Browsing articles tagged with " weakness"

67. Dr. Jun Xu’s calling from West Africa

Mar 5, 2017   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

Dr. Jun Xu went to Leprosy village in 2013, 2014 and 2016, soon he will go to the leprosy village on March 31, 2017.

In 2013, there was no a single room being used for treatment in the leprosy village, Dr. Xu and his team had to use a tent. The temperature was around 125 Fahrenheit degrees.

The leprosy patients were waiting for their turn to be attended. Dr. Jun Xu saw about 200 patients a day.

Typical leprosy patient:
Early Stages
Spots of hypopigmented skin- discolored spots which develop on the skin
Anaesthesia(loss of sensation) in hypthese opigmented spots can occur as well as hair loss
“Skin lesions that do not heal within several weeks of and injury are a typical sign of leprosy.” (Sehgal 24)

Progression of disease

“Enlarged peripheral nerves, usually near joints, such as the wrist, elbow and knees.”(Sehgal 24)
Nerves in the body can be affected causing numbess and muscle paralysis
Claw hand- the curling of the fingers and thumb caused by muscle paralysis
Blinking reflex lost due to leprosy’s affect on one’s facial nerves; loss of blinking reflex can eventually lead to dryness, ulceration, and blindness
“Bacilli entering the mucous lining of the nose can lead to internal damage and scarring that, in time, causes the nose to collapse.”(Sehgal 27)
“Muscles get weaker, resulting in signs such as foot drop (the toe drags when the foot is lifted to take a step)”(Sehgal 27)

Long-term Effects
“If left untreated, leprosy can cause deformity, crippling, and blindness. Because the bacteria attack nerve ending, the terminal body parts (hands and feet) lose all sensations and cannot feel heat, touch, or pain, and can be easily injured…. Left unattended, these wounds can then get further infected and cause tissue damage.” (Sehgal 27)
As a result to the tissue damage, “fingers and toes can become shortened, as the cartilage is absorbed into the body…Contrary to popular belief, the disease does not cause body parts to ‘fall off’.” (Sehgal 27)

Every year, Dr. Jun Xu and his team bring around $300,000 worth of medicine donated from his team members and Americares in Stamford, CT to treat the leprosy and other patients in Senegal and Guinea Bissau. http://www.americares.org/, in 2017, his team also received medicine donation from Direct Relief in California, https://www.directrelief.org/.
Dr. Jun Xu and his team finally established a clinic in the leprosy village, one building for the clinic, and another building for the living of doctors and nurses.

Leprosy village people were celebrating the opening of the clinic.

There are 8 wards, which could hospitalize the patients if it is medically necessary.

Dr. Jun Xu’s team usually stay in Senegal for 10 to 14 days, these are the foods his team brought from US in order to keep them health and safe. They do not dare to eat street food.

The above are the coolants contained food Dr. Jun Xu’s team brought from US

Dr. Jun Xu and his team from US in 2006.
If you are interested in joining Dr. Jun Xu’s team or donating to his work in Senegal, please address your check payable to AGWV, and send to
Jun Xu, MD, 1171 E Putnam Avenue, Riverside, CT 06878, USA.
Dr. Xu promises that all your donation 100% will go to Senegal and his team will nerve use a penny from your donation. You will receive the tax deductible receipt. Any amount is a great help for Africa patients.
For more info, please visit our websites at
http://www.drxuacupuncture.co/ and http://www.africacriesout.org/

49. Acupuncture and Post-Treatment Lyme Disease Syndrome

Jan 25, 2013   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 5 (1), January , 2013, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

Robert Blizzard III, DPT

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Fax: (203)637-2693

 

Post-Treatment Lyme Disease Syndrome

My dear friends,

Before you read my case discussion, please read the following ,

I was the president of American Traditional Chinese Medicine Society  (www. http://atcms.org)  between March 2010 and March, 2012. Now, I am honorary  president of ATCMS.  On behalf of ATCMS,  I advise you sign the petition to  urge Obama Administration recognize acupuncturist  as  healthcare providers  and allow Medicare to pay acupuncture treatment.

Thank you for your support! Please sign the petition now!

Jun Xu, MD

Recognize Acupuncturist as Healthcare providers

Despite overwhelming evidence of the positive impact acupuncturist have on patient health, they are not recognized as healthcare providers under the Social Security Act and, therefore, cannot be paid by Medicare for therapy management.

Please visit the website at: https://petitions.whitehouse.gov/petition/recognize-acupuncturist-healthcare-providers/NTNpVFnp, and sign this petition to urge President to recognize acupuncturists as Medicare providers. We do need at least 25000 signatures by February 10, 2013, in order to get a response from the White House. Please forward this email to your family members, friends, and patients, and ask them to do so. Your participation will make a difference.

Thanks for your efforts and participating!

American TCM Society (ATCMS)

 

Fig 1-1

 

Janet, a 36 year old woman, came to me with complaints of body aches and multiple joint pain for the past 6 months.  Janet reported, “Every inch of my body is achy, I am depressed.” She reports having a tick bite about ten months ago, while she was playing with her son in the backyard of her house.  A dead tick was found on her neck close to her hair line with a bull’s  eye rash prompting her to see her physician immediately and receiving antibiotics (doxycycline) for three weeks. She felt fine at that time. However, after one month, she started to develop some flu like symptoms; feeling fatigue, poor sleep, stomach cramps and poor appetite. She took advil for 2 weeks without any improvement. She also felt poor concentration along with severe headaches. Later she developed bilateral knee joint swelling, difficulty walking, a tingling like snake sensation at both legs and hands. She went to many different doctors for her symptoms, though no one could give her a definite answer and treatment, therefore, she came to me for help.

Janet is most likely to have Post-Treatment Lyme Disease Syndrome

Approximately 10 to 20% of patients treated for Lyme disease with a recommended 2–4 week course of antibiotics will have lingering symptoms of fatigue, pain, or joint and muscle aches. In some cases, these can last for more than 6 months. Sometimes it is called “chronic Lyme disease,” this condition is properly known as “Post-treatment Lyme Disease Syndrome” (PTLDS).

The main symptoms of PTLDS are listed as following,

  • Arthritis. After several weeks of being infected with Lyme disease, approximately 60% of those people not treated with antibiotics develop recurrent attacks of painful and swollen joints that last anywhere from a few days to a few months. The arthritis can shift from one joint to another; the knee is most commonly affected and usually one or a few joints are affected at any given time. About 10% to 20% of treated patients will go on to develop lasting arthritis. The knuckle joints of the hands are only very rarely affected.
  • Neurological symptoms. Lyme disease can also affect the nervous system, causing symptoms such as stiff neck and severe headache (meningitis), temporary paralysis of facial muscles (Bell’s palsy), numbness, pain or weakness in the limbs, or poor coordination. More subtle changes such as memory loss, difficulty with concentration, and a change in mood or sleeping habits have also been associated with Lyme disease. People with these latter symptoms alone usually don’t have Lyme disease as their cause.

Nervous system abnormalities usually develop several weeks, months, or even years following an untreated infection. These symptoms often last for weeks or months and may recur. These features of Lyme disease usually start to resolve even before antibiotics are started. Patients with neurologic disease usually have a total return to normal function.

  • Heart problems. Fewer than one out of 10 Lyme disease patients develops heart problems, such as an irregular, slow heartbeat, which can be signaled by dizziness or shortness of breath. These symptoms rarely last more than a few days or weeks. Such heart abnormalities generally appear several weeks after infection, and usually begin to resolve even before treatment.
  • Other symptoms. Less commonly, Lyme disease can result in eye inflammation and severe fatigue, although none of these problems is likely to appear without other Lyme disease symptoms being present.

 

The exact cause of PTLDS is not yet known. Most medical experts believe that the lingering symptoms are the result of residual damage to tissues and the immune system that occurred during the infection. Similar complications and “auto–immune” responses are known to occur following other infections, including Campylobacter (Guillain-Barre syndrome), Chlamydia (Reiter’s syndrome), and Strep throat (rheumatic heart disease). In contrast, some health care providers tell patients that these symptoms reflect persistent infection with Borrelia burgdorferi. Recent animal studies have given rise to questions that require further research, and clinical studies to determine the cause of PTLDS in humans are ongoing.

Regardless of the cause of PTLDS, studies have not shown that patients who received prolonged courses of antibiotics do better in the long run than patients treated with placebo. Furthermore, long-term antibiotic treatment for Lyme disease has been associated with serious complications. The good news is that patients with PTLDS almost always get better with time; the bad news is that it can take months to feel completely well.

If you have been treated for Lyme disease and still feel unwell, see your doctor to discuss how to relieve your suffering. Your doctor may want to treat you in ways similar to patients who have fibromyalgia or chronic fatigue syndrome. This does not mean that your doctor is dismissing your pain or saying that you have these conditions. It simply means that the doctor is trying to help you cope with your symptoms using the best tools available.

It is normal to feel overwhelmed by your ongoing symptoms. Some things that may help you manage your PTLDS include:

  • Check with your doctor to make sure that Lyme disease is not the only thing affecting your health.
  • Become well-informed. There is a lot of inaccurate information available, especially on the internet. Learn how to sort through this maze.
  • Track your symptoms. It can be helpful to keep a diary of your symptoms, sleep patterns, diet, and exercise to see how these influence your well being.
  • Maintain a healthy diet and get plenty of rest.
  • Share your feelings. If your family and friends can’t provide the support you need, talk with a counselor who can help you find ways of managing your life during this difficult time. As with any illness, Lyme disease can affect you and your loved ones. It doesn’t mean that your symptoms are not real. It means that you are a human being who needs extra support in a time of need.
  • Being strong mind, if you know the mechanism of your illness and have strong mind to fight this illness, you will finally get out of the control of the disease.

It is important to note that people with a history of Lyme disease have more musculoskeletal impairments when compared to those without a history of the disease.  Physical Therapy is very effective at treating musculoskeletal impairments such as pain and muscle spasms though multiple means of massage, heat, ultrasound, electrical stimulation.  Muscle weakness and limited endurance are other symptoms that can be greatly improved with treatment.

A common impairment is decreased standing balance and impaired gait pattern that a routine of lower body strengthening, core training and balance exercises would help to restore.  Functional limitations would include difficulty with stair negotiation; sit to stand transfers and the inability to continue to work.  It is important not to over stress yourself with exercise or daily activities to prevent from exacerbating your PTLDS

A few exercises would be a light general warm-up that is easy on the knees being the exercise bike at low-moderate intensity taking breaks as needed.

 

Fig 1-2 http://visionfitness.mercola.com/exercise-bikes.aspx

After warmed-up, a whole body exercise that also works on a common ailment of decreased transfer ability with sit to stands would be chair squats.  With this exercise it is important not to allow your knees to track beyond your toes and to barely allow the hips to touch the seat before standing back up again.  Start with 10 pain free reps and working up to 30 reps total.

 

 

Fig 1-3 http://holistichealthgurus.com/blog/body/squats-with-chair-facing-the-wall/

 

 

Balance is another ailment that can be worked with exercise.  Start out on a flat surface with eyes open for one minute, once that becomes easy start to challenge yourself by closing your eyes only as long as you are standing in front of a couch or table that you can grab hold of if needed.  Continue to progress by then standing on a foam pad to make the surface uneven or stay on the flat surface and stand on one foot at a time with eyes open and then closed.

Fig 1-4 http://www.acefitness.org/certifiednewsarticle/687/designing-balance-exercise-programs-for-older/

A light stretching routine is encouraged to decrease joint stiffness and improve range of motion.  Shown is a simple stretch that if held for 1 minute on each leg will loosen muscles around the most common effected area with PTLDS being the knees.

Fib 1-5 http://www.livestrong.com/slideshow/558801-finding-the-fitness-30/#slide-2

Acupuncture is an excellent alternative way to treat your symptoms. It has no side effects and can be combined with traditional western medicine to relieve your symptoms. The choice of acupuncture treatment of PTLDS  is as following,

  1. Common used points: Du20 Bai Hui,  GB8 Shuai Gu, UB9 Yu Zhen, Ht7 Shen Men, GB20 Feng Chi, UB15 Xin Shu, UB20 Pi Shu, UB18 Gan Shu, UB23 Shen Shu, St6 Zu San Li, Sp6 San Yin Jiao, Lv3 Tai Cong, UB2 Zan Zhu, Kid3 Tia Xi.
  2. Arthritis: Shoulder: LI 15 Jian Yu, SI 9 Jian Zhen, SJ 14 Jian Liao, SI 10 Nao Shu, SI 11 Tian Zhong, LI 16 Ju Gu  Wrist: LI5 Yang Xi and SJ 4 Yang Chi.    Knee: LI 4 He Gu, LI 11 Quchi, St 35 Du Bi, Nei Xi Yan, Sp 10 Xue Hai, St 34 Liang Qiu, He Ding, UB 40 Wei Zhong,  ,
  3. Neurological Symptoms: Fatigue, Depression and Poor Sleep: Major points: St 36 Zu San Li, PC6 Nei Guan,  LI4 He Gu, Ht7 Shen Meng, Sp6 San Yin Jiao, GB20 Feng Chi, Du20 Bai Hui, EX-HN1 Si Shen Cong, assistant points: Du14 Da zhui, Ren12 Zhong Wan, Ren14  Ju Que, Ren6 Qi Hai, Ren4 Guang Yuan, UB21 Wei Shu and UB23 Shen Shu.
  4. Bell’s Palsy: GB14 Yang Bai penetrating  Ex Yu Yao, and Si Bai, Tai Yang  penetrating  St7 Xia Guan, St4 Di Chang penetrating  St6 Jia Che, LI20 Ying Xiang, UB2 Zan Zhu, Ren24 Cheng Jiang.
  5. Heart Palpitation: PC6 Nei Guan, Ht7 Shen Men, UB15 Xin Shu, Ren14 Ju Que, UB14 Jue Yin Shu
  6. Dizziness: Si Shen Chong, Du20 Bai Hui, Du12 Shen Zhu, UB12 Feng Men, UB43 Gao Huang, Sp6 San Yin Jiao, St36 Zhu San Li, LI11 Qu Chi.

Janet’s Treatment:

Janet was treated with me for 2 x per week for 8 weeks. I first try to decrease her pain at the joints and body with the points of group 1 and 2 , then, I used the group 3 points to help her to improve her fatigue and depression, after about 2 month’s treatment, Janet felt much improved. Her pain scale decreased from 9/10 to 2/10. She then had maintenance treatment for once a week for another 2 weeks, she finally discharged without pain.

Tips for Patients:

  1. Early diagnosis and early treatment: Always suspect you might have Lyme disease if you have exposed to wild environment with skin rash. Early treatment is the key to reduce the rate of  Post Treatment of Lyme Disease Syndrome.
  2. Multiple Therapy is the best way to treat PTLDS.  Anti-inflammatory Medication, Physical Therapy and Acupuncture Treatment together will help you a lot.

Tips for Acupuncturists:

  1. Treat your patients as a whole person, you not only treat their pain symptom, but also their stress, fatigue, and depression. To relieve the mental stress is the key for the effects of your acupuncture treatment.
  2. Encourage your patients to have at least 8 weeks treatment. It is very important to have a long term treatment to achieve the best results.

 

 

References

Reviews of human research

Marques, A. Chronic Lyme disease: a review. Infect Dis Clin North Am 2008; 22:341–60.

Feder, et al. A critical appraisal of “chronic Lyme disease”. New Eng. J. Med. 2008; 357:1422–30.

Non-human research

The following publications refer to studies in mice and monkeys. Please note that while animal studies are helpful, further research is necessary to determine whether these results correlate with human disease.

Barbour A. Remains of infection. J Clin Invest. 2012 Jul 2;122(7):2344–6. doi: 10.1172/JCI63975. Epub 2012 Jun 25.

Bockenstedt LK, Gonzalez DG, Haberman AM, Belperron AA. Spirochete antigens persist near cartilage after murine Lyme borreliosis therapy. J Clin Invest. 2012 Jul 2;122(7):2652–60. doi: 10.1172/JCI58813. Epub 2012 Jun 25.

Embers ME, Barthold SW, Borda JT, Bowers L, Doyle L, et al. (2012) Persistence of Borrelia burgdorferi in Rhesus macaques following antibiotic treatment of disseminated infection. PLoS ONE 7(1): e29914.

Reference resource:

http://www.webmd.com/rheumatoid-arthritis/arthritis-lyme-disease 

http://www.cdc.gov/lyme/postLDS/index.html

 

 

48. Acupuncture and Multiple Sclerosis

Dec 22, 2012   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

News Letter, Vol. 4 (12), December , 2012, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

Robert Blizzard III, DPT

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Fax: (203)637-2693

Multiple Sclerosis

                                                                                    americancompanioncare.com

 

 

Jane is a 40 year-old woman who complains of feeling tired and fatigue now for 6 months.  She works as a computer programmer and has two children ages 4 and 6 years old. She never felt fatigue before, as she works 40 hours a week then comes home to take care of her family.  She recently reports heat intolerance and a stumbling gait with a tendency to fall. Two months ago the patient was working very hard and was under a lot of stress. She then got sick with the flu and her neurologic condition worsened. Her visual acuity also seemed to change periodically during several years.  She has had difficulty holding objects in her hands accompanied with significant tremors and severe exhaustion. She also had several bad falls. Since then, she had noticed multiple areas of joint pain on the right and subsequently on the left side of her body. Then, the patient abruptly developed a right side half body sensory deficit after several days of work.

She visited her Neurologist, who ordered a MRI scan which revealed a multifocal white matter  in both cerebral hemispheres. Spinal tap was also done which showed the presence of oligoclonal bands in Cerebral Spinal Fluid. Visual evoked response testing was abnormal with slowed conduction in optic nerves.

This patient is most likely to have Multiple Sclerosis. This disease occurs more often in women between ages of 20-40.  MS is caused by damage to the myelin in the central nervous system, and to the nerve fibers, which interferes with the transmission of nerve signals between the brain, spinal cord and other parts of the body. Depending on the location of the pathology, patients reveal the following symptoms.

Most Common Symptoms

Some symptoms of MS are much more common than others.

Fatigue

Numbness

Walking (Gait), Balance, & Coordination Problems

Bladder Dysfunction

Bowel Dysfunction

Vision Problems

Dizziness and Vertigo

Sexual Dysfunction

Pain

Cognitive Dysfunction

Emotional Changes

Depression

Spasticity

Less Common Symptoms
These symptoms also occur in MS, but much less frequently.

Speech Disorders

Swallowing Problems

Headache

Hearing Loss

Seizures

Tremor

Respiration / Breathing Problems

Itching

The Criteria for a Diagnosis of MS

In order to make a diagnosis of MS, the physician must:

  • Find evidence of damage in at least two separate areas of the central nervous system (CNS), which includes the brain, spinal cord and optic nerves AND
  • Find evidence that the damage occurred at least one month apart AND
  • Rule out all other possible diagnoses

In 2001, the International Panel on the Diagnosis of Multiple Sclerosis updated the criteria to include specific guidelines for using magnetic resonance imaging (MRI), visual evoked potentials (VEP) and cerebrospinal fluid analysis to speed the diagnostic process. These tests can be used to look for a second area of damage in a person who has experienced only one attack (also called a relapse or an exacerbation) of MS-like symptoms — referred to as a clinically-isolated syndrome (CIS). A person with CIS may or may not go on to develop MS.

The criteria  (now referred to as The Revised McDonald Criteria) were further revised in 2005 and again in 2010 to make the process even easier and more efficient. (http://onlinelibrary.wiley.com/doi/10.1002/ana.22366/full)

Treatment

There is no known cure for multiple sclerosis at this time. However, there are therapies that may slow the disease. The goal of treatment is to control symptoms and help you maintain a normal quality of life.

Medications used to slow the progression of multiple sclerosis are taken on a long-term basis, they include:

  • Interferons (Avonex, Betaseron, or Rebif), glatiramer acetate (Copaxone), mitoxantrone (Novantrone), and natalizumab (Tysabri)
  • Fingolimod (Gilenya )
  • Methotrexate, azathioprine (Imuran), intravenous immunoglobulin (IVIg) and cyclophosphamide (Cytoxan) may also be used if the above drugs are not working well

Steroids may be used to decrease the severity of attacks.

Medications to control symptoms may include:

  • Medicines to reduce muscle spasms such as Lioresal (Baclofen), tizanidine (Zanaflex), or a benzodiazepine
  • Cholinergic medications to reduce urinary problems
  • Antidepressants for mood or behavior symptoms
  • Amantadine for fatigue

The following may also be helpful for people with MS:

  • Physical therapy, speech therapy, occupational therapy, and support groups
  • Assistive devices, such as wheelchairs, bed lifts, shower chairs, walkers, and wall bars
  • A planned exercise program early in the course of the disorder
  • A healthy lifestyle, with good nutrition and enough rest and relaxation
  • Avoiding fatigue, stress, temperature extremes, and illness
  • Changes in what you eat or drink if there are swallowing problems
  • Making changes around the home to prevent falls

At some stage during the course of MS, over 75% of people report problems with balance.  In addition to issues with balance is the prevalence of falls which is reported to be over 50%.

 

Evidence suggests that balance may be positively improved by:

Individual physiotherapy using facilitation and functional activities

Group exercise classes, primarily by way of a functional based framework

Home balance training interventions

Targeted force-platform balance tasks

(Balance for people with multiple sclerosis. ISBN: 978-0-9806637-2-3. MS Australia June 2009)

 

 

 

 

http://www.acefitness.org/certifiednewsarticle/687/designing-balance-exercise-programs-for-older/

 

It is critical to prevent overheating while exercising or performing daily activities as this will cause MS symptoms to become much worse.  Taking numerous breaks with exercise, breaking daily chores down into smaller steps and avoiding hot and humid weather are a few steps to take.  A cool water swimming pool is a great way to seek a fitness routine or finding a gym with air conditioner during the hotter months of the year.  Again heat and humidity will cause nerve transmission to become slower and make symptoms intensify until body temperature returns and all of this can occur in just a half degree raise in body temperature.

 

Acupuncture treatment for MS:

Acupuncture can not cure MS, however, acupuncture treatment may significantly improve patient’s symptom, the following methods could be used to help MS patients.

  1. Common used points: Du20 Bai Hui, GB7 Qu Bing, GB8 Shuai Gu, UB9 Yu Zhen, Ht7 Shen Men, GB20 Feng Chi, UB15 Xin Shu, UB20 Pi Shu, UB18 Gan Shu, UB23 Shen Shu, UB32 Chi Liao, GB30 Huan Tiao, Sp6 San Yin Jiao, Lv3 Tai Cong, UB2 Zan Zhu, Kid3 Tia Xi.
  2. Fatigue and depression: Major points: St 36 Zu San Li, PC6 Nei Guan, LI4 He Gu, Ht7 Shen Meng, Sp6 San Yin Jiao, GB20 Feng Chi, Du20 Bai Hui, EX-HN1 Si Shen Cong, assistant points: Du14 Da zhui, Ren12 Zhong Wan, Ren14  Ju Que, Ren6 Qi Hai, Ren4 Guang Yuan, UB21 Wei Shu and UB23 Shen Shu.
  3. Weakness in the upper extremities: LI15 Jian Yu, LI11 Qu Chi, LI10 Shou San Li, SJ5 Wai Guan, LI4 He Gu
  4. Weakness in the lower extremities: GB30 Huan Tiao, St31 Bi Guan, GB31 Feng Shi, St36 Zu San Li, GB34 Yang Ling Quan, Sp6 San Yin Jiao, GB39 Xuan Zhong, UB60 Kun Lun.
  5. Speech difficulty: Ren23 Lian Quan, LI4 He Gu, Ht5 Tong Li, Du15 Ya Meng,
  6. Swallow difficulty: Ren22 Tian Tu, Ren23 Lian Quan, LI18 Hu Tu, GB20 Feng Chi, LI4 He Gu
  7. Bladder Dysfunction: Ren4 Guan Yuan, Ren6 Qi Hai, Ren3 Zhong Ji, UB23 Shen Shu
  8. Constipation: St36 Zu San Li, GB34 Yang Ling Quan, St25 Tian Shu, UB19 Da Chang Shu, Ren12 Zhong Wan
  9. Vision: UB1 Jing Ming, EX-HN5 Tai Yan, GB37 Guan Ming
  10. Facial Paralysis: SJ17 Yi Feng, St7 Xia Guan, St4 Di Chang, St6 Jia Che

Jane’s Treatment:

Jane’s main complaints are fatigue and weakness with visional difficulty. I choose the first and second groups of the points, plus Jing Ming, Tai Yan, Guang Ming. She received my treatment 3 x per week for 4 weeks, she felt her energy level was much better. She also was told not to be exposed to heat, because heat usually exacerbated fatigue and weakness. Her symptoms were getting better, she then kept her treatment once a week for maintenance. Her quality of life now is much improved.

 

Tips for Acupuncturists:

  1. St36 Zu San Li, Sp6 San Yin Jiao, LI4 He Gu and LI11 Qu Chi are most important points to improve energy and decrease fatigue for MS patients.
  2. Du20 Bai Hui and EX-HN1 Si sheng Cong can greatly decrease patients’ depression and improve energy.

Tips for Patients:

1, Massage Zu San Li 10 min x 2 to 3 per day will improve your energy level.

2.  Avoid over heat, the more heat you exposed, the more fatigue and depression you will         have.

 

42. Acupuncture and Postchemotherapy Syndrome

Jun 24, 2012   //   by drxuacupuncture   //   Blog, Case Discussions, Uncategorized  //  No Comments

 News Letter, Vol. 4 (6), June  , 2012, © Copyright

 

Jun Xu, M.D. Lic. Acup., Hong Su, C.M.D., Lic. Acup.

Robert Blizzard III, DPT

www.drxuacupuncture.co

Rehabilitation Medicine and Acupuncture Center

1171 East Putnam Avenue, Building 1, 2nd Floor

Greenwich, CT 06878

Tel: (203) 637-7720

Fax: (203)637-2693

          

Postchemotherapy Syndrome Treatment

Alleviating Amanda’s Chemotherapy Symptoms

Amanda W. is a forty-five-year-old woman who was diagnosed two years ago with stage 3A cancer symptoms in her left breast. She was screened by a mammogram and an ultrasound, which found a tumor about one inch across on her on her left breast, with five positive lymph nodes under her left arm. She had a mastectomy on the left side, with clearance of the lymph nodes under the left arm. She also was given chemotherapy for about three months. After chemotherapy, Amanda complained of nausea, vomiting, diarrhea, and a change of taste in her mouth; she also felt very weak and fatigued. She experienced hair loss and poor concentration, with occasional numbness and tingling on the tips of her finger and toes, and came to me for help in relieving or decreasing these multiple side effects of her chemotherapy.

Breast Cancer Statistics

In the United States, breast cancer is the second most common type of cancer among women. And among women worldwide, after non-melanoma skin cancer, breast cancer is the most common form of cancer. It is the number-one cause of cancer death in Hispanic women, and is the second most common cause of cancer death in white, black, Asian/Pacific Islander, and American Indian/Alaska Native women.

In 2005 (the most recent year numbers are available):

  • 186,467 women and 1,764 men were diagnosed with breast cancer;1,2
  • 41,116 women and 375 men died from breast cancer.1,2

Risk Factors for Breast Cancer

The key to preventing breast cancer is knowing the risk factors and practicing self-screening. The following risk factors might increase your chances of developing breast cancer:

  • Age. The older you are, the higher the chance that you can develop breast cancer. In women over sixty, there is usually a higher chance of breast cancer than in women under sixty.
  • A previous history of breast cancer.
  • Family history. If a mother, sister, or daughter had breast cancer, or if breast cancer runs anywhere in your family, the risk is higher than for the average woman.
  • Gene changes. If you have the BRCA1or BRCA2 genes, you will probably have a higher chance of developing breast cancer.
  • Reproductive history. The older a woman is when she had her first child, the greater her chances of developing breast cancer will be.
  • Women without children are at increased risk of breast cancer.
  • If you got your first menstrual period before age twelve, there is an increased risk for breast cancer.
  • If you became menopausal after age fifty-five, there is an increased risk of breast cancer.
  • Menopausal women using hormone therapy with estrogen plus and progestin after menopause are at increased risk of breast cancer.
  • Race. White women have a higher chance of developing breast cancer than darker-skinned women.
  • Breast density. The higher the density of breast tissue, the higher the chance of breast cancer.
  • Overweight or obese women have a higher chance of breast cancer.
  • Lack of physical activity leads to a higher chance of breast cancer.
  • Alcohol consumption in immoderate amounts leads to a higher chance of breast cancer.

Screening Mammograms

A mammogram is a picture of the breast made with x-rays. The National Cancer Institute recommends the following:

  • Women in their forties and older should have a mammogram every one to two years.
  • Women who are younger than forty and who have risk factors for breast cancer should ask their healthcare provider whether to have mammograms and how often to have them.

If a mammogram is positive, the following procedures might be recommended.

  • Ultrasound. This will identify if the lump is a fluid-filled cyst or a solid mass.
  • An MRI. This will give a detailed picture of the breast tissue.
  • Needle biopsy, core biopsy, and surgical biopsy.

Stages of Breast Cancer

Here are the stages of breast cancer.

  • Stage 0 is carcinoma in situ. Abnormal cells are in the lining of a lobule or in the lining of a duct.
  •  Stage 1 is 2 cm or smaller and has not spread outside the breast.
  • Stage 2 is one of the following: The tumor is no more than 5 cm, with or without it spreading to the lymph nodes under the arm.
  • Stage 3 is locally advanced cancer. It is divided into stages 3A, 3B, and 3C.

According to the United States Cancer Statistics 2005 from the Centers For Disease Control and Prevention, the following statistical data showed the chances of cancer for American men and women. (The numbers in parentheses are the age-adjusted—U.S. standard—rates per 100,000 people.) http://www.cdc.gov/Features/CancerStatistics/

Cancer Among Men

The three most common cancers among men include:

  • Prostate cancer (142.4): First among men of all races.
  • Lung cancer (84.6): Second among men of all races.
  • Colorectal cancer (58.2): Third among men of all races.

The leading causes of cancer death among men are:

  • Lung cancer (69.4): First among men of all races.
  • Prostate cancer (25.4): Second among white (22.7), black (54.1), American Indian/Alaska Native (18.0), and Hispanic (18.7) men.
  • Liver cancer: Second among Asian/Pacific Islander men (14.5).
  • Colorectal cancer (21.0): Third among men of all races.

Cancer Among Women

The three most common cancers among women include:

  • Breast cancer (117.7): First among women of all races.
  • Lung cancer (55.2): Second among white (56.6), black (50.9), and American Indian/Alaska Native (37.6) women, and third among Asian/Pacific Islander (26.9) and Hispanic (25.2) women.
  • Colorectal cancer (41.9): Second among Asian/Pacific Islander (32.2) and Hispanic (33.9) women, and third among white (40.8), black (49.4), and American Indian/Alaska Native women (24.5).

The leading causes of cancer death among women are:

  • Lung cancer (40.6): First among white (41.6), black (40.2), Asian/Pacific Islander (18.2), and American Indian/Alaska Native (29.2) women, and second among Hispanic women (14.4).
  • Breast cancer (24.0): First among Hispanic women (15.1), and second among white (23.3), black (32.9), Asian/Pacific Islander (12.3), and American Indian/Alaska Native (15.3) women.
  • Colorectal cancer (14.6): Third among women of all races.

Racial or Ethnic Variations

  • American Indian/Alaska Native men have the lowest incidence rates of cancer; however, Asian/Pacific Islander men have the lowest death rates from cancer.
  • White women have the highest incidence rates of cancer; however, black women have the highest death rates from cancer.
  • American Indian/Alaska Native women have the lowest incidence rates of cancer and the third-highest death rates from cancer.

Treatment in Western Medicine—Chemotherapy

Many cancers are treated with chemotherapy IV in their various stages. Therefore, different side effects will accompany the chemotherapy. The main organ or tissues of the human body that may be affected by chemotherapy doses are where normal cells rapidly divide and grow, such as the lining of the mouth, the digestive system, skin, hair, and bone marrow. After a treatment period longer than six months, your nervous system will be affected as well, and the symptoms of this, including poor concentration, decreased memory, peripheral polyneuropathy, and tinnitus, might appear. Long-term side effects can also include weight gain, loss of fertility, menopause, and secondary cancer, such as leukemia.

Short-Term Side Effects of Chemotherapy

  • In the digestive system, some chemotherapy drugs can cause nausea and vomiting, even diarrhea, sometimes a sore mouth or mouth ulcers, changes in taste in the mouth and tongue, and changes in smell.
  • Chemotherapy can affect the blood stem cells in the bone marrow. The bone marrow stem cells will divide into three different types of blood cells.
    • Red blood cells, which carry oxygen to all parts of the body. If the red blood cell numbers are decreased, then the transportation of oxygen around the body will slow down and the person will develop anemia and feel very tired and lethargic. Sometimes she/he may feel shortness of breath, or feel dizzy and lightheaded because there is less oxygen being carried around the body.
    • White blood cells, which are essential to the immune function for fighting infection and monitoring mutation, among other things. If your white blood cells counts are decreasing, the immune function will decrease and there will be an increased chance of infection.
    • Platelets, which help the blood clot and control bleeding. If your platelet counts are decreasing, you have a high chance of bruising and you may have a nosebleed or may bleed more than usual from minor cuts or bruises.
  • Hair loss: Some chemotherapy can damage the hair and make it brittle or thin, and some chemotherapy can make all of the hair fall out, usually a few weeks into treatment. The body, pubic, and underarm, hair may be lost as well. However, if your hair does fall out due to chemotherapy, it will grow back over a few months once your chemotherapy is finished.
  • Skin and nail changes. Skin may become very dry and discolored and more sensitive to sunlight. Nails may grow very slowly or become brittle or flaky.

Long-Term Side Effects of Chemotherapy

  • Chemotherapy’s effects on peripheral nerves: Some drugs can cause peripheral polyneuropathy, which is a sensation of tingling, numbness, and pins and needles in your hands or feet. This neuropathy will affect your ability to detect hot or cold objects, which could lead to burns or frostbite, and it can also decrease your sensitivity to the steps you take, which could lead to a fall.
  • Chemotherapy’s effects on the central nervous system: Long-term use of chemotherapy may cause poor concentration, decreased memory, tinnitus, anxiety, restlessness, dizziness, sleepiness, or headaches.
  • Chemotherapy’s effects on the kidneys: It can change the kidney function and lead to water retention, loose protein in the urine, or increased BUN and creatinine levels. In order to prevent kidney deterioration, intravenous fluid must be given for several hours before the treatment, and the kidney’s functions must be checked before and after each chemotherapy treatment.
  • Secondary cancer is another long-term side effect of chemotherapy: Many different types of secondary cancer, such as leukemia, can occur.
  • Chemotherapy’s effects on fertility: Some chemotherapy treatments may cause infertility. For women, it can sometimes bring on symptoms of menopause and temporarily or permanently stop the ovaries from producing eggs. For men, some chemotherapy drugs may reduce the number of sperm, or affect the sperm’s ability to reach and fertilize a woman’s egg during intercourse. Some drugs may also, temporarily or permanently, affect the sex life.

Treatment for Chemotherapy in Traditional Chinese Medicine—Acupuncture

Traditional Chinese medicine can help with many, but not all, of chemotherapy’s side effects. The acupuncture treatments listed below can be helpful with some side effects of chemotherapy.

Gastrointestinal (GI) symptoms

Gastrointestinal symptoms include nausea, vomiting, gastric regurgitation, tenderness or fullness of the stomach, abdominal pain with very bad breath, also hiccups, diarrhea, and constipation.

  • For nausea and vomiting, Zhong Wan, Zu San Li, Nei Guan, He Gu, and Feng Chi are used.
  • If a person feels hot and thirsty, it is good to add Da Zhui, Jin Jing, and Yu Ye.
  • If the person has bad breath, Xia Wan and Nei Ting are added.
  • If there is vomiting of clean water and the person experiences dizziness, Feng Long, Tan Zhong, and Gong Sun are added.
  • For hiccups, Ge Shu, and Ju Que are used. If they are accompanied by diarrhea, Ta Chang Shu, Shen Shu, and San Ying Jiao are added.
  • For constipation, Feng Long, left Shui Diao, and the left Gui Lai are used.

Table 6.1

Points Meridian Number Conditions Helped
1 Zhong Wan Ren 12

See Table 13.32Nei GuanPC 6

See Table 16.13Zu San LiSt 36

See Table 13.34Feng ChiGB 20

See Table 12.15He GuLI 4

See Table 12.16Da ZhuiDu 14

See Table 12.17Jin JingExtra HN 12

See Table 26.48Yu YeExtra HN 13

See Table 26.49Xia WanRen 10

Abdominal pain, diarrhea, indigestion, vomiting10Nei TingST 44

See Table 29.111Feng LongSt 40

See Table 13.312Tan ZhongRen 17

See Table 14.413Gong SunSp 4

See Table 21.114Ge ShuUB 17

Vomiting, hiccups, belching, difficulty swallowing, asthma, coughing, spitting up blood, afternoon fever, night sweats, measles15Ju QueRen 14

See Table 16.116Da Chang ShuUB 25

See FigureSee Table 19.217San Yin JiaoSp 6

See Table 16.118Shui DaoSt 28

See Table 26.1119Gui LaiSt 29

See Table 26.11

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Figure 6.1


Fatigue

Chemotherapy can lead the person to feel fatigue, and have shortness of breath, weakness, difficulty walking or standing, heart palpitations, or insomnia.

  • The acupuncture points will be Pi Shu, Wei Shu, Zhong Wan,and Zu San Li.
  • For heart palpitations and insomnia (poor sleep), Xin Shu, Sheng Men, Ju Que, and San Yin Jiao are added.
  • If the person feels cold, has weakness of the lower back and legs, Bui Hui, Da Zhui, Sheng Shu, and Guan Yuan are added.
  • If the person feels hot or annoyed, has trouble sleeping, then Fei Shu, Tai Xi, San Yin Jiao are added.

Table 6.2

Points Meridian Number Conditions Helped
1 Pi Shu UB 20

See Table 15.22Wei ShuUB 21

See Table 31.13Zhong WanRen 12

See Table 13.34Zu San LiSt 36

See Table 13.45Xin ShuUB 15

See Table 16.16Sheng MenHeart 7

See Table 29.17Ju QueRen 14

See Table 16.18San Yin JiaoSp 6

See Table 16.19Bai HuiDu 20

See Table 22.410Da ZhuiDu 14

See Table 12.111Shen ShuUB 23

See Table 14.412Guan YuanRen 4

See Table 30.113Fei ShuUB 13

See Table 13.114Tai XiKid 3

See Table 16.2

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Menopause and Loss of Fertility

Many people undergoing chemotherapy have impotence, decreased menstruation or menopause, and low libido, accompanied by dizziness, tinnitus, weakness in the low back and knees, and they always feel cold and have insomnia. The treatment is Sheng Shu, Guan Yuan, Qi Men, Zhi Gong, San Yin Jiao, and Zu San Li.

Table 6.3

Points Meridian Number Conditions Helped
1 Shen Shu UB 23

See Table 14.42Guan YuanRen 4

See Table 30.13Qi MenLiver 14

See Table 19.34Zi GongExtraordinary Point

Prolapse of the uterus, irregular menstruation5San Yin JiaoSp 6

See Table 16.16Zu San LiSt 36

See Table 13.3

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Hair Loss

After chemotherapy, many people will have hair loss. Acupuncture can be used to help with this, mainly body acupuncture.

  • Tai Xi and Xue Hai, Sheng Men, Feng Chi, Qu Qi, and He Gu.
  • Plum Blossom needle, a cluster of 7–9 needles grouped together with a long handle, can be can be used for the hair loss, gently tapping on the scalp until the skin shows slightly redness or mild bleeding. The plum blossom should be used on alternative days, tapping on the scalp for about twenty minutes. After three or four weeks of treatment, the hair will start to grow gradually, especially in those areas that have lost a patch of hair.

Table 6-4

Points Meridian Number Conditions Helped
1 Tai Xi Kid 3

See Table 16.22Xue HaiSp 10

See Table 30.13Shen MenHeart 7

See Table 29.14Feng ChiGB 20

See Table 12.15Qu QiLI 11

See Table 12.26He GuLI 4

See Table 13.1

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Effects on the Central Nervous System (CNS)

After chemotherapy, some people may feel such CNS symptoms as poor concentration, loss of memory, tinnitus, insomnia, nightmares, headaches, or fatigue.

  • Acupuncture points for these symptoms will be Zu San Li, Nei Guan, He Gu, Sheng Men, San Ying Jiao, Feng Chi, as well as Bai Hui, Tang Yang, and Tou Wei.
  • Another important treatment uses Plum Blossom needles around the cervical, thoracic, and lumbar spine, along the urinary bladder meridians. This is done by tapping from the top and going down three lines following the urinary bladder meridians. Normally, these treatments will greatly improve a person’s concentration, memory, and mental function.

Table 6.5

Points Meridian Number Conditions Helped
1 Zu San Li St 36

See Table 13.42Nei GuanPC 6

See Table 16.13He GuLI 4

See Table 12.14Shen MenHeart 7

See Table 29.15San Yin JiaoSp 6

See Table 16.16Feng ChiGB 20

See Table 12.17Bai HuiDu 20

See Table 22.48Tai YangExtra Point

See Table 22.29Tou WeiSt 8

See Table 22.3

Please refer to the accompanying Figures (illustrations) for the locations

of the points. And please note that these illustrations are for information

only and may not show all the exact locations of the acupuncture points.

Peripheral Polyneuropathy

The long-term side effects of chemotherapy can gradually damage the peripheral nerves. The person may symptomatically feel numbness and a tingling sensation on both the hands and the feet, and may also experience burning, sharp pins and needles along them. The treatments will depend on the location of the condition.

  • For the upper extremities, Jian Yu, Jian Liao, Qu Chi, He Gu, Tian Jing, Chi Zhe, and Da Ling, Yang Xi, Wan Gu, Yang Chi, and Wai Guan are used.

Table 6.6

Points Meridian Number Conditions Helped
1 Jian Yu LI 15

See Table 26.12Jian LiaoSJ 14

Pain and motor impairment of the shoulder and upper arm3Qu ChiLI 11

See Table 12.24He GuLI 4

See Table 12.15Tian JingLJ 10

Migraine, pain in the neck, shoulder, and arm, epilepsy6Chi ZheLu 5

See Table 13.27Da LingPC 7

Cardiac pain, convulsions, epilepsy, foul breath, insomnia, irritability, mental disorders, palpitations, stomach ache, stuffy chest, vomiting8Yang XiLI 5

Headaches, redness, pain and swelling of the eye, toothache, sore throat, pain of the wrist9Wan GuSI 4

Headaches, rigidity of the neck, pain in the wrist, jaundice10Yang ChiSJ 4

Pain in the arm, shoulder and wrist, malaria, deafness, thirst11Wai GuanSJ 5

See Table 12.2

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Figure 6.2

  • For the lower extremities, Huan Tiao, Chi Bian, Cheng Fu, Yang Ling Quan, Du Bi, Liang Qiu, Zu San Li, Kun Lun, Tai Xi, Jie Xi, Qiu Xu, Sheng Mai, and Zao Hai are used.

Table 6.7

Points Meridian Number Conditions Helped
1 Huan Tiao GB 30

See Table 26.72Chi BianUB 54

See Table 26.23Cheng FuUB 36

Bloody stools, diarrhea, dysentery, hemorrhoids, impotence4Yang Ling QuanGB 34

See Table 15.35Du BiSt 35

Pain, numbness, and motor impairment of the knee6Liang QiuSt 34

Pain and numbness of the knee, gastric pain, motor impairment of the lower extremities7Zu San LiSt 36

See Table 13.38Kun LunUB 30

See Table 22.19Tai XiKid 3

See Table 16.210Jie XiSt 41

Pain of the ankle joint, muscular atrophy, motor impairment, pain and paralysis of the lower extremities, epilepsy, headaches, dizziness, and vertigo, abdominal distension, constipation11Qiu XuGB 40

See Table 32.212Sheng MaiUB 62

See Table 29.213Zhao HaiKid 6

Irregular menstruation, prolapse of uterus, urinary retention, constipation, epilepsy, insomnia, sore throat, asthma

Please refer to the accompanying Figures (illustrations) for the

locations of the points. And please note that these illustrations are

for information only and may not show all the exact locations of

the acupuncture points.

Figure 6.3

Figure 6.4

Treatment for the Side Effects of Amanda’s Chemotherapy

As you read from the above, Amanda had one of the common side effects of chemotherapy. I first treated her symptoms of pain, depression, and anxiety, with the above-mentioned methods and they are getting better. Then I tried to treat her GI symptoms and fatigue. Although her treatment with me was on, off, and regular, because she was busy going for chemotherapy a few times a week, after my treatments, she feels her appetite is better and her fatigue is much improved. I also treated the numbness and tingling sensation in her hands and toes for about three months, but it proved the most difficult problem to solve as she still felt numbness and tingling after the three months, so she was advised to come to my office once a week to maintain her treatment. The treatments were successful and she finally feels the numbness and tingling has been reduced. Additionally, her energy has been restored enough that she has been able to return to a regular schedule for her work and family life.

Tips to Use at Home or Office

  • Acupuncture cannot cure cancer. Please be aware of the limitations of acupuncture in this respect.
  • However, acupuncture can help a good deal with the side effects of chemotherapy. It is therefore worthwhile to try if you have gastrointestinal symptoms, fatigue, hair loss, infertility, CNS-related problems, or polyneuropathy after chemotherapy.

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