Monday, July 28, 2008

Case Study - Wisdom Teeth Extraction

Initial Observations: A patient’s impacted lower back molars were extracted on Thursday morning at 8:30am. I treated her the same day at 3:00pm.

Like many, she purchased Vicodin prescribed by her surgeon. She was instructed to take it ASAP and then as needed (but no more than 1 every 3 hours). She had enough Vicodin to last 3 or 4 days.

She was very swollen and said she took a Vicodin at 11:00 am (stabbing pain in jaw). She could barely open her mouth and moved slowly. It was difficult to understand her words.

Diagnosis: Qi and Blood Stagnation with Pain and Inflammation

First Treatment: acupuncture points were selected to reduce the pain and inflammation. Some ear needles were left on her face and arms 24 hours until Friday. In this case the patient didn’t take any Chinese herbal formula although there are herbs that reduce inflammation and swelling, stop bleeding (traumatic hemorrhage), and relieve muscle spasms and cramps.

Follow-up Observations: She came in Monday and said that she didn’t take any pain killers until Saturday morning when she took Advil because she had to work. She is a masseuse and performed 6 one-hour massages with 5-minute breaks between clients.

She stated that Friday she already was eating solid soft foods like pancakes, eggs and macaroni and cheese. By Sunday, she was eating normally but the pain had returned. She took another Vicodin Sunday evening after working another 8 hour shift.

Second Treatment: another group of Acupuncture points were selected to insure fast healing and reduce residual swelling. The treatment was composed of ear needles on the face and arms and lymphatic massage to reduce the swollen, injured area.

Outcome: This patient healed faster than expected (back to work in 1 day instead of 3) and with a lot less pain. She said,
“if I had realized how effective the acupuncture would be, I could have come straight here and saved $50 bucks.”
She used fewer drugs than prescribed. The surgeon told her if she didn’t feel she needed Vicodin but was still in pain, she could switch to “Advil or Aleve” (Ibuprofen or Naproxen, respectively). She only used 2 of the Vicodin pills and took 2 Advil.

Western Medical Approach vs. Traditional Chinese Medicine (TCM): I would like to mention that any surgery, accident or sports injury can benefit greatly from acupuncture and Chinese formulas. Both drugs and acupuncture are effective and play slightly different roles in trauma management. In both cases, treatment needs to be re-administered in short intervals to most effectively reduce pain and inflammation. The differences are health risks/side effects and recovery time.

Vicodin (APAP/Hydrocodone) is a prescription opioid analgesic. Known side effects include dizziness, upset stomach, and respiratory depression (difficulty breathing). Advil and Alleve are Over-The-Counter (OTC) non-steroidal anti-inflammatory agents (NSAID). Known side effects include duodenal ulcer, gastrointestinal bleeding, tinnitus, blurred vision, dizziness, and headache. (1)

Acupuncture relieves acute symptoms (pain and inflammation in this case) without side effects and promotes long-term recovery. The focus of the treatment is to activate Qi and Blood circulation, remove Qi and blood stagnation, relieve pain and facilitate healing by regeneration of bone and soft tissues. It achieves both immediate and long term benefits. While drugs can make the recovery process tolerable, Acupuncture shortens it.

  1. Clinical Manual of Oriental Medicine: An Integrative Approach, 2nd ed., Lotus Institute of Integrative Medicine
    ISBN: 0-9772270-0-6

1 comment:

  1. Sigal saved my life! You may think I exaggerate, but for some strange reason, I didn't believe my surgeon when he said I would be out of commission for AT LEAST 3 days.
    I scheduled myself for work anyway.
    Thank G-- for Sigal. All I remember of the initial treatment was the pitying look on her face. I was horrified she had to see my all puffy and discombobulated. [Balagan baroush]. She was so kind and soothing. The acupuncture worked so well I was able to attend a co-worker's birthday party the very next night. THANKS, SIGAL!


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