Guest guest Posted August 1, 2008 Report Share Posted August 1, 2008 Hi all - I have a patient I'm treating for open-angle glaucoma. I've treated her 5 times so far (Lv3, GB37, LI4, GB20, plus a glaucoma pt. that is 1 cun superior and 1 finger-breadth lateral to SJ23). Her IOP is stable at 14 with drops, visual acuity is the main issue which varies widely for her. She was planning on testing pressure again after 12 acupuncture treatments. The first 4 treatments were fine, however, on the 5th treatment, when I removed the two glaucoma pt. needles, there was blood and hematoma that swelled quite large and now a week later are still somewhat visible. Although nothing was visible when I removed the needle on right LI4, over the next day a large (large marble sized) hematoma formed here as well, now a week later it is only slightly swollen. 3 hematomas on the same day at points that I had done 4 times previously with no problems. She wants to finish the series of 12 treatments if at all possible, but I feel very hesitant to continue. What baffles me is, why this treatment, and why 3 different locations when this had not happened previously. She has not changed medications, and takes no supplements. her diet has not shifted significantly. She is a pharmacist, so the first thing she did was check to see if any have blood coagulation properties, and they don't. Thoughts? Also, as a new practitioner, I'd love to know if multiple hematomas are a common occurrence, or do they usually occur one at a time. Thanks so much in advance. -- Sean Michael Hall, L.Ac. East Bay Acupuncture & Natural Medicine 2346 Stuart St. Berkeley, CA 94705 (510) 457-8886 www.ebacupuncture.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 3, 2008 Report Share Posted August 3, 2008 It happens. If she wants to go ahead I would do them. Obviously she has some either temporary or on-going blood issues assuming that you are reasonable in your technique. I usually find that I can press strongly on the hematoma (for 5 minutes) as soon as it comes up and they go away. Doug , " sean_michael_hall " <seanmichaelhall wrote: > > Hi all - > > I have a patient I'm treating for open-angle glaucoma. I've treated her 5 times so far (Lv3, > GB37, LI4, GB20, plus a glaucoma pt. that is 1 cun superior and 1 finger-breadth lateral to > SJ23). Her IOP is stable at 14 with drops, visual acuity is the main issue which varies > widely for her. She was planning on testing pressure again after 12 acupuncture > treatments. > > The first 4 treatments were fine, however, on the 5th treatment, when I removed the two > glaucoma pt. needles, there was blood and hematoma that swelled quite large and now a > week later are still somewhat visible. Although nothing was visible when I removed the > needle on right LI4, over the next day a large (large marble sized) hematoma formed here > as well, now a week later it is only slightly swollen. 3 hematomas on the same day at > points that I had done 4 times previously with no problems. > > She wants to finish the series of 12 treatments if at all possible, but I feel very hesitant to > continue. What baffles me is, why this treatment, and why 3 different locations when this > had not happened previously. She has not changed medications, and takes no > supplements. her diet has not shifted significantly. She is a pharmacist, so the first thing > she did was check to see if any have blood coagulation properties, and they don't. > > Thoughts? Also, as a new practitioner, I'd love to know if multiple hematomas are a > common occurrence, or do they usually occur one at a time. > > Thanks so much in advance. > > -- > Sean Michael Hall, L.Ac. > > East Bay Acupuncture & Natural Medicine > 2346 Stuart St. > Berkeley, CA 94705 > (510) 457-8886 > www.ebacupuncture.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 I share your frustrations as tcm practitioner when we do not see results in patients as expected. LI4 (he gu) is very easy to form hematoma if the insertion angle is not appropriate. In order to avoid hemmtoma, we need exercising extra care when pulling out the needles. I find that it is especially popular in post stroke patients as they have blood issue and nothing to do with our techniques. You are lucky to have a very easy-going patient as patients are not particularly delighted to see hematoma. Herbal medicine can be as effective when treating open-angle glaucoma, if not more than acupuncture. I suggest you use granule as well. You can kill two birds when one stone; generating more revenue and the patient sees results sooner. Medicinals such as gou qi zi (lyceum berry), ye ming sha (bat's dropping), mi meng hu (buddleia),and qing xiang zi (celosia) etc can all work well on eye issue. Of course it can be even more effective if pattern identification is observed. By the way, I would much appreciate if you explain to me what is IOP and its significance. SUNG, Yuk-ming Phd (chengdu) BA (Houston) L Ac/CMD (HK) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 Hello Sean and group, I really buy into the idea that blood is a more condensed from of qi. I was taught this in school as being a fundamental truth in our medicine. The first time we see a hematoma, we abandon our philosophy and wonder what went wrong. I see it this way. The Glaucoma points you used are pulling qi and phlegm stagnation away from the surface of the eyes. That is what supposed to happen. The qi is venting through those points. When there is more qi to vent than the points can process a backlog occurs. The qi condenses and forms blood. I would say job well done and march forward to work through it. ~Mark Evans , " sean_michael_hall " <seanmichaelhall wrote: > > Hi all - > > I have a patient I'm treating for open-angle glaucoma. I've treated her 5 times so far (Lv3, > GB37, LI4, GB20, plus a glaucoma pt. that is 1 cun superior and 1 finger-breadth lateral to > SJ23). Her IOP is stable at 14 with drops, visual acuity is the main issue which varies > widely for her. She was planning on testing pressure again after 12 acupuncture > treatments. > > The first 4 treatments were fine, however, on the 5th treatment, when I removed the two > glaucoma pt. needles, there was blood and hematoma that swelled quite large and now a > week later are still somewhat visible. Although nothing was visible when I removed the > needle on right LI4, over the next day a large (large marble sized) hematoma formed here > as well, now a week later it is only slightly swollen. 3 hematomas on the same day at > points that I had done 4 times previously with no problems. > > She wants to finish the series of 12 treatments if at all possible, but I feel very hesitant to > continue. What baffles me is, why this treatment, and why 3 different locations when this > had not happened previously. She has not changed medications, and takes no > supplements. her diet has not shifted significantly. She is a pharmacist, so the first thing > she did was check to see if any have blood coagulation properties, and they don't. > > Thoughts? Also, as a new practitioner, I'd love to know if multiple hematomas are a > common occurrence, or do they usually occur one at a time. > > Thanks so much in advance. > > -- > Sean Michael Hall, L.Ac. > > East Bay Acupuncture & Natural Medicine > 2346 Stuart St. > Berkeley, CA 94705 > (510) 457-8886 > www.ebacupuncture.com > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 4, 2008 Report Share Posted August 4, 2008 > Thoughts? Also, as a new practitioner, I'd love to know if multiple > hematomas are a > > common occurrence, or do they usually occur one at a time. > Another option for the patient who bruises easily (for whatever reason) is to observe the points just after removing the needle. If you see a little welt starting to grow, then applying pressure for 30 seconds can prevent a tiny problem from becoming a huge bruise. Sometimes the histamine response will generate a flattish red " hive " , but a hematoma will be more rounded and perhaps not have that redness associated with it on the surface of the skin. Also, and this is especially important for those who do a lot of facial acupuncture, having some ice packs on-hand can prevent small bruises from growing in to large ones. -- , DAOM Pain is inevitable, suffering is optional. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted August 5, 2008 Report Share Posted August 5, 2008 Yes, I think I was reasonable in my technique, 36 gauge needles for face points, without manipulation. 34 gauge for LI4 with minimal stimulation. I'm curious as to whether she has elevated homocysteine and/or fibrinogen levels, and have suggested she gets these tested along with a full lipid profile. In regards to the gentleman who asked about IOP, it stands for Intra-occular pressure, a common marker for glaucoma. I did rx herbal therapy, but this client was only interested in acupuncture. thanks all for your responses, they've been very helpful sean , " " wrote: > > It happens. If she wants to go ahead I would do them. Obviously she > has some either temporary or on-going blood issues assuming that you > are reasonable in your technique. > I usually find that I can press strongly on the hematoma (for 5 > minutes) as soon as it comes up and they go away. > > Doug Quote Link to comment Share on other sites More sharing options...
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