Back Pain and Water Swelling.

Today's patient was quite interesting. A worker at SACHR, she presented with back and neck pain. So, I figured maybe a standard protocol for her, but her case turned out to be unstandard. Her limbs had definite signs of edema, with her legs showing non-pitting edema. Aside from bad low back and neck pain, she also said that she lives in the bathroom (to urinate). She also suffers from constipation, moving bowels only every 3-4 days. She suffered from nightmares, and then she was too afraid to go back to sleep. She had pain in her limbs as well. She reported that she often ran cold.
This patient definitely had signs of Kidney Yang deficiency, with deranged water metabolism. Her tongue didn't quite match. It was broad, pale, but with a dry yellow coat. However, she smokes roughly half-a-pack a day. Her pulses were relatively deep, slippery, and soft.
For this patient, I decided to focus on her back pain, and only obliquely address the water issues. Luckily, they overlap somewhat, since the Kidney Yang deficiency has a role in both. Points used were: UB 10, 13, 15, 23, 39, 40, 58, and 60. Other points were Lung 7, L.I. 4, Kidney 3, and Du 9. UB 10, 23, 40, 58, and 60 address her back problems, especially 10 and 40, while the other points help to strengthen the Organs responsible for water metabolism. Lung 7 and UB 13 for the upper source of water, the Lungs, L.I. 4 to help the L.I. with water absorption, UB 39 to help rectify the San Jiao, the minister of the water passages, and Kidney 3 with UB 23 to tonify the Kidneys, which dominate water. Du 9 is also useful for this, as fortifies the Spleen, drains dampness and strengthens the middle jiao. I added UB 15 to help regulate her Heart qi and ease her nightmares.
Pole moxa was applied to Du 4 Mingmen for ten minutes, to help boost Kidney Yang, further helping regulate water metabolism and relieve lower back pain.
The patient fell asleep on the table practically from the first needle, a sign that she was really sleep deprived. I retained the needles for 30 minutes, purely to let her sleep as long as possible. After withdrawing the needles, and waking her up, the patient was much refreshed. Her shen/disposition was vastly improved, she was more energetic, and she even bent over to tie her shoes, something she said she never did. I should be seeing her tomorrow as well. Hopefully, her other symptoms should have eased as well.

Migraine and GB channel fire.

Yesterday, had my first "emergency" case. As I was getting ready to treat a patient, SACHR's director made an appointment for someone she said was suffering from migraine. When the guy came in, I could see that "suffering" was a bit of an understatement. He was in agony. His eyes were tight shut against the light, and he was starting to curl around his chest. The pain was also affecting his breathing.
The pain was right behind his left eye-ball, and was intense. He also indicated the left side of his head. Speech was very slow and labored. His pulses were rapid, and bounding, indicating exuberant heat.
In my experience with drug users, there is often a surfeit of Liver/GB channel fire. The drugs they take directly affect the Liver. The drugs move qi for a little bit, but then the qi stagnates rapidly after. The constant cycle of moving and then stagnating qi heats the Liver. If they also drink, and most do, the alcohol damp-heat further insults the Liver. Eventually, that heat has to go somewhere, and it usually ends up in the GB channel. Usually, treating the GB channel goes a long way to soothing and smoothing a user's qi.
With this person, I felt I had to act quickly, so I didn't bother placing him on a table, but treated him where he sat. I needled GB 20 and GB 43 bilaterally with draining. GB 20 to unconstrain the qi in his head, and GB 43 to descend GB channel fire, which was essential. Within 2 minutes, the pain had diminished, and he was able to open his eyes somewhat, but not entirely. He also appeared more relaxed, and he had uncurled from around his chest. I retained the needles for about 20 minutes.
After removing the needles I sat him down on a low chair, and did tui na on his GB 21 area, including pushing, grasping, kneading and dredging GB 21 as well as SI 11, and beating along the traps. I also round-rubbed up along the medial border of the scapula, up into GB 20 again. The area around GB 21 was very tight, indicating a lot of stagnation of GB channel qi. After finishing the tui na treatment, the patient was able to completely open his eyes, and he said the pain was completely gone.
For someone like this, Longdan Xie Gan Tang would be ideal, but no one at sachr can afford herbs. Points like GB 43 and GB 34, which clears Liver/GB damp-heat, also work well. For someone who isn't in such extremis, I also like to use GB 41 a lot to help clear the head and spread Liver qi.

Being at St. Ann's.

Well, since May 4th, I have been working as acupuncturist at St. Ann's Corner of Harm Reduction (SACHR). For those not familiar with the term, "harm reduction," it's a way of dealing with drug addicts that doesn't necessarily try to get them to stop drugs, but minimize the harm they do to themselves and others. SACHR started in the trunk of the director's car, as a needle exchange. Joyce Rivera's goal was to lower the prevalence of HIV in the Bronx. She succeeded. Joyce and her staff were able to reduce the prevalence from 69% to 11%.
Since then, SACHR has outgrown her car's trunk. Now located at 310 Walton Avenue, SACHR gives counseling, provides food, and offers some training for people that a lot of New Yorker's hipster crowd would rather not be near.
Treating such a population is challenging. SACHR does provide the National Acupuncture Detoxification Association (NADA) ear acupuncture protocol, and a meditative "sanctuary" for the patients to rest in during treatment. I was brought on board to provide full treatment, as needed (as were two other acupuncturists). Not everyone understands that there's a difference between the NADA protocol and regular acupuncture, and I have to explain a lot to people who've never been exposed to it. One thing is certain: these people really need it. My very first patient saw me for shoulder pain, but had a laundry list of injuries and ailments; bullets still lodged close to the spine, hep C, on top of his addiction. While taking his pulse, I noticed that his Lung pulse (right cun position) was very depressed, and I asked if he had any respiratory problems. He answered that he was missing a lung, as a result of gunfire.
If anyone is interested in St. Ann's, either to make a donation or to volunteer, please look it up at www.sachr.org.

-Rob