John Amaro, LAc, DC, Dipl. Ac.(NCCAOM), Dipl.Med.Ac.(IAMA)
Having practiced acupuncture along with chiropractic since the inception of my practice in 1971, I have developed a reputation for successfully dealing with difficult, unusual, and nonresponsive conditions.
In reflecting on my history in this profession, I cannot help to feel one of the primary reasons I have attained such a high level of success in dealing with such unusual, chronic, and difficult cases is simply that I listen to what patients say in consultation, especially the first 50 words.
This was not a learned, academic response but one which developed over years of observation. In my early days of practice, as most new practitioners, I found myself talking about four times as much as I was listening. Of course I felt compelled to tell the entire chiropractic story to include the address of the Ryan building on Brady street, and the story could not be complete without mentioning that Harvey Lillard was black.
Quite by accident and possibly divine guidance, I heard what a new patient, Mrs. Jones, said one day. I didn't say "listened," I said "heard." "I have these horrendous headaches," she began. "One day when I was in the grocery store, a can of corn fell on my fourth toe -- or was it green beans? Ever since that time I've had these headaches."
Everyone reading this on five continents, can relate to a similar case history. The first thing most of us do is to disregard the seemingly insignificant part of the story and go right to the heart of the matter, namely, the headache. Dropping the can of corn on her toe carries no weight as to the cause of Mrs. Jones' problem, or does it?
From an acupuncture perspective, the fourth toe relates to the gallbladder meridian, which relates directly to the frontal, temporal and occipital portions of the head. Injuring the fourth toe could most definitely create a disturbance in the meridian. A meridian, of course, affects what it's named after or where it courses through.
Mrs. Jones had previously received several months of chiropractic care, along with prescription and over the counter remedies. Her headaches however were relieved by dealing with her gallbladder meridian which, of course, relates to the fourth toe.
Perhaps one of the most interesting observations I have made regarding this phenomenon of the case history is that these very "insignificant" portions of the consultation generally come within the first 50 words of the patient.
I will refrain from relating scores of case histories that come flashing to mind, but one of my favorites which bears sharing, is one that happened in my office last year. On referral from a friend and colleague, Fred contacted my office for a consultation and possibly acupuncture for relief of his condition. Even though he had sought acupuncture prior, his DC requested he try it again and maybe we could pull some "tricks out of our hat." Fred's problem was that he was unable to swallow. Even the simple attempt at swallowing water was a task which took considerable effort, concentration and frustration. His diet was limited to extremely soft food which he "Fletcherized" (Fletcher was a health advocate in the '30s who touted chewing the food 200 to 300 times creating total liquid before allowing the liquified food to trickle down the esophagus).
Needless to say, this 40-year-old man's life had nearly been devastated by this cruel dysfunction. It was virtually impossible for him to have a social life as our lives seem to revolve around food and drink.
He had been examined and treated by a variety of numerous physicians specializing in almost every focus of medicine. He had even been sent to a faith healer in a desperate attempt to do something for this five year problem. The only response he ever seemed to obtain was when he was given trazadone, an extremely high potency muscle relaxant. His swallowing improved, but it was far from being even close to normal. He elected to discontinue using the drug, as he could virtually not function physically because of the drug's side effects.
On consultation Fred said: "Five years ago my mother died, I went back to Wisconsin for the funeral. Her passing was a relief as she had been ill for some time. However while I was back there, suddenly and unexpectedly my father-in-law died. This came as a total shock. I actually felt worse about my father-in-law dying than I did about my mother. But you know what, Doc? Three months prior to all of this, I was walking down the hall at home and there was my cat lying dead. There was no apparent cause, he just died. This sounds horrible, but I actually felt more emotion when my cat died than when my mother and father-in-law died."
With these statements, the condition Fred was experiencing suddenly became clearer. Even though most of us would have listened to Fred's story of lament, it would not be associated with this condition other than of psychogenic origins. Fred not only experienced grief but also guilt over feeling more emotion about his dead cat than his deceased family members.
According to Asian philosophy, the three causes of disease are: 1) environmental, 2) emotional, and 3) others. D.D. Palmer specifically stated the three causes of disease were 1) poisons, 2) trauma, and 3) auto-intoxication.
By his grief and guilt, Fred was shown to have a pathologic disruption of the lung meridian which not only deals with these two emotions, but specifically controls and harmonizes the function of the throat.
By balancing his lung meridian through the tonification point and focusing on Lung 1 (LU-1), known as "the great letting go" point, (see Figure 1). Fred's condition was 80 percent relieved immediately following the first treatment. His condition continues to improve and reports a relief of symptoms to the level of 90-95 percent improvement. He has had four treatments.
Listen to what a person says, but more importantly "hear" what they say. Most often these tremendous insights will come within the patient's first 50 words.
Act upon your instincts, insights, and intuitions; relate it to academics and don't question it when you find yourself stymied for a logical explanation. Learn acupuncture theory, philosophy and practical academia and allow yourself to deal successfully with some of the most unusual, difficult and nonresponsive patients who are desperately seeking our help.
As strange as this may sound, stimulating SP-4 on yourself will bring your level of intuition to its highest level. This truly is one of the "secrets of the masters." (Note: SP-4, the spleen meridian, is at the medial side of the foot, in the depression anterior/inferior to the proximal articulation of the 1st metatarsal bone.)
Some doctors thrive in a personality-based clinic and have a loyal following no matter what services or equipment they offer, but for most chiropractic offices who are trying to grow and expand, new equipment purchases help us stay relevant and continue to service our client base in the best, most up-to-date manner possible. So, regarding equipment purchasing: should you lease, get a bank loan, or pay cash?
Some pundits say that the upcoming presidential and congressional races, and many local races, might be the most consequential in our country’s history. We do not have the choice of sitting on the sidelines and hoping our patients will carry our water. Unlike other medical professions such as physical therapists, podiatrists, nurses, etc., the health care class (AMA) will not protect us. We must be in the game.
The most common condition affecting the shoulder is rotator-cuff disease. From acute tears to chronic tendinopathy, it’s common and needs a thorough workup. In fact, even asymptomatic shoulders can have full-thickness rotator-cuff rears in up to 40% of instances. Let’s look at additional conditions that can present to the office with weakness, loss of motion and pain in the shoulder beyond rotator-cuff tears.
