Friday, August 8, 2014

sunflower field with tree
Late Summer

As we enter Late Summer, we come into a season influenced by the Earth element in Traditional Chinese Medicine (TCM).  It’s a time of fruition, ripening and harvest.  Spleen and Stomach are the associated organs and energetic pathways.  Like Stomach Qi, Spleen Qi relates directly to digestion.  Spleen Qi health is central to our abilities to gain nutrition from what we eat.

Other associations with the Earth element include the color yellow, the “negative” emotions of worry or anxiety and the “positive” emotions of fairness and openness.  When we are Spleen Qi deficient, we tend to feel anxious and obsess about certain thoughts.  One of the simple antidotes to over-thinking is exercise.  This is because the Earth element rules muscles.
 
Some of the physical symptoms of Spleen Qi deficiency could be fatigue, poor digestion, abdominal bloating or loose bowel movements.  Treatment typically involves dietary changes and appropriate exercise.  If needed, acupuncture and Chinese herbs are used.

Earth element’s associated taste is sweetness.  Here we hit a common weakness in our culture:  an excessive, runaway craving for sweet food and drink.   Most of us know some of the blatant health effects of overindulging in sweets, for example, diabetes, periodontal disease, tooth decay and excess weight.  A few of the lesser known effects can include headaches, sadness, temper tantrums, foggy thinking, pre-menstrual or joint pain and candida infections that are hard to clear.  Cancer thrives on sugar consumption.

There are plenty of good books that talk about sugar and how to kick the habit.  The old stand-by is Sugar Blues by William Duffy.  A more recent book is The Sugar Addict’s Total Recovery Program by Kathleen DesMaisons.  Duffy details the fascinating history of sugar consumption in the North America and its relationship to economic systems of recent centuries.  DesMaisons provides an addiction recovery model for getting out of the sugar trap.

Some books include sugar issues within broader dietary concerns, for example, Nature’s Cancer-Fighting Foods by Verne Varona, or the Self-Healing Cookbook by Kristin Turner.  I like Turner’s delineation of “high drama,” concentrated sweets such as white or brown sugar as well as corn syrup.  She contrasts these with “slow-burning” (slowly metabolized) sweets, for example, carrots, winter squash or apples.

Qigong masters talk about daily practice of a new behavior (for example, a specific qigong form for stress relief) for 100 days before one decides whether or not it is effective. It makes a lot of sense in terms of behavioral conditioning.  This applies to a sugar-free diet, as well.  Usually by the time 100 days of practice have transpired, the habit is well established.  Also, one has experienced enough reinforcing results to seek further practice of the behavior.  Living without simple sugars is certainly a new behavior that requires some time and practice to integrate into our diet.

Many of us know the strong pull of sugar cravings.  The good news often is that after a few days of doing without the simple sugars, the cravings dramatically reduce.   However, each time sugar is re-introduced, the cravings re-start; we may say, “Oh, I’ll have just a little bit of (fill in the blank with your favorite candy/dessert/donut/marshmallow ‘salad’).”  Therefore, it’s often easier to consistently stay away from simple sugars. 

For some, the addiction model of recovery is helpful.  It includes a recognition that sometimes it takes a greater power than a mortal to attain and sustain a sugar-free lifestyle.  Recovery also implies a group process, i.e., a collective working together rather than an isolated individual struggling alone.   Just like recovering alcoholics earn chips for achieved milestones of recovery time, the “sugarholic” can also celebrate extended time periods of sugar-free life.  Slips are acknowledged and addressed by one’s support team but they involve no shame.

How ever one reclaims and maintains a lifestyle that involves radically fewer simple sugars than what is often standard fare, it is important to view it as a positive step.  It’s not so much about giving up a pleasure.  It’s about a return to wholeness and health.  When your brain gets this positive message, it is more cooperative.

Scroll down to read a related blog entry that features personal reflections by someone who accepted the Get-Off-Sugar Challenge.  Ann shared it with me in the spirit of support for others.  With gratitude to her, I pass it on to you.

Janet Lee Cook
 Licensed Acupuncture and Chinese Herbal Prescriptions
 512-826-1164 

REFLECTIONS on SUGAR and BEYOND

Dear Current or Future Patient of Janet’s,

I write to you because you’re trying to get off refined sugar and refined carbs like I am. I had a medical event that made it seem like a good idea. With my journal, I hope to provide a peer’s perspective of someone actually living through this experience.

I reported to Janet my success after several days without sugar.  She was clever.  Janet asked me to write to her again after “thirty days, three months, and six months of adhering to this new way of life.” SIX MONTHS?!?!  WTF?!

This was supposed to be a short term experiment, just to see if I could do it. I secretly cherished the notion of going back to the old ways sooner or later. But I HATE the idea of writing to Janet and admitting failure. Lesson: Never mess with a behavior expert!

As of now, I’m on the ninth day without refined sugar or refined carbs; from here on out for brevity I’ll just say ‘sugar’. Here are some things I’ve found.

The first 72 hours were horrible. That’s when I discovered I was dealing with a bona fide addiction. I had pounding headaches. I wrote a very nasty email to a friend because I got angrier than I’ve been in a long time. Fortunately this friend went through sugar withdrawal herself some years ago and knew what was going on; otherwise, I might have lost that friendship. I chose to go cold turkey. It did a real number on my moods. Some people may need to taper off more gradually. If I were to do it over, I might do that.

I have learned since then that there is a ‘21 Day Sugar Detox.’ I don’t know how good it is. I do like the idea that someone recognizes that sugar is something some people need to DETOX from, just like one detoxes from alcohol, prescription painkillers, or street drugs. I freely call myself a recovering sugar addict.

I was lucky. I have two sugar-free friends. Most people won’t have that kind of social support and won’t know anyone other than Janet who isn’t eating sugar. From work with addicts at my job at Austin State Hospital, I know how essential social support is to kicking an addiction. It has been a lifeline for me. We tell addicts “If you don’t like your playmates, change your playground” but that’s impossible to do with a sugar addiction, because everyone eats sugar. Or so it seems.

There’s no Sugar-Eaters Anonymous. You might want to try Overeaters Anonymous if you like support groups. It isn’t exactly the same thing but it’s close. Or get with a friend or two who want to go sugar-free with you, and support each other. At least have someone who’s your cheerleader. If I didn’t have my two friends to continuously show me it’s possible to live without sugar, I would have given up before now. And it has only been nine days!

It has been an eye opener that I was living a ‘sugar lifestyle.’ My favorite almost-daily ritual was to stop at a bakery/coffee shop in the morning to select and eat my favorite pastry. I spent a lot of time thinking about my next sugar treat, going somewhere to get it, loving the joyful anticipation of un-wrapping the chocolate bar, and searching for places I hadn’t been before that sold chocolate and various kinds of pastries. “Look! An ASIAN bakery!” It was all sugar, but seeking and finding different kinds of sugar was fun.
 

And then there was wine, picking and choosing a label. I’m not an alcoholic, fortunately, but that had to end, too, as it has a lot of sugar in it.

What I’ve found is that I can keep my coffee shop ritual. I just dumped the sugar part. After a few days, the cravings weren’t so bad and I could go there, look at the croissants and scones that I used to think of as my best friends, and say, “It’s okay; I don’t need that.” I get a cup of tea or coffee and sip it slowly. I still watch the people and listen to the music at that place because it’s a good experience for me. I might go with a friend or take a book to read. If I end up falling off the wagon there, I’ll reconsider going, but for now it’s all right.

My appetite has decreased. It’s no longer out of control.

I’m slowly developing some new rituals and habits, too. I put some new plants in my garden this week. I read, walk and write more.  I’m going to start walking a friend’s dog.  It will mean still more walking which is all good. I have more time and desire to exercise now.

Honestly, after nine days I sometimes still feel at loose ends. My former smoker friend says it was like that for her when she gave up cigarettes. She called smoking physically, mentally, emotionally, and socially addictive and described how she built her daily life around smoking. I could relate to everything she said. She used to take smoke breaks; I used to take sugar breaks at work. Now I take walk breaks. I go outside to walk or sit, instead of to Central Market for a sweet treat.

Three helpful things I’ve heard since I gave up sugar:

  • “It gets better after the fourth day.”
I got this Facebook post in the midst of that awful second day and it helped me hang tough. The woman was right. And I realized I had a THIRD friend who didn’t eat sugar. Maybe there are more of us out there than I thought?
  • “Eating sugar makes me want to eat sugar.”
Yes, me too. I eat it and then get a burst of energy which feels wonderful.  Then I crash, which makes me want to eat sugar to feel “up” again.
  • “It’s great you’re doing that. I’d love to give up sugar.”
Some people want to do it, but don’t think it’s possible. I keep thinking that if I do it, maybe I can give someone else hope that they can too.

One helpful nonverbal gift: Getting a sugar free Easter basket from caring friends.

Warning: Expect sabotage, intentional or not.

Intentional sabotage: Some people are in families or relationships where someone giving up sugar, or any addiction, puts the whole system out of joint. You may get flack from others for this reason; they don’t want change. If you get opposition from your nearest and dearest, just remember it’s their issue, not yours. Take good care of you! You’re worth it! If you encounter continuous sabotage from those closest to you, I encourage you to see a life coach or therapist who can be your advocate and help you more than I can.

Unintentional sabotage #1
: When I said on Facebook that I missed deciding whether it would be a walnut, chocolate chip, or raisin scone for me today, my cousin Sue posted, “I chose a chocolate chip scone today.” I thought, “Thanks for nothing, Sue. I really needed to hear that today.  NOT.”

Unintentional sabotage #2“What’s the big deal about sugar?” This includes the “You must be crazy” looks I get from some friends, peers, co-workers. Many can’t understand why anyone would do this to themselves.

Unintentional sabotage #3: Opening an email from a friend that had as a banner slogan, “A little chocolate a day keeps the doctor at bay.” That one sneaked up and surprised me. It triggered a chocolate craving that lasted for hours.

And I KNOW that for at least some women, like my mother and me, there is a natural affinity for chocolate. Chocolate to me is beautiful, smooth, soothing, wonderful stuff. I have wondered how I can ever live without it.

Just sayin’. Be prepared for sabotage. It doesn’t have to derail you.

And okay, sugar is for me a highly addictive substance. BUT it isn’t just an acceptable addiction, it’s actively promoted and encouraged. TV bombards us with ads for sugary, starchy processed foods. It’s so completely woven into the fabric of our culture (sugar hearts on Valentine’s Day, chocolate eggs on Easter, pumpkin and pecan pie at Christmas), that the thought of living without it seems unthinkable to many people…and often to me, too.

There is huge ignorance around how harmful sugar is. Most people think sugar “makes you fat” and might have a tiny chance of giving them diabetes. Not so tiny, it turns out. The rate of diabetes in this country in 2012 was 9.3%. That year, a whopping 37% of Americans 20 and older were pre-diabetic.  People with these blood sugar levels are at higher risk for developing Type 2 diabetes and other serious health problems.  This includes heart disease and stroke. I know three “brittle” diabetics.  They sometimes experience drops and peaks in blood glucose so severe that they require medical attention.

Almost nobody I work with knows about the relationship between sugar and cancer.  Cancer loves sugar!  It gets fed by it like nothing else.

There is huge ignorance around how universal sugar is. I like this website: http://www.sparkpeople.com/resource/nutrition_articles.asp?id=1663 with its sources from the American Medical Association. What I especially like about it is how sneaky the big food companies are about hiding the way they add sugar to processed foods. Here are some labels/disguises that should say “SUGAR”. There are 49 different ways to say it!  This includes high fructose corn syrup, evaporated cane juice, dextrose, maltodextrin, and on and on. Find the whole list on page 3 of the website above.

For this reason, I’ve become an obsessive ingredient label reader. In general, I shop the periphery of the grocery store for staples and only occasionally dart into the center aisles if I need one or two things there. If I randomly pick up a frozen or canned processed item, chances are...hello sugar!

It feels like I am battling evolution and that the taste for sweets is to some extent hard-wired.  I also battle years of reward/reinforcement...Janet knows the correct behavioral lingo for it. As a child, I was taught to eat the “nasty,” not-sweet vegetables so then I could have the delicious dessert. I’ve been rewarding myself and celebrating with sweet stuff ever since. That will be hard to overcome.

I’ve found that without sugar I feel things more intensely. Anger, fear, and also joy are sharper. One sugar-free friend said that when she gave up sugar, she realized she had been living in a kind of “fog.” I wonder if the same is true for me.  That intensity is disturbing at times.

It seems I think more clearly. I will see if that continues to be true.

I fell off the wagon when I went to Souper Salads. My intentions were good, as were the salad fixins. Unfortunately, the gingerbread muffins, puddings, and Jello-O were good, too! Sad to say, I went crazy. I found out I don’t do well at All You Can Eat buffets.  Afterwards, I felt kind of run-down. I also got mad at myself, but realized it was no big deal. I find it’s so important to practice self-forgiveness and self-compassion. This isn’t at all easy.

To talk about addiction is to talk about shame.  This includes shame I might feel for any reason at all leading to eating sugar to numb it, shame in realizing I’m addicted, and shame in relapse. “Relapse is part of recovery” I’ve heard. That helps.

I eat fresh fruit when the sugar cravings hit. I always keep a bag of apples or pears handy to grab at a moment’s notice.  I also like plain yogurt mixed with unsweetened applesauce, with lots of cinnamon on top.  My sugar-free friend likes to slice a Granny Smith apple, douse it with cinnamon, and then nuke it.

I’ve started exploring other herbs and spices, for example, red pepper flakes and dill on sauteed veggies or fish.   It’s delicious!  I think my taste buds are starting to change...maybe.  One sugar-free friend says broccoli now tastes sweet to her. Unbelievable.

I still get BIG sugar cravings. Have to stay honest!

Finally, I’ll return to the idea of writing to Janet after 30 days, three months, and six months to let her know how it’s going. Guess what. I’m not going to give up sugar for 30 days, three months or six months. No. I’m giving it up just for the next 24 hours. An alcoholic never tries to stop drinking forever. It’s too daunting. She or he only says, “I will not drink today.”

Sincerely,
Ann

Saturday, July 12, 2014

InflammationWhat Food Choices Fuel It and What Helps Quell it

Young woman buyinig produce in a marketOne autumn in a burst of nostalgia, I prepared a casserole of stuffed bell peppers.  It evoked my family of origin.  We had always grown the peppers in our gardens and had enjoyed the baked form as the weather cooled.  Then, when my 50+ year old shoulder joints shortly thereafter began to seriously ache as never before, I realized that I was indeed sensitive to this form of nightshade plant!  It was a powerful, if uninvited, lesson.

If you suffer from arthritis, a cardiovascular disorder, cancer, an autoimmune disorder or any other of the numerous diseases that result from inflammation, consider what you eatTake more control of your health.  You will feel better when you make informed food choices. 

In a nutshell, what many of us are accustomed to eating aggravates inflammation.   This includes fast and highly processed foods as well as “home-cooked” items that involve unhealthy fats and oils.  It also covers low-fat diets that can have large amounts of refined carbohydrates.





Here’s a table summary of general dietary influences on inflammation.

It is based upon the work of Dr. David Servan-Schreiber, MD, PhD
in Anticancer:  A New Way of Life.


Aggravates Inflammation
Reduces Inflammation
Chemical food additives:  sulfites, benzoic acid, parabens, antioxidants (e.g., BHA or BHT), NutraSweet, Splenda, Sweet One, MSG, food coloring, and nitrites
Whole foods only—no preservatives or other chemicals
Refined sugars, including alcohol (especially hard liquor & more than 10 oz./day of red wine with a meal),  and white flour
Organic whole grains, for example, brown rice, quinoa or millet
Red meat from industrially raised animals
Legumes or high omega-3 fish as protein sources.  At most 3x/week:  organic red meat from animals fed grass or flax meal
Oils rich in omega-6 (corn, sunflower, safflower, & soy), margarines and trans fats.
Olive oil, flaxseed oil, canola oil
Dairy products from industrially raised livestock
Organic dairy products from animals fed grass or flax meal
Eggs from industrially raised hens fed corn & soybeans
Organic eggs from hens raised with extended time outdoors


Here are more details of an anti-inflammatory diet, taken from Dr. Andrew Weil, M.D.’s suggestions:
  • Vegetablesminimum of 4-5/day, raw and cooked, of all colors. Artichokes, spinach, broccoli, sweet potatoes, cucumbers, tomatoes, onions, parsley and zucchini are especially good anti-inflammatory vegetables.
  • Fruits3-4/day, fresh in season or frozen.Eat brightly colored fruits like cherries, blackberries, blueberries, and strawberries.
  • Beans and other Legumes1-2/day
  • Healthy FatsThis includes extra virgin olive oil, nuts (especially walnuts), avocados, and seeds (including hemp and freshly ground flax). The amount of fat varies according to preference and health needs.
  • Fish and Seafood that are high in Omega-3 fatty acids2-6/week, for example, mackerel, rainbow trout, salmon, sardines
  • Soy foodsno more than 1/day. This includes tofu, tempeh and soymilk.  Tempeh has the advantage of being fermented.
  • Cooked Asian Mushroomsno more than 1 serving/day
  • Healthy Herbs and Spicesraw ginger, garlic, turmeric, and cinnamon in unlimited amounts.
  • Tea1-4 cups per day of green, white or oolong
  • Plain dark chocolatesparingly and without dairy, which cancels cocoa’s benefits. Rather than add sugar, an inflammatory substance, to some organic cocoa, try stevia as a sweetener.
  • Red Wineoptional and no more than 1-2 glasses/day
Some people can also handle:
  • Grains1-2/day, only ungroundConsider wheat- and gluten-free, such as whole grain brown rice, quinoa and millet.
  • Pasta (al dente)2-3/weekConsider wheat- and gluten-free.
Dr. William Davis, a cardiologist and author of the best-selling book, Wheat Belly, talks about these drawbacks of modern wheat:
  • It includes a protein that stimulates appetite and thereby contributes to obesity. 
  • Modern wheat germ is very different from ancient strains.  It is largely responsible for many of the pervasive, and difficult-to-diagnose, ill effects of wheat.  It is most highly concentrated in whole wheat, including sprouted wheat.
Whenever possible, eat organic foods and not genetically modified food, for example, any soy or corn that is not organic.  You want to avoid herbicides and insecticides.
These days, many people are sensitive to the following foods and benefit from avoiding them:

Try avoiding all of these for at least two weeks and observe how your body reacts.  If you like, gradually re-introduce one of them at a time.  Wait at least one week between each re-introduction to you see how you feel with each specific change.

If you have rheumatoid symptoms, also try eliminating nightshade vegetables.  These are white potatoes, tomatoes, peppers except black pepper, and eggplant.  Tobacco is also a nightshade.  Commercial curry powders have hot pepper in them; make your own without hot peppers if you want curry.

Consider the vitamin D complex to reduce inflammation and enhance bone health. It has much more than an isolated vitamin D2 or D3, with hundreds of variations that work in a synergistic manner. 

The omega oils with odd numbers are a family of inflammation-cooling and heart-protecting oils.  They include:

  • DHA omega-3, found in fatty fish like salmon and ocean trout or in high quality cod liver oil (CLO).  One of the few sources of fermented CLO appears to be Green Pasture’s Blue Ice. 
  • ALA omega-3, found in walnuts, avocado, flaxseed, canola oil and chia seeds
  • Omega-5, found in pomegranate seeds
  • Omega-7, found in macadamia nuts
  • Omega-9, found in olive oil
Cook with stainless steel, glass or cast iron containers. Do not use aluminum pots and pans.  Flaking Teflon-covered pots and pans are suspect.

Do not consume foods or liquids that have been in contact with hot plastics, for example, microwave plastic bowls or plastic mugs. 

If we consider what we eat, how it is prepared, and how these two aspects affect our overall well-being, we can better appreciate and enjoy healthy food.  This is the real way to think about “Comfort Food” when making food choices.



Janet Lee Cook
 Licensed Acupuncture and Chinese Herbal Prescriptions
  512-826-1164 




Thursday, June 5, 2014


Some Inflammatory Words
Often, I treat patients with medical conditions that relate to inflammationIf you see “-itis” in a diagnosis, it means inflammation is a player.  Examples include arthritis, tendonitis, sinusitis, tonsillitis, bronchitis, colitis, hepatitis, cystitis, gastritis, and appendicitis. 

Like many things in life, inflammation is neither “bad” nor “good” in itself.  It is a basic part of the normal healing process, helping us deal in the short-term with most infections and wounds. 

Chronic inflammation, however, sets the stage for challenging health problems.  It comes about in response to consistent exposure to dietary or environmental triggers, malignant tumors, or chronic infections, as well as the dysfunctional immune response seen in autoimmune disease.

Chronic high inflammation is a major factor in these diseases:
  • Osteoarthritis and rheumatic diseases such as rheumatoid arthritis and lupus
  • Cardiovascular (high cholesterol, high blood pressure)
  • Neurological (depression) and neuro-degenerative (Alzheimer’s, Parkinson’s Disorder)
  • Pulmonary (asthma, allergies)
  • Metabolic (diabetes/obesity, low thyroid hormone)
  • Neoplastic (cancer)
It’s common for someone with a painful, inflammatory condition to reach for a bottle of a non-steroidal anti-inflammatory drug (NSAID).  These include aspirin and ibuprofen.  However, NSAIDS can have unpleasant side effects such as nausea or diarrhea as well as toxic, life-threatening ones, especially if used long-term.  At any time and without warning symptoms, fatal stomach and intestinal reactions can occur during their use.  Elderly people are more at risk. 
 
If your inflammatory condition has led to use of a corticosteroid, for example, cortisone, hydrocortisone and prednisone, there are even more things to worry about.  Orally-taken corticosteroids are most likely to cause significant side effects.  This could be increased pressure in the eyes (glaucoma), fluid retention that causes lower legs to swell, high blood pressure, mood swings, weight gain, cloudy vision (cataracts), high blood sugar that can trigger or worsen diabetes, increased risk of infections and slower wound healing, thinning of the bones (osteoporosis) and fractures, thin skin that bruises easily, and suppressed adrenal gland hormone production.  In other words, you pay a price for the “easy” fix! 

Thankfully, acupuncture and Chinese herbal formulas can definitely help decrease inflammation, and without nasty side effects.

You can also empower yourself by implementing some important, evidence-based strategies.  At the same time, they also address some common root causes of inflammation:
1) Manage stress:
  • Practice “belly” breathing.   Basically, you stick your stomach out when you inhale and pull it in when you exhale.  It signals your body to relax. 
  • Practice mindfulness as you breathe and go about your day.  If you stay in the present, your body is more likely to relax. 
  • Practice qigong, a gentle yet profound therapy that combines breath, movement and visualization.  Qigong switches the nervous system from the stress-related “fight or flight” mode to the restorative healing mode of the parasympathetic branch.  I recommend Lee Holden’s DVDs, for example, Qigong for Stress, Qigong for Deep Sleep or Qigong for Upper Back and Neck Pain.   Go to www.ExercisetoHeal.com to access these. 
  • Make more connections with friends. 
  • Free yourself from feelings of powerlessness.
  • Learn to accept your emotions, including fear, sadness, despair and anger, but address ongoing feelings of helplessness.
  • Find someone with whom you can process your emotions, for example, a peer counselor or a psychotherapist.
  • Resolve past traumas via therapy.
  • Make choices, for example, in relationships, to help avoid undue stress. 
  • Seek happiness.  A fascinating study shows that it can lead to anti-inflammatory changes in your DNA, but only when that happiness comes from a pursuit of a “noble” purpose (for example, volunteering or participating in community projects) versus a hedonistic pursuit (for example, eating a great meal or buying a new car).  
2) Get at least six hours of sleep each night.
3) Exercise.  This could be a 30-minute walk, six times a week.  Less than 20 minutes of physical activity per day contributes to inflammation.
4) Create clean environments.
  • Stay away from cigarette smoke.  If you are addicted, use acupuncture to help stop. 
  • Avoid products that contain industrial and domestic chemicals.  These include pesticides, insecticides, chemical cleaning products, skin contact with aluminum, parabens and phthalates in cosmetic products, and foods and liquids that have been in contact with hot plastics (e.g., microwave plastic bowls, plastic mugs).  Air dry-cleaned clothing. 
  • Work with others to stop atmospheric pollution.  Meanwhile, you may benefit from a good room air filter. 
5) Look at your relationship with alcohol.  The experts say that an occasional glass and no more than 10 ounces per day of red wine are OK if you want to decrease inflammation.  Anything beyond that, as well as hard liquor, raises inflammatory levels.
6) Maintain a healthy weight.  Being overweight, especially with too much abdominal fat, feeds inflammation.
7) Choose foods and prepare them in ways that actively fight inflammation.  By far, the most important way to control inflammation via diet is to minimize unhealthy dietary fats.    Steer clear of refined carbohydrate and high-glycemic-index foods.  More on diet later in an upcoming article
Finally, give yourself credit whenever you make a move toward better health by choosing any of these habits.

Janet Lee Cook
Licensed Acupuncture and Chinese Herbal Prescriptions
512-826-1164