edmund6334

Updated appointment types

Some of you may have noticed a change in the types of acupuncture appointments available for online booking. The new types are:

Acupuncture (single sided, 35 min)

Acupuncture (double sided, 55 min)

These replace the older descriptions of initial vs express, which were frankly not very informative.

One reason for this change is to make highlight the difference in time commitment for the two types of treatment. Understanding this on the way in to an appointment is important for a patient in terms of scheduling, and also understanding the impacts of being late to an appointment. (e.g. If you are 15 minutes late to a treatment that takes 55 minutes, I may not be able to treat everything you hoped for that day. The appointment slots are all an hour long, and I can’t in good conscience make the next person wait because you had a bad time in traffic.)

Let’s be honest here. Inflation is bad, and this change is also meant to set up a framework which I may use in the future to charge more for the double treatment. For the time being, I will continue to charge $50 for either a single or double sided treatment, but if prices at the grocery store continue to rise, I may have to raise the price of the more complex treatment. I will give at least three months notice of any price change with another post on this website, and will endeavor to notify any patients returning after a long hiatus of any changes in price prior to their appointment.

To make things more affordable to new patients, I am going to offer a new incentive. New patient treatments are normally $80, while follow up treatments are $50.

It really does save a lot of time if a new patient fills out forms and signs waivers in advance. These treatments wind up taking very little additional time, so if a patient completes their forms (no blank forms), I will waive the $30 premium for a new patient treatment, and charge that new patient only $50 for a single or double sided acupuncture treatment.

Thanks for understanding, and please feel free to contact me if the changes here cause any confusion.

Updated missed/late appointment policy

Effective January 1, 2026, I will be implementing a new policy for missed appointments.

If you become ill, please call or text the clinic at 713-487-9921 and I will be happy to cancel or reschedule your appointment without penalty.

For cases not involving illness, a $20 fee will be charged for:

Missed appointments
Late cancellations (less than 24 hours notice)
Late rescheduling (less than 24 hours notice)
Late arrival resulting in too little time to do a treatment

At least 45 minutes are needed for a double-sided treatment, and 35 minutes are needed for single-sided treatment.

Thanks for understanding that your being punctual and informing me of schedule changes well in advance allows me to see other patients in the time slot that you are unable to use.

Scams targeting acupuncturists (and other small businesspeople)

It’s tough sometimes being in a business that requires having to do marketing, because it renders you a target for all kinds of spam calls and scams. I’m writing out a description of a scam which several people have tried on me over the years, with variations. Partly my goal is to warn other people like me that these things may happen. Another part of me is hoping that future scammers who come across my website will be less likely to bother me, because I am never going to send them any money. I have a long standing policy of boycotting anyone who cold-calls me.

The way this one starts is with an e-mail:

Hello, my name is Emily ***. I’d like to schedule appointments for my daughters. Could you please let me know your available dates and times? Thank you!

Best regards,

Emily

Plausible, so I respond:

Thanks for writing, Emily,

I see patients from 10 AM to 4 PM Monday through Friday. The easiest way to see my schedule is to look at my website at http://www.kao-acupuncture.com . You can book online through the website, or you can e-mail, text or call me. (713-487-9921)

This week, I have quite a bit of availability, I think because people are trying to get in a last bit of travel before school starts again.

Please let me know if you have any questions or need further assistance.

– Edmund Kao, L.Ac.

Next e-mail:

Thank you for getting back to me. I thought about calling to discuss this, but I want you to know that I’m currently in a private medical center, recovering from lung cancer. Unfortunately, I can’t make any calls right now since I’m on full bed rest. I’d appreciate it if we could communicate here. I’d like to schedule sessions for my five daughters, who are currently on vacation, as a surprise gift for their return. Since I want to keep it a surprise, I’m making the arrangements on their behalf. They do not have insurance, and I will be covering the cost of their sessions.

I would really appreciate your help in booking these appointments, as I’m not very tech-savvy. I’d like the sessions to begin on August 27th or 28th, preferably at 11 AM. Please let me know if those dates and times are available. My daughters are between the ages of 18 and 26.

Additionally, kindly provide me with the total cost for ten sessions (two sessions per daughter)

I look forward to your response.

Implausible, so it’s likely a scam. Why? She has made an excuse for not being willing to speak on the phone. She promising a large amount of business. She wants to gift acupuncture as a surprise. She has five daughters, which may be an attempt to appeal to masculine weaknesses. Also, her daughters are traveling on vacation for a month, while their mother is recovering from cancer?

I’m willing to play a little longer because it’s not obvious what the catch is yet. A previous encounter with a scammer ended when he 1) refused to speak on the phone or delegate speaking on the phone to another capable party and 2) suggested that I pay a driver $1000 up front (because the driver refuses to take credit cards) to get all of the clients to my clinic, at which point they would pay me back by credit card. (Joke’s on him. For $1000 extra, I will do a house call. And take a credit card.) My next response:

Scheduling should be no problem.

I don’t take insurance, so it would be payment up front (mail me a check, Venmo, PayPal, or Zelle) or at the time of treatment (cash, check, credit card). Initial treatments are $80, and followups are $50, so the total would be $650.

Perhaps the best way to do this would be to set up a phone call. I understand that you may have difficulty talking on the phone, but perhaps you could arrange for one of the nurses or other staff at your clinic to call me, and then he or she can act as an intermediary. He or she could be in your room at a time when you feel up to communicating, and we can discuss on speaker phone or video chat while you are there to listen and indicate approval or disapproval.

The other option to consider is that for an additional travel charge, I would be willing to make a house call to do all five treatments in a row. That way, they would not be all stuck in the waiting room for so long. If you would like this option, I would need your address, so I can determine the travel charge for the house call. As a baseline, I would charge xxx for up to a 30 minute drive from my clinic, which is near I-610 North Loop and Ella Blvd. Longer distances would naturally cost more.

Next e-mail from scammer:

Hi Edmund,

Thank you so much for the detailed message and for offering flexible options — I truly appreciate that.

The $650 total for the initial treatments sounds good. I’d prefer to pay by check, so please let me know the name to make it payable to and the mailing address.

While I truly appreciate your offer to do a house call, I’d prefer to have the sessions held at your clinic. If possible, I’d love to schedule all five treatments back-to-back to make coordination easier.

Here are the details for each person:

C*** *** – Born on April xx, 2006 (18 years old)

E*** *** – Born on September xx, 2004 (20 years old)

M** *** – Born on November xx, 2002 (22 years old)

K*** *** – Born on February xx, 1998 (26 years old)

C*** *** – Born on January xx, 2000 (24 years old)

Thanks again for your time and thoughtful care — I’m looking forward to getting this scheduled.

Best regards,

Truly implausible, but with several nice touches. The names (including the name of the writer) are all so generic that it would be impossible to look up any of them. Some of the older daughters have different last names, implying marriage. No new identifying information has been given – no other form of contact besides e-mail, which can be easily faked from some other country where US financial laws will not allow me to get any money back.

The FCC has a very nice website offering information on a variety of scams, including fake check fraud. (https://consumer.ftc.gov/articles/how-spot-avoid-report-fake-check-scams)

In general, the approach is to send me a check (possibly stolen from an unsuspecting US tourist while overseas). I deposit the check, and my bank makes the funds available within 2-3 days. Then, the bank starts checking to see if the check is fraudulent, which can take several weeks. This seems backwards, but the law is such that the banks have to take this kind of risk, otherwise, the banking system would be paralyzed by funds being held in limbo for long periods. During that time, the scammer says she needs a refund, but now, suddenly, she’s much more tech savvy and willing to take payment in the form of a Venmo, Zelle, wire transfer, ACH transfer or cryptocurrency. The idea is to get me to send her money via a reliable platform. They run with the money, and I am out $650 as soon as the bank figures out it’s a bad check several weeks later.

My final response, designed to end the interaction:

Please make the check out to:

Edmund Kao, L.Ac.

1415 N Loop W

Ste 300-23

Houston, TX 77008

I have blocked off a set of five appointments starting at 11 AM on August 27.

I will also need a cell phone number for at least the first one of your daughters who will arrive that day. I find this is essential because my clinic is in a building that is kind of complicated, and patients often get lost when arriving for a first visit. I frequently have to call them to direct them the last few turns to the clinic.

Since this process for scheduling and payment is a bit irregular, I also feel that it is wise to ask for certain safeguards to protect against the possibility of check fraud. Since it may take several weeks for my bank to detect if a check is fraudulent, I will be unable to process any refund for at least 90 days after I deposit it, or use the funds you are sending for anything other than in-person acupuncture treatment at my clinic, at the time already specified. This way, my only risk is a lost day of work.

I hope you understand me being cautious.

Additionally, if the check does not arrive within 10 days of the treatment date, I will have to cancel your appointments and allow my existing patients to schedule during that time.

Please let me know if you think these terms are acceptable, and if so, feel free to send payment when you are ready.

No further e-mail from scammer. If she had sent a check, I might have looked up the person with the phone number and address listed on the check. I could call or write a letter to that person “verifying receipt of a check for $650 for acupuncture treatment.” This would have been a polite way to continue the process of making sure that I’m not blocking off a large chunk of my schedule for no reason, which is the only form of financial risk to me. It would also be a way of notifying the real person (from whom the checks were stolen) that their identity is still being used for fraudulent purposes.

It’s really a pity that such people are out there. They wouldn’t be doing it unless it was successful and they ripped off some poor person at least some of the time. However, it’s also important to remember that the person typing the e-mail may be a victim themselves. Human trafficking of fluent English speakers does happen, in which that person is basically held prisoner and forced to write e-mails like this to make money for much, much worse people – actual evil people. And that is the part that makes me saddest about this kind of thing. I really hope that person is able to get out someday and get back to living their own life.

How to work out in different stages of life

Usually, I do pretty well at this, but I made a few major mistakes this year. I thought it might be a good idea to post my theory of how to exercise, partly as a reminder to myself while I am in my healing phase from a complex injury.

When you are young, up to about the age of 25, your body heals very quickly, but not necessarily completely. What this means, is that it’s possible to work out at 100% of your maximum ability, and you can do it regularly because it feels fine. Worked out til it really hurts? Well, in two days you will feel good again, and you can do it again, even harder. However, if you work out this way, you have a tendency to accumulate small injuries which will plague you later in life. I see plenty of former athletes who are now 35 or 40 years old, and don’t understand why they are incapacitated with pain. Often those micro-injuries are so old, they don’t even remember how they injured themselves. Fortunately, a lot of those injuries are manageable with acupuncture and stretching (that’s how I did it), but especially if you were very athletic when you were young, you have to be careful when you are in your next phase of life. I do try to warn young athletes about the importance of preventing these kinds of injuries (rest, stretch), but I’ve only ever seen one young person take it to heart. The others don’t believe me. They think that they will not end up like the 40 year olds they see who have debilitating, chronic sports injuries. (Which is exactly what those 40 year olds thought 20 years ago.)

I’m 50 years old. The right way to work out now is to figure out what 100% is, but only work out regularly at 70-80%. Working out at a lower level will cause you to gradually improve, i.e., every few weeks you might find that 100% is more than it used to be. You can test yourself once every few weeks, but if you push it more than that, you have a real risk of injury. If you get injured, you need to cut your workouts down by half, or more – down to a level which does not cause pain. (You may have to stop altogether) You need to operate at this level for at least two months to heal. Injury is counterproductive, because while you are out, you get really out of shape. Ignoring injury leads to worse injuries. Increases in the intensity of a workout should happen a few percent at a time (initially, the smallest increase you can measure). You can repeat a given workout three times or so within about a week. If you can tolerate the new level of working out with no discomfort for that whole week, then you can do another small increase. Tiny increases in your workout are unlikely to injure you, but you can compound the improvement over time, like money earning interest at the bank. Even a few percent a week can result in doubling your ability in a year. (I wish I could find bank that paid a few percent interest per week…)

I do see some patients who are 80 years of age or older and still active. At that age, I recommend working out regularly at about a 50% level. At a 50% workout level, you can maintain what you have, and maybe gain a tiny bit more. However, I suggest never intentionally testing yourself at 100%, because there will come an age where doing that is almost guaranteed to cause a serious, long term injury. You don’t have to fear being incapable in old age if you really take good care of yourself, but you can’t go around trying to prove that you’re still great. If you are smart about it, you can keep yourself fit enough to live a full life (shop, cook, clean, enjoy family and travel). You know at the back of your mind that you have a little bit athleticism saved up for emergencies, BUT using that power is going to leave you badly injured for months. Imagine a situation where you are 90 years old and you see a little kid in the street who’s about to be run down by a car. You could decide to use your one bit of strength to save that child, and if you’ve been taking care of yourself, you might succeed. You might decide that being badly hurt for a long time would be a worthwhile price to pay. Keeping that ability to late age is a long term goal of mine.

So my philosophy of working out through life is that in the beginning, enthusiastic young athletes usually cannot be talked out of causing themselves chronic sports injuries. Middle age athletes can reverse a lot of the damage they did when they were young, but they have to be careful and patient about healing to preserve their bodies, even if it means progressing at a slower, more gradual pace. Elderly athletes who do this right will be able to preserve a certain amount of awesomeness, which should be very carefully rationed. The positive part of it is that you never have to feel helpless. You just understand that there are consequences to overdoing it.

Here’s a few examples of me doing it wrong:

Horse stance:

A few months ago, I wanted to do some extra leg training to get in shape for a kung fu seminar that I was going to attend. I knew it would involve getting up off the ground repeatedly, which is a surprisingly difficult workout for your legs. I started doing a low horse stance, which is basically just a very broad squat with the tops of the thighs level with the ground. This was fine for 10 seconds. The right way to do it would be to hold it 10 seconds each day for a week, then if that felt okay, try 11 seconds each day. Do that for a year, and you’re holding the stance for a minute, with little to no risk of injury, provided you do the right stretching before and after to keep the muscles happy. However, I was on a schedule, so I decided to try doing 10 seconds, then 20 seconds the next week. I made it up to a minute, which would have been enough to survive the seminar, and then hurt myself. Why? Because I was not increasing a few percent at a time – I was going much too fast and irritating a muscle in my hip, the piriformis. While doing a rock climbing movement that was not particularly strenuous, I had a major spasm in my piriformis muscle, which required some immediate acupressure, and several rounds of follow-up acupuncture. I made it through the kung fu seminar, barely. If I had stuck with doing horse stance for 10-15 seconds, on schedule, I would have been in better shape. Mark calendar for two months, so I know when I can start training this muscle again. No difficult stances until then.

Jogging:

About six months ago, I got an Apple watch. Mainly, I was interested in the pulse monitoring and electrocardiography functions, to be on the lookout for possible future heart conditions. Conditions like atrial fibrillation and atherosclerosis run in my family. They are the reason why I am quite paranoid about keeping thin and fit. So long as my weight and fitness levels are good, my blood pressure, cholesterol, blood sugar and other metabolic measures are fine, and my risk of those heart conditions is relatively low. However, the Apple watch told me that my VO2max levels were a little bit below average. (Insert pause to represent me looking up what the heck a VO2max is. Apple watch results are probably not super accurate on this measure of cardiovascular fitness, but could be useful if watching general trends) I decided that I should start jogging a little bit. Using the pulse monitoring of the Apple watch, I very carefully worked my way up to doing one jog each week (in the middle of a regular daily walk), which ultimately came up to a 0.6 mile jog with three 100 meter interval sprints on the way back. Things felt fine and I was rewarded with a VO2max measurement that increased from 36 to 40. (Above average, yay!) The trouble came when I injured my piriformis. The injury did not impact my walking or running, so I thought I could keep doing it. Then after a month, my innately competitive nature was triggered by a sudden decrease in the VO2max level to 39. (What happened? Meaningful or not? Maybe run more? Do I need to do something about this?) So I stupidly started doing the jogging and running twice each week. The right way to do it would be to do one jog per week, and then add 5% of a jog on a different day. Instead of increasing a few percent, I did a sudden jump of 100%. It didn’t take long before the piriformis started to hurt, along with my Achilles’ tendon on the same leg. I presume that the pirifomis injury changed my gait enough to put extra stress on my calf and Achilles’ tendon. So much for running. Reset calendar for another two months off, now watching the entire left leg. Total injury time: now three and a half months.

Zone 2 walking:

So I heard about this thing called cardio training zones. Very interesting. There are five zones, of which the second lowest one is interesting. Apparently, if you train in Zone 2, which means a level where you can still breathe reasonably well (able to hold a conversation with effort), you can improve your cardio fitness, reduce your risk of a lot of health problems and burn fat calories rather than carbohydrates or proteins. This is very appealing to a competitive person such as myself, especially since I am at this point unable to run for exercise. I found that, for me, Zone 2 was walking at a pace of about 14-15 minutes per mile rather than my usual 16-20 minute mile. Well, I thought since I can’t run for two months, maybe I can get some benefit for my cardio by increasing all of my daily walks to this pace. Wrong. If my average pace before was 18 minutes, dropping to 15 minutes is a 16% increase, which is more than a few percent. After two weeks, I noticed that my Achille’s tendon and piriformis were getting gradually worse after walking, not better. So now I am back to walking at a 20 minute pace. Reset calendar for two months, again. Total injury time: four months. The good news is that walking at a 20 minute pace seems to make both injuries feel better. My VO2max is just going to have to go down for a while.

In conclusion:

So the problem is that three times in a row, I got excited about working out and ramped up my workouts faster than I should. Once my final two months of taking it easy and healing (with lots of stretching and acupuncture) are up, my plan for working out is going to be this: Continue walking at a 20 minute pace, but add 100 meters of faster walking at a 15 minute pace in the middle. (I could try to see if I can figure out how to walk at exactly a 19 minute pace, but I think pacing myself with that level of precision would be hard without a treadmill. On the other hand, a 20 minute pace and a 15 minute pace are obviously different.) If this is fine for a week, then I will add another segment of 100 m walking at the faster pace. Repeat for about 20 weeks until I am walking fast for the entire 1.2 mile portion of the walk (which is on the nice portion of sidewalk which does not have vehicle crossings). Next, add in 100 m of jogging at a slow, 11 minute mile pace. And repeat adding things very slowly.

So the question is, how far do I go? In three years, if I am careful, I don’t doubt that I could be running 1.2 miles at an 8 minute pace. But do I need to? I’ll be thinking about that. I have to be careful to not get overexcited by any medical results (from Apple watch or other source), which might cause me to go fast and have another setback. I do believe that someone my age can still be awesome. I should point out that my martial arts and rock climbing continue to go well, and improve, despite the injuries, because I tend to be very careful with those workouts. So I do have it figured out in certain areas, but I also need to make sure I apply my advice to every part of my life.

Summary:

Going fast and getting hurt = going slow (or backwards)

Slow and steady is the way to go.

How to walk up and down stairs more safely

Every one of us has at one point fallen up or down the stairs. If you had this experience as a young child, you might have been fortunate enough to escape with just a lot of crying. However, adults tend to land harder, and the consequences can be much more severe, especially as we age and our bones become less resilient.

I have always been amazed when I watch people walk up and down stairs, because many of us only put a part of our foot on each step. This habit is dangerous, because it increases our risk of missing a step and falling off it entirely.We can learn to walk more safely, by putting our entire foot (as much as possible) on each step.

Metabolic syndrome in Asians

A few years ago, I started having trouble with high blood pressure and cholesterol. The good cholesterol was low, the bad cholesterol was bad, and the triglycerides were going up. My blood sugar was also a little bit worryingly high. At the time, my doctor said I was doing everything right; diet, exercise and weight (I was obviously skinny – by American standards), and that my metabolism going all wrong was “just genetics.” He said that at some point soon, I would have to start taking medication to control it. Because my father has the same sort of problems, I figured that he was right.

That sort of statement – “Just genetics” is a tough thing to hear, because it suggests that there’s nothing you can do about it. However, a few months later, I happened to read a scientific article [1] that said that some Asians start having trouble with their metabolism with a Body Mass Index (BMI) as low as 22. At the time, my BMI was exactly 22, and it got me thinking. What would happen if I lost a few pounds? I recalled an uncle who suddenly lost 20 pounds after being hospitalized for a stroke, and among other surprises, his diabetes went away. Was that just a fluke, or could it be a clue to something that might work for me?

I decided to lose three pounds to see what would happen. I chose the number three because my weight varies about that much over the course of a given day. I would normally weigh about 147 lbs in the morning, and about 150 lbs at the end of the day before going to bed. If I lowered those limits to 144 lbs in the morning, and 147 lbs at night, then it would be about the smallest measurable weight loss I could accomplish, but it would put my BMI at 21.7.

It took about a month to lose the weight, and I was pretty unhappy about it the whole time. I held the same weight range for the rest of the year, and then I went and got all of the same tests done at my next annual checkup. While there was no meaningful change in my blood sugar, the blood pressure and cholesterol were all great. They were as good as they had ever been when I was younger and ridiculously athletic.

I had thought that maybe it was age. Maybe it was not being physically able to tolerate the amount of cardiovascular exercise I used to do. Then there’s the genetics. But losing a little weight was a relatively simple, non-pharmaceutical and not-so-stressful way of achieving the same healthy blood pressure and cholesterol levels.

Subsequently, I decided to lose an additional 3 lbs. That’s just because it’s too easy to gain 3 lbs over the course of a vacation, and I wanted a little bit of wiggle room before having to worry about my blood pressure and cholesterol.

I suspect it would work well for the blood sugar if I were willing to put the weight loss in combination with a low carbohydrate diet, but as an Asian, I really like my rice and noodles. It’s also possible that an even lower weight threshold might take care of the blood sugar. It may be in the cards for me in the near future, and I will update if I decide to go low-carb or lose another three pounds.

I think the take home lesson is that if you are an Asian experiencing any sort of metabolic control problem, such as cholesterol, blood pressure or high blood sugar, one of the first things you should consider is getting your BMI under 22. It seems that some of us might be genetically wired to be healthy at a lower weight than comparable non-Asians. Also, it’s possible that 22 might not be a magic number, as more recent research suggests that Asians can get in trouble at an even lower BMI [2].

Maybe my doctor was right about it being genetics. However, maybe it’s genetics and there’s still something you can do about it.

Shoulder and neck pain? Check these muscles

For many patients who are experiencing chronic shoulder pain at the top of the shoulders, leading into the neck, there are three main sets of muscles that are likely to be tense. These muscles tend to be tight as a result of stress or poor posture (frequently due to poor ergonomics when working at a computer). Learning to stretch these muscles and to periodically check they are in a healthy position, especially when working under stressful conditions, can be very helpful in minimizing this type of shoulder and neck pain. An acupuncture treatment can help relax these muscles to alleviate much of the pain, but learning good posture is critical for preventing the problem from recurring.

The first and most obvious muscle is the upper portion of the trapezius, which extends from the base of the skull to the outer edge of the shoulder. Flexing this muscle causes the outer portion of the shoulder to rise. Second is the levator scapula, which extends from the upper vertebrae of the neck down to the inside top corner of the shoulder blade. Flexing this muscle causes the inside part of the shoulder blade to rise. The third set of muscles are the scalene muscles, which connect the neck bones to the upper ribs, and assist in respiration by lifting the ribs a little bit. Most people don’t have a lot of conscious control of the scalene muscles.

If all three of these muscle groups are tight, then your entire shoulder is elevated (which makes your neck look shorter than it really is, and makes your shoulders look square), and it may be a little bit hard to take a deep breath. If all of these muscles are chronically tight and knotted, severe neck and shoulder pain are not far behind. Unfortunately, stretching these muscles to alleviate the tension and pain is difficult. If you attempt to stretch the muscles on one shoulder by tilting your head, it’s difficult to avoid aggravating tension in the same muscles on the opposite side.

Now consider the Venus de Milo. Like many ancient Greek statues, her neck appears very long and elegant. This posture comes from elevating the head while lowering the shoulders. To get into this position, the woman who modeled for the sculptor must have had relaxed muscles throughout her upper shoulders and neck, and we can presume that at least at that point in her life, she didn’t have any pain in that part of her body.

The stretch I recommend is to imitate the appearance of the Venus de Milo’s neck in several steps.

Hold a light weight such as a one pint water bottle or small barbell in each hand, and let your arms hang at your sides
Elevate your head up as high as you can
Allow the weight of the water bottle to pull your shoulders down.

Hold this position for perhaps 30 seconds, until the neck appears longer (indicating that the levator scapula and scalene muscles are elongating) and until the shoulders angle downward on the outside (indicating that the trapezius muscle is elongating).

I would suggest doing this stretch preventatively if you have a profession that requires a lot of sitting at a computer desk, or if you have any sort of job which requires holding your arms up for prolonged periods, e.g. driving.

One other hint is to be careful of the types of bags you hang on your shoulders. If you carry a satchel or purse on one side, using a single strap on that same-side shoulder, you may be unconsciously elevating your shoulder to prevent the bag from sliding off. People who have shoulder and neck pain should avoid using this kind of bag. Instead, use a double strap backpack (which can also help you do the Venus de Milo stretch), or use a courier type strap which extends over the neck to the opposite shoulder, switching sides periodically to avoid lopsidedness.

Eating more fresh fruit to lose weight

I would guess that the typical American isn’t getting enough fruit in his or her diet, and this is a big contributor to the obesity epidemic in our country.

Current dietary guidelines recommend that at adult get about two cups of fruit per day (on a 2000 Calorie diet). Most fruits also have a low glycemic index, which makes them a good healthy food choice for diabetics, even though fruits do contain sugar. This is because they also tend to be high in fiber, which helps slow absorption of sugar and moderates how fast blood sugar rises. (Also, fiber is good for you and the fruits are loaded with vitamins.)

So what exactly does two cups of fruit mean? A typical medium-sized apple or orange is about one cup of fruit. Are you eating an entire apple and orange every day? I do on some days, and it feels like a lot.

One of the most important qualities of fruits is that they have a very low calorie density. What this means is that for the amount of calories (or sugar) that is in a piece of fruit, it tends to take up a large amount of space in your stomach. Since fruit is also high in fiber, it tends to stay in your stomach for a long time, because your stomach has to grind it up before it can pass on to your intestines. This means that fruit can be used as an important substitute for unhealthy foods. You eat the fruit, and it makes you feel full. That keeps you from eating too much of something regrettable.

Recommended approach: Substitute some of your usual food with fruit

Here’s how this might work. Suppose I normally eat two slices of pizza at dinner and follow it up with two scoops of ice cream. What I could do is instead eat one apple before dinner, and then limit myself to one slice of pizza and one scoop of ice cream (if I still have room for it). By making a substitution like this, I can reduce my calorie intake by almost half, and still feel full after dinner.

I would say that any trick which can help you cut your calorie intake by half, but not result in you feeling hungry, could be the difference between losing weight and gaining weight very quickly.

To maintain my weight at my typical level of exercise, I need to have about one quarter of my food to be fruit. If I’m trying to lose a few pounds, I need to increase my fruit intake to about half of my diet. If I get lazy and stop eating fruit for a few days, I start to gain weight.

One important suggestion is that eating slower can really help increase the impact of this technique. If you eat the fruit and then follow it with the “healthy” portion of your meal, you should consider waiting a little while before you think about dessert. A delay of maybe only 20 minutes can allow your brain to catch up to your stomach, so you realize how full you are, and you can eat less dessert or skip it altogether.

The “Crazy” approach: Add a weight cap

People have been asking me how I’m still skinny at the age of 43, even though many of the elders in my family are struggling with their weight. (In other words, me being skinny is not genetic.) Because I’ve seen loved ones struck down by diseases that are compounded by poor diet, high blood sugar and obesity, I am kind of crazy serious when it comes to not gaining weight.

I have a hard upper limit on my weight. I don’t recommend this approach to everyone, because it requires kung fu discipline (which basically means you consistently do something difficult despite suffering, because it’s important).

I weigh myself several times each day. If my weight is over 148 pounds (chosen because it’s a safe BMI for Asians to avoid diabetes), then I stop eating. After that point, I am only allowed water or fruit. If I am craving protein, I may allow myself an ounce or so of pecans or other nuts. The fruit contains very few calories. The water contains no calories, and if I eat nuts, it’s not very much of them. The fruit makes me feel full, and the nuts add a level of satisfaction. I suffer a little bit, but barring a major metabolic problem like liver or thyroid disease, it’s more or less impossible for me to gain weight with this approach.

Given that I’m eating fruit for the remainder of the day, and only consuming fluids, the extra weight that is keeping me over 148 pounds is always gone the next morning, digested away and excreted as urine. (I normally start the day at about 146 pounds.)

Obviously, I don’t do this on special occasions, like holidays or vacations. If I’m out on a dinner date, I can’t run home and weigh myself before dinner, so I just eat like a normal person. However, on your typical week, I am restricting myself on about six of the seven days of the week. Do I feel deprived sometimes? Yes, I do. But I also don’t worry about diabetes, which to me is worth it.

Herb tincture

One of the more interesting ways of taking an herb in Chinese medicine is the topical tincture. Herbs are soaked in liquor for a period of several months. The liquid is filtered and applied to the skin for a variety of conditions. The advantage of applying a medicine topically to an affected area is that compared to drinking an herbal concoction, there is less risk of adverse systemic affects, such as allergies or interactions with other medicines. This particular mixture is modified from a traditional formula used by martial artists to help them recover from the constant injuries they suffered as a result of their strenuous physical conditioning.

How to weigh yourself

One of the biggest health problems that people face in this country is weight loss. To be able to control your weight, the first thing you must be able to do is measure it correctly, and the vast majority of people don’t. This leaves them unable to tell what effect their lifestyle changes are having on their weight, and leaves them often mystified as to what is going on with their weight. From the point of view of a former engineer, I would say there are two major problems with the way that people tend to weigh themselves. First, they don’t do it often enough. Second, they don’t consider how variable a person’s weight is during the course of the day.

One of the main things that prevents people from weighing themselves is that they don’t want to see the number on the scale. Of course, it is frustrating to see the numbers on the scale stubbornly refuse to budge, or worse, go the wrong way, despite all of the hard work you are putting in to diet and exercise. However, the more you can weigh yourself, the better you will be able to understand what’s going on.

Let’s consider the speedometer of your car. Imagine if your speedometer had to calculate speed the old fashioned way by timing out a minute and seeing how far you got in that time. If your car only told you the speed every 60 seconds, you would get pulled over for speeding all of the time. Accelerating from a stop sign to the speed limit takes less than 60 seconds. If you hold down the accelerator too long or too hard, you could be easily 10 mph over the speed limit and not realize it. That’s why our speedometers are designed to give us continuous feedback about the speed of the car, so you can keep an eye on the needle and not wind up going 35 mph in a 20 mph school zone.

Suppose you only weigh yourself once per week. In the same way that a car could go from zero to 60 mph or 70, or 80 mph in a minute without you realizing it, you can gain or lose several pounds during a week. That means you could get in trouble while you are between weight measurements, and as we all know, it’s way easier to put weight on than it is to take it off. Similar to a speeding ticket, it’s a costly mistake to make. This is why it’s important to measure more often than your weight tends to change. I would say for most people, they should consider weighing themselves once or twice a day, if their weight has a tendency to go out of control. That way if you see that you’re suddenly eating way too much during the course of a day, you can consider whether you really need to have that bedtime snack.

The second problem is the variability of a typical person’s body weight. I’ve seen people celebrate or mourn a change one pound on the scale reading, but consider how fast my weight changed yesterday at different times, and under different conditions.

	Weight (lbs)	Change (lbs)
Before breakfast	146.6
After breakfast	148.0	+1.4
With clothes	148.8	+0.8
After workout	148.6	-0.2
Walk and lunch	148.8	+0.2
Bathroom and shower	147.0	-1.8
Before dinner	146.8	+0.2
After dinner	148.4	+1.6
After workout	146.8	-1.6
Bedtime snack	148.2	+1.4
Next morning	146.8	-1.4

As you can see, a meal can be as much as 1.6 pounds (cereal and milk with fruit for breakfast, or a noodle or rice soup for dinner or bedtime snack), but it can also be as little as 0.2 pounds (a spinach salad and some bread for lunch). Similarly, a mild workout during which I was able to properly hydrate results in a drop of 0.2 pounds, but a more intense workout during which I didn’t drink enough water causes me to drop 1.6 pounds. (That’s why I had a noodle soup before bed – partially to rehydrate.)

The presence or absence of clothing can result in significant changes to your weight measurement. If I’m wearing sweat pants and a T-shirt, it causes my weight to change by 0.8 pounds, and it’s possible for heavier clothing to affect the reading even more. Blue jeans, for example are very heavy. One pair of my blue jeans weighs 1.8 pounds.

So how do you tell if you’re gaining or losing weight?

I would recommend that the typical person watching their weight should weigh themselves twice each day.

First, every morning on rising, most people go to the bathroom. I would suggest immediately after doing so, but before eating breakfast, you should measure your weight with no (or almost no) clothing on. This measurement tells you if you are gaining or losing weight, because it will be the most stable measurement from day to day. You should watch for trends in this measurement. I.e., is this week’s average morning weight different from last week’s?

Second, I would suggest weighing yourself prior to the last meal of every day. If you find that you weight has skyrocketed over the course of the day, it’s a sign that you may have eaten too much that day, and you should seriously consider how much to eat for the rest of the day.