May 2019

May 2019

The Office: Herbs for Peripheral Neuropathy

  • Warm extremities
    • This pattern has both inflammation and ischemia.
    • Swollen blood vessels impair blood flow into feet.
    • This pattern occurs more with diabetics.
    • Using cooling herbs to shrink the swelling of the vessels and then blood moving herbs to promote blood flow.
      • Dan Gui Nian Tong Tang -30- 40
      • Chi Shao – 15
      • Yu Jin – 15
      • Dang Gui -15
      • Chuang Xiong – 15
      • Shui Zhi – 5
      • Tu Bie Cong – 5
      • Quan Xie – 5
      • Astringents – 20
    • If there is heat in the body, you can also use herbs to clear heat.
      • Mu Dan Pi
      • Xuan Shen
      • Zhi Mu
      • Huang Bai
      •  
  • Cold extremities
    • Ischemic problem. Move the Blood
      • Si Ni Tang – 20
      • Dang Gui Si Ni Tang – 20
      • Chuang Xiong – 10
      • Dang Gui – 10
      • Tu Bie Chong – 5
      • Di Long – 5
      • Quan Xie -5
      • Tao Ren – 10
      • Dan Shen – 10
      • Hong Hua – 10

The Office: DNA™ for Peripheral Neuropathy

  • Three types of peripheral neuropathy
    • Diabetic
      • 80% success rate with DNA™ at our clinic in Poulsbo
    • Chemotherapy-induced
      • Difficult to treat ~40% chance of success.
    • Etiology unknown
  • Dysfunction of nerves causes pain and numbness
    • Numbness is the most advanced stage
    • All types are caused by ischemia
      • Small vessels (Jing Mai and Cun Mai) are affected and the nerves do no get proper blood flow
  • Acupuncture
    • Need to promote a strong response from the CNS to vasodilate the affected area
      • Use the joint zones!
    • Example of peripheral neuropathy on the bottom of the feet
      • Needle the Yin Joint Zones on the ankle of the affected foot
        • Ki 6, Sp 5, Lv 4
      • Needle the anterior- exterior pair on the other ankle
        • Ub 62, Gb 40, St 41
      • Needle the same Jing Jin on opposite side wrist
        • Ht 7, Lu 9, Pc 7
      • Other wrist: needle anterior – exterior relationship
        • Li 5, Sj 5, Si, 5
    • Using Knees/ elbows:
      • For sensitive patients, you can use the same strategy as above with knees and elbows
    • Other points
      • Du 20 (image of the foot)
      • Needle between metacarpals on the hand for feet can also help
    • Treatment will take time
      • Expect ~32 visits
        • First month: 3 times a week
        • Second month: 2 times a week
        • Third month: 1 a week
  • How to determine success
    • End of the second month
      • The patient should be at least 40% better
      • If the patient is only 20-30% better, you may not be able to help the patient more than that
        • 50% chance of helping the patient more at this point
        • Talk with patient if continued care is wanted based on possible outcome

The Office: Long Term Patients

  • Some patients will want to continue care indefinitely.
    • This is a really good idea for people of the age of 60
    • You cannot stop the aging process, but you can slow the process down.
  • Most practioners take herbs every day, why wouldn’t we offer the same for our patients?
    • This is the optimal situation for patients long term.

The Office: Prepaid Health Plans

  • It’s easy to feel guilty about what our services cost.
  • This can create an impulse to minimize a necessary treatment plan.
    • If you sell a weakened treatment plan, you will not be able to treat the patient to the level they need.
    • In other words, you will fail to live up to your promises.
    • Does doing this really help the patient?
  • You need to provide the patient with the amount of treatment they need.
    • Other medical specialists tell the patient what they need. Then charge the patients their standard price for the treatment/procedure.
    • Acupuncturists need to have the same type of confidence in what they do, and not feel guilty about charging for their services.
  • Don’t prejudge the patient!
    • If a patient wants the care, then they will figure out a way to do it.

The Office: Obesity & Headache Case Study

  • Case study
    • 50yo female patient
    • 5′ 4″ 260lbs
    • Occupation: City Bus Driver
  • Chief Complaints: Vertigo with severe protracted headaches, fatigue, insomnia, recurrent sinus infections, depression, and weight loss.
  • Pulses:
    • R Cun: Blocked Stage 3.
    • R Guan: Deep, Convex and Pounding
    • R Chi: Deep, Pounding
    • L Cun: Blocked Stage 2-3
    • L Guan: Deep, Convex, Pounding
    • L Chi: Deep, Pounding
  • Morbid obese patients are easy to treat!
    • Pulses are usually very deep against the bone.
    • Excess fat will squash blood vessels, especially in the abdomen
    • These patients will usually have dilated cardiomyopathy and/or congestive heart failure
    • What do you do? You move the blood!
  • First herbs
    • Vitality 100 to move the blood
  • Second herbs
    • Feels better, but still has a headache
    • Right Cun still blocked
    • Herbs
      • Bai Zhu – 20
      • Ban Xia – 20
      • Fu Ling – 20
      • Zei Xie – 20
      • Tian Ma – 20
    • This formula can be very dry
      • Add Qing Zao Jiu Fei Tang if needed
        • You wouldn’t give this to a patient like her that has a lot of dampness.
  • Third herbs
    • Three weeks later dizziness is gone, but the headache remains.
    • Sinuses are still inflamed causing headache
      • Resolve Em – 40
      • Herbal Abx – 15
      • Astringents – 15
      • Clear Heat – 15
      • Huang Lian Shang Qin Wan – 15
  • Prepaid plans/commitment are crucial!
    • If you get to see a patient 30-40 times, you can change their life!