I have not yet done any posts regarding specific cases in my office but this one stood out to me as a success story that should be shared. It is not uncommon for patients to come to me as a “last resort.” After seeing western doctor after western doctor and getting no results, or being offered a multiple drug regimen with multiple risks and side effects people become frustrated. They want to get better, they think they CAN get better, and they try acupuncture in a “last ditch” effort to get better. These cases are especially exciting to me for two reasons. One, often these are situations in which TCM excels. Whenever someone’s situation is “mysterious” or unresponsive to western medicine, it is often quite responsive to acupuncture and herbs. Two, when they get better, they are so thankful and it warms my heart to know that they have been helped after so much time feeling desperate and frustrated. It is particularly satisfying when they report back to their western physician that they have indeed gotten better with this medicine. It plants a seed in that physicians head that maybe there is something to this Asian medicine.
So, back this case I want to share.
A 27 year old man came to me 2 months ago with a five year history of urinary frequency, small bladder capacity and pain. His bladder could not hold the normal amount of urine and when it became “full” he would have severe, sharp lower abdominal pain that could only be resolved by urinating. He woke 3 to 4 times a night to pee, and had trouble falling asleep due to lower abdominal discomfort. He had been through every western bladder/kidney/prostate test available including a very invasive Cystoscopy. He had been to three different Urologists, none of whom could offer him a diagnosis or a treatment plan. The last of which prescribed him antidepressants. Now, side note, this happens ALL THE TIME. My patient was not the least bit depressed. He had some anxiety around the urination issue, but nothing outside of what would be considered normal considering the intensity of the pain and the lack of diagnosis. I have seen this so often I am no longer surprised when it happens. When western medicine cannot find the cause of a physical problem, patients are given antidepressants. Maybe this was all “in his head”, but this man decided he did not want to take drugs that he didn’t think he needed and sought out alternatives.
During his initial visit I discovered that the man had lower back pain as a result of an injury in which he was run over (!) by an ATV when he was 7 years old. He did not require surgery but several of his lower lumbar vertebrae were permanently damaged. This piece of information would mean nothing to a urologist but it meant a lot to this TCM doctor. In addition to back pain he suffered from knee pain that he chalked up to “getting older” at his mere 27 years. His urine was usually clear, although occasionally cloudy and was slow to come out. His hands and particularly his feet, were always cold. He was always thirsty, for room temperature water, but he was afraid to drink because of the bladder problem. He felt fatigued all the time which he didn’t feel was caused by the night waking.
Urinary frequency can be the result of several different TCM patterns. In this case all signs pointed to one thing: Kidney yang vacuity with blood stasis in the bladder. I was fortunate that his symptoms painted such a clear picture, as this isn’t always the case with such chronic conditions. I believed that the Kidney vacuity was primary, and had existed since that terrible childhood accident, if not before, and the blood stasis was a result of the bladder not functioning well for so long. (Chronic conditions often develop blood stasis over time.)
Treatment was simple. We were to start with acupuncture and moxibustion weekly and would add herbs if we didn’t see results in 6 visits. For you TCM geeks out there I used a combination of BL23, 28, Du4, Ki7, Sp8, Ht7, Ren2, 4, 6, and Ki11 over the course of 6 sessions. I applied moxa to the points on the low back and lower abdomen. The results have been great with progressive improvement after each treamtment. After the first couple of visits he noticed a reduction in the number of times he woke at night to pee. After the 5th he noticed a reduction in daytime frequency and a big reduction in anxiety. After the 6th visit he reported he was peeing around 5 times a day (as opposed to hourly) and he was only waking once a night to urinate with a big reduction in fatigue. Although we have reached our 6 visit goal we have determined that more treatment will be necessary as it would be best if he were not waking at all at night. We will continue weekly treatment until we accomplish that and if it hasn’t been accomplished in 3 more visits we will add a granular herbal formula. For the TCM geeks: Jin Gui Shen Qi Wan + Lian Zi, Fu Pen Zi, Tu Si Zi, Suan Zao Ren, Yuan Zhi
In addition to the physical improvement mentioned above, one of the things that stands out to me when I think about this patient is how much his affect has changed in the two months I’ve known him. The first few visits he was somewhat “tightly wound” so to speak. He was visibly uncomfortable, a little defeated in his tone, and all around frustrated. Now when he comes in he is downright cheerful and bright. I hope that he continues to improve and that he can get on with being a normal healthy 27 year old with a life that does not revolve around having a bathroom nearby.