What diagnosis methods do you incorporate?
I usually incorporate the patient’s subjective information, along with my objective information to get a clearer picture of what the general cause of their chief complaint is, and to narrow it down to the specific pattern(s) that the patient may be experiencing at the time of the visit. For me, I find it best to focus on what the patient’s is coming into the clinic for (their chief complaint) as this will help to simplify my treatment strategy, as well as there is realistically not enough time within one session to address all of their complaints in one visit, especially if they have a chronic condition. If the patient does list a wide range of complaints, I write them down in the subjective section of their SOAP notes. Having noted all their complaints, I feel it can be beneficial as there may be an underlying factor that may connect all of their complaints together when I reflect back on their case.
In obtaining what they want taken cared of during the treatment session, I often ask them, “Out of all the complaints you have described to me, what are one or two complaints that you’d want me to address today?” The patient usually notes their chief complaint when I ask that question, and some have a complaint that relates to their chief complaint that they’d like relief from. I do however, try to incorporate points in my treatment plan that have multiple functions which cover their secondary complaints/root issues regarding their condition. If the patient is a female, I ask questions that describe the duration, quality, quantity, and experience of their menstrual cycle to also deduce any signs in affirming the diagnosis of their condition. I integrate a few points that will supplement/aid the time of stage they are at on their menstrual cycle, if I determine it is needed.
In acquiring subjective information, I ask the patient general questions about their sleep, their diet, what they tend to drink, their water intake, energy level day/night, etc. I also ask questions that are relevant to their chief complaint. For example, if the patient’s chief complaint involves pain, I use the “OPQRST” questions to understand if the pain is acute or chronic, and in their own words, the description of their pain they are experiencing so that I can formulate my point prescription accordingly with distal and/or local points to treat the affected area(s).
For acquiring objective information, I look at the persona of the person (voice, posture, their interaction when greeted), the shape of their face, the color of their complexion, and body type, to get a general glimpse as to their overall constitution. After obtaining sufficient subjective information, I ask the patient if I may read their pulse, feeling first all levels of the pulse on each hand, and then individually starting from the cun, guan, and chi positions. Rolling the fingers within, around, and between positions for a more complete assessment of the pulse is fundamental to obtain an accurate reading as well as to access the complimentary positions from superficial, middle, and deep levels. Lastly, I observe their tongue which presents strong visual indicators of a person’s overall harmony or disharmony of their relationships and connections with their meridians and internal organs of their body. Therefore I use this objective observation of the tongue as an important integral part in confirming their TCM diagnosis.
What treatment style do you use?
The treatment style I use is not one that is solely concrete in a specific methodology. I utilize an eclectic style that is abstract across the theories and methods in formulating an acupuncture prescription tailored uniquely to the patient, their condition, and constitution. For example, I may use the extraordinary meridians for a patient, balancing method of yin and yang points on the body for another, or having the similar functions of points on one side of the body and another point prescription on the other side of the body that does different actions and functions. It really all depends on what I feel the patient needs to aid in facilitating their healing process. And that is something which comes more metaphysical to me, as I tune in to the universal energy aligning with the patient for their best interest, rather than my existential logic in the formulation of their acupuncture prescription.
Needling patients, I often do free handed needling because I get to connect myself as a catalyst to the universal energies and propel the patient’s own energy in recognizing their self-worth in wanting to become the change they see for themselves. It has become comfortable for me to be able to thread the needle into their body, along with gently massaging and pressing on the point, metaphorically knocking on the door of the spirit of that point and ask permission for me to enter in. I seldomly use guide tubes, as there are some advantages to their practicality. Reasons I use the guide tubes for when there is a point on the patient’s body that I am not able to reach, given the context of the patient’s position relative to my accessibility; if the patient requests for me to use guide tubes, or if there is a point that may be extremely sensitive to the patient in order for me to quickly tap it in to their body in the effort to lessen the initial pain-like feeling. The latter reason for me using guide tubes is that I am still developing the skill to quickly tap the needle in free handed, like a bow and arrow.
What is unique about your style of how you treat? Such as do you prepare yourself before treatments, do you channel Qi, do you feel the Qi?
I do not let my ordeals, my pain (physical, emotional, mental, spiritual) interfere and affect my ability to be fully present while I am with a patient, especially during the needling process. I never want to send any negative vibrations into or onto a patient, as well as reciprocating any negative energies that are bound on a patient onto me. I wear jewelry made from the earth, to aid in protecting myself from any residual energy being transmitted from the patient. And also it protects the patient in propelling universal energy through me like a catalyst, amplifying the earthly materials surrounding me instilling their essential vibrations onto the patient. The energies that I work with, within the realm of the Tao, is to work with light, love, and warmness.
I believe the theme of overall longitudinal treatment for each patient, is working with the patient to understand who they are in relation to their ancestors, and by finding patterns in which their human existence is overcoming a similar past situation/condition. Their condition(s) can manifest in physical, emotional, spiritual constraint/pain. Herbs and acupuncture can help to stimulate a chemical response that the patient’s body needs, to assist in the patient’s willingness to resolve their past life issues. The purpose is to aid in building up on their strengths, to wield within them the ability to overcome their weaknesses, instead of the person finding out the hard way by repeating the same thoughts, behaviors, and feelings throughout their life experience. To get a feel for what herbs the patient may need for therapeutic assistance, it takes a connection of energy between patient and a higher source in knowing what the patient needs to help heal themselves on their own.
During the treatment process, I do not work against the patient’s energy, or rely on my own energy to heal. Working against the patient’s energy can make their condition(s) worse. And using my own energy to heal is not wise, as it is limited by my existing constitution and Jing reserve. If I were to use my own energy to heal, I’d probably age faster and have a short life span. The proper method of etiquette, as a practitioner, is to be a catalyst or facilitator in connecting with the universal energy of light and love, and empower the healing process in letting the patient overcome the darkness that is holding them back from transcending spiritually. Fighting fire with fire does not work as it does not naturally bring a person to a state of balance, but creates a void in another aspect of their life, which could be more harmful than how they were initially before treatment.
The main goal in mind for me is to have the patient feel validated. Having the ability to empower the will of healing within themselves, by wanting to change for the better to improve their quality of life. And then to provide universal light and love in areas that are weak for them, which can aid the patient to naturally heal their own self spiritually, emotionally, mentally, and physically.
When seeing a patient for the first time, how do you make them feel comfortable? How do you deal with the patient’s anxiety if they have a fear of needles? Do you do anything special if it’s a first-time patient for you?
When I see a patient for the first time, I give them a warm welcome and tell them that I am pleased to see that they have made the step in wanting to improve their quality of life with me. I explain to them what to expect during their session with me, how long it will take and if they have a time limit as some patient’s may be pressed on time and needing to keep on their daily schedule. For me, establishing rapport is key to create lasting practitioner-patient relationships, and to keep the patient coming in to see me.
If a patient expresses that they have a fear of needles, I assure them that the tools that I use is intended to be painless, that the needles are more like pins which is a sterile tool made of solid metal and hair-like in thickness.That the pins glide through the spaces between the skin and muscle fibers, so the only thing they’ll feel is their energy being activated, connecting the mind with the body, making way for the healing process to begin. I also would recommend that there are also other methods other than acupuncture that I can integrate in their path to healing, utilizing various traditional Chinese medicinal methods like cupping therapy, acupressure massage, gua sha, chi kung energy healing, and herbal therapy.
What I do with every patient that I have a session with, is that I always tell them that during the acupuncture process at any time, if they experience a burning or stinging sensation after I insert the needle, to let me know and that I can readjust it, so it will be comfortable for them as I do not want them to experience pain for the duration of the treatment session.
How does your past experiences assist you in treating?
I have my Master’s degree in Counseling Psychology and so my experiences of working with people, talking and making a person feel comfortable in being in a vulnerable setting, along with establishing patient/practitioner rapport has been useful. The skills that I have acquired while being educated and vocationally in the field of counseling has greatly helped me to have the patience and discernment of how I behave, act, speak, accordingly to the patient by aligning with them on their goals and needs. Actively listening to their concerns and facilitating their own growth in knowledge of how to take control of their health and healing process has been always a focus for me, both in the counseling field and here in the acupuncture field. The patient needs the acceptance to be independent on managing their lifestyle/health with the guidance of a health practitioner, rather than being dependent on a practitioner to manage their lifestyle/health. This empowers the patient with the capability to take care of their own well-being by making healthy lifestyle choices which they comfortable doing, and most importantly, being happy with those decisions.
How do you feel that Qi of the acupuncture point, how do you know you’re on the point?
I palpate the location of where the point would be, and then anatomically feel around the local area, as acupuncture points on a person may tend to move superior, inferior, anterior, or posterior to their textbook location for various factors. I know that I am on the point from a depression or a bubble in the location, along with calling on the point I can metaphysically connect and use my intuition on the place that their body is needling the healing.
How do you know when you get the Qi?
I usually watch the patient’s eyes or facial reaction to see how they are being affected by the needle, but I typically can feel the qi grasp the needle as I call upon the point either vocally or internally. The patient may also say that they have an “electric” sensation that radiates along the channel meridian pathways which tells me that their body’s energy has connected with that point and needle. Stimulating the needle, I can also feel if the patient’s qi has been grasped by a slight tug that feels magnetic within the sensation of my fingertips, but that is as close as I can describe it in literal form.
What kind of needles do you use?
I have tried various brands as well as different gauge thickness and found for me, the most effective and efficient needles I use while doing free hand needling is the brand EACU Korean style stainless steel spring handle, with the gauge thickness of 0.20 mm in diameter (36 in Chinese gauge size). The thinner gauges are said to be supposedly less pain on entry and smooth, but for me, trying to free hand needle any size less than 36 (i.e. 38-44) is too soft of a needle as it is hard to penetrate the skin, while keeping the needle from bending (which hurts on myself as it is wiggling into the skin instead of being straight and sturdy). In my opinion, the thinner gauged needles have a higher risk of breaking while free hand needling since it is wobbling and bending in every direction. However, using the guide tubes with thin needles won’t give you the effect like that of free handed needling. So it is all on your preference and how comfortable you are with the brand and gauge you use.
What has helped you to become confident in treating?
Believing in myself has been the major shift from feeling doubtful, to being able to trust my instincts and inner voice of what treatment plan and point prescription that I will do for each patient. Yes, textbook point and herbal prescription is vital to know in clinic and most importantly for our board exams, however Chinese Medicine is practiced as a medicinal art, the beauty of creating a masterpiece of health and resilience, each patient we interact with, our canvases. The needles and herbs are our brushes and colors. And we as practitioners are the painters that uniquely blends the shades of colors, utilizing the abstract skills we have acquired, to bring life into our canvases.
“Trust in yourself with all your heart. Never rely on what you think you may know. Remember who you are in everything that you do, and the Universe will show you the right way.”