The Malcolm X Elementary School Garden

Today I spent a wonderful morning with Rivka, the gardening teacher at Malcolm X Elementary School in Berkeley.  I arrived during a break in the February rain, and met her in the 4,000 square foot section of the school's yard about 15 minutes before recess began.

There were several volunteers there already.  One, a general contractor, was creating a rainwater capture device from the roof of the garden shed.  Another was tending to the garden.  And yet another, a yoga teacher named Angela, was there to help with the students.

Rivka told me the history of the garden program; she began it 15 years ago in the raised planters by the school. As she pointed to these planters they looked more like the type of place where landscaping shrubs would typically go.  But that was what she had access to back then, when the whole schoolyard was concrete.   So she started planting with the students there.  When that no longer worked, for a while there was a garden across the street at another facility, or for a time fava beans on the front schoolyard.

A few years later when the schoolyard was being redone to include trees and other equipment, the playground committee allotted a portion of the schoolyard to the garden, and that it is where it now sits.

Malcolm X Elementary's 4,000 square foot garden, located amidst their playground, on Prince St in Berkeley

As Rivka finished up telling me about the garden's genesis the recess bell rang and students started pouring out onto the yard.  Students started to pick their activity, and some wandered into the garden to see what they could do.  "Ms. Rivka, can I shovel?"  "Can I collect snails?"

With every activity, I was surprised at the enthusiasm the children brought.  With great zest, they wanted to dig, to shake the soil loose from the weeds, or to hunt for snails.  When one boy brought five snails back to Rivka she told him that she would show them how to have a snail race.  The boy thought that was quite cool!  A third youngster wandered over and wanted to pick weeds.  Rivka showed him how to do it.  A few other girls came by and spontaneously joined in.

One thing I found impressive was how Rivka ties the garden into whatever topics the students are learning in the classroom, whether it be about cycles, or the digestive system.  For instance, third graders learn about indigenous cultures.  So Rivka does a curriculum about medicinal plants, and talks about what defines a plant as a "weed."

Third grade project on the medicinal properties of locally growing herbs.

Many weeds are actually quite useful and tasty, like miners lettuce and chickweed.  As a matter of fact, these and other greens are so popular here that students make what they call a "Weedo" (as opposed to a "burrito") by taking a big leaf which acts as the tortilla, and then putting inside it other greens, chamomile flower, sour sorrel, and fennel.

Children are taught to see the uniqueness of the vegetables.  Rivka tells students that if they like licorice, they'll like fennel.  And she says that children love sour things, and that the sour sorrel brings them into the garden.

Yes, the students come into the garden during their recess time just to have a handful of freshly picked leafy greens!

One young man is making his "Weedo."  I made one myself - quite delicious!

After the students finish their weeding or snail collecting project, they ask Rivka if they can have a treat. In this case, their treat is a Weedo that they make for themselves.  As the bell sounds the end of recess, the students make their way back to the building enthusiastically munching on their greens.

Sour Sorrel - usually a bit higher than in this picture.  It's very sweet and tangy.  And a student favorite!  

After recess, Rivka led a small third grade group through a lesson in nutrition.  She was very gifted and experienced in engaging the children, and making sure that they were given the chance and guidance to truly engage with the food.  The children took turns cutting carrots, and then together took a turn juicing chunks of carrot, apple and beet in a juice machine.  The results?  They had learned about how "You are what you eat" in a meaningful way, engaged in a healthy class discussion about nutrients, fiber, organic growing,  how to be balanced (which was right in line with Chinese Medicine), and how their body felt when they ate candy versus healthy food.

And, when Rivka asked them how the juice tasted, they all gave a "thumbs up"!

The students made juice in the classroom when it started raining too hard.  You can't see, but on the board were their ideas on how they felt when they ate sugary foods vs. eating carrots and apples.

Students are engaged in the garden and the food making.  Thumbs up!!

Rivka was full of enthusiasm and expertise.  She told me that you don't need all this space to have a successful gardening program.  Wine Barrels can be found for $20.  Free compost is given out monthly for Berkeley residents.  A cutting of Tree Collards, or just a few seeds that are grown in little cups, can be the start of a valuable learning experience for the children.

Wine Barrel Planters

Miners Lettuce

Fennel - a Weedo MUST!

Tree Collards

Greens....

...and more Greens!!

Long gone is the time when Rivka had to figure out what tiny spot would accommodate her garden.  Furthermore, now there is grant money that puts a garden in every Berkeley elementary and middle school.  Rivka's position in the school is more secure, and judging by the way she knows all the children's names and interacts with them and the teachers, I can tell that she is a highly valued member of the school community.

Aside from that, she was incredibly generous and encouraging to me as I was asking her questions about how I could develop workshops with young people that incorporated gardening, cooking and nutrition.

The one point she conveyed to me both in words and actions was that by engaging students in the whole process, from planting, to weeding, to preparing and then finally eating, students are very eager to try all sorts of foods.  They just need to be involved.

And this was what I found so magical.  I have worked in many schools and know how hard some health advocates struggle to get students to put down the coke and chips and sample a fresh vegetable.  And I know that in a lot of schools while there might be a nutrition curriculum of some sort, there is not access to the food itself.

But here Rivka not only made it all work - the kids were asking for a Weedo as a treat for having weeded the garden - but she made it look easy!


How would the health prospects of young people change if more of them had access to a teaching garden like the one at Malcolm X Elementary in Berkeley?   


A big thanks to the inspiring Rivka, and the young scholars at Malcolm X in Berkeley.  May the carrot, apple and beet juice you made today help you have a very happy and healthy Valentine's Day!


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Still curious?  Watch this great video about Rivka's garden! Or check out Rivka's garden blog.

The Top 10 Reasons People Visit The Acupuncturist: 2. Hypertension

According to the American Heart Association, about 74.5 million people in the United States age 20 and older have high blood pressure.  This is about one in three adults.  High blood pressure is defined as systolic pressure that averages 140mm Hg or higher, and/or a diastolic pressure that averages 90 mm Hg or more.  However, anything above 120/80 is considered pre-hypertensive.

In a study published by the Journal of the American Heart Association, results showed that acupuncture significantly lowered average 24-hour ambulatory blood pressure for a six-week treatment, a randomized trial reported. However, the effect disappeared in three months after a cessation of acupuncture treatment.  This suggests that ongoing treatment is required to maintain the effects of treatment.   Read the full article here.

Most patients included in the study were already on antihypertensive drug therapy, and these patients were instructed to not change their medication throughout the study period, or to use over-the-counter drugs or herbal supplements.  This is very important because in the real world, due to the high risks associated with hypertension, patients with high blood pressure should keep their medications unchanged while first seeking acupuncture care.  If your numbers go down far enough, then of course you can talk with your prescribing M.D. about changing your drug therapy.  But, especially in the case of hypertension, it is important to always have an M.D. monitoring your prescription drug therapy.

Acupuncture's holistic treatment of the body can also have a healthy influence on blood pressure.

Anxiety, which does not cause hypertension, but which can cause temporary spikes in your blood pressure that could potentially damage the cardiovascular system, is greatly alleviated by acupuncture.

Insomnia, which might be linked with hypertension, is also relieved with acupuncture.

And while researchers aren't sure if high stress is linked with hypertension, activities known to reduce hypertension can also reduce your stress level.  A key example is exercising 30 to 60 minutes per day.

The point of mentioning anxiety, insomnia and stress is to remind readers that acupuncture is a holistic medicine that is capable of treating patterns in the body not just limited to a patient's chief complaint.  And sometimes, when treating what might appear to be unrelated symptoms, your primary symptoms improve.

Part 1. Journal Studies

In my previous entry I talked about the treatment of pain with acupuncture and TCM.  Here are a sampling of research articles.


Study Shows that Acupuncture Effective in Treating Carpal Tunnel Syndrome
This study, published in the May 2009 Clinical Journal of Pain, showed that acupuncture was as effective as corticosteroids in treating carpal tunnel.


Low Back Pain
Acupuncture was proved to have a long-term pain-relieving effect in a randomized placebo-controlled study. The study found a significant improvement for the treatment group in return to work, quality of sleep, and analgesic intake, with effects lasting up to six months.  The results were published in the December 2001 Clinical Journal of Pain.


Another study examining Low Back Pain, published in 2006 by the American Medical Association, randomly placed patients into one of three experimental groups; full acupuncture treatment, minimal acupuncture treatment*, and no acupuncture treatment.  Results showed acupuncture was more effective in reducing low back pain intensity than no acupuncture in patients with chronic low back pain.  Most outcome variables tended to be slightly better in the acupuncture group compared with the minimal acupuncture group.   

Pelvic Pain in Pregnant Women

The British Medical Journal in 2005 published an article reporting that adding acupuncture to standard treatment is superior to standard treatment.  

Ginger (Zingiber officinale) reduces muscle pain caused by eccentric exercise.
This study showed that both raw and heated ginger reduced pain after an exercise induced muscle injury. The New York Times covered this article, although I recommend reading the original abstract because it's shorter and more clear. Ginger is a common cooking and medicinal herb in TCM, although I've never heard of a TCM practitioner using it alone for treating muscle pain. We normally combine it with other herbs to make larger formulas, or use it in medicinal cooking.




The take home message is that acupuncture can be very effective in treating pain throughout the body.  And it is a very safe treatment method.  


Compare this with a common way that people treat their pain - using over-the-counter NSAIDS (non-steroidal anti-inflammatory drugs) such as advil, motrin and aleve.  A recent study in the February issue of the British Journal of Sports Medicine showed that while many athletes use NSAIDS on and before race day, most do not know about serious possible side effects, including kidney failure and gastrointestinal bleeding.    


While I am a huge proponent of advancing acupuncture research, I also want to remind people that we do not need to wait for further studies to know that acupuncture is a safe and effective treatment option that can not only help people recover from pain and injury, but can optimize training and performance.

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*You might be now wondering, "what is the difference between full and minimal acupuncture treatments?"  The answer to this question is contentious within the field of acupuncture research and deserves a blog entry of its own.  The short answer is that when designing a study, researchers would prefer that their patients (i.e., research subjects) do not know what experimental group they are being placed in.  This is half of the "double blind" design that is universally agreed to be the gold standard in research, with the other half being that the researcher delivering the experimental intervention (in this case, the acupuncturist) doesn't know which of the interventions she is delivering.   


Minimal acupuncture is a type of "sham acupuncture." And sham acupuncture is a type of intervention that is aimed at making the subject believe that they are receiving acupuncture while (in a perfect world) not receiving any benefits of a true acupuncture treatment.  In other words, sham acupuncture is intended to be perceived as an intervention by the subject but to have zero treatment affect.  The trouble is that most sham treatments affect acupuncture meridians in some way and therefore can't truly be considered the same as not receiving a treatment at all.  

From a practical standpoint, what you end up with is many acupuncturists on one side of the argument saying, "we understand the need for double blind studies, but the way they are currently being implemented is erroneously biased against showing acupuncture's efficacy" and some western trained researchers sticking to their point that "the gold standard of research ought to also apply to acupuncture research so that we can distinguish efficacy from placebo."

Harvard Medical School has looked into this, and if there's interest I can write more about this topic.  

In the end, the take home message is that while acupuncture research can't neatly fit into the double blind design model, acupuncture research is continuously providing us with a growing database of helpful studies that show that acupuncture is effective in treating many conditions.

The Top 10 Reasons People Visit The Acupuncturist: 1. Something Hurts

Pain is by far the top reason that people seek care from an acupuncturist.

This discomfort could be an old knee injury from high school that gets creaky in the cold weather, a repetitive stress injury from computer use,  low back pain due to heavy lifting, a stiff neck due to a job that requires a lot of sitting, or a sports injury that strains the musculoskeletal  system.  Fibromyalgia and chronic pain are also common.

So how does acupuncture address these types of pain?

First of all, acupuncture treatments increase the amount of endorphins in the body. These are the chemicals that make the body feel good during exercise, pain, feelings of love, and during sex.  Endorphins chemically resemble the opiate morphine which explains its analgesic effect, and ability to promote a feeling of well-being.

But how strong could a painkilling chemical be if it just comes from your own body?  

Well, I can remember when I was a kid I went to the emergency room with my parents because my little brother needed a couple stitches.  When we arrived we saw a little hyper boy running around the waiting room, dashing up and down the little slide, and happily playing with all the toys. 

That boy went in to see the doctor right ahead of my brother, and when he came out we were shocked to see his arm in a full cast!  He’d broken his arm in two places!

How had he been able to run around and play like a healthy child when in just a few minutes x-rays would show he’d suffered a major trauma?  He was experiencing an endorphin rush that commonly follows traumas such as broken bones.  That story has always reminded me of the power of endorphins -  our body's natural pain killers.  

Another avenue of pain relief is through the nervous system;  acupuncture has a profound calming effect on the nervous system, and in this way can regulate nerve impulses transmitting pain.  

Acupuncture also reduces inflammation, which is often a component of pain.  For instance, we all know that there will be inflammation in a newly sprained ankle.  But there can also be inflammation in the gastrointestinal tract that causes discomfort, such as in the stomach lining.  Acupuncture’s strong effect on reducing inflammation is very helpful in this situation!

Lastly, in situations where an increase in circulation will help an injury heal faster, acupuncture is very helpful.  By increasing blood flow and thus oxygen and nutrient delivery patients often find that they heal faster and can comfortably return to activities faster.

So that is the short story of pain relief from a western perspective.  But what about pain relief from the perspective of Traditional Chinese Medicine?

When a patient comes in for help with pain we ask them some questions about the pain so that we can devise an individually tailored treatment.

• Where is the pain located? 
• Does this location stay fixed, or does the pain move around?
• Can the quality of pain be described as dull, sharp, heavy, cramping and/or burning?
• When pressure is applied is the pain alleviated or aggravated?
• Does applying heat alleviate the pain? What about applying cold?
• Was the onset of the pain slow and gradual, or sudden?
• Does the pain feel better with movement or rest?
• Is the client feeling any melancholy, depression or anxiety related to this pain?

Through these questions, as well as by doing a complete initial intake, we can find out if the pain is caused by stagnation, channel obstruction, cold, heat or a deficiency within the body. We can also find out which particular acupuncture channels are being effected.


Then we might put needles on the acupuncture points near the site of the pain (a local point), or we might treat points on that channel in an area of your body that is not currently in pain (a distal point).

An example is someone who reports sharp, fixed headaches on their forehead, that are aggravated by applying pressure, and relieved when doing exercise. The location of this headache indicates that the Yangming channels are being affected with blood stasis. For treatment we would needle yangming points on the lower legs and forearm, as well as a few points to increase circulation.  Herbs to treat the blood stasis could also be prescribed.

Lastly, while most people think of acupuncture as something you do after you get hurt, it is also a tool to optimize athletic performance and help prevent injury. More about that in a later post....

Also, as this post is getting quite long, I'll save my sampling of research articles for my next post.

The Top 10 Reasons People Visit The Acupuncturist

Lately I've been going to a lot of networking events, and the most common question I encounter revolves around the theme of what types of conditions acupuncture can treat.

• "What problems do people come to you for?"  
• "What diseases are you trained to treat?" 
• "Can acupuncture help with my child's headaches?"  

Since acupuncture relies on a careful evaluation of signs, symptoms, tongue and pulse within a logic system that is often quite different than the western medical logic, we acupuncturists don't always first think in terms of western disease diagnosis.  After all, we might get five different patients with the same western diagnosis of "stomach ulcer," but in our system they are all exhibiting different patterns which require unique treatments.  In other words, the way that we diagnose takes into consideration the western diagnosis, but uses that just as a starting point for further differentiation.

However, in the United States I think it's important that acupuncturists clearly convey the types of ailments that acupuncture can help, so that people know when to recognize that a trip to see us would be helpful!  For example, a new client comes to me complaining of tennis elbow.  During the initial intake, I find out that she also suffers from insomnia but didn't know acupuncture could help improve her sleep.  If she hadn't overdone it with her backhand, she might have never known it was a treatment option.

In this spirit, I am going to start out my new blog by making posts about the Top 10 Reasons People Visit The Acupuncturist.  This is in no way scientific;  I just did a quick mental list of all the patients I've treated over the past several months and came up with this collection.  When possible, I'll link my blogs up with applicable research.

My Top Ten List (in no particular order or importance or prevalence):

1. Something Hurts:  (including Back Pain / Sports Injury / Injury due to sedentary job / Chronic pain)
2. Hypertension
3. Stress / Anxiety / Depression
4. Fertility (including men...!)
5. Headache
6. Insomnia
7. Gynecological Issues: (including Menstrual Cramps / Hot Flashes / Cycle related mood slumps / Fatigue after childbirth / Mastitis)
8. High Blood Pressure 
9. Trouble losing weight / Feeling low energy
10. Digestive Issues (acid reflux, pain, indigestion)
11. Frequently catching colds  (Yes, I'm cheating by sneaking an eleventh in.  But it's so common that I don't want to leave it out!)

In each future entry I'll make my way down this list.

If you are an acupuncturist and commonly treat something that I haven't included please leave a comment with your experiences!

If you are someone wondering if acupuncture could help you then my advice is to make an appointment with a licensed acupuncturist near you.  Acupuncturists need to do an initial intake before we can concretely let you know what your treatment options are.

To make an appointment with me, you can either visit www.acutuneup.com and make an appointment online, or call my office at (510) 545-2283.