The World Cup and the End of Soccer Headers

“Use your head!!” yell some parents from the sidelines. Our coach winces at my son’s high kick to bring down the soccer ball – he shouts at my 11 year old son and motions to his head, an instruction for my son to use his head the next time. My son glances at me from across the field. 

What the other parents and my son’s coach don’t know is that my son is not allowed to do headers in soccer. That’s our deal. If he wants to continue playing the game, he’s not to use his head; otherwise, I won’t let him play anymore. You might say if I wasn’t going to let him play the game fully, why did I ever get him into the sport in the first place? Well, prior to letting him start, I was pretty ignorant about the sport and its physical nature. Another one of those things I wish I knew before. . .

Unfortunately, with World Cup 2022 mania sweeping the globe and my household, I can see that headers are still very much a part of the game.  Will disallowing headers ever be possible? Would it “ruin” the sport?  Soccer is a highly physical contact sport and headers are certainly not the only source of major injury, but header rules are perhaps the most straightforward thing to change about the sport to reduce the risks of head injury and long term brain damage. 

Mom, what a buzzkill, right? Seriously, first, no screen time, and now, we can’t even play soccer like we’re supposed to? And, like with the France vs. Argentina final coming up, nobody wants to hear about that now! Surprisingly, I did find some recent research and media commentary suggesting that a ban on headers may be in the future.

Soccer Football – FIFA World Cup Qatar 2022 – Quarter Final – England v France – Al Bayt Stadium, Al Khor, Qatar – December 10, 2022 England’s Harry Maguire in action with France’s Olivier Giroud REUTERS/Hamad I Mohammed

What’s the Danger of Headers in Soccer?

First, there is increasing evidence to support my anxiety. Cognitive impairment can result from just a single training session involving the practice of headers. Whether that impairment is just short term or long term is yet unknown (but we could take an educated guess on what the research will likely find). Plus, do any of us knowingly want that impairment even if it’s just for a day? Don’t practice headers before your math test? 

Long term, it’s suspected that soccer players may eventually suffer from CTE (chronic traumatic encephalopathy – a degenerative brain disease) as has been the case with MLS players, Scott Vermillon (confirmed CTE), Bruce Murray (suspected CTE, early dementia in his 50’s), former England international, Jeff Astle (confirmed CTE), and many players in American football. CTE is caused not only by repeated concussions, but it’s also suspected that small, repetitive hits to the head have the same damaging effects.

Will Headers Ever Be Banned from Soccer?

Soccer organizations in England and Scotland have already responded to the growing research on the dangers of headers by putting guidelines on heading practice in adult games. In both the US and England, soccer authorities have delayed the introduction of headers in youth soccer. 

With the World Cup in Qatar going on, I’ve caught a few articles covering soccer that discussed the end of headers, including a New York Times piece projecting that with increasing evidence, it’s just a matter of “when,” and not “if” headers will eventually be banned.

The more studies that come out to show the risks of headers and the more educated parents become on the dangers of letting their kids beat their heads with a high velocity ball, the harder it will be to knowingly endanger the long term health and safety of all the athletes and our kids.  

Resources

A sampling of the media attention to the dangers of headers and the possibility of ending them:

Soccer players with dementia or CTE:

In the US, moms’ organized to delay (or eliminate) the use of headers in youth soccer:

Ruining the sport if we ban headers – the comments at the end of this article highlight the perspective of those who feel the sport should be left alone:

Storelli tries to sell some head gear by pointing out that headers are not the only cause of concussions (although they are the cause of CTE and dementia):

Prevent Foot, Knee, and Heel Pain from Soccer Cleats 

The standard fit of soccer cleats doesn’t make any orthopedic sense (see this article on podiatrists whose patients play soccer) and yet, it’s the norm. If you play soccer in cleats, you probably know they can be pretty uncomfortable. However, when I was a new soccer mom, the first time I went shopping for cleats for my kids, I was stunned by the stiffness and narrow shape of the shoe. The uppers were stiff, synthetic leather and the sole plate was hard plastic with a thin, flat insole. I sucked it up and after twisting many a pair, I settled on some Nike cleats that I generally find are the least stiff of all the brands. Fast forward through 5 years of soccer playing, and my kids started complaining of knee and heel pain, enough to knock them out of sports for weeks at a time. 

I wish I had paid more attention to the cleat fit issue from the beginning because now I realize what I should have done from the start to help the cleats fit better. It should be standard soccer education along with “what is a shin guard?” Here is a list of the things I learned to do to help the cleat fit as much as possible:

Replace Insoles with OTC Orthotic Inserts

Far and away, the best thing you can do to make your cleats fit more comfortably is to replace the soccer cleat insoles with orthotics. Out of the box insoles on cleats are minimal drop with minimal padding. If you follow some principles behind minimalist footwear, it would seem like this is a good thing. However, the stiffness of the shoe and rigidity of the soleplate probably negates this. 

Instead, the insole should provide some of the shock absorption and protection that you will need from both the impacts and the rigidity of the cleat. There are a couple of OTC orthotic inserts that are often mentioned as fitting well in cleats: Currex CleatPros and Superfeet Carbon. We tried a couple of different Superfeet and found the Everyday Superfeet Insole (Green) to have the deepest heel cup and the most cushion for shock absorption. 

  • Tip #1: Orthotics and insoles are FSA/HSA eligible. (They can feel expensive, but then again, the visits to the orthopedists or podiatrists cost even more. We’re skipping those type of doctor visits in the future. Plus, they will just tell you to buy orthotics, too!)
  • Tip #2: When selecting orthotics, pay attention to:
    • the level of arch support, 
    • depth of heel cup, and 
    • the thickness of the insole to determine if it’s the right orthotic for you.
  • Tip #3: it’s easier to try orthotics in your cleats if it comes with a removable insole. However, it’s also possible to scrape out any glued on, out of the box insoles and slide in your orthotic inserts. See pic below.
soccer cleat insoles removed for orthotics
Glued on insoles removed from Firm Ground Nike Cleats

Stretch and Soften the Uppers

Stuff a compression or regular tennis ball or shoe-tree as far into the shoe as it can go. We were able to get into the lower toe area and leave it in for awhile. This can help resolve the squished pinky toe feeling to some degree and give a little more room in the toe box. This is player preference, but there’s a balance to be had between ball feel and painful toes.

Add Heel Lift or Heel Cup

Sometimes the orthotic insert isn’t enough shock absorption particularly on the heel. You can add a gel heel lift which increases the drop on the cleat, which is usually zero drop (i.e. completely flat). Sever’s and plantar fasciitis are common heel injuries that occur with cleat-wearing athletes. In both diagnoses, contributing factors include tight calf muscles, irritated heel pad, or muscles that just haven’t caught up in growth with the bones. A heel lift reduces the stretch on the calf muscle and heel cups can provide more shock absorption and support for the heel strike during activity. We ended up with the heel lift which I stuck to the shoe underneath the insert. Heel cups can sometimes be hard to get used to – my kids kept feeling like the cup was going to come out of the shoe, but they are also a popular option. 

Wear Cushioned Soccer Socks

Some soccer socks don’t come with extra cushioning, but many do. Cushioned socks just add that one more layer of shock absorption and some protection against blistering in cleats. 

Twist Before First Wear

I’m sure the boot guy does it for the pros. By that I mean, break in soccer shoes for fit and comfort.  On an episode of Amazon’s All or Nothing: Manchester United, the camera shows the boot room for the team and there’s an equipment guy giving all kinds of TLC to each of the players’ cleats. Wow, until my son turns pro, it’ll have to be his poor mom. Wring the cleat multiple times and knead the uppers until the shoes feel like they give more easily. Yeah, you could also let your kid break them in on the field, but then they may have a blister or two – depends on how much of a helicopter parent you are! 

Resources

Podiatrists weigh in on the problem with soccer cleats and offer advice:

Products we’ve used:

Common pains from soccer:

Reversing Myopia: Update #2

My last update about my experience trying to reverse my myopia was about 20+ months ago. For previous posts about my experience, please see: my first post and my first update. Today my 2nd update, in short, is that my vision still seems to be improving, but the improvement is quite slow when averaged out over 3.5 years – a 1.50 diopter improvement total in each eye when measured by my contact lens RX. See below for an updated chart and further notes about my experience:


Eye Exam Date
Glasses RX (from optometrist)Contact Lens RX (from optometrist)My Reduced Glasses RX for reversing myopia during this time
October 2018Corrected to see 20/15:
R: -8.00 w -0.50 astigmatism
L: -6.25 w -0.50 astigmatism
Corrected to see 20/20:
R: -7.50
L: -6.50
I first started wearing reduced lens June 2019:
R: -7.25 w -0.50 astigmatism
L: -6.00 w -0.50 astigmatism
End of Sept 2019Corrected to see 20/15:
R: -8.00, no more astigmatism
L: -6.25 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7.5, no more astigmatism
L: -5.75 w -0.50 astigmatism
Corrected to 20/20:
R: -7.00
L: -6.00
In October 2019, I started wearing:
R: -7.25 
L: -6.00 
Early August 2020Corrected to see 20/15:
R: -7.5
L: -5.75 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7
L: -5.75 (no astigmatism correction)
Corrected to 20/20:
R: -6.50
L: -5.25
In March 2020, I started wearing:R: -7.00 L: -5.75 
Nov 2021Corrected to see 20/20
R: -6.75 w -0.25 astigmatism
L: -5.75 
Corrected to 20/20:
R: -6.25
L: -5:25
In December 2021, I started wearing glasses:
R: -6.50
L: -5.25
Contacts:
R: -6.00
L: -5.00
July 2022 (haven’t visited optometrist yetNot available yetSeeing 20/20 with:
R: -6.00
L: -5.00

Notes on My Recent Experience with Reversing Myopia:

  • As I continue to reduce my glasses and contact RXs, my close vision seems to benefit so I still have no major need for bifocals or readers while most people my age are starting to have more trouble with small print.
  • I think I had trouble improving my right eye in years 2020 to 2021 because contact lenses above -6.00 don’t come in increments of -0.25, and so my left eye was always doing the heavy lifting. Finally, I tried reducing my left eye to match the blur in my right eye. I first started wearing contacts at the reduced lens of -6 and -5 in December 2021, seeing about 20/40. Things were slightly blurrier than I would like then, so I actually wore glasses with a -.25  lens for driving at night. Although that felt silly, it allowed me to wear contacts and get through the transition while my eyes slowly improved which took about 3-4 months to seeing 20/20 in daylight. I still don’t see 20/20 in dim lighting nor at nighttime. I haven’t measured it, but signs and people’s faces over 20 ft away are just slightly blurrier.
  • I haven’t done print pushing (Todd Becker method) or active focus (Jake Steiner method) consciously. My computer screen sits over 90cm from my eyes when I am working and when I’m outside, I make a conscious effort to constantly check how well I can read signs or see activities taking place at a distance. Maybe someone could improve faster with a more concerted effort, but at the moment I’m satisfied with the slow change with seemingly little effort.
  • Interesting comment from my optometrist: He said that young people tend to want to see super clear and their young eyes are able to do so. As a result, during a manual refraction, they will tend to pick the higher powers – this tends to lead to overcorrection in prescriptions.

IGE and Oral Immunotherapy (OIT): Sample Size of 2

I’ve received many questions about what the kids’ IGE numbers have been since they began oral immunotherapy. I was definitely curious when I was researching OIT and I like to see numbers too, so I’ve posted them below. Basically, the numbers trend downwards since OIT. Unfortunately, the numbers were already down from their peak before they began OIT (2019), so I won’t ever know if the continued downward trend is due to OIT or if they were on their way to becoming less allergic anyway. Below I list the raw data, and then graphed. I don’t have 2022 numbers, so check back after this summer for those.

Peanuts and IGE

YearTotal IGE (IU/mL)Peanut IGE (kU/L)Ara h 2 IGE (kU/L)F447-IGE Ara 6 IGE (kU/L)
20213588.358.884.51
202041317.314.8no data
(numbers right before OIT start) 201927918.717.3no data
2018420no data41no data
2017no datano data31.1no data
201689.211.623.7no data
20151195.19no datano data

Pistachios, Cashews, and IGE

YearTotal IGEPistachioCashew Component (F202)Cashew Component (F443-IGE Ana o 3)
20212971.211.260.91
20204482.512.631.85
(numbers right before OIT start) 20193263.412.841.9
20183652.182.251.56
2017no data4.353.62no data
20162681.921.45no data
2015no data3.673.08no data

 

What You Need to Know About a Health Savings Account (HSA)

Everywhere on the Internet, you will easily find the basics on health savings accounts (HSAs) about who is eligible, what the rules are, etc. However, as they say, “the devil is in the details,” both good and bad.

Is an HSA right for you?

Using an HSA is, in fact, a big pain in the ass. It’s not easy to manage and use it efficiently and a certain amount of administration is required. While financially beneficial, I have to view it as getting paid a decent amount of money to do some low-level administrative work. 

Opening an HSA

Below are the things I “wish I knew before” I got started with the HSA:

#1 Start Saving in an HSA as Early as You Can

If you’re going to set up an HSA, the younger you are, the more money you can “make” with it! If you are eligible, see how your HSA with high-deductible plan compares with your other health insurance options in my other post, “Health Insurance Plan Comparison Spreadsheets.”

It’s one of the best retirement account options out there, without actually being limited to retirement. It’s pre-tax money going into an investment account and tax-free withdrawals (for qualified medical expenses). There’s no other investment account like that. It’s essentially tax-free income that you can use before retirement. As much as I hate the administrative side of the HSA, I think it’s the financially savvy thing to do, and I’m going to teach my kids to set up an HSA (and a Roth IRA) account as soon as they can. 

#2 Watch Out for Employer Contributions and Contribution Limits to the HSA

If your employer contributes to your HSA, make sure that you account for that in your overall contribution limit and set up your contributions accordingly. We didn’t pay attention to that and over-contributed last year. You may pay a penalty for excess contributions. Fortunately, you can typically rectify it online and with the IRS before the tax filing deadline, but it’s more admin work for you!

#3 Set Up a Stable HSA Provider Outside of Your Employer’s Provider

HSA providers can change even if you don’t change jobs. Set up an HSA provider account that is separate from your employer. Even if you don’t change employers, your employer may often change the HSA provider from year to year or even mid-year. It gets complicated to manage funds in multiple accounts. Ideally, we would have kept it to two.  Additionally, some of the employer’s HSA providers charge fees for the investment portion of the account. 

I followed the Finance Buff’s recommendations and opened an account at Fidelity which is fee-free. (Seriously, the Finance Buff author is like the financially savvy uncle I always wish I had!) It seemed like a no brainer when compared to HSA providers that do charge a fee to invest your HSA funds.  

#4 Avoid Investing With the HSA Provider That Your Company Uses 

Why? Because when your company decides to change providers, you have usually have to liquidate all investments or roll over to another provider. When you are forced to rollover your investments, you have to liquidate your investments and find equivalents in the new account, regardless of market timing. To keep it simple, keep cash funds in the employer account and only make investments with your own provider. Many employer HSA providers also charge fees for investment accounts – all the more reason to choose your own provider that doesn’t charge fees.

#5 Create a Physical and/or Virtual Home for Medical Expense Receipts

Create a physical home (a file folder, envelope, box, sock, whatever!) for the expense receipts as well as a file folder on your computer. Separate that into two piles –  reimbursed and not yet reimbursed. Creating the structure before you begin accruing medical expenses increases the likelihood of your staying organized and getting the most or anything out of your HSA! This sounds so basic, yet you would be surprised how critical it is to not hating your HSA. Just ask my husband for which paperwork is the all-time enemy of mankind. Even if you only reimburse yourself once a year or every 5 years (theoretically, there is no time limit), having the organization structure is what makes this manageable.

#6 Avoid Using the HSA Debit Card

I’ve found that reimbursing myself later gives me much more flexibility and time to think about which HSA I want to draw from and when I want to withdraw it. It also potentially allows your money to grow in the meantime. The flexibility offsets the inconvenience of having to manually reimburse.

Another reason to avoid using your debit card is that some people have the debit cards that draw from both your HSA and your LPFSA (the FSA account that you are allowed to have in conjunction with an HSA).  Watch the debits carefully because a technical error may draw from the HSA instead of the LPFSA (it happened to me!) Why is this a problem? Your LPFSA is “use it or lose it” for vision and dental expenses in the calendar year, while your HSA is not. You should always use up your LPFSA first, so you have to monitor the debits carefully to make sure there are no technical errors (which sadly, are quite likely) and time-consuming to fix.

#7 Plan How You Want to Use Your HSA Funds

It’s no use for you if you never use the money in the account, so have a plan for what medical expense you would like to use the money on. The longer you wait, the “less” the medical purchase will cost, assuming growth in your savings. A prudent way to manage the funds is to leave a portion uninvested so you can access it immediately if needed, and invest the remainder. Ideally, you should not draw from the invested funds when the market is particularly down. 

#8 Review the Complete HSA Eligibility List

Make sure you know what is considered an HSA-eligible expense to get the most out of your HSA. Medical bills and services with conventional medical providers are usually obvious HSA-eligible expenses. However, depending on what the balance of your medical and financial needs are, you should know that there are a lot of day to day items that are HSA-eligible items now, particularly after the CARES Act of 2020. (This post calls the items out about half-way down the page.) 

The website, HSA store, seems to have the most current and comprehensive eligibility list. Familiarize yourself with the list, so you can save those receipts to reimburse yourself as needed. Some of the less obvious, but commonly purchased items that I found useful here are many items of common use: OTC pain relief, allergy meds, face masks, Covid tests, sunscreen, orthotic insoles (OTC or custom), sports wraps and bandages, and first aid products. 

#9 Watch Out for State Taxes on HSA Investment Income If You Live in CA or NJ!

HSA investment income is currently federal and state tax-free everywhere except California and New Jersey. It doesn’t mean that HSA is not beneficial in those states. It just means that if you live in either CA or NJ, your HSA investment earnings are subject to state tax (they are still federal tax-free). Again, my “uncle” at the Finance Buff has a very helpful post on this called, “California and New Jersey HSA Tax Return Special Considerations.” 

Using an HSA can be a lot of work – think about whether you can do the job. It can save and earn you a lot of money, but you have to use it correctly to maximize the financial benefits.

Do you have extra tips? I’m still learning, so would love to hear more ideas! Email me at wishiknewbefore20@gmail.com

Resources

Best HSA provider:

Over contributing:

CA and NY state tax considerations

Comprehensive list of HSA eligible expenses

Where to Dispose of Expired Epipens

Updated as of 10/18/22

I discovered that it was unbelievably difficult to properly dispose of expired and/or used Epipens, injectors, and medications. Here’s a summary of the first 50 Internet search results: “Take expired EpiPens to a doctor’s office, hospital, or pharmacy for disposal.”

NOT!!! Our local Walgreens wouldn’t take them. Our doctor’s office wouldn’t take them. Our local police station would only take old medications. Even our allergist’s office said no. I carried around a bag of our expired Epipens for a couple of years, trying to get these “drop-off locations” to take them. Our collection of expired Epipens and injectors was growing into a very large pile.

photo credit: Med-Project

How to Dispose of Expired or Used EpiPens

I eventually found a couple, more reliable resources:

#1 Med-Project, an organization that provides you with the packaging and an address to mail your disposal. Better than schlepping your expired EpiPens, back and forth across town. Depending on your location, they also provide a local list of mail back or drop off kiosks for other products like expired medications and inhalers.

Enter your zipcode on their site to see what your area’s options are:

https://med-project.org/

#2 Safe Needle Disposal, this resource for disposing of medical sharps would include your expired/used EpiPens):

https://safeneedledisposal.org/

Best Chinese Medicines

Traditional Chinese medicine (TCM) has been a part of my American upbringing because my parents grew up under TCM principles and philosophies. Our family healthcare approach has evolved to be a mix of both Western and Chinese medicine along with some skepticism for each of them (see “5 Reasons Not to Rely on Doctors“). However, through generations of family trial and error, we’ve come to find a few Chinese herbal remedies that are popular, commonplace, and often more effective than Western options. Here are the top Chinese herbal remedies that sit in our medicine cabinet:

Best Chinese Medicine for Strains, Sprains, Bruising, and Soft Tissue Trauma: Yunnan Baiyao

Best Chinese Medicine for Strains, Sprains, Bruising, and Soft Tissue Trauma: Yunnan Baiyao
Yunnan Baiyao in powder form, photo credit: tiensproduct.com

Yunnan Baiyao is an ancient Chinese remedy for severe bleeding, trauma, bruises, sprains, strains, and pain and a whole lot more. A lot of Chinese herbal medicine is slow-acting, so it’s not easy to tell if and when they start to help. This is definitely not that kind of medicine – Yunnan Baiyao effects are almost immediate. It’s available in powder, capsule, and patch form. As I understand it, it keeps blood circulating (and not stagnating) through the applied area and also provides some pain relief. We’ve used this regularly for severe bruises, sprains, and fractures, but have not tried it for post-surgery recovery. With it, we’ve had significant swelling and sprains disappear in 1-2 days. We’ve also used the patch version for chronic, recurring pain – with about 80% success rate. There’s an interesting story behind this medicine that you can read about here. We would reach for this before any ice pack and are now using an integrative approach to speed up healing.

Best Chinese Medicine for Allergies and Sinus Infections: Bi Yan Pian

Chinese medicine Plum Flower brand, Bi Yan Pian works as  well as Zyrtec
Plum Flower brand, Bi Yan Pian

I came across this Chinese formula for allergies called Bi Yan Pian, when I was browsing this book, Between Heaven and Earth: A Guide to Chinese Medicine. It’s similar to this pediatric liquid extract herbal formula called Windbreaker which I had originally been giving my child. However, this has worked way, way better and faster. It seems to work even better than Zyrtec for both me and my child. The dosing instructions for the Plum Flower brand are 4 pills, 3x a day. However, I only need 4 pills once a day and my 8 year old takes 2 pills once a day whenever we experience symptoms. During our last allergy season, we would take them only after we started having hay fever symptoms, and the pills seemed to halt the symptoms within the hour. Zyrtec often doesn’t work for us after our symptoms have already started.

Best Chinese Medicine for UTIs: Ba Zheng Tang

Ba Zheng San or Tang seems to be the most effective remedy (in both Western and Eastern spheres) for UTIs
Ba Zheng Tang, liquid formula

Ba Zheng (Eight Rectification) San or Tang seems to be the most effective remedy (in both Western and Eastern spheres) for UTIs in our experience. I wish I had known about Ba Zheng (Eight Rectification) from the beginning when my mom first started having UTIs. The UTIs became chronic after regular antibiotic use. After years of trying tons of Western remedies (D-Mannose, premarin, antibiotics, garlic pills, oregano, cranberry, you name it), I saw this formula mentioned quite a lot in my research on Chinese medicine for UTIs. It seems to be a formula that specifically targets urinary symptoms and is used for acute UTIs. After 10 years of recurring UTIs every 4-6 months, my mother stopped her last two UTIs with this formula and hasn’t needed antibiotics in 2 years! It almost seems too good to be true. I’m guessing that overcoming the last two infections without antibiotics helped to stop the cycle of antibiotics to recurrent UTI. Berkeley Community Acupuncture has helpful information on how long and how often it could be taken. It’s not meant to be taken long term. If you can’t stand pills, I also found Ba Zheng in liquid formula.

Best Chinese Medicine for All Things Female: Dang Gui

Best Chinese Medicine for All Things Female: Dang Gui
Sliced dang gui root, photo credit: tcmwiki.com

Also known as Chinese Angelica Root, dong quai, or Angelicae Sinensis Radix. This is popular as the go-to herb for any female issues. It’s apparently beneficial for men’s health as well. We’ve used it for improving regularity of menses and reducing the side effects of hormonal imbalance that women naturally go through. Don’t take during menses (only in-between periods). 

Anecdotally, a friend of ours tested extremely anemic to the point that she was recommended to go through iron IV infusion. Before doing the IV, she decided to take iron pills (known to have poor absorption by the body) and dang gui for a few months first to see if she could get the numbers up without IV infusion (which can have some side effects). When she retested, she was no longer anemic and the hematologist said she could hardly believe the results as iron numbers don’t typically go up that fast through oral intake of iron pills. This is a strong- acting herb. It comes in pill form, but we have only ever used the dried root form brewed in soup. Here’s the basic recipe we use: Simple Dang Gui Soup or Tea Recipe.

Best Chinese Medicine for Immune System and Energy: Ginseng

Best Chinese Medicine for Immune System and Energy: Ginseng
Ginseng roots, photo credit: superfoodevolution.com

There’s American or Asian ginseng. We’ve only tried the Asian ginseng. I see it suggested for use in a variety of ailments, but in our family we take it for primarily overall vitality, energy, and immune system strength. In our family sample size, we’ve linked it to improved asthma and allergy reactions and general sense of well-being in both the kids and adults. Depending on your body’s constitution, some may find it too strong, akin to taking a dose of caffeine. As with dang gui, it is one of the stronger herbs and and it’s important to check the contraindications for it, as it really depends on your body type and needs. Definitely read the literature on it before taking, to see if it’s a good fit for your body’s needs. This also comes in natural dried root form, and in pill and extract forms. 

Best Chinese Medicine for Eye Health and Clearing Inflammation: Chrysanthemum

Best Chinese Medicine for Eye Health and Clearing Inflammation: Chrysanthemum
Dried white chrysanthemum flowers, photo credit: amazon.com

We take chrysanthemum flower in tea form, steeping the dried flower in hot water. To feel any benefits, you have to take it regularly for long periods of time. It’s indicated for clearing heat and inflammation in the body. There’s white or yellow chrysanthemum and they have different indications. White is mostly taken for eye health (dry eye, etc.) and visual acuity. Yellow for common cold-related symptoms. The most obvious benefit we’ve ever had from it was relief from dry eye and allergy-caused eye irritation. Here’s the basic recipe we use: Chrysanthemum and Goji Berries Tea Recipe for the Eyes

Best Chinese Medicine for Mouth Sores: Watermelon Frost

Best Chinese Medicine for Mouth Sores: Watermelon Frost
Watermelon frost, photos credit: suanie.net

Watermelon frost is available in spray or powder form and is indicated for canker sores and sore throats. We’ve only used it topically for sores in the mouth and it seems to reliably heal the sore quickly. I see many TCM/naturopathic practitioners recommending it for sore throats, so I may try that someday. 

Resources

Yunnan Paiyao

Other TCM for injuries (sprains, strains, bruising)

Bi Yan Pian

Ba Zheng

Dang Gui

Ginseng

Chrysanthemum

Watermelon Frost

Heal Fast and Prevent Recurring Pain

With two kids in contact sports and my own, easily injured, aging self, I’ve looked into ways to heal the body faster and avoid recurring pain and injury. This means doing more than just ice and rest to reduce recovery time. Below I’ve combined emerging practices from Western sports medicine and Traditional Chinese Medicine (TCM) to heal soft tissue injuries

heal injuries fast
Heal an ankle sprain fast!
(photo credit: Vittori Foot and Ankle Specialist)

Don’t Use Ice on an Injury

Immediately after the injury, do not apply ice. In fact, do not apply ice at any point. Instead, apply some compression and massage to help ease the pain. Most Western sports medicine recommendations are to RICE (Rest, Ice, Compress, Elevate) and even many practitioners of TCM, acupuncturists, etc. will still recommend ice in the very first moments of an injury. 

However, in reviewing the literature, the use case for any healing benefits with ice is murky. In TCM, cold is an enemy to the body’s natural healing reaction and invasive to the body. Even in Western studies, there is recent research that suggests ice actually damages muscle fibers as highlighted in this New York Times article, “Ice for Sore Muscles? Think again.” Furthermore, even the original coiner of the term RICE (Rest, Ice, Compression, Elevation), has recently come out against using ice at all in the healing process – except to numb the area and relieve initial pain. If there is so little benefit to using ice, and some possible damage – why bother at all with the ice?  

Integrative Treatment for Soft Tissue Injuries

In all stages of recovery, the guiding principle involves keeping the blood circulating properly and quickly through the area of injury as blood flow is the key to healing the area.  Certain tissues in the body have different levels of blood flow and that is why some tissues, like muscle, heal much faster than ligaments or cartilage. (Here again, ice would only serve to slow this process.)

TCM offers external application of herbal medicines as well as herbal medicines to be taken internally – all with the aim of circulating more blood through the injury. Emerging Western sports therapy recommends that patients work on continuing to move the area of injury almost immediately – they call this method, METH (Movement, Elevation, Traction, Heat)

For the first few days to weeks, depending on the severity of the injury:

  • Apply an external TCM. We apply the Yunnan Baiyao patch or spray continuously for the first few days. If there is an open wound in the area that makes the patch or dit da jow sting or uncomfortable, you can cover that small area with a nonstick pad or Tegaderm which will allow you to apply the spray, patch or medicinal wine to the non-open areas of the injury. If the area is not painful to massage, then in between applications of the Yunnan Baiyao, we also massage with a Chinese herbal liniment, dit da jow (though there are many types and brands to choose from), which purportedly also improves the circulation to that area. We taper off external application after the first 1-2 weeks. Towards the middle to end of recovery, we typically just do daily massage with dit da jow to the area. I did this diligently with a recent, moderate grade ankle sprain, and surprisingly did not go through the bruising stages.  
  • Take a Chinese herbal medicine that helps with improving blood flow throughout the body. In this category, I am only familiar with Yunnan Baiyao capsules or The Great Mender Tea Pills, although I have seen other products mentioned online. The product dosing typically recommends taking these medicines for just a few days to a week at a time, so in the initial stages of the injury. When ingesting Chinese herbal medicines, you should be cautious or check with a practitioner if you know one. Some can have contraindications and depending on dosage, may be too strong for your constitution. 
  • Keep the injured area moving and stretching as much as you are able without inducing pain. Elevate the area as appropriate to keep too much blood from stagnating / pooling at the injury. If you rest the injury too long, stiffness can settle in and make it more difficult to retain or regain mobility as the tissues heal. Google the METH method or MOVE method for guidance in this area. 
  • Apply a warm compress to the area, which can help with pain relief, and again, encourage blood flow to the injury. 

Integrative Treatment for Chronic Pain Avoidance 

Post-injury, not having a thorough recovery can lead to chronic problems in the area of the original injury. Towards the final days/weeks of recovery, I’ll feel that my injury is more or less recovered and I don’t want to mind it so much anymore. Just because you don’t feel pain anymore doesn’t mean your injury is fully healed. In fact, that final phase could be going on for quite some time.

I’ve learned that this phase is critical and long in terms of making sure the injury is thoroughly healed to avoid developing some chronic weaknesses, aches, pains, or arthritis in that injured area as we grow older or continue to be active. I suspect this phase could be as long as months or even years for many people, but that complete healing is possible.

Even though you may feel healed from your injury, it would be ideal to do the following:

  • Try to avoid allowing recent injured areas to be cold – even if it feels fine to you.
  • Massage with dit da jow on days where you might feel achy or if you used the formerly injured area a lot that day. 
  • Apply warm compress, keep the area warm as much as possible. People who tend to have cold hands / feet (which means poorer blood circulation to formerly injured extremities), keeping those areas warm in the last recovery stages can be particularly important.
  • Keep the area moving and stretching as much as possible as long as there is no pain. Protect or enhance your strength and range of mobility in that area. For example, some therapists recommend wearing a protective brace during exercise and doing preventative exercise for up to a year post ankle sprain. This probably feels like overkill when your injury feels healed, but it would likely prevent chronic pain long term.

Resources

Time it takes for different tissues to heal:

Stop the ice (study shows that ice can cause damage to the muscle fibers and could delay healing):

Western sports medicine starting to recommend METH or MOVE, over RICE as an approach for speedy and thorough recovery:

Posts on how to heal injuries quickly with TCM:

Posts on getting through the chronic stage with TCM or Western sports medicine:

TCM products for soft tissue injuries:

5 Tips for Reversing Myopia

In my experience so far with reversing myopia, I’ve learned a few things that have made a big difference for me. They’re mostly related to ways you can make this journey easier for yourself. If you’re still experimenting with reversing myopia, below are some tips you can consider, too. 

Tips for reversing myopia
Tips for reversing myopia

#1 Use the Eye Chart Regularly

Put up one or two eye charts in places that will be easy for you to use to check your vision casually and without much effort. (Get free printable eyecharts here.) This tip is actually CRITICAL because it keeps the idea of vision improvement in your mind and incorporates it into your daily routine without adding extra work. Without a convenient and well-placed eye chart, I think I would forget about checking my vision and give up. 

I put one up near my work space (directly behind my computer monitor), so that whenever I looked up from my work/screen, I could see how well I was seeing. The distance doesn’t matter so much as long as you have something of varying font sizes and an easy way to remember how well you are able to see certain sizes (20/40, 20/50, etc) from day to day, and time to time. With this method, you will almost effortlessly start to notice how your vision changes based on the close up work that you do: reading a book versus reading on your phone versus working on your computer. Glance at the chart before you even start working – I found that my vision is often better after I’ve been outside driving or playing racket sports. 

#2 Pay Attention to How Well You Are Seeing

Pay attention to your vision everyday or as often as you can. If your vision is getting worse, you’ll catch this sooner and have a better opportunity to adjust habits that may be contributing to the deterioration. Small +/- changes in vision seem not to be always permanent initially. Conversely, if your vision is improving, then consider what might be helping. 

Check your eyes separately. Pay attention to how your vision in each eye differs. Pay attention to whether words become more clear if you focus your eye on it longer. Or if you see a word clearly and slowly back away from it, does it stay clear? And for how long? People’s eyes work together in different ways. I have one eye that seems to always improve faster than the other one. When your vision varies, think about what factors may have changed it. More sleep or less sleep? Less screen time? Reading more or less or for a long period of time? Or even the sequence of wearing contacts first, followed by wearing your glasses later during the day. Interestingly, I have found that I can see noticeably better in reduced RX glasses if I wore contact lenses (at a higher relative RX) during the daytime.

#3 Use a Computer Monitor

Use a monitor instead of a laptop screen and place it as far as is realistic for you and your screen size. This could also reduce eye strain, not to mention the superior ergonomics of the position. With a monitor so far, I think I may be doing some light variation of print pushing (a method articulated by a fellow named Todd Becker) without realizing it. I currently have a 27” screen that is placed about 90cm, 3ft from my eyes. I’m not the first person to have thought of this, and I recently came across this article on endmyopia.org which is a popular reversing myopia website.  My husband thinks I’m nuts, but I used the same set up for my kids through the Zoom school pandemic and while it looked stupid, at least their eyes didn’t become more myopic during that period. (Luck of the draw or careful attention to eye breaks and screen time/distance, we’ll never know!)

#4 You Can Reverse Myopia While Wearing Contacts

You can continue to wear contacts regularly and still use the reduced RX method to “work” on vision improvement. I got tired of wearing my glasses so often (I’m quite myopic, my glasses were heavy, and it was hard to play sports). I learned that I could buy contacts without an RX on https://www.visiondirect.co.uk/no-prescription-needed, so I didn’t necessarily need an optometrist exam every time I wanted to adjust my RX. Then I bought one pair of inexpensive glasses with a mild -0.25 RX (from zennioptical.com), so I could see better for driving or for any other time when you would like to see a bit more clearly.  

#5 Have Patience

Maybe you’ll be lucky and be one of those people I’ve read about online who seem to experience drastic, quick improvements. In general, though, you really need to adopt the mindset that this process will take place over a long period of time. If you’re the impatient type, trying to reverse your myopia or at least with the reduced lens method, is probably not for you! My experience feels painstakingly slow. I recently wore a reduced RX for almost a year without seeing any change and then out of the blue, I started seeing 20/15 periodically and now almost daily. I’m guessing that will amount to just -.50 improvement this recent year. 

Overall, the more convenient you make the process for yourself and the more you incorporate mindful vision habits, the easier it will become for you to continue trying to improve your vision!

Changing Jobs? Check the Impact to Your Medical Benefits

changing jobs, HSA, FSA, health benefits, job benefits
Image credit: events.ibx.com

Updated as of 2/22/22

If you’re changing jobs, don’t forget to think about how to coordinate your benefits between the two jobs, so that:

  1. you’re not without coverage between the two 
  2. you maximize your benefits
  3. you minimize any forfeits in FSAs
  4. you coordinate your HSA contributions and providers

(If you’re wanting to compare plans at your new job, check this post on health insurance plan comparison spreadsheets.)

Below are the main things that I’ve learned to check during job changes:

Fill the insurance gap between jobs

  • If you and your partner are each insured through different employers, then whoever is losing insurance is considered to be having a qualifying event – which means the remaining insured partner will be able to enroll you into their insurance plan regardless of the time of year.
  • When leaving your job, make sure you know how long your benefits will last. Check if all benefits will extend through the end of the month or if they cease immediately on resignation. Apparently, this can vary by employer. 
  • If you are ending a job and starting another job in the same month, you may not have any gap in coverage. Confirm with the benefits providers in each job about the termination date of the coverage in the current job with the effective date of your benefits coverage in your new job.
  • If there is a coverage gap of any amount of days, it’s always safest to buy some sort of coverage for those days. You will have to do a cost risk analysis on your own situation. You have 3 main options:
    • COBRA insurance, which is pretty much an extension of your current coverage except that your employer no long pays for any of it, so it is usually very expensive. 
    • Short term insurance – which can vary in cost but is usually the cheapest option, because it is essentially catastrophic insurance, to minimize the financial impact if you were to unexpectedly have any major medical costs during your gap days. Remember to always review the insurance terms in detail as these plans all have different levels of coverage, too.
    • Standard health insurance, including Affordable Care Act (ACA) plans – the cost of these plans are usually less than COBRA costs, but more than short term plans. However, you should always check all the costs before selecting. 

Your age, your family size, your medical needs, your risk threshold, and expected duration of time between jobs will determine the best choice for you. 

Maximize Your Benefits

Timing of routine, preventative services 

If you will have any sort of gap between coverage, it’s always safest to take advantage of any preventative doctor or dental visits before your coverage ends. This minimizes the likelihood of your needing to pay out of pocket for routine checks. 

Timing of non-covered benefits 

Conversely, if you are close to changing plans and haven’t met your deductible, then you may be better off delaying (if possible) costs that could contribute to your new deductible rather than your old one which you most likely won’t meet at the end of your current coverage. 

Timing of benefits that are capped

If you have any benefits where only a certain amount is covered per plan or plan year, then you may want to use them before switching. For example, vision plans often cover $150 per year in contact lenses or glasses. Even if you don’t need the contact/glasses yet, you should stock up or you would just be losing $150. In your new job, you may have a new plan that provides another $150 to use – essentially giving you a $300 contacts/glasses benefit for that one year. 

Check the latest FSA and HSA rules

Finally, doublecheck the rules on your FSA and HSA – there are often updates to these rules. It’s no wonder that the FSA and HSA are often under-utilized by people because they can be such a pain to track. Always recheck the rules each time you change jobs to make sure you know the latest. In 2022, here are some things to know about the FSA and HSA when changing jobs.

Regular FSA during job change

Your FSA must be used up – they don’t transfer to the next employer, so you should spend it all before you leave. However, the medical FSA plan limit is per employer and not per year, so even if you maxed out with your first employer, you are eligible for the maximum amount again with your new employer ($2850 in 2022). 

HSA during job change

Your HSA funds are not impacted by changing jobs. Whatever you have is yours to keep and use as needed for qualified medical expenses. You can roll it over to another HSA provider or continue to use it through your existing provider. 

However, you do have to be careful about how much you contribute. The annual maximum amount per individual or family has to be pro-rated for each month that you are eligible to contribute (e.g. that you are enrolled in a high-deductible, HSA eligible plan). Therefore, if your new job provides HSA eligibility or no longer provides it, you will have to adjust your monthly contributions accordingly. This PDF from Benefit Strategies, LLC and this post on the Finance Buff provide helpful information on mid-year changes and HSA eligibility and contributions.

Also note that some employers contribute towards your HSA – these amounts count towards your annual HSA limits. Don’t forget to account for employer contributions when calculating how much you will contribute while still not exceeding the limit.

Limited-purpose FSA (LPFSA) during job change

This is the FSA that you’re allowed to have if you also elect the HSA and is only usable towards vision and dental expenses. Like the regular FSA, it must be used up when changing jobs – they don’t transfer to the next employer, so you should spend it all before you leave unless you feel like gifting your employer. However, again as with the medical FSA, your plan limit is per employer and not per year, so even if you maxed out with your first employer, you are eligible for the maximum amount again with your new employer ($2850 in 2022).

Dependent Care FSA during job change

Dependent care FSA – I found some conflicting answers on this one and basically, it is up to your employer. Some employers allow you to use your funds through the end of the plan year. Others will require that you use it up or forfeit it upon departure. You will have to check with your employer. In 2020-21, there were COVID-related changes to the dependent care FSA that you should definitely check on with your employer. In fact, after doing this research, I’ve decided to check these specific terms with any new employers, so I know what I’m getting into when I sign up for the dependent care FSA. By the way, don’t forget that dependent care FSA expenses can include after school care, summer camps, as well as family members who babysit for you!

Do you have other tips to share? Email me at wishiknewbefore20@gmail.com or add them to the comments below!

Resources

Filling in the gap

Maximizing benefits in all categories

HSA and mid-year changes

LPFSA

Dependent care FSA

Chinese Herbal Medicine for UTIs

You may have tried a lot of different things to treat UTIs by now (e.g. D-mannose, garlic, cranberry, oregano, etc.). We certainly have, and have battled UTIs for 10 years without lasting success. In yet another bid to avoid antibiotics which cause all kinds of issues, I’ve looked into how Chinese herbal medicine (CHM) might help. Since both my kids seemed to resolve their problems (cough-variant asthma and clammy/sweaty hands respectively) with a tailored course of CHM, we decided to try Chinese herbal medicine to treat UTIs as well. In this post, I share a list of formulas I found and share our experience with taking some of them successfully!

Why Chinese Herbal Medicine Could Treat UTIs

In Traditional Chinese Medicine (TCM) theory, people may present with similar UTI symptoms, while the causes for the symptoms are often different for each person. Sometimes they are a constellation of causes. For a UTI, you could even think of the overgrowth of the bacteria (E. coli or proteus mirabilis) as one of the symptoms rather than the cause itself. For people without UTIs, they are exposed to those UTI-causing bacteria all the time, too, however, their bodies just don’t allow the bacteria to take root or multiply enough to cause an infection.

In this context, a Chinese herbal formula, (which may or may not have some antibacterial or anti-inflammatory properties) also tries to address the weaknesses that allow the bacteria to flourish. These weaknesses vary from person to person. They can be a weakened immune system, an imbalance of hormones, lack of estrogen, a weak liver function, or a weak kidney function. TCM typically sees UTI symptoms as damp heat in the lower body. Damp heat is a distinctly TCM term, but just think of it as the state of a physical environment that’s conducive to the growth of mold, other allergens or bacteria – except in this case, that physical environment is in your body. 

Common TCM Formulas that Treat UTIs

I found the formulas (listed in this section) to appear most frequently on various TCM practitioners’ or TCM-related websites when I searched for Chinese herbal medicines to treat UTIs. Most of these herbal medicines appear to be targeted towards clearing damp heat in the lower body. Some are targeted more towards hormonal/menstrual regulation, and others help to reduce inflammation. Some seem to address an endless variety of symptoms. 

Chinese herbal formulas for UTIs, from L to R: Zhi Bai Di Huang, Ba Zheng Wan, Long Dan Xie Gan Tang, Ba Zheng Tang

Here are the formulas that I came across most often:

  • Ba Zheng (Eight Rectification) – I saw this formula mentioned quite a lot and seems to be a formula that specifically targets urinary symptoms and is used for acute UTIs. We tried this and it worked! Unfortunately, while the UTI symptoms disappeared, it also caused a lot of diarrhea in my sample size of one (an elderly female). However, my data point also happens to have a sensitive digestive system, so you may not have the same experience. Berkeley Community Acupuncture had helpful information on how long and how often it could be taken. It’s not meant to be taken long term. If you can’t stand pills, I also found Ba Zheng in liquid formula.
  • Er Xian  (Two Immortals) – this formula seems more commonly used for menopausal symptoms. However, some research indicated that it was also recommended by some TCM practitioners for preventing recurring UTIs.
  • Long Dan Xie Gan (Gentiana) – this formula is targeted at liver health and seems to be recommended for acute UTIs with pain.
  • Zhi Bai Di Huang (Anemarrhena, Phellodendron and Rehmannia Formula) – this formula is known to address menopausal symptoms and boost kidney function. It can be taken long term, and was listed as a formula suitable for chronic UTI sufferers.
  • San Jin Pian (Three Gold Tablets)  this was mentioned in some of the clinical studies and seemed to have good potential for effectiveness. On a separate UTI occurrence, we tried this one too. It didn’t seem to work for us, but did cause diarrhea.

Final Notes to Keep in Mind When Trying a Formula

Formula name conventions – note that when searching for a formula, each formula name ends with either a Pian/Wan/Tang/San. These are Chinese terms for the form that the formula comes in and corresponds, in order, to tablets/teapills/decoctions/granules.

Best used immediately – Through my reading, as well as witnessing the experiences of an elderly female, I think that TCM formulas are best used immediately at the first sign of symptoms or in conjunction with antibiotics. It seems that after a certain amount of time, too much bacterial growth or inflammation has occurred for TCM formulas alone to overcome. While some formulas are anti-bacterial in nature, I don’t know if any would be as strong and sweeping as an antibiotic. Some research has found that simultaneous use of CHM and antibiotics to significantly reduce the rate of recurring UTIs. This suggests that while CHM may not be able to overcome a raging infection, it can balance your body’s internal environment to make it less conducive to bacterial growth afterwards.

Finding the right formula  for you may largely depend on accurately diagnosing your own individual causes for the UTI.  A good TCM practitioner can probably help you with that and can also modify these well-known formulas to even more specifically tailor them to your particular needs. However, seeing a practitioner can cost upwards of $200, not including follow up visits, etc., which may or may not be covered by health insurance. I don’t have any great ideas for addressing that cost because even after researching a lot of the material online, I didn’t have enough experience with the herbs or diagnosing a person’s health from a TCM perspective to feel confident in my assessments.

Nevertheless, we tried to skip working with a TCM practitioner, and did some trial and error. Then we tried a TCM practitioner who couldn’t seem to diagnose accurately enough. Finally, after the Ba Zheng Wan caused diarrhea while simultaneously curing the UTI, I felt that it would be worth trying yet another TCM practitioner to get a more customized formula that was easier on the digestive system. Additionally, we were interested in finding a suitable, long-term formula for addressing the body’s imbalances since we suspected that these imbalances were at the root of the recurring UTIs. 

As of this post’s date, we have managed to avoid antibiotics for 6 months, while addressing two flare-ups with CHM instead. If you’re a fellow UTI sufferer, you know how that feels! Fingers crossed!! 

Resources

This research suggests that Chinese herbal medicine (CHM) can help reduce the rate of recurring UTIs and has a role in treating UTI symptoms:

A review of clinical studies on CHM and UTIs:

A TCM practitioner recommendations for UTI treatment (primarily recommended San Jin Wan and Ba Zheng Wan):

Online Chinese herbal medicine storefront with nice write up explaining TCM view of UTIs and different types of formulas that might work:

Online post about UTI and treatments including TCM:

Lowest Price for EpiPens

Updated as of 11/4/22

We have food allergies and we need to carry around EpiPens. But we also have a high-deductible HSA-eligible health insurance that doesn’t cover very much, so below is a rundown of the options I went through to find the best price for EpiPens. My takeaway is that if you can’t get an EpiPen or EpiPen alternative for free, you should only pay up to the low $100s in the U.S. See the rundown of options below.

(This fall of 2022, I had to fill our EpiPen RX at Walgreens for $109 with a GoodRX coupon. The GoodRX price is only if you don’t use insurance. In prior years, I bought Auvi-Q which was available at $25 for those with poor insurance coverage, but that Auvi-Q price went up to $125 in October 2022. All of this is ridiculous, isn’t it?)

EpiPen size comparison
In case you’re curious, an EpiPen size comparison: (L to R) Auvi-Q, Adrenaclick, Mylan/generic EpiPen

#1 Health Insurance EpiPen Cost

When we had excellent health insurance, I was able to buy a pack of two generic EpiPens for as little as $30. I’ve also seen online that some people have health insurance that can bring the cost down to $0-$5. 

Unfortunately, now that we have health insurance with a very high deductible, those generic Epipens would cost me $476. I detest anything associated with health insurance these days, so even if I could afford $476 for epipens, I would do my best to avoid this option.

#2 EpiPen Manufacturer Discount

On the Mylan brand name EpiPen website, you can get a savings card for up to $300 on brand name Epipen, and a savings card of $25 on generic EpiPens. However, you’re only eligible for these savings cards if you also have commercial health insurance:  

“The Epipen Savings Card® helps eligible patients who have commercial health insurance save on out-of-pocket costs.”  

– Mylan website

And in fine, fine print, Massachusetts or California residents are not eligible. At any rate, if I were eligible for the savings card of $25, my generic EpiPens would now cost $451 instead of $476. The search continues. . .

(FYI, the brand name Mylan EpiPen and the generic EpiPen look and work exactly the same. The EpiPen alternatives operate a little differently.) 

#3 EpiPen Alternatives

There are a few other EpiPen alternatives. You would need to get your doctor to write you an RX specifically for one of these alternatives. 

  • Adrenaclick – about 6 years ago, this was the wonderboy of EpiPen alternatives because CVS offered them for as little as $10 (I don’t remember the fine print of this offer). However, without insurance, it’s now offered at a retail price of ~$110 at Target/CVS pharmacies. You can also print out a $10 savings card that should bring you to ~$100. 
  • Auvi-Q – our allergist suggested trying Auvi-Q. This is the EpiPen alternative that talks you through the process. It has a retail price of $4500 that nobody actually pays. I called the Auvi-Q customer service number and learned that they have contracted with a direct delivery pharmacy called ASPN Pharmacies. To start the process for direct delivery service, call them or complete this direct delivery enrollment form. The pharmacy itself has mixed reviews. (My personal experience was that it took me about 2.5 weeks and two followup phone calls to get the EpiPens.) However, the ASPN representative told me the following:
    • If you have commercial health insurance AND YOUR INSURANCE COVERS the Auvi-Q, then the cost will be $0, even if you have a high insurance deductible.
    • If you have commercial health insurance AND YOUR INSURANCE DOES NOT COVER the Auvi-Q, then the cost will be $125. (In October 2022, this cost increased from $25 in prior years to $125 this fall!)
    • If you need more than one pack of 2, you can order a second one for the same price after a 30 day waiting period.
    • For those without insurance, they offer a patient assistance option if you complete this patient assistance form. If you don’t qualify for financial assistance, they say that the most anyone should have to pay for Auvi-Q is capped at $360. At that price, you would be better off with a Adrenaclick or the generic EpiPen options through GoodRx and the like (see #4 below).
  • Symjepi – I’m not familiar at all with this option, but I saw it listed on the GoodRX website as an Epipen alternative. Pricewise, I didn’t see any quotes that made it a better deal than the Adrenaclick or Auvi-q. I’m not sure there is any point to considering this option seriously.

#4 Prescription Cost Saving Websites for EpiPen

There are a lot of prescription cost saving websites out there now that can offer prices in the low $100s. To get these discounts, you search the name of the drug and the website returns an out of pocket cost comparison of the Rx’s cost at local pharmacies, along with a coupon that you can use at the pharmacy. These are the costs of the EpiPen if you pay without using insurance.

Here are a few of the sites I looked at. The costs below are based on my local zip code, so may be different for you. This is what I found for 1 pack of 2 generic epinephrine auto-injectors: 

#5 Your Allergic Friend with Good Health Insurance 

It also crossed my mind to ask if any of my allergic buddies with good health insurance wouldn’t mind just calling in a refill for me to pick up. I figure that would be about $30 and without the kids in school, I really don’t need an RX in their names. Just throwing this idea out there. . .

#6 Expired Epipens

You either already have expired Epipens or you have friends that do. I think I’ve never felt that comfortable with expired Epipens, knowing that I carry them around in all sort of temperatures that could lead to its degradation in performance. However, if they’ve been stored safely, they could very well be perfectly useful, so you may keep that in consideration in terms of how many new Epipens you may want to buy. A study in 2019 showed that even Epipens that were 30 months past their expiration date were still effective. (See here if you’re trying to figure out how to dispose of them.)

Resources

Articles summarizing EpiPen costs:

Auvi-Q

Epipen

Adrenaclick

How to Raise Good Eaters

Updated 9/2/2021

Feeding our children in this day and age is challenging – unhealthy food is too readily available and social norms of accommodating children can cultivate picky eaters. As parents, we’re met with a plethora of feedback from grandparents, pediatricians, parenting books, media, peers, societal norms, and social pressures and expectations.  

My kids, ages and 7 and 9, are good eaters, in the sense that they eat a wide variety of foods (meats, vegetables, grains), and will try new foods. Some of this may be luck, but it’s also due to habits. There are constant “turning points” in their eating career, and we can’t take their eating habits for granted at all. Their tastes and behavior continue to evolve and I’ve sometimes had to double down on some habits that wane easily. Below are our top 10 habits (10+ actually) to raising healthy eaters.

Today’s array of food options are endless

#1 Limit Snacks

Start with limiting snacks in quantity and frequency. This is very subjective – we’ve had friends who say they are limiting snacks but I see that their “limits” are quite different than ours. The basic idea though is that snacks, whether in the morning or afternoon, reduced my kids’ appetites for regular meals. 

Not over-snacking is fundamentally important to being a good eater at mealtime.  It’s totally fine and good for kids to be a little hungry or thirsty. The effectiveness of any other tactics that we use at mealtimes is very dependent on this habit of limiting snacks. I have seen a friend give his child a cupcake 30 minutes before dinner, and then fight with his son to have him finish a pasta dish. My friend didn’t realize that he himself had sabotaged his son’s appetite for that dinner. 

#2 Eat Only in Designated Areas 

We only allow eating in the kitchen and dining room, never in any other area of the house. First, it reduces ant and sticky toy problems. Secondly, it takes away the temptation to extend snacking and meal times and distract from the eating process itself – eating is not to be multi-tasked. Originally, we started this habit from when they were mobile because we didn’t want to be chasing them, or cleaning up after them all over the house. Then, I saw other kids running around their homes after taking a few bites, and coming back to the table for now cold food, and fighting with their parents about finishing their food. I realized we had conveniently sidestepped this battle. 

#3 Try Everything At Least 10 Times (not during the same meal)

I once read from one of those child nutritionist guides that people need to try something at least ten times to determine if they like that particular food or taste. Whether this is true or not, I have actually used that rule of thumb to great success. My children have expressed dislike for a lot of foods at one point or another. I tell them the rule and continue to put the foods that they dislike on their plates. My only requirement is that they have at least one bite of the food that they dislike and they can discard the rest. Over time, they surprisingly just started eating more of that food.

One of my kids hated mushrooms with a passion. Over the course of a year of seeing them on his plate regularly, he suddenly started eating them. So don’t give up. Keep making the food a part of their meals whether they eat it or not. Foods come in and out of “favor,” especially the vegetables, so if I remove them from the lineup altogether, I’ll never know when they’re coming back into favor!

# 4 Don’t Offer Alternative Foods During a Struggle

There have been times when my kids didn’t like the meal we had prepared for them, and basically looked like they were going to be missing a meal. Their grandparents have then suggested that I heat up some leftover pasta or other food that they knew the children liked. First, missing a meal here and there is okay. Second, try not to give in during those moments. All it takes is your doing this a few times, for your child to see your potential as a short order cook. 

#5 Prepare a “Reliable” Food

I might sound like a mean mom, but I don’t like my kids to go hungry either. To be proactive about avoiding a struggle, try to always have one aspect of the meal that is “reliable.” Reliable as in reliably eaten. That could be something as basic as rice, pasta or bread. If you’re introducing a new grain, then try to make sure either the meat or vegetable portion is “reliable.” That way, even if they’re not fully satisfied, they won’t “starve.” Or I might even heat up the “backup leftover food” and offer it as a side dish in advance, so long as they don’t think I got up specifically to go make a special dish that only they like to eat.

# 6 Offer Yucky Foods in a Variety of Ways

We prepare the “yucky” foods in different ways: different shapes, different spices, and different sizes. Our kids hated red bell peppers. Then I chopped them up and put them in chili (which has a pretty overwhelming flavor on it’s own). They noticed them, but couldn’t taste them. Gradually, I put the chopped bell peppers in less overwhelming dishes and before I knew it, they were eating large pieces without complaint (although still without love). 

#7 Have One Bite and Don’t Force Finish

We have a one bite rule. It doesn’t matter if they spit it out. The important thing is that they put it in their mouth. And the important thing is that they try it every time it’s offered. 

On the flip side, we never encourage the kids to finish their meal either. We encourage them to stop eating when they feel full even if it means leaving a lot of food on the plate. We don’t say just “a few more bites.” However, we also have limited snacks and don’t prepare special meals outside of meal times (unless someone is sick), so there’s no gaming the system for extra snack food.

#8 Offer a Variety of Foods Early On and Repeatedly

It’s now commonly encouraged for parents to introduce babies to a diverse diet as a way of limiting the likelihood of developing allergies. However, this advice has multiple benefits. It helps develop a diverse palate early on. The ability to eat a variety of foods early on makes it easier for kids to get the different vitamins and minerals that their growing bodies need. To avoid FOMO, even junk food, snacks, and desserts are all sampled – just in limited quantities! The important thing is to keep offering the variety even as it is rejected. . . possibly over and over again. 

#9 Control Meal Portions

Controlling how much food your children eat is contrary to most of the advice I found in baby-led weaning books, parenting books, and from our own pediatrician. All these sources advised that babies and young children know how to self-regulate and will stop eating when full. This ranks among some of the most incorrect advice I ever heard from “official” sources. Maybe this was true for breast-feeding, but absolutely wrong for milk and solids. Or perhaps this may have been true for humans prior to a world of processed foods, fiber-free food where eating bite after bite was not so easy. 

Yet given the ubiquitous advice, I tried this many times, and watched as my babies, and later, children absolutely did not know their limits over and over again when eating a food they liked (usually something fried, sweet, or a processed snack). In fact, adults often don’t know their limits either when it comes to snacking or foods they like in particular, and we somehow expect children to? Allowing kids to stretch their stomachs too much on a regular basis sets them up for a cycle of overeating and getting more than their bodies need. Try to limit meals to reasonable quantities until you’ve taught your kids to reliably know how to stop eating. 

#10 Educate About the Foods They’re Eating

Don’t underestimate the ability of your children to want to do right by their bodies. In past societies, food education may not have been so important, but with all the choices of foods these days, teaching kids how to navigate the food world is just as important as teaching them how to navigate cyberspace. 

I wasn’t very aware about food growing up, but the trends towards understanding what we put in our bodies and our babies has really heightened my awareness around food and its impact on our health. Talk to them often about what your family is eating and why it’s good for you. Or when you’re having junk food, talk about why it’s not good for you and why you shouldn’t eat too much of it. Talk about cultural differences in foods and diets and the relative healthiness of each. Talk about the evolution of food. Talk about it all repeatedly. Eventually, it will resonate. 

For example, you can explain in a way kids can understand more easily. An 8/18/21 study published in Nature Food, framed eating a hot dog to be akin to losing 36 minutes of healthy life! Eating nuts, on the other hand, added 25 healthy life minutes. That news gave my children pause!

#11  Educate About Junk Food, Peers, and Society

When we joined the food world through organized sports and school, our kids became inundated with birthday party pizza and cake, sport practices that included brown bags filled with a variety of processed/healthy/sugary snacks, and classmates who got to eat candies and chocolate milk regularly at school lunchtime. We had to teach our kids about how food and snacks are thought about differently by each family and why they might not get to eat as much of the snacks and sweets as their friends. Holding off the peer pressure to eat like their friends can be one of the toughest things to do, but it gets easier the longer you do it.

#12  Model Food Behavior

Finally, what if you’re a junk food junkie and / or a picky eater yourself? It’s extra, extra tough to raise your kids to eat differently than you do, so I had to model the food behavior I wanted them to have. 

I found myself learning to be a better eater by following the habits that I was trying to model for my kids. Interestingly, my appetite for junk (formerly quite strong), waned when I removed a lot of the items from my shopping list. After I learned to pay attention to labels and ingredients, the rational side of me was put off by many of the ingredients in a lot of packaged foods that I used to eat. 

Similarly, I hated lamb meat, eggplant, and brussel sprouts growing up, but in an effort to diversify and follow the behavior I was trying to encourage in my kids, we introduced it in meals periodically. Roasted brussel sprouts and spicy garlic eggplant are now in my list of favorite vegetable dishes. I’m still working on the lamb meat, one bite per meal. . .

Prevent Food Allergies With the Latest Research

It may be too late for my children in some respect, but it seems there are more things that we now know about how food allergies develop that would have COMPLETELY changed the way we approached our kids’ diets at birth. If you’re concerned about your baby or child possibly developing allergies, below are some things you should absolutely consider. Actually, there are an increasing number of individuals who are developing allergies as adults, so it’s worth taking a read below even if you’re no spring chicken. 

Food Allergy Epidemic  

First, some statistics that I came across recently – according to Dr. Kari Nadeau, who is well-known in the food allergy treatment world:

  • 1 in 12 children in the US, Europe, China, Korea, and Japan have food allergies
  • 1 in 10 children in Australia
  • 1 in 10 adults had food allergies according to a recent survey of 40,000 adults. 50% weren’t aware of the allergies until they were adults.

I don’t have food allergies yet, but I’ve developed some environmental allergies as an adult. . . are food allergies on the way? Below are three food allergy prevention strategies that every one should know.

Food Allergy Prevention Strategy #1: Avoid Antibiotics and Heartburn Medications 

the cause of food allergies
This visual illustrates the theory of how modern life may be altering our body’s natural defenses

Avoid antibiotics and heartburn medications if at all possible –  they cause changes to your gut flora, which in turn, affects the way your body responds to food.For all ages, studies have come out showing a link between the increased likelihood of food allergy and the use of antibiotics or heartburn medications. While the studies have shown correlation and not necessarily causation, it’s suspect enough to reconsider your next antibiotic or heartburn medication RX. If there are alternatives, why risk it? Until recently, I didn’t realize that there are a lot of things to try before resorting to antibiotics or heartburn medications, so do your research on alternatives.  Your doctor may or may not be aware of this information, let alone warn you of the possible issues when prescribing these medications. For further understanding:

Food Allergy Prevention Strategy #2: Introduce Potential Food Allergens Early – Don’t Avoid Them

Neither my husband nor I have any food allergies – just hay fever, so I didn’t consider that my kids were at high risk for food allergies. Yet both kids ended up with nut allergies (and underwent oral immunotherapy). We followed the accepted approach at the time of avoiding nut introduction until age 1. 

Studies over the last few years have reversed that recommendation and pediatricians now recommend introducing potential food allergens as early as possible. This is a pretty time-sensitive, age-sensitive recommendation, so don’t miss this window if you want to try it. These two articles from verywellhealth.com give a good introduction on the change in recommendations as well as guidelines for how to do this early introduction to food allergens as safely as possible during COVID-19 (when you may be tempted to hold off). They write specifically about peanut, but it’s the same idea for all food allergens:

Alas, it’s also clear that there is still confusion and the guidance you receive will depend on your pediatrician. This study by Contemporary Pediatrics found that pediatricians today are still not necessarily recommending the current guidelines. Regardless of what your doctors say, do your own research too, especially given the inconsistencies across medical professionals, and come to your own conclusion about what you want to do. If you do introduce potential allergens early, do it with the support of a doctor because the risk levels vary by family.

Food Allergy Prevention Strategy #3: Control Eczema

The existence of food allergies has also been strongly linked to eczema, of which some forms are suspected to trigger food allergies. 30% of children with eczema also have food allergies. Researchers call this the “atopic march.” It’s described as a pattern, “in which eczema generally appears first, followed by food allergies, seasonal allergies, and asthma.” The link to eczema is so strong that the American Academy of Pediatrics first guideline  “recommends that the highest risk infants — those with severe eczema and/or egg allergy. . . — be introduced to peanut as early as 4-6 months of age, following successful feeding of other solid food(s) to ensure the infant is developmentally ready.”

For babies and children (and who knows, perhaps adults, too?), it appears particularly important to try and control eczema as best that you can to avoid the risk of further allergy development. This includes finding and avoiding the triggers for eczema as well as treating it topically. 

Both Western and traditional Chinese medicine have some strategies (listed extensively on the National Eczema Association website). In Western medicine, there are injections (like Dupixent), topical creams, and washes. In TCM, I’ve heard about herbal pastes that are applied topically as well as herbal medicines to alter the body’s reaction to triggers. I’ve read on the Facebook group for Dr. Xiu Li Min (an expert on integrated East/West approach to food allergies) that she believes part of the food allergy treatment involves addressing the severe skin issues first (which she has done with apparent success through Chinese herbs) before tackling the food allergy.

Resources

Antibiotics linked to development of food allergies

Heartburn medications linked to development of food allergies

The latest in food allergy prevention

Developing food allergies as adults

Eczema and food allergies

Free Printable Eye Charts

Since I started trying to reverse my myopia and control my child’s myopia progression, I’ve found eye charts to be handy. During the pandemic with distance learning and increase in computer use, I have used eye charts as a way to check my kids’ vision regularly. However, I’ve also found that those sneaky kids have memorized the eye charts so it’s harder for me to check their vision accurately! So below I’ve included links to the best free printable eye charts that I found online as well as links to some eye charts that I can customize

Standard charts typically come in two formats, one designed for 10 feet viewing distance and one for 20 feet (6 meters) viewing distance. The 10 feet (3 meters) chart is useful when you don’t have enough space for a 20 feet check. 

Best, free standard eye charts

These were the best, free eye charts that I could find online:

20 feet, 6 meter – free standard eye chart in PDF format

10 feet, 3 meter – free standard eye chart in PDF format

Free, customizable eye charts 

I also made my own, so I could occasionally change the lettering. To customize either of the charts below, log in to your Google account while you are accessing the Google document. Select “make a copy” and modify the letters and spacing however you want in your copy. (Be sure to print them on default settings and not “custom scale” or “fit to page,” etc. as it will throw off the size of the printed letters.)

20 feet 6 meters customizable eye chart – 1

10 feet 3 meters customizable eye chart – 1

Eye Massage and Eye Acupressure Points for Myopia

I reviewed some online literature on eye massage to add to my repertoire of things to try for slowing / reversing myopia. As an acupressure layman, I found the acupressure points and techniques seemed to vary just enough from site to site to confuse me initially. Finally, I cobbled together some basics. 

(Note: there are also eye exercises and acupressure points on other parts of the body that directly affect the eyes. I think I will have to review those thoroughly another time.)

My basic takeaway

  • The theory is that eye massage improves the blood circulation to the eyes and relaxes the eye muscles. Tight eye muscles are understood to eventually contribute to myopia. 
  • Eye acupressure is practiced regularly in schools in China, but studies haven’t been conclusive about their benefits on myopia and I’m not sure that any studies could ever be conclusive. After all, how could they really know if the kids were doing the massage correctly? Plus, there are so many other factors that may also affect myopia progression. 
  • You have to be able to do this pretty regularly for some duration to judge whether there is any benefit to you. 
  • I don’t get the feeling that eye massage could slow myopia down significantly on its own but perhaps it would be helpful as a supplement to other methods like myopia control.

Acupressure points for myopia

I cross-checked the acupressure points that children were taught to use in some of the myopia and acupressure studies with some other articles that I found about acupressure for improving vision and eye health. Below are the points (and diagram of what) I found. I listed all the variations in naming that I came across:

  • BL2 / Zan Zhu / Cuanzhu / 攢竹 – located on the inner end of the eyebrow
  • EX-HN5 / Tai Yang / 太阳 – located on the flat sides of the temple
  • BL1 / Jing Ming / 睛明 – located in the inner corner of your eyes
  • ST1 / Cheng Qi / 承泣 – located directly below the pupil between the eyeball and the intraorbital ridge. A questionable source, Dr. Deborah Banker identified this as the access point for the ciliary muscle. Although her credibility is unclear, the ST1 point is indeed frequently mentioned as an important acupressure point. 
  • ST2 / Si Bai / 四白 – located on the depression of the infraorbital foramen below ST1, about where the nostrils begin
  • Tianying / Ashi – I could only find mention of this point twice, but I included it because it was mentioned in articles that were specifically dealing with myopia.  It seems to be located vertically between BL2 and BL1. It is also the first point referred to in this video by Dr. Grace Tan, whose credentials seemed legit (if you are open to TCM). The Dr. Banker article stated that this point could manipulate the superior oblique muscle which is a muscle that can cause the eye shape to change.
  • Series of points covered by scraping along the eyebrow and just below the lower lash line, points which were included in both of the studies of Chinese students and also an easy to follow video of Dr. Grace Tan performing the massage
    • ST1 (see above)
    • TE-23 /Sizhukong / 丝竹空 – located on the outer end of the eyebrow
    • BL2 (see above)
    • EX-HN4 / Yuyao / 鱼腰 – located in the middle of the eyebrow in the hollow, directly above the pupil
    • GB1 / Tongziliao / 瞳子髎 – located on the outer corner of the eye
Eye acupressure points for myopia
Eye acupressure points for myopia

How to do acupressure on the eye points

For each of the points, there were different recommendations for what to do – it seems that you could do either a circular massage or a press and release: 

  • Circular motion – This is a circular kneading motion on the point with your fingers. Apply gentle pressure at the same time as kneading.
  • Press and release – Press at a 90 degree angle for 10-30 seconds and slowly release. Do this for a couple of minutes for each point. If you prefer a more precise time prescription, you’ll just have to make it up as I found a range in my review of the literature. 
  • Scraping – Apply light pressure and sweep your fingers along your brow line and below your bottom lash line. This encompasses stimulation of multiple points around the eyes.

Resources

Research on whether eye exercise or massage can be helpful:

Identifies different eye acupressure points and talks about the specific eye problems that they may address:

Explains how to do the acupressure:

Videos that show how to do eye acupressure:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reversing Myopia: Update #1

Reducing myopia: Going the other way seems doable. . . but slow

It has been about one year since I began trying to reverse myopia and I am relatively encouraged by the results after visiting the optometrist to validate my progress. If you’re new to trying to reduce your myopia, check out this post first: 

  • Going off of the contact lens prescription, my right eye improved by -1.00 diopter. My left eye improved by -1.25 diopters
  • Going off of the spectacle prescription, both my eyes improved by about -0.50 diopters (SPH), and neither eye needs astigmatism correction -0.50 (CYL) to see 20/20. 
  • I read on this post that the average rate of change on eye improvement forums seems to be about 0.25 to 0.75 diopters per year. 

In order to minimize variation in measuring my eyesight, I made sure to go to the same optometrist (actually, I’ve been to the same one for the last 13 years). Here is a chart of the optometrist prescription changes and my own reduced lens RXs over the last year:

Eye Exam DateGlasses RX (from optometrist)Contact Lens RX (from optometrist)My Reduced Glasses RX for reversing myopia during this time
October 2018Corrected to see 20/15:
R: -8.00 w -0.50 astigmatism
L: -6.25 w -0.50 astigmatism
Corrected to see 20/20:
R: -7.50
L: -6.50
I first started wearing reduced lens June 2019:
R: -7.25 w -0.50 astigmatism
L: -6.00 w -0.50 astigmatism
End of September 2019Corrected to see 20/15:
R: -8.00, no more astigmatism
L: -6.25 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7.5, no more astigmatism
L: -5.75 w -0.50 astigmatism
Corrected to 20/20:
R: -7.00
L: -6.00
In October 2019, I started wearing:
R: -7.25 
L: -6.00 
Early August 2020Corrected to see 20/15:
R: -7.5
L: -5.75 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7
L: -5.75 (no astigmatism correction)
Corrected to 20/20:
R: -6.50
L: -5.25
In March 2020, I started wearing:
R: -7.00 
L: -5.75 

Things that may have contributed to this vision improvement

I do think the improvement is significant enough to indicate that something about the reduced lens method could be working. At the current rate, I will have decent vision without glasses in 5-6 more years! Here are all the things that may (or may not) have contributed to this improvement:

  • I wore reduced lens by about 0.25 diopter from 20/20. Each time, I started to see 20/20 with my glasses, I reduced the lenses by 0.25 diopters more. For what it’s worth, -0.50 amount of astigmatism (CYL)  is approximately 0.25 (SPH) according to this helpful manual. I find that to seem about right in my own testing.
  • I did not wear differential lenses (for close up work) as suggested by some myopia reversal sites. It’s a bit of work to do that.
  • I tried to incorporate regular eye breaks during screen time with this cool timer (that I originally bought for my kids).  I used eye charts as a way to check my vision in a consistent way. Unfortunately, I still sometimes have 2-3 hours of uninterrupted screen time when I’m really focused. I used eye charts as a way to check my vision in a consistent way.
  • I averaged 6.5-7 hours of sleep at night. I’m trying to bring that up to 7-8 hours.
  • I average 1-2 hours outdoors everyday. 
  • I drank chrysanthemum tea with goji berries about 1-2x week on average.
  • I’m in my forties. According to some accounts, this is when distance vision gets a little better and close vision gets more difficult – but not typically by a lot.

Things to note

  • Night vision – on endymyopia, many folks seem to say night vision is challenging despite improvements to daytime vision. I agree night vision is definitely not as good as day vision, but I am probably still seeing 20/25 at night. My optometrist said that even measured at 20/20, I could expect my night vision to feel especially worse, because I was used to a certain amount of clarity at night (because I can be corrected to see 20/15 and am used to that clarity). 
  • Despite not doing a whole lot of conscious active focusing or print pushing or wearing a differential lens, my eyes did improve. I’m guessing that I will need to step up the active focusing on things, etc.in the next year to come if I want to keep improving my vision.

Thoughts? More info? Better info? Questions? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Chrysanthemum and Goji Berries Tea Recipe for the Eyes

Are you trying to bolster your eye health? In our family, we are definitely doing what we can to strengthen the eyes. At any given time, members of our family will have red and/or itchy eyes, dry eye, or blurry / myopic vision. While we use artificial tears and allergy eye drops, we also do what we can to help address the root cause.

In traditional Chinese medicine, chrysanthemum (菊花, ju hua) is the go to herb for clearing and strengthening the liver which is apparently closely tied to our eye health, among other things. While there are extracts and capsules, our form of intake has always been through tea. 

Which kind of chrysanthemum (菊花) is best for eyes?

When I first looked up chrysanthemum tea recipes, I found many refer to chrysanthemum generally without specification. In fact, there are (at least) two main kinds of chrysanthemum, white (白菊花, bai ju hua) or yellow (黄菊花, huang ju hua). In the realm of eye health, yellow is much more popular and is indicated for dry, tired eyes. White is suggested more often for visual acuity. There was some conflicting info online (I’ve listed the main sources that I consulted below in ‘Resources.’) So I’ve settled on buying and drinking some of both. The white version is definitely more bitter and tastes more like medicine. 

You can buy chrysanthemum at your local Asian grocery, Chinese herbs store, or online. I’ve been buying an organic version from Starwest Botanicals that is sometimes available on Amazon as well as directly from their website.

White chrysanthemum from Starwest Botanicals

Which kind of goji (枸杞子) is best?

As with chrysanthemum, I didn’t realize there were different kinds. There are at least two different kinds of goji berries (also known as wolfberry, gou qi zi, 枸杞子). Until recently when someone gifted us a box of black goji berries (the exact product that I’ve linked to here), I had only heard of the red goji berries. But apparently, the black goji berries are even more powerful and have more antioxidants than red goji berries. You can supposedly chew the dried black goji as a snack (the red ones are definitely snackable and have raisin consistency), but when I tried the black ones, they were very dry and tasteless. Maybe I have the wrong kind. 

Red goji berries are sold at various grocery health food stores (Whole Foods and the like). They even sell them in bulk at our local Costco. Black goji berries are not so ubiquitous, but I found them at my local Chinese herbal store, online herbal stores, and even Amazon seems to have some selection these days. 

In the end, I concluded that choosing the goji berry depends on your needs at the time. Both are generally good for you – the red goji berry is sweet and more neutral in nature, and the black goji berry may be more powerful, but less tasty. We have some of each, as I like to hedge my bets and balance things out.

Goji berries from Costco

If you don’t have access to the variety, don’t get hung up on it. Any chrysanthemum and any goji will likely have some benefit. As with a lot of Chinese medicine, long term, steady consumption is advised for more benefit. My children’s TCM doctor told us that we, including the children, could safely have chrysanthemum tea everyday and that it would be great for subduing allergic tendencies. 

Basic Recipe

Ingredients (for 1 serving)

  • 4-5 dried white or yellow chrysanthemum flowers (this quantity is more dependent on taste, the more flowers, the stronger the tea, and so on)
  • A handful of goji berries (again, the quantity is also more about taste. The more you add, the sweeter the tea). Use either black or red berries, or both!
  • Honey (optional)

Directions:

  1. Boil water.
  2. When water comes to a boil, turn off heat. Throw in flowers and berries. Let it steep for at least 5 minutes. (More time won’t hurt; it’ll just taste stronger). Variation: Simmer the flowers and berries for a few minutes before steeping.
  3. Strain out the flowers and goji berries. 
  4. Add honey if desired and drink! 

Resources

Different kinds of chrysanthemum, indications for white vs. yellow:

Goji berries, red vs. black:

Other chrysanthemum tea recipe write-ups that I like:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reduce Your Allergies Naturally

phytocort asthma allergies
From left, Vitamin C, a bottle of liquid extract of Chinese medicine, Phytocort

Maybe Zyrtec doesn’t work for you lately or perhaps you don’t like its side effects. Personally, I fear that we don’t know much about the long-term use of these “safe” OTC antihistamines for allergy relief. Instead, I’m hoping to treat my sneezing family as naturally as possible. Below are some of the things that I’ve been reading about (and in some cases, trying out):

1. Avoid Antibiotics as Much as Possible

Scientists are increasingly looking at an imbalance in the microbiome as the root cause of many of the problems we have with our immune systems not working properly. These problems include both food and environmental allergies, asthma, and dermatitis.

It’s not too far of a stretch to see the problem with taking antibiotics, since antibiotics essentially kill all the bacteria you have, both the good and the bad.

I really wish I knew this before, both for myself and the rest of my family. Apparently, some of the good bacteria don’t come back. Antibiotic overuse has also been linked to people suddenly developing serious allergies later in life. It should also be noted that antibiotics can be found in our food and water supplies, so even if you’ve managed to avoid antibiotics for infections, you’ll probably still have some low level of exposure to it. (This topic deserves it’s own blog post.) But basically, avoid antibiotics as much as you’re able!

2. Try Traditional Chinese Medicine to Address the Root Cause

Perhaps strengthening your body in other ways can still help to address your immune system gone awry. I don’t want to be lugging an air purifier around for the rest of my life! Traditional Chinese Medicine (TCM) practitioners often claim that acupuncture and herbal medicine can alleviate symptoms as well as address the root cause of hay fever.

Since TCM is tailored to the individual’s constitution, I didn’t find any obvious herbal formulas to try for adults. Generally speaking, I found these herbs commonly listed in formulas to address the root cause of allergies: ginseng, huang qi (astragalus root), bai zhu, gancao. I’ve also read about PhytoCort which some people find to treat asthma and reduce allergies.

For children, I’ve been looking for ways to address what seems to be cough-variant asthma in one of my kids. A TCM practitioner recommended a combination of liquid extract formulas from “Gentle Warriors”, a line of children’s herbal formulas. The formulas were selected based on my child’s constitution and the presenting symptoms. I’m skeptical, but also hopeful. We’re trying it out for 1-2 months and I’ll be sure to update this post with our results.

Update as of 1/6/2021: After we tried these formulas last year, my child’s cough-variant asthma seems to have disappeared! After having this asthma cough for over 1 year, it’s now been gone for 5 months! We’ve managed to keep off of Qvar and Singulair, oral steroids that had bad side effects for us.

3. Eat a Diet Rich in Natural Antihistamines

If you’re in the midst of having allergic symptoms, this approach isn’t going to help you right away. However, over a couple weeks, it sounds like a person with mild allergies could benefit. Common foods with natural antihistamines include: bell peppers, citrus fruits, pineapples, broccoli, cauliflower, berries, apples, tomatoes, black/green tea, ginger.

My family has pretty good eating habits and many foods on this list are already a regular part of the diet. Yet we still have allergic symptoms so I’ll have to say this doesn’t get rid of all your allergies, although I guess they could always be worse.  Anecdotally, as a data point, I’ve noticed that my two kids who rate equally on the allergy scale, have different levels of allergic symptoms. The one who happens to eat a lot more fruits (2-3x more than the normal serving that everyone else eats), also happens to experience less allergic symptoms. Then I read this study about how a Mediterranean diet rich in fruit and vegetables was found to be associated with less allergy symptoms, which further boosted my small finding.

4. Take Natural Supplements to Boost the Immune System

The amount of natural antihistamines found in foods may not be enough for some allergies. Higher dosages in capsule or powder form enable higher intake to replicate the dosages given in scientific studies. These supplements include:

Vitamin C – I found Vitamin C at the top of many lists. Apparently, vitamin C both inhibits the release of histamine from anti-inflammatory cells as well as helps to break down histamine after it has been released. However, the current recommended daily allowances (RDAs) for children (25mg-45mg) and adults (65mg-90mg) may be too low to create the expected allergic relief. The current RDAs were in fact calculated as the amount needed to prevent scurvy and not other ailments. According to the ODS, the highest daily intake likely to pose no risks is:

  • 400 mg for infants aged 1–3 years
  • 650 mg for children aged 4–8 years
  • 1,200 mg for children aged 9–13 years
  • 1,800 mg for teenagers aged 14–18 years
  • 1,800 mg in pregnant or breastfeeding teenagers aged 14–18 years
  • 2000 mg for adults

For my kids, I decided to trial 400-500mg dose. We are only 1 week into it, so I will have to update this post when I have more observations.

Quercetin – this is an antioxidant also regularly included in everyone’s list. It’s high in leafy greens, apples, grapes, and onions to name a few. I saw a range of dosage recommendations for taking it as a supplement. For adults, I saw a range from 500mg daily to 1000mg 2x/day. For children, Dr. Weil says 200mg daily 2x/day for hay fever.

N-acetyl-cysteine (NAC) – this is an antioxidant that some websites report is stronger than Vitamin C. It’s touted as being able to break down mucous, and reduce allergy symptoms. While it can be found naturally in protein-rich foods that you might eat, like turkey, eggs, etc., a much higher dose is needed for therapeutic effect. I read that NAC caused stomach pain in high doses for some users, so I would proceed with caution. I saw recommended dosages of 300mg 2-3x daily.

Probiotics – Probiotics are the supplements that contain the good bacteria that your gut needs for a healthy immune response. Whether probiotics are effective in putting the good bacteria in your gut is still being studied. However, this doesn’t stop a lot of people from trying. There have been quite a few studies that suggest taking probiotics may result in less hay fever symptoms.

What has worked for you? If there is something that has really worked for you, I would love to know about it!

Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

 

Resources

Natural allergy relief in general

On Traditional Chinese Medicine for children

https://www.craneherb.com/shared/articles/28_Gentle_Warriors.aspx

On Vitamin C

On quercetin

On NAC

On probiotics

On antibiotic use and allergies

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

7 Ways to Reduce Physical Exposure to Environmental Allergens

I try to avoid the use of allergy medications as much as possible, so I’ve tested out a variety of non-medical ways to reduce my family’s environmental allergic reactions to tree pollens, grass pollens, and dust mites. Here are the things that we do that seem to have helped in order of suspected effectiveness.

1) Run the air purifier

We have serious dust mite allergies, so I run an air purifier on high in my children’s carpeted bedroom about 1 hour before their bedtime, then I switch it to low for the remainder of the night. We’ve been told to run it 24/7, but that seems excessive. Apparently, it takes approximately 1 hour for the air in the bedroom to be completely filtered. I also run it about 1 hour after I vacuum. Our vacuum doesn’t have a HEPA filter, and I’ve also read that even if it does have a HEPA filter, the sheer act of vacuuming kicks up enough dust (mites) that then need to be filtered. There seem to be a lot of fancy, pretty models on the market these days. We have a pretty old Honeywell one that looks like this model. It seems to do the job, so my thought is, you may not necessarily need a fancy medical grade one.

2) Avoid being outside between 5am to 10am

I only recently learned about this, but according to multiple online sources, pollen counts are highest between 5am-10am and after sunset. Close your windows before dark! I realized how true it was when one of my kids started having a runny nose every time we tried to do a 7am walk during shelter-in-place, but had zero issues when out in the afternoon. So much for trying to become an early morning exercise person.  On the other hand, now I feel a lot better about sleeping in.

3) Wear a face mask

ReduceEnvironmentalAllergens
I’ve got a lot of face masks around the house these days.

If you do have to be outside in the early morning, then try a face mask. This made a HUGE difference for my massive grass allergy when I was outdoors recently – it wasn’t even a PM 2.5 or N95 mask. Just a simple, single layer fabric mask seemed to do the trick. Fortunately, it’s become normal to wear masks these days, so my grass allergy symptoms have significantly improved.  I also suspect I have a temperature sensitivity allergy that is sensitive to the change from the warmth of my bed and being suddenly cooler. I swear it’s real, and putting on a mask immediately after getting out of bed seemed to help!

4) Vacuum regularly

By this, I mean once every 1-2 weeks. That may seem like a lot or very little to you. To me, it feels like a lot and so we have an iRobot that we set loose in the bedroom. It really helps, especially with getting under the bed and not making it seem like such a chore. Again, we have a very old model (older than this, so it’s not a true HEPA filter and doesn’t filter dust mites), but I still see a very full dust container at the end of each run. I run it twice for good measure. We run the air purifier to get rid of the resulting airborne dust mites (in theory).

5) Use a nasal spray / Neti Pot / eye wash

I keep a few canisters of regular saline spray by our home’s entrances. If it seems like a high allergen day, I have the kids do a thorough spray in each nostril and blow, when they’ve been outside. We’ve tried this Arm & Hammer brand and the Little Remedies brand with similar results. Arm & Hammer is available at our local Costco for a much better price. Ideally, I could teach them to use the Neti Pot, but it’s a little too involved.

My mom and kids seem to also have a strong reaction to allergens in the eyes and frequently have very red or itchy eyes after being outside. We have used allergy eye drops, but I don’t find them very effective. Instead, briefly washing the eyes out with a few artificial eye drops or eye wash seems to help clear or prevent the red. The sooner you do it after being outside, the better it works. We use these single use Refresh vials the most.

6) Use dust mite covers

These alone, didn’t seem enough to make an actual difference. My kids were still getting congested at night when we had these. I think the air purifier made the most difference. But now we have the dust mite covers for all their pillows, mattresses, and duvets, and I’m not about to remove them to test. All covers are not equal though, so I researched a bit and ended up using this website’s reviews to help with the selection and considerations.

7) Run pillows and comforters through the dryer on high heat

High heat is supposed to kill or at least reduce dust mites, so I run the kids’ pillows and comforters on high heat in the dryer for 20-30 minutes every month. Since I only do this about once a month, it’s hard for me to tell if this is a necessary step or if changing sheets along with the use of dust mite covers is enough.

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.