Archive for tag: pain

Giving a Brazilian at Stroger

"Give her a Brazilian in Room 1!" This is the new catchphrase around Stroger. That's right, we're giving Brazilians at the pain clinic in Cook County Hospital. I occasionally worry that a passing doctor thinks I'm waxing ladies in the treatment room, but the concern quickly fades as I get down to business. This Brazilian is all in the ears, and the only intimate part is the bleeding. I always think bleeding is sort of a personal interaction.


According to a successful acupuncturist in Brazil, the best treatment for relieving joint pain with heat signs is to tonify the energy of the major internal organs, direct it towards the affected joints, and then bleed it out of the body. How do we do this exactly? Here's a sample case: inflammatory knee pain, let's say on the left knee. It's painful, the area is red, swollen, and warm to the touch. The patient often reports feeling warm, the pulse is slightly rapid, and the tongue is often red.


The Brazilian technique is essentially a three-step process. First, we needle the following points on the ear of the non-affected side: Shen Men, Sympathetic, Liver, Kidney, Heart, and Lung. Six needles so far, if you're counting. Then, we needle the corresponding painful body parts on the ear of the affected side of the body: Knee. OK, we're up to 7 needles so far. Totally doable. Now we let those needles rest for a while while we enter the SOAP note in the lovely electronic medical records system at Stroger.


After about 10 or 15 minutes, we take those needles all out. Next step, we get intimate. It's time to bleed the Ear Apex on the affected side. I like to give it a few hard squeezes to ensure I'm stealing as much hot blood out of this person's body as possible. Don't worry -- it's usually just a drop or two.


What happens next? Well, it varies. Often times, though, it goes like this. The patient stands up, wiggles around to "test" for any perceptible changes in pain level and range of motion, and starts to smile. "I feel better!" Pain levels are dropping from 10/10's to 4/10's in that 15-minute treatment time. Is it unorthodox? Somewhat. Is it effective? Seems to be. Will we keep giving Brazilians at Stroger? You bet.

Why Are We So Wimpy?

2014-06-10_wimpYes, I said "we." I'm lumping you all in with me and almost everyone else I know. We're wimpy. My sister said it best several years ago in a comment about the "wussification of America." No, I'm not sure how to spell that. She was speaking about the general wussiness of people these days, and I'll see that new word and raise it to another contextual use.

I'm sure you know what I'm talking about. If you have had a baby in the past 10 years, you've certainly had to explain to a grandmother (your kid's or otherwise) why baby has to ride in the car seat for every little trip. "Yes, grandma, I know we're just riding up the street to the corner store. Yes, she still needs to be strapped into her car seat. Just because." Grandma undoubtedly replies, "I never strapped your father into a car seat, and he lived. He would ride all the way to Florida to visit Aunt Ida every year and nothing ever happened to him." Then simply to justify my own wussiness, I make up something about how I'll be arrested if the police see me with my kid riding on my lap.

2014-06-10_signSome of you might not be convinced about the car seats. They're important. Even I strap my kids into those things just to ride up the street, and I don't consider myself a huge wussy. Just start extrapolating this theory, though, and you'll surely jump onto the "wussification of America" bandwagon. We all drink light beer. Every kid gets a trophy. They cancel school when it snows. I'm so hot walking the 10 feet from my air-conditioned car to my air-conditioned office. I have to wait 3 whole seconds for my Facebook page to load on this old phone. Waaaah.

How does this relate to Acupuncture and Oriental Medicine? Well, the wimps don't leave their wimpiness at the door of the clinic. That is for sure. I can write this post without fear of offending anyone, because I, myself, am a needle wuss. That's right. I don't want to feel the needles. I'll needle you, but don't you try to needle me.

Clearly I am not alone. Sure, you have a few patients who never flinch when you insert a needle. They never complain that something hurts or feels weird. These are the lovely "exception" patients, and they are few and far between. Most of us recoil in pain -- pain that is really just an unfulfilled apprehension of pain -- with the insertion of each needle. At first, I liked seeing this reaction from patients, because it justified my own wimpiness. Now, though, I've evolved. As I become less wimpy about needling myself and letting others needle me, I think I subconsciously expect more of my patients, too.

2014-06-10_smokeThe people in Nicaragua never flinched. We would jab those needles right into the sore back or the tired feet, and the patient would hardly notice. Are Nicaraguans simply a stronger people than Americans? Probably, but I didn't stop there. No, what about the Chinese needling? So deep, so hard, so scary for most Americans. Are they inherently stronger than us, too? They want to feel that moxa until it burns a blackened memorial into ST36. I would move to Japan, home of "shallow needling," to avoid those 6-inch needles I've been told so much about from the Chinese professors and clinicians.

2014-06-10_needleNo, I don't think it's that Nicaraguans are freakishly strong or that Chinese people are particularly masochistic. I just think Americans are caught in the throes of the recent trends towards wussification. Be careful, don't get hurt; don't let the sunshine get you! I reject wussification insofar as I legally can, but I am still and will always be one of the wimpy ones in the clinic when I'm on the receiving end of that needle business. So, if you're afraid of needles and therefore have not yet tried acupuncture, this post is for you. If I can do it, you can do it.