Herbal Intern Reflection 2: P.W. 5/31/16

P.W. is a mid-40s female coming in for neck and shoulder pain. This is her first time receiving treatment at the AOMA clinic. Her treating intern did an excellent and through intake but because of how many physical and mental issues the patient had became a bit lost. P.W. is a single mom, has anxiety, and has unspecified alcohol dependency. She is also on a long list of western prescriptions ranging from muscle relaxants to blood pressure diuretics to Cymbalta and proton-pump inhibitors. The treating intern wanted me to prescribe something for her underlying symptoms. After reviewing her long medication list I had to inform him that I didn't feel comfortable doing that at this time. I felt this to be the best course of action for three reasons, one: Cymbalta, specifically, has many drug interactions and precautions including a higher risk of bleeding especially in the stomach. The second reason being that in order to treat her blood stasis, ST Qi rebellion and high blood pressure the herbs we would want to use could harmfully enhance the effects or side effects of the drugs she's already taking. The third reason was due to her alcohol dependency. Without knowing the full effect alcohol has had on her body it would be dangerous to put her on herbs. Once I explained these reasons to the treating intern he agreed with my assessment and went ahead with his acupuncture treatment. Treating someone who is or was an alcoholic or has abused alcohol is not something I'm opposed to or wouldn't want to do in my future treatments but I think it's vital to know the full history before prescribing anything. Finding out this information can take time and require trust before the patient may want to tell you all the information.