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Japanese Acupuncture and Palliative Care
By Alan | March 29, 2010
Japanese Acupuncture and Palliative Care might seem an unusual combination but my clinical experience strongly suggests that there may be some significant positive clinical outcomes as a result of judicious treatment.
Robyn
A grandmother in her late 60s who has been sadly diagnosed as suffering from stage 4 ovarian cancer.
The symptoms include extreme ascites that necessitates regular drainage, overwhelming lethargy and as a result of chemotherapy, diabolical nausea, body aches, poor appetite and over the last few days the significant increase in pitting edema of the lower legs.
Her daughter’s best friend and client of mine strongly recommended treatment in an effort to relieve some of the debilitating symptoms as a result of her declining health.
Neither Robyn, her family nor friends are any illusion regarding the serious nature of the condition, she has been diagnosed as suffering terminal illness and has only been given months to live.
My role as a practitioner is primarily to relieve the overwhelming nausea and help make what remains of her life as comfortable as possible.
Since Robyn is unable to attend clinic, home treatments are necessary.
1st treatment.
Due to the nature of her discomfort it was impossible to treat her laying face down, as a result treatment was confined to the anterior aspect of her body.
As an aside Robyn also suffered from breast cancer some five years ago resulting in a mastectomy and chemotherapy, she has also had extensive abdominal surgery and has a tube inserted in her abdominal cavity to help drain the fluid from the abdominal cavity to relieve her extreme ascites.
Palliative care in my opinion involves one goal and one goal only, to help make the patient as comfortable as possible.
The extreme of nausea is the most debilitating of the symptoms she is experiencing.
Treatment.
Whilst not abandoning the principles of Meridian therapy/Japanese acupuncture, my clinical experience dictated that I use my accrued knowledge of point function to expedite a positive clinical outcome as quickly and comfortably as possible.
My goal was to achieve a positive clinical outcome in a totally painless manner, as such I retained .14mm needles in an extremely judicious manner.
Her pulse was floating and full especially in the liver, heart and stomach positions.
Following are the points that I used in this initial treatment.
All needles were left in place as in an orthodox TCM treatment.
Ki. 2 to control the heat affecting her heart.
SP.6 to build the yin qi to counteract the enormous amount of heat generated by chemotherapy
Liv.8 to relieve the stagnation in her abdomen.
ST. 43 and LI.10 to relieve the heat accumulating in the Yang Ming meridians resulting in body aches, lethargy and debilitating nausea.
CV.4 – ST.25 – CV.12 to assist the transformation and transportation of nutrients.
Liv.14 front mu point of the liver and extremely reactive touch, I use this point to work in conjunction with Liv.8 to relieve some of the stagnation and discomfort in the liver.
Pe.6 a specific point to relieve the nausea and calm the shen.
Yintang was used also as a calming agent.
Treatment outcome.
Within 12 hours Robyn experienced a big improvement in her general well-being and the nausea was significantly relieved.
Her appetite improved to a level that inspired her to eat her first solid meals in a long time.
In her own words she felt the best she had felt in months.
To quote Robyn’s daughter’s message to me the following day.
“Oh Alan, she ate some dinner last night and breakfast this morning.
We are so very grateful, mom said that the nausea is not overwhelming her, which is great!”
For mine this is a satisfactory clinical outcome regardless of the means used to achieve it.
Treatment will be ongoing, more than likely twice-weekly.
I will continue to refine treatment in an effort to achieve positive clinical outcomes with a more specific diagnostic and treatment protocols.
2nd treatment.
As stated her overall condition, nausea and appetite had improved significantly, however there was a significant increase in pitting edema of the lower legs.
KI. 8 specifically for the pitting edema around the ankles
St.44 more specific me to relieve that the accumulating in the Yang Ming meridians since the body aches had improved significantly.
CV.4 - ST.25 – CV.12 to assist the transformation and transportation of nutrients.
Liv.3 -14 to relieve the stagnation in her abdomen.
Ki. 2 to control the heat affecting her heart
Pe.6 a specific point to relieve the nausea and calm the shen.
Yintang was used also as a calming agent
I am continually inspired by the courage and fortitude of many of my patients, especially in this instance.
Robyns positive attitude and concern for others sets the behavioral bar very high, whilst the situation is ominously similar to that of my late wife’s some 20 years ago and definitely has the potential to rattle the bars of my cage, Robyn demonstrates many of the finest qualities of being human, making my situation so much more tenable.
3rd Treatment
Robyn’s condition had stabilized, the nausea remained but at a subdued level.
Her pulse had also settled down demonstrably.
As a result of the amelioration of the symptoms I decided to revert to a more classical/Meridian therapy approach to treatment and for the first time I administered back shoe points in conjunction with a specific root treatment.
As a result of albumen supplementation and acupuncture treatment the pitting edema had also subsided.
Also after consultation with her oncologist and family members it was decided she would seek no further orthodox medical treatment or chemotherapy.
Treatment
Spleen root treatment Tonify Pe.7 – Sp.3, shunt St. 44 – Liv.3 –GB.34
Back Shu points Bl.13-17-18-20-23-40-58
I will be making another home visit this morning on my way to clinic and I am hoping further improvement as a result of being more specific in my approach.
Experience tells me that there is often a significant change in condition of the patient who has undergone chemotherapy after the first treatment but there is a tendency to plateau with incremental improvement after subsequent treatments.
I trust his blog post will be of some benefit to both you and your patients should you have the opportunity to administer palliative care.
All the best,
Alan
Alan Jansson is an internationally recognized teacher and practitioner of Traditional Japanese Acupuncture. For well over a decade, independent of and in conjunction with Masakazu Ikeda sensei and Edward Obaidey, Alan has presented, convened and hosted more than 40 Traditional Japanese Acupuncture workshops in Australia, New Zealand and USA. Driven by a strong desire to promote the consumer friendly nature, clinical efficacy and potency of Meridian Based Traditional Japanese Acupuncture, Alan is a staunch advocate of practically based workshops and draws upon his 25 years clinical experience and 14 years post and undergraduate teaching in a concerted effort to lift the bar globally in the clinical application of this most amazing medical art.
Join him in Exploring the Art of Acupuncture in the 21st century at http://www.Worldacupuncture.com
Topics: Case Studies, Japanese Acupuncture Education, Palliative Care, Post Surgery, Stress and Anxiety | No Comments »
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