​Digital Detox:
For those whose job duties include massive amounts of screen exposure, having time to live IRL is a must. Even if we don’t work in front of our computers, the lure of the quick dopamine hit, and a subsequent potential for addiction to that quick hit, may make us seek out that powerful, pocket-sized, magic-machine a little too often. 

Shopping Detox:
We might know that the over-consumption is an environmental nightmare. Post winter-holidays can be a good time to give your wallet and capitalism a rest. Keep it simple - don’t buy anything new for a prescribed period of time and utilize only the items that you already own or come second hand. Clothing is certainly on top of the list but no-buy detoxes can apply to items from housewares to electronics, etc.

Focusing on Perfection Detox:
Whether it’s exercise, self-improvement, or even “healthy” eating - balance is key to success. Taking a breather from our self-imposed “better, stronger, healthier me” routines can again, increase effectiveness, uncover underlying issues, or even just relieve any sense of boredom or obligation. Food can be trickier given allergies, gastrointestinal issues, or serious illness. 

Get some sleep.
This one was tougher to word because the point is not to give up on sleep but the lifestyle that keeps us from getting enough sleep.  Push aside late nights out, revenge staying up, and scrolling on the phone for hours.  Aim for seven to nine hours every night. Adequate sleep supports and maintains a healthy brain and studies continue to support the connection between amount of sleep and cognitive function.

How will you reset and refresh in 2023?

The Black Rabbit year is an extra special one because typically the Rabbit is the color white and in Chinese astrology when the animal is represented by another color, there is an even more auspicious meaning to the year. The animal itself is considered wise, a little mischievous and a very hard worker. The Black color of the Rabbit signifies the Water element and Yin. 

The Rabbit represents the Spring time of year when animals emerge from their hiding places and start creating the movement needed for Spring. This is the time when the powerful Qi grows from a dormant winter and expands into new energy. 

Spring is all about the energy of rebirth and renewal
Breaking its way out of winter and anticipating summer like a flower whose bud’s makes its way through the cold winter earth, shining its color upon a beautiful sunny day for all of us to enjoy.  This is the same idea with the notion of Qi in Chinese Medicine, which rises up in Springtime and surges through our bodies in its splendor. With this, comes an energy of immense growth and the motivation to push through and forward into planning and projects that may now come into fruition. 

Spring and the Rabbit are also represented in the Wood Element.
Wood gently penetrates the earth to bring forth water, the source of all life. Drawing from our roots, we find the energy to push forward with strength and firmness of purpose, always remaining supple, yielding, and true to our nature. Gentle, Wise, Persistent and filled with creative potential 
Spring is the time to move, be motivated and create. The Rabbit represents the month of March and the time 5am to 7am on the Chinese Clock. 

“Rabbits live in dens, hidden securely underground, allowing them to restore their lively energy. They possess great strategic qualities and know when to act or retreat, thus 2023 holds awesome potential for putting a plan into action. The nimble nature of rabbit empowers us to maneuver around any obstacles that arise in 2023. There can be old patterns or belief systems that hold you back and the rabbit’s agility enables you to let go of these and just do it! Fortunately, rabbits are not risk-takers or fighters, and their cautious nature allows you to move forward with care and cultivate progress while considering all various outcomes. The doors are open, and growth is quick.”  CT Holman

Black always represents the element of Water.
Water is also the most Yin substance which is why this is a Yin year. The nature of water is to flow unobstructed and change, bend and adapt to it’s environment. The water element gives us the energy to adapt and to expand into 2023 and also is associated with mystical, spiritual energies. Water has the ability to hold and absorb emotion and as most of us experienced, 2022 was an emotionally charged year. 

Water in Chinese medicine is also associated with the emotion of Fear.
Fear can create inaction while the movement of Wood wants action. “This would be like the flooding of a forest. Take care to manage emotion by connecting to the earth and bringing grounding qi to daily life which controls the emotion of water.” 
Yin is symbolized by going inward, the feminine, nighttime, the moon, retreating and resting.
“Yin represents Mother Earth and feelings of safety, being held, and nurtured, which allows us to navigate the expanding growth of 2023 with an inner stillness.”

Yin water is yin within yin, the most yin substance, emanating gentleness & softness.
The yin water also helps soften the hardness of wood, allowing ourselves to truly tune into our path and move forward with the both the force of the wood energy and the direction of water flowing within it’s own current. This allows us to take time to go inward, connect to the universe with the compassion and wisdom of the Rabbit.  

Happy Lunar New Year! 


*The reading above was summarized from the great Lotus Institute and from the teachings of Lilian Bridges that have been now passed down to CT Holman. To read the entire forecast please follow this link 

The mere fact that you eat food and have abdominal organs could alone can cause some bloating

What's not normal to have a completely flat abdomen all day long while you're nourishing yourself properly with enough calories to sustain good health.  So, now that we've gotten that out of the way. There are also some other functional, but not problematic reasons why you might be bloated.

Here are just a few of them:

• eating too fast
• eating too much
• diet high in sodium and carbs 
• drinking carbonated beverage 
• Menstrual cycle is about to begin

If you've crossed all those off your list and are still bloated, here are some other health-related reasons for bloating you can consider doing a deeper into:

• lactose or gluten intolerance
• constipation
• gut bacteria imbalance
• low in stomach acid
• food sensitivity

To know if one of the factors above are truly at play, working with our digestion specialist Dr. Bezjak will provide you insight, education, testing evaluation, and a treatment plan.  

​If there's a serious underlying cause for your bloating, these tips will only get you so far. But if they don't help, it can also be a litmus test that the issue is more complicated and its time to bring on a professional.  

Tip #1 - Dial in your good eating habits.
Bloating is often a result of your body struggling to properly and efficiently digest your food. When food moves through your digestive tract before you can digest it all, your gut bacteria get free reign at it, which can result in bloating. So to minimize this, make sure to engage your parasympathetic system (that good old, rest and digest) while eating. Don't eat on the run, taking 2-3 deep breathes at the table before eating, and chewing your food thoroughly 

Tip # 2 - Eliminate bloat triggers.
Unfair fact - some foods will cause bloating no matter who we are. Foods like gluten, dairy, sugar alcohols, and starches just tend to make us more bloated than other foods.  If bloating is messing with your day, try eliminating these foods from your diet for a time and monitor for improvement.

Tip # 3 - Determine what foods you're sensitive to.
If you have any underlying food sensitivities, those are bound to cause bloating. By using a food journal you can try to identity what sensitivities you may have. When you're sensitive to a certain food, eating it creates inflammation in your GI tract, leading to issues digesting and absorbing all your food, the symptom - bloating arises. 

Tip # 4 - Address underlying gut infections.
Imbalance in the microbiome is a prime culprit when it comes to bloating. Whether that's a bacterial imbalance, parasitic infection, or something else, figuring out what's actually happening in your gut and treating it is your best bet for clearing up that bloating. 

The last couple years have hit us hard. The motto of ‘work hard, play hard’ (which is already a fallacy) has been replaced with "work hard and then worker harder because playing and fun are hard to come by".

Burnout tends to affect both women than men due to the numerous plates we are supposed to keep up in the air. Our roles as a parents, partners, worker, child, friend etc…. are putting constant demands on us. in this hyper connected yet disconnected world. 

So that feeling of running on empty, whilst not giving ourselves the time to refuel and recover is an all too familiar feeling. 

• Exhaustion:  Feeling emotionally exhausted, depleted, and a loss of energy.
• Cynicism:  Having a negative attitude toward clients and those you work with, feeling irritable, and withdrawing from people and activities you once enjoyed.
• Inefficacy:  Experiencing diminished personal accomplishment, a perceived decline in competence or productivity, and expending energy at work without seeing any results.

While no gender is immune to burnout, research discovered that men and women process these burnout dimensions differently.  Women typically experienced exhaustion first, followed by cynicism, then inefficacy. The men, on the other hand, tended to experience cynicism first and then exhaustion.

Physical and Emotional symptoms

• Chronic fatigue, from being tired every day to full on exhaustion where you just can’t face the day ahead.
• Insomnia
• Lack of focus and concentration
• Physical symptoms such as chest pain, heart palpitations, shortness of breath, gastrointestinal pain, dizziness, fainting or headaches (all of which should be medically assessed).
• Increased illness.
• No appetite
• Anxiety and depression
• Anger

In Chinese Medicine, there is a saying: “one disease, many roots; one root, many diseases.” The exemplifies how burnout can present in slightly different ways depending on the person.  In TCM the common root is a Kidney Deficiency. 

TCM aside, our Kidneys (combined with our Adrenal Glands) are one of our most important organs systems. Together, they connect our brain to our instincts and intuition. The Kidneys influence our hormonal rhythms and response to stress, shock, fear, and trauma: think, the release of cortisol and your body’s Hypothalamic-Pituitary-Adrenal (HPA) axis.  That pathway is responsible for regulating your body’s sympathetic “fight or flight” response. 

In TCM, the health of the Kidneys are expressed through the brain, bones, ears, and hair. With that theory in mind, doesn't it makes sense that when our Kidney Qi declines that mild memory loss, osteoporosis, deafness, and hair thinning become more prominent. While this can all occur with age, environmental and lifestyle factors also weaken Kidney Qi. These include sleep deprivation, substance abuse, nutrient deficiencies (from poor appetite/diet/digestive issues), and long hours of physical/mental exertion without rest.

Sound familiar? 

On an energetic level, the Kidneys are the root of our body’s life force, they hold our reserves of Inherited Qi and Vital Essence (Jing). Think of the Kidneys as our body’s savings account, a reservoir that we too often take from but don't often replenish. 

When your Kidney Qi is abundant, you’ll have a healthy sense of self, direction, and will-power to pursue your goals. 

Acupuncture is a gentle, safe, and effective therapy that promotes your body’s own physiological processes which become weakened or pathological from chronic stress, trapped emotions, as well as long-standing illnesses and injury. 

Acupuncture reminds the body how to repair, regulate, and heal itself again.  

From a Western-scientific standpoint, it: 

• Down-regulates your body’s stress response by shifting it from a “fight or flight” state to one that can “rest and digest.” This is why patients fall asleep during treatments, hear gurgling/stomach noises during sessions, feel a deeper sense of calm, and report having better quality sleep sometimes in as little as one treatment. 
• Increases body’s natural feel-good hormones to reduce pain.
• Reduce cortisol and increase serotonin to alleviate anxiety, depression, irritability, and stress. 
• Promotes circulation to the brain to improve cognitive functioning as well as the viscera to regulate autonomic functions. Think - heart-rate: reduce palpitations, digestion: improve nutrient absorption, appetite, and energy levels; regulates bowel movements.
• Increases circulation to relax tight muscles and reduces joint stiffness 
• Enhances the body’s  the body’s immune system to decrease inflammation and reduce inflammatory processes 

For patients that come in during and in the aftermath of burnout, their appointments are their designated time to unwind, re-cultivate their energy reserves, and re-establish resilience to life’s stressors. It’s a time where you are not on high-alert so your body can heal in the ways it needs to. 

We can also pair this with functional medicine and herbal medicine for a knock-out combo.  

Cortisol, our main stress hormone and hormone of alertness, peaks at around 9am and then should drop to an absolutely low level at bedtime.  As the sun goes down and cortisol drops melatonin rises and our circadian rhythm is established. This basic rhythm is established by environmental and internal cues that have signaled our biology since the dawn of time.  Unfortunately, we had to come along with modern stress, technology, and a 2 plus year pandemic to muck it all up!

​So what happens to our sleep if this rhythmic release of cortisol is distorted?

• Feeling tired and wired when we lie down for sleep
• Waking up alert between 1 – 3am like clockwork
• Night Sweats so strong we need to change our t-shirt and invade our partner’s side of the bed!
• Waking 1 – 2 hours before our alarm with no chance of falling back asleep.

 
Luckily, correction of the cortisol rhythm (HPA-Axis) can be done by utilizing acupuncture and functional medicine.  With severe cases, we do recommend a simple salivary cortisol test to determine exactly what is happening with your hormones.  Once we know the unique nature of your cortisol disruption it can be treated with a combination of acupuncture, lifestyle changes and supplements that gently signal the body to release hormones at the right time and in the proper amount.  

Our ancient physiology still wants to exist in harmony with our natural signals.  If we proper align the HPA-Axis we enjoy alertness during the day and calm restorative sleep at night.  If you are struggling with insomnia and let’s reset your stress hormones and give you back the biological right to a good night’s sleep!

The more we study dry needling, the more we understand its benefit and expand its use in the treatment of musculoskeletal injuries.  Addressing everything from low back pain, migraines, and sports injuries; dry needling proves beneficial in the most common muscle, tendon, ligament, and joint issues.

Since we  utilize this technique, it is important to for patients to know what to expect from treatment, and what conditions can benefit from this therapy. 

The most common issues we treat in the office 

• Pelvic floor dysfunction 
• Repetitive stress injuries
• Low back pain, neck and shoulder pain, hip pain, calf pain 
• Persisting pain that worsens over time
• Aching pain in the muscle
• Deep muscular pain that is not improved by massage or chiropractic 
• A tender knots or adhesive spots in the muscle
• Difficulty sleeping due to muscular pain.
• CLICK HERE TO READ MORE

Below are five important items to understand when seeking treatment.  

Dry needling is a skilled technique performed by trained acupuncturist or MD aimed at managing neuro-musculoskeletal injuries, pain, and movement dysfunction.  Dry Needling utilizes the same thin filiform acupuncture needle to penetrate the skin, fascia, and muscles to address adhesions, trigger points, and connective tissue.  By doing dry needling, just like in acupuncture, we are able to speed up healing and relieve pain by decreasing muscle hypertonicity, increasing joint range of motion, and correcting movement dysfunction through releasing a trigger point adhesion.

Acupuncture is an ancient traditional Chinese technique that utilizes the knowledge of meridians, reflex points, and fascia networks.  This focus allows an acupuncturist to work on more than just muscle pain but also a person's internal health disorders, energy, and qi.  Work up and exam include a physical, tongue, and pulse examination.  Needles are retained for around 15-25 mins. 

Dry needling focuses on skeletal, muscular, and neuroanatomy.  This allows for the identification of damaged and sensitive tissues, taut bands, and trigger points as well as injured and overused tissues.  At SFIM we utilize an extensive examination that includes movement analysis and orthopedic evaluation.  Needles are not generally retained.  A muscle twitch is elicited and then the needle is removed.

​A trigger point is a spot of muscle/fascia that is hypersensitive and composed of a taut muscular/fascial bands.  These taut bands restrict oxygenated blood flow, and can refer pain and tenderness while causing dysfunction. Trigger points can and may develop during occupational, recreational or sports activities when muscle use exceeds the muscles capacity to handle stress, disturbing normal recovery.  Dry needling differs from other types of therapy because it focuses on stimulating these trigger points and releasing the tension in order to alleviate pain.

That muscle jump you feel is also called a fasciculation or twitch response.  It is a localized, reflexive response of a dysfunctional area of muscle to palpation, or in our case, a dry needle.  When needling these adhesive knots and trigger points, this is one of our goals as it leads to a rapid release of a taut muscle band, decreasing tightness and sensitivity of the surrounding area.  A tight muscle or one with a trigger point will feel an achy discomfort with an occasional twitching or cramping sensation. This fasciculation response returns the muscle to a normal state by releasing inflammatory chemicals and restoring blood flow to the area.  

The Dry Needling technique uses acupuncture needles. These are thin filiform needles used to penetrate skin, fascia and muscles to address adhesions, trigger points and connective tissue to speed healing and relieve pain.  Often, our patients will describe the sensation as "odd and weird" but not painful per se.  Patients will experience a mild, dull ache during treatment and up to 24 hours post treatment.  Some discomfort is experienced during the rapid fasciculation but this discomfort is minimal and last only a few seconds.   It is normal to have mild to moderate muscle soreness after dry needling treatment.  Drinking lots of water, stretching, moving your body and heating the sore muscles can reduce the duration of the soreness.  Side effects include mild muscle soreness and bruising in some patients.

While dry needling is a new spin on an old technique, it's unfortunately only covered by around 5-10% of insurance plans.  Luckily, it is covered by FSA and HSA plans. 

Click here to enter your insurance information to see if your plan covers Dry Needling. 

Our dry needling appointments are focused, one on one sessions.  Fees are $250 for initial consultation, exam and treatment, $200 for follow up sessions 

More and more people are coming into the office seeking help with symptoms of Long-COVID.

What exactly is Long-COVID you ask?
That is a great question and one that doesn’t really have a great answer. The mechanisms that cause Long-COVID are not yet well understood, it is a diagnosis used to describe a collection of symptoms that develop after a person is acutely infected with COVID-19.

There is no way to predict who might develop Long-COVID, it can affect both those who become seriously ill, and those with initially mild infections. There is a wide range of symptoms associated with Long-COVID (the CDC lists some of them here) and those symptoms can vary in terms of severity and predictability as well. This variability and the lack of understanding around the causes of the disease mean that there are not very many cohesive treatment strategies for Long-COVID, which can be disheartening for people dealing with it. 

Fortunately for us, we don’t need to understand the mechanisms of Long-COVID to help its sufferers manage their symptoms and feel more resilient. One of acupuncture’s magical qualities is its ability to activate the parasympathetic nervous system, often referred to as our rest and digest state. It is the optimal state to be in if we are trying to reduce inflammation, promote healing and elevate mood. And while we might be biased on this one, we think community acupuncture is especially powerful for people who are dealing with chronic illness because feelings of isolation are known to have a big impact on how well we heal. 
​
The symptoms of post-covid we are most treating in the office are:

• Fatigue that is persistent & often worse with activity
• Unrefreshing sleep  Waking up exhausted after a full night of sleep
• Cognitive/neurological problems  Difficulty remembering things, poor concentration, brain fog, inability to process new information
• Muscle or joint pain 
• Digestive symptoms  Nausea, diarrhea and/or constipation
• Increased sensitivity  to light, smell, or sound
• Racing heart beat
• Headaches

At the same time that we are helping our Long-haulers cope, they are helping us by sharing their experiences and the lessons they have learned so far on their journeys.

For anyone out there dealing with Long-COVID we encourage you to stay hopeful, and get empowered.

Connect with others, gather information and get acupuncture!

There is fascial line from the pelvis to the jaw and this is created during embryonic development in the womb. On day 15 of conception an embryo forms two depressions – one becomes the mouth and the 2nd the opening of the urinary, reproductive and digestive tracts.

These remain forever connected even as the spine develops and creates space between them.

For many people this knowledge about the pelvic floor and jaw connection shifts their body awareness forever. They discover if they immediately ease up any tightness they’re holding often subconsciously at these two major points in their body the jaw and pelvic floor their whole body function improves 

Holding too much tension in the pelvic floor due to stress or excessive movement such as Kegels – can be a significant cause of incontinence or pelvic floor dysfunction often called a hypertonic pelvic floor.

Pelvic Floor or the Root Chakra in Eastern tradition, is tied to fear, especially around our families, well-being, money, and safety. This is fascinating when consider that too often we hold tension in the jaw as a way to repress anger, frustration and fear–you can see how important this connection is.

Are you noticing a connection between one or both, if so pay attention to where you are holding tension and learn how to address these biomechanics of your body that are affected both physically and mentally.
​
To target these areas of the body we use a combination of acupuncture, dry needling, gua sha and fascia release
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A recent study out of Yale examined how one particular infection can trigger autoimmunity.

“Bacteria found in the small intestines of mice and humans can travel to other organs and trigger an autoimmune response, read more here.”

Our standard testing protocol at San Francisco Integrative Medicine goes far beyond testing for just this bacteria identified in the study.  The medical scientific community has now identified multiple infections related to autoimmunity, as well as ratios of healthy bacteria that when disrupted to trigger our own immune systems to attack us.

In order to reverse and heal autoimmune disease the pathogenic infections need to be identified, cleared without disturbing normal flora, and a healthy biome supported.  

If you would like to take action on your autoimmune condition, schedule a phone consult to discuss your unique situation.

In Health,

Dr. Bezjak and Dr. Korian 

First off its a good reminder that the fact that we eat food and have abdominal organs could alone be the reason bloating occurs.  It's not normal to have a completely flat abdomen all day long while you're nourishing yourself properly with enough calories to sustain good health. 

A Few Daily Reasons Bloating Can Occur - If you notice that you get bloated after eating make sure you double down on these factors before jumping to any health conclusions.

• Eating too fast
• Eating too much
• Consuming a lot of sodium
• Sparkling and bubbly beverages
• Menstruation 
• Eating a high load of carbs

But if you've crossed all those off your list and are still bloated, here are some other health-related reasons for bloating you can dive deeper into:

• Lactose intolerance
• Constipation 
• Low stomach acid
• Gut bacteria imbalance
•  Food sensitivity

The only REAL way to know if any of those factors are true for you is to work with a practitioner for educated insight and testing. (Pssst - Dr. Bezjak specializes in this!)

​

• Eliminate bloat triggers
• Dial in your good eating habits
• Determine what foods you're sensitive to
  
• Address underlying gut infections or microbiome imbalances
  

If you still need some help and guidance after implementing these tips, book a 15 min complimentary phone consult to see how functional medicine can address bloating and other digestive complaints