Here is an article from her that provides an example of her practice.
By Michelle Thelen, L.Ac., M.S.T.C.M. @ Chapel Hill Acupuncture
“Olivia,” is managing her health. She is 72, and her story is a striking example of the battle between mind and body, as stress and aches and pains creep into a once vibrant body. I’m not sure if it’s fair to demarcate the age of 70+ as the “Golden Years…” It is only cited as a way of framing the gist of the health issues reported as expected aches and pains that appear more and more with aging. Yet there are some others, aches and pains that is, that make themselves known like unwelcome house guests that never leave, and linger in hallways and corridors never finding the front, or back door.
Yes, retirement can mean real freedom and an opportunity to refocus one’s energy. It represents a most intriguing set of new challenges in which time becomes more fluid, opening up wide passages and at other times creating a wall.
A particular pursuit stands out above the rest – to stay active, healthy and free of disease. It is ironic to find that the pursuit of good health can become like the job recently vacated: in constant and dire need of improvement, and never quite “satisfactory.”
Back to Olivia. Chief complaint: hip pain. History: Many visits to Duke in a rotating hallway of doctors giving 3 steroid injections, a nerve conduction test, MRI and Cat Scan, and a rather bizarre evaluation of sympathetic nervous system dominance based on an abbreviated questionnaire of symptoms. Other options and adventures: physical therapy, yoga, pilates, bicycling, and meditation. I guess last on the list was acupuncture.
By the time I met her, Olivia had sought out most conventional treatment solutions including pain medication, injections, physical therapy and stretching. I wish she had come sooner, as acupuncture is often the most effective treatment around for pain. Her battery of tests did help in terms of getting an actual diagnosis, which was lumbar disc degeneration, and arthritis of the lower spine and sacrum. This type of pain refers to more than one spot in the body, including anterior thigh, lateral hip and thigh and sometimes down the leg and into the knee. In practice, it is important to ask the patient not only the location of the pain, but also the nature of the pain with questions like “Is it dull and achy, does it radiate, or is it sharp and stabbing?” Because her pain was sharp in some places, and also achy in others, in addition to the fact that she often ached in every joint, I concluded that other systems of the body were also involved such as connective tissues and even nerves.
Making an assessment using orthopedic tests is often helpful as well. Indeed, when watching her walk across the room, her gait was slightly bent over with a fixed posture that did not allow full flexion of the lumbar spine. Her toes also pointed out and she walked with a wider stance (known in orthopedic offices as walking like a duck).
As a Chinese Medicine practitioner, it’s important to ask questions not often asked by other health care providers. Question about the systems of the body are important fact finding opportunities. I always check on the state of digestive, cardiovascular and respiratory function. “Looking” is a part of diagnosis as well: the tongue for interior states like inflammation, problems in an organ system, and digestive functioning. The pulse provides even more information about these same areas. All of these diagnostic methods combined, plus a thorough health history intake, provides the basis for diagnosing based on meridian and organ system, and leads to decision-making about how to treat with acupuncture and/or herbal medicines
In Olivia’s example, I felt a rather strong and forceful Liver pulse which can indicate heat or overactivity of the organ. The stagnation was there due to her history of alcohol abuse combined with aging, and Kidney deficiency although mild presented by problems with back and hip which is the area of the body ruled by the kidneys. I felt that at least some of the etiology for her discomfort was related to adrenal gland exhaustion , so I prescribed a supplement containing Ginseng, Rhodiola, Vitamin C and other support for tired adrenals. Her body type, a rather protruded abdomen and skinny legs, also fits the body type associated with adrenal imbalance from excess cortisol (one of the stress hormones that leads to body fat, especially of the abdomen).
Some background: One of the areas I read and study about is Somatics, which means the body’s awareness of itself. The definition needs to be thought of in a subtle way, it doesn’t translate to self-consciousness, but rather an awareness of the movements, sensations and feelings one sees inside of oneself. This is in stark contrast to a physician’s or outsider’s view of the body. Thomas Hanna authored many books on this subject, and describes the process of losing awareness of one’s muscles, which he calls “sensory amnesia” – caused by the stress of living.
Olivia showed a type of sensory amnesia in her posture, which is stooped over and frozen. She leans forward from her hips at about a 30 degree angle, with her feet spread apart to compensate for this imbalanced stance. Her abdominal muscles were tight upon palpation, and her back as well from having to keep herself upright. This is what I believe caused the initial injury to the sacroiliac joint, and the rigidity of the muscles. The lack of movement has predisposed her to arthritis, due to poor circulation to the sacrum and tissues supporting the hip and low back. Often, pain in the back and even in the joints is caused not by arthritis but by the trigger points in tight, overstretched muscles. Treating the points, using acupuncture and/or acupressure, can deactivate the trigger point and reduce or even eliminate pain.
I performed an acupuncture treatment at her first session, using points both distal and local. I also needled orthopedic and trigger points located in the gluteus medius, piriformis and tensor fascia lata. These are all muscles that act on the hips. The gallbladder meridian crosses the front of the hip area near the prominent bone below the waist called ASIS and follows along the lateral length of the thigh and leg, into the foot. These points are great at releasing stagnation, which often settles into this meridian when too much energy has been generated for too long into the anterior and posterior thigh muscles. When the adrenal gland is over-stimulated, it pumps epinephrine, cortisol and adrenaline to the large muscles first, such as the Quadriceps (runners have bi g ones) and the Buttocks to help the body move quickly and efficiently. Eventually, the glands get overworked and begin to wither and age, causing the commonly identified illnesses of stress that include symptoms such as fatigue, dizziness, inability to concentrate. In some individuals, like Olivia, the fatigue goes on for many years and leads to chronic inflammation due to overworked muscles, a frozen sacrum, and pain.
Olivia reported relief after her first treatment, and returned for 5 more treatments before taking a break. She has less pain, more mobility and feels calmer overall. Now she returns every 3 months or so for a course of 3 treatments. She still takes pain medications when she overdoes it and her hip begins to act up. She is happy to be active again, riding her bike and traveling to France with her boyfriend.