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.

1 comment:

  1. A very clear overview of osteoporosis but I am wondering if the young woman has other deficiencies from her anorexia which could complicate the treatment. Also, since she is in her early twenties her bones should still be growing not so much in length but in thickness. Anorexia suspends maturation (the reason why many girls practice it) in much the same way that drought and famine do. What happens to these women after they resume a proper diet? Does the maturation process pick up where where it left off?

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