ASSOCIATES (2008, March, v. 14, no. 3)


Be a Good Patient and You’ll Get a Lollipop, or
How I Learned to Look Beyond Conventional Medicine and Found Acupuncture

jdree.jpgJulia D. Ree
University of California, Riverside

Perhaps you remember as a child, going to the Doctor’s Office and being bribed into good behavior, usually before some horrible event, like getting a shot or having your blood drawn? “Be a good little girl and you’ll get a lollipop!” I used to go to the Doctor’s Office quite a lot and needless to say, I’ve had my fair share of rewards. I think back on those times and I’ve decided that what they were really trying to do was to condition me into exhibiting a certain kind of behavior. It follows that if you are on your best behavior, you are not causing trouble and you are listening to what the doctor is telling you, because, after all, he or she is the expert on all things Medicine. In fact, he/she is a Medicine God and better to be on the Doctor’s good side, than risk peeving off the one who is going to make you all better now.

I think that as an adult patient, I still follow those “rules.” I tend to put my trust and faith in the medical profession, and although I know in my brain that most of these people did NOT graduate in the top of their class, I’m still conditioned to sit quietly and not question or dismiss what they have to tell me. What, never? Well, hardly ever!

I don’t know how it happened exactly, but sometime in the Spring of ’07, I developed a gradually increasing pain in my right wrist. Ibuprofen was my friend, but even those little beauties were becoming increasingly ineffective, to the point where I broke down and made an appointment with my PCC, who referred me to a specialist. After the briefest of examinations (how God-like is that!) I got the diagnosis: De Quervain’s tenosynovitis. De Quervain’s is generally a repetitive condition, although it can come on suddenly. It’s not Carpal Tunnel, but it shares some of the same characteristics. Basically, the sheath or tunnel that surrounds two tendons that control movement of the thumb is inflamed, causing aches, then pains, then loss of movement, then thoughts of gnawing off the limb…wait, I’m getting ahead of myself.

I’ve always had trouble with that arm. First, the shoulder got strained and the solution was to get rid of the heavy purse. That, and lots of physical therapy and before I knew it, I was walking around pain free! Then I developed tendonitis in my elbow, often called tennis elbow, the solution besides many helpings of Ibuprofen was long months of physical therapy. It only makes sense that my wrist would be the next area to fail. I seem to have abnormally tight tendons. The tendons in my legs as well as arms just seem to be too taut for my own good. Add the inflamed sheath to the mix and viola! I become a poster child for the NSAID group. What is weird about all of this is that I’m left-handed. Militantly left-handed. Fight for your right to cut paper, use a pen and mouse with your left hand left-handed. So, of course, my affliction turned up in my right wrist. Huh? How did that happen?

According to internet resources, there is no definite cause of De Quervains. A cause can’t be specifically determined, because there is no one defined cause. Unfortunately, there is also only one way to really treat De Quervains…conventionally speaking. First, you try getting a cortisone injection at the trouble site. You can have 2 or 3 of those before the doctor cuts you off. You don’t want to run the risk of permanent damage to the area by using cortisone. Failing that, the only, again, I say conventional recourse is to undergo surgery.

So, I did the good girl patient thing and had one, then another shot of cortisone. I fully expected them to work. I was NOT the model patient, however, because the injections themselves were extremely painful. Or maybe the doctor was just a lousy shot. I was told that the second injection would be my last and I did not get a lollipop for my trouble, either. The pain-free period lasted about 6 months, but by November I was feeling pretty lousy. I began thinking about how much time off I would need for surgery. I decided to do more internet research, when I discovered that surgeries in this area have a 40% success rate. Only 40%!! Are you kidding me? If the cortisone didn’t help, what kind of luck would I have with a surgery where 60 out of 100 people don’t have a successful resolution to their problems?

As part of the workforce that sits at a computer station 40+ hours a week, having pain-free limbs is more than a nice idea, it’s a “must.” We try to have an ergonomic working environment, but sitting too long in the same position is not healthy. Using your fingers for hours on end without a break or a change is a recipe for disaster. After trying to keep the wrist from moving too much, continuing to down the anti-inflammatory meds, and realizing that surgery was just NOT an option, I began my quest for relief. Again I looked to the internet to give me some guidance and discovered that acupuncture could work for pain management and was one of those alternatives to conventional medicine that might work for me.

If you know anything about me, you know that I am absolutely terrified of needles. I had many kinds of injections as a child, and while I’m sure that most of the population doesn’t yell: “Yippee! I’m going to get a shot!” at least they don’t cry or faint or get freaked out the way I do. Willfully deciding to have needles stuck in all sorts of places was not my easiest decision. But, as the pain increased, I made up my mind to at least try acupuncture to see if it had any validity. But I was not going to let my fingers do the walking. I wanted a real person I knew to fix me up with someone or some office they knew and trusted. I asked around and got a recommendation. It would mean traveling 2 hours back and forth, but it would be worth it if they could fix me.

needles.jpgI began treatments in mid December, and in retrospect, it was probably not wise to begin a long treatment schedule when I knew I’d be out of the area over the holidays. Maybe I was hoping for a quick fix. The treatments have been remarkable, but I lost ground by missing 3 weeks, just as I was starting out. Next time I’ll know better and just make sure that I’m available for the foreseeable future to take full advantage of a schedule that is not interrupted.

I arrived for my introductory session with a little apprehension tucked under my arm. I was going to have needles stuck into me, after all. The acupuncturist was very sensitive to my phobia, and demonstrated how small and flexible the needles were. Although needles can range in size from the very small to the very large, depending on which part of the body they need to enter, the needles they use on me are a bit over 2 cm. in size and they bend! They are only inserted to a depth of 5 mm. or so, and are only inserted to the point of feeling a “twinge.” These are not your Doctor’s flu shot needles! No sir! Thank goodness! Still, all the pent up anxiety took its toll and I was delighted when instead of sitting up, I got to lie down. Better to lie down than fall down!

liniment.jpgThe treatments take about an hour. The room is darkened and quiet. There is new age “massage” music playing in the background. The room reminds one of a message therapy room. It’s all very relaxing. I won’t fib and tell you that the treatments are completely pain-free, particularly when the needles hit an area along the same nerve point. There is that twinge that I spoke of earlier. The “twinge” means that the needle placement is where it’s supposed to be, working, freeing up the tension deep-down. Other aspects of treatment can have some measure of pain, but it’s all to get back to a state of pain-free life. “No pain, no gain” has some meaning here and is an apt description.

For the first few sessions, I got the right arm, left foot needle insertion. The acupuncturist inserted several needles along the line of my tendon, from thumb to elbow and along my ankle bone. One of my issues, beyond the inflamed sheath at the wrist was also swollen and tight tendons all along my arm. He worked on loosening up my arm’s tendons and eventually discovered that my arm had “forgotten” that it was supposed to be healing from the De Quervains injury. So, using deep tissue massage, he “re-injured” the area, thus stimulating the body response to heal. In addition to the needles, he introduced weekly massages to the area using a heat-release liniment, something call Eagle Brand Wind Oil. Besides being a pretty green liquid, the menthol-infused ointment sends a penetrating heat into the whole area.

mugwort.jpgThe acupuncturist also introduced the use of mugwort, a rather hardy weed, also used in herbal medicine as nervous system stimulant. In this pulverized and aged form, the technician lights the mugwort and the lit end becomes a glowing ember, that, when applied to the needles, sends heat through to the tissue beneath. The acupuncturist also tried electro-stimulation. Tiny electrodes from a portable machine are attached to two needles at different points along the arm. Depending on the current, the arm can twitch wildly (oops!) or just be stimulating the area. The whole idea behind all these techniques, the needles, the mugwort, the electricity, and the massage with liniment is to stimulate the body’s own natural healing ability. Heat promotes healing. Even when I’m not at the acupuncturist, I’m still trying to keep the wrist warm. I do exercises to stimulate the area. I even rub some of that wind oil on my wrist, just to keep up the good work that is done once a week at the clinic.

My acupuncturist doesn’t go into all the philosophy that is part of the Chinese holistic approach to acupuncture. I haven’t been schooled in the yin and yang of how the energies of bodies work. I don’t know if I’m still blocked or if my Qi is free flowing. He recognizes that I’m kinda new at this and by coming to see him rather than go straight to surgery is a big step, in and of it self.

When I first arrived at the clinic, I had a very limited range of motion in my right wrist. My swollen, puffy, fluid-filled appendage was painful to use. My thumb “clicked” when I moved it down and toward my fingers. I couldn’t even wash a glass or lift a book without great pain and ultimately with great frustration. After 10 sessions, most of my range of motion is back. My thumb can now touch my fingers and it doesn’t click any more. The wrist isn’t nearly as puffy as it once was. There is still some measure of pain, and overuse of my right hand makes it ache by the end of the day, but all in all, it is much better than before I began the treatments. I am still a work in progress, but thanks to acupuncture and the supplementary therapies that include the deep tissue massage, the mugwort and the electro-stimulation, I am confident that I will be pain-free without the need for surgery. And knowing that I made the best choice for me is the best medicine of all.

Julia is a cataloger with UC Riverside, specializing in Speculative Fiction monographs. For the last 5 years, she has been the Selector for the Eaton Collection of Science Fiction, Fantasy, Horror, and Utopian Literature.
And, given her experience as an Air Force Brat, she will defend to the death your right to be left handed.