Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 Colleagues, I have been in practiace for 1 year and a half, have treated folks from 13 - 93. I'm finding my way on how to handle the " social " situations of those who call me, sometimes being successful, sometimes making blunders, it all comes with part of the learning on how to be a compassionate practitioner. I have been contacted by a mom of an 11 year old girl for treatment of headaches. I have not personally seen either of them, but here is the information I've gleaned through 2 phone conversations. The girl has had headached " severe enough to make her cry " for 2 years. She has been treated with reiki and Ayruvadic medicine. She was taking about $100/week in herbal supplements which helped, but the problems returned when the treatments stopped. The parents are divorced. Mom feeds the child a vegetarian diet, the father does not. The child also has constipation (no surprise.....) The child is home-schooled. She has not yet started menses. Mom has asked the child to keep a detailed log on diet, emotions, etc to look for triggers. Blames dad for letting her eat " junk " food. (poor child caught in the middle....) So when I asked what her pediatrician thinks, she told me she has not taken her to a MD and does not plan on doing so. I told her that I highly suggest she see a physician to rule out any medical condition. I told her that the treatment plan either Western or Eastern can then be decided. The mother wants to make an appt with me. My question is this; shouild I refuse to treat her until she has been seen by a MD? HOw do I gently suggest counseling? Thank you for any words of wisdom. Jean Dombroski, L.Ac. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 Hi Jean and All, I would look at the case in the following way: 1. I have no problem seeing or treating the patient. They are seeking you out for a reason. Go meet that reason. 2. Take a very careful and detailed examination (a lot of this will have to be non-verbal). Because the mother is likely to be answering questions for her child you will have to be careful to separate the two stories. Become aware of which areas of the history are contentious and which have agreement from both sides. It would probably be useful to be taking pulse for 10 to 15 minutes as the conversation goes on in order to feel the changes in the child as she interacts with her mother. 3. Be aware of red flags: - daily headaches (i.e. her headaches are constant, whether or not there are problems between her parents) - headaches that are fixed in nature (do not change much, including in their location), have very localised pains, and do not quickly respond to appropriate massage. - Are they getting worse as time goes on? - Headaches that worsen with sneezing, coughing, or exercise - " Worst headache ever " - Nausea and vomiting with headaches - Headaches associated with fevers, stiff necks or rashes - Thunderclap headaches that come on suddenly and ferociously - Headaches that are exclusively one-sided - Headaches accompanied by obvious wind / neurological signs, irregular eye movements, numbness, weakness (weakness does not mean fatigue here) The presence of red flags indicates a need to see an md, and does not necessarily mean that there is something seriously wrong. It just means get it checked out. 5. Don't be afraid to make a CM diagnosis. 6. Keep in mind Joe's recommendations regarding leading questions. Hope this helps, Hugo Jean <greypal Chinese Medicine Friday, 6 June, 2008 7:24:14 AM Seeking Guidance on 11 year old Colleagues, I have been in practiace for 1 year and a half, have treated folks from 13 - 93. I'm finding my way on how to handle the " social " situations of those who call me, sometimes being successful, sometimes making blunders, it all comes with part of the learning on how to be a compassionate practitioner. I have been contacted by a mom of an 11 year old girl for treatment of headaches. I have not personally seen either of them, but here is the information I've gleaned through 2 phone conversations. The girl has had headached " severe enough to make her cry " for 2 years. She has been treated with reiki and Ayruvadic medicine. She was taking about $100/week in herbal supplements which helped, but the problems returned when the treatments stopped. The parents are divorced. Mom feeds the child a vegetarian diet, the father does not. The child also has constipation (no surprise.... .) The child is home-schooled. She has not yet started menses. Mom has asked the child to keep a detailed log on diet, emotions, etc to look for triggers. Blames dad for letting her eat " junk " food. (poor child caught in the middle....) So when I asked what her pediatrician thinks, she told me she has not taken her to a MD and does not plan on doing so. I told her that I highly suggest she see a physician to rule out any medical condition. I told her that the treatment plan either Western or Eastern can then be decided. The mother wants to make an appt with me. My question is this; shouild I refuse to treat her until she has been seen by a MD? HOw do I gently suggest counseling? Thank you for any words of wisdom. Jean Dombroski, L.Ac. ________ Sent from Mail. A Smarter Email http://uk.docs./nowyoucan.html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 6, 2008 Report Share Posted June 6, 2008 Jean, I would also recommend that you inform the father, at the very least make the attempt, but realize that this may be a touchy situation. Cover all of your bases, and get rid of the youngsters headaches. Good luck. Douglas Knapp Doctoral Fellow, L.Ac. Full Moon Acupuncture 1600 York Avenue New York, NY 10028 212-734-1459 Hugo Ramiro <subincor Chinese Medicine Friday, June 6, 2008 10:23:16 AM Re: Seeking Guidance on 11 year old Hi Jean and All, I would look at the case in the following way: 1. I have no problem seeing or treating the patient. They are seeking you out for a reason. Go meet that reason. 2. Take a very careful and detailed examination (a lot of this will have to be non-verbal). Because the mother is likely to be answering questions for her child you will have to be careful to separate the two stories. Become aware of which areas of the history are contentious and which have agreement from both sides. It would probably be useful to be taking pulse for 10 to 15 minutes as the conversation goes on in order to feel the changes in the child as she interacts with her mother. 3. Be aware of red flags: - daily headaches (i.e. her headaches are constant, whether or not there are problems between her parents) - headaches that are fixed in nature (do not change much, including in their location), have very localised pains, and do not quickly respond to appropriate massage. - Are they getting worse as time goes on? - Headaches that worsen with sneezing, coughing, or exercise - " Worst headache ever " - Nausea and vomiting with headaches - Headaches associated with fevers, stiff necks or rashes - Thunderclap headaches that come on suddenly and ferociously - Headaches that are exclusively one-sided - Headaches accompanied by obvious wind / neurological signs, irregular eye movements, numbness, weakness (weakness does not mean fatigue here) The presence of red flags indicates a need to see an md, and does not necessarily mean that there is something seriously wrong. It just means get it checked out. 5. Don't be afraid to make a CM diagnosis. 6. Keep in mind Joe's recommendations regarding leading questions. Hope this helps, Hugo Jean <greypal > Friday, 6 June, 2008 7:24:14 AM Seeking Guidance on 11 year old Colleagues, I have been in practiace for 1 year and a half, have treated folks from 13 - 93. I'm finding my way on how to handle the " social " situations of those who call me, sometimes being successful, sometimes making blunders, it all comes with part of the learning on how to be a compassionate practitioner. I have been contacted by a mom of an 11 year old girl for treatment of headaches. I have not personally seen either of them, but here is the information I've gleaned through 2 phone conversations. The girl has had headached " severe enough to make her cry " for 2 years. She has been treated with reiki and Ayruvadic medicine. She was taking about $100/week in herbal supplements which helped, but the problems returned when the treatments stopped. The parents are divorced. Mom feeds the child a vegetarian diet, the father does not. The child also has constipation (no surprise.... .) The child is home-schooled. She has not yet started menses. Mom has asked the child to keep a detailed log on diet, emotions, etc to look for triggers. Blames dad for letting her eat " junk " food. (poor child caught in the middle....) So when I asked what her pediatrician thinks, she told me she has not taken her to a MD and does not plan on doing so. I told her that I highly suggest she see a physician to rule out any medical condition. I told her that the treatment plan either Western or Eastern can then be decided. The mother wants to make an appt with me. My question is this; shouild I refuse to treat her until she has been seen by a MD? HOw do I gently suggest counseling? Thank you for any words of wisdom. Jean Dombroski, L.Ac. ____________ _________ _________ _________ _________ _________ _ Sent from Mail. A Smarter Email http://uk.docs. / nowyoucan. html Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 8, 2008 Report Share Posted June 8, 2008 thank you Hugo and Doug. perhaps i will offer mom an auricular treatment in another room, to treat her stress as well. then time alone with both. thanks again, be well. jean > The presence of red flags indicates a need to see an md, and does not necessarily mean that there is something seriously wrong. It just means get it checked out. > 5. Don't be afraid to make a CM diagnosis. > 6. Keep in mind Joe's recommendations regarding leading questions. > > Hope this helps, > > Hugo Quote Link to comment Share on other sites More sharing options...
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