?

Log in

No account? Create an account

Previous Entry | Next Entry

3 stages of interview
1) relationship building, find common ground, acknowledge difficulty, give choices, touch the patient to facilitate connection
2) info gathering, open ended questions
3) education, negotiation, dx and tx, prioritize, starting place, bite sized piece


normal compliance for taking just one pill with allo tx: 50%
asking pt to change whole life: much more difficult

"everybody on prozac is still depressed"
cancer-->qi gong is his first suggestion

opening line is important
"what brings you in today" not so hot "what's bothering you"
"how can we help you" is disempowering, enabling
"how have you been"
"what's going on" can send pts into tailspin
"what do you want"

include touch in diagnosis and treatment
as well as in greetings and goodbyes

doc as magician
pts need something outside their normal realm of existence
profound change
if pt lives in world of technology, have them walk barefoot
if they walk barefoot, tell them go for a drive

diagnosis inquiry from Chinese med perspective
ask
look
listen
smell
palpate

processes:
sleep
digestion
elimination
menses
temperature

5 phase correspondences
ht/si (heart/_), sleep/dreams, chest, palpitations, speech
sp/st (spleen/stomach), dig, focus, energy
lu/li (lung/_), resp, allergies, skin, boundaries, sinus tx: magnolia flower, neti
ki/ub (kidneys/_), lumbar, knees, teeth, bone, urogenital
lr/gb (liver/gallbladder), eyes, tensions stress, spasm, tendons, eye probs-->tx liver

liver feeds heart
lung feeds kidney

PULSE EXAM
pulse responds to pressure
angle of contact
like muscle testing, use to open your intuition
ask a simple, neutral question and track the pulse in the 1-2 seconds as the pt responds
can have pt hold a supp and ask, show me yes, show me no
can just think of question, don't have to ask it out loud

****************************

12 STEPS
1) admit powerlessness
2) believe in higher power
3) turn over will to hp
4) make moral inventory
5) admit wrongs
6) ready to remove shortcomings
7) ask hp to remove shortcomings
8) list those harmed
9) make amends
10) continue moral inventory
11) prayer and meditation
12) practice in all affairs, carry the message

science hasn't caught up
meetings are natural, organic, and free
it's the last thing they want to do
go to five or six until you find one that feels like home

hierarchy of addictions
power at top of pyramid
money
sex
food
caffeine
tobacco
cannabis
alcohol
street drugs at bottom of pyramid

cannabis
we have better tools
but he is for legalization
why? best cure for heroin addiction: doctors dispense it

acupx doesn't work for obesity, but it works for hunger
point is close to adrenal point on the ear

money = tincture of bipolar

pt comes in
wife says I have to stop drinking
doc says what do you think?
pt is where pt is
doc says here is what we can do when you are ready
but you have to be ready
power stays with the patient, doc has none

HERBS
chemical vs energetic approaches
he's talking about energetics, biofields, "bi fi"
this exists between matter and spirit

what do pts need that they aren't getting?
nature

ALCOHOL
damp-heat
middle jiao
organs: liver/gall, stomach/sp, pancreas, esophagus
power dynamics: solar plexus
impotence in chronic alcoholism
fatal withdrawal possible: watch for high or narrow (20pt) bp with rapid pulse rate, this could lead to seizures, ask seizure history
WU BREW excellent: 3 parts chamomila to 1 part each: hops, catnip, skullcap, yarrow flower, peppermint
brew in conventional coffee maker, 2-3 rounds from one batch of herbs
effect: lowers bp, helps insomnia, calms nerves, reduces seizures

OPIATES
heroin
phlegm-heat
metal: LU/LI
Shaoyang component
safe withdrawal (3 days acute)
50% dropout rate for heroin addicts: highest
history of opiates:
morphine-civil war
laudanum-oregon trail
heroin
methadone used for opiate dependency tx 1960-2000, now used for pain control
1990's if you used heroin once you could get a lifetime supply of methadone federally supplied

AMPHETAMINES
Kidney Yin Xu
kundalini excess goes into brain
"purest" addictive pattern
Hitler's drug of choice: was getting injected 6x/day
loaded with impurities
goosing the kidneys, adrenals
highest rate of pscyhiatric complications

TEA
cool: green
anti-cancer (cancer is a kind of fire, need cooling things)
hot: red/black, what the Dutch drink
middle = digestion
WuLong (Oolong)
PuErh-anti-chol research

*******************************************

CHINESE HERBS by phase
simple herbs at safe dose
casual prescribing
what every family could have in their kitchen cabinet
low doses
ok to double the dose for something chronic
ok to triple dose for something acute
up to 3-4 grams/day, watch for lose stool
for acute psychosis: Licorice, Red date and Xiao Mai (a type of wheat)

Profile

moon
liveonearth
liveonearth

Latest Month

August 2019
S M T W T F S
    123
45678910
11121314151617
18192021222324
25262728293031

Tags

Powered by LiveJournal.com
Designed by chasethestars