Pain is like "a pig on ice".

I have Hoosier teacher, antique dealer Richard Oxenrider to thank for this expression. The double predicament of both chronic pain patients and pigs stuck on ice is that of those clutched in the dual dynamics of gravity and immobility. Trust me, I have seen it more than not. With pain patients, not pigs on ice. But I can imagine the later, spread-eagle d, panicking, the ice groaning beneath them threatening a cataclysmic crunch followed by a bone-chilling dunk. How to extricate the chronic pain patient from their predicament is the common question not well answered by either surgery or drugs, which tend to immobilize even more. Motivated movement toward the saving shore is the answer. Or as George W. said to his soldiers rowing him across the Delaware toward the encamped Hess ions, "Pray to God...and keep rowing toward shore."
So breaking the plane of inertia is important in both instances.

IMPACT:
What appears to be working more and more" first visit" at Stroger/Cook County Hospital Pain Clinic is Scalp Acupuncture. It seems to have the impact to shock those hardy enough to bear it in a direction away from the paralysis of pain. We (my interns and I) always have them move the offended area as soon as the first few needles are retained. I was taught to jump-start the treatment from the Middle Burner area, then go to the equivalent scalp somotope, usually the hip and back or neck and shoulder. Then get the patient mobilized immediately while gripped with the distracting pain in another part of their body. Sometimes my interns or I will add an opposing needle for stronger stimulation. (The jab and move, stimulus/response tactic is one I also saw my friend, Master John Howard also use with ASP Auricular Darts in his Battlefield Acupuncture Seminars.)

Follow-Through and Combination Punches
In boxing, follow-through and combinations add power to the attack. I learned this first-hand from Nappy, our Italian boxing coach at Notre Dame. The same seems to hold for stuck pigs and stuck"Energy and Blood" (the latter is the source of pain in Chinese Medicine). What this translates into during our weekly pain clinic shifts is making sure that patients have a combination of therapeutic activities they can do at home to support any movement they have made away from pain's grip, and toward more function. This can include teaching them Sujee Korean Hand Therapy, Sotai Corrective Exercises, and or Medical Qigong Movements to secure and reinforce any progress made away from pain and toward healing. This tactic of follow-through/combinations is, I believe, what keeps hospital-based acupuncturists from succumbing to the slippery slope of heroic vs. holistic therapy, designed to empower rather than enslave those in pain.

Putting Milk Back In The Cow

"Better to dig a well before you are thirsty...to forge weapons before battle." So says the ancient Chinese Medicine book, the Nei Jing. They are well past thirsty, our pain patients, and exhausted from battle. They come with years of scars dulled by drugs that have lost their edge. Now what? We start by beholding them differently. Three pulses each wrist, front, middle back, lungs and heart, spleen and liver, kidneys. What do they say? Fast, slow, superficial, deep, slippery, wirey. And the tongue, pale, purple, red? Thick or thin coat, white, yellow, black or none? They are wounded but hopeful. And sometimes progress is measured by teaspoons, or not at all. Sometimes there is a quantum leap forward from a handful of needles stuck well. And a slow return to before. Or not. No attachment to outcome. Just persistence. For Hope is Passion for the possibility. Of less pain, less drugs, no pain. No depression. Use come back, of a back, a shoulder, a knee, a hip. Slowly at first. Barely noticed. More by third parties than in the mirror. Rarely fast enough. The poser works on many things at once, plays the odds in the hope that one horse wins,places or shows. Not so the master. She locks on to the biggest gargoyle, takes him to the ground, and works her many holds, looking for submission. A frantic tap, sooner or later, signalling another round, with a lesser evil. We can't put milk back in the cow. But perhaps we can chill and stir it, and adding some flavor, serve up some ice cream.

Three new interns start at Stroger

Mary Thurmer, Misty Blomquist and Erica Perez joined Greer and I in treating 34 pain patients today. We have moved to scheduling 1st time patients for 1/2 hr. initial intake to establish the Pattern of Imbalance, with an automatic 1/2 hour, 6th visit review and re-evaluation. Another Dr. took advantage of our services for recalcitrant neck pain, which responded quickly from 4 to 0. Of our 7 new patients, one presented with blood sugar over 300,and terrible leg pain from dia etic neuropathy. Both lowered dramatically following Girdle Meridian Therapy. We are ramping up patient instruction in Qi Gong and Korean Hand Therapy as Carry Out Therapy to speed patient recovery.

No Pain Is Safe

Five of our 25 pain patients were new this week at Stroger Hospital's Acupuncture Pain Clinic. One had chronic migraines. One was a young woman 20 weeks pregnant with back pain so bad she needed a walker to steady her weak and throbbing right leg. 3 press tacks on her right ear shut down the pain immediately. The migraine will have to see the benefit of 6 needles between the toes and hot, mustard powder foot baths. Our Russian testicular and prostate pain patient skipped out with no pain after dermal needles were placed on the auricular prostate point, along with electro-stim on the Foot Shaoyin Meridian. And finally, a woman with stage 4 bone cancer, and excruciating rib pain that wrapped half around her body brought her friend and herself to tears from the total relief 4 dermal needles placed on auricular shenmen, liver, and rib points on the left ear provided. In time we will document changes to the autonomic nervous system with Heart Rate Variability monitoring before and after treatment for hard data in addition to patient feedback. We have doubled our NUHS interns from 2 to 4.

Carry-out Acucare comes to Cook

Our delivery menu of acu-therapies at Cook County's Stroger Hospital Pain Clinic is expanding. It started primarily with the use of needling body points,and where appropriate, adding electro-stimulation to key points. The next evolution was the employment of the Ear, Scalp and Hand micro-systems either on a stand-alone or auxiliary basis. This addition appeared to both accelerate the treatment's analgesic effect and in some cases reduce treatment time. There is another advantage, in that some of these Micro-system somatotopes can, with instruction, be self-stimulated by the patient, lengthening their salubrious effect. This expands the role of the acupuncturist even more in the area of teacher, as well as "treater". Moving even more progressively in this direction, modalities such as Medical Qigong and Sotai Corrective Exercises can be taught, complete with take-home handouts, to both enlist the patient in their participation in self-healing, as well as expanding both the scope and effect of natural therapeutics. Common herbal supplements can be added to the follow-on instructions. Such is the case with an acute prostatitis case where one point on the Liver Meridian mediated the pain to zero, and the proven over-the-counter herbal remedy combination of Saw Palmetto,Stinging Nettle, Pygium and Zinc was recommended. Evidence such as pain, urine flow, ease of urination and completeness of emptying will monitor effectiveness. With this shift in focus, with time spent having the patient employ carry-out therapies between shorter duration, in-clinic therapies, better outcomes are anticipated in terms of both rapidity and resolution of recoveries.

Carving an elephant

Once upon a time, in a land far far away, there was a famous artist who would carve elephants out of boulders. He would take his helpers down to the river, and walk along the shore, looking for boulders that would have elephants contained in them. He would then have his helpers drag them back to his studio, where he would work with his hammer and chisel. He explain that he was knocking "not elephant" off the boulder, to reveal the elephant. We do the same with the art of acupuncture.

Last Thursday a patient presented in acute pain. She was hyperventilating and screaming my name. She was having difficulty breathing, and near passing out. I attempted Lu 7, CV 22, and several ear points. She got worse. We got a wheel chair and transported her to ER. The first of the several hundred patients treated in the last several weeks with varying degrees of success, some extraordinary. It is good for our humility. We are facilitators. No more. And we are defined as much by our failures as our successes.

Exploring Microsystem Efficacy in treatment of pain

"Form follows Function"
With the doubling of intakes at the Cook County Hospital Pain Clinic last week,the use of more acupuncture modalities was explored, with the motive of discovering the advantages that the specific microsystemws of scalp and auricular acupuncture might have over macrosystem acupoints.

AURICULAR Acupuncture
3 patients were selected for minimally invasive auricular tberapy today who were 1st time patients, needle-phobic, or had eaten no breakfast. Pain reduction was comparable to or greater than macrosystem points.

Scalp Acupuncture
2 new patients with acute pain, who were open to tbe stronger stimulation and often more rapid pain reduction and function restoration afforded by scalp acupuncture, as well as 2 existing patient who had limited respnse to previous macrosystem point stimulation, received scalp acupuncture, with significant pain reduction, and in some cases, remarkable improvement in movement ability.