Conditions that are difficult to diagnose and treat

While some conditions are easy to diagnosis and treat, others are harder, and sorting out multiple signs and symptoms can take time and patience on behalf of both the patient and the professionals, whether they practice western or Chinese medicine.

The case I will describe here concerns a patient in Dr Wang’s Beijing clinic where I was observing for 4 weeks in October/November 2013. The patient was a 53 year old woman and her main complaint was a constant, severe pain around the umbilicus (navel). By the time she came to Dr Wang’s private clinic she’d already been treated in hospitals with both western and Chinese medicine. Coming to Dr Wang’s clinic in Beijing, which was some distance from her home town and province, was the end of a long journey to find relief. But while she’d had numerous western medical tests and several possible diagnoses had been mentioned, there hadn’t been a conclusive one and none of her previous treatments had been effective.

On presenting to Dr Wang’s clinic she’d had the umbilical pain for at least a year, but the only medication she was taking was an anti-depressant. Other signs and symptoms included: frequent, burning urination, back pain, poor sleep, loss of appetite and significant weight loss, sweating both day and night, and feelings of fear and loneliness. These last symptoms may sound strange to western ears (we automatically think of such a person as being anxious or depressed) but in Chinese medicine ‘fear’ is an emotion which arises when a very specific aspect of a person’s physiology has got out of kilter, and it is not regarded as being synonymous with anxiety or depression.

Being unable to give the patient a diagnosis for her main complaint, it’s perhaps understandable that hospital doctors trained in western medicine felt they could only offer her anti-depressants to relieve her mental-emotional symptoms and help her sleep. Or perhaps they thought that the physical symptoms were caused by anxiety or depression, and that they would be resolved by taking anti–depressants. In any event, this woman’s distress was still very much evident when she came to Dr Wang for treatment.

So, while Dr Wang had the advantage knowing what conditions had been ruled out by western medical tests and what other treatments (western and Chinese) had been tried, he didn’t have a western diagnosis. Nonetheless, he was still able to commence treatment based on his understanding of her condition in terms of Chinese medical theory, and using his own unique skill of Channel Palpation, which gave him vital diagnostic insights.

After three acupuncture treatments the patient reported an improvement in her pain and other symptoms. Unexpectedly, though, she reported that ongoing hospital investigations had come up with a new diagnosis; Interstitial Cystitis. The unusual location of her pain (around the umbilicus) was no doubt part of the reason that hospital doctors were cautious about making this diagnosis earlier because the condition is usually diagnosed by the presence of pain related to the bladder (which is much lower on the abdomen), frequent urination and the absence of other conditions that could cause the symptoms.

Unfortunately, there is no cure for Interstitial Cystitis, although there are western drugs to alleviate the symptoms. However, because the patient had already begun to feel better, she chose to continue being treated by Dr Wang rather than go back to hospital for treatment. She came for a total of 11 sessions over 4 weeks, ending when she had to return to her home town.

At some point during the course of her treatment she stopped taking the anti-depressants on Dr Wang’s advice. When commenting to observers like myself, Dr Wang expressed the opinion that while anti-depressants do make patients calmer, they are not a good treatment if the reason for prescribing them is not correct, and long term use is not good for patients because they adversely affect the nervous system. (These effects can actually be felt — or rather, not felt — on patients being treated with acupuncture. Such patients do not experience the unique sensation of Qi when being needled, and they do not respond to treatment as swiftly as those who haven’t taken anti–depressants.)

By the 11th session the improvements in her condition were remarkable. The umbilical pain was mild and intermittent, the frequent, burning urination was almost normal, and the back pain was mostly gone. Her appetite had improved greatly, she had gained 11 pounds and her gaunt, strained face had filled out. Also, her sleep had improved and she had lost the feelings of fear and loneliness. All round, her symptoms were about 80% improved.

It seems that Dr Wang thought the patient’s poor sleep, loss of appetite and weight loss were mainly a result of her umbilical pain and the understandable distress of not receiving a diagnosis or effective treatment. As such, he concluded that the correct treatment approach was to focus on her primary complaint, plus the related symptoms of frequent urination and back pain, although he also addressed her feelings of fear and loneliness with acupuncture, which improved her mood and allowed her to stop taking anti-depressants. The sweating during the day and night, which was probably related to the menopause, was also successfully treated with acupuncture. Herbs were prescribed to support the patient’s recovery when she returned home.

So what happened next?

During her last consultation Dr Wang asked the patient to get in touch a few weeks later to let him know how she as feeling. The patient did this, telling Dr Wang that she continued to feel well, and requesting further herbs. Three months further on the patient is still understood to be healthy.

Of course, if the condition is Interstitial Cystitis there is a chance the symptoms will return some day, but for the time being the patient has regained her quality of life and she now knows there is a treatment that will provide rapid relief.

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