By: Michael G. Pingicer, M.S., L.Ac.
In the 10th grade, I played baseball with a kid who had a swing that begged you to take notice. He was a natural, and everyone from the kids to the adults knew it. Though his swing was as sweet as honey, he had an Achilles heel. He had asthma. When a ball is hit into the gap in the outfield, that usually means a double in baseball, but he could not make the effort to run to second because he might end up with an attack. His doubles were usually singles. He would have attacks at the beginning of the season when a chill was still in the air that ended up keeping him out of the entire game. Talent does nothing for a team when it is riding the pine. He did not play baseball beyond the 11th grade. His natural talent was hindered by asthma and more importantly, the quality of his life was diminished. He loved playing, but it was too much for his body to handle. He was not the only kid I knew whom suffered from asthma. Growing up, I was surrounded by kids who had a variety of ailments, and I could see how it affected their lives in so many ways. They got called down to the school nurse every day for medication; they had certain things that they couldn't eat, etc. I took note of these things as a kid, and maybe it had influence on my choice of profession as an acupuncturist and herbalist.
What is Asthma?
Asthma is a chronic disease that affects the tubes that carry air in and out of the lungs. During an acute asthma attack, the inside walls of these tubular airways become inflamed, the muscles spasm, and excess mucus accumulates. The attacks can be triggered by a variety of things such as:
- Environmental allergens (pollen, mold, animal dander, etc.).
- Irritants (changes in air temperature, cigarette smoke, air pollution, perfume, etc.)
- The common cold.
- Mental stress.
- Foods or food additives - sulfites are a big culprit and are found in dried fruits and wine, among a whole host of other foods.
Click here to read about sulfite sensitivity and a list of foods that could contain sulfites.
When the airways react and are having an attack, they become narrower, and less air flows through to your lung tissue. This causes symptoms like wheezing, coughing, chest tightness, and trouble breathing.1
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The Traditional Chinese Medical (TCM) Treatment of Asthma
The severity and frequency of asthma varies from patient to patient.
For example, here are two possible manifestations:
- Patient #1:
- is asymptomatic between attacks.
- asthma attacks are mild and only come once each year and are manageable with rest.
- Patient #2:
- has a cough, phlegm, and wheezing between asthma attacks.
- asthma attacks occur once a week and can be so severe that the patient is hospitalized once a month.
Treatment for asthma is broken down into two categories: managing the acute attacks by easing the intensity of the attack and maximizing the time between the attacks. The long-term goal of treatment is to provide the patient with a better quality of life or increased feeling of well being. If a patient is having attacks every week, and with treatment they are able to have them every other week, treatment should theoretically bring them a better quality of life because they are suffering half of the attacks over 1 year than they would have without treatment. This reduction is a very important aspect to treating recurrent, chronic diseases such as asthma.
TCM Theory about Breathing and Asthma
According to TCM theory, the lung and the kidney both take part in breathing. The lung opens at the nose, is responsible for breathing, and the production of true qi. The lung is the way that the da qi ("great qi" aka air) enters the body. The da qi is important to the person because this is mixed with the qi of food to create usable qi that a person can use day to day. The kidney plays an important role in breathing, too. The kidney is the root of a person's qi. If the kidney qi is insufficient, other organs may dysfunction. The lung's ability to absorb da qi is partly dependent on the kidney. If kidney essential qi is insufficient, it is incapable of ensuring the absorption of da qi through the lung. This results in respiratory insufficiency which can result in the signs and symptoms of asthma.2
Through the use of acupuncture, herbs, and dietary analysis, asthma can be managed through TCM. Asthma presents as a repletion or excess pattern during the acute attack. The periods in between attacks are characterized as a vacuity or depletion pattern. Let's explore the acute attack and the period between the attacks to see how TCM categorizes each.3
Repletion - the asthma attack
The acute asthma attack is something that the body reacts to that is in excess, meaning it is not supposed to be there in the body; it is too much (in excess). The trigger that causes the attack is something that is not supposed to be in the body, and the asthma sufferer's body responds with an asthma attack. These triggers are called external evils in TCM. The more frequently the external evils attack the body, the weaker the body becomes. The body is like an army that is attacked over and over again by the asthma trigger, sometimes without fully replenishing its resources. This can cause a vacuity or a weakness in the patient's body leaving it even more vulnerable to future attacks sometimes making them more frequent and intense.
Vacuity - the state of the patient's body and health
The period between the attacks show the state of patient's true body strength and ability to fend off the trigger. This tends to be a state of weakness or vacuity in asthma patients. This is the time for the patient to replenish the resources that were depleted due to the asthma attack. There are occasional instances where phlegm can become lodged in the lungs. This is called a mixed pattern of vacuity (state of the patient's body) and repletion (an abundance of phlegm making a home in the lungs). The overall treatment goal at this stage is to strengthen the body (fill the vacuity) so that the attacks are less frequent and less intense because the body is stronger. Phlegm can be dislodged from the lungs while simultaneously strengthening them. This will make the patient's life easier and much more enjoyable because he/she does not have to take so much time off from work or time out of recreational activities.
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Acupuncture and Chinese Herbs for Asthma
Giving acupuncture and cupping during an asthma attack can help to calm the patient down and to aid in opening up the chest muscles to provide easier breathing. Acupuncture can help to shorten the length and severity of the asthma attack.
It is more common to treat people when they are in the remittent state. The goal of the treatment during this stage is to supplement the body with acupuncture, Chinese herbs and dietary changes in order to strengthen the body's qi. If there is some phlegm lodged in the lungs and some cough and wheezing during this time, relieving those symptoms are also part of the treatment. The diet is analyzed to see if what the patient is eating is exacerbating the asthma attacks. In general, it is best to stick to a diet that consists of whole foods that are not prepackaged or fast food. Whole, organic, real foods have less/no additives and have better qi. The more healthy the qi of the food you put into your body, the stronger your body's defenses and the better able your lungs will be to resist your asthma trigger. Try to keep dairy intake to a minimum as TCM dietary theory states that dairy products can exacerbate phlegm production. A qualified, well-trained TCM practitioner will be able to diagnose your vacuity pattern correctly and get you on the path to a better quality of life!
NYC Air Quality & Differences in Seasonal Air
One of the hot topics in NYC since 9/11 has been air quality. There was a severely diminished quality of air in the city for that acute time, but there is now more attention paid to this topic. The Air Quality Index (AQI) is an index for reporting daily air quality. It tells you how clean or polluted your outdoor air is and what associated health effects might be a concern for you. The AQI focuses on health effects you may experience within a few hours or days after breathing polluted air. EPA calculates the AQI for five major air pollutants regulated by the Clean Air Act: ground-level ozone, particle pollution (also known as particulate matter), carbon monoxide, sulfur dioxide, and nitrogen dioxide. For each of these pollutants, EPA has established national air quality standards to protect public health.4 The worse the air quality, the worse your asthma could become due to the fact that more particle matter in the air can cause more irritation and inflammation. Here is a link to a fact sheet talking about asthma and air pollution put out by the EPA. They have some good tips about how to protect your lungs during differing levels of pollutants in the air. Here is a link to a daily update on the air quality in NYC. Another thing to consider is if you are affected by the air of the different seasons. Does cold, dry winter trigger your asthma? Maybe the humid heat of the NYC summer? How about spring air that is full of pollen? Take the seasons into account to see when you should be taking more of a break from the outdoors as opposed to being more active. Speak with your practitioner about what your triggers are so that your attacks can be minimized.
Written by:Juliette Aiyana, L.Ac.
Aiyana Acupuncture & Chinese Herbs
41 Union Square West, Suite 519
New York, NY 10003
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"Juliette treated me for digestive system problems I was having in pregnancy. She helped me to develop a diet plan that kept me well-nourished while also completely alleviating all my symptoms. When I fell off the wagon on occasion, her acupuncture treatments solved the problem. Juliette listens carefully, and adjusts her treatment plan to meet her patients' individual needs. I have recommended her many times to other pregnant friends."