Every Chinese medicine practitioner is different just as every patient is different. The interaction between doctor and patient has a lot to do with the way the appointment proceeds and whether it turns out to be a mutually agreeable experience or not. However, there are some basic elements that will be present in every appointment. In this article, I'd like to detail the most important of these. I hope that it will help set your mind at ease prior to your first appointment, or if this isn't your first appointment, help you to be an advocate for your own excellent care!
Although every doctor has a slightly different interviewing process based on their training and personality, there are standard questions that most every doctor will ask. She will begin with learning more about your chief complaint and possibly more detail about your health history. If you are on medication or under the supervision of other physicians, she will likely ask you questions about this. Then she may begin to ask you questions that may appear to be irrelevant to your chief complaint.
Questions about your sleeping patterns, digestive and urinary function, sexual function, emotional quality and basic level of stress are typical. Be prepared to disclose the frequency and quality of your urine, feces, and if you are a woman, your menstrual period. Rest assured that these questions are not meant to make you feel uncomfortable. Many conditions that manifest in a non-digestive/urinary/menstrual way (such as skin conditions) may have a basis in your basic digestive function or other apparently unrelated system. Answering these questions completely honestly will increase the accuracy of diagnosis and help your doctor to craft an excellent treatment. Believe me, it won't be anything your doctor hasn't heard. She is used to it.
3. Insightful questioning and the sense that the doctor is already hot on the trail of a spot-on diagnosis.
You will probably notice that the doctor will ask you questions that you had not anticipated. Often, however, when you answer them you will see that there was an unusual finding that you hadn't thought about. For example, the doctor may ask you about your sleep though you came in for shoulder pain. Though you weren't prepared to talk about your sleep and perhaps hadn't thought about it, upon considering the question you may find that your sleep has been restless and interrupted recently.
This, along with other cues, will probably give you the sense that the doctor has a real idea of what is going on with your body. This should set you at ease, although some people experience it as being a little disconcerting! We're not used to doctors with answers!
4. Taking of the pulse and observing the tongue.
The cornerstone of any Chinese medicine diagnosis is the pulse. While patients descriptions are certainly important, it is the more objective information available to the skilled practitioner that really cements the diagnosis. They will have you relax your arms and will feel your radial pulse for a minute or more on each side. Sometimes they will return to a pulse they have already felt. Every doctor has a slightly different technique, and some doctors are more skilled in pulse taking than others. This art has been practiced in some form in Chinese medicine for thousands of years. It gives the practitioner information about your entire body and everything in it.
Another very important diagnostic technique is the observation of the tongue. In CM, the tongue is thought to be a "microcosm" of the entire body. This means that the entire body is reflected onto the tongue in such a way that observing the quality of the tongue in particular areas tells the practitioner something about the corresponding area of the body. They will look at the color of the tongue body, the quality and color of the "fur" on the tongue as well as the general shape and any deviations in form. It can be a little embarrassing to show your tongue to someone you don't know – but it is important and the doctor will appreciate your cooperation.
As a quick note – it is important not to scrape or brush your tongue on the day of your treatment. Additionally, eating highly colored foods or drinking highly colored drinks (like orange soft drinks or coffee) may impede diagnosis.
Treatment will consist of the use of needles or pressure (with hand or other implement) to access the Qi of the channels, usually at specific points along the body. It may also involve the use of moxibustion (the burning of a medicinal herb either directly on the body or indirectly from an inch or so away), cupping (glass cups placed on the skin with a negative pressure, producing suction) or other techniques specific to the doctor's training.
You may feel some discomfort during the insertion of the needles – this is normal. For a rundown of some of my thoughts about acupuncture, you might want to check out our page on acupuncture.
All of these reactions are just fine and you shouldn't stop them unless they cause you an unreasonable amount of discomfort. Your doctor may help you through these reactions, but most often they will simply leave you to process what is coming up. If you feel that you need help – just ask your doctor. He will be happy to help you.
7. Possible restimulation of the needles and eventual removal of the needles (if used).
Sometimes the doctor will come back to restimulate the needle, producing more sensation and more Qi movement. They may use specialized techniques during this time to further encourage your body's Qi to help in your healing process. The final removal of the needles is usually painless.
8. Discussion of the treatment, delivery of herbal formula or other recommended supplements.
After your treatment, the doctor will probably discuss your future treatment options with you as well as providing you with any recommended supplements or herbal formulas. It is very important that you understand what your doctor is explaining to you – if you have ANY questions at all, inform her immediately. This is particularly the case if you are being asked to use bulk/crude herbs, boiled at home and drunk over a period of time. There are many important things you should pay attention to, such as: how to boil the herbs (with how much water, in what kind of container), how to drink the herbs (when? what temperature? with food or without?) and how to store the herbs (at room temperature or in the refrigerator?).
Your supplements and herbal formula are an extremely important part of your treatment and they MUST NOT be neglected. If you find the herbs too distasteful, contact your doctor and ask him about other possibilities. But remember, though the herbs may not always taste the best they are very powerful and will help you immensely in your healing journey.
9. Scheduling of follow-up, possible contact mid-stream if the appointment is far away.
If your doctor does not talk to you about your treatment plan, solicit the information. Find out when you should come back and if there is anything you should do in the meantime. In some areas, "group acupuncture" may be available. This is a form of acupuncture where you will be treated – usually fully clothed – in a room with several others. It is typically very affordable and some doctors recommend it to their patients in between "regular" appointments. It will keep your Qi moving and continue the treatment you are receiving. Your doctor may also want to see you briefly if your next appointment is several weeks away in order to take your pulse and observe your tounge and possibly make modifications to your herbal formula.
People sometimes report feeling a bit spacey after an acupuncture treatment, and for this reason you should give yourself time to relax before driving or jumping straight into work or other duties. The work of acupuncture and related treatment usually continues for several days after the treatment as your body realigns around this "new information." If you are concerned about your reactions, feel absolutely free to contact your doctor. In the unlikely situation that the reaction is unanticipated by your doctor or causing you much distress your doctor may ask you to come back to the office so she can rectify the situation.
I hope this information is useful to you as you find the right treatment fit for you!