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Collapse during acupuncture


#1

Hello,

first I would like to apologize for starting so many topics recently, but it seems I just have so many questions pop up this month, hopefully things will settle down soon... :)

I've had an unfortunate experience that I know rarely happens during
acupuncture, yet I was hoping I would never witness it personally. A
friend of mine suffers from lower back pain, and I did
acupuncture on her last week with no problems whatsoever. She has had
low blood pressure in the past, but that has been under control over
the last year. Her only other known medical condition is rheumatoid arthritis, she is in
her 50s, and physically quite fit. We've had some "heavy" weather this week in these
parts, however, she said she was feeling well upon arrival for
her second session. Her heart rate and pulse seemed even and strong, yet I am still learning how to read pulses well (she is aware of this).

The only thing we did differently is that she was not lying on her stomach (since that position hurt her back), but was sitting on a chair, leaning comfortably forward on some pillows on a
table - the position you've suggested to me, and which she found very comfortable and suitable. After inserting about 5 needles (I started with the BL points), with feedback from her that it felt quite good and comfortable, she pretty much collapsed, incredibly suddenly. She didn't pass out, but nearly, and she felt awful (incredibly dizzy, sweating, pale, very nauseous, tunnel vision, tingly hands etc), it came on within a second of her saying she is feeling great, and quite soon after we started. I of course immediately removed the needles and helped her to the bed, and did everything to help her current medical situation. It took her at least half an hour to feel better, and even by the time someone came to drive her home she was still not feeling well
(she energetically refused medical help, claiming it was probably just a low blood pressure attack - even though she never had something like this before; I encouraged her husband to take her to the doctor straight away, not sure if she'll let him).

I don't need to tell you how distressing this was for both her and me.
I kept my cool at the time, however, it was a very upsetting situation.
She is not blaming the acupuncture, however, I am sure acupuncture triggered this reaction (well, if anyone dares to tell me again that acupuncture has no effect, this clearly shows that a few thin needles can do wonders).

I remember learning that this sometimes happens during acupuncture, regardless of the ilness or needle positioning. Yet I don't remember it being explained to me "why and how". Do any of you know what the explanation is for this? How can acupuncture trigger such a collapse? What is the theory behind it? I feel that if I understood the theory behind it better, I could do more to predict it in the future and avoid it.

Thank you,

Irina


#2

Usually you want to even the treatment out a little more instead of focusing so locally. For back pain, GV 20 is a commonly used points for a variety of conditions but will also keep people from fainting. You want to avoid GB 21 in patients with a propensity towards this, or low blood pressure and you may want to balance the treatment better with SP 6 or ST 36 or some other relevant point. Personally I start treatments with more distal/systemic points to regulate the overall qi of the body, then I work in local points.


#3

So she had low blood pressure history, and the needles all done on leg or lower part of her body, this could lead her body&#39s Qi and blood go down, her head will lack of blood support cause low blood pressure happen again. I think this is the reason she feel dizzy and uncomfortable. To avoid this situation, first should ask clear her illness history, check her blood pressure first, and ask her energy level, if she feel tired and lower level, that mean her Qi and blood defficinecy, should lie down needling to avoid needle shock, and must have Du 20, if low blood pressure, have some tonify Qi and blood points, for example: St36, Ub17, Ren4,6. Li4. the last thing is calm down spirit, use Yin Tang.


#4

Thank you, this has been quite an eye opener, and a steep learning curve experience.


No matter how much I read about vasovagal collapse (I am not sure what the TCM term for it is yet), it just doesn&#39t seem to follow specific rules. I am trying to figure out if it was predictable or not, her low blood pressure has been under control for a year now (not with any medication, it just got better on its own), she is a sporty person, her pulse seemed strong and even to me, and she has no fear of acupuncture (was very positive about the treatment), and has eaten a good meal beforehand.


However, only after her collapse did she tell me she used to be scared of needles, and that she has been feeling "a bit strange today because of the weather". She didn&#39t want to tell me that before the needling, "so as to not worry me". I have now learned to be more specific with my questions to avoid such subjective answers.


I think I shall, from now on, check blood pressure in every patient that has had issues with blood pressure in the past or present.


Thank you for the points, and the explanation behind it, this makes sense to me.


Ironically, my next needle was going to be ST36 (I just had a feeling this point benefits her). I had BL 23, BL 25 and was just finishing BL 26 when she collapsed. With BL 26 she felt a strong da qi (she described the sensation texbook perfect, and quite enjoyed it) and immediately after she collapsed.


It seems I am more concerned about this than she is, since despite it being a quite uncomfrotable and scary experience for her, she would like to continue the acupuncture sessions (since she so enjoyed the first one we had, when there were no problems).


Next time I shall do a more thorough physical, keep her lying down, start slowly with distal points you mentioned, and monitor her very closely throughout.



Thank you again for your support and input,



Irina


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