Case Study - Cranial neuralgia with Fibromyalgia

Female patient age 49 first consulted Jiune 2011, for Cranial neuralgia since extraction of a right upper wisdom tooth in March 2011. She consulted her rheumatologist and a neurologist both were unable to provide a resolution to this condition. The patient also presented with fibromyalgia and insomnia for the past 5 years. She was taking Pristia 20mg at night for depression, Lyrica 75mg at night for fibromyalgia and Lorazepam .05mg for stress as needed. Her fibromyalgia worsened in 2009 after sinus and lap band surgeries. She suffered with hypertension which both parents had. She was not interested in having hypertension treated with acupuncture and was taking Benicar 20mg and Clonodine .20.mg. The patient refused Chinese herbs as part of her treatment. Her symptoms were as follows: Continuous sharp stabbing pains in the chin, lateral inferior aspect of zygoma, bilaterally, and the vertex. Throbbing pains in the temples, and occipital region extending to UB 2 which would wake her during the night. Exhaustion and marked fatigue with generalized body sensations of heaviness.. Diverse fibromyalgia sharp aching pains; in the arms being worse at the elbows and hands, upper back at the medial borders of the scapulae bilaterally and at left lumbar extending from UB 52 down the left buttock and 6 cun down the back of the left thigh on the UB channel. Her pains caused mental confusion, and sluggishness. She suffered from stiff shoulders, and melancholy. Her history included a blood clot on her Liver during phase of great stress, which resolved. Stress from death of parents , her own family, and her job. Taking her pulses according to Dr. Tan’s method relating the pulse positions as yin or yang, creating a trigram relating to internal organs, the trigram of the Large Intestine came up prominently. Her tongue presented as pink and purplish with purplish edges, and only slightly peeled sides and tip. Japanese internal organ diagnosis revealed left - right sided deviations of the Liver, Gallbladder, Spleen and Lung. Japanese extra channel polarizations which came up were Jue yin - Pericardium/Liver and Tai yin Lung/Spleen. Divergent meridian which came up was Lung/Large Intestine. TCM diagnosis was Blood Stagnation Bi Syndrome of the Head, with Stagnation of Liver Qi and general Qi Deficiency. Acupuncture treatment delivered was mainly a combination of Dr. Tan’s Balance method and Dr. Li Chun Huang’s advanced auricular therapy. The first 20 treatments were 2X a week. Auricular component of treatment was bilateral: Initially, Temple, San Jiao, Nerve subcortex, Shenmen Upper Jaw, Helix 4. Right side: Liver and wisdom teeth. Comment: Precise point location including Visual and point finder diagnosis is important.. Upon removal of needles while wearing gloves it’s common in my clinic to get spontaneous release of drops of blood corresponding to areas of inflammation. This is great as it accelerates treatment results. First treatment. Infrared heat focused at right UB 13 and left UB 18 & 19 to balance deviations from Japanese internal organ diagnosis. Body Acupuncture was Dr. Tans Shao Yang / Jue Yin 3-6 Gong Yao with Addition of LU 7, LI4, SP 9, ST36 Left side: San Jiao 3 & 10, LI 4 / Dr. Tan’s Liver 8A, Liver 3, Sp 9 Right side: P3 & 7, Lung 7 / GB 34 & 41, ST 36 Second treatment Felt 15% improvement since #1 treatment felt pain ‘trying to leave the face and chin’, felt calmer. Assessment – I am not satisfied. Decision – change body points. Add to Auricular points. Auricular Treatment: treatment was bilateral: Temple, San Jiao, Nerve subcortex, Upper Jaw, Helix 4. Liver and wisdom teeth right side. ADD Li chun Huang’s points for systemic inflammation: Shenmen, Endocrine, Adrenal, Allergy Body Points: Dr. Tan’s 8 Magic Meridian’s. which are combinations of 1-4 and 3-6 Gong Yao Ba Gua. Noting that the imaging of points go to the head and face while many of the meridians travel through the digestive system and cranium. The meridians that do not have trajectories through the face and head automatically transform into the internal organs whose meridians do flow through the face and head. For example Heart becomes Gallbladder and Pericardium becomes Stomach. So I have to thank Dr. Tan for the genius of this treatment which has been a real gift. The body treatment for the next 19 treatments remained as follows with switching sides of the body every other treatment with .20 gauge needles. LEFT: H7 & 3, P6 &9 GB 34 & 41, ST 42 & 45 RIGHT: SJ 1 & 4, LI 1 & 4 SP 1 & 4, K1 & 4 After this 2nd treatment the pain in her face went away. She would have some very mild recurrences between treatments which got progressively less. Headaches also went progressively and dramatically away. Then the patient noticed her energy level going way up. Her insomnia went away. After 8 treatments her fibromyalgia was 50% reduced. After 16 treatments her fibromyalgia was gone as was her depression. Then she was weaned off her Pristia, Lyrica, and Lorazepan by her rheumatologist who was quite surprised to see her improve so dramatically. Her levels of stamina, calmness and abilities to function under stress greatly improved. Then something unexpected happened. With the patients innate energy of health so strengthened, in my opinion it rebelled against the lap band. She developed a hiatial hernia, for which she required surgery during which time the lap band was deflated so it was no longer restricting the stomach. The surgery went well the patient was temporarily put on Prilosec. To help recover from surgery the patient agreed to take the amino acid, L Glutamine one 500mg capsule a day for a week prior to surgery, after surgery 1 capsule a day for 3 days, then 2 capsules a day with meals for 2 weeks. She was also given homeopathic medicines, Arnica 30C – twice a day for 5 days after surgery and Calendula 200C once a day for 4 days after surgery. Arnica 30C helps the body recover from the trauma of surgery, it relieves blood stagnation, inflammation and pain. Calendula 200C helps surgical incisions to rapidly heal minimizing possibilities of scar tissue and resulting stagnation. Homeopathic medicines don’t go through the digestive system and thus are appropriate for the patient having had gastric surgery. L Glutamine very gently feeds the healthy lining of the digestive system. L Glutamine is known to get depleted from surgery in general so it was well indiacted to this patient. Homeopathic medicines are now part of the scope of practice for licensed Acupuncturists in California. In 2010, my efforts were responsible for setting a landmark decision in a grey area of the California Acupuncture Board Law making homeopathic medicines, with the exclusion of medicines made from controlled substances, part of the scope of practice. Since her rapid uneventful recovery from the surgery the patient received a few simple acupuncture treatments of Dr. Tan’s Yang Ming / Tai Yin 3-6 Gong Yao, with Ear Shenmen. The cranial neuralgia, fibromyalgia, insomnia and low energy never returned.