food, health, herbal medicine, Traditional Chinese Medicine, Uncategorized

Do you know these herbs and spices?

Sri Lanka AHG cardamom tea
Cardamom black tea

So a lot of us use a range of herbs and spices in our cooking and medicines and yet we may not have a clue what they actually look like when they’re growing on the bush or vine or tree. (I also know some of you grow an extensive range of herbs in your gardens and very much know what they look like and how to use them.)

By definition herbs are plants of a particular type (soft, succulent and mostly grown from seed) but this doesn’t truly capture all of the plants we use as herbs. Broadly speaking, herbs can be any plant we use in medicine, food, flavouring, for fragrance or even as a dye.

While I was in Sri Lanka late last year I wanted to visit as many Ayurvedic herbal gardens as I could to learn more about these medicinal plants. Here are some photos I took at the Ananda Spice Garden (near Koggala Lake) of some herbs you may use on regular rotation in your kitchen or even in a medicinal brew:

Sri Lanka AHG aloe vera
Aloe Vera
Sri Lanka AHG cinnamon
Cinnamon
Sri Lanka AHG ginger
Ginger
Sri Lanka AHG red ginger
Red ginger
Sri Lanka AHG vanilla
Vanilla

Aren’t they gorgeous?

And if you are interested, here is a east-west fusion (read: not Classical Chinese Medicine but still really interesting) of the Five Elements of herbs I found in one of my favourite, old herb books – Isobell Shiphard’s How can I use herbs in my daily life?

Isabell Shipard 5 element herbs

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.

acupuncture, herbal medicine, Traditional Chinese Medicine, Uncategorized

What is acupuncture college like in Sri Lanka?

Sri Lanka Acu college noticeboardOne major reason for my trip to Sri Lanka was to visit the Sir Anton Jayasuriya International Centre of Acupuncture. I have good friends who have studied there, under the direction of the late Sir Anton Jayasuriya, and there are students from my college who would like to do a study trip here.

I was lucky to be put in touch with Dr Amila, a lecturer at the college. She showed me around the college so I could see their classrooms and the students treating their patients.

The college clinic has a lovely, breezy feel to it (which is rare in steamy Colombo). The patients are people in need so treatment is paid for by donation. Patients are treated for a range of chronic illnesses and pain-related conditions however the college also offers cosmetic acupuncture treatments. Interestingly, while acupuncture is the primary treatment method here, Chinese herbs are replaced with Ayurvedic herbs. Herbal medicines may be prescribed but prescriptions are filled by independent herbal dispensaries. The college accepts students from overseas to do study programs and train in their clinics. It’s always interesting to see how other acupuncture colleges operate and meet my international colleagues. (Here’s a college I visited in Japan).

I’m really grateful to Dr Amila, the staff and students for taking the time to introduce me to their college. I’d love to visit again. It is obvious that this college and its clinic helps a lot of people through acupuncture treatment.

Here are some photos from my visit to the college:

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.

Diet, health, nature, Traditional Chinese Medicine, Uncategorized

How do you make tea?

Sri Lanka Tea Pedro BOPHow do you make tea? Well not how do YOU make tea, but how is tea actually made?

Firstly I have an image warning! You are in for some damn fine images of tea porn here – hot, steamy, bushy and breathtakingly gorgeous. 😉

I love tea in pretty much in all its forms (well maybe except for the black tea bag variety with cow’s milk poured in – but that’s mainly because I don’t tolerate dairy and didn’t ever develop a liking for it).  In fact it’s probably the beverage we love most in Chinese Medicine. I’ve been to China and learnt a lot about the various forms of green teas, I’ve even done a tea appreciate course but I’d never seen how this delicious, medicinal and incredibly popular drink was actually made to give us those medicinal qualities (from bush to cup that is). Just so you know whatever research says I don’t believe a microwave forms part of the tea making process. So I trotted off to Sri Lanka, where some would say is the source of the best black tea in the world (Ceylon tea anyone?), to find out. I visited no less than four tea plantations and their factories to try to get an understanding of how the cammelia sinensis leaf is transformed to make a delightful cup of tea. (For those not in the know, all true tea comes from the leaves of just one plant – cammelia sinensis – be it black, green or white. (Herbal and rooibos teas are made from different plants altogether.)

So here is a photographic journey of the tea making process from the Handunugoda Tea Estate, at Ahangama in the south, where they produce their tea with beautiful, old machinery. They are also famous for their virgin white tea and a range of flavoured teas.

Sri Lanka Tea factory 1 picking
Tea leaf picking
Sri Lanka Tea factory 1 drying
The moisture is dried from the fresh leaves – smells good

Rolling the leaves in the heavy rolling machine.

The rolled leaves further ferment and then are heated as part of the firing process (the leaves turn black at this stage).

Ungraded leaves are put through the grading machine. Four grades are produced – from small pieces to large pieces. Small pieces are used for tea bags and large for the loose leaf tea. The small pieces produce a stronger black tea and the larger pieces a lighter black tea. The size does not indicate quality. This tea making process is followed to maximise the medicinal benefits and flavour of the tea.

The finished product – black tea ready to be sold at the Colombo tea markets to the big brand names.

I mentioned earlier that I visited four tea factories. Handunugoda Tea Estate was the first. Later, I visited the towns of Ella and Nuwara Eliya which are in the high country. The area is famous for tea and the scenic railway that shows off the tea plantations.

Enjoy these images from the  Newburgh Estate Green Tea Factory (Finlays) (Ella), Uva Halpewatte Tea Factory (Ella) and Pedro Tea Estate (they pride themselves as an ethical tea producer) (Nuwara Eliya) and the railway trip between.

Newburgh Green Tea Factory (Ella) – the process is similar without the ‘firing’ part of the process that black tea goes through. This factory was small and cute; it smelled fantastic!

Halpe Tea Factory (Ella) – these images do not do this factory justice. It is the largest tea factory (or so I was told) and has sweeping views of the local tea plantations. They have a lovely variety of flavoured teas also.

Pedro Tea Estate (Nuwara Eliya) – This factory produced my favourite cup of broken orange pekoe of the trip (the gorgeous orange cuppa pictured above as the very first image of this blog). The factory tour was interesting and the plantation is incredibly beautiful.

And here is one of the most beautiful railway journeys you might take (from Ella to Nuwara Eliya and just beyond) and those magical leaves:

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.

Diet, food, food allergy, recipe, Traditional Chinese Medicine, Uncategorized

Banana coconut fritters – pikelet style

I’ve recently signed up to get an organic vegetable box delivered each week from the fabulous Farmer Foster. Together with a bounty of great vegetables is an array of beautiful fruit.

vegetable box farmer foster

One such fruit I have in abundance is bananas. I’m a sucker for a banana fritter so I decided to experiment with a dairy and gluten free version with no added sugar; let’s face it, bananas are just about sweet enough anyway!

According to Chinese dietetic theory bananas are considered to be sweet in flavour and cold in thermal nature. They have an affinity with the Stomach and Large Intestine so together with their flavour and thermal nature they moisten the fluids (Yin) of these digestive organs. Bananas are traditionally used for dry throats and constipation. Autumn and winter bring dryness so a lot of us need some extra Yin nourishing at this time. Frying the fritters and adding a touch of cinnamon helps to warm up the bananas a little too.

banana coconut fritter served

Banana coconut fritter recipe

Ingredients

  • 300g bananas, mashed
  • 3 tbsp brown rice flour
  • 2 tbsp desiccated coconut
  • 1/4 tsp baking powder (gluten free)
  • 1/8 tsp baking soda
  • 1/8 teaspoon salt
  • pinch of stevia to taste
  • cinnamon to taste
  • coconut oil for frying

Method

  1. Mix all dry ingredients together.
  2. Add mashed banana and mix until combined.
  3. In a frying pain, heat coconut oil to medium heat and shallow fry heaped dessertspoons of banana mixture until golden on each side.
  4. When cooked, remove fritters from pan and place on a plate covered with a sheet of paper towel.
  5. Serve warm, sprinkled with toasted coconut and if desired a scoop of coconut milk icecream.

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.

Diet, food, food allergy, recipe, Traditional Chinese Medicine, Uncategorized

Carrot cake goodie balls

I have resisted the goodie ball/bliss ball craze so far but recently at an Endeavour College of Natural Health open day I came across a recipe that was a must try: these Carrot Cake goodie balls (gluten and dairy free) designed by a former student of the college. And I have to say they were absolutely delicious and a better alternative to other snacks that have been hanging around since the holiday period. They’re great to fit into the lunch box too. I’m now a goodie ball convert.

I did put my own spin on them to Chinese Medicine them up a bit. Given that the ingredients were raw I wanted to add a little more warming spice to the mix to aid digestion (there is cinnamon in them already though) as the recipe is quite rich. That was the addition of some uncrystallised ginger (like the crystallised but without the sugar crust on the outside) and I replaced the sultanas with currants, just because I like them more. The nut base is made with walnuts which already have a warm energy too.

So this recipe has Earth element written all over it. Sweet, orange coloured and carrot flavoured with some nice spice. It’ll nourish your Spleen, Stomach, Qi and Yin.

What are your favourite goodie balls? Why not share the recipe in the comments below. Let’s have a goodie ball recipe swap!

Enjoy!

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.

 

Uncategorized

Rekindling the flame

Last year finished on a sad note for me. My mother, who had been battling chronic illness (scleroderma and others) passed away. She was an incredible source of inspiration to me and those who knew her. She allowed me to share one of her speeches on this blog several years ago and she asked that this same speech also be read at her funeral. Very wise words from a very special woman. I hope you find some inspiration in them too.

Sarah George Acupuncture and Natural Health

This post was written as a motivational speech by someone very close to me who suffers from several health problems.  She was happy to share it.  It’s one of those things that’s good to read now, and then put in a safe place, so it can be read again, when inspiration is needed.

Rekindling the Flame

When things get tough and you feel burnt out – mentally, physically and spiritually, how do you rekindle your flame and find the inspiration keep meeting life’s challenges?

For some, it comes from the beauty and peace of nature.  For others, it’s the company of family and friends or even pets.  Yet others, seek the wise words of our gurus or the magic of music.  All of these can teach us wonderful things, but sometimes, it’s something completely unexpected that makes the biggest  impact.

Let me tell you, how it happened for me.

I’d…

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acupuncture, Uncategorized

Acupuncture does have a place in Evidence Based Medicine

acupuncture needleLast time I was at Western Sydney University (WSU) I was staying on campus and shared a unit with a medical doctor who was working at the local hospital. On finding out I was an acupuncturist she said, “so, is acupuncture evidence based? Our medicine is evidence based.”

I took a deep breath and summed up all of the tact I could muster and calmly replied “well, some of it is, and some of it isn’t, just like you guys.”

I’m not here to create an ‘us and them’ situation. I have great respect for a lot that western medicine has to offer. I regularly refer to GPs as I should. We do different jobs and a GP can do a lot that I can’t as an acupuncturist – I am aware of where my scope of practice ends. I consider myself to be an integrative practitioner making sure that my patients have access to all of the health practitioners who will ultimately see them reach the best outcome possible. Working as a team is good for patients.

Strap yourselves in. This is a going to be a long post. But I sincerely hope you read through to the end. 

Please read this post with the intention in which it was written: to take an Evidence Based Medicine approach to all medicines and therapies regardless of the school they belong to. Patient outcomes are what matter in the end, there is no room for ego or turf wars. And working together we achieve more.

What is Evidence Based Medicine?

You could be forgiven for thinking that Evidence Based Medicine (EBM) is solely based on using only medicines/therapies that have gold standard randomised controlled trials (RCTs) to prove that they work, or at least that’s what we’re lead to believe through the media.

Well it isn’t just that. This is only part of it. There is a lot more to it.

David Sackett is considered to be the father of EBM. He sadly passed away this year but made great contributions to the fields of epidemiology and best clinical practice.

Sackett considered that EBM had three fundamental components (and you may have seen these linked together in this Venn diagram):

  • Best external evidence (eg. systematic reviews, randomised controlled trials but also research that measures qualitative patient outcomes)
  • Individual clinical expertise (eg. the individual experience and training of the practitioner)
  • Patient values and expectations (eg. what the patient will and won’t do, or can and can’t do)

Like the diagram implies, none of these parts always hold more weight than the others for every clinical patient situation.

Anyone who has ever managed a patient with several chronic or unusual illnesses knows that relying only on the best quality external evidence might not give you many treatment options for your patients.

Bias is alive and well

Have you ever asked your doctor or specialist, “so, is pharmaceutical medication or surgery evidence based?” No, probably not. Because it is actually a stupid question. When inquiring about evidence we want to know if there is evidence for a therapy giving a clinically significant outcome on a particular health condition or symptom. Asking if pharmaceutical medication or surgery is evidence based as a general question is not likely to give you a useful answer, just as it doesn’t if you were to ask that of physiotherapy, chiropractic, osteopathy, acupuncture, Chinese medicine, massage, herbal medicine, naturopathy or nutrition. And no modality of medicine should be ruled out on such a general question. I think there is bias in anyone who thinks that you can. Bias is the opposite of what scientific research is all about.

What we’re interested in is blow by blow, which therapies are best for which condition. Where we have the best external evidence we can use it. Sometimes we can’t or it doesn’t suit the patient’s needs. And we all know that certain practitioners are sought after because they are known to have excellent clinical experience, judgement and patient care, even though they all have access to the same external evidence.

If you’re still not sure that western medicine isn’t completely based on the best external evidence then you should view ABC TV’s 4 Corners: Wasted, ABC TV’s Catalyst’s: Too Much Medicine and then have a listen to ABC RN’s Background Briefing: Cold Comfort: Is the fertility industry misleading women?

Arthroscopy for osteoathritis of the knee anyone? How about a scan for that uncomplicated back pain? Do we have the clinical trials to show if that long list of medications that you’re on work well together and are all still benefiting you now? Or what about freezing 10 eggs, or was it 15, to maybe fertilise some years later and possibly get a positive pregnancy test but probably not a live birth?

Now, we wouldn’t write off western medicine over these findings, but what we do know is we need to find therapies that might work for these patients instead. We’ll also still happily use western medicine for the treatments that do show good evidence for positive patient outcomes, and there are plenty of those. It would be a shame to lose the baby with the bathwater. Let’s apply the same rule to acupuncture and other integrative medicines.

I also need to point out that the gold standard of research, the double blind RCT, is best suited to therapies that involve taking a pill. Giving a ‘pretend medicine’ (sham) to the control group is much easier when you can give a sugar pill which looks the same as the medication. Giving ‘pretend acupuncture’ is a whole lot harder. Surgeons, physiotherapists and massage therapists all face this problem when designing randomised controlled trials. Acupuncture research will always lag in methodological quality if double blind RCTs remain the primary measurement tool of clinical effectiveness.

Which conditions does the best external evidence support acupuncture for?

If you’re reading this Australian Federal Health Minister, Sussan Ley, some of these should be on the table for consideration if we are actually serious about providing the best of EBM to patients. (Because we are taking a scientific approach and aren’t biased about these things are we?)

Let’s not muck about and head straight to the the gold standard of medical evidence, The Cochrane Review. (Some of the authors conclusions below rightly mention the problem with acupuncture trial methodology as discussed above).

Here are some of the author conclusions from the results of a search of acupuncture Cochrane Reviews:

  • Tension-type headache“In the previous version of this review, evidence in support of acupuncture for tension-type headache was considered insufficient. Now, with six additional trials, the authors conclude that acupuncture could be a valuable non-pharmacological tool in patients with frequent episodic or chronic tension-type headaches.”
  • Migraine prophylaxis“Available studies suggest that acupuncture is at least as effective as, or possibly more effective than, prophylactic drug treatment, and has fewer adverse effects. Acupuncture should be considered a treatment option for patients willing to undergo this treatment.”
  • Neck disorders“There is moderate evidence that acupuncture relieves pain better than some sham treatments, measured at the end of the treatment. There is moderate evidence that those who received acupuncture reported less pain at short term follow-up than those on a waiting list. There is also moderate evidence that acupuncture is more effective than inactive treatments for relieving pain post-treatment and this is maintained at short-term follow-up.”
  • Chronic low back pain“For chronic low-back pain, acupuncture is more effective for pain relief and functional improvement than no treatment or sham treatment immediately after treatment and in the short-term only. Acupuncture is not more effective than other conventional and “alternative” treatments. The data suggest that acupuncture and dry-needling may be useful adjuncts to other therapies for chronic low-back pain.”
  • Dysmenorrhoea (period pain)“Acupuncture may reduce period pain, however there is a need for further well-designed randomised controlled trials.”
  • Low back pain and pelvic pain in pregnancy“Evidence from single studies suggests that acupuncture or craniosacral therapy improves pregnancy-related pelvic pain, and osteomanipulative therapy or a multi-modal intervention (manual therapy, exercise and education) may also be of benefit.”
  • Pain management in labour“Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced use of pharmacological management. However, there is a need for further research.”
  • Cephalic version (breech presentation) “There is some evidence to suggest that the use of moxibustion may reduce the need for oxytocin. When combined with acupuncture, moxibustion may result in fewer births by caesarean section; and when combined with postural management techniques may reduce the number of non-cephalic presentations at birth, however, there is a need for well-designed randomised controlled trials to evaluate moxibustion for breech presentation which report on clinically relevant outcomes as well as the safety of the intervention.”
  • Irritable Bowel Syndrome (IBS) – “In comparative effectiveness Chinese trials, patients reported greater benefits from acupuncture than from two antispasmodic drugs (pinaverium bromide and trimebutine maleate), both of which have been shown to provide a modest benefit for IBS.”
  • Schizophrenia“Limited evidence suggests that acupuncture may have some antipsychotic effects as measured on global and mental state with few adverse effects.”

But like Sackett taught, research trials are not the whole picture, sometimes we need to provide patients with treatment that may offer some benefit, with low risk of serious adverse events, because we simply have nothing with better evidence left to try. Acupuncture often fits into this picture when practiced by a Chinese Medicine Board of Australia registered acupuncturist (AHPRA).

How does the story end?

And if you are wondering about the doctor at the beginning of the blog, well in the end she asked where she could see a Chinese Medicine practitioner to help with her low immune system because nothing else she had tried from ‘her medicine’ had worked. Good luck to her, I’m glad we were able to have that open minded conversation over the breakfast bench that day at WSU.

To book an appointment at the clinic or further information on Chinese Medicine contact Dr Sarah George (Acupuncture).  Sarah is a practitioner of acupuncture (AHPRA registered), massage therapy and natural health.