Adapting for the treatment of Complicated Patients

To be successful in the clinic, you may want to consider becoming fluent in several treatment modalities. When one type of treatment does not work, move on and try another one. Here is an experience I recently had.

During an ordinarily stressful workweek, a patient called to schedule an emergency acupuncture treatment on my day off. On her voice message she talked about having excruciating pain for several weeks and she could not take it anymore. She sounded as if she was going to do something drastic. I made a special trip in to see this woman. All of my tools were ready and I mentally reviewed possible causes for different types of pain.

A 62 year-old woman hunched over and shuffling her feet came through the clinic door. No eye contact was made from her, only through her exhausted looking husband’s eyes could I get a feel for the pain she suffered. An extensively long intake of her history revealed a three week-long headache, chronic and untouchable body pain, nausea, three days of insomnia, extreme fatigue and a psychological/emotional history spanning close to five decades. All these symptoms were of course accompanied by a handful of prescription drugs, electric shock therapy and several stays in the psych ward.

It was unpleasant to watch her whimper with pain while she eased onto the treatment table. Her body twitched and her legs kicked following insertion of the first needle. After two more needles her anxiety escalated dramatically, so I removed the needles for her safety and my piece of mind. I still needed to relieve her pain, so I started lightly administering tuina. This turned out to be the wrong plan because her pain only increased when I touched her body.

With this suffering patient’s husband looking at me in desperation, what was I suppose to do? An idea came to me moments later and I grabbed the tiniest needles and began to disinfect her ears. Her anxiety about the treatment I was administering was still very high but I continued and gently put 3 needles into each ear. The initial sensation from the ear acupuncture subsided after a few seconds. I believed her already heightened anxiety and focus on the pain would allow me to leave these needles in place for a short time. She agreed it was bearable and felt that she could try and relax for 10 minutes.

To my surprise, when I returned to the treatment room after 10 minutes, she was calm. No spasms, no crying, her fidgeting had stopped. I removed the needles and we discussed herbal treatment for her headaches, body aches and long-term psychological problems. I gave her my private telephone number and told her to call me if the herbs did not help or caused adverse side effects. When the patient left, I noted that she was walking more upright, didn’t have a shuffle anymore and was making eye contact and speaking without a stammer and in complete sentences.

I did not hear from her until the next treatment the following week. To my surprise, she walked in smiling! She told me how all of her pain was gone, including the headache and body aches. She also commented that her appetite returned and she was sleeping soundly again. The patient’s main goal and focus now is treating the uneasiness of her mind and spirit.   Even though we saw small improvements with just a couple acupuncture treatments, I told the patient that because of her long history, it will take many treatments before we see significant results with Chinese medicine.

I could feel her determination and newly found hope for a better life.

Dr. Brian Grosam