Patient experiences

Since somebody requested it, I will tell you two stories from my experience in treating patients. The first one began way back in the winter of 2000. I had graduated from my school, finally received my license to practice in the state of California and was just ready to join the workforce. Ideally, I would have liked to a job set up when I received my license but that was not the case. Instead, after looking through many “Want Ads” and interviewing with various facilities, I was fortunate enough to find an outpatient physical therapy company in the greater Los Angeles area. The interviewer was nice (in fact, she was the vice president of the whole operation and we are still friends to this day) and I had just gotten my first “real” job as an adult.

I would begin the following week. I was ready to treat patients and was just “buzzing” with anticipation to really make a difference in someone’s life. The moment of truth came and I was off to my first job. Now since they had just incorporated acupuncture as part of a treatment option, I did not have many patients to start out with. In fact I think that first day I had three total. Still, I saw it as a first step and was just excited that I had gotten a job which I spent numerous hours studying and practicing as an intern. Went into the office I was assigned, was greeted by the staff, and was just getting myself familiar with my surroundings. It turns out my first patient was already at the office waiting for me.

Let me give you a brief illustration about acupuncture training at a school. You are pretty much supervised the whole time. They go by four stages. The first stage, you don’t do much other than observe what the supervisor and the senior interns do. You literally sit there and watch and help out with the cleaning. The second stage, depending on your instructor, is where you do the intake on a returning patient and discuss the treatment options with the supervisor. At times, this can get boring but this where you pretty much try to apply what you have learned in the classroom into the clinical setting. The third stage is that you are in charge of every aspect of the patient care except that when you are needling the patient, you have to follow exactly what the supervisor does. The final stage is pretty much you do what you want in treating the patient and the supervisor comes in an makes sure you did everything right. Notice the theme of having a supervisor there all the time to check your work or just act as a safety blanket.

Well the first professional patient of my career was a burly gentleman with a neck and low back pain. The man was in his 40’s and was a very large man who was a big rig driver. He, though, was very soft spoken and polite despite his appearances. So I do my thorough intake and even devised a treatment plan that was suitable for this gentleman. I was ready to become a licensed acupuncturist.

I placed the first needle in his hand and what happens? The guy lets out a whimper. Seriously. This big man who could probably crush me with his bare hands, let’s out a whimper. I finish putting all the needles in (total of 8) and within 5 minutes, the patient asks me to come into the room again. I ask what was going on and he tells me, in a voice where he sounded like he was whimpering again, that he was getting nauseous and getting dizzy. These are common symptoms of what happened when someone who does not eat breakfast or any meal and decides to get a treatment (acupuncture, chiropractic, physical therapy, massage, etc…) So I asked him if he ate anything and his response was a “no”. I immediately took out the needles and gave him some warm water and a piece of candy to get his body normalized (very common procedure). While this is happening, my first thoughts that came to my head were “Oh Sh#@$!!! Why me?! Please don’t let this guy pass out and have an ambulance come to pick him up?!”

After a while, he was fine and able to go home on his own. What did I learn from this ordeal? No matter how much you think you are ready, you are never ready. Sadly, that was the last time I ever saw the patient. Do I blame myself for losing the patient? No, because I did everything correctly from what I have learned and was trained for. I took the proper steps and even did the correct protocol in dealing with patient. You win some, you lose some…

Another patient story I have to tell you about is to illustrate how the mind can affect the body, whether it be negatively or positively. First, let me explain a disorder called fibromyalgia. Fibromyalgia, in a nutshell, is total soreness or pain in the body. There really is no reason why it happens and even the medical doctors diagnose it as an “unknown etiology” which means they don’t know why it happens. Most doctors think it’s a psychogenic disorder where the problem comes from the person’s mind and manifests into the body. All I know is that it exists. The common symptoms are just a general soreness all over the body. It’s usually diagnosed when practitioner touches specific areas of the body in a sequence and, if it illicit pain, then you have fibromyalgia. Also, there is a theory that states it could be an excessive amount of lactic acid (the reason why your muscles feel sore after a workout) build up of the body that can come from diet.

So I had two patients who had this disorder. Let’s play a game. I will describe two patients with this disorder and you, the audience, try and guess who had a better prognosis. Ready? Here’s patient number one:

A female of 37 years old complains of having soreness all over her body especially in her hips, buttocks and neck regions. She has been diagnosed with having fibromyalgia by her MD for the past three years. She has been taking many prescription drugs such as vicodin, celebrex, ambien, naprosyn, and prevacid. She is a divorced mother of three. Physically, she looked fit and healthy for a woman of her age. She states that she eats properly and has no other medical conditions. When I initially spoke to her, she was very positive in her out look of “beating this disorder” and was excited to have her treatments done. She has been receiving other therapies such as massage and physical therapy and will now add acupuncture into her treatment plan. She has also has been attending a weekly support group meetings on fibromyalgia. When asked to rate her pain on a daily basis from 0 to 10 (zero being no pain and 10 being so much pain she has to go to the emergency room), she rates her pain at a 9.

Ok for patient number 2:

A female of 67 years old complains of having soreness all over her body especially in her hips, buttocks and neck regions. She has been diagnosed with having fibromyalgia by her MD for the past seven years. She has been taking many prescription drugs such as vicodin, celebrex, ambien, naprosyn, prevacid and vitamin supplements. She is a retired grandmother who lives with her husband. Physically, she looked fit and healthy for a woman of her age. She states that she eats properly and has had a history of having high blood pressure and two surgeries (one for fibroid removal in her ovaries and a herniated disk in her low back). When I initially spoke to her, she was very polite but neutral in her outlook of how acupuncture would help her. She has been receiving other therapies such as massage and physical therapy and will now add acupuncture into her treatment plan. She has also has been attending a weekly support group meetings on fibromyalgia. When asked to rate her pain on a daily basis from 0 to 10 (zero being no pain and 10 being so much pain she has to go to the emergency room), she rates her pain at a 9.

So can you guess from the information I have provided who actually did better with the treatments? If you guessed the first person, you would be incorrect. It turned out to be the second one. Here is a brief breakdown of why.

Patient one, while initially positive in her outlook, was a very non- compliant patient. She rarely attended her appointments and, when she did make it, she was always late. Late, as in she would come in 10 minutes before we were closing. You may think “ok maybe she’s working” but the truth was that she was unemployed. “Ok she has three kids and they take most of her time.” Well she has a hired nanny to watch them three kids. The thing that got me about her was this: She was so negative. Negative about her life, her kids’ lives, her current situation and all. She would constantly tell me that she was “going to beat this disease!” but, deep down, I knew it wasn’t going to happen. I even suggested to her that she go and meet some of her friends and just take it easy or go to the park with her children on the weekends just to relax. Her response was that she had no friends she can trust and that her children stress her out more than her condition. Ooookkkaaaayyy then…. Every time she came into the office, it was complaint of some sort about her life, her condition, her future. Even I was getting depressed just listening to her half the time. Also, when asked about her pain rate from the 0 to 10 scale on every one of her visits, it was always a 9. No changes whatsoever.

Patient two was, at first, let’s say a tough nut to crack. She thought what I was doing was not going to work. Well after the first treatment, she became a believer and was doing quite well. She came to all of her appointments and, after the first visit, she was actually a very pleasant person with a positive outlook on life. A very religious woman, she and her husband not only attend church but also participated in other church functions such as volunteering and singing in the choir. She also spends a good amount of time with her friends playing bridge every weekend. Every time she came into the clinic, she would often talk about many topics such as religion, what she did at church over the weekend, politics, cooking recipes and even boxing. She always had a smile on her face and was really one of those patients I enjoyed treating. Her pain scale at first was a 9 but after receiving 3 months of treatments for 3 times a week, her pain went down to a 4 where she states that her condition was tolerable.

So what’s the whole point of this? For one, if you are pleasant with your practitioner, they will be pleasant to with your treatment. Give us a reason why we want to help you. Don’t come in and complain all the time. We, too, are people and hate to listen to why your life is miserable. We know that and we’re doing our best to help you. Put it this way, I have to listen to "X" amount of people complain all day about their bodies and their lives. What makes your story so special that I will do something miraculous? Come in with a positive attitude and I will feed off that energy and make your treatment experience a positive one too. The second point is that while you may have physical symptoms of pain, the best thing to help alleviate that isn’t a magic drug. It’s having a positive, stress free mind. You will be surprised by what the mind can do. In Chinese medicine they say the governor of the whole body is…you guessed it! The mind. The mind will control the body. Having stress in your mind will cause your body a lot of unnecessary burden. Where do you think the phrase "He's got the weight of the world on his shoulders.." comes from? Stress can make you not only crazy but it will show up om the body as well. They usually appear around the neck and shoulder ares.

Keep in mind that to be healthy all around, it begins with your head. Get your head right and everything else will follow.