn't exist before? And now it does, it's like a relatively new thing in human history. So how do we know that it's effective? And all of these things are like, how does it work exactly? How come Chinese medicine understands it, but other medicine doesn't understand it? 

And the way I describe it is this, East Asian medicine is very much based on a system of internal dynamics, that the body is almost like in its own ecosystem, right. So if you think of, for example, a forest where you know that this amount of sunlight is going to make this amount of vegetation grow, and this amount of rain is going to make the waters, you know, the rivers and creeks fill up to this amount, right. We understand from an ecological perspective how a forest operates. We have the principles and we can't necessarily control those principles, but we can predict how they're going to behave. 

So for example, at a time where let's say there's a really, really big forest fire to the magnitude that we've never seen before, even if we've never seen that before, ecologists are going to be able to understand how will this fire maybe affect the life that's here, or the air quality, or all these other things. 

And so even though East Asian medicine has never treated long, COVID before in terms of like human history, we have the baseline principles of how that ecosystem functions, such that when something is awry, bringing it back into balance, and bringing those aspects of the internal dynamics back to center is actually something that's very accessible and very clear too 

Jackie Baxter  
Yeah, and this is really interesting, because, correct me if I'm wrong here, but it partly seems like you're looking more kind of at the whole body, rather than individually at little tiny, you know, some of the studies are sort of scanning insides of cells and things, you know, which is extremely fascinating, and, you know, it's important work. 

But you are looking much more at the bigger picture and sort of thinking okay, well, this this person, this forest, let's take a kind of broader view. And then you were saying how you can kind of get into sort of symptom clumps and a little bit more specifically for things that you know that will work because they have come up before in different things. That's a terribly kind of coarse way of describing it.

Elizabeth So  
No, it's great, coarse is great, because that is like getting it down really to sort of a very plain speak, is really important for people to sort of get it, a really just sort of baseline foundational understanding. And I would say that yes, that is very, very true. 

And East Asian medicine in general, for example, when I start working with somebody, always we first have a very, very long intake, where we are talking about every single body system, even if somebody comes in and they're like, my neck hurts because I pulled a muscle. I want to know how quickly are you going to respond to treatment? You know, What might your body do? After this, let's say, had you not received treatment? How would your body have internalized it? Are you the sort of person who would heal really quickly move on, it would never come back? Are you the sort of person who would maybe hold a pattern for longer? 

So no matter what, when somebody comes through my door, we're doing a full systems overview. Every single body system, we'll talk about respiration, digestion, sleep, body temperature regulation, childhood illness, we'll trace it all the way back to even like, what were the circumstances around your neighborhood when you were growing up that maybe led to having an asthmatic response to the air, right? 

So we'll go through and we'll trace back everything all the way back to their history to create this ecosystem, this internal landscape understanding of how exactly does your body function, your specific body, when it is given certain inputs? How does it respond? 

And in the same way, that's why I think another very frustrating aspect of long COVID for people is that it doesn't present exactly the same in everybody. In fact, it presents in a very frustratingly unique way for everybody. But that, again, for us is not really news, because everybody has this very unique internal landscape that is really, really individualized to that person. No two people are alike, even if it's subtle changes, even if there are sort of general body types that people tend to fall into, really, when you comb all the way down to the details, everybody is extremely different. 

And so you do need to have this like very, very fine tuned understanding of how someone's internal landscape is going to respond to different things, including something like long COVID. Because some may present with headaches, while others may never have headaches, but they have a chronic cough that never goes away, right. So you're kind of like how, what is coming up for whom. And when you have this full picture, for every single case, long COVID or otherwise, you generate this first so that you can always be working on that overall ecosystem. 

So you're always kind of tweaking and adjusting and making sure that things are centered and balanced. And then we call that sort of like a foundational or like root treatment. And then there's the offshoots of that, what's springing up to the surface. If your core is this is generally how your foundation is operating or the center of everything, your baseline ecosystem, then sometimes, you know, maybe there's forest fires, or sometimes maybe there's excess brush that builds up or maybe sometimes some of the river ways get jammed, right.

And so we start to see what are the branch treatments? And what are what are the branch presentations, actually? And then how can we do a combination of foundational and branch treatment every time we see somebody so that you're always working on that core baseline, while helping someone to feel better

Jackie Baxter  
Yeah, so it's kind of building up from the bottom almost, you know, you're doing that kind of did you say root, more broadband kind of, and then drilling down more specifically, and kind of building up, more specifically to that person? Yeah, this is fascinating. 

And, and going back to what you were saying a moment ago about how long COVID is, in terms of the history of medicine, a relatively new thing. And, you know, how can we be treating long COVID Because it's only just arrived, and, you know, East Asian medicine dates back to a long time ago. 

But this comes back to, you know, looking back at post viral illness over history, you know. MECFS, for example, it's kind of nonspecific in terms of what infection it is that has caused that. I think majority of MECFS cases are caused by infection, I think. But you know, it's not like long...

Elizabeth So  
long flu, right?

Jackie Baxter  
Exactly. So, the fact that COVID is the trigger here is, you know, useful but probably not entirely relevant to the treatment really, is it? Because you're looking more at the person and their presentation, and what their particular forest is looking like, I suppose, to go back to that analogy.

Elizabeth So  
I love that you brought that up, because that idea of sequela to different diseases has been built into East Asian medicine from 1000s of years ago. So the idea of sequela to a febrile disease, for example, or an infectious disease is something that we already work with. So exactly like you said, and how that might present in somebody based on their body type is going to vary from person to person and disease to disease. 

So I would say yes, and no, in response to your question. Which is the yes being - Exactly, it doesn't almost matter whether or not it was COVID that did it if you're presenting in this particular way. Because right now today, in my office, in front of me, you are having these symptoms for this amount of time. With this amount of treatment resistance, in these various ways. 

It's not really going to change what I do as a practitioner, because, again, I'm not going to be prescribing a medication, for example, I'm going to be responding to the set of symptoms in front of me. 

However, where it does become important is that this is now more of a sort of integrative concept. Different diseases may have, for example, different tendencies for how they will present afterwards. So for example, one that's really on my mind these days, because it's going all around the city is norovirus. Norovirus versus flu, or COVID, or RSV, these things are going to behave slightly differently and how they interact with your system, and then how they also leave or don't leave your system. 

So it is useful to know if you have that information. Maybe you don't know whether you had COVID, or RSV, or just the flu. And now all you know is you feel horrible. And you've been feeling horrible for some amount of time. But knowing that actually does give me information. And I will say with Long COVID cases, the amount and the mechanics, internal mechanics of how long COVID presents is pretty distinctly different from other kinds of infectious disease, sequellae to other infectious diseases, if that makes sense. 

So whereas somebody who had norovirus, if their system took a hit, and is really having a hard time bouncing back, you might be looking at somebody who if it goes untreated for an extended period of time, maybe from there on out just has slightly bad digestion that worsens over the years. Whereas somebody with long COVID might have a resurgence of migraines that went away 10 years ago. And now all of a sudden their migraines are back and they won't go away. And they're 10 times worse than they were before. 

So it does kind of matter what the disease or infection is beforehand, because it does give me, as a practitioner, information about what I can maybe predict and how it will manifest in the body, if that makes sense. 

Jackie Baxter  
Of course, and I guess if you are seeing, you know, for example, a lot of long COVID patients, and you might have picked up on, okay, these things really work. And some of these other things work less well. Then if you know that somebody has long COVID, then that could maybe help guide what you're going to offer them, what you think might work best for them. If you know that in advance, I suppose.

Elizabeth So  
Yeah, one good example for this is for people who have, let's say, had a flu, where they had a lot of fever, a big lots of sweating at night and they lost a lot of bodily fluids, their temperature rose to a high level multiple times in a week. And now they have what we would refer to as sequellae to febrile disease in East Asian medicine, which is that is sort of damage to the overall body fluids, and a presentation of what we refer to as heat, which would maybe just be called inflammation, which you know, heat and inflammation in the translation of Eastern to Western is very congruent. 

And so maybe somebody who had the flu, who lost a lot of fluids, maybe their presentation is that now they're sort of low grade running hot all the time. They're having a hard time sort of like shaking night sweats, maybe now they just have perpetual night sweats or now their sleep is a little bit different. Whereas somebody who had long COVID, you know, maybe they're having more of a sort of what we refer to as blood stasis presentation, which is this sort of like thickening of the blood because the platelet count is slightly higher than average. 

And so what you would recommend for those two things, maybe both people and say hypothetically are having headaches. What I would recommend for the person with the sequellae to flu versus sequellae to COVID would be two completely different things and one might actually even be in opposition to the other right. So it's kind of, it is good information to have if the client or patient has that information, 

Jackie Baxter  
yeah, of course, and it goes back to what you were saying a moment ago about taking that full history, the more you know, you know, even going way, way, way back to childhood, you know, there are potentially things that happened, then that could be informing what's going on now. So the more you know, the more informed you are, then, you know, the better you're going to be able to help the person I suppose. So it's like knowledge is power, isn't it? 

Elizabeth So  
Absolutely, absolutely. And especially with long COVID, which I am sure you can speak to yourself as well. But long COVID, I always say is very personal. You know, if you take that history, I would say, I will say nine times out of 10, because 10 times out of 10 is sounds a bit arrogant. But I will say it's close to 10 times out of 10, that when I do an intake with somebody with long COVID, as we trace back the presentation, it really is pretty much with every single person I've spoken to, the current presentation usually is some kind of amplification of a series of things that they have already gone through at some point in their life. 

And it's not till they go back and look at that whole history, they sit down, and we really trace it, that they even realize that that's what's going on. And so for myself, you know, I, when I was younger, I had a history of migraine, my migraines came back full force. I used to have irregular periods, my periods got irregular again. So you know, it's very personal. And it's very targeted to seemingly things that people have dealt with in their past. 

So knowledge is power. And it really can be very, very enlightening, because it gives me more information about what exactly is going on. And it has to do directly with those people's baseline tendencies that led to the original presentation of that symptom, maybe 10, 15, 20 years ago. 

Jackie Baxter  
And isn't that fascinating, because even just thinking of myself, and of you know, a few people that I've spoken to, you know, that slightly dysfunctional breathing, for example, before COVID, you know, wasn't that much of a problem, but suddenly, you know, come along COVID and boom. Same with, you know, if you were living high stress life and had a slightly dysfunctional nervous system like I did, you know, I wouldn't have thought that at the time. But looking back on it, yeah, I probably did. So then when COVID came along, that was kind of what happened for me. 

So that's very interesting that you've been noticing the same thing. It's like, it kind of goes for those weaknesses, isn't it? You know, if that if there's a chink in your armor, it will find it.

Elizabeth So  
It will, it will. It's very, very sneaky. And it's very, very personal.

Jackie Baxter  
So what I would love to kind of maybe dive down a bit more into. I think, when I asked you the question earlier of what is Eastern medicine, and you named a whole load of different things that started off with acupuncture and kind of herbs. And then there were a load more things as well, some of which I'd heard of, and some of which I was like, Oh, I've not even heard of that one. Would you be able to kind of go through some of these things, maybe in a little bit more detail, to just sort of demystify them maybe a little bit?

Elizabeth So  
Absolutely, I would love to. One that I'll start with, which is called guasha. I'd love to start with that one, because it is one that I use a lot with long COVID. And it's very important in terms of what it is offering as a supplemental treatment, in addition to acupuncture, other things breathwork whatever someone is doing that's making them feel better. This is one of my favorite modalities to bring into the treatment for the following reason. 

A lot of times when people get long COVID, they accumulate in their system, some amount of inflammation, and/or the accumulation of almost like biological waste in their blood, in certain parts of their body, specifically their lungs. Or in maybe accessory breathing muscles, especially if one of the mechanics that's happening for them is this thickening of the blood that then causes a little bit of constriction that allows for further blockages to form and all these things. 

So there's this modality called guasha that I use all the time for long COVID which is also known as scraping technique because it sort of looks like you're scraping the skin. And it has a similar function to cupping, which I think a lot of people are familiar with, the sort of circles on the back that a lot of athletes and Olympians have, that is meant to kind of be pulling out sort of this biological waste, this biological debris so that your body can basically dispose of it, digest it, break it down into smaller parts, excrete it in whatever way it needs to. 

But if it's all jammed up, it's like having a big sort of knotted mess of something in your bloodstream or in a particular muscle group or in a particular organ group, that's then causing further congestion. And then it becomes a sort of vicious cycle where it's like, more congestion. You know, if you think of a roadblock, or in a, you know, a river, right where some debris falls into the river, and then that catches on more debris, and that catches on more debris. And then all of a sudden, there's like this giant nest in the middle of the river. And it's everything's blocked up, nobody's happy. 

And so we're kind of doing with something like cupping, or guasha, is you're helping to the body to break down those debris piles by kind of going in, breaking it up and bringing it to the surface. So with cupping, some people get those purple marks. And that is basically biological junk that's in your blood that's coming to the surface. The cup is able to pull it to the surface of the body, to the skin, where then it can be disposed of. 

And guasha is a very similar mechanism. It also is designed to bring things to the surface. But instead of it being a sucking mechanism, it's a pressing mechanism. So usually you use some kind of a tool that's made of stone. To be perfectly honest, my favorite tool, and all of my clients will vouch for this, is just the lid of a jar, because for whatever reason, it is really effective at bringing things to the surface, and you can cup your hand around it in a way. And I've used all the fancy tools, I've tried 100 different things. And this is the most effective tool for me personally. So I can't speak for other acupuncturist, but I love my jar lid. 

And I'll use the lid to basically kind of drag it along the channel with oil, so it's not so uncomfortable. And you are, as you're dragging, if there's something that's gunked up, it will start to come to the surface in a way that's visually similar to cups, this sort of like this purple, red splotchy stuff, that is really just like old junky blood. And if there's nothing there, if there's nothing to be released, nothing will come up. 

So you know, you might work on someone, and they might have a whole bunch of purple stuff come out. And the next person, if they don't have all that junky stuff in that particular area of the body, they might not have anything. And so what that does, and the reason why it's so important for long COVID, is because of this history of poor circulation, inflammation that leads to the debris even being in your blood in the first place. 

And it helps to break it up, break it down and your body to dispose of it so that it doesn't contribute to further inflammatory patterns, further congestion, further poor circulation. It's using that modality is actually one of the things that helps people move past the sort of plateaus of recovery, which is really wonderful, because you're able to actually really clear things out on a deep, deep level.

Jackie Baxter  
Wow. I guess I mean, you were saying that if the person has stuff to come out, then it will come out. And if they don't, then it won't. So you'll be able to kind of see straight away - Is this working? Or is this not? So you don't have to go through like, you know, three months of taking a pill to find out if it's made any difference, you can literally as you're doing it go, Hey, we have gunk.

Elizabeth So  
Exactly. Or hey, there isn't that much gunk, maybe your presentation really wasn't on this, you know, blood stasis or blood congestion level, right? Maybe that actually, and again, everything is diagnostic in what we do, so if you do that, and it's only a little bit of gunk comes out or none at all, that tells me something really important, which is that great, this blood stasis thing is actually not a big part of what you're dealing with. And so then we can let that be and then continue to work on the other things.

Jackie Baxter  
Yeah, there was someone I spoke to recently, I think it might have been Raelan Agle, but I might be wrong here, who said, You know that that kind of frustration that we get when we try something and it doesn't work. And it's like, I just invested, you know, time, effort, energy, possibly money in this thing, and it didn't work. And you know, we can get so frustrated and so down when that happens. And she had the most beautiful take on it, which was that if it didn't work, that's great. You've crossed it off the list, and you don't have to do it anymore. You know, it's gone. Move on to the next one. And I thought that's a much nicer way of thinking of it.

Elizabeth So  
Yeah, I really love that attitude. Because it's like, what doesn't work is just as valuable as what does work, in some ways. Yeah, it's always information. And I really love working with people really closely. And that's why my approach is so educational. And I really bring people into what we're doing together. It's not like oh, show up. Get on the table, I'm not going to tell you anything, totally opaque, leave, and then maybe you're feeling better, maybe you're not right. It's just, you know, in and out. 

My approach is very, very educational. It's really collaborative, because it's like, it helps people not only engage with their health within a framework that works for them, and they understand and it starts to make sense for the first time since they've been ill. And it also shows them like, Yeah, this is something that's a process that we're doing hand in hand, and your participation, your bodily awareness, all of these things that you've cultivated, the skills of tracking exactly what's going on with you, actually are really valuable, and are going to tell me something really important. 

So yeah, and I love, I love week by week, tracking with that person, this is what we did, this was our intention, this is what shifted, this is what was maybe more stubborn. And then this is why, right? Like this is the why of it, which is a really hard thing to come by, sometimes, in a medical field, which is, okay, this worked, and this didn't, but how come? And within my practice, I really love to bring people into the why of a positive or a negative. 

Something that's, that's really, really beneficial for them, and why their body just loved it and totally sang with it. And why maybe this other thing is more slow moving, and a little more stubborn, and a little more frustrating. Because also when they know the why and they understand the internal mechanics, it also grants people more patience, less frustration, less anxiety, that it's never going to change. 

If I tell someone, hey, when I see this particular kind of presentation, actually, it really is going to take probably six weeks before you're going to notice a major shift in that. Look out for the subtle things, but probably, you're really not going to notice a major change for about, you know, four to six sessions, it just allows people to sit back a little bit rather than looking for a resolution that makes them feel overly pathologized, you know.

Jackie Baxter  
Yeah, and I think people understanding, you know, some things, you might notice an input straight away, you know, and that's, that's great. But some things, as you say, are a bit of a slower burn, they take a bit of time, for whatever reason. And if people have those kind of expectations, then it kind of helps, as you say, with the frustration, with the kind of like, you know, I'm spending time and effort and precious energy and you know, money, you know, on this thing, why didn't it work? I tried it once and it hasn't worked. And you know, for some things, you do need to kind of persist a little bit longer. 

Now, I think I probably said this to you in my email. When I'm talking about sort of recovery and how different things work for different people, the example I always like to give is that I like getting into ice cold water. That really does it for me. And that was a huge part of my recovery. But that isn't for everybody. And the one that I always give as the kind of opposite to that is acupuncture because honestly, that really doesn't appeal to me. 

Can we dive into this just a little bit, like demystify this a little bit for us because for me, it makes me kind of feel slightly squirmy and I don't think that is the idea.

Elizabeth So  
Definitely, and I do think the the fact that it is needles and you know, it is also very unknown, sort of mystified type of modality is a huge barrier to entry for most people. Like I always joke that I'm the last person someone's gonna see. They have tried everything else. And they really don't necessarily want to get into acupuncture, Chinese medicine, but they just don't know where else to go. And so I'm the sort of like, last attempt at figuring something out for most people. 

Which honestly, I don't even mind because I'm like, Oh, great. Yeah, let's do it. You know, I fully and it also helps, I think people recover from really the trauma of having gone through lots of different medical care, and seeing a ton of different providers without a lot of answers. So I'm always happy to hold that space for people because I know how frustrating that can be. And those are usually the people that I'm seeing. 

So the experience honestly is quite nice once you're over this squirmy part of it, because it's very relaxing honestly. Usually the first session is always weird. I still remember so vividly my very first acupuncture session. I was very squirmy, I was so nervous. I was so uncomfortable. And I was also one of those people who had waited, so this is for my migraines years ago before they came back around during long COVID. 

It's very strange to lay on a table with a bunch of different things sticking out of your body, especially if you don't understand what they're doing or what the benefit is. But I will say after that first session, and this is almost completely, I would say like, again, 9.9 times out of 10. After the first session, people just love coming back, because it is so relaxing, and it feels so good. 

And sensation wise, normally, especially on the first one, what people can expect, is, maybe upon insertion, the needles are very, very, very thin. I feel like the media quote that I hear all the time is like they're thinner than a hair, like as thin as a hair, which is true, they're super, super thin. And it's not even close to, for example, getting your blood taken or getting a vaccine, because they're so tiny. 

They're so tiny that the way that they work is the point of the needle is actually a little bit rounded. And it's designed to push cells apart. You're not causing any kind of rupture of any tissue, if you're careful. I mean, that's not to say that it's not possible to do that. Certainly it is. But the idea is that you're actually just pushing cells apart, because the needle is so fine, that you're able to just kind of glide it in between cells. Which is on a microscopic level, I mean, pretty impressive. I remember when I learned that I was like, What, that sounds wild. 

So it's quite comfortable. Honestly, the weirdest thing is that you're like, Okay, now I have all these things in my body. And I have to lay here for about, you know, 25 to 30 minutes. But really, after the first session, when your body kind of adjusts and understand how to use the treatment and what it's doing, you really just start dropping in. Like most people now after the first session, you know, second, third, fourth session, they're just conked out on the table, people take naps all the time. And it's a very, very relaxing experience. 

So yeah, people really love it. Even people who have really big sort of like needle phobias and things like that I love working with people who are scared, because also, you know, how you're introduced to it, and how gently you're introduced, I think does make a difference. So of course, picking a provider who will be kind about that, especially if you're nervous, is a good idea. You know, don't go to somebody who's like, well, you're being a baby, which I don't think anyone would really say. But it is nice to introduce people in a very kind and gentle way to this. 

Jackie Baxter  
Yeah. So what kind of like biomechanically is happening? I mean, like that, that thing with the cells, like, that's just blown my mind, that is so cool. So the sort of the needles with the little kind of balls on the end, they push aside those cells. But yeah, what does that do? 

Elizabeth So  
Yeah, it's a great question. And in the late 90s, and early 2000s, Western medicine really had a field day with this, because they were like, what even is happening in the body with acupuncture? Because we're seeing that it's effective, but we have just no idea what even is going on there. And what they found, they were like, Okay, well, is it endocrine thing, right? Or is it a hormonal cascade? Is it a neurological thing? Is it a local stimulation that's causing a local reaction around the tissue in the area? 

And really, the answer was sort of all of the above and more, is what they discovered. So there's a few different things that happen. The first of which is like, let's say the most like lowest hanging fruit of what's going on, which is just the local reaction. You put a needle into a point, because there's now some kind of a foreign body in that area. There's this micro response, micro immune response that then kind of like locally boosts circulation, it locally sends like white blood cells and things to the area to enact some kind of change. So that's more of a kind of orthopedic function. 

But then there's also hormonal implication. So it has a really strong regulatory effect on your autonomic nervous system, it helps to balance out your like parasympathetic and sympathetic responses. So you know, it is dropping you down into a parasympathetic state, which just gives your body more space, and more frankly, hormonal precursors to make nice, happy, good, regulatory hormones, rather than the sympathetic nervous system taking over and hijacking your entire hormonal system and then using all the precursors for things like cortisol and adrenaline. 

It also has a strong neuroplasticity component, which is a huge, huge, huge thing, not only in long COVID, but also in things like stroke rehabilitation, the amount of things I've seen in the stroke rehabilitation. One of my trainings was at NYU Hospital in New York, in their stroke rehabilitation department. I did like a residency there for one of my sort of like rotations you And the amount of improvement that you see because of the neuroplastic effect it has on the brain and the nervous system is incredible. And these studies exist. I mean, all these things that I'm talking about, you can just google and you can find the studies related to them. 

There was a big study that was done around neuroplasticity in stroke patients, that obviously isn't just going to work for stroke patients, you know. Like, yes, they studied it in stroke patients, because that was who needed the research to be done. But this neuroplastic effect happens to everybody who's getting acupuncture, regardless of whether or not it's because you had a stroke, and you need to rehabilitate from that stroke. 

There's also various kinds of like neurological implications. So we know that from a Western science perspective, through anatomy, basic anatomy and physiology, that from your brain, to all of your tissues, to your skin, to your muscles, to your organs, all of your neural, your entire neurological system is propagated based on electrical impulses, right. So the entire body is operating based on electromagnetic activity of electrical impulse from one neuron, to the next neuron, to the next neuron, to the next neuron. 

So, one of the most accessible ways that I like talking about what is happening during acupuncture is that we know those things to be true. And we also know that acupuncture points have been found to be these little little pools where electromagnetic activity is actually stronger than in the rest of the body. 

So you're kind of doing this neurological hacking, where you're able to manipulate the electromagnetic conductivity of your neurological system by putting in almost like a lightning rod, right, you're putting in like a little metal stick into that area. And it's helping to balance out the electromagnetic activity to send various impulses for a variety of different reasons. Either for, you know, gate channel theory to override erroneous pain responses coming from the brain, that are actually don't have anything to do with the part of the body anymore that it thinks it has to do with. 

Also with helping to improve circulation, with helping even to use a dermatome, the neurological system attached to a dermatome, the innervation of that - a dermatome is like a swatch of skin that is innervated by a particular nerve that leaves from your spine, right. And also leaving from your spine from the same place, in a lot of cases, is an offshoot of that nerve that then goes to an organ. So you can use the neurological system on the surface on a dermatome level, in an area where that electromagnetic activity is stronger, to then influence the organ that has the same innervation as that dermatome. Right. 

So there's a lot of different things going on. And I could talk about this for hours. I mean, we could be here for truly forever, because there's more and more and more and more. And it really overlays Western medicine and anatomy and physiology beautifully. I think this myth that they don't go hand in hand is completely ridiculous. Because ultimately, you're talking about the human body, whether you're using the framework, vernacular of Western anatomy and physiology, or East Asian medicine and physiology, you're still talking about the same human body. 

So the patterns, all the phenomena that you witness within that body is the same. And so it overlays gorgeously, I mean, it's it's the same thing. It's not like, Oh, I think this is what's going on. And I think this is what's going on. It's like actually, they're both going on, which is the amazing thing. And so that's why my approach generally is really, really integrative.

Like my education, my formal education, at least, is roughly 50/50 in terms of East Asian medicine and Western medicine. Because not only did I do a lot of adjunctive things, to understand the integrative component as it kind of folds into western medicine, but also just the baseline program. My program in particular, you had to leave and be able to not only recognize, diagnose, and know that the standard of care would be from an Eastern perspective, but from a Western perspective as well. 

Because that school understands that you're going to be functioning within a Western medical world. We are in the US, people are going to be coming into you with Western diagnostics saying like, what do you make of this? And you have to be able to be the translator because the other side of things is not going to be the translator. Western medicine isn't going to be like Well, let me tell you what this is in Eastern medicine. So you have to know and be able to explain these things to people from a Western vernacular. 

And in general, I mean, I've always been really interested in anatomy, physiology, biology, I think it's so fascinating and I've always loved the western side. So having done that Eastern context in my doctoral program was really I mean, it's just another lens through which to see the exact same body, that is experiencing the same things, whether you're talking about it with one set of language or another. 

Jackie Baxter  
Yeah, that's amazing. Like, yeah, this has totally just blown my mind, which I was really excited to do. But yeah, one body, that is the stuff that is happening. That's what we're handling, that's what we're dealing with. But you've got different ways of thinking about them. But it doesn't have to be either or, you know, things can all kind of work together in this kind of beautiful harmony. There we go. Music metaphor. 

And that is good. That is okay, that is wonderful. You know, you can take your beta blockers to help with your PoTS. But that doesn't mean that you can't also use your acupuncture and your Chinese herbs, and all these other wonderful things that you've been talking about, you know. Things working together is good, I think it's like the opposite of the crossing things off the list, it's like, there's more things. The wider you cast your net, and the more open to other things you are, there's then more stuff that's there to help you. And that's awesome. 

Elizabeth So  
Absolutely. And the more and the better, you can identify which tools are going to be for which instances, you know, like my tools are not always the right tools. And I am the first to say if somebody comes to my door with something that I think is not a right fit for what my skill sets are, and what the tools I have at my disposal are. I will be the first to say, You know what, this isn't actually really my lane, I think. Really, Western medicine is better at this particular lane, and you should seek attention here. Or it'll just be like, much faster and not very detrimental for you to take this one medication for a couple of days in order to you know, interrupt this thing that's happening. 

So the more tools you have in front of you, the better you can understand what actually is going to be the most efficacious in what circumstances. And I think they go really, really well together. I feel generally really passionate about bringing more Western medical professionals into this perspective, because we're not competition. Honestly, our lanes are very, very different. 

What Eastern medicine has to offer most Western medical providers is those frustrating cases that make them feel like they really don't know what to do with that particular thing. We can take those and be like, Okay, we got you, don't worry, like, I have somebody who has appendicitis, I have somebody who needs to take beta blockers. I have somebody who needs this medication or this procedure, like let's cross reference, right, we can really be working hand in hand. 

And actually one of the residencies that I did, I did an internship at a hospital in Taiwan, that was an integrative hospital. And it was amazing. I mean, it was so deeply inspiring. I learned more from that particular internship, than a lot of other things that I've done, of which there are many, because I've done a lot of adjunctive education in addition to my formalized education. 

And that was just seeing how streamlined it can be with, even in their inpatient unit, where people are checked in, in a hospital bed, where they are given herbal medicine, in addition to their western medicine. They have a very clear understanding of how those things are going to interact with one another. And they're not shaming one or the other. It's amazing. 

I mean, it just really enhances how someone can recover. It can help offset side effects from a really necessary medication like chemotherapy, right. And so it's just like, the potential is incredible. And I'm really passionate about continuing to talk to more and more Western medical providers to show the benefit of how we can work together without being competition in any way. 

Jackie Baxter  
Yeah, I just I love this. Everyone working together. You know, we're not saying this is rubbish. That's rubbish. No, we're saying that everything is valid. Everything has a place. A lot of things have places together. And let's just all kind of work together to do this. And I just love that so much. That makes me really happy. 

Well, we could literally talk all night and I would really love to. This has been so educational for me. I feel like I've learned so much. And you might even have persuaded me that maybe I should give acupuncture a go. So thank you so much for coming along and sharing all your expertise. It has been amazing. So yeah, thank you so much. 

Elizabeth So  
My pleasure. Thank you for having me on. It's been such a joy working with you

Transcribed by https://otter.ai