22-year old male, traumatic brain injury (TBI) to the left skull, brain stem injury. Forcibly stimulated from coma in June after injury late May 2014. From hospital received rehab services for six weeks then evaluated as non-responsive (vegetative) and sent to nursing home where receives next to no care. For six weeks I provided daily Tuina and integrative massage to attempt brain stimulation and address contractures. Currently providing 4-5 times per week Tuina etc.. Sporadic progress includes recognizing me, some ability to track, respond to command to turn head, sit up, attempt to speak, beginning to move tongue, overall health improvement (skin tone, circulation, etc) and increased relaxation. But contractures (left side arm crossed over midline, leg tending to scissor on top of right leg but left hand relaxed) and right arm relaxed, right hand clenched, right leg rigid. Contractures sometimes worsen in response to deep work so integrated approach seems best (incorporating rocking, vibrating).No access to acupuncturist currently, unfortunately. Full body session but somewhat limited because I have to work on him in the bed, sitting up. Does anyone have experience working with brain injured and/or contractures?
When you say "I provided daily Tuina" - what in very exact terms are you doing and for what reason in your own words (and/or tcm terms)? If you can describe this I may be able to offer some more suggestions.
There is a clinical proven acupuncture therapy for brain demage. Dementia is one of common sequelae of craniocerebral injury. I have the paper where this procedure is very well documented. The procedure must go with bilateral daily basis acupunture on Houxi (SI3) and Shenmen (HT7). Retain needles for 30 minutes after the De Qi (arrival of Qi felt by the practitioner) with reinforcing and reducing method every 5 minutes. Do this once a day for 20 days. The results must be outstanding!
The explanation of these pair of points is quite straightforward: Shenmen is a Shuxue (Stream point) and Yuanxue (Primary point) of the Heart Meridian and can be used to treat dementia and amnesia etc. by relieving mental stress and removing the obstruction in meridians and collater. Houxi is Shuxue (Stream point) of the Small Intestine Meridian and one of the Eight Confluent points and links with Du Meridian (Governor Vessel).
In my opinion, SI3 must be needled first and let Du be "charged" with Yang for at least 5 to 10 minutes, after needle H7 and Yang must be "directed" properly to the brain.
Good luck and ask me should you need the paper.
Patricio (from Chile)
Hi Chad, Thanks for your reply, sorry for the delay. I am a former shiatsu practitioner now working a desk job. I have continued to study TCM informally and for some years have received Tuina weekly so I am incorporating that knowledge into the session which I stress is volunteer, I am not presuming to be a professional, I am just using what I know and trying to be of some help to this person. So EXACTLY what am I doing? I do lots of "main" points that I do not remember the names or numbers of and work points on the head, neck, shoulders, back etc. The boy is lying in a bed, so my techniques are limited, i.e. I cannot use elbows and it's difficult to leverage gravity. I have looked in the Journal of Tuina and Acupuncture Science. My biggest concern is addressing the contractures. It's completely different working on a brain-injured person because they sometimes spasm as a response to deep pressure and the contractures are really challenging. So I am incorporating rocking and vibrating with some success.But essentially I just work along a lot of meridians, the heavy hitters, along the bladder and kidney in the leg and so forth. I am hoping to hear from someone who worked using their hands (not acupuncture) on a brain-injured person and especially, if they had some success preventing contractures. Very curious about critical head points--his injury was to the left part of the head. Btw since I posted this the mother of the boy agreed to bring in an acupuncturist 3X/wk but I have no idea what that person is doing. The boy is in a so-called vegetative state of coma, in an out of consciousness. The Western medical establishment seems to think leaving him in a bed without any attention until he "comes around" is a good idea. What I'm doing is perhaps not all that effective but it is better than nothing. (I am not working with the boy on the days the acupuncturist comes, by the way.) Thanks for any input.
THanks so much Patricio and sorry for the delay replying to you. I am not an acupuncturist, I am working with my hands incorporating Tuina. But thanks.
I suggest some light touch away from the body resetting the nervous system, you can use powder to help keep a smooth connection.
I also suggest a lymphatic touch which is really light aswell and moves with the lymph lines towards the belly.
warm rice packs or covered water bottles along the back of the neck and base of the skull can help improve csf flow, and a rice pack down the spine can help as well.
I would work the fhands, feet and legs to reduce atrophy and also use your tui na there, rolling, rocking and vibration can be supportive and grounding. hands and feet have many start and ending points for meridian lines.
hope this is simple enough and still useful to you
Thank you, that is helpful. Beautiful idea for rice packs. I had thought of hot water bottle, the rice packs sound especially relaxing and would make a dense heat. What do you usually pack the rice in? Maybe pillowcase? Heated in a microwave?