Tuesday, January 10, 2017

An interesting treatment

A question:  if you are a five element acupuncturist and a patient comes to you with the following medical history, how would you start your treatment, particularly if the timescale is very short?  My patient was only in this country for a further week, was then flying to France for two more weeks, followed by another stay of a few weeks in London before finally returning to her home country at the other end of the world, with no five element acupuncturist within living distance.  

Here first is my patient’s medical history, which she has given me permission to write about.  She is a 70 year old woman, who had breast cancer 20 years ago, and had her left breast removed.  She refused to have chemo- or radiotherapy at the time, but has done other kinds of more natural treatments which she feels have helped her.  She developed cancer of the uterus and stomach about 10 years ago, had a full hysterectomy and was given 6 months to live.

Her most severe current problem is a blocked artery under the left arm.  She has been told that she is now at very high risk of a stroke. Her left arm swells up badly very frequently.  She also has very severe constipation, vertigo and panic attacks.

What do we do if we only have such a short time in which to treat?  We all learnt as students that we should gradually build up our patients’ energy by slow and steady treatment on what we have diagnosed as the guardian element.  That means an average of about 6 – 10 weekly treatments to start with.  This gives us time not only to get to know the patient but to assess whether the element we have chosen to treat is effecting the required level of change which confirms our diagnosis.  Should we then accept to help a patient when we have only a much reduced timescale to work with?

This is a dilemma which many of us have to learn to face, particularly in such a frenzied world where our patients are often away on business flying from country to country.  There will be many other reasons, too, why patients are unable to grant themselves the luxury of having the regular treatments needed.  So what do we do?  The simplest thing for me might have been to say I could not help  the patient because there was not enough time to treat her properly.  Experience has however taught me how effective a simple AE drain can be, even if there is little time to do much more.  Often I have found a surprising improvement in pulse qualities after removing the AE needles, even when I have found no AE. I see this as the elements giving a sigh of relief at being addressed, as though they know that help is on its way.

This was true for this particular patient, too.  She had no AE, somewhat surprisingly I felt after all the major surgical procedures she had undergone, but her pulses changed quite dramatically.  From feeling very uneven and jerky to me, they stabilized themselves before I did any other treatment.

If there is nobody apart from us who can offer the five element treatment which a patient asks us for, and that patient is in great need of help, as my patient is, then I think we have to tell ourselves that surely some treatment, however little, is better than none.  We have to be brave enough, as well, to adapt our treatment protocols which we learnt as students, and do whatever we think it is safe to do in the little time granted to us.  In other words, we have to take some short-cuts, something that is only advisable in these kind of cases.  This has to be done on the understanding that we must not be lulled into introducing similar short-cuts into our everyday practice, a temptation we might feel because we may think that we can speed up treatment in this way.  All of us in the world today, patients and practitioners alike, are always in a hurry and like to cut corners unless we take care not to.

Treatment given:
I am listing the following treatments with the above strict proviso.  These are the two treatments I was able to give my patient before she left London yesterday (all points with moxibustion and all tonified, except, of course, the AE needles).  She did not want me to needle her on her left arm, so all points on the arm were only needled on the right side.
Based on meeting her socially on a few occasions before she came for treatment, my diagnosis was that she was Outer Fire (Heart Protector and Three Heater).
Treatment 1:  Checked for IDs.  No treatment for this needed
                      Checked for AE:  None          
                      IV (Ki) 24  (I would not normally do this point at the first treatment, but she had gone through so much over the years, that I thought she needed this kind of spiritual resurrection which the point offers)
VI (TH) 4, V (HP) 7:  Source points, with moxa. (We were told by JR Worsley that we could use moxa on these points only after 2 years in practice. He said that novice acupuncturists have a tendency to leave the moxa burning for too long on the cones, which is dangerous over an artery)

Treatment 2:  Patient told me that she had felt very good indeed on the day of the treatment, and had had a surprising amount of energy the next day.

No blocks found (no H/W, no E/E blocks)
III (Bl) 38 (43): A point which reaches every cell in the body
III (Bl) 22, 14 (Normally we would wait a little longer to needle the AEPs (back shu points), and simply do III 38 at this treatment)  
VI (TH) 3 (tonification point)

* Patient suddenly said that she was experiencing one of her panic
attacks, and had to rush off to open her bowels. I talked gently to her to calm her down, and asked what she felt she was most frightened of.  She said that it was fearing that her partner might die before she did.  She had witnessed the death of a close member of the family at first-hand a few years earlier, and could not forget the trauma of this. 

I then needled I (Ht) 7 as a first-aid point, to help calm the Heart.  She recovered quickly and was happy for me to continue treatment.  I finished by needling the remaining tonification point on the Heart Protector:

V (HP) 9

She looked very peaceful as she left, and phoned me the next day before going to the airport.  She had slept for a full 10 hours after the treatment, and felt totally refreshed.

Treatment 3 will be in a few weeks’ time.  My suggestions to myself for the next treatment are:

Checking for blocks (of course!)
CV 8 or 14 (CV 14 addresses greater deficiency of the spirit than does CV 8.  Which point I choose will depend on how she is when I see her next)
VI (TH) 6, V (HP) 8 (horary points at horary time), or if that time is not possible, then:
VI (TH) 10, V (HP) 7.  I always remember JR saying that VI 10 Heavenly Well is a “much under-used point”, which is why I like to use it.  And which Fire person would not like to take a dip in a Heavenly Well? 

I think this sequence of two treatments is a good example of my dictum:  “The simpler the better”.  Just because somebody has been very ill, and even now is not out of danger does not mean that we should forget the basic rule of our practice, which is to do as little as possible, and give the elements the chance to do their work without too much interference from us.

(With apologies for the formatting errors in this blog.  My computer seems to have developed a mind of its own, and I don't want to waste any more time trying to correct things.)





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