WORKING PACU: WHAT IT REALY MEANS

Our Post Anesthesia Care Unit has 3 Stages: Pre-Surg.; Post Surg.Phase I; Post Surg. Phade II. Phase I patient come back from surgery to be managed before returning to inpatient care.  Phase II  are in step-down for discharge in 6 to 8 hours. Our mission was described as managing both groups for Pain and Nausea, using optional acupuncture as a means to be able to influence the reduction of the strength, dosing frequency and duration of pain medication following surgery.

Prety straight forward. We had worked out protocols over the last 7 years downstairs in the Pain Management Clinic. Treating Head, Neck, Back, Shoulder, Hip, Knee Ankle & Abdomnal Pain. Resuliing from the trauma of GSW's, Stabbing, Beating, Burning, MVA's and Surgery. Down there we used needles. Up here in PACU we mostly use Ear Seeds (quick and non-invasive). Three weeks in we are seeing significant VAS Pain Reduction.

Here's what else we are treating with Ear Seed Stimulation:  Low Blood Pressure, Low Respiration Rate, Slow Return to Conssiousness, Depression, Hysteria. Plus Pain and Nausea. And my last case of the week was Pre-Surg. Treating to prevent nausea following surgery. I will know tomorrow how that worked. That's what Acupuncture can mean in PACU.  Lower dose pain meds less frequently. Et.al. Bingo.

fy

TAKING ACUPUNCTURE TO JAIL....FINALLY!

He was young, big, burly, and Hispanic (you expected something different?) Legs shackled, wrists manacled ( so tight he couldn't pick his nose if he had too). He had busted his arm up breaking someone elses jaw. Resulting in a plate and screws in his right forearm. And an opportunity to get stuck with needles for the pain, limited movement, and loss of strength. Bottom line is that for both of us, this is worth the possibility of turning one less junkie out on the street.

First needle was Gall Bladder 34, opposite leg. He whimpered a tad. Second was the Zhu Scalp Point above the left eyebrow, and back a few inches. Call it distraction. Or whatever. But the point is that in addition to less forearme pain, where the hardware was installed, he had more mobiity, instantlly, and increased finger strength. Call me "pisher", as my second ex-wife would say. But back to Juan. And his 2 burly guards, heavily laden with restraining, maiming and killing tools of their profession.

Because, although it is important that Juan finds a better alternative than opiates for his pain, his angst, his boredom at not being swooped up to make a meanful contribution to society (at least not just yet), it's the guards that count here.  It reminds me of the story of this guy pushing a wheelbarrow full of straw across the border. And the border guards (how appropriate) riffle through the straw every trip, to detect what he is smuggling. Finally, after the umpteenth time, he finally tells them what he is smuggling, after cutting them in on the deal. Wheelbarrows. Smuggling wheelbarrows right under their sunburnd noses. The point being that it's the guards that are really the story here. Whether it's boredom, a free get-out-of-jail card, or curiosity, it is on their backs that this revolution in prison care will be carried,

And Juan keeps on coming back. Weekly. Three visits now. But who's counting.

y.

VAMPIRE ACUPUNCTURE FOR SHINGLES

Ben/Biao. Roots and Branches. Causes and Symptoms. The symptoms were sciatica down the left leg.. It started after her back surgery.  Five years ago. She had a breakout of shingles following surgery. From her hip to her ankle. Ben. Inflaming the sciatic nerve. Biao. Heat. What do you do to cool heat? Bleed.

The points? The tip of the ear. The apex. I used a lancet and then squeezed a few drops of blood from it. The other point, Governing Vessel 14. The intersection of all the Yang Meridins. Again, pricked with a lancet and squeezed a few drops of blood out. Relief. After 5 years of suffering. Cooling heat. Inflammation. Restoring functkon.

 Without drugs. Without side-effects. I learned the technique from a Korean Acupuncturists in the Western burbs years ago whose name I forget. Two days after the first patient I saw another patient with the same problem. And used the same solution. It worked. Thank you Seoqsa!

y.

No Pain, to Cane

This was another of those patients I have been treating for awhile for his back pain and leg pain with routine care. It would work for a while. Then he would come limping back. No real breakthroughs. No significant, sustainable improvements. My silent question tickling the back of my throat is in those instances, "How good can you stand it? I speak for both of us.

As I stared at his smooth, cloesely shaved head....you know by now what was running through my silver-coifed cerebellum.  Why haven't I asked him if he would like to try scalp acupuncture? So I gave him the usual advantages. I allows us, real-time, to see how it's working, since he can use the the affected part of the body because, rather than pocupine peppering the affected area, rookie style, we are going up to the CPU to do a software fix. Reprograming operating systems that drive the hardware. His muscular/skeletal hardware. Reminding him that software operates hardware. And we were needling over that part of the brain that operates the affected part of the body. With the bonus that we would get immediate feedback how the rewrite was working, Kind of like an instantaneous neuroplasticity patch. Installing modified drivers to help improve affected back and leg function, along with simultaneous pain reduction.

The the first round of needle insertion in the Zhu points, and mindful "bucket down the well" stim, allowed him to get up caneless, and do the stroll down the central corrider, while the Attendings, Fellows and Nurses clapped their ears muttering "La, La, La, La, La, too much information!" (just kidding, not that overt).  Rather "Oh no here comes Yurasek again, rubbing it in. "Has he no respect? Or humility?" Actually I have neither. Just a deep respect for my paired teachers. In this case Dr. Zhu. And my patient at the time. They teach me whether what I have learned works or not. "No tickee, no laundry." That simple. Following my the Barefoot Doctor operating principle. "See it. Do it. Teach it."

 Perfect practice makes perfect. And with each stim and stroll he got up easier and walked better. Pain-free. You can't tell me we didn't have some real-time Neuro-Plastics going on. Even though it catches everyone by surprise (get over yourself) it's really quite predictable. One just has to risk looking like a fool (both patient and pricker) and do what might mean more to the patient, than just hanging another scalp on your belt.

Triple Header Friday

She was zoftig, with salt & pepper hair, hunched over her walker, every agonizing step a memory of how bad the next one would be. She had responded well to her first acupuncture treatmen, scrunched on the hard, high floroscopy table that doubles as an acupuncture bed. We went local on her back with e-stim on Bladder 23, 31, 57. A protocol I inherited from my second senior acupuncture mentor from Liaoning Provencial Hospital. We worked together for bubkas at the Westside Health Authority clinic in the hood in another life-time. Vanilla. Safe. The Plain Jane treatment had worked ok. No knee pain for 4 hours and no back pain for 4 days. Time to bring out the big guns. Zhou. Particularly after Monday's success. I peppered her head with a handful of Zhou's points and, to her surprise, asked her to stroll with me sans walker, down the corridor.  She took the leap of faith, and walked strong, first with the help of my hand clenching hers. And then free fall, re--learning what it is like to be self -powered again.

I told her the story of the grapholigist I called in Colorado decades ago. In my Mad Ad  days. To inquire about her classes in handwriting analysis. She didn't answer. I repeated the message she left for callers to hear. " When you get to the edge of the circle of light, and step off into the darkenss, one of two things will happen. Either your foot will hit solid ground, or you will fall, grow wings, and fly." My patient  flew that day. But it doesn'end there. While she was sitting in the room, getting well, I saw a second patient, the calligraphy of pain etching her face, and thought I would walk her back for some salt & pepper. With her consent. She sat their. Like the Queen of Cures. The angle of the chin. The sureness in her voice, Head tilted just so. Lips pursed to add emphassis to her pronouncements. I was mesmerized. I, and the patient beside me were charmed by what she saw and heard. How these slender needles blending into the black & white landscape, might also help her own condition. Lessen her pain. Take the hitch out of her get-along. We went back to the other treatment room. And it did. But not before we paid it forward. With a surley black sister who wasn't going to let anyone pull the wool over her eyes.

When I suggested the flavor of the day to her, Zhu Scalp Acu[ncture,   she said "What ever."  Rolling her eyes at this frosty-haired white guy who had no idea how many miles of bad roadshe had traveled in this lifetime. Time for the hand off. A Black sister with terrible back and leg pain having a Hispanic sister tell her how those needles in her scalp had instantly made a difference in her pain level. And added a fluidity and grace to her gait. Somehow I felt separated from it all. Like a spectator. Someone in the audience of a play called "This works.  Pass it on." Or part of some kind of conspiracy. That needed secret passwords. And twisted finger handshakes. To gain access to hidden, life-changing knowledge.  Passed down through the centuries. Carried by Otzi up through the Alps 5,000 years ago. Shouldering his back pain and abdominal pain from the whip worms in his belly with him. To be found bled out in the Otzil Alps Glacier. By a honey-mooning Austrian couple. Waving up at them. Whispering "share my secrets." They did. And so did the Lancet British Medical Journal. Which postulated that the strokes and hatchmarks tattoed on Otzi were short-hand for the acupuncture points he used for his arthritic back, and wormy belly. pain. And now a varient of this Wisdom Medicine, had been passed on by another Time Bender,  from Northern Italy where Otzi had lived, to a busy Chicago clinic nested in a much larger vortex dedicated to easing pain. Offering people of all shapes, ages and color hope. And healing.
y.

A Single on Monday and a Triple Header on Friday.

He was Polish (still is). Young. And saddled with RSD and MERSA. Waiting for knee surgery he doesn't want. Right-sided pain from his neck to his knee. To much area to cover with needles. Unless you go Micro. Like in Microsystems. Like in scalp. I was convinces the first time I saw Dr. Zhu in action. At a training in Chicago in the '90's.
Upstairs in a bank building in Boystown. The kid was a victim of a drive-by. Carrying 6 bullets around his spine. He had to white-knnuckle the  arms of his wheelchair just to keeep from swaying side to side. In 5 minutes Zhu had him standing up for the first time in a couple of years. With the help of several of us. And an 8 needle mosaic, in the shape of a face-up homunculus, from the his hair line to the apex of his head. Found by putting one's thumbs on the tip of the ear, and stretching the index fingers to touch each other on top. "Think of the needle as a bucket you are pulling up and lowering down a well," Zhu said, through his translator, "And never pull the needle, and the patient's sick qi into the palm of your hand." Pointers I still practice.  But back to this past Monday, and the young tattooed Pole.

I decided to treat him Zhu style. Since it was his first time, I used only 4 needles. One at the Middle Warmer area, to amp up his energy. And then one slid along his right arm point and another along his right leg point. Then I did my favorite manuerver, jockying him, caneless, by the busy Pain Residents lined up at their work station, facing the corridor we treaded. He muttering, " I can't beleieve this, This is great."  From there I boldly displayed him, with his joyful consent, to the 10 new Pain Fellow Candidates gathered in the conference room, where Dr. Linda was talking about the integrateive aspect of our clinic. And voila, there I show up with evidence. They were Mesmerized.

Because treatment space in short supply, I'll tag team him with Dr. Linda nextime.  A Psychologist I do "Simutaneous Therapy" with. I work above the brain with acupuncture. She works on the brain with Mindfullness. At the same time. We work togther for addiction and Xerostomia patients as well. Using the Auricular Microsystem. I work on the ears. She works between them.

(to be continued, with Friday's 3 Zhu Scalp Aucupuncture Patients treated the same time. They actually interacted with each other, needles deployed)

How do you spell relief, when they turned off the opiod faucet?

This 38 year old African American male had 3 surgerieslast year. Right shoulder in April. Back in June.  And Neck in December. Five days before Christmas. His pain meds got shut off January 29th. Happy New Year. He showed up around Chinese New Years for Acupuncture. Year of the Dog.
 I love Dogs. It spells God backwards. The Asian Astrological virtues are incredible. I've raised and showed Ridgebacks, brought up Afghans, Collies, Labs, Blue Healers, Standard Poodles, Staffordshires, and now a Dutch Collie puppy that's smarter then most people I know. Sometimes. Scary. And definately smareter than the folks that would drug this guy up 3 times for surgery, and between surgeries,  in the space of 10 months, and then  say......
  "Surprise! We're turning off the joy juice. Because we have to. Sorry.  But let's see if acupunctue can pull the rabbit our of the hat for you."

He;s been ridden hard and put away wet. But your turn, go ahead now, put some needles in him. We used to call that a hospital pass  in sand-lot football.  Shove it off  to the sap next to you just before you get hit.We don't know how or if it's going to work. But give it a shot.

I did. It did. Work. About 10,000 worth of out-patients a day. In China we would see him 3 to 5 times a week for a month or more.

Over here my interns and I are lucky to see him monthly.  There it's 5 bucks a treatment. They're still trying to figure it out over here. A penny a needle and 10 minutes of time.  Go figure. I used Zhu's scalp system to jump start this patient to less pain. . And added Chinese Carryout of ASP needles on the ear  Battlefield Acupuncture Points for carryover. With a lttle sprinkle of Sotai Corrective Exercises on the side. Go figure.

The Bull Horns Showed Up Yesterday in Our Waiting Room

There's a saying that the way to avoid getting impaled on the bull horns of a dilemma is to grab one of them vigorously, and hang on. A patient sat in a chair near the door gasping for air last night. I had just gotten the skinny from the Resident working with her. She had been to E.R. at a sister hospital for her pain the night before. She received an injection which she claimed did not work. 

I walked over to her and told her that I was ready to see her. She struggled to get up out of her chair, holding her legs, and gasping how bad they, and her back hurt her. We walked slowly to my office. I took her intake, delivered in shallow bursts of fitful information. I walked out to her Resident and said he was right, I could not do much for her. I told him  I was going to do Battlefield points on her ear, to try to take the edge off her pain, which might be contributing to her difficulty breathing.

But in the end I grabbed the "shortness of breath" horn, and after little relief to show from peppering her ear with ASP darts,  like a clove covered baked ham, had her transported by wheel chair to the Emergency Department to address her worsening struggle to breathe.

 This morning the Resident told me that the ER's dx. was anxiety. And that resolved, he planned to work her into his rotation for a procedure for  her pain later in the day.

Heart-based Healing/Marine Style

I have my brother John Howard of Battlefield Acupuncture fame to thank for the gift of my  Bethesda Naval Hospital, Marine Amputee Grand Rounds experience. From which I have never recovered.  Walking up and down a long corridor housing 17 Marines, hanging on, wracked by phantom pain, and trollied down to ICU regularly for debraiding, and recovery from the lala-land of morphine. We entered each room geared up in gel, gloves, and disposabal gown over our scrubs. Infection was the new enemy.

One Marine we looked in on was fading fast. Both legs and an arm blown-off. Tubes everywhere. Hyper-ventilating. Waxen, ashen face, covered with a light sheen of sweat. What to do? Anything? I looked down at his stumps. A voice said no Kidney channel, Kidneys pull down Lung Qi. Ear is the Entrance to the Kidney. Some force took an ASP dart clutched in my hand and pushed it in the Kidney point on his ear. He grinned weakly, started breathing more evenly, and whispered "Oooorah".

John and I finished up our rounding, and on the way off the ward passed by a door with a big red placard taped on it, with the following Marine message:

                                   ATTENTION TO ALL WHO ENTER HERE!
If you are coming into this room with sorrow or because you feel sorry for my wounds, go elsewhere. The wounds I received  I got in a job I love, doing it for people I love, supporting the Freedom of a Countyr I deeply love.

I am incredibly tough, and will make a full recovery. What is full?  That is the absolute utmost physically my body has the ability to recover. Then I will push that about 25% further through sheer mental tenacity.

This room you are about to enter is a room of fun, optimism, and intense, rapid regrowth. If you are not prepared for that GO ELSEWHERE.

THE MANAGEMENT

I can say nothing more. Only committed, full-out action is the appropriate response.

This Little Piggy went to market...

Actually it was her thumb. Her right thumb to be exact (and she is right handed to boot).  It hurt worse then her back. Which I usually treat for her. But thing about it is that the thumb is what separats us primates from the rest of the animal kingdom. And makes our brain bigger. More cpu's necessary to operate its multiple vectors. So there she was, pained and frustrated. With a simple band-aid wrapped around its tdj.
Because that skinny splint was enough to immobilize. And lock in the pain. Thumper (remember the rabbit in Bambi?) was sceptical when I explained one needle in Gall Bladder 34 on the opposite leg would begin to address the issue...("they laughed when I sat down at the piano, but when I began to play...the old headline reads).

Needle in I asked her to move her thumb. "Touch it to the base of your little finger," I gently prodded. She did. Grimaced. Said it hurt. "More movement..., " I said.

"But it hurt."
"It did. It will. Less and less," I replied. Slowly (hypnotically?) To add emphasis.

I left the room to go next door to check with a newby that our Charge Nurse said had some questions. She was disappointed (it showed on her face) that I wasn't Chinese.
I get that with some frequency. My usual reply is "Not in this life."  I asked her to follow me. Grabbing the new Pain Fellow (he's Romanian, thus slightly more open to what looks like magic, not getting a rapid scientific explanation rattled off regarding what just happened, other than "you hit that first valve down, the music goes round and round, oh oh oh oh, and it comes out here". There we were. The 4 of us, waiting for the teaching. From the patient. (God I love this work! You actually get paid to practice). I twirled the needle a bit. And asked her to touch "thumper" to pinky, and beyond. She did. Anticipating pain. Of which there was very little. But significantly more movement. Then I walked over to the right ear and pointed to the ear chart I had brought into the room early. We found the thumb point I palpated, and, showing her the ASP dart (she had had seeds before and I told her this was a step up, and would, in so many words, and velocity to the new ascending vector of relief/function we had established today--we're still talking about the dart) said dart into the auricular thumb point. I explained the care and feeding of said dart, which would pop out of her ear like a stainless steel splinter in a few days. She was happy. The newbie was happy (but I warned not guarantees, to which she asked how long will it last?) What a great, and frequent question. To which I smugly answered,  "Your body will be the first to let us both know." I went on to add my usual spiel that we are all different. And that I could speculate. As most do. But I would rather we both listened to the wisdom of the body. Whether it whispers, or yells. Listen. And honor the communication. We all temporarily got it. And went on our separate ways.

And then he kissed her hand!

He was a first-timer. Never had acupuncture before. All 325 pounds of him. And he had a heap of hurt. And I had a newbie acupuncturist. Very tentative. Particularly when it came to Sacred Turtle Abdominal Acupuncture. Shipsley wrote a book recently about it's use in his clinics in London and Dublin. Published by Singing Dragon. It works. A lot.
So I had her watch our Neuralogist/Acupuncturist intern from Mongolia. She's good at Sacred Turtle. And we had used  it last week for 8 out 20 patients. For back pain, neck pain, shoulder pain, and the teethgrinding immobility that goes with them.

The Newbie and I conferred about the big guy's intense hand and foot pain. And what  5 points she should needle on his Hara (Japanese for  belly).  So I decided to run the table (5 ball in middle pocket). I directed the new intern  back into the treatment room, fortified with 2 viewings of the Mongolian's handiwork.
After her maiden-flight Sacred Turtle Treatment she burst breathlessly back into my office. "He had no pain for the first time in 5 month," she exclaimed. "And he kissed my hand!"  "Trained monkeys can do it," I replied. Quoting an admonition used by Dr. Michael Smith during my NADA training 30 years ago.

The Heart of the Matter

In Chinese Medicine, the relationship between the Organs and the Sense Organs has always been a mystery to me, and an inspiration. I have learned that developmental disorders exhibited in kids, is a function of Kidney Energy. And have found that treating youngsters with autism, ADHD, and other developmental issues is best addressed from the external opening of the Kidney Meridian, the ear, and Auricular Therapy.

The same goes for the eyes, the external opening to the Liver Meridian. Years back I had a  printer from Russia who was not able to pass his eye exam for his driver's license. It turns out he had been exposed to the nuclear fallout from the nearby Chernobyl reactor when it melted down. After his Liver Meridian was treated, through the controlling influence of the Lung Meridian, he easily passed the eye exam and got his driver's license.

Fast forward to this past week, and a Pain Clinic patient not responding to acupuncture for severe, deep pain at the base of her tongue. So bad that she could barely eat or talk. Yesterday she told me that her doctor had just found out she had "a hole in her heart". Hearing that, I remembered that the tongue is the opening to Heart Energy. And once more my therapeutic approach was tweaked in a way that could never be realized through the diagnostic filters of more conventional medicine. Now the challenge is to just find a way through, bringing together the many options opened up by that unique insight.

The Sacred Turtle Swims Into a Cook County Hospital Pain Clinic

It was at the 200,000 member-strong World Federation of Acupuncture Societies Meeting in Houston 2 years ago Halloween that I first got a glimpse of the stunning power of Sacred Turtle Abdominal Acupuncture. They were one of 60 different presentations by Doctors from all over the world (next blog I'll talk about the Brazilian Doctor's research presentation on ear bleeding  to reduce rheumatoid pain, I promise!).

Italian men can be quite dashing. These Italian Docs, with their thick Tuscan accents, dapper haircuts and stylish couture we're no different. What was different was the stunning videos of their 2 patients, one with severe cervicalgia, the other sporting a nastty, angry incision from a recent knee replacement. In a matter of minutes these two Doctors tag teamed their way to an amazing demonstration of how one needle twirled in the turtle's neck area on the belly of the neck pattient, and the lower right flipper on the knee patient's belly, to the crowded rooms amazement and disbelief, got both patients mobilized in a matter of minutes.

Fast forward to Chicago, this past Tuesday. A 265 lb. white male in his 50's limps in to the acupuncture clinic with his mother. His speech is thick, his left hand knurled and twisted. The by-product of right-sided head trauma, and a brain bleed a few years back. Sprawled back on the recliner in my office, he could barely raise his left leg, dorso-flex his left foot, raise his left arm, or open his tightly clenched left hand. To the amazement of  the for of us, mom, son, my intern and I, foot, leg, arm and hand were working, with varying degrees of ability, rapidly following the placement and twirling of 2 needles  each, placed in the upper and lower flippers of the turtle envisioned on his belly.

Answer me this....

Recently I asked 100 patients 4 questions. In Spanish. And in English.
The questions involved their acupuncture experience in terms of Courtesy; Communication; Pain Reduction; and Continuity of care.

They could choose from 3 answers: a) Above Average; b) Average; c) Below Average. There was also a space below for additional comments regarding any areas of dissatisfaction. It was the first time in my 4 years at the hospital that I stepped out of the box of 100 patient visits a week to actually get a birds-eye view of patient satisfaction. And a valuable tool that I had left inside the door when I exited a 25 year career in advertising and P.R..

Feedback is not something that should be relegated to bats. To keep them from crashing into objects in their path. Our questions asked of those we serve can add trajectory and velocity to our flight as well. And make our navigation more precise and unerring.

This experiment reminded me of a training I did in Constructive Living Therapy with it's  founder David Reynolds about the same time I began my Acupuncture Study. He requested that we ask 3 questions regarding our key relationships:
What have I received from you?
What have I given you?
How have I harmed you?
I dare you.

And how does this work.....exactly.

It's the "exactly" that throws me. Every time. It happened again yesterday. From an attending. He had finished writing up a recent case of mine for presentation at an upcoming Anesthesia Conference. This was a 22 year old Hispanic girl with a small calibre through-and-through gsw entering at the left scapula and coming out through the left upper chest wall, barely missing her heart, but severely affecting her brachial plexis. She had come in for a nerve block, but had no driver to take her home. The attending asked if I could do anything for her, and I gave my standard answer. Sure.

I was introduced to her by the attending. She was crying. Her PCP had told her she had a 2% chance of regaining any use of her arm. 5 minutes later, with needles in Gall Bladder 34 and Stomach 38 on the opposite leg, hooked up to e-stim, she was raising, lowering, and rotating her arm. And opening and closing her fingers. I recorded a video of it on my cell phone, with her permission. I didn't want either of us to forget. Lift-off Houston.

Over the next 10 weeks I would see her once or twice a week, with less and less regularity. At that point she was working part-time as a hostess at a restaurant downtown. And able to drive with 2 hands on the steering wheel and flip the turn signal with her left hand to get there. She didn't really need me. She had "flown the coop". But there was the ever-lingering question. Curious minds want to know. How does it work?

My answer to the resident was standard. How does heating a point on the ouside corner of a mother's little toe (Bladder 67) cause her breach baby to flip head down? Not knowing doesn't seem to effect the outcome.  Trained monkeys could do it. Happy New Year!

"Who ever touches them last is it!"

She came to the clinic for acupuncture for her stubborn back pain, on a scale of 8 out 10. Her tongue was pale, with a bright red tip, and thin white coat. While taking her pulses I noticed a small bruise over the heart pulse position on her left wrist. The pulse was knotted, intermittently intermittent.  I asked her about the bruise. She said she went to ER a few days earlier, with chest pain, and, because they couldn't do an inguinal angiogram, they retried from her left wrist.
In the process she had an allergic reaction to the dye. And her blood pressure dropped to 70/25.

Hearing this I had our nurse take the patient's  blood pressure. It was 96/66. She also mentioned that her cardiologist had put her on a new prescription, and had given her his cell phone number to call him at the first sign of trouble. At that point I walked across the hall and asked our Attending Pain Physician if he would consult with her, and possibly tweak her pain meds, since I was not comfortable doing acupuncture. I told him, based on a classmate of mine who found a heart patient dead on his table, following a potty break,  I told him I was guided by the rule, "who ever touches the patient last, before a major health breakdown, is it."

After I triaged her to the Pain Physician, I later asked him how things went. He reported that during the consult she mentioned that while she was in ER her heart stopped and they had to give her a shot to restart her heart. Bad odds. High risk. Not a good acupuncture candidate.

Acting Like A Cripple (cont'd)

The second time back the Champ  brought his daughter, his biggest fan, and cheerleader. She watched as I threaded needles through the Zhu back and hip points on his scalp again. This time we did one leg standing, then the other.  Then one legged semi squats. This time he had a family witness. No backsliding. Someone who knows who he is when he forgets.

 The hospital where he was hurt wants to make nice. Do another surgery. He wants nothing to do with it. He's gone on facebook, and the surgeons are getting concerned,  running a little scared. Sooner or later, as he continues to improve, he will get pressed up under the horns of a dilemma. Get  better, and miss Payday for Malpractice, or back-off the breakthroughs of recovery, and finesse the difference in payback for pain and suffering. (the way not to get impaled on the horns of a dilemma is to grab one of them fiercely ).

He has had a lot of that (suffering).  Stuck in a wheel chair having food spooned into his mouth,  in-between sucking down Narco. That's  when I turned him on to Tolle's The Power of Now. And asked him how good he could stand it.?

Secondary Gain Can Cripple

He staggered into the pain clinic barely able to walk. Out-patient back surgery had turned into a nightmare of extended in-patient recovery (sort of). When I called his name, and slowly walked with him to my office, he grabbed my arm and said "I wanna be a champ.  Can this make me a champ?"

He comes from the barrio, and has that Rocky Balboa toughness. So I took a chance, and said yes. (This is what the panel of Docs at the VA, assembled for my vetting there, sternly warned me to never do. Never mention possible postitive outcomes. CYA?) But that is another hospital, another saga.

Back to Rocky. Within minutes of my placing needles in the Dr. Zhu scalp points for his back and left leg, he was walking up and down the corridor without his walker, and more importantly, sitting and standing from his chair without holding on to the arms. I finished with a ASP darts in his left ear, and whispered into it, "Stop acting like a cripple!"

Of course I can't be this bold with everyone who comes to the Pain Clinic. But the opportunity, when one meets a Lion, is to play like a Lion. And the art is to distinguish them from the antelope.

Patients as teachers

It happens all the time. It happens every time. Patients teach. They tease out our skills. We just have to listen. To look. To touch. Carefully. Without prejudice. Someone once told me, "we hold the space for their wellness to show up in". And sift the root cause of their illness. Example.

Last Friday two patients thanked me. One for referring her to ER, where she subsequently had a stroke. The second for referring him to ER, where they discovered he had kidney stones. A nickels worth of needles would have delayed the inevitable.
 Knowing when not to treat, based on the muted advise of the patient. Not just their recitation of what went wrong, way back when. But right now, piercing the veil of Story. Filled with disappointment, frustation, and overwhelming, grinding pain, reveals what really needs to be known. To make a quantum leap out of the morass of misery.

The last patient of that day was a first-timer with us. She spoke only Spanish. Which warranted getting a translater on the Speaker phone, and the delay of translating questions from me, and answers from her. As well as translating questions from her. And answers from me. But the body is universal.
Her right shoulder and neck were very painful. More importantly, she had a history of breast cancer, a left side mastectomy, chemo and radiation.
 She was disappointed when I used only one needle on the opposite leg to restore 80% of her mobility. And significantly reduce her pain. As an afterthought I also did a Wind point on the back of her neck. Given the Weather's rapid 20 degree change to cold and snowy.

We wound up with about 30 minutes of talking, and 10 of acupuncture. I promised her more later. She will teach me more then.

NONE LEFT BEHIND

He came to the PTSD Clinic with a death sentence for his leg.  The VA docs said he would continue to lose function and gain pain from the gift of shrapnel stitched in his right thigh and groin from a landmine 30 years ago. Later he had rolled a jeep and crushed his shoulder.  For some fluke of fate he had gotten significant relief of that on a riverboat cruise in China, from a boat- bound acupuncturist who used a combination of bone-setting, needles and tuina massage to make it whole.  Hope from that is what drove him to my doorstep at the National teaching clinic.  One scalp needle got rid of the pain and restored function in minutes. His follow-up 2 days later confirmed he had gotten 75% improvement with that first salvo.  Treatment two focused on the shoulder with a needle through St 38 to Bl 57 points with similar results, followed by the 5 NADA ear points for the deeper, PTSD scars.  He, his wife, his farm (he sits on his tractor without pain) and his VA friends are thankful beneficiaries.  Happy July 4th ya'll.