|Hank Barru, RN, L.Ac.|
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What happens in an appointment?
Going to see an Oriental medicine practitioner has some things in common with visiting an MD or Nurse Practitioner, but there are differences as well.
Your first office visit will be longer than later appointments. The practitioner will do an exam and a thorough diagnostic interview. OM practitioners try to keep paperwork to a minimum, but there will also be a few forms to fill out. An hour and 15 minutes is realistic for a first appointment; later visits typically run 45 minutes to an hour.
Loose fitting, comfortable clothes are best for a treatment. It's good if you can roll up sleeves/pant legs to expose elbows and knees- many acupuncture points are on the extremities. If the treatment requires access to your back, your practitioner will give you a disposable gown.
It is best not to have acupuncture when you are very hungry, very exhausted, under the influence, or directly after a heavy meal. If you are tired or hungry, it's good to have a snack and rest for a bit before treatment.
Oriental medicine is empiric- that is, based on concrete observations. But the system pre-dates modern technology. As a result, there are no xrays or lab work, and for diagnosis the practitioner relies on what s/he can see, hear, and find out by asking the patient.
Traditional Chinese medical diagnosis includes two parts. The first is a disease diagnosis or presenting complaint that is similar or even identical to Western catagories. Problems such as stomach pain, headache, and irregular menstruation are classified as "diseases" in tradtional diagnosis.
The second part of the diagnosis is called the Pattern Discrimination, and has no counterpart in western medicine. The pattern discrimination is a person's overall pattern of energy imbalance.
Pattern Diagnosis is like a mosaic- think of the old Greek or Roman mosaics that created distinct pictures from small, simple colored tiles. Each tile by itself conveys very little information. But with enough of these tiles, a bigger picture emerges that is more than the sum of the parts.
In the same way, a pattern diagnosis is made by gathering many simple facts about a patient, and finding the overall pattern that emerges. This is why the initial medical interview (which is traditionally called "asking" or "The ten questions") covers so much ground. It's a review of many of a person's basic life functions. The practitioner does not need highly detailed answers to each question- just a overall idea of function in each area.
In the exam, practitioners examine the patient's tongue and take their pulse. They also look at the patient's complexion, affect, and movements, and listen carefully to the patient's speech and voice tones. Some practitioners will also palpate along channels and at acupuncture points. All these give further clues to a person's energetic pattern.
Based on your presenting complaint and pattern discrimination your practitioner will make a diagnosis and write a treatment plan. This could include any of the treatment modalities of Oriental medicine- acupuncture, tui na massage, cupping, etc. that are useful for addressing your problem. It's customary to get a first treatment directly after finishing the diagnostic interview and exam, so you can get started immediately.
Herbal remedies are dispensed differently from clinic to clinic. Some practitioners keep a full stock of herbal formulas and individual herbs, and can dispense directly to you. Others do not stock herbs, and will order formulas from an herbal supply house. These can be sent to the office where you can pick them up at your next appointment, or they can be shipped direct to your home.
In China, people are often treated several times a week. On occasion they are even treated every day for a short time, when starting a treatment plan for a severe problem. Obviously, very few Americans have work and family schedules that make this possible. The most common pattern in this country is a treatment every week.
People respond differently to treatment- some feel effects immmediately, others notice improvement after the treatment or the next day. Acupuncture helps muscles relax, and also releases endorphins- the brain's natural pain-killing substances. As a result, it's common to feel very relaxed or "floating" after a treatment.
How many treatments will it take? This often depends on how long a person has had a problem- chronic issues generally take longer to resolve. Some acute problems can show good response in a session or two, but as a rule it's good idea to be willing to do at least five sessions to give Oriental medicine a fair trial.
About Oriental Medicine
What to Expect in an Appointment
Training and Licensing of Practitioners
Research and Resource Links