Showing posts with label trauma. Show all posts
Showing posts with label trauma. Show all posts

Sunday, October 4, 2009

Herbal Remedies for your Gym Bag



Our poor neglected blog is coming back! Take a look at this article featuring Tom Bisio and Frank Butler's Zheng Gu Tui Na physical medicine: Herbal Remedies for your Gym Bag.

Fat Turtle Herb Company carries most of the products mentioned in the article, so give us a buzz at orders@fatturtleherbs.com or 310-691-5226 if you want to try these in the clinic or for yourself.

Nini and I will be attending the Zheng Gu Tui Na seminar in San Diego in a few weeks. This is excellent stuff to know and will be immediately useful in practice. I actually met Tom Bisio when I was working at Kamwo - he seems like a nice guy.

Thursday, September 3, 2009

Treatment of Sprains and Strains with TCM

Here's an interesting article from Alon Marcus on the treatment of strains and sprains with Chinese medicine. It goes into great detail on the different types of sprains and strains but is oddly lacking when it comes to acupuncture treatment strategies. Perhaps these will be covered in part two?

Curiously, the only herbal formula he mentions includes a highly toxic substance, 蟾酥 Chan Su, or toad venom. He neglects to mention the two most famous formulas for the treatment of external injury, 跌打丸 Die Da Wan and 三黃散 San Huang San. Die Da Wan, or "hit-fall pill", can be taken orally directly after injury for 2-3 days. San Huang San, or the "three yellows powder" consists of Huang Qin, Huang Lian and Da Huang powdered and mixed together in equal amounts (one popular modification adds Pu Gong Ying, Shan Zhi Zi and Hong Hua). This powder can then be mixed with green tea, water or egg white and spread in a plaster on the affected area. For details on these formulas, take a look at Tom Bisio's A Tooth From the Tiger's Mouth.

Thursday, June 11, 2009

Case Study: More of My Foot

Remember my foot injury about six months ago? It's mostly healed now; I would say about 90% healed, but every now and then it gets kind of funky. So I decided to find a good die da doctor to help me out.

A search on the Chinese yellow pages under 跌打 led me to 許俊明,醫師 Xu Jun Ming, PhD, LAc. Yesterday, he took a look at my foot and said, "needles are not going to help this." He proceeded to tui na the heck out of my ankle in a two-inch square space, producing a pain which I wasn't even aware could possibly exist before. He then moved on to a one-inch square space on the inside arch of my foot, complete with this popping thing he did similar to snapping his fingers, except that my foot was wedged in-between.

After about 30 minutes of solid tendon work, he grabbed my foot with two hands and manipulated the joint back into place, sending a shock of blinding pain followed by a sensation that can only be described as the best my foot has felt in months. I asked him what he thought was causing the problem, and he said that my joint was slightly dislocated. Had I gone to get imaging, he suspects that they would not be able to find anything wrong with it because nothing is fractured or severed and the joint is not grievously dislocated. According to him, it was ever so slightly off, and when he popped it back into proper alignment, I believed every word he said.

He finished with a hand-made herbal plaster that he mixed up in the treatment room next door as I waited, and came back with two patches that he placed over the spots he had done tui na to. He expertly bandaged my foot into middle position with some gauze, and I was told to stay off of it for the next two days.

I'll be going back to see him on Tuesday, and will let you know how it goes! In the meantime, if you need a recommendation for a good TCM traumatologist and physical medicine specialist, try this guy:

John Jun Ming Xu, PhD, LAc
617 S. Atlantic Blvd. #C
Monterey Park, CA 91754

Call for an appointment: 626-300-8986

Friday, December 12, 2008

Battlefield Acupuncture


Stephen M. Burns, a specialist in acupuncture, inserts a needle into the ear of Lt. Col. Catherine A. Reardon to treat her headaches and hand pain. (Baltimore Sun photo by Glenn Fawcett / December 9, 2008)

Col. Anyce Tock, chief of medical services for the Air Force Surgeon General, said two days ago that the service has authorized 32 active-duty physicians to begin "battlefield acupuncture" training. They announced today that they will begin teaching their physicians deploying to Iraq and Afghanistan early next year.

This endorsement of acupuncture by the traditionally conservative military medical community is very exciting news!!

Acupuncture has been used effectively in acute trauma and chronic pain, and even for analgesia during surgery. It is relatively easy to administer, requiring only a trained professional and a pack of needles, with little to no side effects. It has a wide range of applications, effective in reducing physical pain as well as emotional and psychological trauma. Acupuncture works best, with the most pronounced results, in the acute stage of injuries and when administered often.

There is an entire arsenal of tools that can be used in the battlefield when it comes to TCM traumatology and martial arts medicine. Besides acupuncture, there are highly effective herbs that can be used externally in conjunction with conventional pharmaceutical pain killers, and tui na body manipulation and bone setting techniques to treat physical disorders like dislocated limbs or broken bones.

The use of Chinese medicine to treat our wounded soldiers immediately after injury on the battlefield would offer them a bit of reprieve from their pain and suffering while in transit from the field to a medical facility. It can then be used to help them in rehabilitation after their necessary surgeries and other medical procedures. It's wonderful that the military is exploring the use of Chinese medicine to complement and enhance the treatment of our nation's service men and women.

Some excerpts from the Baltimore Sun story below:
Battlefield acupuncture has been especially effective among patients suffering from a combination of combat wounds, typically a brain injury or severed limbs, burns and penetrating wounds along with severe disorientation and anxiety.

But neither does acupuncture provoke the kind of adverse side effects, allergic reactions and potential addiction associated with powerful psychotropic drugs often used to dull the pain of the severely wounded.

"This is one of the fastest pain attenuators in existence - the pain can be gone in five minutes," said Niemtzow, a physician, acupuncturist and senior adviser to the Air Force surgeon general.

"We use acupuncture as an adjunct" to traditional therapy, said Niemtzow. "The Chinese have used it for 5,000 years. It works, and it's powerful."

"Acupuncture has been very helpful for people for whom other treatment has failed," said Lt. Col. Terri L. Riutcel, an Air Force psychiatrist who deployed to Iraq last year where she treated victims of roadside bomb blasts, among other injuries.

Acupuncture "is very well tolerated and there are very few side effects," apart from occasional bruising, she said. "I think it has tremendous potential for military medicine."

Battlefield acupuncture caught the eye of U.S. Army Rangers, who often operate in remote locations. At their invitation, Niemtzow and his team trained some Rangers last summer.

Nonetheless, advocates of the practice recognize that they must overcome skepticism within the ranks of military doctors.

"Oh, sure, some haven't gotten the word," said Burns, the clinic chief. "We are very much ahead of the curve."

Wednesday, November 12, 2008

My Foot

I know we promised you all diabetes, all the time for the month of November, but I have to take this rare opportunity to present you with a fresh case study.

My foot.

So, I was sparring in Kenpo class last Wednesday night when the most unfortunate thing happened. My right foot was forward, my left foot behind, and I was gearing up to punch this guy. As I was lunging forward, but before making any contact with my opponent, I heard a loud "SNAP" and I fell to the floor.

This is what happened:





It's amazing all the different colors the body can make!

I believe it's a severe ligament tear, though I haven't gotten the MRI to prove it. It's definitely not a broken bone, and nothing is completely severed as far as I can tell. The night it happened, I was fortunate enough to be near the clinic while it was still open, and Keven Uchida - a wonderful supervisor and orthopedic specialist - took a look at it. I also showed it to three different MD's who agreed that it's probably not broken. So don't worry. I know those of you out there who know me well and are concerned that I'm not taking the proper precautionary measures can rest assured that I'm not self-diagnosing... not entirely, anyway.

But I am self-treating, and it's been great!

Day One:
  • 30 minutes on ice immediately after injury
  • E-stim acupuncture at SI-3 and SI-4 on contralateral for 15 minutes
  • Dr. Brady Chin's dit da jow all over top and bottom of foot
  • San Huang San plaster made of huang qi, huang lian, da huang, pu gong ying, hong hua, and zhi zi powdered, mixed with just enough green tea to make a thick paste. Wrapped my foot loosely in gauze roll and medical tape overnight
  • Five Photos Brand hit pill (these always make my heart a little thumpity, but work like a miracle every time)
Day Two:
  • Woke up with no swelling and no bruising, but my skin around my foot was red. Removed plaster, and within five minutes my foot started to balloon. Reapplied dit da jow til dry, then another coat of plaster and gauze. The swelling went down immediately
  • Needled contralateral hand sensitive points near SI-3, SI-4, LU-10, Luo Zhen, Yao Tong Xue, and SJ-4. Manually stimulated for 20 mins.
  • Change of plaster and gauze overnight
  • Jin Gu Die Da Pian patent pills for the pain
Day Three:
  • Definite bruising! All blurple in color
  • Acupuncture treatment at the clinic with Kumiko Yamamoto (wonderful intern, by the way). E-stim acupuncture with same points on contralateral hand. Additional points without e-stim: ST-36, SP-9, SP-10, LV-8, GB-34, and Yin Tang
  • Epsom salt soak
  • Plaster and gauze
  • Jin Gu Die Da Pian
Day Four:
  • More purple and green in color
  • Epsom salt soak
  • Moxabustion all around foot for 30 minutes
  • Dit da jow
  • Jin Gu Die Da Pian
Day Five, Day Six, and Day Seven
  • I stopped using the plaster because my foot wasn't swollen; it had effectively kept the swelling to a minimal, and then no swelling at all. The bruising seemed to reach its climax around day six (the pics are from day five), and is now lightening around the edges
  • Moxabustion 2 times a day over affected area on foot, and on reflective areas on the opposite foot. Also ST-36, SP-10, GB-34, UB-60, KD-1 on affected foot/leg.
  • Acupressure on contralateral hand
  • Jin Gu Die Da Pian
And here I am on day eight! I can move my foot fairly freely in all directions, and wiggle all my toes, but am still unable to put any weight on it. Throughout the week, I've been doing strengthening exercises with all my new-found spare time, flexing and extending through the ball of my foot and ankle. I can stand on it just long enough to pick my other foot off the floor, as long as I'm holding on to something for balance.

There is no swelling, but there's a significant amount of bruising all along the top of my foot, as though I've spilled a bucket of ink on it or something. It's kind of purple, kind of blue, kind of green all in one. It still hurts, but at least I'm sleeping through the night now and can get around on my crutches without it hurting due to movement.

All in all, a steady and fairly speedy recovery. I'm planning on using a tendon soak from here on out, coupled with the moxa, acupuncture and exercises. I'm not taking the pills anymore, since they're really dispersing and moving, and hope to be back on my feet in another week.

If you have any questions about the herbs I used or where to find such wonderful remedies, feel free to contact us!

Tuesday, August 19, 2008

Cạo Gió



Cạo gió in Vietnamese means "to scrape the wind." In Chinese it is known as gua sha 刮痧, or "to scrape sand." It is a method of healing used throughout East and Southeast Asia for a wide variety of maladies, such as the common cold, flu, abdominal discomfort, bronchitis, asthma, and any other kind of illnesses where there is a sensation of being "stuck." It is extremely effective for muscular pain of any kind, whether acute or chronic, and as you can see from the picture above, it worked wonders for me back in the summer of 2006.

Cạo gió is an adaptogenic treatment that is akin to myofascial release, though it does so much more. We learn this treatment method as part of our training in TCM school in the US. In Viet Nam, everyone in the family has had this done to them and/or has done it to someone else. It's like the equivalent of taking Tylenol when you've got a cold or headache; it's actually the first line of defense when you feel an illness coming on. As the Chinese medicine sayings go: "Wind is the chief of the hundreds of diseases," and "If there is damage, there must be wind." The treatment, therefore, would be to get the "wind" out.

Oil or ointment is first rubbed on the skin as a lubricant, usually on the neck, back, and upper shoulders, but occasionally on the limbs, upper chest, and abdomen. A coin, Asian ceramic soup spoon, carved water buffalo horn, or any other rounded blunt edge is then used to scrape the surface of the skin with an even amount of firm pressure that produces a redness that kind of looks like "sand" is coming to the surface. Collectively, the "sand" ends up looking like the person receiving cạo gió has just been beaten with a baseball bat, but, unlike a bruise, the marks are very superficial and disappear after 2-4 days. Also, unlike a bruise, the marks appear to be painful, but they are not.

(As a funny aside, when I was in kindergarten, my teacher asked me why I had bruises on my neck. I had to explain to her that I was sick, and that it helped me. There were two other Vietnamese kids in my class, and we all told her it was ok, so she was satisfied with the explanation. On the other hand, when my brother was in the first grade, his teacher thought he was being abused and immediately called my parents.)

So how does it work?

In biomedicine, the effects of cạo gió are largely attributed to the placebo effect. Since so many Asians have been using it as folk medicine for such a long time, the belief that it works for all kinds of health problems makes the person perceive that there really is a reduction in pain and symptoms. This placebo effect is an accepted explanation because there have not been studies conducted that can adequately explain why it works.

According to Chinese medicine, cạo gió works to release stagnation in the muscles, channels, and collaterals, bringing pathogenic qi to the surface and allowing it to release through the skin like sweating. Because stagnation is an excess condition that can be brought on by either a deficiency or excess of qi or blood, breaking up the stagnation can bring flow and balance that results in either tonification or sedation, depending on the problem. That makes cạo gió a very versatile modality, useful in both wind and pain conditions. Because the scraping is usually performed along the spine and ribs, it can be used to treat organic problems through the activation of the back Shu points as well. It is useful when large areas of the body require the breakup of stasis, as well as when smaller areas of the body like the neck, wrists, ankles, hands, and feet need myofascial release and cupping isn't possible or practical.

Just to give you an idea of what cạo gió is good for, I'll use myself as a case study. In 2006, I was hit by the door of a taxi cab while on my bicycle, commuting in Manhattan. I was knocked into traffic, and hit the asphalt on the left side of my body. I had been in a motorcycle accident just the year before, and had almost completely recovered from that when this happened. All of my symptoms came back: my back spasmed and seized, I had difficulty walking, my periods came every two weeks, and I was an emotional wreck. The first treatment I received involved needling of LI-14 Bi Nao 臂臑, LV-5 Li Gou 蠡遘, and cạo gió on my back as depicted above.

Bi Nao means "upper arm" and is the intersecting point of the hand tai yang, hand yang ming, and foot tai yang channels, and the yank linking vessel. Its alternate name is Tou Chong or "head thoroughfare." It is used as a point that helps one to "stop seeing ghosts." In my case, it was needled to disperse the qi and enable me to let go of the experience on both the physical, emotional, and psychological level.

Li Gou means "woodworm canal," connecting the two wood channels (LV/GB) together. Instead of tonifying or moving qi throughout the whole body, I believe the doctor was trying to divert the stagnant qi through the Luo point of the Liver channel specifically to affect qi and blood simultaneously.

The cạo gió unblocked the blood stasis from the traumatic injury, as well as the qi stagnation from emotional constraint that was causing the physical pain. My back was scraped all over, including my shoulders, upper, and lower back. However, as you can see from the picture, the marks appeared most noticeably in areas that gave me the most trouble: angry-red on the level of Heart Shu UB-15 to Liver Shu UB 18, more purple-red in the other areas, with no marks appearing at all on the tops of my shoulders and lower back.

After the treatment, there was a significant improvement in my physical condition. Even though my periods were still irregular, I no longer experienced any of the pain in my back and it didn't hurt to walk. I also felt less like a victim and more like "well, these things happen." The next time I received cạo gió, the color was lighter and the area affected was smaller. After a few more treatments with herbs and acupuncture, my periods were normal again and I was able to fully recuperate.

That, my friends, is the power of folk medicine.

Here's a good website if you want to read more on cạo gió, or gua sha.