The weeks keep flying by, probably because I am in clinic six
different shifts, which seems to make the days fly by. I would like
to take a moment to talk a little about a special case I have. I
started treating a patient this trimester that was recently
diagnosed with fibromyalgia.
Everyone is familiar with the word or diagnosis of fibromyalgia,
but how is it defined? Fibromyalgia is defined as a disorder of the
muscles and connective tissues. Patients have muscle pain, tender
spots, and they may have sleep disturbances, fatigue or depression.
Researchers have many theories of what may cause fibromyalgia such
as low serotonin levels, or an increased chemical called "substance
P" that can be caused both by stress or emotional trauma. Others
believe muscle "microtrauma" leads to fibromyalgia, and yet some
researchers believe genes play a role in how the body responds to
pain stimuli.
Diagnosis
In TCM, we diagnose based on the answers the patient states
about their pain as well as their response to questions about other
bodily functions. TCM does have acute and chronic pain diagnoses as
well those that sound like they have nothing to do with pain.
However, we always diagnose the whole person and not just their
manifestations.
Fellow interns.
Treatment
I started treating my patient at the beginning of May. Her
rheumatologist had just diagnosed her as having fibromyalgia two
weeks previously. During history taking, she said she also had
severe arthritis in her toes and knees. These disorders were
confirmed by either X-rays or bone scan. After completing an
extensive history, I came up with a diagnosis with my clinician and
began treatment. My point prescription was based on the pattern the
patient had that seemed to be causing the TCM organ disturbances
and thus the pain. After the treatment I discussed with the patient
how often I would like to see her and when I would reassess the
condition. I wanted to see her twice a week for three weeks.
Results
After the two weeks she seemed to be getting great results. Her
pain went from a 5 on VAS pain scale to no pain but just soreness.
She also had no headaches, an improved mood and some increase in
energy. She has not had to take her Celebrex for pain control in
two weeks.
Self Help
After such improvement, I wanted to incorporate stretches that
she could perform at home to relax the muscles and tendons. I
consulted some of my books but also my fellow chiropractic
students. They gave me instructions on how to perform the stretch
and how it would benefit the patient as well as the results I
should see. After explaining and showing these stretches to my
patient, I also gave her diagrams of the stretches with
instructions of how many reps, sets and amount of time to hold.
She was very grateful and appreciated the time I took with her.
This in turn made me feel good because that's what I look forward
to every day--helping my patients improve their condition as well
as allowing them to take control of their health.
Follow-Up
After reassessing her pain condition I have concluded that we
can treat once a week and hopefully see enough improvement that we
can do monthly treatments to keep her energy
balanced.