AcupunctureToday.com the Importance of Symptomatic Treatment 1376187581

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    Acupuncture Today

    August, 2013, Vol. 14, Issue 08 Share |

    acupuncturetoday.com >> General Acupuncture

    The Importance of Symptomatic Treatment

    By Kenton Sefcik, RAc, DiplAc, DiplTCM

    "Maintaining order rather than correcting disorder is the ultimate principle of wisdom. To cure disease

    after it has appeared is like digging a well when one feels thirsty or forging weapons after the war has

    already begun." Nei Jing

    When patients present themselves in the clinic, are they not already thirsty? When they complain of hot

    flashes, night sweating and pain in the knees, is it not too late to just treat the root? Within the constraints of

    private practice, group or private room treatment alike, the approach in the West generally allows for a

    limited amount of treatments on a regular basis before spacing them out to bi-weekly or monthly visits.

    With third-party coverage only available for 8-9 treatments, this doesnt leave a lot of time to work on

    chronic root conditions. Already, within the construct of our healing paradigm and the limitations due to

    societal time and monetary constraints, I believe facing the reality rather than offering a Band-Aid approach

    is most important and most effective.

    After years in practice, I have only ever had one patient come in, who had Type I Diabetes, and ask for

    maintenance treatments even though she had no pressing issues. She also did Crossfit, and saw a

    naturopathic doctor.

    Another patient, a physician with severe lower back pain, shows the other side of the spectrum. She saw me

    once (yielding results) before the pain specialist told her not to see me anymore to determine if the nerve

    root blocks were working or not. They didnt and she opted for a radio frequency ablation (read: burn the

    nerve). Finally, after her going through the health care system for a couple of months, shes back in my care

    with the same amount of pain. I have limited time to make a difference and this is after everyone else has

    had their fun with her back.

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    "Wherever there is pain, there is a point" could be the most basic maxim of our ancient healing approach.

    Again, this lends to the importance of treating what the patient is experiencing in the present moment. This

    is not barring that Chinese medicine theory has always spoke on treating branch and root at the same time;

    however, there are times when I find too much concentration on the root of the treatment leaving good

    results to be desired.

    Instead of an egocentric based approach, I feel its important to get back to a patient-centric approach. More

    explicitly, instead of telling ourselves that we are practicing some esoteric, high-level, root-based medicine,

    we should ask what our patients want which is always: "Fix me. Fast."

    Getting caught up in the inner workings of an industry is common. We find ourselves looking around to see

    what others are doing and how they are marketing themselves. Everyone wants to stand out. An issue arises

    when we are standing so close to the tree we cant see the forest. A medicine designed to zoom out has us

    zooming in and in the wrong direction.

    Changing to patient-centric goals would immediately have us discover that we need to get results and fast.

    Im no different than anyone else. While I educate my patients that a course of treatment is once a week for

    10 weeks, I only have one to two treatments to make a difference, and make them a believer in both the me

    and the medicine.

    When I need to influence a major change I use what I call "heavy-hitters." These are acu-points that willyield the greatest results in many areas at one time; acu-points that take up pages and pages in the history

    books. There is a time and a place for more subtle acu-points such as Liver 4; yet most times Liver 3 will do

    with greater results. Treating subtly or with just the root in mind are appropriate strategies for, perhaps, the

    aforementioned patient who was coming in for maintenance.

    Due to the demographic in my area, I see many patients who present with hot flashes and night sweating.

    For most of us, we learned that this is most likely due to a Kidney-Yin Deficiency. So, simply, a Kidney 3

    or Kidney 6 should do. The problem remains that this type of treatment may require a long time to take

    hold. Another combination, empirical and symptomatic, yields better results: Small Intestine 3, Heart 6, and

    Kidney 7. There could be other causes of hot flashes, such as overabundance of Heart and Lung Heat, Liver

    Qi Stagnation or sometimes even a cyst on the ovaries and/or liver. However, more often than not, the

    above-mentioned treatment quashes the problem.

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    Constipation is another one that reacts well to symptomatic treatment. Large Intestine 4, Large Intestine 11,

    and Stomach 25 are great points for getting Heat out and moving the stool. When constipation is quite

    severe or the patient isnt responding to the usual, I implore Triple Warmer 6 and Kidney 6 to increase

    peristalsis of the intestine and increase the water to "float the boat" on out.

    In an ever-stressful world, many ailments are due to Liver Qi Stagnation. Chinese medicines Liver Qi

    Stagnation is akin to Naturopathic Medicines Adrenal Fatigue. I call them the two types of burnouts:

    burnout from stress, and burnout from overwork.

    Liver Qi Stagnation can manifest as many different symptoms. A common one is clenching of the jaw,

    which can cause TMJ. Symptomatic points are Stomach 6, Stomach 7, and Large Intestine 4.

    Hypochondriac pain can be symptomatically treated with Triple Warmer 6 and Gallbladder 34. And

    abdominal distention responds well to Ren 6 and Stomach 36.

    A group of points I find myself using in the home quite frequently are for fever. Having young children

    wake in the middle of the night can be unnerving, especially when they have a very high temperature. Large

    Intestine 4, Large Intestine 11, and Du 14 all work well for bringing the fever down often immediately.

    These are the basis for all fever conditions that I use, adding in others depending on a Wind-Cold

    (Gallbladder 20, Lung 7) or Wind-Heat (Gallbladder 20, Triple Warmer 5) presentation. Kidney 7 is also a

    good one to add when there is anhidrosis.

    Often, when one is ill, breathing problems can ensue. Ren 17 and Pericardium 6 relieve the feeling of a

    suffocated chest. Ren 22 and Ex-B1Ding Chuan relieve cough and asthma conditions. If there are breathing

    problems due to Liver Qi Stagnation, a combination of two groups can be combined, for example:

    Pericardium 6 and Gallbladder 34.

    The last group of points I would like to comment on are for lower back sprain. I find myself cringing at the

    sight of my patient painfully, and not very gracefully, making their way out of the car. The worst case Id

    ever seen was when one gentleman was lying down in the back of his car; I pretty much had to carry him

    into my clinic.

    Any type of debilitating pain requires the quickest relief possible to improve quality of life a key goal for

    me in clinic. I may not be able to obliterate a condition, but improving quality of life to 80-100% over a

    course of treatment is what Im all about.

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    Ex-UE7 Yao Tong Dian and Du 26 are a very powerful combination one I have dubbed the "Chinese

    Robaxacet." I find almost an immediate response and decrease in pain and find these points imperative

    before jumping into a local treatment, which is equally important. Decreasing the spasm and pain before

    treating an area is a great symptomatic protocol when it can be used (example: Ex-UE8 Luo Zhen, Stomach

    38, etc).

    A lot can be said for symptomatic points and local (Ashi) points to relieve conditions. Essentially, this is

    how point prescriptions are made: local, adjacent, distal, Key/Command/Influential/etc, and root treatment.

    If we can augment the result by having certain protocols floating around in our heads, we succeed in more

    ways than one.

    Bruce Lee, a famous martial artist, had a teacher by the name of Ip Man when he studied Wing Chun in

    Hong Kong. There are stories that Ip Man used to say, "Go out and try it for yourself. I might be tricking

    you!" This was not meant to be interpreted that the aging instructor was lying or teaching false knowledge;

    it implies that one must prove it to oneself that it works or not. This is especially true in combative arts.

    The same can be said for any knowledge. A great time to experiment is when the clinic slows down. Try

    using symptomatic points. Try not using them. Try these options over a few treatments and make up your

    own mind based on what your patient is telling you. Because at the end of the day its really just about my

    patient, sitting across from me in clinic, telling me their life story. And its my hope, through the vehicle of

    acupuncture and Chinese medicine, that Ive made a difference.

    Click here for more information about Kenton Sefcik, RAc, DiplAc, DiplTCM.

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