Patient care is winding down here at the NUHS Chicago Clinic for
me. I am slowly turning over all my patients to ninth trimester
interns as I finish with the last of my numbers for graduation. It
is a bittersweet moment with a lot of the patients because we have
been working together for the last six months. Although the
patients are sad to see us moving on, they have been super
supportive and excited for all us as we move on as doctors.
Over the past few months, my favorite pastime at clinic has been
learning more and more about acupuncture. It has been such an
effective treatment options for many of my patients. The results I
have gotten when using acupuncture for treatment nine times out of
ten have way exceeded my expectations.
Auricular therapy with ear seed
The newest facet of acupuncture I have been using with some of
my patients is auricular therapy. Auricular therapy consists of
needling specific points on or around the ear that correspond to
the rest of the body. Auricular therapy is a very effective
treatment for depression, fatigue, post-traumatic stress disorder,
smoking cessation, facial rejuvenation, appetite suppression/weight
loss, energy, and focus. For lasting results of an auricular
therapy treatment, ear seeds can be placed in the patient's ear on
specific pressure points. The ear seeds can be covered with a small
bandage and left in the patient's ear for a few days after the
Close up of ear seed
I have been treating a patient at the NUHS Chicago Whole Health
Center for fatigue, focus, and increased energy using a lot of the
acupuncture points in the ear. The patient is a student and also
works two jobs. On average, the patient gets about four hours of
sleep a night and her fatigue is mainly due to the stress of the
her hectic schedule.
After the initial treatment, the patient has seen a significant
increase in focus. Before starting treatment, she typically would
doze off when attempting to study for long periods of time. Now,
while studying, the patient stated she is able to maintain focus
for a much longer period of time. With continued treatment, the
patient has noticed increased energy levels throughout the day,
decreased fatigue, and a more restful night's sleep.
The start of 2014 has been a very trying one. As I mentioned in
earlier blogs, stress has been high due to my master bath remodel,
car troubles, the worst winter I can ever remember, and finalizing
everything for graduation. I can finally say that I think most of
the stress is behind me! The weather has been slightly (ever so
slightly) getting better. As of last Thursday, the finishing
touches were put on our master bathroom. As of last Friday, I sold
my car (huge relief). And as the weeks have been going by, more and
more of my numbers and paperwork have been completed for
graduation. I spent a large portion of the day on Monday cleaning,
organizing, and knocking things off my to-do list. With so much
stress taken off of me, I am feeling revitalized, ready for spring,
and more importantly ready for graduation.
Now that school is coming to a close, I have been working on the
paperwork for my license. There is lengthy application that needs
to be filled out and sent into the Illinois Department of Financial
and Professional Regulation. Along with the application, a fee,
undergraduate transcripts, and graduate transcripts also need to be
sent in as they approve the paperwork. It was a fairly confusing
application and process to put all together, but it was a great
feeling to put that envelope in the mail. Also, the sooner the
state gets the application and all supplemental materials, the
sooner it is processed, and the sooner I can start practicing after
The acupuncture course I was enrolled in ended back in the
beginning of February. I have been really enjoying practicing and
experimenting with acupuncture on my current patients. From carpal
tunnel syndrome, to headaches, to low back pain, to muscular
strains, to facial rejuvenation (an all natural form of Botox), I
have been getting really good results. Most patients love having it
done and some even come in requesting it. One big reason I enjoy
practicing acupuncture is the fact that if certain points are not
working for a patient, there's a large variety of additional points
and protocols to use with them. On top of that, if a patient
doesn't want to be needled, there is acupressure, auricular
therapy, and cupping that can all be used to achieve similar
Over the past few weeks, I have been learning about and using
acupuncture for facial rejuvenation. Acupuncture for facial
rejuvenation is an excellent option for patients who are looking
for a natural approach and want to avoid costly surgery or harmful
chemicals like Botox. The treatment involves a series of needles
that are placed in the hands, wrists, feet, and ankles for
detoxification. Another set of needles is used on specific
acupuncture points on the neck and face. The final set of needles
is contoured to the wrinkles on the patient's face. When the
treatment is complete, there are about 40-50 needles that are used.
It's a very complicated procedure, but the results patients have
For patients who have never had an acupuncture treatment before,
it is important to start with a tonifying or "four gates"
treatment. This is a combination of points in both hands (LI4) and
points in the feet (LV3). This is used to promote general qi
circulation and relaxation. Some patients feel a sensation of
tingling as they are undergoing the four gates therapy.
After the patient receives the four gates treatment or if the
patient has had acupuncture before, the practitioner starts with
the full facial rejuvenation protocol, which is described above.
After the needles are removed, a facial massage is performed on the
patient. This is an important step as it is not only relaxing for
the patient but it also reduces the chance of bruising.
The first questions that most patients have are: Does it hurt?
What results can I expect?
Some of the needles might be sensitive when inserted, but most
of the patients do not even feel them going in. The two areas I
have found that are most sensitive on patients are the upper lip
and nasal area. As for results, the first thing people notice after
treatment is the improvement in tone and texture of their skin.
After a few more treatments, patients come back saying that their
friends have noticed that, they are "looking well", but they can't
put a finger on what has changed. And after more treatments,
patients see a reduction in fine lines and wrinkles, pores tighten,
there's more color in their face, and a better facial skin
I plan on making this a part of my practice, and I hope it is a
big part. I have really enjoyed learning about it, practicing it,
and hope to learn a lot more as I practice.
This week has been what seems like an ongoing nightmare. I have
had a host of weather, car and house problems. The below zero
temperatures and snowfall have continued here in Chicago during the
worst winter I think I have ever experienced. During one of the
large snowstorms, water got into the FRM module in my car (not
entirely sure what that is, but apparently it controls the lights).
So I had to take my car in for some pricey and lengthy repairs. On
top of that, we have been re-doing our master bath at home, so our
entire apartment is a mess. There are tools, tile and dust
everywhere (or at least it seems like it to me). The good news is,
by the end of the week, I should have the car repairs taken care
of, the tiling should be finished in the bathroom, and we are
supposed to have weather above 30º this weekend and into next
De-stressing with the Olympics
One of the joys and stress-free activities I have had this week
is watching the Olympics any free chance that I get. I love
everything about the Olympics from the pageantry at the opening
ceremonies to the amazingly talented athletes, to the sense of
national pride everyone gets as they play out. One of the winter
Olympics events that blows my mind are the downhill skiing moguls.
Skiers absorb the impact of a series of bumps, and then show off
their ability to perform turns, flips, and other tricks on a series
of jumps. It's one of those sports that as you watch you are not
only amazed at what the athletes can do, but also that anyone can
actually do it. With the combination of the fast speeds, series of
obstacles, and massive flips, it really is one of the most intense
and difficult sporting events.
In clinic this week, I had a patient present with headaches and
sinus congestion. I particularly enjoy treating headache patients,
and I feel like it is one of the areas I excel in treating. After
going through a physical exam with the patient, I diagnosed the
problem as headaches due to cervicogenic tension and sinus
congestion. Most of the patient's pain was centrally located over
the area of the frontal sinuses. The pain was described as a
throbbing sensation, which changes with the weather, and is worse
when bending forward. The patient also has neck pain and cervical
muscle tenderness associated with myofascial trigger points, which
is characteristic of cervicogenic headache patients.
For treatment, I have been using a combination of soft tissue
work including: soft tissue massage, instrument assisted soft
tissue massage, pin and stretch, and post isometric relaxation to
the tight cervical muscles. I also have been using chiropractic
manipulative therapy to the patient's cervical spine, thoracic
spine, and cranium. The final therapy I have been using is
acupuncture. Acupuncture is particularly good for sinus congestion
and helping to drain those structures.
Over the past two weeks, I have been treating a patient with
carpal tunnel syndrome. Carpal tunnel syndrome is a median nerve
entrapment neuropathy, which causes paresthesia, pain, numbness,
swelling, and other symptoms in the wrist and hand. The symptoms
mainly occur around the thumb, index and ring fingers. These
symptoms are due to compression of the median nerve in the carpal
tunnel of the wrist.
The wrist carpal bones and a connective tissue covering called
the flexor retinaculum make the carpal tunnel. Several structures
pass through the tunnel including: flexor digitorum profundus
tendons, flexor digitorum superficialis tendons, and flexor
pollicis longus tendon, and the median nerve. Some of the main
causes are diabetes, obesity, pregnancy, hypothyroidism, and heavy
manual work especially with vibrating tools.
The treatment I have been using is a combination of chiropractic
manipulative therapy, instrument-assisted soft tissue manipulation,
acupuncture, therapeutic exercises, and supplementation. With this
combination, I have been able to take the patient from an 8/10 to
1/10 on the visual pain scale with almost no remaining
The main chiropractic manipulation I use for carpal tunnel
syndrome is called the opponens roll. The doctor takes a contact
over the palmer side of the wrist and spreads the flexor
retinaculum with a force applied. Patients get a lot of relief with
this adjustment due to stretching of the flexor retinaculum and
increased cross-sectional area of the carpal tunnel.
Acupuncture has also been a very effective tool in the
management of carpal tunnel syndrome, especially with the pain and
swelling. Some of the main points I have been using include: Liver
4, Lung (LU) 7, LU8, LU9, LU10, Pericardium (PC) 5, PC6, PC7, PC8,
and Heart 7.
Finally, I recommended that the patient supplement with
pyridoxine or vitamin B-6. This has been shown to help with carpal
tunnel syndrome by facilitating biosynthesis of pain-relieving
serotonin, reducing excitatory neurotransmitter glutamate, and a
diuretic effect through inhibition of anti-diuretic hormone.
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