TCM Office Hours - Livestream Q&A (11/13/20)

[Music] hey this is nicholas welcome to the live stream q a we're answering questions about acupuncture herbs chinese medicine foundations starting a practice so this is the second live stream q a uh so if you're here live go ahead and uh tell me in the chat where you're from uh and what you're studying right now are you in your first year are you studying for tests are you studying for boards let me know what you're doing or if you're here on the replay go ahead and leave it in the comments all right and so we can just jump into answering some questions and if you have any questions go ahead and leave them in the chat if you haven't if you're watching this on the replay and you have some questions go ahead and leave them in the comments and we'll we'll uh we can answer those sometimes i have a little bit of delay so hopefully this is showing up on the youtube here we have somebody from uh bastyr in seattle awesome hello i got my little stickers now thanks for joining us and i did this in the afternoon last time i did this friday morning and i had a bunch of people coming in from the philippines and so some people came in at two in the morning and so i tried to do it in the afternoon um so we can get more people in here oh we have a roof from portugal uh what time is it there got ainsley from manitoba i got some people from our so hello and thank you for uh coming into the live q a so we'll just get into some questions i have some questions from last week that didn't get answered i went back and went through some of the chat and some of the comments and there were some questions that i didn't get to so we'll maybe start with those first oh we have uh some people from uh peru coming in from toronto what's the story with gb42 let's uh that's i have a thing about gb42 we can talk about that later i i'd ask some scholars about gb42 like was that a real point or not uh so we can we can get to that so uh but first i want to get some questions that we that came in last week and i didn't get a chance to so if you're on the replay and um you didn't get to ask a question you can leave it in the comments and i'll get it next time if you're in the chat right now and i have trouble uh seeing the chat sometimes so if you ask a question question in the chat and i don't get to it go ahead and leave it in the comments and we'll do it for next time and something i should have mentioned last time uh with this q a this is a sort of an educational question and answer session meaning that this is for people who are students people who are studying and have questions about books and things like that uh basically what i'm trying to say this is not for personal medical questions sometimes this happens in the comments on the youtube videos where people will say i have this condition what herb should i take or i have these symptoms going on what points should i what point should i do or what point should i use for acupressure and um i just can't answer those questions here there are sort of legal and ethical boundaries there that uh this isn't meant to be personal medical advice this is just uh for educational purposes for people who are studying looks like we've got a lot more people come in oh there's an echo i'll have to take a look at that let me uh close this we'll see if that's good that gets better i might have to switch microphones for next time so i'll have to i'll have to look at that and and so that should that should go for all the videos too if i make a video about an herbal formula that doesn't mean you should say oh this this these symptoms look like me i'm going to take this herbal formula or something like that if you want uh if you want to take herbs go see a licensed practitioner if you have some condition go see a licensed practitioner um that's where i can't do online consultations over youtube that just creates legal and ethical issues but let's start with some questions from last time uh i can't see very well helena is asking how long can we keep the needles on the patient so how long do we retain the needles this is actually something that a lot of people have a lot of different opinions about this and a lot of styles will do this differently i would say that generally people tend to leave needles in for like 20 to 25 minutes after they insert all the needles so let the patient relax for 20 to 25 minutes and then they'll come back and take them out i'm not sure if there's an actual theory behind this i think sometimes this is just if a person is running two treatment rooms sometimes they'll put the needles in one patient and then go start their intake on the next patient and whenever they're done with that they'll come back to the first patient so that might be why that is but different people have different opinions i've heard some people say that you should leave the needles in for exactly 28 and a half minutes and i thought that was really weird and i had to go look that up but later i was reading the nan jing and the nanjing was talking about how the qi flows through the 12 channels through long large intestines on the screen heart siu kidney pericardium sandra goldberg liver that it goes through that circuit 25 times during the day and 25 times during the night for a total of 50 uh continuous circuits and so if you take 24 hours and divide it by 50 you get 28 and a half minutes so that's what this person thought that you should leave the needles in for 28 and a half minutes because that's how long it takes for the chi to complete one cycle through all 12 channels i don't know if a lot of people do that i've heard some people say that they just leave the needles in as long as they need to or until they're ready and sometimes that's a very long time i don't quite agree with that all the time there are some styles that don't retain the needle sometimes with japanese style acupuncture they just do contact needling and so they actually or their insert the needle and pull it out i know some five element practitioners that all they do is they insert the needle they get very strong stimulation and then they remove it right away so there are some people who don't retain the needle as well some people retain the needles for half an hour 45 minutes or even longer [Music] but as a general guideline i think 20 to 25 minutes is what most people do and then we do um there is some theory about tonification versus sedation when we talk about the methods of filling and draining with acupuncture when we talk about lifting and thrusting or rotating needles or needling for or against the channels some people will say that if you need leave the needles in for a less amount of time that's more tonifying where if you leave the needles in for a longer amount of time that's more draining and so that's something you can do with your treatment but i'd also say that's something that we shouldn't leave the needles in too long otherwise the patient might feel very drained afterwards but i feel like most people do 20 25 minutes unless you're practicing a specific style we got joyce here from the phil from moscow hi joyce i got my little buttons i'm really happy about so that had to do with needle retention time next one from last time does tablet form of the herbs differ in practice from using the original herbs and so so this is so this is a question about how we take the herbs what form we take the herbs in and so when it comes to taking herbs we do have a couple of different options that uh the traditional way we could take herbs is we could take an herbal decoction that's we took the raw sticks twigs and leaves and boiled them down into a thick soup and drink it that's an herbal decoction we can take an herbal powder a sand and where we grind up the herbs into a powder usually you pour on boiling water and drink it as a draft or you can take the herbs as a pill or a tablet juan or pien i don't think there's really any difference between a pill and a tablet i think it's just the shape but don't quote me on that but basically with that we take the herbs and grind them up and then use something like tea or honey to form it into a pill or into a tablet so we can do decoction powders or pills and generally speaking the decoctions are the most potent or the most powerful they have the most efficacy because you're sort of distilling the essence of those herbs and then you're taking them in a way that's very easy for the body to absorb and so in terms of potency the the decoction is the best the downside of that is decoctions are very inconvenient to take because each time you have to boil it uh it can take like half an hour or an hour to boil the herbs and then you have to drink it and you have to taste it and that can even be a deal breaker for a lot of people that they just don't want to taste the herbs and so pills are because they're not boiled down because we're not doing that extraction process pills generally aren't as powerful but they are allowing it because you get you just have them already made you don't have to cook them you can take them right away um and so the only downside is they're not quite as powerful as taking the raw herbs powders are somewhere in between and then we have to make a distinction between um in the traditional idea of asan like xiaoyasan as a powder that's they took the raw herbs and ground them up into a fine powder and this is very different than nowadays we have granules which is kind of like the instant coffee version of uh tcm herbs so so again i would say the granules are maybe a little bit less potent than the raw when you're cooking it raw but it's also a lot more convenient you just add some hot water and stir it and drink it and so each one has their pluses and minuses also when you take a raw formula it's very easy to modify you can adjust the dosage or add and subtract ingredients whereas when you're taking a pill or a tablet there's no way to make any adjustments you just have to take what's already made so those those are pluses and minuses i would also say that sometimes um how do i want to say it a lot of people will choose pills for their tonifying formulas part partly just because when you're taking a tonifying formula say you want to tonify kidney in or tonify kidney essence you're going to have to take that formula over a long period of time and so just for convenience it's easier to take it in pill form if you have to cook a decoction every day for two years that can be very hard in terms of compliance so a lot of the tonifying formulas we make them in pill form just because we're taking them long term and sometimes uh when traditionally when they formulated pills they kind of took that into account that they were going to be less potent and so when you look at formulas like the difference between yogway yin and yogway wan or zuogwei yin and zuogweian is a decoction it's a drink yoguiwan is the pill the pill has more animal parts in it and the pill has more stronger potent medicinals in it just because they know that you're taking it into pill form and so it might not have as much absorption so we kind of take that into account when we formulate the pill i guess there are also some herbs that we really only take in pill form too like good ga you don't really boil geckos you only use that in pill form so that's another thing to keep in mind is that there are certain herbs that we only use in pill form but generally those are the options in the modern clinic our options are raw herbs and decoction granules and pills or tablets and those are kind of things we have to balance usually in a modern clinic the thing we're worried about is patient compliance that a lot of people don't like to prepare the herbs they don't like to smell the herbs i've had some patients that they're fine cooking the herbs but their family will complain other people in the house will complain that the they smell up the house every time they cook their herbs um some people are really excited about it the for the first week they say oh i have these herbs it's like harry potter i'm cooking up a potion and they get really excited but after the first couple weeks it gets real old and they switch over to the pills just because it's more convenient so we do have some options there in terms of what form we take and we just have to take that into account about pills and tablets versus the raw herbs next one do you find yourself using specific point combinations or making your own as you see the diagnosis like host and guest six point needle technique um oh six needle technique maybe that's four point needle technique i'm not quite too sure about six needle technique um so question is about leo oh yeah i remember leo he had a really nice lion uh avatar which i didn't copy and paste so that was leo asking about uh point combinations so yes i really like point combinations a lot of times this is like a just a personal preference thing that i do i like to base my treatments off of point combinations so i kind of think of it like when you're building an herbal formula we talk about herbs having dwayau pairs that based on our diagnosis we might start with a dwayau pair and then we'll add in different supporting herbs to help us achieve the goal of what we're whatever we're trying to do in treatment so a lot of times i take the same approach to acupuncture where i'll start with an acupuncture point pair and that will be like the basis of my treatment which matt which matches my diagnosis and my treatment principle we'll start with that pair and then add on supporting points to help with that um so where do these pairs come from well we have a lot of different options in terms of pairs and a lot of different styles we'll use different pairs as well i've shown this book before i'm a really big fan of the wang ge applied channel theory there's a section in the back where he talks about a lot of different point combinations or point pairs that he likes to use and so i borrow from a lot of those so um how do we construct a point pair well we have a couple different ways we can do it um one way we can do it is we can use points that are on the same channel name they're the same six channel name so for example if a person has a lot of spleen q deficiency or just general deficiency might do stomach 36 and li10 so stomach 36 is a point on the foot yang ming channel and li10 is a point on the hand yang ming channel and it's kind of like their mirror images stomach 36 is right below the knee eli 10 is right below the elbow and they're on the the same yang ming channel so that's one way we can do it um or another example like that i i like wong jui's point pair um liver five pericardium six so with liver five pericardium six liver five is the wool connecting point on the foot dwayin channel pericardium 6 is the dual connecting point on the hand weigh in channel so we're using uh we're using the same category of points but we're using them um on the opposite limb i guess that's another thing when i do point pairs i usually like to have it balanced out that one one of the pairs is on the leg and one of the pairs is on the arm and and so he has a lot of pairs like that sanjal's 6 gallbladder 34 gb 41 sonja 5 uh four gates is a common one liver 3 li4 [Music] so that's one option is we can use things on the same channel name another option for point pairs is thinking about the five phases so i think this is something that especially japanese style practitioners will do is uh if a person has spleen qi deficiency they might do pericardium 7 spleen 3 because pericardium 7 is the source point on the fire channel spleen 3 is a source point on the earth channel so we're using the the five phases the shung cycle that fire generates earth so they're they're using the the five phases in that way or or another common one lung five kidney seven here we're doing the water point on the metal channel and the metal point on the water channel so we can also develop our point pairs in terms of the five phases as well and think about those relationships so we have a couple options and then we can just have things that look similar in mirror images like liver 3 li4 is just that the points look similar on the hand and the foot so we have some options there so i do like point pairs i usually um uh i really like the ones listed in wong ju yi or i look at the ones that are in japanese style acupuncture so i don't necessarily make up my own but i do look at other point pairs that other people have come come up with so that was a question about um point combinations guest and host is an interesting one i feel that like that's one that we always talk about and we have to talk about in school because it's something that deadman mentions in this text but it's kind of funny when you read that section in deadman he says that this is a thing but not a lot of people make reference to it like the only one they say is uh li4 and lung seven to release the exterior so that's kind of an interesting thing that i'm not sure a lot of people used guest host maybe the other one i use a lot is a kidney 3 ub58 so kidney 3 is the source point and ub58 is the low connecting point and so especially if i'm doing a lot of back shoe points sometimes that's just nice the um uh basically i'm doing if back shoe points are all on the ub channel so i'll do ub 58 is sort of a lower point on the ub channel then kidney 3 is a nice tonifying point so that's another guest host pair that i use but i'm not sure that's classical i think that's just something i made up at some point and it's not a real thing cody do you think there is something to star signs in your opinion does it mean anything to you yeah this one was kind of funny um last time somebody asked me about uh what's what's my sign or what's my astrological symbol sagittarius in western astrology i was born in the year of the rat in chinese astrology um but honestly no i'm not i'm not really into astrology either eastern or western i'm not really into feng shui in terms of chinese astrology so i'm getting distracted let me go let me come back to this one this this looks like a good question let me come back to that oh but so astrological symbols um yeah i'm not i'm personally i'm not really into it i don't assign a lot of significance uh to be completely honest i'm kind of morally opposed to uh astrological symbols it's just in that i don't think that you should judge someone or develop preconceptions about someone based on when they were born and i think that's a bad habit to get into and i guess maybe if you're like just doing it for fun that's one thing but i have had some students that when they're in the clinic they get a new patient they'll look at the chart and the first thing they do is they want to look at the patient's birth date to see uh what their zodiac is and then they'll start to say things like oh this person's so that must mean they're really bad at commitment or they'll start inventing things about the patient that they they haven't seen this patient they haven't met this patient but they try to make some inferences based on when they were born i don't think i don't think that's a very good habit to get into i think it's better to treat what's in front of you i kind of want to go back to this one before i forget it i have to go and look it was a question about window of sky points i can't find it so i'll just say it so there's a question about i i think the question was we we saw something about window of sky points um and what are those so so those are we have a category of points we call them window of sky points or window of heaven points and this is just a category of points of different that go across different channels they're usually located on the neck that's not entirely true but they're usually located on the neck and the the window of sky points have a couple different functions so one of the ways we can think about it is uh we want chi to be able to flow harmoniously between the head and the rest of the body and sometimes the neck can be sort of a bottleneck that the this is a place of constriction and the chi can't get through and so sometimes we'll see certain symptoms that the chi is not flowing harmoniously from the head to the rest of the body and so then we can use these window of heaven points or window of sky points to open up that area so that the qi can flow between the head and the rest of the body so these are points we call them window of heaven points most of them are on the neck so like stomach 9 li 18 um but we have a few that are not on the neck like a lung three uh but of the of them i think only two are not on the neck so so this is just a category of points that they have they have a couple different functions i might have notes on this on the website as part of the um the point categories i'm not sure if i have those notes on the website or not but they have a couple functions one they treat issues in the neck like goiter scrofula things like that they treat um conditions sudden conditions of the sense organ so like sudden deafness or or things like that that that's a sign that the chi is not flowing to the head they can treat certain mental emotional issues as well then that's just a sign that the chi is not flowing between the head and the rest of the body so there's a section on that in in deadman i might have some notes online but that's just one of our point categories window of heaven points oh so this is a good question this is a question a lot of people ask me this is a question i have to answer very carefully that so on on the youtube channel i have a bunch i have a couple videos about the channels uh so far i have lung large intestine stomach spleen and people are always leaving comments about are you gonna are you gonna finish that are you gonna do the rest of the channels where's the kidney channel where's the si channel could you please do uh the the liver channel things like that um so kind of the answer is yes i'm going to do those eventually um i want to be careful about how i say this because because i'm because i'm very glad that people enjoy those videos that people get a lot of useful information out of those videos so i'm really happy those videos have become so popular the thing is like on my end of it those videos are like they take a long time to make and they're not the most exciting videos to make either so for me it's they're like they're kind of boring to make and so the first ones i made long large intestine stomach spleen i made those and they were easy to make because i was already teaching those in a classroom and so i already had all the materials for it and all the information i already had all the slides made so it was a little bit easier to make those and i was making those for the class that i was teaching once we get into the other ones it's kind of i have to make those from scratch so that takes even longer to make so it's kind of like i have to write a 20-page script about the the channels i have to make all the drawings and everything like that make basically a powerpoint presentation with 300 slides so sorry i have a siren going by so those videos can be a lot of work and so that's sometimes i just get overwhelmed and it's hard for me to get started on those um the other thing is i tend to get i've been getting very distracted in terms of making videos they call that like shiny object syndrome around like a cat going after different things and so i have a lot of people asking me can you make acupuncture videos can you make more herb videos can you do herbal formulas can you do point location can you do foundations can you explain uh a principal diagnosis can you explain shanghain loon and all these things so i have a lot of people asking a lot of different things and so it's kind of like i can't do um it's hard to do all of them and really i should just i probably should just pick one and focus on that and get all the channels done but i do kind of like to jump around just to make it more interesting so i guess what i'm saying is i'll eventually get to all of those i'll eventually get to all of the herb categories all of the channels all of the point location but i'm just going to jump around so it might take a while the other thing um is i guess i even though people really like those videos i haven't been super motivated about it just because i feel like each of those videos is the same so if you look at those that should give you a good format as to how to study the rest of the channels so if you like if you look at each video it's it's very much divided up into first we're going to talk about the functions of the organs and the channel and see how that relates to what's going on with the points then we're going to look at the pathways of the various channels to see where those pathways go and then we're going to go through all the points and we're going to relate that to the functions and the pathways and we're going to relate it to the point categories so it's kind of like setting up this way of thinking of how to make sense of why the points do what they do but it's like once you understand that way of thinking you can apply that to any of the channels that you want and you don't know you don't necessarily need a video that's something that you can you can get out your books and you can as you know say you're studying the the kidney channel you can you can go through that same methodology you can think what are the functions and characteristics of the kidney well the kidneys the root of all yin and yang the kidney has to do with the water element the kidney has to do with water metabolism if the kidney fails in its function of metabolizing water we get swelling and edema those are the functions of the kidney then you can start to look at the pathways of the channel we can say the kidney starts at the bottom of the foot we have this branch that goes up into the throat and into the tongue so we see that kidney 6 is good for benefiting the throat that makes sense because the kidney channel goes to the throat and then we go through the individual points and look at the point functions you can look at the look at the point categories and see if the categories make sense in terms of the point function so when you say kidney 3 is the yuan source point and it tonifies everything does that make sense because it's a yuan source point things like that when you look at the law connecting point the kidney four treats fear and we say that little connecting points have to do with mental emotional things you can start to make those connections and so hopefully that kind of method of looking at the channels and looking at the points i've given you a few examples of how to do that already hopefully you can take that same methodology and apply it to the other channels as well so i hope that doesn't sound to me i'm kind of saying like go try it yourself you'll learn something which is maybe not a very nice thing to say but um i'll get to those i'll get to those videos eventually because i because i think they are good videos to make they just take a long time and i tend to get distracted it's like maybe i should be working on the small intestine channel right now instead of doing a live stream but i'm having a lot more fun doing a live stream so we'll just do that for now oh sorry sorry that's that's what i was trying to click on hi julio uh julio is from the philippines he has his own uh youtube channel as well so you can go maybe go take a look at uh his channel i think he's doing some stuff with massage and he's going to start making some tcm videos as well oh so studying question oh i guess we can't do that oh leo i was trying to see the name do you have any tips for studying and remembering point combinations point combinations always irritated me when i was in school so i remember not liking that at all so i'm not sure if i have any uh good tips for that in terms of studying or point maybe i should say point prescriptions instead of just combinations because because if we're talking about just like point pairs that's a little bit easier because we can think about like do they belong to the same category are they on the same channel thing like that um but i feel like when i was in school we had to memorize point prescriptions and i was really not into that so like in machiocha the machioche foundation's book he goes through all of the zong foo patterns and he has a point prescription for each zong food pattern so he has a point prescription for a lung yin deficiency and a point prescription for damp heat in the liver and then we had to memorize those and then when you go look at a cam cam has certain point prescriptions based on um more like disease or symptoms they have like point prescriptions for infertility and things like that and that was something that we had to do i feel like that's a very test oriented thing that when you're answering questions on the test you need to know those point prescriptions when you're answering questions on boards you just have to know those point prescriptions and i was always really annoyed by that because i hated memorizing things and i feel like that's just that's not necessarily the way you would practice in clinic you you you know acupuncture isn't supposed to be like reading a recipe book where it's like oh this person has spleen q deficiency all do these points that machio just says to do i think we can we can be a little bit more creative than that so unfortunately that's just something that you have to memorize when you're uh in school and but we're looking for an approach to it i guess we can we can still try to learn something from it so sometimes i would take the approach the same way i if i wanted to memorize the herbs that are in herbal formula if i need to do to memorize the ingredients in a formula i'd first look at what does the formula do what's it treating what is it trying to accomplish and then i would go through the ingredients and say how do these ingredients accomplish that goal or what role are these ingredients playing in order to treat those treat this condition and so then instead of just memorizing a list of herbs it helps you review the functions of the single herb so you can say oh ren chen is there to tonify chi but fooling is there to drain dampness because spleen qi deficiency leads to dampness and then we have chen p to regulate qi and dry things out so you can look at how how are these herbs working together in order to achieve this goal you can do the same thing with your point prescriptions so if you have a point prescription for a spleen qi deficiency leading to heart blood deficiency with problems like anxiety and insomnia and things like that you can go through the points and you can ask yourself why are these points in this prescription so so we have maybe we have spleen 6 and we can say why is spleen 6 here well spleen 6 tonifies chi spleen 6 tonifies blood and the spleen channel connects to the heart so it makes sense that we want spleen 6 in this point prescription and then we say oh heart 7 is there heart 7 is there because it's the yuan source point of the heart channel and we need to tonify the heart to take care of the insomnia so i'd say when you have these point prescriptions try to figure out why each point is there and then when you do that you'll also be reviewing the functions of the individual points um so that's the way i would go about trying to understand it but then to some extent when you get questions on the test unfortunately you just have to memorize it so that can be difficult i like this one do you find that going to acupuncture school is still a good investment that's a difficult one i suppose it depends on what you mean by a good investment um if you're talking about the ability to make money and like the like going to acupuncture school costs money and you can if you want to think about how quickly are you going to make that money back or what are your career prospects going to be i i don't know because i feel like it varies a lot i've known a lot of people that they go through acupuncture school and then they end up not practicing acupuncture i had a few classmates that they went through four years of school then after they graduated they got pregnant and had a kid and they just they be they became a stay-at-home mom and yoga teacher and they never practiced acupuncture and i thought that was kind of weird um some people some people go through school and they they practice acupuncture for a couple years and it doesn't work out some people struggle a lot but then on the other hand i know people who are millionaires from practicing acupuncture and so it kind of varies i know um i know some people who were able to get salary positions where they're making a six-figure salary i know some people who started their own clinic and after a couple years they're making a lot of money so it kind of varies it depends on how you go about doing it and what you do with uh with a degree but i would say for me i i didn't study i guess i wasn't drawn to chinese medicine because i thought it might be a good money-making job or anything like that i came to chinese medicine because i was curious and i was interested in chinese medicine and so and i'm still kind of that way i don't necessarily look at this as a an investment or a money-making endeavor it's more of a i saw chinese medicine and i thought it was cool so i went to study it and now i i enjoy seeing my patients and and things like that so it kind of depends if you're looking at it in a very practical way of i need to pay the bills is it worth it i don't know schools cost a lot of money nowadays so it's kind of hard to say i know a lot of people who are freaking out about their student loans and i'm not sure what the job market is like now either that when i when i graduated school kind of the assumption was everyone was going to go start their own practice and i think that's a little bit different now i think now there are more opportunities that you can go work for someone else or go work at a hospital and get a salaried position i think there are maybe more of those opportunities whereas for me it was kind of like you had to go start your own practice and kind of starting your own business can go a couple different ways some people are some people are really business savvy and they're really good at it and they're able to make a lot of money some people struggle for years so it's hard to say so this is what this one i would say like if you're just looking to make money maybe maybe acupuncture is not the best way to do it well i guess that's the the last of those questions so those are the questions from from last week and i threw in a couple others so we can we can maybe go through and look at some of the comments how are we doing on time oh nice sorry i haven't been paying attention to the chat so let's go look at that and see if we have any good questions kyle asks is it possible to go sorry is it possible to get a long way clinic wise with just herbs and no acupuncture yeah and this is something that again people have varying opinions about this some people say that certain conditions uh respond better to acupuncture some people say that certain conditions respond better to herbs some people do one or the other some people do both um it's kind of interesting i would always say we can do both so if my patients ask me i would always say we can do both herbs and acupuncture there are certain things i would say like if you don't have a lot of time or if you don't have a lot of money we might choose one over the other um but it's kind of interesting i had a co-worker a guy i worked with that sometimes he would have patients come in and they say i have this chief complaint i have insomnia or something like this and he'd say and they say can i schedule appointment and he'd say wait a minute and he'd go and take their pulse and then he would then you would tell them no don't come in for acupuncture i'm going to give you some herbs and i want you to take these herbs for two weeks and after you take these herbs then you can come in for acupuncture and kind of an explanation for that was with acupuncture it's like we're moving chi through the system with the needles are creating movement but it's really hard to add more qi to the system through acupuncture so his explanation was you need to take herbs for a couple weeks first in order to build up chi in the system and then you can come in for acupuncture and will circulate that chi around so that was one approach can you get results with just herbs yes there uh i i believe in china i'm not sure if this is still the case but in in china it used to be that uh practitioners would either specialize in external medicine and do acupuncture or they would specialize in internal medicine and do only herbs and so it was very possible that some people would come in only for herbs and we still have patients that like that they come in only for herbs so especially when there's a lot of deficiency you can just give herbs and still get good results especially for like fertility things sometimes i'll say just take herbs oh nika's here from the philippines hello hello this time it's not two in the morning like i said as i said before that we i did one last week and people people came at two in the morning boop boop so we had a question before about um taking decoctions versus taking pills and so now we have if pills are meant to be taken long term how quickly can the patient start seeing improvement one example might be lyowe dihwangwan if a person has a kidney in deficiency or if they have kidney in deficiency with uh with a lot of heat we might give them derby di huang wan or if they have um kidney and deficiency with a lot of anxiety we might give them qian wang bushindan sometimes this depends but even even though we say pills are more long term we can still see some quick results like for example one time i gave a patient she was having trouble sleeping and had a lot of night sweats and i gave her tianwang bushindon in pill form and she was able to see noticeable results within a week um couple days to a week and so i think we can still see results but sometimes uh with those pills taken long term sometimes we expect to see more gradual results and one that will want to take the herbs long term in order to make sure that those results stick so um so even with pills we do expect to see an improvement but it's not going to be like uh my symptoms are completely gone after i took the pills it's not always like that it might be more like i took the pills for a week and my symptoms are 30 percent better and then i took them for two weeks and they're 40 or 50 percent better and things like that so sometimes we expect to see some gradual improvement sometimes it depends on the on the condition um like i had a classmate who was who had really poor night vision and she wanted to take herbs for to improve her eyesight and her practitioner straight up told her you need to take these these herbs for two years and you might not see a whole lot of results in in for quite a while so sometimes it depends on the condition and then this also gets in it gets into the idea of treating the root versus the branch that sometimes treating the root like kidney in deficiency to treat the root cause can take a long time now we just kidney in we have to build up very gradually it can take a long time however if the patient is experiencing some branch symptoms if they're experiencing insomnia and night sweats we can make sure we choose a formula that has herbs that treat the branch symptoms of heat and so maybe we have some herbs that the branch symptoms can resolve a little bit more quickly and then we'll continue the treatment of building up the route so that's that's a good question this one's difficult come on button any suggestions for palpation practice while we're in quarantine that's very that's that's kind of difficult because i had i had some some people kind of complaining to me about that too that it's it's uh with the school is closed we can't learn point location in person and so they're kind of like how are we supposed to learn point location if we don't have a teacher instructing us if we don't have people to practice on so that can be really difficult and that's like i've been making point location videos but like it's hard to learn something from the video you need someone there in person correcting you and you need to practice palpating on people so that can be really difficult so i'm not sure let's see if let's see if anybody else has some good good suggestions about that because sometimes it can it can help to like practice the points some of the points you can practice on yourself and locating and palpating on yourself um but a lot of the points you can't get to so that makes it very difficult well this is interesting have you seen that many acupuncturists have similar personality types i don't know i feel like i've seen a lot of variety um i think maybe like introverted maybe is common um i always get these ads on facebook about uh somebody has uh how to build your practice if you're an introvert or the introverts method to getting patients to come in but i do know i do know some very extroverted people who are also acupuncturists um it's kind of funny i had a i have a chinese teacher he would always say um sometimes students would do weird things you know i say acupuncturists are so weird or he would say or he would phrase it this way anybody who wants to to anybody who wants to study chinese medicine must be strange by default and the the reason he was able to say that is when he studied chinese medicine it was it was during the mao regime and so at that time in china you just applied to school and you didn't get to choose your area of study you didn't get to choose your major they would just assign you uh what you were going to study and if you didn't like it you just didn't go to college so he so you know i said he wanted to be an engineer but the the chinese government made him be a be study chinese study traditional medicine so i say oh anybody who wants to study chinese medicine must be weird and so i feel like that's kind of true just because it's not it's kind of like this isn't a normal path most people would take so just that you would even be interested in especially like i think especially in the west or if you're american to be interested in doing traditional chinese medicine you're you're probably not the the normal person you know like my my brother works for a consulting firm and that's that's more that's a more traditional thing to do rather than to go study traditional medicine so that's an interesting question um but yeah i would say there are also things that uh maybe the way to say it is a lot of people who study chinese medicine are tend to be more touchy-feely people they're kind of like oh they they're very hands-on they're like oh i want to help you or things like that kind of more empathetic people and so i do feel like that is a trait that we see sorry i'm scrolling back up here to see if we have any uh any other questions what do we got i try i'll try not to go on too long this time i think the last time i went like an hour and a half i might try to keep it to an hour i'm kind of running on caffeine at this point i did a tongue diagnosis lecture for the for the philippines last night we saw that my tongue isn't very healthy look at these teeth marks i don't know if you can see it but it's i have a pretty pale tone with teeth marks i should probably uh stop eating m m's some of these are good questions but i feel like they might be difficult to answer simply what exactly is empty cold empty heat and how is it how does it connect to blood and chi um this is a really weird one and this has to do this kind of has to do with terminology when we talk about like empty cold empty heat and we talk about heat and cold um we have a couple different ways to describe it um this might be hard to do without drawing pictures um i i wouldn't necessarily relate it to qi and blood necessarily i would relate empty cold empty heat to more yin and yang and so this is kind of a weird thing i've been trying to think of a good way to explain this i had to i had to substitute for an fcm for a foundations class once and i was trying to think of a good way to explain it because this was something i was really confused about when we first started out when we talked about yin and yang he said that yin and yang are balanced so i always so when i heard that i always thought of yin and yang as being like a pie chart that if you're 80 yin that meant you were 20 young or if you had 60 percent young you had 40 yin or it's it's kind of like even if you did martial arts if you had 80 of your weight on your back foot that necessarily meant you had 20 percent of your weight on your front foot so you when i s when we say yin and yang are balanced i always assume that meant it added up to a hundred percent that's not necessarily how we think of it in uh tcm terms especially when we're talking about heat and cold instead of thinking like a pie chart sometimes it's easier to think of it as a bar graph that a person has a normal amount of yin and yang and sometimes we can have the yin becomes excess but the yang stays the same or we can have the yin becomes deficient and the yang stays the same so it doesn't necessarily add up to 100 percent they can actually move independently and so that's where we get the terms full heat and empty heat or we can say excess heat and deficiency heat i'm trying i feel like there might be oh uh repletion heat and vicuity heat those are all mean the same thing so so in terms of empty heat if we if a person has a normal amount of yin and yang and the yang increases so we have normal yin but but more yang we could call that full heat or excess heat or repletion heat whereas if a person has normal amounts of yin and yang but then the yang gets lower or maybe would say the yin gets lower we could call that deficiency heat so when we say empty heat or deficiency heat or vacuity heat that just means that there's less yin than there is then there is yang so we have a deficiency of yin but a normal amount of yang or just relatively more yang i'm not sure any of those words made sense but uh but empty heat and empty cold have to do with the yin yang balance and we just uh that's that's kind of the same it's the same thing as deficiency heat and excess heat or uh the acuity heat and repletion heat they all those all mean the same thing and when we're talking about the relative amounts of yin and yang we just have to know that they can go separately so when we say empty heat that means we have yin deficiency when we say empty cold that means we have young deficiency and the opposite of that would be full heat or excess heat or full cold or excess cold the only thing we have to be careful about is that true heat and false heat are something else so don't get those confused i'm not sure if that made any sense maybe maybe uh send me an email and i can try to send you some drawings about uh about that but sometimes it's sometimes it's just confusing because people use different terms and empty heat and deficiency heat mean the same thing so and i wouldn't necessarily think about qi and blood we can to some extent but i think more about yin and yang turned out with blood deficiency usually a person is cold with blood deficiency but we can have blood deficiency with heat so it's a little bit weird so i think more about yin and yang rather than um rather than she in blood ooh what's the next step advanced discovery in tcm in your opinion that's kind of that's not a really interesting one because it's like it's a traditional medicine it's not known for making advancements that's kind of the thing about when we compare like modern western medicine versus traditional chinese medicine uh traditional chinese medicine where we're still looking at books that were written 2 000 years ago it's like we're not we're not necessarily trying to make innovations or things like that most people are looking backwards and trying to understand the tradition and the things that came before rather than applying uh trying to come up with something new so western medicine is about finding cutting edge newest stuff uh newest breakthrough whereas tcm is more about uh honoring past traditions so that's that's kind of an interesting thing i think um i don't know maybe has to do with how we can apply uh how we can apply the medicine to uh more modern conditions because like some of these conditions we haven't really seen before um uh because or like some of the things that when we talk about the huang ding jing or the shanghai loon it's like people don't live like that anymore that we might have to adapt it to people living in air-conditioned houses and things like that and so that might that might be the kind of thing is how do we adapt this to something modern while still keeping the traditions do you prescribe qigong to your patience uh i try that's one of those things where sometimes i try and sometimes it's very difficult um sometimes because sometimes it's uh we can just turn this into a general question general discussion of it can be really good to give your patients homework that a lot of you have to have this discussion with them that they can't just come in once a week and get needles and expect some magical results that it's good for them to get them on board at least a little bit to help them with their sort of healing journey so sometimes you get very difficult patients that they have they have these problems and they come in for acupuncture and you do a good treatment but then they go home and drink two liters of mountain dew and smoke cigarettes and don't exercise and eat cheetos and and things like that and so sometimes you have to get them on board as well um so i think giving patients homework is a very good thing uh sometimes they can be very simple things so if we're talking about like dietary changes getting patient compliance with dietary changes it's very difficult so sometimes you can start out with small things trying to make small changes a lot of times it's in terms of diet it's easier to make additions rather than subtractions so instead of saying stop eating so many peanut m ms you can say make sure you have a green vegetable at least once a day or something like that sometimes it's either it's easier for them to add in broccoli than it is for them to remove ice cream so small homework things like that um with musculoskeletal things uh i think that um i basically after a treatment sometimes i like to explain what's going on and i have some some flip books that have very good pictures of the muscles and things like that so sometimes i'll try to educate the patient on oh you have sciatica here we can look at this chart that's you have this piriformis muscle that's going from uh going from the greater trochanter to the sacrum this muscle is tight and it's pinching on that sciatic nerve so we did some needling in that area but something you can do at home is you can stretch stretch that piriformis muscle and that can give you some relief and then sometimes i'll demonstrate it but a lot of times i'll just say uh look there's you know type this in in google or look up this youtube video and so sometimes the stuff like qigong that's um that's what i do is i found a couple of good videos about qigong and i if i want them to do qigong i'll say here's a video go go look at this youtube video or if i want them to do like they need to stretch and do yoga you can find some youtube videos that's like 10 minute yoga or 15 minute yoga so if they're not really they don't have a lot of time or they're they're not really willing to commit a lot you can find some things for that so sometimes with my patient homework i just say go i'll give them a sticky note and say go google this or google the stretch or go look up anterior scalene stretch and that'll help out your neck stuff like that but yeah ideally we should but just sometimes it's difficult to do that just because patient compliance is a real issue there that ideally everybody should be eating healthy and sleeping at night and doing qigong or tai chi and things like that but just we get into patient compliance problems with that this is a good question i'm trying to think if i have a good answer for this taking into account the different schools of thought because we have different schools we have different schools um uh the the you have the earth school or the i don't know if you call the p loon school but the the the book the guy wrote was the p loon the treatise on the spleen and stomach and so he believed that uh everything came from the middle jowl that you need proper digestion in order for in order to nourish the organs so we should focus all our attention on the middle jaw other people will say no that gets the kidneys that are the root of all yin and yang so we should focus our attention on the kidneys and we have like the fire school where it's like everything is fire and if a person has if a person is cold give them futsa if a person is hot give them futsa i don't quite get that one um so we do have these different schools of thought and uh i think somebody asked this question before talking about uh how do we follow the shanghan loon versus the wen bing we have one school that's the cold damage school and one school that's the warm disease school which should we just pick one and follow that is one more right than the other uh how do we do that and kind of the fun thing about um i think this is chinese medicine but this might also just be chinese philosophy and chinese thought is in that way of thinking they're very accepting of contradictory positions that is you can have two things maybe they're completely opposite but in like especially in tcm you can have two things that are opposite and they can both be true at the same time and that's that's sort of contradictory to our aristotle logical rational way of thinking but it's it's it's completely appropriate that they can they can draw from different schools or that two different two opposing ideas can be true at the same time so sometimes it's kind of like you you use it you use whatever you can when it's useful so if you have symptoms that look like cold damage go to the shanghain loon if you have a disease that looks more like uh heat damage then you can go to the when bing and then there might be certain times where going to the earth school and tonifying earth is appropriate there might be other times where going to the going to the kidneys and tonifying the root is appropriate there's a purgative school i'm not sure if anybody does the purgative school anymore we don't we don't prescribe a lot of medics or purgative we don't necessarily purge everything out so but it is it is completely reasonable that we can just draw from different schools and we don't have to necessarily choose one over the other and then sometimes when we have it we have a particular formula if if it comes from if it's a li dong yuan formula for it comes from a particular school then we can try to understand the construction of that formula uh in the context of that school and then but then if we have a different formula from a different school we can kind of understand it in that and kind of look at different masters had different styles too and different preferences and so we can kind of look at that as well and we can kind of understand that as to why did they choose these herbs it could just be that that was that had to do with their preference or their school of thought what's your suggestion for board exam preparation a lot of people ask me that i'm not a good person to ask that question um because i'll be honest i people ask me about studying for boards i actually didn't study very well for boards um especially california bor california boards it's like i was expecting to move i didn't think i was going to stay in california so i'd already signed up for the test so i was like i'll just take it and see what happens and i passed by one point so i barely made it um when should you start preparing i think ideally this this is kind of a weird thing when i see people studying for boards as well and i don't mean to sound like really stuck up or snooty about it but um sometimes i feel like people they graduate and they start studying for boards and they have this idea it's it's kind of like okay i have boards coming up i need to learn everything now and they're like oh i have there's there's so much i have to cram for everything now and it's it's all it's almost they treat it like they're looking at it for the first time and i'm kind of like i went to school for four years what have you what have you been doing for the last four years so it's kind of like hopefully you're doing this along the way throughout school and so when you get your boards that's you you should have a grasp on it and you should just be sort of reviewing stuff hopefully you're not trying to you know memorize 150 different formulas hopefully you've been you've been doing that work throughout the throughout the years of school so um i i think that's the thing that's why i um i didn't have as much trouble with boards because when i was in school i was a full-time student i didn't do anything else i didn't have a job i didn't have a life i went to school and i went to the gym and i read books about chinese medicine and so it's kind of like i was constantly reviewing leading up to that so that's that's i feel like ideally you should be you should be focusing while you're in school and then then you just kind of have to run through it when you get to studying but i know that isn't necessarily possible for everybody um yeah using young herbs for all conditions yeah this is something like i don't want to say mean things about other people but like like i feel like i have known people from the fire school and i've known people that would go those practitioners and it's like they just gave they gave me high dosages of futsa for everything and it was always it was always really confusing to me that they'd be like oh you're cold let's give you a futsa to warm up your middle it's like oh you're hot well that means your yang is floating to the exterior we need to give you futsa to root it back down and i had some people who didn't necessarily get good results with that so that's that's kind of an interesting school of thought and so it's probably just i don't know enough about it that i need to research it more to make sure it's um it's being due done appropriately um best acupuncture points for fertility this is this is one where remember when we're giving a treatment we need to look at pattern diagnosis so if we're having uh fertility problems we want to look at what's the underlying pattern and then choose points that are uh treating that pattern um so this is something that we can um we have books on gynecology and um obs ups that sector whatever the ob stands for obstetrics we have books about that and so sometimes they break down the various different patterns a really common one is blood deficiency but could be spleen qi deficiency could be dampness and phlegm things like that there could be a lot of different things so it kind of depends on what kind of underlying pattern you're seeing and with a lot of my patients and i um with a lot of my patients i use herbs and i've had a lot of colleagues that do do the same thing that when it comes to fertility they prefer to use herbs they might use herbs in conjunction with acupuncture but a lot of times when we're dealing with fertility they'll say herbs aren't optional you have to take herbs so that's another thing to think about as well and usually with fertility we well a lot of our questions are going to have to do with the period and regulating the period so we'll want to know is there a has a period been regular or has it been delayed is it um heavy bleeding or very scanty menses things like that and sometimes we'll say we want to first focus on regulating the period and we want a couple good periods before we expect to get some results but definitely this is one where we're treating the pattern we do we do have some extra points like um the gong shui and stuff like that but generally so we can add those in as extra points but we generally want to treat the pattern let's see if there's anything else maybe we'll just do one more i said i was going to keep it to an hour and we're over an hour so maybe we'll just see if we can find one more oh sorry thomas says i don't think you see any of my questions sorry i have i have trouble like like i'm staring at the screen because i have trouble reading the thing so if i don't see your questions go ahead and leave them in the comments below and i'll get to them next time so and so and some of these are good some of these are good questions too but i i feel like i'd have trouble explaining them very simply um here master tongue points i don't know a whole lot about master tongue points and i feel like that's a that's a separate specialty and so a lot of people it's like they go through and they learn the regular points and then afterwards they go through and do a course on master tongues points so i actually don't have a lot of experience with those i know some people use them and really like them uh i'll be honest when i got done with school i was kind of like we just learned 400 points i don't really feel like learning anymore so i was kind of like i'm just going to work with with what i got yeah some of some of these are specific oh here's that window of sky point a question i was looking for here we can do this real quick because this is this is something i i think i kind of talked about on the last one that was i think somebody asked about how i got into acupuncture and i told the story about um i was in math and engineering and then i was doing a lot of yoga and i went to india um so yeah so it's uh i started out in math just because in school i was just very good at math i actually really liked math too and that's kind of weird that i feel like a lot of people think that's weird a lot of people don't like math and i actually really enjoyed it i remember like in high school sometimes we'd have these extra credit problems and i would go home and i'd be really really excited about working on these working on these math problems and trying to solve it and so i really like the logic and the puzzle aspect of it and then i went to school for computer engineering and uh doing computer programming and and i was i liked it and i was really good at it um and it was the same sort of thing where we we get these homework problems where we had to um uh write code yeah we were using java i don't think we were using c plus plus we would write things in java and we we got assignments and sometimes the assignments would come out on friday afternoon and like me and one of my friends friday night instead of going out we would sit there and work on our machine problems for a computer science class so it's like i really like the puzzle aspect and the logic and the reasoning of it and i was really good at it um the problem was i just it's like this is going to sound really mean part of the problem was like i saw other engineers or other computer scientists and i like had this like fear of going down that path i could just see myself sitting in a cubicle every day for the next 40 years drinking mountain dew i guess i still drink a lot of mountain dew so that hasn't changed but this this idea of just like sitting in a cubicle in front of a computer just uh really turned me off so i didn't i just didn't like that uh so i thought oh i want to do something else and i got out of that and then it just so happened that i kind of fell into uh tcm when i went to india doing yoga so um they just had a um when i went to india they had a free clinic there and some americans were volunteering there so i hung out with some other acupuncturists and i got really into it and it seemed really excited um this is embarrassing to admit but it probably has something to do with me like being into star wars that that mystical stuff kind of appealed to me from because i was really into star wars so that probably uh was a contributing factor as well but i just wanted to do qigong and become a jedi knight so um here let me scroll back down to the bottom i said we were going to do one more we'll say this is the this is the last one so julio you're getting the last question and then we'll call it a day because it's friday evening here i think in the philippines it's probably saturday morning so you can start your weekend and i'll start my friday evening and i can go watch the the new episode of the mandalorian so here here's our last one what if we diagnose a patient having multiple pattern disharmonies how can we determine as to what disharmony needs to be treated first or treated simultaneously so this is this is a really good one and this this um it's going to kind of depend on the situation um and so we kind of have to see so one thing we can say that sometimes we can have disharmonies leading into each other and sometimes we can have very opposite things going on so as i was going to say like sometimes when you look at like eight principal diagnosis sometimes we can have two things that are opposite and that can be very difficult we call that a complex situation that a person has heat and cold at the same time they might have heat on the exterior and cold on the interior or they might have an exterior attack of cold but they have heat constraining in the interior but it's like they're cold and hot at the same time or you have a person that it's the they have an exterior condition and an interior condition at the same time they have an exterior pathogen with interior deficiency or they have um excess and deficiency at the same time and so sometimes we have all of these opposites and you're like which what do i do how do i treat these two opposites if a person is both hot and cold can i give them both hot and cold herbs and it's kind of like yes you can sometimes that's going to be about we can have two opposites and we just have to direct the opposites to the to the correct part of the body and so we have certain formula construction and herbs that we can do that and we can kind of do that with acupuncture as well but sometimes it's like you can have one disharmony that leads to another disharmony that leads to another disharmony and things like that and sometimes it can be very difficult and some because sometimes it goes into it goes into a circle uh where just you don't know what came first and you sometimes you get these patients where it's like oh this person has spleen qi deficiency with liver chi stagnation with underlying kidney young deficiency because and then the kidney young's not warming the spleen but then because the spleen is deficient there's not enough blood going to the heart so they have heart things and then because the heart's not circulating the blood you have these other problems and sometimes you have like five different things going on at once um generally i would say sometimes we can see the path sometimes like sometimes it's very common that people have a spleen qi deficiency with liver chi stagnation so we have liver over acting on spleen and sometimes you can by doing your diagnosis you can tell which one is more predominant is it that the spleen is angry and it's attacking the spleen and that's causing the sling to be weak or is it that the the spleen is very uh is very tired and very lazy and because the spleen is weak that's allowing the liver to overact so we can kind of say which sometimes we can kind of determine which one came first and we can tell from the history which one came first and then maybe we'll treat whichever one came first so if a person was like oh i was really i got fired from my job and i was really stressed and angry and i was uh very irritable and then after that i started developing digestion problems well then we can say oh it was liver cheese stagnation came first and then spleen qi deficiency came second so let's treat the liver cheese stagnation and so we can kind of tell from the history sometimes there's just so much going on we can't tell where it started and so sometimes it's maybe the easiest way to start is just pick one thing and work on that and a lot of times when you when you work on one thing the other disharmonies will resolve automatically and so this is my same chinese teacher had a story where he said say you have a ball of string a ball and it's very nodded with a ball of string whereas like say you have a net i feel like one time he told me the story and it was a ball of string another time he told me a story and it was a net like a fishing nut so say you have a fishing net it's very tangled and it's very knotted you have so many knots you don't even know where to start what do you do well the way to do it is you start with the biggest knots go to the biggest thread and find the biggest knot and untangle the biggest knot first when you untangle that big knot sometimes some of the smaller threads will become untangled automatically as a consequence and so that's something if you have all of these uh symptoms that you have like oh i have spleen cheat deficiency with liver cheese stagnation with kidney young deficiency with heart blood deficiency blah blah blah sometimes if you try to treat all of those things your treatment just becomes too muddied and nothing happens so if you said just pick one and say you know what i'm going to focus on the spleen and i'm going to focus on tonifying the spleen well once you tonify the spleen well once the spleen is full the liver is no longer allowed to overact so the liver calms down and once you tonify the spleen the spleen is able to will be able to create blood to nourish the heart so now the heart has calmed down and once you once you taunt to find the spleen you're getting good nourishment from the food and that will tonify kidney yang so it could be that by just by picking the spleen you you're helping everything and sometimes it doesn't you can just pick one and whatever seems the biggest maybe instead you go for the kidney you say i'm going to tonify the kidney and by tonifying the kidney that's the root of all yin and yang when i tonify the kidney yang the kidney yang warms the spleen and so once i tonify the kidney the spleen is going to be able to function because it's getting warmth from that uh that ministerial fire and now the spleen can function and all these other things can happen so i'd say um pick one uh go for the biggest knot and try to untangle that and then some some of the smaller threads will be untangled automatically um so let's just leave it there for now it's we're getting a little bit late let's just leave it there for now we'll we'll do this again next week i think maybe next week we'll talk specifically about herbs but if you have questions that i didn't get to um i'll look in the i'll look in the chat but if you have questions that you want to answer next time go ahead and leave them in the comments and we can get to those next time i'll have to see what time we're doing it next week i'll um i'll put something up on facebook i'm not entirely sure what my schedule is next week so it might be in the morning it might be in the afternoon or we might have to move it to saturday but i'll um i'll send out an email or put something on facebook about when we're doing it next week and we might try to do specifically some herbal stuff because i had some people contact me that they have herbs finals coming up or a year and herbs exams coming up so let's just leave it there um i'll say have a good weekend and uh we'll see you next time you

Channel: Nicholas Duchnowski

Views: 950

Rating: 5 out of 5

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Id: c-8OjjiwGlQ

Length: 81min 25sec (4885 seconds)

Published: Sat Nov 14 2020