A Taxi drivers Taxing Knee pain!
I recently got a phone call from an elderly client, whom I had not seen in almost two years. I was surprised to hear from him, and was curious as to what had driven him to make the call after such a long time. Tom a 77 year old, part time Taxi driver was driven mad with chronic knee pain. He is very, ”old school” and generally rather “conventional” in his health care! I had only done two treatments previously, as he was reluctant to try acupuncture in the first place and saw it with suspicion and as a last resort before surgery, which at his age was not really an option (his option).
After the first session he had complained to another client, whom had persuaded him to try acupuncture, that he didn’t like the needles and found them painful! After convincing him to do a second session, in which I only used abdominal acupuncture, I never saw him again…………..my curiosity was palpable upon receiving his call!
“TOM, how are you” I inquired,” I need your help Dave”, he replied, (Umm, interesting, I thought)…..”my knee pain has started to come back and I really want to stop it from getting as bad as it was before, can you come over sometime soon and do some acupuncture? I asked how he had been since I last saw him almost two years ago and he declared that he had been “Great, no pain what so ever”.
We arranged a visit after he said that he was ready to embark on a series of treatments to resolve his arthritic pain and clear his asthma. Funny how things turn out as I had only thought about him the previous day, one of those random thoughts (maybe I should start thinking lottery numbers and playing it too!)
The treatment I had done for him previously was initially a Dr. Tan style using ahshi points on the opposite (left) hand Yangming (LI 11 ish) and Tai Yin (Lu 5ish), I had also used Lu 7 (left) and Kidney 6 (right) with Lu 6, Sp 6 and St 40 bilaterally, to help clear his cough and move Phlegm, I added LI 4 on the right as the lou connecting point and to help with the pain although my first two ahshi points had brought his pain down from 10 to about 1 or 2! It always strikes me as odd, when treating people in pain that they remember the Qi sensation from the strong points that fixes their original pain, rather than the wonderful result that it has given them, how do we (acupuncturists) deal with that? I do always get clients to acknowledge the difference, in the original pain, yet they seem to forget the benefits, is that a short term memory thing?
Anyhoo’s the next treatment needed to be gentle, as he was extra cautious and sensitive to anything that might feel like a needle! I had to treat him lying down on his sofa, I used abdominal acupuncture and he seemed a bit perplexed by the concept of needles in his abdomen fixing his arthritic knee, still he went reservedly with it! I had him score the pain medially, laterally and centrally all around his right knee, each area was given a reference pain score of 10 at the start. I palpated around his abdomen and found a number of small nodules around Ren 9 (Shuifen) which indicated the damp nature of his Bi Syndrome, the area below his navel was cold and either side there were also some grainy nodules , a further indication of Spleen Dampness. His right side knee point was warmer than the surrounding area at a superficial level indicating heat in the arthritic knee!
The Abdominal Acupuncture treatment consisted of the following prescription (fig 1), ‘Bringing Qi Home’ with Ren 12 (Zhongwan), Ren 10 (Xiawan), Ren 6 (Qihai) and Ren 4 (Guanyuan) to move the postnatal Qi to the Kidney and supplement pre-heaven and Spleen Qi, given his age it was important to reinforce this with bilateral Kidney 13 (Qixue). St 25 (Tianshu) was used bilaterally to help clear the damp heat via the LI, while also helping with his asthma. Ab 7 Qipang was used on the contralateral side to capitalise on the Kidney Qi and to move it from the source to the afflicted right knee. St 26 (Wailing) the hip point was punctured in order to move Yangming Qi through the right leg. Three needles were used in a triangular form to give maximum relief around the knee point (Ab4) on the right. The knee point (Ab4) and ahshi needles ranged in depth from 0.2-0.4 cun to address the pain at the front and back of the knee. One further ahshi point was used between Ab4 and Ab5, the medial knee area, that was it, 14 needles in total. I wanted to keep it comprehensive and yet somewhat minimal, I decided not to use Rheumatism points or Ren 9 (Shuifen) to further address the dampness as I needed to regain his confidence. When asked where the pain was, he looked at me cautiously acknowledging, it was down to a very slight shadow of about 1 or 2!
I was disappointed that I never got any feedback and had presumed that he thought I was some kind of “Lunatic” using “Voodoo”, now two years later I can rest assured I am not crazy (at least in his eyes!)