All posts by Ryan Less

Case Studies

CASES OF EARS AND DIZZINESS

Ear problems often present with dizziness or vertigo as a common symptom. In the last couple years, a number of people have come here to the clinic with these types of cases. Over time, I have found that many of these patients respond very well to a combination of therapies we use here at New England Acupuncture. Lets look at a handful of these cases. (As always, many details are changed to fully protect the identity of patients).

Jonathan the MapMaker came in presenting with a previously diagnosed case of Benign Paroxysmal Positional Vertigo ( BPPV). This is a condition where a crystal in your ear breaks off, floating around, and causing vertigo. It is a temporary condition that eventually will resolve. The conventional therapy used by doctors and physical therapists, to treat this is the Epley maneuver. Even though it may be a self limiting condition, this makes it no less uncomfortable for patients.

In my experience, the Epley maneuver seems to perform poorly, as evidenced by the many patients who come here to the clinic after having gotten no relief from the Epley maneuver. Of course, this could be selection bias.

At any rate, Johnathan Map Maker, a 59 Swedish bodybuilder, had severe vertigo, had gotten no relief from Epley maneuver, and hoped I could give him some relief. On his first visit, he received acupuncture and craniosacral therapy. The acupuncture focused on treating both the channels (aka meridians) that ran through the ear area, as well as the kidney channel ( kidneys are said to govern hearing). Points used included TW 3(Triple Warmer 3), and empirical point known to treat ear problems, as well as GB41 and GB 40. These points are located on the gall bladder channel, which both connects with the Triple Warmer channel , which means that the two channels can help treat each other, and both run around the ear area. Also, the point GB 12, a point located near the mastoid process (behind and below the ear) was needled. Lastly, K3 and K2 were needled on the kidney channel.

When the needles were removed about 30 minutes later, acupressure and craniosacral therapy were applied. The very next day, the patient reported he felt 70% improved. One more treatment was given a few days later, the BPPV resolved and the patient has had no more symptoms. Other patients with BPPV have had similar success here with the same or very similar protocols.

Dizzy Dan

Dan, an 80 year old cop originally from Ontario, came to the clinic already having been diagnosed with Meniere’s disease. He had relatively frequent attacks of dizziness even though he had been taking the medication meclizine. The treatment protocol overlapped with the one used for the aforementioned case of BPPV. Craniosacral was applied similarly, but the acupuncture points were somewhat different. In this case, the local point GB 12. located near the ear was used again. Additionally, points that treat the imbalance known as damp phlegm were also used (st40, st36, sp9,etc) as well as TW6 and other points that assist the bodies ability to transform damp and phlegm. After two visits the patient reported less frequent flare ups of dizziness. After about 4 treatments, the improvements were significant enough that the patient only came once per month for maintenance.

This year another patient came in with meniere’s. He received a very similar treatment and gained similar relief. Though I have not seen him in a few months, he seemed to be doing fairly well at last visit.

The final ear related case we will discuss is Myrtle with the utricle. Myrtle is an older woman who had been diagnosed with some type of issue involving the utricle, and organ in the ear. Her symptom was that the world felt tilted to her, not actual dizziness. She had already started therapy with a physical therapist, and was engaging in various specific exercises involving her head and eyes. After making no improvement two weeks into that therapy, she came in for acupuncture.

Overall, she was fairly healthy, with her only issues being mild hypertension, well controlled with medications, and back pain from arthritis. From the principles of traditional Chinese medicine, she suffered from kidney vacuity. It is said that , “the kidneys open into the ears”. So, i utilized acupuncture points on the kidney and urinary bladder channels ( both of which share an important connection). Utilizing the imaging system from Dr. Tan, I selected and needle the appropriate points. After three treatments the symptom had improved by 50%. Myrtle continued receiving two acupuncture treatments per week, and after a few weeks, she had hardly any of the tilting symptom left.

There are a variety of ear related disorders. Many respond quite well. One condition, tinnitus, does not respond well. So, if someone you know has meniere’s, BPPV, or some other ear related ailment, go ahead and make an appointment.

Case Studies

A Cancer Patient Rejuvenates

NOTE: SOME DETAILS CHANGED TO PROTECT PATIENT IDENTITY

Though Traditional Chinese Medicine is roughly 5000 years old, it has a lot it can offer patients who have cancer. In this case history, we will look at a patient who benefited greatly from some basic acupuncture, herbs, and moxibustion. This patient’s story is a really great example.

The patient, whom we will call Mr. C, had been in remission for some 2 years but was still getting chemotherapy twice a year. At that point, the patient was diagnosed with a bladder infection, and shortly after that, he contracted an intestinal infection known as c. diff, which can be life threatening. Additionally, he was informed that the cancer had returned and would need to begin undergoing regular scheduled chemo treatments as well as a new treatment of rituxin. By the time the proverbial smoke had cleared and the infections had resolved, the patient was quite “wiped out”. Furthermore, Mr C also suffered from loose stool (a side effect of chemo), weakness of the legs, and a general malaise and lack of his normal mental vibrancy.

How did we go about helping Mr C regain vitality, improved digestion, improved recovery time after chemo, and increased zest for life? We carried out what, in traditional Chinese Medicine, is referred to as ‘fu zheng therapy. The term means support the normal. Simply put, this means strengthening the normal functions of the body so that it can withstand the chemo and other treatments. Another way to think about it is that therapy is used to reduce side effects of the cancer treatmenent.

As was mentioned previously, Mr. C’s side effects included fatigue, weakness of the legs, unsteady gait/dizziness, loose stools, somewhat depressed affect and feeling cold. In fact, the abdomen and arms and legs on Mr. C were ice cold to the touch. Real improvement was made within even the first week. While acupuncture was used, the biggest contributors were moxibustion and herbal therapy. Moxibustion is a type of ancient heat therapy where a specific herb is burned safely and comfortably over certain acupuncture points to strengthen the body and is particularly indicated in cases such as this, where the body is very cold to the touch, significant fatigue is present, and the pulse is deep and forceless at the radial artery.

An herbal formula, known in Chinese as Shen Ling Bai zhu San was given. The herb formula immediately began to improve digestion and improve bowel movements so that they were no longer loose. Energy levels also began to improve within about a week. Additionally, after 3 treatments of moxibustion, the abdomen was no longer ice cold, but only very mildly cold, and the limbs also felt warmer to the touch. The radial pulse was improved, though not entirely. As of this writing, the patient has reported that he finally feels like his old self, with an enthusiasm for life returning. While no one can predict the future, we plan to keep helping Mr C, doing what we can, to feel the best he can feel under these difficult circumstances. Seeing him smiling and animated again is very satisfying

If you or a loved one is undergoing chemo or other conventional cancer treatments, it may be worth looking into complementary treatments to help improve quality of life and potentially have an even deeper positive impact. Always discuss these matters with your physician before trying anything new.

Favorite Things, Recipes

Oatmeal non-milk milkshake

Oatmeal Fruit Smoothie (aka The Oatmeal Breakfast Milkshake)

1 Cup of fruit (frozen berries work nicely)
can use mango, banana, citrus, etc..

1 or 2 packets of quick or instant oatmeal (uncooked)

2/3 cup of water (roughly)

Combine in a blender at high speed until smooth. If it is too watery just add extra oatmeal. If too thick add a bit more water. For more fruity taste simply add more fruit.

You will get a creamy fruity oatmeal milkshake. In only a few minutes you can have a healthy drink full of antioxidants, complex carbs, fiber, vitamins, and great taste.

Articles

Chinese Herbal Medicine: An Overview

OVERVIEW

Traditional Chinese Medicine (TCM) is the indigenous medicine of China, which developed over the last 5000 years.  It employs three main methods/therapies to restore health to patients: herbal medicine, acupuncture, tui na (massage).

While it is acupuncture that has usually grabbed the headlines here in the U.S., it is actually herbal medicine that is considered the primary method of treatment by the Chinese themselves; at least in so far as TCM is concerned.

All three therapies in TCM (herbal medicine, acupuncture, tui na) are based on the same fundamental theories.  It is this sophisticated theory that helps make Chinese herbal medicine so successful.

Pattern Discrimination: What is it?

Most people who want to take an herbal remedy ask a question something like this: What herb can help my X (x being whatever problem they have)? This implies a single remedy for a single problem. For example, if you have gout, get some sour cherry juice. If you have a urinary tract infection, take a cranberry pill.  If you have inflammation take curcumin, for liver problems take milk thistle and artichoke. Its not that this is bad per se. But it could be better.  How so? Ah, that is where pattern discrimination comes in.

Let’s say you go to your doctor because of headaches. It is his/her job to figure out the cause of the headache. If you had neck tension that is severe, maybe a muscle relaxer helps.  If you had migraine, maybe Imitrex helps. But what if the problem is bacterial meningitis? You can’t treat that with a muscle relaxer or migraine medicine; you need antibiotics instead.  The point is that there is not ONLY ONE remedy for headache. Rather, there are many. And finding the right one will depend on getting the correct diagnosis.

A pattern discrimination is a similar thing. When you come into our clinic for a visit, we must determine which ‘pattern of imbalance’ is specifically causing your symptom.  Only after this is done can a Chinese herbal remedy be chosen. Let’s look at an example to make it easy for you to really grasp. Once you have this example stored in your memory, then you will be able to know about Chinese medicine on a deeper level.

Two patients come in complaining of low back pain. Let’s call them Larry and Sally.  Larry has pain that came on suddenly. He thinks it started when he did some extra yard work a couple days ago.  Now it aches and he notes that it improves once he gets moving. But pressing on the area or massaging it aggravate it.  Sally on the other hand has low back pain that came on slowly over time.  It started as a mild little ache, but in the last two years it has slowly gotten worse. It seems better when she rests, and she notices that it is worse by the end of the day.  Sally says that her back ‘feels weak’.

Obviously Larry and Sally are experiencing two very different sets of symptoms. In fact, two patients like this came into the clinic. And, as you might guess, they received two different treatments.

The point is that to treat a patient, we look at more that just the chief complaint.   In fact, the chief complaint is only meaningful when it is seen in the context of all the other signs and symptoms the patient has.  When all this information is woven together, it forms a ‘pattern’, and this pattern will direct the practitioner to the correct herbal formula.

CAN HERBS REALLY BE EFFECTIVE?

Chinese herbs can be VERY effective.  Just like anything else, they will not work 100% of the time, nor can they cure every disease known to man.  But they often can have a significant beneficial impact, sometimes even when other therapies have failed.  And the effects can be quite noticeable to the patient.  A few months ago, a woman came into the clinic because she had a severe yeast infection with vaginal itching, discharge, and was constantly feeling uncomfortable.  She had taken prescription drugs for some time, and they had given no relief.  The herbs we gave her began to give relief within a day, and 3 days later she felt about 75% better.  By the end of one week the yeast infection was eradicated.  Another great example is a patient who came in with significant fatigue.  After one week of herbs the fatigue had vanished.

Not all cases are that simple however.  People with more signifcant problems such as fibromyalgia, CFIDS(chronic fatigue syndrome), or conditions like lupus, may take longer to get reasonable results.

Chinese herbs do not work by magic. They take time and care.  And, in some cases, even the best crafted formula can fail.

RESEARCH

While Traditional Chinese medical theory is sophisticated and beautiful, how about some research.  Can herbs really affect the body? Consider for one moment that 25% of prescription drugs are actually directly derived from natural substances.  AN example is Digitalis, a heart medication which come from the flowering plant foxglove.  How about the antibiotic penicillin? It comes from a common mold.  Therefore it should be no surprise that Chinese herbal medicines can have very real benefits that have been studied and researched.  Here are a few examples:

The Chinese herb jin yin hua (lonicera flower) has shown to be able to inhibit the growth of 73.9% of oral pathogens, and also has a strong ability to inhibit influenza and HIV viruses.  This info is from the following references

Sun Y. et al. Antimicrobial properties of flos lonicera against oral pathogens. China Journal of Materia Medica. 21(4):242-3 Inside Back cover, Apr 1996

Chang W. et al. Antiviral Research. August 1995

The Chinese herb yan hu suo (rhizoma corydalis) exerts strong anti-inflammatory effects and can help with both acute and chronic inflammation.  It also has analgesic(i.e. pain killing) properties. The references are below

Kubo, M. et al. Biol Pharm Bulletin. February 1994

Zhu, XZ. Development of natural products as drugs acting on central nervous system. Memorias do Instituto Oswaldo Cruz. 86 2:173-5, 1991

Suffice it to say, Chinese herbs offer people a multitude of opportunities to improve health and well-being through real mechanisms of action on the body.

Articles, Services

Accessory Techniques:The Other Part of Acupuncture

The Chinese word for acupuncture is zhen jiu, and translates as ‘needle and fire’, or as ‘acumoxa therapy‘. Where does the fire come from? Well, there is a technique that has been employed by acupuncturists over the ages, and it is called ‘moxibustion’.  It is a special form of heat therapy. Below, we will describe this and some of the other techniques which, while lesser known here in the U.S., are quite valuable.  They are commonly used by acupuncturists all over the world, and we at New England Acupuncture & Herb Clinic utlizie them whenever they can be of value to the patient, offering another way to move closer to the desired therapeutic outcome and achieve success.

Moxibustion

As alluded to above, moxibustion is a special form of heat therapy commonly used as part of acupuncture. Not every patient will receive moxibustion. But when it is used, its effects can sometimes be remarkable.

Essentially, the practice of moxibustion involves the burning of various substances near the acupuncture points on the body. While there are some forms of direct moxibustion (i.e. burning it right on the skin), we do NOT use the direct method here at the clinic. Instead we use the indirect method, which means the moxa is comfortably held at a distance from the body while the heat gently penetrates the body and benefits the patient.  Patients find this therapy very enjoyable.

The most common substance used for moxibustion is artemisia vulgaris, an herb. Wen it is ground up and prepared for use in the clinic, it can resemble brown cotton, or ground up twigs. Other substances can be used for various therapeutic reason. Indications for the use of moxa include pain worse with cold and better with heat, a tendency to feel cold all the time, fatigue, conditions which in chinese medicine would be termed, ‘damp conditions’, and others. It may even be indicated in breech presentations in pregnant women.

The moxibustion is said to increase the yang energy of the body, dispel cold, promote cirulation of qi and blood, and transform damp. One of the wonderful uses I have found for moxa, is its use in helping older women who experience a feeling of distention and discomfort in their urinary bladder, but who have no infection. They often also have a feeling of  incomplete voiding of urine when they go to the bathroom. Another specific example of the use of moxi is cases of arthritis where the joint pain is worsened by cold weather. For more examples of real life cases treated here at the clinic please go to our case history page. There we have posted some of the cases we have treated, in order to illustrate some of the principles of how Chinese medicine works and the results that can be attained.

Cupping

Cupping is pretty straight forward. It is the application of ‘suction cups’ to specific areas of the body, most often the back and shoulders. This technique can be combined with others, or used by itself. It can be very effective for relieving muscle tension. This is its most common use. Sometimes the cup(s) is placed in a particular spot and left for a few minutes. Other times hypoallergenic massage oil may be rubbed into a broad area and the cup can be moved back and forth over this area. That is termed ‘moving cupping’, or ‘sliding cupping’. There are some people who may be sensitive to the pressure, but most patients seem to find it fine, and even quite pleasant.

Tui Na (no, its not pronounced “tuna”.  It is “tway na” or “twee na”, depending on who you ask).

This translates as ‘pushing and grasping’. While it sounds a bit rough, it is not. Actually, it is a sophisticated and ancient form of massage developed in China. It has been imported to other coutries where it was modified to fit their needs and cultures. The prime example that comes to mind is Shiatsu, which is what tui na became after it was imported to Japan.

Tui Na, sometimes called Anmo, or amma, is based on the same theories and principles as all of Chinese medicine. Thus, it too works to stimulate or relax the acupuncture points and channels that lay on the surface of the body. It also works directly on the muscles, ligaments and tendons. Some patients have described it as a ‘complex form of acupressure’.

In summary, Chinese medicine offers many therapeutic techniques. Each one brings with it a good deal of value and benefit. They are non-invasive, quite safe, and often highly enjoyable.