It's starting to get cold out there, and I've already seen a number of patients who required moxa. I love moxa, and use it often, but recently I've noticed an uptick in the number of patients requiring it. The several people I used it on all had diminished pulses in the Kidney Yang position, and all had pain conditions that were worse with cold. As stated in the Huang Di Nei Jing, "What is cold, heat it." Naturally, this makes the small treatment areas at St. Ann's more smoky than a bar that has an OTB hook up, but it's all in a good cause.
Most recent was a patient who suffered from elbow pain. His elbow had swollen before, and I had treated it without moxa, but now, although the swelling was gone, there was pain. He had no pain elsewhere in his joints. He's a kind of large guy, but somewhat tubby and not very physically fit. His pulses were somewhat soft, and a bit empty, but his Kidney Yang pulse was deep and somewhat feeble, in comparison to his Kidney Yin pulse which was was soft and not nearly so deep. Interestingly, his tongue had no coat, and was slightly moist. He reported frequent, clear urination, but mentioned that he drank lots of water.
Diagnosis was Kidney/Spleen Yang deficiency with failure to move fluids, which is why his tongue was coatless yet moist. Treatment involved lots of moxa, with the use of stick on moxa at SJ 10 on his left arm (the affected elbow), and pole moxa on Ren 9 Shuefen, and Ren 6 Qihai. Other points included, with needles, Spleen 9 Yinlingquan, SJ 3 Zhongzhu on his right arm, GB 34 Yanglingquan on the contra lateral side, and GB 41 Zulinqi and St. 36 Zusanli bilaterally. SJ 14 Jianliao and SJ 4 Yangchi were also used on the affected arm.
The patient was almost, but not quite pain free after treatment, with a lot more mobility in the affected joint. I'm waiting for him to come next week to see how his elbow is after.
Sunday, December 12, 2010
Thursday, November 11, 2010
Them Dry Bones...
A young woman recently came to my practice at Saint Ann's complaining of back pain. This in and of itself is not that remarkable; people young and old suffer back pain from a variety of reasons. What made this case more remarkable is the fact that the young woman is suffering back pain from osteoporosis. This young woman is still in her early 20s, at the most, and to be suffering osteoporosis at such an early age is unusual. Osteoporosis usually affects women who are post-menopausal.
Osteoporosis is a condition wherein the bone becomes porous, or less dense. This is distinguised from osteopenia, wherein the bone material doesn't become less dense, but does become softer. Basically, osteoporosis is an imbalance between bone formation, and bone resorption. After menopause, the osteoclasts, which are responsible for bone resorption, begin to outperform osteoblasts, which lay down new bone matrix. Lack of estrogen is one factor in this off kilter mechanism; the lack of estrogen increases the rate of bone resorption. Another factor is calcium metabolism; lack of calcium and vitamin D result in decreased bone deposition. The lack of calcium and vitamin D also induce the parathyroid glands to secrete parathyroid hormone, which increases bone resorption to ensure that there is enough calcium in the blood for the heart and muscles.
The key factor in this young woman's condition is that she's anorexic. A model, she no doubt felt the pressure to be thin as do so many women in that profession. Sadly, she succeeded; she was incredibly thin. Many of her bony tissues had been affected by her condition; she told me she had lost seven teeth from the constant vomiting (binging and purging). The acid had eaten away the enamel of those teeth.
In Traditional Chinese Medicine, the Organ most closely associated with the bones happens to be the Kidneys. In this young woman's case, she has extreme Yin (substance) deficiency. Lack of post-natal qi, from foods, has forced her system to draw heavily on Kidney Yin and Essence. Much of her pain is centered around her lower back, the residence of the Kidneys. Nails were lusterless and dry, and she admitted to poor concentration and memory, which are Blood deficiency symptoms, underscoring the sheer lack of post-natal qi. I gave her a back treatment, to nourish Blood, Yin, and Kidney Essence. Points included the Four Flowers (UB 17 and 18), Pishu (UB 20), Shenshu (UB 23), and points along the Heart and Kidney channels to calm mind and tonify the Kidneys; Heart 7 and 5 the Heart Yuan Source and Luo points, Lung 9 to help nourish Yin, Kidney 3 and 6 for Kidney Qi and Yin, respectively, and Pericardium 6.
I have only seen this patient once, and am hoping she either returns for more treatment, or that she follows up with someone else. She did report after the treatment that she felt much better, and seemed more at ease. I sincerely hope that she receives treatment for her anorexia, as she was a very intelligent person, and clearly has a full life waiting for her.
Osteoporosis is a condition wherein the bone becomes porous, or less dense. This is distinguised from osteopenia, wherein the bone material doesn't become less dense, but does become softer. Basically, osteoporosis is an imbalance between bone formation, and bone resorption. After menopause, the osteoclasts, which are responsible for bone resorption, begin to outperform osteoblasts, which lay down new bone matrix. Lack of estrogen is one factor in this off kilter mechanism; the lack of estrogen increases the rate of bone resorption. Another factor is calcium metabolism; lack of calcium and vitamin D result in decreased bone deposition. The lack of calcium and vitamin D also induce the parathyroid glands to secrete parathyroid hormone, which increases bone resorption to ensure that there is enough calcium in the blood for the heart and muscles.
The key factor in this young woman's condition is that she's anorexic. A model, she no doubt felt the pressure to be thin as do so many women in that profession. Sadly, she succeeded; she was incredibly thin. Many of her bony tissues had been affected by her condition; she told me she had lost seven teeth from the constant vomiting (binging and purging). The acid had eaten away the enamel of those teeth.
In Traditional Chinese Medicine, the Organ most closely associated with the bones happens to be the Kidneys. In this young woman's case, she has extreme Yin (substance) deficiency. Lack of post-natal qi, from foods, has forced her system to draw heavily on Kidney Yin and Essence. Much of her pain is centered around her lower back, the residence of the Kidneys. Nails were lusterless and dry, and she admitted to poor concentration and memory, which are Blood deficiency symptoms, underscoring the sheer lack of post-natal qi. I gave her a back treatment, to nourish Blood, Yin, and Kidney Essence. Points included the Four Flowers (UB 17 and 18), Pishu (UB 20), Shenshu (UB 23), and points along the Heart and Kidney channels to calm mind and tonify the Kidneys; Heart 7 and 5 the Heart Yuan Source and Luo points, Lung 9 to help nourish Yin, Kidney 3 and 6 for Kidney Qi and Yin, respectively, and Pericardium 6.
I have only seen this patient once, and am hoping she either returns for more treatment, or that she follows up with someone else. She did report after the treatment that she felt much better, and seemed more at ease. I sincerely hope that she receives treatment for her anorexia, as she was a very intelligent person, and clearly has a full life waiting for her.
Not Always Physical
Sometimes, pulse diagnosis can tell you interesting things about a person. I have a regular at SACHR that comes to me for a range of things, often mental. One day, she came in, and told me that physically, she had no complaints. Feeling her pulse, however, I found that the Cun position on her right wrist, the Lung position, was intermittent. I asked her if she was having a hard time keeping things, thoughts, and life activities separate, and she said yes. In her own words, "As I was studying, I felt the whole outside world crashing in on me."
It should be noted here that this isn't just a random question that popped into my head, or a diagnosis that I mystically knew had to be the reason behind the feel of her Lung pulse. As I said, she's a regular, and so I already know something of her temperament, and have a feeling of what may be bothering her. As one of my teachers noted, pulsing is steeped in a kind of mysticism, and that even in China, people feel that if you can't guess what's wrong with them through only their pulse, they won't think of you as a good physician/clinician. So, there is a bit of P.T. Barnum that surrounds pulse diagnosis in China and here in the West also, in order to keep patients. However, in this case, there had been a lot of prior treatment, and extensive history, which allowed me to ask this question right off the bat after feeling her pulse.
Much of TCM has a mental component also, and this case illustrates the Lung/Metal aspect's role in helping people to compartmentalize, or delineate borders around activities. This young woman has some blood deficiency stemming from Spleen Qi deficiency, and since Spleen/Earth is the mother of Lung/Metal, the Lungs weren't being properly nourished to perform this function of delineation.
Treatment was kept very simple, in this case. I used Lung 9, as the Yuan-Source point of the Lungs, along with Spleen 3 and Stomach 36, both of which strongly tonifies Metal's mother, Earth. I also used LI 1o and Lung 7, the former to help boost Qi and Blood, and the latter, as the Luo-Connecting point, to calm her Spirit. Moxa was applied to Ren 4 to help boost Blood.
Seeing her again the following week, I asked her if she was still having the same problem, of keeping things separate. She looked thoughtful, and replied, "I didn't think of it."
It should be noted here that this isn't just a random question that popped into my head, or a diagnosis that I mystically knew had to be the reason behind the feel of her Lung pulse. As I said, she's a regular, and so I already know something of her temperament, and have a feeling of what may be bothering her. As one of my teachers noted, pulsing is steeped in a kind of mysticism, and that even in China, people feel that if you can't guess what's wrong with them through only their pulse, they won't think of you as a good physician/clinician. So, there is a bit of P.T. Barnum that surrounds pulse diagnosis in China and here in the West also, in order to keep patients. However, in this case, there had been a lot of prior treatment, and extensive history, which allowed me to ask this question right off the bat after feeling her pulse.
Much of TCM has a mental component also, and this case illustrates the Lung/Metal aspect's role in helping people to compartmentalize, or delineate borders around activities. This young woman has some blood deficiency stemming from Spleen Qi deficiency, and since Spleen/Earth is the mother of Lung/Metal, the Lungs weren't being properly nourished to perform this function of delineation.
Treatment was kept very simple, in this case. I used Lung 9, as the Yuan-Source point of the Lungs, along with Spleen 3 and Stomach 36, both of which strongly tonifies Metal's mother, Earth. I also used LI 1o and Lung 7, the former to help boost Qi and Blood, and the latter, as the Luo-Connecting point, to calm her Spirit. Moxa was applied to Ren 4 to help boost Blood.
Seeing her again the following week, I asked her if she was still having the same problem, of keeping things separate. She looked thoughtful, and replied, "I didn't think of it."
Wednesday, October 20, 2010
An Easy Fix
Sometimes, the best things in life are easy. A longtime client of SACHR came to me today with pain on the dorsum of her right foot. The poor woman had dropped a paper hole-puncher on it, and it had been hurting her for the whole week.
She told me that it would swell up, but that there was no bruise. Indeed, on examining her foot, the dorsum had a swollen, tight look to it, but there was no black and blue. The swelling would go down at night when she put her feet up, but would return, along with the pain, after getting up to walk around on it. The injury was localized along the Liver channel aspect of her foot.
Crucially, there were no broken bones. She had gone to the doctor and had X-rays taken which were negative for any kind of break.
Her pulse was wiry and choppy, and her tongue was unremarkable.
Basically, it came down to a pattern that one of my teachers back in PCOM thoroughly hated: Local Blood and Qi stagnation, albeit this time resulting from trauma. A Wu Yang patch would have been ideal, but we have none at SACHR.
Using TCM's theory of one body part reflected in another, I treated her with only three points; the most important being San Jiao 3, on the dorsum of her left hand. Essentially, this was treating one dorsum with its contralateral opposite. San Jiao 3 was particularly tender. Initially, I looked for tender points on her wrist, until I realized that I should be looking for a point that reflected the location of the trauma; hence, the use of the back of her left hand.
For good measure, I also used UB 60 and GB 41 on the affected foot, to move Qi and Blood.
The affect was almost immediate. Within a few minutes of needling, she reported that the pain was much reduced. At the end of the treatment, she walked out of the clinic without limping.
She told me that it would swell up, but that there was no bruise. Indeed, on examining her foot, the dorsum had a swollen, tight look to it, but there was no black and blue. The swelling would go down at night when she put her feet up, but would return, along with the pain, after getting up to walk around on it. The injury was localized along the Liver channel aspect of her foot.
Crucially, there were no broken bones. She had gone to the doctor and had X-rays taken which were negative for any kind of break.
Her pulse was wiry and choppy, and her tongue was unremarkable.
Basically, it came down to a pattern that one of my teachers back in PCOM thoroughly hated: Local Blood and Qi stagnation, albeit this time resulting from trauma. A Wu Yang patch would have been ideal, but we have none at SACHR.
Using TCM's theory of one body part reflected in another, I treated her with only three points; the most important being San Jiao 3, on the dorsum of her left hand. Essentially, this was treating one dorsum with its contralateral opposite. San Jiao 3 was particularly tender. Initially, I looked for tender points on her wrist, until I realized that I should be looking for a point that reflected the location of the trauma; hence, the use of the back of her left hand.
For good measure, I also used UB 60 and GB 41 on the affected foot, to move Qi and Blood.
The affect was almost immediate. Within a few minutes of needling, she reported that the pain was much reduced. At the end of the treatment, she walked out of the clinic without limping.
Friday, February 26, 2010
A Day at the Expo
This past weekend, the Integrative Healthcare Symposium came to New York City. And wretched timing it was also; Mother Nature walloped us with a HUMONGOUS snowstorm. A friend of mine who lives in South Jersey was prevented from attending by the weather. There was a decent turnout, even so, although I wonder how many might have been there had the weather been better.
The timing was spot on in a more abstract way, however. At a time when people are hurtling faster and faster into the future, riding the wave of modern technology, people seem to be getting less healthy, not more so. You'd think that with learning more things, it'd be the other way around, but, you'd be wrong. The symposium was a sobering wake up call to anyone who didn't think there was a problem.
Case in point: Nutrition. We know more now then we ever knew about food and the molecular-enzymatic-genetic dance that nutrients do in our bodies, yet we're no healthier for it. If anything, people are far worse off. Obesity and diabetes (what one speaker lumped together as "diabesity") is a growing problem that threatens to eat our economy alive as fast as a bunch of kids hopped up on caffeinated soft drinks and sugar devour a packet of McNuggets. We all know what to do (eat right); we just don't do it.
Another case in point: We have more technical and scientific knowledge now about electro-magnetism and radiation, yet no one seems to think anything about being bathed in EMF from cell phones, microwaves, and a plethora of other sources. Nor does anyone think that this is a bad thing.
What's going on here? Actually, it's the conjunction of a number of factors. Powerful interests that make money on the status quo, and with the new technologies that come down the pike coupled with the public's rather apathetic nature. For most of us, if we're not dying from it immediately, we don't consider it to be dangerous.
Of course, that's not entirely fair of me. Part of the apathy stems from the fact that so many people have come to depend on these things, and consider them "normal." A lot of my colleagues have found the iPhone, for instance, to be indispensable. All the same, industry does do a lot to block knowledge of how dangerous their products can be, all the while wowing us with ads for how wonderful life is with them.
Most pernicious is the marketing toward children. Parents today have it really bad; they not only have to work like donkeys, but have to shepherd their children through the minefield of modern life. Problem is, the shepherding is a bit distracted, owing to the fact that they're working like donkeys. So other voices, all of whom want to sell the children something and for the parents to pay for it, find it easy to slip through the parent filter and hawk directly at the children. Why else is all the candy at the checkout counter put at children's eye level? Why else are so many cute mascots associated with horrible food-like substances? Why has the level of discourse continued to drift toward things being more "extreme?" Someone is trying to have a conversation with our children, and the message increasingly is one of, "Don't worry about tomorrow, eat this crappy food, and be sure to buy this or your nothing but a failure."
So it was nice to see at the symposium a lot of people, such as Dr. Devra Davis, who are urging everyone to slow down and notice what's going on around us. Dr. Davis is the author of "The Secret History of the War on Cancer," and other literature that asks the simple question, "Who's interests are behind what's being sold to us?" It's a question that more of us need to ask.
On the nutrition front, attendee Dr. Mark Hyman helped call attention to the growing "diabesity" epidemic, and the simple steps that can be taken to help solve it. Simple, but very difficult. Modern life just doesn't offer an easy way to feed ourselves with whole foods as in the past. Still, basics apply, and a lot of people still do them: don't eat garbage, and get regular exercise. One thing Dr. Hyman said which I thought was excellent advice: Don't exercise, play. Exercise in a gym is drop-dead boring. Play, however, is very stimulating. So, go play. Bike, swim, play basketball, throw a frisbee. Just avoid the Hot Pockets.
Ironically, the symposium itself was filled with people who all want to sell you something for your practice. I think my favorite was the hair grower. Looking like the old fashion hair dryers that housewives across America used to gather under, it uses lasers and diodes to stimulate the scalp, and bring more blood flow to the hair follicles, thus increasing the nutrients they get so that they can grow. Of course, I can do the same thing with a seven-star hammer and a bottle of Si Wu Tang, but it's not nearly as cool as a big, honkin, hair-dryer looking thing with 20 lasers and a mess of diodes in it. It will also, I was assured, annihilate planet Alderon and crush the rebellion once and for all, should the need arise.
There was much more to see and do, of course, including massage (Thanks, Mikala!) and some free acupuncture, provided by my colleagues from Pacific College, but I can't write about everything that went on there. Next time it rolls around, and you have the time and money, check out the symposium. Or, you can skip it and watch some tube while eating Domino's and drinking Mountain Dew.
The timing was spot on in a more abstract way, however. At a time when people are hurtling faster and faster into the future, riding the wave of modern technology, people seem to be getting less healthy, not more so. You'd think that with learning more things, it'd be the other way around, but, you'd be wrong. The symposium was a sobering wake up call to anyone who didn't think there was a problem.
Case in point: Nutrition. We know more now then we ever knew about food and the molecular-enzymatic-genetic dance that nutrients do in our bodies, yet we're no healthier for it. If anything, people are far worse off. Obesity and diabetes (what one speaker lumped together as "diabesity") is a growing problem that threatens to eat our economy alive as fast as a bunch of kids hopped up on caffeinated soft drinks and sugar devour a packet of McNuggets. We all know what to do (eat right); we just don't do it.
Another case in point: We have more technical and scientific knowledge now about electro-magnetism and radiation, yet no one seems to think anything about being bathed in EMF from cell phones, microwaves, and a plethora of other sources. Nor does anyone think that this is a bad thing.
What's going on here? Actually, it's the conjunction of a number of factors. Powerful interests that make money on the status quo, and with the new technologies that come down the pike coupled with the public's rather apathetic nature. For most of us, if we're not dying from it immediately, we don't consider it to be dangerous.
Of course, that's not entirely fair of me. Part of the apathy stems from the fact that so many people have come to depend on these things, and consider them "normal." A lot of my colleagues have found the iPhone, for instance, to be indispensable. All the same, industry does do a lot to block knowledge of how dangerous their products can be, all the while wowing us with ads for how wonderful life is with them.
Most pernicious is the marketing toward children. Parents today have it really bad; they not only have to work like donkeys, but have to shepherd their children through the minefield of modern life. Problem is, the shepherding is a bit distracted, owing to the fact that they're working like donkeys. So other voices, all of whom want to sell the children something and for the parents to pay for it, find it easy to slip through the parent filter and hawk directly at the children. Why else is all the candy at the checkout counter put at children's eye level? Why else are so many cute mascots associated with horrible food-like substances? Why has the level of discourse continued to drift toward things being more "extreme?" Someone is trying to have a conversation with our children, and the message increasingly is one of, "Don't worry about tomorrow, eat this crappy food, and be sure to buy this or your nothing but a failure."
So it was nice to see at the symposium a lot of people, such as Dr. Devra Davis, who are urging everyone to slow down and notice what's going on around us. Dr. Davis is the author of "The Secret History of the War on Cancer," and other literature that asks the simple question, "Who's interests are behind what's being sold to us?" It's a question that more of us need to ask.
On the nutrition front, attendee Dr. Mark Hyman helped call attention to the growing "diabesity" epidemic, and the simple steps that can be taken to help solve it. Simple, but very difficult. Modern life just doesn't offer an easy way to feed ourselves with whole foods as in the past. Still, basics apply, and a lot of people still do them: don't eat garbage, and get regular exercise. One thing Dr. Hyman said which I thought was excellent advice: Don't exercise, play. Exercise in a gym is drop-dead boring. Play, however, is very stimulating. So, go play. Bike, swim, play basketball, throw a frisbee. Just avoid the Hot Pockets.
Ironically, the symposium itself was filled with people who all want to sell you something for your practice. I think my favorite was the hair grower. Looking like the old fashion hair dryers that housewives across America used to gather under, it uses lasers and diodes to stimulate the scalp, and bring more blood flow to the hair follicles, thus increasing the nutrients they get so that they can grow. Of course, I can do the same thing with a seven-star hammer and a bottle of Si Wu Tang, but it's not nearly as cool as a big, honkin, hair-dryer looking thing with 20 lasers and a mess of diodes in it. It will also, I was assured, annihilate planet Alderon and crush the rebellion once and for all, should the need arise.
There was much more to see and do, of course, including massage (Thanks, Mikala!) and some free acupuncture, provided by my colleagues from Pacific College, but I can't write about everything that went on there. Next time it rolls around, and you have the time and money, check out the symposium. Or, you can skip it and watch some tube while eating Domino's and drinking Mountain Dew.
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