Saturday, September 27, 2014

Dr. Ping: Con job or great job?

Eighteen months ago, Chris switched medications from Abilify to Respiridone because he didn't like Abilify (I've forgotten why).  Three months after switching he began to rapidly put on way more weight than what the Abilify did for him. I got alarmed at his out of control appetite and insisted he get a blood test, which revealed (surprise surprise) high cholesterol, for the first time in his life. So, after discussing all this with Dr. Stern, at the beginning of the year, he went back on Abilify and dropped the Respiridone all in one go. I assumed that his weight would go back to his Abilify weight. Well, it hasn't. Many months later, Chris's weight has not returned to his pre-Respiridone level.

My Internet pal, Irene, is a nurse who is quite familiar with Traditional Chinese Medicine (TCM). She suggested, based on her understanding, that TCM herbs can help with the metabolic weight gain caused by antipsychotics.

Dr. Stern, Chris's psychotherapist, wrote him a prescription for ten acupuncture sessions and I located a Dr. Ping, who runs two TCM clinics in our city.

Part of my thinking (and Dr. Stern's) was that in addition to dealing with metabolic weight gain, acupuncture would also work on Chris's ever elusive body/mind connection.  I was hoping that acupuncture could super glue or better yet "weld" Chris's intellectualizing head to the rest of his body to give him a real physical presence and "flow." Dr. Stern had previously taken up my body/mind suggestion by sending Chris to a metamorphic massage therapist. 2014 is the body/mind or bust year for Chris.

I haven't accompanied Chris to his medical appointments for several years. Once he got to the point of remembering he had them and actually getting there on time, there was no need for me to go with him. The missed appointments are a thing of the past for Chris. This time, I made an exception in the name of "research" and went with him. I had a lot of questions that I wanted to put to Dr. Ping himself. Chris had undergone 5 point acupuncture several years ago, at the suggestion of Dr. Erika, his holistic psychiatrist. At the time, I didn't think it did much for him, but he was at at different stage, and maybe being further along in the recovery process would make a difference. I really wanted to grill Dr. Ping on what exactly he might be able to do for Chris. Otherwise, this latest adventure could be a huge waste of Chris's time and our money.  I'm mustering less and less enthusiasm to keep suggesting new therapies for Chris. For much of the past two years he has been happy to just get on with his own life, his way. As it should be.

We sat down with Dr. Ping and his Chinese assistant, and he asked Chris why he was there, which got a rather lengthy philosophical reply, but eventually he got the idea that Chris was there to see if acupuncture could help him lose weight. I kept my mouth shut. Once Chris's pulse testing was done and his tongue examined, I asked about using Chinese herbs.

"No! said Dr. Ping.  "Maybe need for herbals later, but now only acupuncture. He have stagnant liver. He need to express himself more!"

"Can I see how you do the acupuncture?" I said, thinking that maybe there was something new since the last time Chris had done it. "Research," remember.

"Okay," said Dr. Ping. "Follow me."

I followed the two of them into a ward of curtained off cubicles.  I noted where Chris's cubical was and then waited down the hallway until Dr. Ping had finished. When I arrived Chris was there on the table, Saint Sebastian in his underwear, his chest stuck full of needles. Dr. Ping had left the room. There was obviously nothing new here from the last time Chris had acupuncture, so I said to Chris "I'll see you at home," and left.

Chris was a bit shaken when he got home. While I was lying on the table, Dr. Ping leaned over and hissed at me "What's your mother doing here? Be a man!"

"Well, be a man, Chris! Do what Dr. Ping says. I've been trying for ten long years, since you came back from university,  to get you out from under my apron strings. I didn't want this job in the first place. Maybe, Chris, what he's telling you is what I've been telling you, in so many words, since you were a child. You let everyone else decide for you. YOU should start establishing stronger boundaries. If you want to be a man, tell your mother she is no longer needed!"

"What else did Dr. Ping say?" I asked.

"He said I need to exercise more and not eat sugar," Chris responded.

Well, you don't need an acupuncturist to tell you that, I'm thinking.

Over the course of his treatment (number 8 and only two more to go) Chris's weight has remained more or less the same, despite his increased daily exercise routine. At his last visit, Chris challenged Dr. Ping on the lack of weight loss. "You not exercising enough. "You do MORE!" said Dr. Ping. As a parting gesture, he hammered three pins into Chris right ear. "Twist them at least four times a day," he instructed.

Dr. Ping. Well done! You are hammering home the body/mind connection by reminding Chris to use his body, to break some sweat. So, YAY! However, my response to this lack of weight loss is: Dr. Ping, then what are we paying YOU for? If we thought Chris could lose the weight by exercising or dieting, there'd be no need for acupuncture. What exactly are you selling here? Everybody knows that antipsychotics produce metabolic weight gain in most people. YOU held out the promise that acupuncture would be different.

Unless, unless, I say to myself, a great part of TCM is the doctor applying psychological pressure on top of the needle pressure. Dr. Ping may be doing a great job. The acupuncture may simply be a distraction, a side show. What may be more important than the needles is the psychology.

The Chinese physician, in contrast, directs his or her attention to the complete physiological and psychological individual. All relevant information, including the symptom as well as the patient's other general characteristics, is gathered and woven together until it forms what Chinese medicine calls a "pattern of disharmony." This pattern of disharmony describes a situation of "imbalance" in a patient's body. Oriental diagnostic technique does not turn up a specific disease entity or a precise cause, but renders an almost poetic, yet workable, description of a whole person.*

Will Chris be able to lose weight caused by metabolic weight gain through acupuncture? I have no idea. It's either a con job or a great job.
Kaptchuk, Ted J., The Web That Has No Weaver, McGraw-Hill, 2000, page 4.

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