[Zena Kocher]

Hello Danielle,

Yes- as a stand alone, I hold BL 67 for 20 minutes. During the acupuncture tx., you can hold for less time or until you feel it reestablishes itself. It is a bit like a Qi Gong tx really- as you are working more energetically than physically on the small toe- but it is potent nonetheless. Hopefully I can explain more next month and actually show you in July. OR now that I am writing- I can try to make a video to show you all. It is something better taught than just explained and I agree with you- it helps to practice on someone with s/s – so you can see the change. Essentially- you are attempting to energetically draw the Qi down and out the small toe and using the BL 67 channel that connects the heart and uterus. The energy spirals inward and out the toes when someone has a healthy flow and often when someone has morning sickness or hyperemesis- this flow is imbeded. So this is bringing it back.

Not sure if anyone has experienced the ebb and flow of Kidney One- but it is similar. Once the flow returns it helps the body reestablish its flow.

Does this help a bit? So glad you are trying it! Sometimes when folks are really sick they refuse- herbs and or needles and that is when I resort to using this on its own. Otherwise, I do like to add it just how you did for 10 mins or so.

[Zena Kocher]

I am curious about what you all use for ear seeds- do you use the pyonex tacks as well or vaccaria seeds or metal beads?

We are so old school and have been using both types of seeds at the hospital for the last 20 years. Wondering if the pyonex are as viable

[Zena Kocher]

Hello Emma,

Yes- this is a very typical case for someone with placenta previa. i am glad to hear that your patient is not super anxious or fearful of this situation. Often this makes many very anxious and constricted- and that becomes something that we are also treating with acupuncture.

People with placenta previa is a common occurence at my hospital. The bleeding usually is associated with the baby kicking or pressing along the placenta and there is nothing really to do other than monitor it- so that is why they tend to be hospitalized and sometimes consistently up until 36 weeks. In the US it is standard to deliver the baby by C/S at 36 weeks with PP. If there are other causes like placenta abruption or hematoma, that is captured in the Ultra sounds, but not always and often it is a bit of a mystery.

I have found it helpful to fortify the blood- typical in pregnancy in general, but even more so in these situations as many become anemic from the persistent blood loss. As you know there are many ways to treat blood- tonify Blood, tonify Qi, tonify Qi and Blood, chong mai, tonify yin, Tonify Sp; Tonify Lv; tonify KD, Blood point in the ear, tonify stomach Qi line ( a Kiikio Matsumoto technigue that we can talk about if interested), and even treating Liver Qi stagnation.

So when you see her- do your regular assessment and treat her underlying pattern thinking about supporting how her Blood is able to move, nourish, grow baby and heal the placenta. I have found that people really appreciate acupuncture during this time. i hope you both have the same experience.

[Zena Kocher]

Hello Engracia, Thank you for your inquiry. It gets difficult to sort things out with they become complicated by multiple presentations. A few things that come to my mind that I hope are helpful for you.

First- looks like she currently has gestational hypertension- as only her blood pressures are trending higher. Since she does not have any other PE symptoms like

• Protein in your urine (proteinuria), indicating an impaired kidney
• Other signs of kidney problems
• A low blood platelet count
• Elevated liver enzymes showing an impaired liver
• Fluid in the lungs (pulmonary edema)
• New headaches that don’t go away after taking pain medication
• New vision disturbances

it would not be diagnosed as PE yet. And yes- it is really important to continue to treat it and the root cause. esp, with her hx if PE. As you are aware, this could become PE at anytime. So- I agree with you to have that be on top of mind and continue to anchor the Liver yang and tonify the Liver and Kid yin.

Second thing to think about is -when treating pregnancy- you are treating two people and at this point in the pregnancy almost two bodily enivronments. So the dx of Liver yang and yin xu for a mother that is pregnant is a dx for her body. So i would encourage you to keep treating her underlying pattern and keep on eye on her BP. But I would feel ok using moxa as that is more directed to the baby’s environment. ( I am assuming that the baby and anmiotic fluid are fine since you didnt mention IUGR or PPROM). I say it this way because in a way I think of the moxa treatment as a treatment that is directed towards the uterus and less towards the pregnant person’s underlying condition. You could also use the small smokeless moxa sticks on BL 67 ( which is what I use in the hosptial with good results) if you are concerned with adding too much heat to her. I also like the idea of cupping or point stimulation with an ear probe. I did that for a pt with PPROM before we could use moxa in the hospital with success. ( Pressed on BL 67 for 5mins each toe ). You could also have her lay in spinning babies’ sideline position to encourage vertex position 5 mins each side daily.

So from the info that we have so far, I would be comfortable doing a mixed treatment: 1. continue to treat her underlying dx and anchor the yang and tonify the yin. Ear pts like SM, Liv yang, ear apex, dec. BP, liv and Kid, endocrine are all really effective as well (and you could add ear seeds between txs.) along with a 10 day dose of moxa or point stimulation for breech treatment. I also often combine the dai mai with my Liv yg/yin xu points and think they fortify each other nicely.

All the best and let us know how it goes.

[Zena Kocher]

Hello Jamie- Kate answered completely how I would- thanks Kate. So wonderful that you have joined MAMPs- great to have another Minneasotan in our group:)

[Zena Kocher]

Yes- thank you for that reminder. It can happen easily with thin bodies. I often prefer to use acupressure on GB21 instead of needling with this caution in mind.

[Zena Kocher]

Hello Ciara,

I often treat post birth trauma. It is a process of course and helping to create a space that validates and allows the birthing person to share the birth story in a gradual manner is an essential foundation. With the acupuncture- I always treat the underlying pattern- often Blood, Qi or yang deficiency with Shen disturbance. I have found that also using a simple treatment that I learned from Kiiko Matsumoto- can also be quite effective in helping birthing people release trauma that is stored in the body. It also help folks come back into their body and reclaim their center- Si shen cong plus Du 20, K27 and K6.

[Zena Kocher]

Thanks Sarah. This has great perspective.

[Zena Kocher]

Hello Danielle,

Yes- We just started to use the Premio 10 at the hospital- but it is expensive. I used to use the smokeless ear moxa that used in the tigerwarmer. It is small and does not create much smoke and warms points well-not as good for warming whole areas of the body like low back, etc.

As well at SAR, Frank Yusasek from Chicago shared with me that he uses a device that is made to relieve bug bites called Therapik to warm points. It is cheap and folks can buy it a local pharmacies- cost is about $15. I have not tried it yet myself but he swears by them and has used them for years for patients at the community hospitals that he works at and has patients buy their own.

Good luck- let us know what you try.

[Zena Kocher]

So glad you found it Danielle and I am planning on discussing more about it and the finished retrospective study in July!

We finished the study in March. ACOG- American College of Obstetricians and Gynecologists, the institution in the US that sets the obstetric standards of care accepted our poster on the study and published the poster in their annual green book. We could not share the poster until after its presentation at the end of May. So now I am free to share with you all. As well, we are finishing up the final article and preparing to submit that to ACOG. So more to come- but exciting and lots of dedication and learning on my end :). Fingers crossed that we can get funding to do a prospective study and look more at the mechanism of AQ and another about how acupuncture can work to prevent PE!

[Zena Kocher]

Hello Sarah,

I am happy to help with this task as well. Lets talk more when we meet next week?

[Zena Kocher]

Hello Cally,

Thank you for your message. Much appreciated and yes- this is such important work for each of us to address and use our sphere of influence to influence. Sorry for my delayed response- my email was sending the notifications to Spam- but think I have it worked out!

[Zena Kocher]

Wonderful news! Thank you for such care.

[Zena Kocher]

Well said Anisa. I completely agree with you and find that as providers we need to really listen for what the pregnant person needs or is attune to. Thank you for sharing your insights.