Demystifying Qigong, Herbal Medicine, and Eastern Practices for Chronic Pain Relief with Brehan Crawford || WBWL Ep 99

I had a really insightful chat with eastern medicine provider, Brehan Crawford, who’s helped many individuals with chronic pain and many other health related issues such as long covid, fibromyalgia, perimenopausal symptoms, and much more.

I love how he has been able to relate eastern medicine in a research back way, and can explain the physiology as to how herbal medicine, qigong, and acupuncture can help with chronic pain.

I’m eager for you to hear this, as western and eastern medicine has been seen as polar opposites, when in fact, the goals and mechanisms of healing are relatively the same.

Hope to hear from you about this episode!

- Dr. Jay

PS Brehan has a free online group where he teaches baduan jin twice per week https://www.skool.com/chorus-circle 

Transcript

0:02

Welcome to the Won Body Won Life Podcast. Hi, I'm your host, Dr. Jason Won, Lifestyle Physical Therapist. As you guys know, I love to talk a lot about anything in regards to pain relief, strength training, mobility, but in general, anything in terms of how to incorporate more healthier strategies and maybe even demystifying things that may be able to help with your health and fitness, whether it's physical and mental health. So today I have a very special guest. His name is Brehan. Crawford, and he is a Chinese medicine provider. So he provides things such as herbal medicine, Qi Gong, acupuncture. And when I dive into some of the specifics of what he does, but also uncover maybe some fallacies around, some Eastern medicine. Cause I think a lot of times people think it's not research based. Some people think there, there may be some things in terms of demystifying how energy flows within the body and me being also of Chinese descent. I have some interest in terms of me. Not necessarily. I've always been interested in the Western medicine, physical therapy, that's the route I've gone down, but I love to hear more insight from Brehan in terms of what he's been practicing for quite a while. So welcome in, man. How are you doing? Thank you. Thank you. I'm having a great day. How are you, Jason? I'm fantastic. Very good. So I guess let's dive into this. Just do a brief intro on who you are, how long you've been practicing and who do you serve? So I went to Chinese medicine school here in the United States and got a master's degree in 2009. It's a four year master's degree program. And so it's a pretty comprehensive education, both in terms of biomedicine and Chinese medicine. Ultimately I was not satisfied with the clinical experience I received in school. So after graduating, I entered into a, basically my profession's version of a residency. And spent five years under close direct supervision of a very senior doctor of Chinese medicine who was trained in China. I went to China, received training there and then have been in clinical practice ever since focusing mostly on patients with chronic Disorders, chronic illnesses that don't respond well to Western medicine. They're, most of these chronic illnesses, fibromyalgia, IBS post viral conditions like long COVID in the last five years, they have more than one contributing factor, more than one cause. And so using a whole systems approach like Chinese medicine, I find to be very effective in addressing all of the contributing factors to these illnesses and helping people find remission. That's really awesome. I actually have some experience with long COVID. It's not the easiest thing to treat by any means. Some people think that people are just. Faking it and they're trying to get out of work, but it is a real thing. There's a lot of, there's a lot of neurophysiological changes that happen that leaves them with chronic fatigue. They can't function have unusual amounts of like muscle soreness that they can't shake. So I guess let's talk about that. Excuse me with the types of chronic pain patients that, that you treat how do you feel like. How do you feel like Chinese medicine is directly integrated? I guess let's dive into maybe the physiological mechanisms like how does this specifically work in someone's body, especially when you're treating? A lot of people like to think that there's a huge difference between the way that Chinese medicine views the body or, and that Western medicine views the body. And ultimately they use different terms to describe what's going on, but they pretty much agree on everything. There, there's very little, there are places that science can't yet describe Chinese medicine theory. And there are aspects of Chinese medicine theory that have a, that seemed to conflict with western medicines, understanding of physiology and pathology, but the deeper we look into it and the more we're willing to play, connect the dots and read between the lines, the more we're able to distill that actually these two things are just describing the same phenomenon using different terms. For example. Chinese medicine, a big part of the physiology of Chinese medicine is understanding the mechanics of what's called Qi. And that character Qi, unfortunately in its, in during most of the time that Chinese medicine has been exposed to the West, it's translated most often as energy. And it Has an energetic aspect in the way that gas, when you put it in the car, gives the car energy, gives the motor energy to run or carbohydrates, in a human body can be, you can get glucose and then go into ATP production. It does have that kind of energy quality to it, but it is. Something that is a better translation of that word is gas so that the idiogram, the Chinese character for tea is steam rising off of a pot of cooking rice. So it's not anything. You don't have to be a hermit. For 30 years to be able to understand what that is, or to be able to perceive it in your own body. It's literally warmth, vapor, gas subtle amounts of moisture. And it's subtle. It's not something, if you're not paying attention, you can miss it. But chi is learning to feel chi. It does not mean that you're, turning into a Jedi. It just means that you're becoming aware of your own body in the way that All of us do as we're growing up or when we're learning a new exercise or physical learning to sew, learning to play a musical instrument, you're becoming more sensitive to your body mechanics to what you're learning to massage somebody. You're learning how to feel learning to feel she is exactly the same. If someone, when someone teaches you to do that. Gotcha. Cool. And is that, does that play into the fact that I guess I could speak from Chinese descent is that, usually When you're drinking like cold water versus hot water. And that's why a lot of times people, when you're at Yumcha you drink tea, right? Cause it provides more warmth and blood flow. So there's a lot of there's a lot of things that my grandma has told me around you want to keep the body warm. You want to bias it towards like hot soup or is it like cold? So does that play into anything at all in terms of. That warmth that moisture where, Chinese people are very interested in always keeping the body warm, promoting more blood flow in a very practical sense. The main difference between a living person and a dead person is that the living person is creating heat. And and you can see this in other places in nature to, a compost pile as disgusting as it is, it's a great pile of compost if it's if there's steam rising off of it. And in it. So in a human body and many traditional. Cultural medical systems, Chinese medicine, especially have noticed this and been like, Oh, okay. Dead people cool down and then stay cold. Living people create warmth and heat. That's life force is warmth is the endogenous creation of that. So doing things that foster that drinking warm liquids versus cold things applying heat to an area of injury or, versus ice And I know in, I've been told in the profession of physical therapy, please correct me if I'm wrong, that there is generally a movement away from icing injuries lately. And that the data has finally caught up to the traditional cultural wisdom of many places around earth where they're like, cold constricts blood vessels and it does dull nerve endings so that it stops pain temporarily. The constriction of blood flow. Can reduce swelling, but it can reduce, it can slow the inflammatory process. But in an acute sense, in a healthy person, inflammation is how we heal. And you need that, you need the inflammatory cascade to complete itself. You need tissue repair to work properly. And in order to foster that, to facilitate that happening, heat is going to be more effective than ice, even if it causes the a bit more temporary discomfort. Yeah. So it was the first Yeah. inflammation is the first phase of remodeling, right? So if you're trying to speed up the first phase and you're skipping out on that phase, right? So you want to, the body does get inflamed on purpose in order to protect the body from moving it. So if your ankle swells, Yeah. For a reason, because it's trying to build inflammation around the area, swell it up so that it has time to heal it. But in, for example, if you're trying to reduce that inflammatory phase and you're speeding up that first phase, which could be catastrophe later on, that ankle might be rendered unstable for a given amount of time. But yeah, like rice, the rest, ice, compression, elevation, tend to be like a dying art. And I think that what you're saying too, is. It makes sense because the way that I help a lot of my clients is whether it's acute or chronic injury is you're trying to actually do more strength training. You're trying to strengthen as fast as possible, but in given return to ability, all of that. Yeah. So what promotes more heat and blood flow? It's also contraction. It's movement, active range of motion. I'm totally with you on that. Yeah. And that Chinese medicine takes a very similar approach especially in areas like Qigong. There's there's an exercise system in China. That's a lot of people are familiar with, Chinese Kung Fu with martial arts. Probably with Tai Chi, which is sometimes taught as a martial art. Oftentimes, it's also promoted just as a health system. And Tai Chi can be a form of what we call Qigong. And then there are, thousands of different kinds of that which are just. At its basic level, it's breathwork body awareness, cultivation and gentle exercise. And oftentimes it involves elements of resistance training of specific mobility, work range of motion, exercises, balance exercises, learning to stand on one foot learning to get down on the ground and get up off the ground, all of the kinds of things that we associate with health and longevity these are built into many of these methods. Absolutely. My grandma who still lives in Oakland, California, she's the last, I guess she's the last grandparent to be alive, right? Because the other grandparents, whether they smoked or drank, chronically over the life, my grandma, she, she's, she just turned, I think, 97 or 98 years of age. So that's pretty. That's pretty respectable. That's up there. I think one of the things, outside of the fact that COVID for a lot of people left, a lot of people deconditioned. We know that. And before COVID though, she was actually walking a good one to two miles to Oakland, Chinatown. She actually led Tai Chi classes, very large group of people. And I remember always being like very respected of her, wow. Like she, her balance is amazing. She was super strong. She was the one obviously again, she's the one grandparent that's still alive. There's probably a good reason for that because she really practiced Tai Chi and a lot of things. Although she is older now, but there was a lot of merit to, even just more anecdotal evidence to say she's the last grandparent. And even today she still has. She's still moving decently. But yeah I think that I'm a huge believer and a lot of my uncles, also practice Tai Chi. I heard a Tai Chi can dramatically decrease your risk for falls by 500%. Oh, but the slow methodical movements, all that eccentric forces, and just like the fact that you're just like slowly moving on a single leg. I think this promotes a ton of blood flow. So with regards to that, how do you integrate herbal medicine, Qi Gong, acupuncture? Is it more individualized as far as how much of each you're giving to each person? Or do you integrate all three together? right away. So when I'm working with a patient one on one, I do the kind of the classic clinician thing of taking a thorough history, making an assessment in Chinese medicine these are, these sound different than biomedical diagnoses. We don't, we wouldn't say like long COVID or chronic fatigue syndrome or something like that, but we would say, something like chi and blood deficiency or a damp phlegm, something like that. But then we create a treatment plan. And so when I'm working with a patient one on one will, oftentimes that will include very specific qigong exercises that are necessary for them, whether that's a breathing exercise, a physical posture that they need to assume and hold a range of motion exercise. I don't my practice right now is largely virtual and I'm not doing a ton of. in person hands on manual care with acupuncture and stuff like that. Used to be, I would do a lot of physical mobilization for my patients, just gentle stretches and body work kinds of stuff during a treatment. Nowadays, I prefer to just teach them to do that on at, and then have them do it on their own at home means they need less time with me and are more able to take charge of their own health and, continue their path forward. But and then herbal medicine as appropriate. So like chronic fatigue syndrome is a great example of this. With, especially after COVID, because, like you were saying, these people have dramatically reduced physical capacity. They oftentimes can't do the kinds of exercise that they used to be able to do prior to getting sick. And there's a great. study that just came out showing how they did some biopsies on people with long COVID versus people who'd had COVID and then fully recovered from it, had no symptoms. They took muscle biopsies and we're looking at mitochondrial function at clotting factors in the muscle small injuries that these people had sustained. The baseline for the long COVID patients was dramatically lower even before exercise than the people who had recovered completely from COVID. And then after exercise, it was even a larger discrepancy. The long COVID patients were even worse. She gone has fantastic benefits for these people because they're the ones who are most going to suffer from post exertional malaise. They're the ones who are going to enter into a an exercise program. And, we know that we know like we have so much data showing like physical exercise can be graduated increasing quantity of exercise can be a path to recovery for people with chronic fatigue. If you know anybody who works with this population, you listen to your patients and you're like, there are a lot of these people who are just getting hurt more by doing it. And So looking at exercise methods that have a way of one, not pushing people too far too fast because the graduated part of that, I think is the key take home where you have to be, you have to help the patient find the tolerable amount and then they have to go 1 percent past that. Or maybe half a percent or a tenth of a percent past that, but just enough that they don't trigger a, a catastrophic decline that takes them a week to get out of bed afterwards. And there's so much being done in China that they've actually studied this in very large populations. The most popular. Qi Gong method in China is called the Baduan Jin. It's the eight treasures of brocade, eight pieces of brocade is what it's often translated as in English. And it's a series of eight exercises that it was invented during the Song dynasty. It's 800 years old. It's been continuously practiced since then. And it's open sourced. And it's, it's one of the ones that You go to a town square or a large park in any major city in China, and you're going to see hundreds of people doing this every morning together. And there's a systematic review of meta analyses of randomized controlled trials, where they looked at this and they found that it was one of the few exercise methods that actually showed objective improvements for people with who are very old for people who and can't do normal exercise. And for people who have chronic fatigue syndrome in terms of, their balance, their sleep quality, their yeah, exercise capacity, all of that. That's awesome. Yeah, I'd love to hear that research or get an article and maybe you can link it. I was going to say that a lot of the stuff that you said like I said, people thinking that Eastern and Western medicine are like, very mutually exclusive. They have no connection to each other. And there's also a lot of. I guess there's a lot of polarity, in terms of what's better. But I do think that even the stuff that you said, like sustained postures it's not much different from what I gave to like my last client with chronic fatigue or long COVID it's sustained postures is isometrics is doing something that yields. a minute, minimally clinically effective dosage of exercise. And so you give him somebody like some dumbbells and you do that immediately. It flares him up. It might help somebody that doesn't have chronic fatigue because they have greater capacity. But you have somebody like isometrics and they're like, Oh, my, my, my legs feel better. My hips feel better. Just sustaining postures or like going from sustained to slow dynamic movement, which What's slow dynamic moving. This sounds like Tai Chi, sounds like Qigong, right? It sounds like Tai Chi. Yeah. Yeah. But if you start somebody on jump squat, which is higher velocity movements, and that's something that could be of use to them later on down the road, when they're like my goals are now once I'm in less pain, I want to run. Okay. That's where we got to speed things up. So everything that you say, I'm starting to even hear more and just connect the dots in terms of. How physical therapy and strength training and mobility are all very similar things that an Eastern medicine provider. Although I understand there's probably some people in your industry that you're just like, they don't practice in the same way, right? Same thing. There's not always good physical therapy. Oh, it's a crap shoot. Like there, there are, I think this is the case in every area of medicine. In any discipline, you find people who are entering the profession for. Absolutely the right reasons and they're listening to their patients and they're digging into research and finding what works and what doesn't. And they're willing to change their mind. They're willing to, really critically evaluate best practices and yeah, and their own methods and passionately pursuing continuing education in every. And then you find people who are just nuts and they're like in it to scam their folks, make a quick buck and leave town. And yeah, unfortunately that's the case in every field. And there are absolutely quacks in my own profession. I'm not going to deny that. Yeah, but the, the core of medicine is to be of service. And and I think, you I think any discipline hopefully is calling people in who are there to help for all the right reasons. Yeah, definitely. So I guess we can talk about maybe we can dive into like little individualized things like, for example, herbal medicine. I definitely think that's, I always consider exercise as my best medicine. I don't prescribe certain medications or anything, not even herbs, right? Because these are just things that I would. refer out for. So can we demystify or, articulate on that event in terms of herbal medicine? How do you prescribe it? Are there certain like herbs that are more effective for certain things? Let's just dive into that topic. Okay. So to take this back to chi the concept of chi is, in Chinese medicine, we're looking at chi blood and body fluids for the most part, in terms of substances that we're working with. circulating throughout the human body. And most of any kind of medicine, whether it's Qi Gong or herbs, is improving that function. If we're looking at forms of Qi. There are many described in classical Chinese medical texts. Most of these have a direct analog in Western medicine to specific gases. And the most common one that we work with is called nitric oxide. And so many people in the West are only familiar with this in the context of if they're into supplements they're taking arginine or beet powder. Or if they're into drugs, they're taking Viagra or Cialis. And those are, those are, huge nitric oxide boosters and they can work as what we would consider a tea tonic in that capacity. Unfortunately, most people that we see in the clinic are actually in what we would consider an excess category. They have adequate nitric oxide. They have adequate tea that it's just not moving through the body in the right. It's not circulating. Just like blood. You can have enough blood in your body. If you have an injury and the blood is stuck there, it's not healing correctly. And same thing with gases. And there's a saying and in when you go through Chinese medicine school, you learn that they say she is the commander of blood. And blood is the house of chi. So the chi tells the body where to go. And the direct biomedical equivalent of this is nitric oxide acting as an agent for vasodilation and vasoconstriction. So when you have that happening smoothly and fluidly throughout the body, you get great blood supply everywhere it needs to be going. When it's inhibited by injury, by infection, by sedentary lifestyle, you don't get that. And so people are often flood, if they're looking for herbs they're going to something like beets, for example, we can use that as a, it's a plant it's a huge nitric oxide donor. But it may actually be causing you problems taking it in high doses long term because all of the receptors that are susceptible to nitric oxide can be, it's a hot inflammatory compound and they can be literally burnt out by having too high of a dose given to them. And we famously see this in men who take drugs for E. D. when they don't really need them. And then. Get E. D. That doesn't respond to the same medication. So it's a, we're looking for a Goldilocks zone with these things. So when we come to herbal medicine the way that we diagnose a patient is is there excess? Or deficiency and whichever camp we're in, we're going to use vastly different herbal formulas. So some mostly with herbal formulas, we're looking at plant substances. We do occasionally use minerals, very occasionally animal substances. No one who is a professional in this field is using endangered species. That's not done by anyone who should be in clinical practice. If you ever find somebody in Chinese medicine, who's pulling out the rhinoceros horn, please go the other way. That's not the right thing to use. We have better stuff available. But that's sustainably grown and processed there. So we're mostly looking at plants and we're mostly looking at their effects on gases. And so we have some plants that can so anything that you ingest orally there's a whole world of herbs that are used topically on the skin, especially for injury recovery. A little bit different way of thinking there, but for most of the time when we're prescribing herbs to patients, they're taking them orally, whether it's a pill or a tea. And. What we're looking at are the effects that those herbs have on the flora of the GI tract and how those flora then because they also produce nitric oxide, they also require a certain amount of nitric oxide to be present in order to live or die. And. Having too much is going to cause what we would classically call heat symptoms in the digestive tract. And this are often associated with gastritis or inflammatory bowel diseases. A lack of them creates a cold and then often very damp, wet environment. And that's where we'll see people who have Candida yeast overgrowth or or sometimes just a straight up deficiency of lactobacillus and bifidobacter. And those kinds of flora are often not being adequately fed by soluble fiber in the diet. Or they've been depleted by which most Americans are not eating enough fiber or they've been significantly depleted by infection. COVID can destroy your bifidum population just by itself. You can also have taken a course of antibiotics and that may have saved your life, but they also really wrecked your guts. And so using herbs to nourish the healthy flora that then you produce enough chi on your own is how these things are working. So for injury recovery if there's somebody who's got I'll use an example of like a, some kind of spinal injury, not a spinal cord injury, but like a low back pain or a disc injury or a low back pain, disc injury, arthritis, stenosis, something like that. We're going to use herbs that are going to make sure that. Nitric oxide is moving through that part of the body adequately and through through Chinese history, the history of Chinese medicine, they've noticed that specific herbs can actually direct cheat direct gases to certain parts of the body. So if we see an injury there, we're looking like, okay, we've got an injury. We have herbs that direct to the shoulder. We have herbs that direct to the lumbar spine, to the thoracic spine, to the cervical spine. It's fascinating stuff. We have herbs that we know specifically. Can increase the production of, or the expression of Oh, what is it called? Now? It's it's evading me. It's vascular endothelial growth factor VGF in the knee. Like it's that specific. And so based on, the classical use of these things and then the modern pharmacology, we're able to prescribe pretty accurately for the needs of the patient. That's really, that's fascinating. Actually. No, just to clarify, you're saying that some people have excess, let's say excess or deficiency of, nitric oxide. So are you saying that let's say they're in deficiency, you're clearly promoting herbs and teas and things that are going to promote more vasodilation across the entire body systemically. Generally speaking, yes. Yes. But what about the people that do have excess? Are you trying to, are you are you trying to vasoconstrict? Is there a different time? We are. So yeah, it's more about smoothing it out. The only time we would try to like really reduce nitric oxide is if somebody had a, gross inflammatory situation, like a fever. That's where we would consider like really trying to bring that down fast. Most of the time. So there is there is, you can't. You can't move Chi without releasing Chi. If it's stuck somewhere, you have to release it to get it to move and you lose a little bit in the process. So if someone's got what we would consider an excess situation in a, in an injury I'm touching my shoulder. Cause this, I have an old shoulder injury and this is on camera. You can see it. We're going to use herbs that would reduce some of the excess nitric oxide that's there by moving it out of the joint. Got it. If there is and if you overuse those things or you give them to a deficient patient, they're not going to work or they might work for a couple of days, but then it'll stop and then they'll just feel really tired or even get the pain will go away for a couple of days and then it comes right back and the same formula doesn't work for it. So this is why a good professional can help you assess excess versus deficiency prescribed appropriately and then treat you in stages. Because you may have a deficiency, but the injury really looks like an excess. Okay, cool. We're going to clear that. Oh, now you're exhausted. Now we got to boost you up or that pain will return. I see. Got it. And is there any, is there anything out there? For example we talked about how people that are on like. ED medication. A lot of times medication can be addicting, can be very reliant. A lot of times your body can stop producing, for example, like melatonin, you can take excess melatonin. Oh, sure. That's a hormone, yeah. And then your body, yeah, but then your body almost, if you use it in excess, you can, Disturb the ability for your body to actually produce melatonin on its own. So is there anything like that in terms of people that either from their belief system that like they start to get hooked on herbal medicine or is there anything in regards to like if you use excessive amount of herbs that their body downplays ability to like regulated on its own? Totally. So this comes into play mostly when we're working with the endocrine system. And that's because of things like you're saying with melatonin, like it can be, it isn't always, but for some people it can be habit forming or cause dependency because they there's a negative feedback loop for that. And if you're, if you're if your body detects that there's adequate or excessive like a melatonin supplement has 5, 000 times the amount of melatonin that your pineal gland. makes for you at sleep onset. And so if you're taking that much regularly, melatonin production is probably going to down regulate because you don't need it. any hormone can well, not any, but many hormones work that way and many and chemistry is universal. So in Chinese medicine, we're not, when we're assessing and prescribing, we're not really thinking in biomedical chemistry. We're thinking in classical Chinese context, but the chemistry still applies. If for example most of the herbs that we will use to regulate a woman's period to reduce pain with menstrual cramps or to help ease the transition through perimenopause will have a very endocrine like effect. They'll be carrying endocrine substances, in a certain context, like you can look at this as a form of HRT and they, it's often not as directly, not as like powerful as HRT, which means it's a little bit more forgiving and because these plants have these are whole plants that we're giving. It's not an extracted single compound. The plants have their own endocrine system. They have their own metabolism and they will often have balancing factors. In the plant that helped to reduce the dependency formation or the it's a gentler way of prescribing and working. And so you see less immediate effect. You also see that there's a safe, higher safety profile. But you can still cause harm that way. If you give somebody, here's a specific case example. I saw a perimenopausal woman a few months ago who had been treated by an acupuncturist who had, and I, and she brought her case record in and she was like, I took these formulas and I felt worse. And the acupuncturist was perplexed. She said, I don't know why this isn't working. You're in perimenopause. You must be indeficient. I give you in tonics. I looked at her tongue, a yin deficient tongue should be scarlet red, like crimson, bright red. It should have no coating on it at all. And the tongue should, in fact, be quite cracked on. So that's showing that there's there's heat that's consuming up the body's fluids and endocrine system in many ways is related to fluid metabolism. And this patient did not have that tongue, but she had been prescribed a formula that would be appropriate if she had, so her tongue was very wide. Had a lot of scallops, tooth marks on it from pressing up against the inside of her teeth because it was swollen and it had a very thick coating on it. And so rather than give her endocrine tonics, something that's like a herbal equivalent of HRT, which is what the previous acupuncturist had given her, I gave her something that would reduce the swelling of like her body. The swelling of the tongue shows that your body is maintaining holding onto too much moisture. like there's excess water being stored in your interstitium. And with that, and with a thick tongue coating, we can tell there's a lot of excess biofilm. And oftentimes we will see that the the biofilm and the excess water is actually blocking endocrine receptors. Her body was making enough. Estrogen enough progesterone. It's just not able to get where it needs to go. So rather than giving her endocrine like substances that tonify her hormones that build her back up and ease her through perimonopause that way, it was about getting the excess biofilm and water out of the way. And in the first couple of weeks, she lost five pounds of water weight. She started sleeping better, her bowel movements regulated. And then the perimenopausal symptoms she was experiencing started to ease off with a formula that's used for digestive health rather than it's not an endocrine classic formula we would look at for an endocrine issue. It's more about the gut health part piece of that. But that's where we see a lot of that fluid regulation occur. Wow, that's really cool. I feel like you're wiring me in ways that I didn't think about in this podcast in terms of how I guess how structured like how structured and how diagnostic truly can be. I understand that we have like our own diagnoses and I've actually been a person that. Has thrown away a lot of the diagnoses. Cause I think people really like strongly identify with it. And then like they, they stay with it, chronic fatigue or you call them your identity and then you can't, yeah, there's seriously going to identify, like I'm a fibro, and I never want them to identify as something that's that damages their identity. So I. I like yours in terms of the more conservative, like diagnostic labels that you would use, but just making sure that like for yourself, who this person is for further treatment. Yeah. Is there a specific, is there a specific types of people or clientele that you're like, okay, these are 100 percent the people that, that match what I have. I am the absolute perfect practitioner for that. And is there some people that you're like, okay, I might need to either refer out. I might need to, I might need another practitioners guidance with this. Cause there are people where I'm like, I need. I need a psychotherapist, that's more person cognitive behavioral therapy. Yeah, can we differentiate that? Because I'd love for people to understand really where Chinese medicine can really play into these, specific people that can benefit from this more effectively. I think there, there are some scenarios where Chinese medicine is, I don't want to say it's a slam dunk, but it's pretty reliably effective. And we see this mostly in the worlds of diagnoses of exclusion. Things like fibromyalgia, IBS these are labels that are applied to patients, largely female patients, but men can get them as well. They're, the diagnostic criteria for those things means either you're in pain or you have tummy trouble or bathroom problems and your provider doesn't know why. And so there's a ton of research into why these things are the way they are. And ultimately like it's a failure in multiple aspects of the medical system of our insurance. industry of, when a primary care provider gets seven minutes with a patient, they're not able to take a thorough history and figure out okay, when did the pain start? And it's okay you were postpartum and you were not sleeping at all. and you caught COVID and then the pain started, there's not time to ask, to go through the questioning process to figure that out. Chinese medicine does a great job because we don't use those diagnostic labels of a disease. We do more of a functional inquiry. When did this start? What is the type of pain? Does it wander around your body or is it fixed in place? Is it is it better if somebody gives it firm pressure or does that make it worse? How's your sleep quality? All these things play a huge role in chronic pain when it comes to digestive stuff, it's, very similar kind of a process and like anybody who digs into the evidence behind this knows that there's a huge association between fibromyalgia, what gets diagnosed or labeled as fibromyalgia and chronic infections or post infectious disorders. We know there's a huge relationship between that and the gut. We know there's a huge relationship between that and the autonomic nervous system. People who have childhood trauma, I don't remember what the statistic is. It's some absurd number of times higher likely chance of being diagnosed with fibromyalgia later in life. With IBS, it's there's one study I love where they took a huge section of IBS patients and gave them the breath test for small intestine bacterial overgrowth. And they found that 74 percent of the patients who'd been diagnosed with IBS had a diagnosable form of SIBO. And we know that those breath tests are not even that accurate. There's some people that they missed. So that that's a and that's a condition where the treatments are. There's emerging science into what treatments are effective for SIBO. And a lot of people will do something like a two week course of antibiotics feel amazing for those two weeks. And it comes right back or they use botanicals and have exactly the same thing. Chinese medicine has a really great track record working with that because we're looking at every aspect of digestion from, Both ends of the tube including bile, motility, stomach acid, moisture levels, gas pressure, all of that kind of stuff and stress. And yeah, that being said, I think a referral is One of the most powerful tools that any clinician has and knowing when it's like, Oh, you also need to see a therapist. Oh, you also need to be assessed by, like I had a patient the other week who was coming here for chronic UTIs and we, we made great headway in that. We made a ton of progress with that. She's basically over the chronic UTIs. We got her guts all fixed. She then started talking about vestibular migraine and I'm getting a couple of hits of Oh, there's something neurologically going on here that I don't order MRIs. I don't do, I do a neurological evaluation for my patients, but I'm not a neurologist, but I'm feeling like this person needs to see one. And we got her in I gave her contact info for the local neurology practice. She got in there, she got assessed in the neurologist. You have a lot of symptoms of MS, which is what I was thinking. And he said, it's probably not possible to diagnose you right now, but we can do that. And he did. They didn't, they, they didn't see lesions. They weren't able to give her a formal MS diagnosis, but she has all the symptoms of it. They come and go, this is a classic thing. It takes 15 years to get diagnosed with MS a lot of the time, but we know from again, from traditional medical systems, there's a lot you can do to proactively work on your neurological health. And so it's okay, you may be going that direction. But instead of taking 15 years to get you a formal diagnosis to the degree that you then need to be taking medication that has really terrible side effects, what if we started now with diet practices with exercise to promote balance with and strengthen your legs with sleep hygiene with all of the things that we know are going to proactively improve your neurological system and get you the best quality of life from here on out that we can. Yeah, that's really insightful. Preventative medicine is something that I've been practicing for the past six years. And the reason why is because with being in the biomedical system and I used to work with insurance based practices, everything's all about when they have the diagnoses, when they're sick, that, that's when we come in and you get them to a place of. Simply just normalcy. And you haven't really, you haven't really led with what you just said, like just covering the basics of like better diet, improve sleep quality, how to mitigate stress, how to incorporate more exercise into life. You're simply just giving them. I always say this, like you're always just given like a kid, like a piece of candy or a lollipop, and then you're sending them their way. But all we know is that the kid is eating more sugar or getting them addicted to the wrong things. We're not really, we're really not helping the person holistically. And I've always considered Chinese medicine, although like I've had a much more thorough understanding, just talking with you more of a holistic way of treating the entire body. Treating it, systemically treating the whole entire person and I, I'm learning something about how now with what you practice is we have that in common too. It's like a very thorough subjective and developing more of a therapeutic alliance. It's absolutely critical to help the person rather than just treating a symptom. You're treating everything that they are. And that's what chronic pain is. It's very multifactorial. A lot of the chronic. These are things that I know that I don't have the best sense of treating somebody's gut flora and having a more thorough understanding of all the different bacterias that you know, but I do know that I can provide them exercise. I can teach them certain dietary principles, but having somebody like yourself to refer out to means a lot to me and demystifying some of the stuff and incorporating a lot of the research that you did to back kind of Eastern medicine, I think was. One of the more insightful things. I think a lot of our viewers and listeners would get from this. So I guess with that being said I don't know if you have something that kind of like really is indeed what you call it, the quote unquote, the slam dunk. What is the slam dunk on Eastern medicine? Why should people look into this further for their overall health? I think if there's one thing I think actually if there's one thing that Eastern medicine is really great at, it's at promoting quality of life before people get a formal diagnosis. And so if you look at like health practices in China, it's eating a lot of cooked vegetables, like a lot of cooked plants. High fiber content is associated like I think people who increase their fiber by 10 or 15 grams a day tend to also increase their longevity by 10 or 15 years. It's some there's some statistic like that. I'm probably getting it wrong, but it's there. There is a relationship between, fiber intake and health and life. There's. People eating together as a family, you rarely see people in China eating alone and we know that Harvard came out with a huge thing a couple of years ago about how the quality of your social relationships, the quality of your friendships in your mid forties is a better predictor of your health and longevity than any blood test. And getting outside, getting physical exercise, gentle, physical exercise that promotes things like balance, which we know are associated with health and then using medicine preventatively. So being able to teach people, this is my current passion is being able to teach people to look at their own tongue and, check in with their own digestive health. Once a day, because this is something anybody can learn to do and make very simple adjustments day by day just to keep them their tummy really happy. Do I need to, drink a lot of warm water today? Do I need to sweat today? Am I a little constipated and I have too many bowel movements like all of that is important to know and looking at the tongue can teach people what kinds of dietary practices they need to do. to really take care of themselves proactively and take care of their families proactively. Nudging the sweet potato towards somebody who needs a little bit more fiber and, maybe sliding the barbecue in the other direction. Yeah, that's their favorite. I think that's great. You're acting more in prevention and the quote I always use is like an ounce of prevention is worth a pound of cure. Yeah. So I think I think a lot of people would be genuinely interested in, in, in hearing this, but also, potentially working with you. I think for me, even too, is that I've always been interested in longevity and longevity, the research on cardiovascular, versus strength training and what's more important for longevity. Both of those, they decrease your risk of all cause mortality by some 15 to 30%. And even the things that you're teaching very practical tools that somebody can do from the comfort of their home to look at their tongue or look at their and to keep their gut happy. I think that's, yeah. That's absolutely amazing. I guess with that being said to just end this off, like where can people find out more about you, more about your practice? How can potentially people can reach out to you as well? So my website is crawford-wellness.Com and that's my. That's my private practice. If they want to work with me one on one, I also started a company called chorus for life that teaches people how to look at their tongues and look at their family members tongues in a polite way and respectful and and eat, normal real world food without hurting. Both, we give dietary advice in terms of paradigms of that but we also teach a free Qigong class twice a week that anybody's welcome to attend. We're currently working through the Baduan Jin the one that I mentioned from the Song dynasty and we're seeing people make profound changes just in the last couple of weeks. Anyone's welcome to join me there. I'd be even very intrigued to join as well. I've always wanted to ask my grandma to teach me Tai Chi. So just like little things that just to piece things together. It's very it's a little harder at 97, 98 years of age. She doesn't walk to Oakland Chinatown anymore. But I think, yeah, there, there's a lot of things that you said that mean a lot to me, considering me of Chinese descent that even me going to Southern California A lot of times we just bask in silence, but the thing is just we just enjoy each other's company. The fact that we're always eating together as a family probably is one of the biggest things that me and my wife's family do. And even on my side of the family, we're a little bit more Americanized, but still, nonetheless, the most important thing is like every single week, no matter what, we always get together and. We eat together. We bask in each other's just social wellness. And I think that can be said for, I'm very happy and obviously very proud of my descent. Yeah, diversity of the microbiome is associated with every aspect of health. And you, one of the things you get from sharing space with people, sharing food with people, breathing the same air rubbing shoulders is that it's not always the, it's a little gross to think about, but you are sharing all of your gut bugs with each other all the time when you share space and that actually really shows a lot of digestive health. Promotion properties for people when communal eating like beyond the social benefits. There are real measurable physical benefits to doing that. We tend to eat slower. We tend to chew more. We tend to make healthier food choices. We tend to eat a healthier number of calories when we're in a social setting and yeah, it's a I think that's a cultural tradition that need that has been unfortunately lost in the United States. There's so many people who just eat alone in front of a screen and yeah that's not good for you. Yeah, absolutely. Any case, I'm going to link a lot of this stuff from Brian's and all the links that he mentioned from like the classes to whether you want to work with them one on one to whether you want to learn how to assess your tongue or assess your family song and just making sure all you guys stay healthy. So I'll link that all into the description. And I just want to thank you for your wisdom and your knowledge and providing some sort of clarity on kind of demystifying Eastern medicine and how it can relate to certain people's long term health. In any case, that's what I got for you guys today. If you found this episode helpful, definitely share it with your friends or leave a 5 star review. That way, this message gets out to more people and, I'll always leave this quote with everyone else is we only have one body, one life, make every action you make be one that makes you a better version of you. So take care. And Brehan, thanks so much for your time. Thank you for having me on Jason.