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Pulse changes frequently


#1

Hello,

I am concerned about a patient I treat for back pain using tui na.

He presents with:

Tongue= indents along LV area on both sides with a purple patch on right side, small cracks all over tongue, Heart crack at tip

Pulse=changing each week, first few month of weekly treatments it was intermittent (skipping every 2-4 beats) when he was very stressed and not sleeping well, at other times skipping every 8-25 beats. I recommended he see an MD for the irregular pulse and he reports that he has and that there is no problem.

2 weeks ago, pulse was slow and skipping, and now this week it's fast (not from exercise) and regular.

The background is an MVA. He has on-going back pain in the low back, neck and shoulders (Gall Bladder channel) that goes right up into his face and eyes and around GB 14. He also has pain along the Gb channel of the legs on the left side. On palpation, the LR and GB Back Shu points are very tight, as is GB 21. His skin turns quite red after massage.

He is very stressed and doesn't sleep well. I've recommended stretches and dietary advice such as avoiding alcohol, fried foods and eating more green vegetables.

I use a lot of deep pressure and kneading techniques with my elbows to break up the stagnation. I have recommended acupuncture but he doesn't want needles. I have also used gua sha which helped but he prefers massage. He gets a couple of days of relief and then the pain returns.

I would appreciate any thoughts as to why his pulse picture keeps changing, and any other recommendations for how to treat him.

Thanks for your help.

Cynthia


#2

I am assuming you are an acupuncturist? You shouldn't let your patient dictate the terms of the treatment, particularly when they are clearly not improving. Either refer them out or treat them properly with acupuncture and the full gamut of Chinese Medicine techniques as appropriate.

In patients that have a hard time understanding/being open to the importance of proper treatment, herbs can be helpful (if they will take them) to start some changes in their body and mind to better realize what will need to happen for them to improve. In a way, they will loosen up a bit and trust other people to help them. Not to be harsh about it, but you not treating your patients properly because they asked you not to, is not helping them in any way with this process.

I find it better just to let those patients go, otherwise you are wasting their time and taking their money. In most cases, they will disappear for a while and then return and be ready to be treated properly - or they find someone else to help them - either way it works out for them eventually in their own time. But short cutting their treatment is a waste.


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