Has anyone ever treated a patient who had multiple surgeries leaving them in a chronic state of pain? I have a patient who had multiple abdominal surgeries and two years later is experiencing sharp burning pain in the abdomen which is maintained at a level of 4/10 with the use of opioids, oxycotin and oxycodone. There are no other systemic signs of blood stagnation, but some of yin and yang xu. The patient has experienced some relief with the use of electoacupuncture locally, but nothing lasting. Any suggestions would be greatly appreciated.
Treatment of chronic postoperative pain???
Herbal Formulas ?
have you tried using some sort of Herbal Formula, something like a modifed Xue Fu Zhu Yu Tang ? Having multiple surgeries I would assume there is blood stagnation (trauma) and a deficiency (spleen/kidney).
I would be confident if the patient has the time for you to create a specific formula for them you would be able to decrease this pain.
What were the surgeries they were going in for?
Keep us posted
Some Ideas
If the pain is that severe, then there must be some local stagnation happening beyond def. Local blood, qi, cold, heat etc stuck in the channels blocking them. Do the scars have any color to them? Are they red and raised, purplish, pale? Also keep in mind "All chronic diseases lead to blood stagnation".
Which channels (not organs) are effected? St, Sp, Gb, Lv, Kd, LI, SI, Ren, Dai or TW? Try adding points from those blocked channels (that usually pass through the painfull areas) to help clear them up. You can also check the fire points, or xi-cleft points of those associated channels for tenderness as well. (Usually indicating they should be needled).
ie St - st34, 36, 40, 42, pc 6
Sp - sp3, 4. 6, 8, 18, 19, pc6
Lv- lv3, 5, 6, 8, 14
Ear points in general for abdomen pain:
Abdomen, Liver, LI, Shenmen, and sympathetic
Use ear seeds to help keep the tx effect longer.
Dont forget the abdomen command point.
Sometimes wrist and ankle acupuncture can have a strong effect on pain, but it is pretty strong itself.
I also agree with Ryan, how about herbs? Make sure to choose herbs that open up the channels and move stasis, and not just the organs. You might need to throw in a little more of those animal stasis moving herbs, but start slow if they are really yin/yang def. Add enough herbs to protect the blood and fluids.
Some skin rolling might be in order (for the chronic, not acute stages). Pinch up that skin and roll it down the abdomen. This can help break up some of the adhesions between the skin and the muscle below which can cause some pain.
Just my 2 yen.
Let us know how it goes. Sounds like its going to need a lot of tx and frequently.
Joined: 2008-01-30