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Phantom Limb Pain case update

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12/25/07

Phantom Pain Case

 

The patient’s left arm, just below the elbow, and the

right hand (except the thumb) were ripped off in a

corn picker farm accident 30 years ago. Since, he has

phantom pains in streaks, sometimes every 3 – 4

minutes, especially in the left arm which

re-experiences the twisting, pulling, turning,

burning, and finally release of the limb. The pain is

worse in the fall and when he is idle. The right hand

is tolerable with the tingling annoyance of

neuropathy.

 

Initially after the accident he also had a constant

excruciating headache in the right shao yang area.

Years ago, seeking relief, the patient had surgery,

consisting of cutting the nerves in the left arm,

snapping them back into the shoulder. The headache

went away immediately. All other pain remained. He

tried many other avenues, including hypnosis. The

last doctor said pain medication is all he can do. Pt

refused, claiming it didn’t help.

 

Other findings: Occ night sweats with severe phantom

pain, arthritic body aches which he reduces by

drinking aloe vera juice, gets winded when overworked,

occ heartburn, frequent urination, wife passed away 2

½ years ago – after which patient broke wrist,

gallbladder removed, hernia, cataract surgery both

eyes. Hearing is “so-so”, no ringing. Worry and over

thinking predominate.

 

Using the suggestions and expertise of the TCM

group, I administered treatment.

 

First session: expel invasion of evil qi

1. Surround dragon Lt shoulder with mild stimulation.

1st needle elicited sensation in phantom limb. 10

minutes.

2. Moxa limbs, especially right hand. 5 minutes.

3. Boundary disorder tx: KD23, 25, LV4, SP5, ST41, GB

40. 10 minutes.

4. Total Qi exchange, Earth to Heaven tx: KD1, DU 20.

15 minutes.

 

Pt reported left phantom hand received drainage

sensation from shoulder and it felt more like his

right hand (less severe pain). Also to be

relaxed/stationary for that length of time was unusual

for him.

 

Instructed pt to report in 3-4 days later. Pt

reported pain subsided quite a bit. It was now out of

left elbow and into the wrist at a tolerable level.

 

Second session: internal wind and bi pain

1. Lt ear points: shenmen, brain, subcortex,

sympathetic nerve, arm.

2. Rt ear shenmen with electro to Rt LI4. Patient

felt tingling in absent Rt. Fingers.

3. Both GB39 and Lt. SP21.

4. Dr. Zhu Scalp needling – 9 needles, stimulated,

passive movement of Lt. arm. Lt ST36, stimulated.

 

Pt report 3 days post tx: Rt hand is different, pain

now moved to fingertips. Lt arm is manageable.

 

Third session: Repeat session 1 treatment.

 

4 day post tx pt. report: “It’s a miracle - had

cortisone shots in legs since 1958 for pain in calves

and Lt foot (@ GB41). Now it’s gone and I didn’t even

tell you about it”. Pt’s fear is it’s not going to

last. Arm, hands haven’t changed much, pain is still

greatly reduced and limited to finger tips.

 

Fourth session: Patient looks real healthy today, but

fears relief won’t last.

Modify tx based on anxiety and leg pain:

1. 7 Emotions, LI11, Lt GB39, Rt LI4, Rt LV2

2. Surround dragon Lt shoulder, Rt TW5, Lt GB41, GB24

& 26

3. Send pt home with Kan formula Release Constraint, ½

dropper- twice/day

 

Fifth session: Patient threw Lt knee out opening

garage door. Incorporate new symptoms into tx’s which

are continuing once/week with phone in 3-4 days later.

Patient is improving, stabilized, looking healthy and

happy.

 

I thank you all for your input, encouragement,

resources, etc. This is a wonderful forum.

 

Hugs to all,

 

Janis

 

 

 

 

 

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Janis,

This phantom pain of your case here is a fascinating story and a

miracle treatment.

What I am trying to study your case, imagine but could not figure

it out what limb your patient is missing ( L or R , arms or legs or

both ) ? You don't mind to give me more information so I could see it

more clearly in my mind, do you ?

I am learning and trying to analyze each set of points in

treatments. By the way , have you prescribed any herbal formulas? I

may be wrong, but I think herbs may be the key for long term success

which I mean to prevent from the re-occurence. If the whole set of

points have reduced or checked the pain, you might calculate all the

essential points into an herbal formula.

I think as acupuncturists, we are to use both acupuncture and herbs

in treatments, but if only acupuncture is rendered, I think we are the

handicapped in our field.

Your case here is a stimulating success story which may help our

spirits growing stronger and stronger in the future.

 

Thanks Janis,

 

Nam Nguyen

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Nam,

 

patient lost left forearm (just below elbow), and all

4 fingers on right hand, leaving only the thumb. Yes,

it is confusing keeping left and right straight when

transcribing the information. I also find myself using

non intentional puns during his treatment (let's keep

our fingers crossed, gotta hand it to you, etc) and

patient has good humor about it.

 

I am limited in herb knowledge. I didn't include that

aspect in my studies, as I had a lot of other things

going on at the time. Just now starting to get into

herbs, but very, very carefully.

 

regards,

 

Janis

 

 

 

 

 

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Janis,

Thanks for your info. It is a very interesting subject. I will keep

it on file and will open it up from time to time to study it.

Whenever you use herbs, please set on a precise or a careful

diagnosis and use popular formula. Do not set your own or modify it at

any cost until your are an expert. For more than 10 years, I have

always use them with astounding results. In some special rare cases I

must use my own. This is my caution. Friends of mine, all of them

prescribed their own formulas and modified the original formulas. They

always think they themselves the best even though they do not know how

come up with a good diagnosis. They always claim that the old formulas

are no use.

God bless them !

 

 

Nam Nguyen

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Thanks for your advice - I will heed it!

 

Janis

--- dr_namnguyen58 <dr_namnguyen58 wrote:

 

> Janis,

> Thanks for your info. It is a very interesting

> subject. I will keep

> it on file and will open it up from time to time to

> study it.

> Whenever you use herbs, please set on a precise

> or a careful

> diagnosis and use popular formula. Do not set your

> own or modify it at

> any cost until your are an expert. For more than 10

> years, I have

> always use them with astounding results. In some

> special rare cases I

> must use my own. This is my caution. Friends of

> mine, all of them

> prescribed their own formulas and modified the

> original formulas. They

> always think they themselves the best even though

> they do not know how

> come up with a good diagnosis. They always claim

> that the old formulas

> are no use.

> God bless them !

>

>

> Nam Nguyen

Subscribe to the free online journal for TCM at

> Times

> http://www.chinesemedicinetimes.com

>

> Help build the world's largest online encyclopedia

> for Chinese medicine and acupuncture, click,

> http://www.chinesemedicinetimes.com/wiki/CMTpedia

>

>

>

 

> and adjust accordingly.

>

> Messages are the property of the author. Any

> duplication outside the group requires prior

> permission from the author.

>

> Please consider the environment and only print this

> message if absolutely necessary.

>

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