Over From ER....

 She came through ER over the weekend for acute back and leg pain, and admitted for tests and meds.  She was discharged on Monday, and back to ER on Thursday, without relief, asking to be guernied over to the pain clinic for acupuncture.   She was wheeled into the the clinic mid-morning, crying and white-knuckling, begging for relief.  The pain was rolling down her leg, from the hip to the toe, along the gall bladder meridian.  I went up to her right ear and placed tiny needles that barely fit between my ring-size eleven fingers into 4 points on her ear, shen men (spirit gate) hip, leg and brain stem, and watched her hyper down, like an air mattress deflating.  After a walk through of the 4 rooms manned by 4 acupuncture interns, I went back out and checked on our ER visitor.  She was dozing fitfully.  I reached down and pressed the gall bladder point in the hollow of her hip, and linked it up to the gall bladder point between his 4th and 5th toe, opening up the channel, and further reducing the pain.  About 45 minutes later transport returned, to wheel her back to ER, leaving all the needles, and most of the pain behind.

The ear is a remarkable energetic keypad to body function.  This was never more clear to me than when I visited a marine amputee at Bethesda Naval Hospital who was having trouble breathing.  When he lost his legs he lost half his kidney meridians.  In Chinese Medicine the Kidney Energy pulls down the breath.  That's demonstrated with the slap over the kidneys that kick-starts a newborn's breath. I put a needle in the kidney point on this marine's ear and which immediately reversed his hyperventilation, and visibly settles his spirit. I look forward to wider use of this remarkable therapy in ER. fy   

  

How 9 Bullets In The Trunk Can Turn You Into A Tree...

...and 4 needles in the head can restore flexibility and eliminate pain instantly.  I constantly work outside the comfort zone of belief, and history.  It happened again at Stroger the other week when I had a patient walk into the pain clinic carrying the fragments of 9 bullets in his chest.  About 23 years earlier I had seen Dr. Zhu use his style of scalp acupuncture on a wheel-chair bound victim of a "drive-by" and have him standing for the first time since he was shot (it always helps when you see what is possible first before you attempt to do it--replication, when done mindfully,  is usually much easier than creation).  When this patient comes back we will launch into the elegant and easy corrective exercises called Sotai, developed by Dr. Keizo Hashimoto, as well as continuing to use acupuncture to help him manage his pain, along with an orderly reduction of drug dependence, orchestrated by and coordinated with the M.D. side of the Pain Clinic.  I dreamed of this kind of collaboration following my first internship in Guan Zhao University of TCM Hospital in 1998, while still working as a Class 4 Felon Acupuncturist in Illinois. The gods grind exceedingly slow, and exceedingly fine.   

Stick out your tongue?

Most of our intakes at the Stroger County Hospital start with a simple request "Stick out your tongue please." After inspecting the tongue, and noting the color of the body and the coating, the shape, the sub-lingual veins, when then place 3 fingers on each wrist to determine the Chinese pulses for the Heart, Liver and Kidney on the left wrist and the Lung, Spleen and Kidney on the right wrist.  Since all of our patients are on multiple meds for pain, depression, and other issues, one might wonder how unsullied the information normally gleaned from tongue and pulse analysis are as indicators of what is happening, and not happening inside the body.  However, all else being equal, theoretically, with the addition of acupuncture and its potential to not merely reduce and in some cases eliminate pain and restore function though the mechanism of moving blood and bioenergy, these internal changes should also be reflected in the signposts of the tongue and pulses.  Were they not observed carefully by our Stroger interns (read the description of the Dali Lama's physician taking the pulse at Johns Hopkins in "Mortal Lessons" by Dr. Selzer) we would not be able to record if, when, and why those subtle yet profound changes had taken place. drfy

Every Tunnel Has A Bright Spot....

You just have to keep your eyes open.  That goes for patients and acupuncturists at Stroger County Hospital.  For practitioners, the crush of unresolved cases, back surgeries, neck surgeries, cancer, migraines, gunshot wounds, they bring not just their unmitigated pain, but its history, day after bone-crushing day.  It is a dark tunnel which encourages one to squeeze closed the eyes of the mind, and the soul, to gut through the next moment, hanging on for relief, no matter how short.

It's easy to buy into the story. I preach ruthless compassion.  Starting with self.  Cultivating the spirit of the Warrior..for Wellness.  It to build on the last post, "You can't give it if you don't have it."  And you don't have it if you are not building your strength, your prudent use of it, every day, with every conscious breath. We move into the painful space of our patients as fire-keepers.  We have the secret knowledge of seeing our work, no matter the circumstance, work more than not.  Without attachment to outcome.  We come into the room smiling, bright, hopeful.  We listen with our heart.  We cut through the story, and with a nickel's worth of needles, chase away the dragon of pain, at least for a while.  Expanding the circle of light. Which we nurture within ourselves, moment by moment.

Don't Get It....Don't Spread It!

Last week I introduced  another acupuncturist to the Pain Clinic at Stroger County Hospital.  He was impressed with both the overwhelming size of the facility in general, and the suite of 4 treatment rooms staffed by our NUHS interns on Wednesdays and Thursdays.  As we met after the tour, and I searched for a governing message to convey, one that might be different than the fundamental concerns which guide us at our Teaching Clinic, on campus.  In these instances it is always good to do a reality check, and look closely at who we serve, and how well we serve them. Two thoughts came to mind: 1) the section in the Stroger Orientation Manual that covers in detail the risks, and prevention protocols to contain cross contamination; and 2) the absolutely frightening book I read last year, The Rising Plague, after I was exposed to,  and treated my  first patient with confirmed mersa.  (I actually had a pregnant acupuncture intern who called me in on the case  initially refuse to assist, which to me was both a breach of her duties, and a lack of understanding about what we are routinely exposed to in our work).

Here's what I said..  More than a thorough, accurate intake, more than a proper and logical Differential Diagnosis, based on proper tongue and pulse diagnosis, and the 4 Examinations, more than an appropriate treatment strategy, including the selection of correct points and their accurate placement, more than proper bedside manner and good rapport with our Western Medicine Colleagues,  more than all these things, if any of our staff has either become infected with mersa, HIV, hepatitis, staph or strep, or any other transmittable disease, or passed it on to another, we have failed our mission. For truly care of self leads to care of others, and abuse of self leads to abuse of others. 

Bringing Threefers to Hospital Based Acupuncture

This week I experimented with sequencing and combining acupuncture protocols to deliver more impact in our treatments that last 40 minutes and because of demand, are repeated every one to two weeks or more.  If the pain was concentrated in one part of the body I would start by finding the points on the microsystem of the hand that corresponded to area on the body that was at a 8 to 10 pain level, and insert 5 needles in a surround the dragon configuration.  Then I would do Tui Na massage on the area, usually the neck, back, shoulder or hips.  I would then remove the hand needles and explain how they can stimulate those hand points themselves for relief between return visits.  Finally I would place an ear tacks on the part of the ear analogous to the part of the body that is in pain.  All patients treated with this new protocol sequence had 2 or more point reductions in pain.  Next week we'll find out how long their relief lasted. 

What has started with 2 interns and 12 patients on a Thursday from 7:30 to 3:30 in November at Stroger County Hospital ,has expanded to 4 interns and 40 patients on Thursdays and spread to a second, shift from 7 to 11 AM on Wednesdays.  Part of this expansion is from an influx of 10 to 15 new patients per shift.  Patients continue to teach us how to facilitate their healing (becoming whole) visit by visit.  We draw from a prodigious woodpile of  knowledge, accumulated over thousands of years,  to feed these flames fed by the desire to kindle the body's natural ability to heal itself.  .