Dr. Ayla Wolf  00:00

In this episode, I interview my dear friend and colleague, Dr Clayton Shiu. Dr Shiu has a PhD from the Tianjin University of traditional Chinese medicine, and did his residency at the distinguished first teaching hospital of Tianjin. He specializes in brain injuries, stroke and neurological disorders in his clinics located in Manhattan and the East Hamptons. In our conversation, we discuss his integration of ancient therapies with modern technology such as quantitative EEG in order to track patients progress and healing. Thanks so much for listening and enjoy the episode,

 

Dr. Clayton Shiu  00:39

because just seeing like a person's brain awaken, which in and where I lived in was training in China, we would call that awakening the Shen, right? Or freeing the Shen that's been buried, we can say. And oftentimes I've heard neurologists say that that part of the nervous system was asleep and that now it's waking up. And it's a beautiful thing that when we met, and maybe I was coining that, because that's what I learned in Tianjin, but it made perfect sense to you, right.

 

Sophia Bouwens  01:19

Welcome to the life after impact podcast, where we do a deep dive into all things concussion and brain injury related. We talk about all the different symptoms that can follow brain injury, different testing methods, different types of specialists out there, and different therapies available. I'm Sophia Bowens. I'm here with Dr Ayla Wolf, and we will be your guide to living your best life after impact.

 

Dr. Ayla Wolf  01:51

All right, welcome to Life After Impact, the concussion recovery podcast, and today, I am interviewing Dr Clayton Shiu, who is a licensed acupuncturist practicing in Manhattan and East Hamptons, and Doctor Shiu and I met back in 2016 or 2017 at a neuroscience conference and found we had a lot in common and teamed up and have been Teaching different continuing education courses. And Dr Shiu has a amazing specialty in brain injuries involving both stroke as well as traumatic brain injuries and concussions. He gets referrals from many doctors and clinics all over New York City, and so I'm very excited to welcome you to the podcast and have you share more about your expertise and a lot of the unique techniques and technology that you are implementing in your clinic.

 

Dr. Clayton Shiu  02:48

Thank you, Dr Wolf, can I call you Ayla?

 

Dr. Ayla Wolf  02:51

You can call me Ayla, yes,

 

Dr. Clayton Shiu  02:55

yeah. Thank you for having me on the show. Congratulations. First off, on launching your podcast, and it's amazing, like just out of the gate growth. I'm really proud of you and all your accomplishments. I get to, get to be your, your wingman at some of these events and special accomplishments that you, you just keep doing and stuff.

 

Dr. Ayla Wolf  03:20

Well, it's it's been wonderful being a guest Doctor at your clinic and getting a chance to work side by side you and your clinics, both your clinics.

 

Dr. Clayton Shiu  03:30

Yeah, thank you. And that's where it's a blessing to have you come and share your expertise. We really have patients asking for you or, you know, like always, like inquiring about when you're going to return. So it's been a great collaboration there. So, but yeah, so I'm happy to be on your new podcast, and even, like seeing that you're going to be your new book is going to be coming out soon too. Is that correct?

 

Dr. Ayla Wolf  03:58

It is. I had a great meeting with my publisher just last week, and they have a lot on their end to do, and then I will be kind of going through another round of editing, but it shouldn't take quite as long. So we are getting close to the finish line.

 

Dr. Clayton Shiu  04:12

I think that your book will be a great contribution and providing a lot of light into a very gray and, you know, mysterious path that everyone starts out on from a traumatic brain injury. So bravo to you there.

 

Dr. Ayla Wolf  04:28

Thank you so much. I do hope that the book accomplishes those, those tasks that's that's definitely the goal of it is to try to cut through a lot of the confusion on what people do or don't need, and what kind of tests are out there and giving people because you don't know what you don't know. And so some people, if they don't even recognize that they haven't been properly assessed, then they don't even realize that there are tests that are out there that haven't been done yet, and that there might be insights that still need. To be gleaned from specific exams, and so that's what I'm trying to highlight, is to make sure people can read that book and say, have, have I had all the right testing done, or is there more research that needs to happen to figure out what's driving my symptoms that aren't aren't getting better on their own?

 

Dr. Clayton Shiu  05:17

Exactly. I mean, this is a funny example, but I had a patient who was probably in their late 50s, early 60s, and maybe, maybe definitely, had some osteoarthritis or arthritis in their hips, you know. And it had some past injuries, but they were scheduled to have, like a hip replacement, you know. And they came in and I was treating them for their hip and everything. But then I noticed a couple times in the process, as we were going into the pre treatments, that they definitely had some very strange eye movements, you know, as we were talking or just sitting down. So I ran through the battery of tests that you taught me, and I was like, Wait a second, I think this person has been suffering from long term concussion issues and symptoms, so when we treated that, her movement and her gait, like, improved greatly, significantly, and basically, she didn't need the hip replacement. You know, that's amazing. Yeah, it's like, Do you know what I mean, and so it's funny, because you have to be really sharp and sensitive to see something so random, right? But then to connect the dots and say, Okay, now let's check your neck and head, and let's go back into like, you know your history a little bit more before you get that hip replacement operation. Because let's, let's make sure this is what we're dealing with, you know, right?

 

Dr. Ayla Wolf  06:48

And I think a lot of people don't put concussions down on their intake forms as injuries as it doesn't occur to them, right, that if they had had a concussion five years ago, 10 years ago to even put that on a medical intake form. And then you start asking people about their history of head trauma. And have you ever fallen off a bicycle, been in a car accident, had a skiing accident, and all of a sudden, you elicit from somebody a pretty lengthy history of potential head traumas that they had forgotten about or didn't think were relevant to why they were coming in in the first place?

 

Dr. Clayton Shiu  07:24

Yeah, exactly. And, you know, sometimes it's, it's maybe because the patient may have a fear that, you know, well, you think there's psychologically something wrong with me, and we're like, No, we're not even talking about, like, we're just saying, if you're having some cognitive, you know, deficits there that we're checking into.

 

Dr. Ayla Wolf  07:41

I had a fascinating conversation with my dear friend, Alicia, who's a massage therapist that I work with, and she was commenting on the fact that, you know, she sees people you know, you oftentimes, once a month, you know, for years, for, you know, general wellness and maintenance and overall health, and made the comment that it's really obvious when somebody develops a very mild cognitive decline or cognitive impairment, because she sees how difficult it is for them to flip over on the table. And this is, you know, something that someone's been doing time and time again. And it's like the procedure is you flip over, and then you move down about a foot so that your head's not hanging off the table. And this is something that this person has been doing time and time again, and then all of a sudden, one day, she says, Okay, time to flip over. And all of a sudden, it's like this big production, and they're not moving as well, and they don't know where their body is in space. And all of a sudden they're laying on the table crooked, and they don't know where their head is, and it's hanging, you know, it's hanging off the table, and they forget to scoot down and and so, because she spent so much time with these people, those things are very important. And it's like that, that art of observation is so huge. And I think, you know, if you think about somebody who's being seen for an hour once a month, every month, that's very different from just having a quick little 15 minute annual appointment with your doctor as like, your annual wellness checkup or whatever, you know, like they're, if they spend 15 minutes with you and they don't even see you moving around, they're going to miss Those things like you can't. You can't pick that up in a 15 minute appointment.

 

Dr. Clayton Shiu  09:25

Yeah, exactly. You won't pick that up just from watching someone walk back and forth. And it takes so much coordination and core strength and then rotation, like you said.

 

Dr. Ayla Wolf  09:38

I mean, it's like that thing where, you know, they say that one of the tests for longevity is, can you get up off the floor without using your hands? And I think another great test would to be, how well can you roll over on a treatment table? So why don't we start with your background, and can you share with our audience how you. Kind of got, got into working with strokes and then traumatic brain injuries and concussions. And I know you spent a good deal of time in China at a hospital that specializes in these things, and picked up a lot of techniques and insights.

 

Dr. Clayton Shiu  10:15

Yeah. So originally I was, I was actually in more of the orthopedic sports medicine field. When I just got out of school in the acupuncture profession, this is probably in the early 2000s and I was, I was relatively, I would say, successful in that I was already treating some different, assisting to treat some different professional athletes in the in the Major League Baseball, the NBA, some mixed martial artists, and I would even get flown to certain NBA playoff games with to treat some different players. And that was fun. That was really, really exciting. Actually felt pretty solid, pretty good. Very, very excited about that whole field, which has grown into an amazing specialty within our profession, you know, tuning like MSK or orthopedic injuries. But one of the things that always caught my attention was whenever somebody or a patient or a friend or relative, like if they got a stroke or traumatic brain injury, and then I always felt like I was caught flat footed. And whatever things I would try never felt comfortable, you know. And I really knew, in my own personal wheelhouse, being supposedly this very established acupuncturist, I just knew that man, there's, there's a couple gray missing pieces there, and that really bothered me. And, and the more I looked at it like, and I'm, I'm very good at looking at trends and patterns and stuff, so I, the more I looked at it, I was like, I think it's getting worse. Like, I think, I think strokes back in 2000 you know, actually 2011 or 12, at the time when this, this idea of me pursuing stroke therapy or the brain was around then, and I was seeing that it was getting worse. Basically.

 

Dr. Ayla Wolf  12:15

you mean that, you mean that more, more strokes were happening. It was becoming more frequent.

 

Dr. Clayton Shiu  12:20

Yeah, it was like, this growing epidemic, and not just stroke, but pull the curtain back more. And I saw that, okay, Parkinson's is on the rise, Alzheimer's. And I was like, why is this happening, and why is it so out of control? And my conclusion is, in all three or four disorders where you're talking about stroke or Parkinson's, Alzheimer's or concussion. You know, you're dealing with the same organ, which is the brain, right? But the etiology changes. So I was always trying different things. I know there's something, there's, there's a technique or a system called scalp acupuncture, which I'm not, it's just not in my wheelhouse or affinity towards,

 

Dr. Ayla Wolf  13:06

and you're referring to, I think that system came about in the 1970s if I'm correct. So it's been around since the 70s, but it's also kind of based on 1970s neuroscience as well, and we've learned a whole lot more since then.

 

Dr. Clayton Shiu  13:22

Exactly and because I was a neuroanatomy geek, even at when I went to Boston University doing my undergrad, like that was my favorite course, versus even gross anatomy and other things like so. So as I was finishing the Chinese medicine studies and stuff, and had the neuroanatomy I like training in my head from the 90s. But then when I when I did see the scalp acupuncture principles, it was based on more of like a one to one functional relationship of the body, which which has its contribution to neuroscience too. It's just that, as we got into more and more research and technology, got better at analyzing nerves, the tissue, the brain, the brain waves, right? How we even generate like energy in a nerve, or what's the brain actually feeding on, and all that stuff. We noticed that, like, the brain isn't just one section of the brain controls one part of the body. Each area of the brain is like a hub, kind of like JFK airport or lax, okay, yeah. So you've got, like, a lot of different tissues running through this intersection, and you can manipulate it in many different ways, you know, which circulates us back to doing like, you know, exercises like the greats right the limb or or even using distal points. It makes distal point. Makes sense, you know, right?

 

Dr. Ayla Wolf  15:01

And so if you shut down JFK Airport, it doesn't just affect JFK Airport, it affects every single connecting flight out of JFK Yes,

 

Dr. Clayton Shiu  15:10

exactly, yeah. And then if you, if you did shut down JFK airport, you would have, you would see an increase at LaGuardia Airport and Newark Airport, and so they would take on the flights and fly the people congested at JFK airport. And this is called neuroplasticity, yeah, translated through airport transportation.

 

Dr. Ayla Wolf  15:36

And actually, you know, you bring up a really good point in that sense, because there was some relatively recent research talking about how, when you get a concussion, certain jobs that the frontal lobe is supposed to perform, if the frontal lobe is, you know, basically not working as well because of the concussion, the parietal lobe tries to take over some of Those functions. But in doing that, you basically have, you know, decreased activity in the frontal lobe and perhaps some hyperactivity in other parts of the parietal lobe, which then might also translate into somebody developing, like, motion sensitivity, because now there's, you know, a part of their brain that's trying to do a job it's not really designed to do. And so it's like, then you have all these downstream consequences of that. And so it is extremely complicated. And, you know, going back to that idea of, like, the 1970s scalp acupuncture, you look at, kind of like doing acupuncture points over the cerebellum. You know, they were talking about it for, say, you know, issues with ataxia or gait problems, but now we know the cerebellum also plays a huge role in coordinating our thoughts as well, and there's this huge cognitive component to the cerebellum. And so, yeah, I think the beauty of what you do now is that you you're appreciating the modern day understanding of how the brain works, and how it's all these different hubs that are all integrated. And then you can start to play around with, Okay, well, what happens when we increase activity over here? Do we see positive downstream consequences over there? And I think that's where acupuncture is huge. And I also one of the things that I think is really unique to you is your power of observation of the actual human body, and your ability to actually see patterns in the human body and in your courses you talk about, you know, the shape of the neck being very significant, and the shape of The skull being significant, and even looking at somebody's back and how their scapulas are positioned, and how much you know kind of inflammation you're seeing between the shoulder blades. And so what I really appreciate about what you teach is that your power of observation is not just even in neurological exams, it's also in palpation skills, and in just physically looking at a person's neck and saying this, there's something wrong here in terms of, like, where they're holding tension, or where this is sunken in, or and I think that that's, like, really beautiful. And I see that as kind of this real specialty of yours that you've you've developed, like, on your own, like, that's, that's yours.

 

Dr. Clayton Shiu  18:26

Thank you. That's extremely kind, especially coming from you, because I respect everything you've taught me, too, and I think, yeah, I my, my approach in life is, is not to discard things that works, even if it becomes, like, a little bit obsolete in the current modern times, it has its place when the situation is right, you know. So meaning, like, like, the Walkman didn't stop being made because it couldn't play music, you know.

 

Dr. Ayla Wolf  18:58

So are you saying that it even though we have all of these incredibly modern forms of technology, which you also utilize in your clinic, you're you recognize the power and the significance of basic human observation, of simply looking at somebody and saying, I'm seeing a pattern here with all of My patients that come in with X, Y and Z, and that that pattern in their skull or their neck or their back is significant and important and should be paid attention to.

 

Dr. Clayton Shiu  19:32

Yes, exactly, so, so meaning, like, Oh yeah, it's like, this is where I was going with this analogy. Sorry, you know me I can get,

 

Dr. Ayla Wolf  19:41

I'm bringing, I'm trying to circle you back.

 

Dr. Clayton Shiu  19:44

So let's say we have like a super advanced imaging machine, you know, like an ultrasound or or like, sonogram device, or something, right? Or a seven tesla MRI, right? Or a seven tesla MRI, and then. And and it works great, and it gives us these images, right? But what happens later is like sometimes that doctor or specialist, they kind of stop touching the patient, and they stop using their senses in their hands, because I got this mega, million dollar machine that can that can tell me everything in the inside seven inches inside the body, when I should have picked up something right on the surface. That would have saved a lot of tests and got us right there, you know, immediately. So, so that's what I mean by like that, that palpation or observation still has significance. And yeah, I think what I've done to circle us back to your your observation of me is I have categorized the normal shapes of things like the neck, the scapulas, the tone of the trapezius, the shape of the skull, and also the degree of palpation, what I'm feeling as I push gently onto like different surfaces, much in the same way we use like pulse diagnosis, which, as we know, with just three fingers touching one section of the wrist, there's 24 plus qualities, right? So you can imagine, then, if you take your three fingers on each side and push it through and follow the path of the skull back to like the occipital ridge, right? Like how many different qualities of things you could possibly notice with during the session when you're diagnosing or assessing, like a mysterious brain disorder or traumatic brain injury case. And what I did was, I don't know if it was instinct, but even when I was just doing sports medicine and regular wellness acupuncture, I would just write it, write down what I was observing on post its you know, so I and been doing that for since my first year of acupuncture practice. So I was just, I would just notice, like, Man, I'm drawing the same picture on this post it, and I keep observing the same bumps that would come up, maybe behind the ear. So for instance, like when we palpate, even behind the helix of the ear. In my practice, there's like 10 things you could observe, and it can tell you the quality of the person's hearing. It could explain to you if they're having tinnitus, if they have a toothache, if they have blurry vision, if they, you know, are just having, like, a hard work week, all that stuff can be done just with that past.

 

Dr. Ayla Wolf  22:45

I think one of, one of the kind of patterns that you pointed out to me, that has, I have seen time and time again, is, you know, when I'm palpating the back of somebody's skull, normally, you should have a nice kind of sloping transition from the occipital bone into the neck. And for people that have cerebellar diseases, it's like, instead of this nice little gradual slope, you just you hit a cliff. And it's like, Wait, this does not feel right. Like this is not normal. And so it's like, I think that's something that really clued me into, like, this is important, and this is significant. And then like to say, can we make a change here? That's what I love. Is that you you're utilizing the timeless skill of palpation, and then you're also pairing it with very high tech things like your quantitative EEG readings and your super fancy RegenPod.

 

Dr. Clayton Shiu  23:47

yeah, I know you that was those are great, amazing modern devices that we have at our Shiu clinics, and we're very fortunate to have them. Part of the reason why I got them was when I started to work with you, and we would go to these amazing neurosymposium events. And my favorite place about all those kind of events are the vendors.

 

Dr. Ayla Wolf  24:12

The toy room!

 

Dr. Clayton Shiu  24:15

Where's Dr Shiu. He's like, probably in some kind of laser device getting zapped right now.

 

Dr. Ayla Wolf  24:22

Well, talk a little bit because I know you just changed your QEEG from one service to another, so you've got a new QEEG and tell me a little bit about maybe some of the patterns in brain wave activity that you see with people who have persistent post concussion symptoms and kind of how you're utilizing that as a before and after means to track people's progress with their their brain healing.

 

Dr. Clayton Shiu  24:51

Sure, as I was getting into skull palpation and observing different patterns, which I was pretty sure. That we were correctly observing, and then we would actually come up and create different acupuncture protocols to treat those different inflammation bumps that we were to to make sure that I knew that what I saw was real or what I thought was significant, was like not deceiving myself. That's why I got into getting modern equipment and things like the QEEG with the quantitative electroencephalogram brain scan, or things that would kind of quantify what I was doing, you know. So the one reason why we wanted to get a QEEG that was one of the first real significant modern pieces of equipment that we got for the office way in the beginning was because if, if our points that we were using were actually working and improving the person's cognitive functions, then we should be able to see a change In a brain wave scan, right? Because it's objective, yeah, and it's live, you know? And the machines that are created today are so sophisticated, the one we used that we first got, you could put the device on and see a live image of the brain as it's firing on the screen, you know. And we could put points in, like spleen six, PC six, and see the brain lighting up differently, you know, awesome, yeah. And so that's so every time we we got some some nice minor equipment to debunk ourselves, we kind of instead justified, nope. That's the right point. Meaning, if you put this point in, you're going to have a higher probability of affecting the brain than you could even realize. I love using modern equipment, actually, to confirm Chinese medicine to to almost one like confirm it, and two further explore it, you know, using our tools.

 

Dr. Ayla Wolf  27:08

Yeah, I think there's a whole untapped world of research that should be looking at QEEG and acupunctures effects on brainwave activity. And you know that modulating what's happening in different parts of the brain. Like you said, even based on different points, have that concept of like acupuncture point specificity. One point is not doing the exact same thing as another point.

 

Dr. Clayton Shiu  27:32

Yeah exactly. And if you have the time and the equipment and the right patients, you can definitely flush that out. It's great. So we got a recently, we acquired a new QEEG machine. It's called a WAVI, and that's specifically a QEEG machine that's focused on concussions and for concussion patients. And I like it because it's very objective. When you scan anyone with a QEEG helmet or headset, there's usually at least 19 electrodes which are dispersed around the helmet to cover the head and the different lobes, and not only do they measure the electricity or voltage that that area of your brain is outputting. But they also can observe how one hub talks to another of the other 19, and you can see those relationships. Those are called coherences. So you can see the coherent relationships of the electrodes or or the lack of coherence. The interesting thing with the wavi is that it gives you this more patient like, almost like a CBC blood result like it gives you a nice itemized list of different data it's collected, and part of it is also the total, absolute number of voltage that your brain can generate during the test and it rates it for you. So, so what I like about.