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Morning Sickness


#1

I have seen a young female patient 3 times for morning sickness. She is 8 weeks pregnant with her 3rd child and suffered throughout both previous pregnancies with nausea/vomiting. She is average height and weight, rests well, has good home support. Pulses are even, unremarkable. Tongue with thin white coat, healthy and unremarkable. Can't keep food down. Craves a chili cheese dog once a week and keeps that down fine (yeah, we talked about that).

I have shown her how to make ginger tea, but not prescribed any other herbs. The points I've used are P6, SP4, ST 36, Du 20, Yintang, Ear Shen, SP 9, and ST CV KD pts on the upper abd. She gets good relief during and immediately after treatments, but within a few hours is miserable again. Yesterday I taped on a Hiniashin at P6 to wear home.

Help? Thank you.


#2

Hi, Nina,


My wife is pregnant she is 10 weeks gone, this is her third as well. She is having a worse time with dry retching and watery vomit. Ginger tea hasn't helped.


I have needled Kid 6, Kid 21 and Kid 27 and you can add ST30 if nausea is persistent. Use even technique and leave needles for about 20 minutes.


This seems to help (particularly if you include ST30)


Check out Debra Betts on this subject.


Cheers, I hope this helps


Andrew Colombini BSc. (Hons) TCM MBAcC MAcSCA



#3

I have had good success using Pericardium 5 as opposed to P6 (learned it from one of my teachers). Also, tell her to get a bag of candied ginger so that she can carry it around with her (as opposed to having to make ginger tea). And if you haven't already told her - have her try to eat frequent, small meals.


Good luck!



Adam Schreiber


#4

I agree with Adam, eating a little and often can help to keep the nausea at bay.


Cheers


Andrew Colombini BSc. (Hons) TCM MBAcC MAcsCA


#5

Thanks guys. I'm seeing her tomorrow and I'll try your suggestions. I did look up Debra Betts, thanks! I'll let you know how it works out.


Nina


#6

Thanks all. I'm looking forward to trying this for me when we try for our second. The first time was miserable. I ended up going on meds and needed IVs once a week to keep hydrated. I didn't feel better until the baby was born. The acupuncture points I tried didn't work so I'll have to try these ones. Does anyone have any other recommendations beside ginger? I tried that and couldn't keep it down. That is now one of two foods that I can no longer stomach, even now.


#7

It sounds like you are on the right track in terms of treatment strategy. I would highly recommend cutting down the number of needles used. It sounds like you are at almost 10 assuming you are not doing bilateral needling, which is a lot. Historically, doctors used only 1, 2 or 3 needles for treatments. 7-8 is the max number of needles for me, rarely do I go over 4-5. With a pregnant woman, I would be even more cautious, as needles use up the patient's qi.


Pc 6 is by far the most important point for morning sickness. It will also do a good job relaxing her. I would also add a St 36, in order to strengthen her digestion but also to bring down the qi. I would also add a Kd point (Kd 3, one of the most important tonic points) as well. You could even leave out the St 36 needle and do some indirect moxa on it instead.


And probably more important, even though it seems like she rests, her digestive system is weak. Recommend napping!


Tim



#8

Tell her to try hypnotherapy, it may be totally psycosymatic.. You could possible try the psycosymatic points from Terry Olsens Auricular Therapy book as well.


#9

These are some useful tips for women have nausea and vomiting during pregnancy. Nice discussion here for getting knowledge.


#10

Please try Pericardium 7 - it is the most recommended - good luck!


#11

Wow, thanks everyone for your thoughtful suggestions. I have treated her a third time with no result. Isn't it supposed to be immediate? Lots of issues require long term treatments that build on each other, but that would defeat the purpose of treating morning sickness since it will end when the baby is born anyway.


Tim, you have caught my attention with stipulating that the number of needles used should be few. Everyone? Do you all use under 8 needles in a treatment? I do use more. I will re-think my protocols. Generally a patient will have several issues to be addressed that stem from several root causes. Spleen Qi deficiency with Kidney Yin deficiency and Liver blood deficiency often tie in together and when I address them I can use a dozen needles or so sometimes. I back it up with direct moxa to put qi back in and herbs to build with. I can't imagine doing a treatment with 3 needles. I'd love to try and see how that works. Really? Just 3, Tim?


Nina


#12

Generally, yes, the treatment for morning sickness should be fairly immediate. It may return until it is resolved completely, but somewhere between 4-8 hours after the tx (at least) the patient should be feeling better.


We use some different points for morning sickness, but nothing too far out of the ordinary from what everyone else has recommended. For me, PC 6 appears to work just fine particularly if the patient regularly massages the point during the week.


The only other somewhat unique thing we do on the more recalcitrant cases is tuina massage for the vagus nerve. Essentially tuina in the ST 10, 11, 12 area. This is helpful for many causes of nausea and vomiting, particularly those that don't respond as expected to standard points.


Number of Needles:


There are certainly many theoretical and stylistic needling choices to make. Many of the Japanese styles use very small number of needles, as do many other systems. I know of a handful of practitioners who only use 1 needle per treatment and many others who use 4-6 on a frequent basis. Personally we use between 12 and 20 on most patients but as we focus on the huatuo points primarily we don't feel it factors into the "energetic overload". Needling technique and depth also factors into how many needles you would use. We do use a very small number of systemic/pattern points to send very clear messages to the body on that level - often using ev pairs.



As a side note, we do have a treatment page for morning sickness. If you haven't see the acupuncture protocol page for that, go to the morning sickness page and half way down on the left you will see a link to the acupuncture protocol for that condition. The condition pages are somewhat new and the layout will change, but there may be some useful ideas in the protocol page.


#13

i had this kind of problem years ago. it looked like morning sickness and went away when my son was born. it wasn't morning sickness. it was chronic hidden liver stress that was exacerbated by pregnancy. there were unrecognized low-level infections that many american-trained practitioners wouldn't recognize because cultural expectations would hide them.


it took years for my real problems to reach the surface well enough to be seen. then it took 6 years of treatment by a recent immigrant with long clinical experience in china to get me past the worst of the metabollic problems. after over 20 years of intermittent treatments of subsequent injuries and infections, we'vee finally gone underneath the original assault on my health and are rebulding from there. that assault took place within my first two months of life. i'm now over 70 and slowly building the kind of strength needed for my body to successfully carry my intelligence and spirit. people no longer routinely twist my intentions to make me look like a fool or manipulate me into displaying anger for them to watch or into spending money for things i don't really want so they can make money.


fragile bodies house people easily tempted to act against themselves. truly healthy bodies are less tempted to go beyond their physical, mental and spiritual strengths. this kind of health is beyond anything i could have imagined before experiencing the little windows that now appear every once. i keep going because i know that eventually they will get longer and longer until they grow together into an all-the-time experience. i only wish that this kind of healthcare had been available to me in the late 1950s when i first learned about and yearned for traditional oriental medicine.


my guess is that, like me, this patient has much deeper problems than she recognizes and that these are only revealed when her body is called on to support two lives. she thinks she is strong when she is not. since her life is fairly comfortable, she'll probably get away with this for many years. if she's a normal american, she would be highly insulted to learn that her problems are probably very deep. i suspect that once upon a time i would have been too. this leaves her poor healer in a very difficult position. if my guess is correct, unless this healer has unusual communication skills, she can be dishonest and believed to be ineffectual or be honest and probably scorned. it's a real conundrum that they great preventative strengths of oriental medicine are so poorly utilized within our mainstream culture..


#14

Thanks Chad. I have printed out the Morning Sickness protocols page. I love the protocols, by the way, and refer to them often. They help me clarify my diagnosis and confirm my point choices. As a rookie in this medicine I am grateful for the work you have put into the protocols pages and your willingness to share your efforts publicly. I will try the Tuina on ST 10, 11, 12 if she ever comes back in again. She loved her treatments, just got only brief or minimal relief from them.


#15

Nina, I have found perservering with Kid 6 21 27 ans St 30 works almost immediately, however it needs to be done every day for a period of time, and in conjunction with Chad suggestions of Tuina on St 10, 11, 12. Whether this lady can come every day of course is an issue.


Good Luck


Andrew Colombini BSc. (Hons) TCM MBAcC MAcScA


#16

I completely agree that these can be much deeper issues and certainly having the same experience with previous pregnancies indicates something that should have been treated between pregnancies. That said, let's not forget that there is a baby growing in there and a whole new network of blood vessels, reconfigurations, etc. Sometimes, just like sciatic pain for example, things are situated just right to press on the right nerve or the right part of a particular organ and you have the symptoms. Not everything has to be some complex psycho/emotional/physical issue - we are just human after all - things happen.


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