Set of 3 Intern Reflection 3: L.E.H. 3/16/15, 4/30/15, 6/4/15

     I started treating L.E.H, a woman in her mid-70s in late 2014. She had a long history of injuries and surgeries on her left knee. She had been a runner as a young women and had previously had reconstructive surgery on her knee. She was given the initial diagnosis of of chondromalacia patella and had undergone an arthroscopy and most recently a realignment surgery.
   Immediately before and for three months post-surgery I treated her systemically. Her wounds were still healing and it would have been far too painful and dangerous to start needling her scar area before that time.
    Once the three months had passed, acupuncture and e.stem were provided weekly to the local area and continued for 6 months. Points were chosen surrounding each scar on a 45 degree angle going toward the center of the scar. If possible the needles were inserted into the interior of the scar as well. E.stem was set between 30Hz-60Hz depending on the pain tolerance of the patient on each specific treatment day. Additional non-e.stem Ashi points were inserted as well. Distal points were chosen based on the differential and from week to week on specific systemic symptoms. Points which were commonly used include: KD3, SP6, LV8, GB34, ST36. Points and e.stem were left in for 20-25 mins and on occasion e.stem Hz were increased after patient reported electrical sensation had dissipated.
     Directly following her surgery L.E.H. reported waking up at night due to pain between 4 and 6 times. By the end of six months she reported only waking 2 times. During this time she was also practicing physical therapy 2 times a week and low impact water aerobics 3 times a week.
    Patient’s scars both reduced in size by close to half and thickness was reduced by more than half. Pain on palpation around scars was reduced and scar tissue was softer. L.E.H. reported that her orthopedic surgeon commented on multiple visits how “amazed” she was by the accelerated healing of the scar tissue.
     This case serves as a perfect example of how staying the course and keeping consistent can be the best course of action. It also shows how a combination of acupuncture, PT and water aerobics can greatly accelerate healing from major joint surgery. Treating L.E.H. showed me that finding a specific symptom to track over time (number of times woken by pain) can assist in showing a practitioner, a patient and the patient's other doctors how things are progressing.