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Tuesday, November 30, 2010

Updates soon !

Hi,

Thanks for following my adventures in China! I hope you liked it and got something from it!
Stay tuned as I am reviewing my experiences and posting new pictures soon!

Best wishes and love,
Damien

Saturday, November 6, 2010

China Japan Friendship Hospital, Beijing: Acupuncture Department with Dr. Bai, part 6. Neuralgia. Chasing the snake around the body.


Another interesting case occurred due to the increased pain level involved.

A female aged 57 presented with day nine of an outbreak of shingles. She had been taking pain killers for 5 days. She was an eye specialist in the China air force.

Shingles is a virus that travels through a nerve pathway of the body. It’s not known why it can re-inflame but it can be from chicken pox years previously for example.

I didn’t catch her description of the pain she was experiencing before she came in but it is well understood to be an extremely painful presentation. We examined the patient and there were red marks on the left side of the back near the armpit and around the left side of the body. Fortunately there weren’t boils or lesions, which is the highly contagious stage of this type of outbreak.

Normal examination procedures progressed, except we were in an open room with 5 interns, 2 assistants and Dr Bai. At this stage all other patients had left though due to finished treatments. The first part of treatment was scraping. This started on the back Bladder meridian and areas reddened straight away around LU, HT, LR and SP Bladder Shu points. As the scraping technique progressed the area indicated was treated. The words “Tong si li” were shouted out by the patient. I know “tong” means pain, but this was a new adaption. Simon (a fellow intern who is fluent in Chinese and English) generously translated that this meant pain like death. The scraping technique continued to below the left armpit area and above the left breast. All these areas are avoided in Western medicine due to the lymph system located in this area. Anyway. At one point TE5, LI4 and LI11 were needled as a pain relief acupuncture which I thought was cool.

The back shu points were then pricked by a lancet and glass jar vacuum cupped. Also around cervical spine 7. The process for the lancet was interesting as both hands were used by Dr. Bai. One hand pushed the area prior to pricking with the lancet with the other hand. This initial body contact makes the process more bearable. Also it was inferred not to take pain killers too. This was stated because it kills ST and SP Qi, some of the areas that came up with initial scraping. The explanation for this on the spot was because in Chinese medicine we are re-cycling everything, unlike Western medicine where things are taken away. As we proceeded one area wasn’t bleeding into the cup enough. The cup  was removed and the lancing process repeated on the same spot. Very painful I would guess. While she was sitting in the chair, arms forward, LI11 was also cupped, but with the needles left in.

Needles were inserted at the left side on the Bladder meridian and retained by being taped down. This was explained as the area of the nerve pathway travels there and therefore treated with acu.

The blood filled the glass cups. It was dark. This was explained in two ways. The virus in the blood making it darker (Western medicine) and the level of pain was reflected in the darkness, or Blood Stasis.

The procedure continued as we followed the snake around the body. The Chinese term for this type of pain that follows the nerve pathway. The snake of course travelled below the armpit and above the left breast. The patient now lying down was pricked with the lance in these areas. Her head twisting left and right in agony as she shouted “Tong si li”. Then cupped in these sensitive areas for further bleeding. Sp 10 was also lancet pricked and vacuum cup bled. Then normal needling to ST 36, StT40, SP6, GB 40, LR3 and an extra “secret” point below GB 34.  I was told 2 or 3 treatments like this would be needed. Not sure if that is cure or hopefully overall massive pain reduction.

In the Western medicine this is a very difficult case to treat, with the strongest pain killers not having any effect and the pain can last for a year in some cases. Hopefully the treatment this brave lady had will go a long way to pain relief and increased quality of life. 

Thursday, November 4, 2010

China Japan Friendship Hospital, Beijing: Acupuncture Department with Dr. Bai, part five. Electro moxibustion machines.




These machines seem to have the effect of moxibustion, but without the smoke. They were used a lot in the clinic when I attended. They looked quite dangerous but when I checked one out it wasn’t hot too complicated to use. Four leads come off the machine. Each has a moxa heating device. The moxa is encased in cotton and placed inside the device, then that is placed on the body where needed. The face and CV 4 were the most common areas I saw. They didn’t seem to get hot after treatment when I felt them and I was told the moxa could be used for two weeks. The two main advantages of them were no smoke and not having to stand over the patient for a period of time holding a moxa stick. They were left on the patient for a while and were also used if using electro too. The way they were placed on the body was by surgical tape strapped over them and then on to the body.  I’ve included some pictures too.

Wednesday, November 3, 2010

01 : Electronic heated Guasha machine and Hong Hua oil in bottle and applied on patient's skin 02: Dr Bai's fire needle collection 03: Used jars after bleeding technique 04: A look at the electro machines and electro moxibustion machines used 05: The special spray used 06: The treatment chair!






China Japan Friendship Hospital, Beijing: Acupuncture Department with Dr. Bai, part four.



More observations from the acupuncture front line and a round up of techniques and ideas.

One female patient presented with gallstones. Reviewing the scan they had I almost took it in my stride when I read the measurements. Then I had to get my brain around it. A 1cm x 2cm x 0.7cm was in the body of the gallbladder and at the top of the gallbladder was a 2cm x 5cm x 1cm stone! This patient must have been enduring excruciating pain for years? Any way she also had radiating back pain and I guess she chose acupuncture needle technique over an operation and also a stone that size would not be able to be sonically treated?

I was told acupuncture could fix this. If I go back hopefully I will be able to get another stone size reading, In the meantime because the patients pain was all the time at night she was given buried needle technique to help. This is were the needles are retained in place, in this case for ten days, by surgical tape over the top to bend them against the skin. The main points used were Bladder back shu for Liver and Gallbladder and also GB 34 and ST 36 which were also taped over and retained. She also received ear acupuncture, but with regular short acupuncture needles that were retained!

The general procedure in clinic was Guasha (scraping technique) first. This is done to move energy around the body and to reduce pain (Blood stasis). This was done on the back and also the front of the body, which I hadn’t seen before. A dark oil was used that contained Hong Hua (a Blood moving herb)to assist in reducing pain. Didn’t seem to work for the actual treatment!

This would be followed by what was called warm needle. The tungsten needle was flashed over a flame and not reddened. This was applied to the back using the back shu points. However 3 or 4 more insertions would be made. So for example centre of the spine, shu point, outer Bladder point and 1 cun or 2 cun lateral to the outer Bladder point. A yellow antiseptic solution was applied (generally) to the point before needling.

Then fire needle proper might be done on some main points and extra important points. The tungsten needle heated to red and applied to the skin. Same procedure as above.

Following this normal needling would be done. Just as a side note patients had to bring in their own needles! Each consultation would cost 300 Yuan and then for a treatment this would cost a few hundred more. So to have to bring your own needles was a bit cheeky I thought. This would be the case with fire needles sometimes too. I think that was for health reasons as some patients knew the same needles were used all the time. There was a presumption of adequate procedures and sterilisation from fire by other patients, or they may not have even considered to think about it. It is yet to be researched and this is frowned upon in Australian clinics, but not outlawed, because it’s such a rare practice in the first place.
The normal needling would consist of quick insertion and maybe some turning on insertion. All free hand. Impressively dozens of needles would be inserted in seconds, quicker than I could write the points down in fact! A face would be covered in less than five minutes.

Also with this scalp acupuncture would be utilised. Working on tracking Western brain function zones. For example the motor area of the brain was located and the scalp was needled above this area to help with leg or arm pain. Turtle image was also used. This is a far out concept but in TCM it makes sense. You map an image to a certain part of the body. For example in reflexology they map a curled human body to the foot and allocate organ areas to where they come up against the sole of the foot. In this case it’s a turtle. The centre is located on the belly button. This area is seen as significant in Chinese medicine theory as it’s where initial life was provided and is strong in energy. So if the patient has a painful right shoulder the right shoulder area of the turtle, superimposed on the belly , is needled. In this clinic usually a clustering of needles.

After this the patient would lie down and have electro to certain areas and usually electro moxibustion. This could last for an hour sometimes!

Another procedure after Guasha would be to use a lancet and bleed areas with vacuum glass jars. Mostly bleeding in Australia is a pin prick technique or one jab with a lance and some bleeding but it’s rarely done. Here many jabs of the lanced and deep. This is to provide good release of Blood Stasis and pain relief. In some cases it was observable to see darker blood (indicating more Blood Stasis).

Also ear acupuncture would be done following normal ear charts with needles and also herb seed placements. Finally Dr Bai would also prescribe herbal formulas in some cases as well.

Sometimes when the needles where retained a special spray was used over the area. It didn’t have any ingredients listed but smelt like balsamic vinegar. It was used to move Blood, relieve pain and I was told it could melt bone spurs..! This was the name on the bottle: Gu You Ling Cha Ji.

And finally there was a really cool electric Guasha tool. It provided heated Guasha, but unfortunately I didn’t see it in action as it had broken down.

As you can imagine a busy clinic with two assistants constantly on the go.

Tuesday, November 2, 2010

China Japan Friendship Hospital, Beijing: Acupuncture Department with Dr. Bai, part three.

Here is another installment of some of the acupuncture I witnessed.
One old man came in everyday. He was suffering from Bells Palsy. The paralysis was to the right of his face and affected his talking, perhaps sight, his philtrum was deviated and his muscles were beginning to atrophy on that side.

I liked this patient. He was tough and stoic. Never letting out any noise, even with 30 or 40 needles hanging out of his face. Dr Bai uses a lot of needles. Although what I do remember is a lot of sweat on his forehead, his shirt being caked in sweat and tears from his ok eye as he endured pain each day.

A combination of western and eastern theory was used in all these treatments. In this case shallow needling on the effected side of the face to stimulate the nerves. But first needling was given to the good side in a tonifying process. Then the diseased side. In fact the case for specific technique was very confusing as keeping track from one patient to the next was difficult and there would always be contradictions and differences in the treatments. One technique was to needle up and down then the inner part of the face and then the outer part.

Main areas would be:
ST 1
BL1
BL 2
Stomach face points
GB 14
LI 20
Tai Yang
Ying Tang
Extra point next to the nose
Plus a host of other extra points to make it up to 30 needles or so.

In another female patient with the same condition ST4 was threaded through to the philtrum inside and above the upper lip.

Anyway I tried to track this male patient’s progress each day. After each treatment there would be a noticeable leveling out of his face and better strength in his expressions with less skewness to his features and a lifting of his muscle structures.

However he would have to endure electro to the face with no compromise. ST 1, around the nose and other stomach points. On one day, and he still came back the next day after this, Dr Bai did a needle through technique on above his right eye. Pinching the skin of the upper right eye lid and needling through the middle of this, above the eyeball and up to GB14 but underneath the eye socket bone..!
Fortunately this area didn’t receive electro.

He would receive electro-moxibustion to the effected side as well. Electro moxibustion was the use of a machine with 4 attached pads that had Moxa attached to each one in a special pouch ( see photos). They were then attached to any part of the body and the machine would heat the moxa without burning creating warmth and releasing the properties of the herbs. Absolute smokeless moxa. I have never seen them before and may get one myself if I can find them.

Just as a side note I recall this gentleman getting electro acupuncture and electro moxibustion to his face for an hour. That is a lot of electro..!

China Japan Friendship Hospital, Beijing: Acupuncture Department with Dr. Bai, part two. Plus here are grown men holding hands before treatment!

Come join me. I’m in cafĂ© pub looking out over the canal near my hotel, trees either side. The Sun is baking the large wooden flake painted structure in front and I am sitting on a purple couch at Crow Dining looking out through the floor to ceiling window. I’m having a beer and the music here is acoustic Janis Joplin and folk. The image they use for Crow Dining is a yellow and blue shield with a crow silhouette superimposed over a red dirt blue sky picture of the Australian out back with some aboriginal kids in it. No worries.

I am looking through my acupuncture notes from last week to catch up with all my experiences! By the way the room Dr Bai worked from was the cleanest rooms I’ve been in so far in the hospital. Still, I can’t get over some of the treatments I’ve seen. I’ve brought it up with my class mates and the only response I seem to get is that “she gets results, but it would be totally unacceptable in Australia.”
Here are some of the cases I’ve seen treated:

Sudden deafness,
A benign brain tumour operation that lead to an internal bleed and some brain injury and paralysis
Emotional issues of a 16 year old psychotic
Shingles
Facial Paralysis (Bells Palsy)
Bone Spurs of the spine
Pain of the neck and back
Slipped Disc
Scoliosis of the Spine
Gallstones
And also patients from Europe for example.

After seeing the first treatment I reported, and also grown men holding hands with one whimpering in pain, I knew I was in for a wild ride.
Hopefully in this update I can describe some treatments that stuck with me and give you and overview of Dr. Bai’s treatment theories and general procedures and set up.
I guess one patient that remains with me was the guy who was wheeled in and out on a hospital bed every other day. He was a miserable bastard, but I guess rightly so as he had endured 14 treatments by the time I’d seen him and he was in a lot of pain. He was a permanent patient in the hospital for the time being because of a benign brain tumour operation that had lead to an internal bleed. This had stopped his speech and paralysed him down his right side and left him with a very vicious looking chunky scar on the left side of his head above the eye to the ear.
However when I saw him he was speaking and moving his arm and he went for and assisted walk after his last treatment.
At one point he was whimpering with pain and he received a timely slap to the forehead to placate him by Dr Bai.
Anyway the remarkable and poignant reason I remember him was that he was a Western medicine trained Chinese surgeon previously working in the same hospital. He sought out acupuncture for assistance with recovery.
What I witnessed not only made my blood curdle, but my stomach churn and my legs wobble.
The general standard procedure for patients was guasha, warm needle, fire needle, regular needling and electro and/or moxibustion. Due to his weak disposition he wasn’t given guasha…
The first technique was acupuncture from warm needle technique. The tungsten needle was flashed over heat but not reddened. Then needling of four points to five points across the spine of the bladder points was done from the top of the spine to the bottom. Then arm and warm needle along the right thigh and leg to the foot. The usual points done were:
GB 21
LI 15
LI 11
TE 5

ST 36
GB 34
SP 6
Sp 4
LR 3
And then other points according to the diagnosis.
Once this was done by the assistant Dr Bai would come along and begin some fire needling. This was when the tungsten needle was reddened with heat before being “invited into the skin”. This was over mainly the same points as before. However some would be added. Heart 1 for example. This is in the centre of the arm pit. I can only describe what I saw. The red hot needle was deeply gauged at this very sensitive area. The arm was lifted high for further penetration. Seeing an adult man’s face grimaced up when he twists around in pain while holding his ancient Chinese mum’s hand was really awful to witness. It was brief though.
These willow trees outside are beautiful.
After this key point and some more on the leg we had finished fire needle. Next was the regular needle. I guess I was surprised. I thought through and through technique wasn’t real and we had only speculated about it in the class room. This is were a needle is threaded through one part of the body to the next. This was done for this patient at PC6 and TE5, just above the wrist crease, through from one side of the arm to the other. Then again on KD 3 and BL 60 at the ankle. I couldn’t stop looking at the sharp end of the needle sticking out of the body at KD3. It was horrible and my poor stomach had already flipped at the first needling point! I felt sorry for the patient who had difficulty moving and the pointy end of the needle was dragging against the bed cloth making it very painful as he struggled for comfort. Phew. Another through and through which Dr Bai does a lot, which I didn’t see fortunately, is LR3 to KD1. This too was a surprise as I had never thought of this and KD 1, on the sole of the foot, is possibly one of the most painful areas to needle.
Following on from this comes the electro acupuncture. With the regular needles inserted electrodes are crocodile clipped to them. A machine that provides a small current of electricity to the area is then used. Due to the number of needles used it wasn’t rare to see three needles to one clip! A practice I would never have considered prior to coming here as one needle getting a current always seemed to be maximum tolerance for a patient back home!
After the head and leg were wired up the intensity of the electro could be clearly seen. The muscle spasms to his right thigh and foot were so large he could have kicked a football to the ceiling.
Anyway his recovery is speeding along with the walking attempt I mentioned before. Hopefully my attitude isn’t read as dismissive or derogatory. Recalling the treatment it just all seems so shocking and barbaric. However the results seem to progress well with returning patients and accolades. I guess Western treatments of chemotherapy and so on can be just as barbaric and disgusting.
However there was always a lot of good spirit, social interaction, talking about treatments and a general positive attitude present. All patients expressing great thanks for treatments.
If I am honest I’m glad I’m only there for a week. Due to some timetable rescheduling I may have some more experiences there though. So I will be able to catch up with previous patients. More coming!

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