Guest guest Posted October 27, 2009 Report Share Posted October 27, 2009 Hey folks - this one is interesting. I have a patient who's a Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall (or perhaps - is there a difference between picking up the arrhythmia on the pulse and knotted quality?) and is often stronger and clearer on the right pulses. There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. So here's the question: The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating). Unfortunately this isn't what they want, they want his blood to stay thinner to prevent possible clots forming from blood that doesn't get pumped completely out of the heart. The arrhythmia is still palpable (or the knotted- ness). I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle colleagues? tx k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2009 Report Share Posted October 27, 2009 This maybe can be approached as a syndrome from old china, called soldier's heart, with our modern twist of crappy kbr sub-institutional rations plate food, drugs, chemical exposure; depends how deep, how long they go. In the old days, a soldier could expect to be 3 years away from his family, at least. The doctors of old saw there was a premature stiffening of the body, from regimented duties and forced calisthenics, and even more from the constant threat of attack when walking point. Stagnant qi and blood, right? No, not enough. This prolonged stress strained the kidney, the heart, the feet and hands. (peripheral circulation) The men had diffuse, sometimes sharp pain in the loins, and available prostitutes didn't solve the obvious problem. Like usual. Nourish the heart and the shen, add secret points, harmonize the occupation, rejoin the families. Soldier's heart, do any of you old boys remember that? If you don't, I'm not going to say any more. I swore to it. The pervasive toxins in modern warfare deserve and have time scheduled for hearings in congress. But acupuncture and good God, herbs can help here. The natural tendency is toward satiating the appetite. Do it wisely. Lets have a beer old man, and talk. --- On Tue, 10/27/09, turusachan <turusachan wrote: turusachan <turusachan afibrillation and coumadin Chinese Medicine Tuesday, October 27, 2009, 10:46 AM Hey folks - this one is interesting. I have a patient who's a Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall (or perhaps - is there a difference between picking up the arrhythmia on the pulse and knotted quality?) and is often stronger and clearer on the right pulses. There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. So here's the question: The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating). Unfortunately this isn't what they want, they want his blood to stay thinner to prevent possible clots forming from blood that doesn't get pumped completely out of the heart. The arrhythmia is still palpable (or the knotted- ness). I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle colleagues? tx k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2009 Report Share Posted October 27, 2009 Hello Karen, Research has become undeniable that acupuncture is effective at regulating arrhythmias in human and animal studies. I encourage you to read up (if you haven't already) on Pubmed and google (keywords " acupuncture " " arrhythmia " ) to see what points and treatment frequency may be most appropriate for your patient. (most well-studied, of course is P6 neiguan.) The wonderful thing about acupuncture is that, although in the beginning tx frequency needs to be more aggressive, long term the idea is to permanently heal the patient so they nolonger need any acupuncture/herbs/drugs. (perhaps 3x/wk first week, then 2x a week, then 1x a week, then finally 1x per month maintenance.) You begin with more frequent " dosing " of acup. and ween off as the condition improves. Goal is to return patient to normal healthy heart function. In comparison, coumadin is only managing the potential risk of blood clot causing stroke/cardiac arrest. It is not treating the arrhythmia itself. It is extremely helpful to become well-versed in the western treatment of this condition, so that we can place acup. w/in the context of other tx options, and educate patients appropriately to discuss all their options with their Western PCP/cardiologist. Cardiac ablation is something that shows some promise; I believe a good option if acupuncture doesn't work for whatever reason. It is important for us to do a side-by-side comparison of the risk vs. benefits of all these tx options, to help patient (and their cardiologist) make informed decision and thoughtful plan. Clearly the acupuncture is low-risk, and given the research on its efficacy, really deserves to have a place as first-line therapy in tx of this condition. Ideally, patient discusses w/ cardiologist if it would be ok to try acupuncture for a few months, and if successful ween off Coumadin within, say, 1 year's time. (I know that in Cardiac ablation, standard-of-care is to re-evaluate patient at 1yr mark and take them off Coumadin is sinus rhythm is 100% normal at the 1-yr anniversary of ablation. So why not do the same with acupuncture?) So ideally patient is evaluated by cardiologist via EKG and 24-hr holter monitor to " prove " that they no longer have arrhythmia after, say,3-6mos of acupuncture, and then again at the 1yr mark. We must understand that the MD has serious liability and protocols to follow and cannot ween patient off coumadin without clear prove that their heart function is 100% normal again. Of course your case has anxiety as root, arrhythmia as branch. 5E offers such wonderful psycho-spiritual point Rx protocols, surely you will be successful in helping this patient with both the root and the branch conditions (internal/external dragons?). Clearly the Coumadin is not going to address that. Good luck and speedy healing to your patient! ~edith -- Edith Chan, L.Ac. Doctoral Fellow www.DanTianWellness.com Office: 415.668.1880 - Mobile: 415.298.5324 On Tue, Oct 27, 2009 at 7:46 AM, turusachan <turusachan wrote: > > > Hey folks - this one is interesting. I have a patient who's a Vietnam vet > with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, > and the doctors have put him on coumadin as a preventative. > > His stated symptoms would indicate there is stagnation in his heart (I'm 5E > trained, trying my best to talk TCM), and he's been living with adrenaline > overload since he was based in Nam. His pulse is knotted overall (or perhaps > - is there a difference between picking up the arrhythmia on the pulse and > knotted quality?) and is often stronger and clearer on the right pulses. > There's no red on the tip of his tongue - it was blue, now is pink, swollen > and dry. > > So here's the question: The test for blood " thickness' is showing that he's > actually getting closer to normal over time (since we started treating). > Unfortunately this isn't what they want, they want his blood to stay thinner > to prevent possible clots forming from blood that doesn't get pumped > completely out of the heart. The arrhythmia is still palpable (or the > knotted- ness). > > I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle > colleagues? > tx > k > > Karen R. Adams, > Lic Ac, Dipl Ac > 25 - 27 Bank Row > Greenfield, MA 01301 > 413-768-8333 > > All shall be well > and all shall be well > and all manner of thing shall be well > Julian of Norwich, 14th century British mystic > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 27, 2009 Report Share Posted October 27, 2009 Karen, The PT/PTT or test for thinness of his blood, is affected by a number of variables. If his diet has changed to include more foods containing Vit. K, that could be the cause of " thicker " blood ,ie. eating more broccoli or green veggies or drinking green tea. Also, the coumadin, as you said, helps to prevent blood clots from the irregular heart rate causing turbulance in the blood vessel but it does not prevent the arrythmia. If his rate is rapid or at least, not too fast, perhaps they could try him on Digoxin which prevents his heart rate from getting to fast and sometimes, also reduces the amount of episodes of a-fib. Might be worth talking to his Western healtcare provider about. Hope this helps...............Betty --- On Tue, 10/27/09, turusachan <turusachan wrote: turusachan <turusachan afibrillation and coumadin Chinese Medicine Tuesday, October 27, 2009, 10:46 AM Hey folks - this one is interesting. I have a patient who's a Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall (or perhaps - is there a difference between picking up the arrhythmia on the pulse and knotted quality?) and is often stronger and clearer on the right pulses. There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. So here's the question: The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating). Unfortunately this isn't what they want, they want his blood to stay thinner to prevent possible clots forming from blood that doesn't get pumped completely out of the heart. The arrhythmia is still palpable (or the knotted- ness). I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle colleagues? tx k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 Hi Karen, What has your treatment been? ________________________________ turusachan <turusachan Chinese Medicine Tue, October 27, 2009 7:46:02 AM afibrillation and coumadin Hey folks - this one is interesting. I have a patient who's a Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall (or perhaps - is there a difference between picking up the arrhythmia on the pulse and knotted quality?) and is often stronger and clearer on the right pulses. There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. So here's the question: The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating). Unfortunately this isn't what they want, they want his blood to stay thinner to prevent possible clots forming from blood that doesn't get pumped completely out of the heart. The arrhythmia is still palpable (or the knotted- ness). I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle colleagues? tx k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 28, 2009 Report Share Posted October 28, 2009 Hi Yehuda - mostly Blood points, often but not always with moxa. Also spirit level points for the Shen (that part, btw, seems to be going very well). So Pc 4, Bl 43, Back Shu for Pc, Ht, Ki (not all at once). Occasionaly an Extraordinary (can't remember offhand, am not at office). So interesting that his blood is moving back into the normal range for people not on coumadin, which the docs view as thickening up. k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic ________________________________ Chinese Medicine Wed, October 28, 2009 5:00:24 AM Re: afibrillation and coumadin Hi Karen, What has your treatment been? www.traditionaljewi shmedicine. net www.traditionaljewi shmedicine. blogspot. com ____________ _________ _________ __ turusachan <turusachan > Tue, October 27, 2009 7:46:02 AM afibrillation and coumadin Hey folks - this one is interesting. I have a patient who's a Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall (or perhaps - is there a difference between picking up the arrhythmia on the pulse and knotted quality?) and is often stronger and clearer on the right pulses. There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. So here's the question: The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating). Unfortunately this isn't what they want, they want his blood to stay thinner to prevent possible clots forming from blood that doesn't get pumped completely out of the heart. The arrhythmia is still palpable (or the knotted- ness). I'm kinda taken aback, not sure how to proceed. Your thoughts, gentle colleagues? tx k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 29, 2009 Report Share Posted October 29, 2009 " Vietnam vet with some pretty strong PTS symptoms. He's been diagnosed with afbrillation, and the doctors have put him on coumadin as a preventative. His stated symptoms would indicate there is stagnation in his heart (I'm 5E trained, trying my best to talk TCM), and he's been living with adrenaline overload since he was based in Nam. His pulse is knotted overall There's no red on the tip of his tongue - it was blue, now is pink, swollen and dry. The test for blood " thickness' is showing that he's actually getting closer to normal over time (since we started treating).The arrhythmia is still palpable (or the knotted- ness). " Hi Karen Hi All your query presents us with the conundrum we face when patients are receiving concurrent medical pharmaceutical interventions. Thanks for bringing it to the discussion. Without actually seeing and talking to your patient, I'll be generalising, and making informed guesses, and referring to acupuncture and moxa, but not herbs. I'm thinking that the coumadin and your Rx have cleared the excess - the Blood Stag in the Heart - caused by underlying deficiencies now revealing themselves on his tongue. As long as there is a chance of deoxygenated blood accumulating in the atria, and hence clotting up, the doctors are always going to want to treat with either coumadin, or aspirin, or similar. I'd leave them to it - I was an RN in a cardio-thoracic unit for a number of years. They'll just keep increasing the dose until they get the necessary clotting times - blood thinness - which they understand helps to prevent life threatening events caused by embolic clots. The dose of coumadin they prescribe will ultimately over-ride responses in the Blood due to the relatively more subtle yet effective acupuncture and moxa. I'd be more interested in seeing if there are progressive changes/improvements in his ECG [EKG] since he began seeing you. Atrial fibrillation is a disarray in communication between the signalling and conductive nervous system tissues of the heart, under autonomic control. I see Sympathetic and Parasympathetic nervous systems and their actions as physical manifestations of Yin and Yang at play - or in this man's case, possibly in disharmonious or non-communicative state with each other. Shaoyin - Heart and Kidneys - Fire and Water - may not be communicating in this man, and it's possible that in him, the only signs and symptoms of this disharmony are the ones he's described to you. I'd guess this is the root, and that the Blood stagnation in the Heart is secondary to that, simply because the pump is not working efficiently, or in a coordinated manner. Any Heart Qi or Yang deficiency is likely to be due to prolonged pushing against the excess [the accumulated blood], with possible Kidney deficiencycontributing. Given this man's apparent history of grievous shocks and prolonged fear and anxiety - your current treatment approach is appropriate, and you have already noted that he is responding well. You've enabled him to start moving towards a state of equilibrium - homeostasis, and his Blood has followed this trend. Keep doing what you're doing; my own sense is that acupuncture is the quintessential treatment for people with significant autonomic nervous system dissary... and the Shen, of course If you can restore harmony to his Heart & Shen et al, then one would hope to see his EKG and pulses normalise, which in turn will reduce the chances of blood accumulating/stagnating in the atria/Heart. Then he shouldn't need coumadin. As an acupuncturist, I'd be more interested in his clotting times as an indicator of his likelihood of bruising or bleeding from acupuncture. Herbalists of course, will take a necessarily different view with respect to anticoagulant medications and herbs. My only other query - do the doctors have him on any heart medications for rhythm disorders? It's unusual for them just to use an anticoagulant in folk with A.Fibrillation. All the best, Margi Macdonald http://margihealing.wordpress.com/ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2009 Report Share Posted November 9, 2009 Hi Karen, How about PC 6, Ren 6 (moxa), SP 10, UB 17 Ear: Shen men, Sympathetic, HT, LV, Blood point Zhi gan cao tang regulates arrhythmic pulse, esp a knotted pulse (HT yang xu, HT blood stasis), but then there's the problem with mixing dang gui and other blood movers with coumadin. K -- www.tcmreview.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted November 9, 2009 Report Share Posted November 9, 2009 My thanks to all of you who responded to my request for information - all of which got delivered from tonite (11/8). I'm encouraged that I'm on the right track, and you've given me some good news to pass on to my patient. Thanks again. k Karen R. Adams, Lic Ac, Dipl Ac 25 - 27 Bank Row Greenfield, MA 01301 413-768-8333 All shall be well and all shall be well and all manner of thing shall be well Julian of Norwich, 14th century British mystic ________________________________ <johnkokko Chinese Medicine Sun, November 8, 2009 9:28:21 PM Re: afibrillation and coumadin Hi Karen, How about PC 6, Ren 6 (moxa), SP 10, UB 17 Ear: Shen men, Sympathetic, HT, LV, Blood point Zhi gan cao tang regulates arrhythmic pulse, esp a knotted pulse (HT yang xu, HT blood stasis), but then there's the problem with mixing dang gui and other blood movers with coumadin. K -- www.turtleclinic. com www.tcmreview. com Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.