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Emily the acupuncturist had performed a compelte physical exam, as they had planned when he called in with a long laundry list of complaints. She had him sit on the edge of the massage table and rolled over to his feet.

In her experience, Emily had seen that allopathic (western) medicine tended to treat symptoms individually using a rather mechanical view of the body. It works well for most individual conditions, but Arty had a lot of systemic problems, not the least of which hormone imbalances such as diabetes and immune issues such as arthritis.

Part 1 – The Gait-way to a dozen issues

“Let’s talk about your feet,” she said.
“Good, because they hurt all the time,” Arty replied.
Emily nodded. “Well, Arty, the problem starts with your weight.”
“How so?”

“Your feet are like your hands in that they have a lot of bones in them, but unlike your hands they aren’t flat they have arches. When you have added weight – and probably developed a habit at a young age – your feet splay out and this causes stress on the arch.”

“Plantar fascitis?”
“Yes, but first there would have been fallen arches and heel spurs because the weight is being redistributed along the sides of the heel. It probably doesn’t help that you wear work boots without support.”
“Well, I do now!”
“Right, but by now you already have the heel spur, fascitis, and bunions…”
“And maybe nodes, there’s a funny bump inside my left foot.”

“I saw that, but that’s not what concerns me Arty. Do you see this here?” she asked pointing to something round, shiny, and red.

“Yeah, my bunion, I know it needs to be removed but I haven’t been to the podiatrist lately.”
“Arty, that’s not a bunion, that’s Gout.”
Sclerosa guffawed.
“Well it is really painful,” he said as Emily prodded it.
“Of course. Arty, this is a result of two things. Number one, your GUI system is out of balance because you wear a really tight belt, are overweight, and you eat fatty, greasy foods – you admitted to me. Secondly, your diabetes and clotty legs have reduced your circulation, so it is difficult to get the uric acid crystals out once they are in there.”
“Well what do we do!?” Arty asked exasperated…
“This is an herbal issue. I know you’re on a diuretic already, so we have to be careful to make sure not to overdo it. I’ll prescribe you some supplements you should already be considering besides Calcium, such as Magnesium, B3, B6, D, and Co-Q-10; and you’ll have to drink plenty of water, but not too much.
“At any rate our Chinese formula uses a cocktail of herbs that have been designed over centuries to work well fighting Gout. It’ll reduce the inflammation and release the uric acid crystals over time. It would probably be too painful to needle directly , so we’re going to perform some moxa around it and needle you in the abdomen. You can expect it to take 1-3 months to resolve.

“As for the bunion,” she continued, “and arches, and fascitis… we can needle the area, and remove some pain, but by in large you need to #1 get good support for your feet to reduce your sciatica and hip issues, #2 do these exercises,” she said, handing him a list of arch-exercises, “and #3 learn how to walk in-line.”

“Yes, your toes should not go out at that 45 degree angle Arty, they should not really go out at more than 5-10 degrees, and ideally should be under five. Most of this issue is due to that, and your diet.”
“Well, how do I fix that?”
“I’m going to teach you how over time, but for the most part, you have to look down and observe your gait. You may experience some mild knee pain as you alter your gait and things stretch back into the right shape. Overall this will be a 3-6 month process to fix your gait and fascitis. The pain relief I bring won’t last forever, you have to do the work.”
He sighed, “Is that it?”
“No, Arty.”

“Doc,” Sclerosa butted in, “before you go on, what should I – I mean we – do about our bunions?”

“Bunions are calcification due to shoe shape being incorrect for you,” Emily smiled with compassion, “unfortunately there’s not much you can do, but get regular massages and then if the feet become very painful and deviated, you should think about surgery. However, mostly you should spend your time and money are larger issues at this point.”
“But they really hurt,” Sclerosa said.
“I know, but that pain is merely like the light on your dashboard saying ‘check engine’ it is leading us to larger issues.”

Part 2 – Poor Circulation

“Now Arty, I can see you have many issues in the feet and ankles related to poor circulation.”
“I don’t understand, Doc, I mean I am on my feet all day, it’s not like I sit around all day and watch TV.”
“I know Arty, so let me explain. You were a smoker before, right?”
“Yeah, but I quit 10 years ago.”
“Well that was a major part of the problem, and the other part being your diet. You see, inside synthetic foods and cigarettes are lots of chemicals that have sharp edges. When you developed hypertension, these chemicals scooted along through your veins and arterioles (small arteries) making tiny abrasions or cuts to the smooth muscle. Whenever this would happen your body would lay down plaques of cholesterol…”
“But at that time,” Sclerosa butted in, “we were on a no-fat or low-fat diet. We always used margarine!”
“Unfortunately,” Emily shook her head, “trans fats have been shown to increase heart disease risks and cholesterol buildup, not help it. Ever notice that flies won’t eat it? There’s a reason for that.”
“So then what?” Arty asked.

“Well, as these plaques built up, the circulation got poorer and poorer. At this point two things were happening simultaneously. Number one, you were aging, slowing down, sitting longer, and this all reduces the natural venous return and lymphatic pump system in your legs. You see you have no heart in your feet and the heart is not a vacuum, it takes movement to push blood and lymph back towards your heart. At the same time, your poor posture and changes were increasing your arthritis and joint deformations which reduced the blood flow. Of course your diabetes was a result of this.”

“OH! I thought the circulation issues were caused by diabetes.”
“No, they are made worse by, but they existed long beforehand. In our medicine, everything is a continuum of a process. When something is not improved it worsens, never staying the same. Now I mentioned you wear your belt too tight…”
“Yeah, what’s that mean?”
“Simply that as you do so and your Girdle Vessel that wraps the body is weakened – meaning your muscle cavities – then your body cannot regulate fluid transfer from the middle to the bottom of your body so well.”
“What about the sores he has?” Sclerosa asked.
Emily nodded, “You see the varicosities on the medial side of his foot and just above the inner ankle? These show that the superficial blood-flow is poor. He may have claudication or thromboangitis, but the infections are a result of poor circulation of superficial Qi and blood.”
“Well the immune Qi circulates around surfaces, protecting our outsides. As I understand it Arty had a series of bronchial infections ten years ago and that’s why he quit smoking. Well all of those antibiotics he took really weakened the source of Qi in the gut and since then his immune system is so busy dealing with gout and joint problems that he’s unable to circulate any to the surface. In that case, anything can take root.”
“Like warts and athlete’s foot?” Sclerosa asked embarrassingly.
“Er, yes,” Emily frowned.
“So… what do we do!?” Arty asked.

Part 3 – The Road to Healthy Blood

“My feet and calves hurt!”
“I know Arty, but the problem cannot go away completely without your help. Now the doctor has added a blood thinner…”
“Not yet. I am not sure I want to be on Cumedin, I’ve heard you’re stuck on it forever.”
“That’s true. And it’s good, because you should start all of your herbal programs before any blood thinners. Once on a blood thinner, your options become more limited.”
“Because Cumedin has a very narrow therapeutic window, and it’s dosage range is easily tampered with, and also your diuretics can affect it. Instead, I propose you start with high dosages of blood moving herbs. These herbs are not thinners, but they do dissolve clots and open veins. We’ve used them for literally thousands of years.
“Are there any risks?”
“There’s always risks, Arty. Not doing anything, though, carries a huge risk. But as it happens I always check for drug-herb interactions which are really limited, and because you’re not on Lithium or Cumedin I am not worried.
“Now, the herbs will be internal and external. We have to close that sore.”
“I’ve been on and off antibiotics for years, nothing helps.”
“Well in their medicine everything is about infection and inflammation. But actually, in our medicine, we believe in two types of sores. The type that are red and hot and ooze a lot, and the kind that are cold, do not close, and ooze slowly.”
“Like mine!”
“Exactly. So we’re going to use external herbs to remove stasis, close the wound, and relieve pain in that Gout you have.”
“So my internal formula will remove Gout and clots!?”
“Yes, Arty, and much more. We tend to do many things in one treatment because we are treat you not your symptoms.”
“What about acupuncture, can it do anything?”

“Yes, but in this case most of my work will be with moxabustion – a heat application – and I’ll be teaching you to use it. You’ll need to come in many times a week to get good results. In China they’d see you everyday, so I’ll need to see you three times a week, two minimum to realyl get results. And that’s just for this condition.”

“That sounds expensive,” Sclerosa said.
“I have a Chronic Pain program Arty qualifies for, as it happens you do, too. It will reduce cost. But think of it this way: how much is the cost of a major operation and all the meds for a heart transplant afterwards?”
“She’s right,” Arty nodded, “I check my insurance, and our deductible can only cover half. Basically we’d be out at least $30,000 and I’d rather put that money towards my term-life insurance.”
Sclerosa teared up.
“Let’s not get ahead of ourselves,” Emily chimed in, “After all, I said your case was difficult, not impossible. You come regularly, keep faith in your body and yourself, and reduce your work hours, you’ll be fine.”
“That might be hard. The time off is ok, but my work needs me.”
“Arty your Qi is very weak, as I’ve explained. And besides they can’t use you if you’re dead.”
“Should I just retire?”
“Um… not yet. Retirement is often the death knell for people. I’d like to think that you can use the opportunity to walk more. But less desk work and sitting, and more movement. No cardio-exercise.”
“I was just going to ask…”
“No, cardio weakens the heart and is for healthy people. That could kill you. No, I want you to work on walking and also your social health by joining a Tai Chi class.”
“Tai Chi?”
“We’ll talk more about that when we get to your knees. But Tai Chi is low impact and great exercise, and has been proven to help posture.”
“Is that all, Doc, about my feet?”
“No, there is just one more thing.”

Part 4 – Stop hitting yourself

“I know that you’ve been spraining your ankles at work. I need you to stop using ice.”
“It really reduces circulation. On top of that it hurts your arthritic joints. You need to learn how to use warmth. If you sprain again, you come see me immediately, instead of ‘manning it out.'”
Arty chuckled, “OK, is that it?”
“No. I also notice you’re using tight socks to keep your feet warm. Stop. The pinching of the cuffs on the legs is causing even more reduced circulation.”
“Gee, really?”
“Yes, look at where all your varicose veins are, and the sore… below the sockline. No more tight socks. Use loose wool socks. Cotton is a poor insulator anyways.”
“Wow, thanks Emily!” Arty beamed.
He’d never thought of how a belt … or his cuffs could negatively impact his circulation. He had no idea that clothing was to be a major part of his problem, and recovery.

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