Thursday, November 3, 2011

Traditional Chinese Medicine (TCM)

October was my month to try out Traditional Chinese Medicine (TCM). I have been experiencing knee pain to a point where I am ready to have my knees replaced. Despite daily doses of Aleve, I was unable to descend stairs without excruciating pain in my right knee. Even with added pain killers, I just could not stand it. While favoring my right knee, my left knee began to complain.

I am a physical therapist, and I cannot figure out the mechanics of what is going on. The most pain happens when weight-bearing is released. Lifting my leg in bed was painful. Yet I could walk up stairs without a problem. After several weeks, the pain relented. That happens, but was it the TCM this time?

I ran into Linda L. at the Grand Gateway Club. She wanted to know if I wanted to take Mandarin lessons. I already do. Did I want to take Tai Qi? I can't because of my knees. Oh! She could do Traditional Chinese Medicine! Okay, I'll try it.

Linda went to university, but studied physics. She learned TCM from family members and others who practiced TCM. Her wish is to study under a certain person who is able to delay late-stage cancer.

Before my first session, Linda told me to eat two pieces of bread and to have chocolate available! I thought she just meant to eat two pieces of bread's worth for a meal, like a sandwich, at least 1/2 hour before the session. I later learned I was to literally eat two pieces of bread. When I said I don't usually eat bread, she then said potatoes are okay. Linda was unable to explain why eating carbohydrates is important, but I found this quote from an article about using food for performance enhancement: "Carbohydrates are associated with tonifing the spleen and builds the qi with the tendency to be sweet and warm; however, not as warm as the proteins." Qi (pronounced chee) is positive energy flow or lifeforce.

Okay, for the first session Linda interviewed me as to the type and location of the pain, how long I've had it, etc. She asked if I had any other health problems. Then she had me eat a piece of chocolate, immediately before the session. Why chocolate? I found this as a comment on the internet: "The flavor of cocoa is bitter, which clears heat and moves qi. The cocoa butter/sugar/milk/ etc. is warm/damp." I understand that chocolate is relatively new to TCM.

The first treatment was for my right knee. I understood that this was a localized treatment for the pain. I lay supine on the bed and exposed my knee. Linda spread a bit of ointment which had a very mild patchouli scent. She then took a flat rectangle of jade, and began to scrape in about 2" strokes above my knee, and slowly worked her way around the knee, always stroking downward toward my foot. The stroking is firm and meant to cause reddening of the skin. Linda called it "bringing out the illness." This technique is called Gua Sha, which literally means to scrape away fever, and it is also called spooning or coining. According to Wikipedia: "When pressure is applied and the Gua Sha tool is moved over the skin, it helps bring stagnant blood called sha that has been lying trapped inside of the muscles. Gau Sha removes blood stagnancy, which is considered to cause harm to the body by disallowing healthy circulation of the blood through the tissues. Immediate relief from pain, stiffness, fever/chills, cough, nausea, etc. is commonly experienced."

If anyone is paying attention, the carbohydrates and chocolate are adding an element of warmth, yet the Gua Sha is removing heat. This may or may not be a contradiction.

Another TCM practice is moxibustion. This technique burns mugwort, a small spongy herb, to facilitate healing. "The herb can be burned on top of needles, above your skin, on salt or a slice of ginger. It is used to warm regions and acupuncture points with the intention of stimulating circulation through the points and inducing a smoother flow of blood and qi." There is also a moxa balm, and I do not know if that was the medium used by Linda for the scraping. I believe moxa is mugwort in a medium of some sort.

I do believe Linda was using moxa on the end of a stick and igniting it to heat the air in the glass jars.  So, after about 15-20 minutes of Gua Sha, Linda then did "cupping." "Cupping is an ancient therapy that stimulates the flow of blood and qi to the superficial muscle layers. The air inside the cup is heated and the rim is then applied to the skin, forming an airtight seal. As the air inside the cup cools, it contracts, forming a partial vacuum and enabling the cup to suck the skin, pulling in soft tissue, and drawing blood to that area." Linda was using small jars, the size of baby food jars, but of different sizes. She did study physics in college, but I don't think she realized that smaller jars would create greater suction than large ones. Then again, I don't think there is any control of the air temperature, when you thrust a flaming stick quickly in the jar, withdraw it and quickly place the jar on the skin.

Now it so happened, that the strongest suction, and thus the most pain, was on the very site where I get the most pain in my knee! Linda could adjust the suction by slipping a fingernail under the rim, and letting some air in. But the idea was to have the suction as strong as you could stand it. Generally I had no problem. The interesting thing was that the opposite knee began to ache. After another 15-20 minutes, she removed the jars (I had four around the knee cap). I then had four suction marks and four pink circles on my skin. They disappeared by the end of the day.

Linda had me stand up and do slight knee bends to assess the pain. I had no pain in the treated right knee, and pain in the untreated left knee! Crepitus (crunching) could be heard from both knees. I was told not to bathe (i.e. wash off the ointment) for three hours, and not to drink anything cold for three hours. Linda appeared to be unhappy that I prefer drinking ice cold drinks.

I think I was becoming a little phlegmy during the treatment, but that happens when I eat bread! After the treatment, I developed the sniffles and sneezing, and I noticed a little cold sore on my tongue. So, was the cold coming on anyway, or was my body clearing itself of toxins? I "cured" my cold with my usual treatment, some garlic and vitamin C (in the form of hot peppers!).

Two days later Linda treated the left knee. I again got the sniffles and sneezes (I'm allergic to mugwort?!), and this time my right knee ached! The next week she treated first the right, then the left knee. I was having less and less pain, and no longer developed cold symptoms afterward. Due to my own history, I do not know if the cold symptoms, nor the decreased pain had anything to do with the TCM, or was it just timing? Linda was able to use stronger suction, which resulted in a couple spots lasting a week.

By then Linda had decided on my diagnosis, that I had "cold in the bone." Now this isn't that I had a cold like the sniffles, nor necessarily that I felt cold. Illnesses in TCM are categorized as either Wind, Cold, Damp, or Heat patterns. Diagnosis usually includes feeling the pulse, which Linda did not do, and looking at the tongue. At the last session, Linda asked me to stick out my tongue, and said I was much improved. She claimed to have observed my tongue when I was talking during our first session. That was when I had a cold sore on my tongue, but did she really see that I had a thin white tongue coating?

Being diagnosed as Cold, I was to wear winter underwear under my pants and not to wear shorts. I panicked, because I tend to get too hot! So Linda said I should wear a knee protector just to cover my knees. So I purchased nylon leg sleeves, which Linda approved. The bulkier knee supports would be too warm for me, and they would be too supportive and possibly lead to weakening of my knees. I should also drink less cold beverages.

I had a pretty painless weekend before my last session, which was to be a whole body session. In other words, Linda was not going to treat the pain in my knees, she was going to treat the underlying problem. I had my two pieces of bread for lunch, and the chocolate just before the session. I lay on my stomach and Linda at first exclaimed that when I next see the doctor, I should have my heart checked! Now through questioning, she knew I was taking medication for blood pressure, so I don't know if she really saw something. She performed Gua Sha with downward strokes on either side of my spine from  between the shoulder blades to my waist for a good half hour. Then cupping, first four jars on my mid-back, then four jars on my lower back for 15-20 minutes.

Today after the jars were removed, Linda cut two small pieces of adhesive that looked like the sticky part of a bandaid, and placed one inside the "rim" of my upper ear on the left and the other on my lower spine. I was to keep these on for three days. As far as I can tell, the ear piece could have been holding something like a sesame seed. This appeared to be the TCM technique of auricular therapy or ear acupuncture, based on the theory that the entire body is represented on the auricle or outer ear. "Ear acupuncture points may be stimulated for a longer period of time by using ear seeds or ear tacks. These seeds are held in place on the ear with a small piece of adhesive tape." The ear spot seemed to be the treatment point for the knee, and not for my heart!

I can't figure out what the seed on my spine is for. The pieces of tape fell off without my realizing it, so I didn't get to check for and look at the "seeds."

Two days after my whole body treatment, I am still relatively pain-free, and have not taken any Aleve.

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