Monday, March 29, 2010
Japanese Acupuncture and Palliative Care might seem an unusual
combination but my clinical experience strongly suggests that there may
be some significant positive clinical outcomes as a result of judicious
treatment.
Robyn
A grandmother in her late 60s who has
been sadly diagnosed as suffering from
stage
4 ovarian cancer.
The symptoms include
extreme ascites that necessitates
regular drainage,
overwhelming lethargy
and as a result of chemotherapy,
diabolical
nausea,
body aches,
poor appetite and over the last few
days the significant increase in pitting
edema of the lower legs.
Her daughter’s best friend
and client of mine strongly recommended treatment in an effort to
relieve some of the debilitating symptoms as a result of her declining
health.
Neither Robyn, her family nor friends are any illusion
regarding the serious nature of the condition, she has been diagnosed as
suffering terminal illness and has only been given months to live.
My
role as a practitioner is primarily to relieve the overwhelming nausea
and help make what remains of her life as comfortable as possible.
Since
Robyn is unable to attend clinic, home treatments are necessary.
1st treatment.
Due to the
nature of her discomfort it was impossible to treat her laying face
down, as a result treatment was confined to the anterior aspect of her
body.
As an aside Robyn also suffered from breast cancer some
five years ago resulting in a mastectomy and chemotherapy, she has also
had extensive abdominal surgery and has a tube inserted in her abdominal
cavity to help drain the fluid from the abdominal cavity to relieve her
extreme ascites.
Palliative care in my opinion involves one goal
and one goal only, to help make the patient as comfortable as possible.
The
extreme of nausea is the most debilitating of the symptoms she is
experiencing.
Treatment.
Whilst
not abandoning the principles of Meridian therapy/Japanese acupuncture,
my clinical experience dictated that I use my accrued knowledge of
point function to expedite a positive clinical outcome as quickly and
comfortably as possible.
My goal was to achieve a positive
clinical outcome in a totally painless manner, as such I retained
.14mm needles in an extremely
judicious manner.
Her pulse was floating and full especially in
the liver, heart and stomach positions.
Following are the points
that I used in this initial treatment.
All needles were left in
place as in an orthodox TCM treatment.
Ki. 2 to control the heat affecting her heart.
SP.6 to build the yin qi to
counteract the enormous amount of heat generated by chemotherapy
Liv.8 to relieve the stagnation in
her abdomen.
ST. 43 and
LI.10 to relieve the heat
accumulating in the Yang Ming meridians resulting in body aches,
lethargy and debilitating nausea.
CV.4 - ST.25 – CV.12 to assist the transformation and
transportation of nutrients.
Liv.14
front mu point of the liver and extremely reactive touch, I use this
point to work in conjunction with Liv.8 to relieve some of the
stagnation and discomfort in the liver.
Pe.6 a specific point to relieve the nausea and calm the
shen.
Yintang was used
also as a calming agent.
Treatment
outcome.
Within 12 hours Robyn experienced a big
improvement in her general well-being and the nausea was significantly
relieved.
Her appetite improved to a level that inspired her to
eat her first solid meals in a long time.
In her own words she
felt the best she had felt in months.
To quote Robyn’s daughter's
message to me the following day.
“Oh Alan, she ate some dinner last night and breakfast this
morning.
We are so very grateful, mom
said that the nausea is not overwhelming her, which is great!”
For
mine this is a satisfactory clinical outcome regardless of the means
used to achieve it.
Treatment will be ongoing, more than likely
twice-weekly.
I will continue to refine treatment in an effort to
achieve positive clinical outcomes with a more specific diagnostic and
treatment protocols.
2nd
treatment.
As stated her overall condition, nausea and
appetite had improved significantly, however there was a significant
increase in pitting edema of the lower legs.
KI. 8 specifically for the pitting
edema around the ankles
St.44
more specific me to relieve that the accumulating in the Yang Ming
meridians since the body aches had improved significantly.
CV.4 - ST.25 – CV.12 to assist the
transformation and transportation of nutrients.
Liv.3 -14 to relieve the stagnation in
her abdomen.
Ki. 2 to
control the heat affecting her heart
Pe.6 a specific point to relieve the nausea and calm the
shen.
Yintang was used
also as a calming agent
I am continually inspired by the courage
and fortitude of many of my patients, especially in this instance.
Robyns
positive attitude and concern for others sets the behavioral bar very
high, whilst the situation is ominously similar to that of my late
wife's some 20 years ago and definitely has the potential to rattle the
bars of my cage, Robyn demonstrates many of the finest qualities of
being human, making my situation so much more tenable.
3rd Treatment
Robyn’s condition had stabilized, the nausea remained but at a
subdued level.
Her pulse had also settled down demonstrably.
As
a result of the amelioration of the symptoms I decided to revert to a
more classical/Meridian therapy approach to treatment and for the first
time I administered back shoe points in conjunction with a specific root
treatment.
As a result of albumen supplementation and
acupuncture treatment the pitting edema had also subsided.
Also after consultation with her oncologist
and family members it was decided she would seek no further orthodox
medical treatment or chemotherapy.
Treatment
Spleen root
treatment
Tonify Pe.7 – Sp.3,
shunt St. 44 – Liv.3 –GB.34
Back
Shu points
Bl.13-17-18-20-23-40-58
I
will be making another home visit this morning on my way to clinic and I
am hoping further improvement as a result of being more specific in my
approach.
Experience tells me that there is often a significant
change in condition of the patient who has undergone chemotherapy after
the first treatment but there is a tendency to plateau with incremental
improvement after subsequent treatments.
I trust his blog post
will be of some benefit to both you and your patients should you have
the opportunity to administer palliative care.
All the best,
Alan
Alan Jansson is an internationally
recognized teacher and practitioner of Traditional Japanese Acupuncture.
For well over a decade, independent of and in conjunction with
Masakazu Ikeda sensei and Edward Obaidey, Alan has presented, convened
and hosted more than 40 Traditional Japanese Acupuncture workshops in
Australia, New Zealand and USA. Driven by a strong desire to promote the
consumer friendly nature, clinical efficacy and potency of Meridian
Based Traditional Japanese Acupuncture, Alan is a staunch advocate of
practically based workshops and draws upon his 25 years clinical
experience and 14 years post and undergraduate teaching in a concerted
effort to lift the bar globally in the clinical application of this most
amazing medical art.
Join him in Exploring the Art of
Acupuncture in the 21st century at http://www.Worldacupuncture.com