Guest guest Posted April 23, 2007 Report Share Posted April 23, 2007 This is tagging onto Jason's question a little bit. Can anyone suggest a good source that recommends typical lengths of time for different syndromes and/or diagnoses. I felt my education was really weak in this area and that my practice could benefit substantially if I could educate my patients and give them some clarity about how long treatments can be expected to last. We used Wu's book in school but I think that often the recommendations are more consistant with TCM in China and not in the US. I look forward to hearing from others who have a good resource for this info. Meredith Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 24, 2007 Report Share Posted April 24, 2007 Hi Meredith, I apologise in advance for not answering your question... I did wrangle with this question for a while (not too long) and I disposed of it by saying to myself that I would not pander to our modern fixation with schedules, even if it costs me patients. Of course sometimes I do try to give time frames, but I find that there are far too many factors in an outpatient and noncomittal setting to give accurate timeframes unless teh practitioner has a lot of experience. What I do is give people " progress frames " . I.e. I simplify their condition into one of steps, levels or phases. Then the patient and I watch as they progress through each level, and hopefully the patient learns more from this process rather than fixating on " I'll be better in 3 months " . I find that this also builds loyalty, since the patient becomes involved and begins to realise that everything has ups and downs, ebbs and flows - they seem to become more forgiving with themselves as well as the treatments. Hope that was useful, Hugo natdoc48 <natdoc48 Chinese Medicine Sunday, 22 April, 2007 8:54:47 PM Additional info desired This is tagging onto Jason's question a little bit. Can anyone suggest a good source that recommends typical lengths of time for different syndromes and/or diagnoses. I felt my education was really weak in this area and that my practice could benefit substantially if I could educate my patients and give them some clarity about how long treatments can be expected to last. We used Wu's book in school but I think that often the recommendations are more consistant with TCM in China and not in the US. I look forward to hearing from others who have a good resource for this info. Meredith <!-- #ygrp-mlmsg {font-size:13px;font-family:arial, helvetica, clean, sans-serif;} #ygrp-mlmsg table {font-size:inherit;font:100%;} #ygrp-mlmsg select, input, textarea {font:99% arial, helvetica, clean, sans-serif;} #ygrp-mlmsg pre, code {font:115% monospace;} #ygrp-mlmsg * {line-height:1.22em;} #ygrp-text{ font-family:Georgia; } #ygrp-text p{ margin:0 0 1em 0;} #ygrp-tpmsgs{ font-family:Arial; clear:both;} #ygrp-vitnav{ padding-top:10px;font-family:Verdana;font-size:77%;margin:0;} #ygrp-vitnav a{ padding:0 1px;} #ygrp-actbar{ clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;} #ygrp-actbar .left{ float:left;white-space:nowrap;} ..bld{font-weight:bold;} #ygrp-grft{ font-family:Verdana;font-size:77%;padding:15px 0;} #ygrp-ft{ font-family:verdana;font-size:77%;border-top:1px solid #666; padding:5px 0; } #ygrp-mlmsg #logo{ padding-bottom:10px;} #ygrp-vital{ background-color:#e0ecee;margin-bottom:20px;padding:2px 0 8px 8px;} #ygrp-vital #vithd{ font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transform:upp\ ercase;} #ygrp-vital ul{ padding:0;margin:2px 0;} #ygrp-vital ul li{ list-style-type:none;clear:both;border:1px solid #e0ecee; } #ygrp-vital ul li .ct{ font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;padding-ri\ ght:.5em;} #ygrp-vital ul li .cat{ font-weight:bold;} #ygrp-vital a { text-decoration:none;} #ygrp-vital a:hover{ text-decoration:underline;} #ygrp-sponsor #hd{ color:#999;font-size:77%;} #ygrp-sponsor #ov{ padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;} #ygrp-sponsor #ov ul{ padding:0 0 0 8px;margin:0;} #ygrp-sponsor #ov li{ list-style-type:square;padding:6px 0;font-size:77%;} #ygrp-sponsor #ov li a{ text-decoration:none;font-size:130%;} #ygrp-sponsor #nc { background-color:#eee;margin-bottom:20px;padding:0 8px;} #ygrp-sponsor .ad{ padding:8px 0;} #ygrp-sponsor .ad #hd1{ font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height:122%\ ;} #ygrp-sponsor .ad a{ text-decoration:none;} #ygrp-sponsor .ad a:hover{ text-decoration:underline;} #ygrp-sponsor .ad p{ margin:0;} o {font-size:0;} ..MsoNormal { margin:0 0 0 0;} #ygrp-text tt{ font-size:120%;} blockquote{margin:0 0 0 4px;} ..replbq {margin:4;} --> _________ Answers - Got a question? Someone out there knows the answer. Try it now. http://uk.answers./ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 Hi Hugo, I really like your idea of progress frames. Could you tell us more about this? I'm interested in how you describe these levels or phases to your patients. Thanks for any more info that you can provide. Peace, Liz Casey - Hugo Ramiro Chinese Medicine Tuesday, April 24, 2007 11:06 AM Re: Additional info desired Hi Meredith, I apologise in advance for not answering your question... I did wrangle with this question for a while (not too long) and I disposed of it by saying to myself that I would not pander to our modern fixation with schedules, even if it costs me patients. Of course sometimes I do try to give time frames, but I find that there are far too many factors in an outpatient and noncomittal setting to give accurate timeframes unless teh practitioner has a lot of experience. What I do is give people " progress frames " . I.e. I simplify their condition into one of steps, levels or phases. Then the patient and I watch as they progress through each level, and hopefully the patient learns more from this process rather than fixating on " I'll be better in 3 months " . I find that this also builds loyalty, since the patient becomes involved and begins to realise that everything has ups and downs, ebbs and flows - they seem to become more forgiving with themselves as well as the treatments. Hope that was useful, Hugo natdoc48 <natdoc48 Chinese Medicine Sunday, 22 April, 2007 8:54:47 PM Additional info desired This is tagging onto Jason's question a little bit. Can anyone suggest a good source that recommends typical lengths of time for different syndromes and/or diagnoses. I felt my education was really weak in this area and that my practice could benefit substantially if I could educate my patients and give them some clarity about how long treatments can be expected to last. We used Wu's book in school but I think that often the recommendations are more consistant with TCM in China and not in the US. I look forward to hearing from others who have a good resource for this info. Meredith <!-- #ygrp-mlmsg {font-size:13px;font-family:arial, helvetica, clean, sans-serif;} #ygrp-mlmsg table {font-size:inherit;font:100%;} #ygrp-mlmsg select, input, textarea {font:99% arial, helvetica, clean, sans-serif;} #ygrp-mlmsg pre, code {font:115% monospace;} #ygrp-mlmsg * {line-height:1.22em;} #ygrp-text{ font-family:Georgia; } #ygrp-text p{ margin:0 0 1em 0;} #ygrp-tpmsgs{ font-family:Arial; clear:both;} #ygrp-vitnav{ padding-top:10px;font-family:Verdana;font-size:77%;margin:0;} #ygrp-vitnav a{ padding:0 1px;} #ygrp-actbar{ clear:both;margin:25px 0;white-space:nowrap;color:#666;text-align:right;} #ygrp-actbar .left{ float:left;white-space:nowrap;} .bld{font-weight:bold;} #ygrp-grft{ font-family:Verdana;font-size:77%;padding:15px 0;} #ygrp-ft{ font-family:verdana;font-size:77%;border-top:1px solid #666; padding:5px 0; } #ygrp-mlmsg #logo{ padding-bottom:10px;} #ygrp-vital{ background-color:#e0ecee;margin-bottom:20px;padding:2px 0 8px 8px;} #ygrp-vital #vithd{ font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text-transform:upp\ ercase;} #ygrp-vital ul{ padding:0;margin:2px 0;} #ygrp-vital ul li{ list-style-type:none;clear:both;border:1px solid #e0ecee; } #ygrp-vital ul li .ct{ font-weight:bold;color:#ff7900;float:right;width:2em;text-align:right;padding-ri\ ght:.5em;} #ygrp-vital ul li .cat{ font-weight:bold;} #ygrp-vital a { text-decoration:none;} #ygrp-vital a:hover{ text-decoration:underline;} #ygrp-sponsor #hd{ color:#999;font-size:77%;} #ygrp-sponsor #ov{ padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;} #ygrp-sponsor #ov ul{ padding:0 0 0 8px;margin:0;} #ygrp-sponsor #ov li{ list-style-type:square;padding:6px 0;font-size:77%;} #ygrp-sponsor #ov li a{ text-decoration:none;font-size:130%;} #ygrp-sponsor #nc { background-color:#eee;margin-bottom:20px;padding:0 8px;} #ygrp-sponsor .ad{ padding:8px 0;} #ygrp-sponsor .ad #hd1{ font-family:Arial;font-weight:bold;color:#628c2a;font-size:100%;line-height:122%\ ;} #ygrp-sponsor .ad a{ text-decoration:none;} #ygrp-sponsor .ad a:hover{ text-decoration:underline;} #ygrp-sponsor .ad p{ margin:0;} o {font-size:0;} .MsoNormal { margin:0 0 0 0;} #ygrp-text tt{ font-size:120%;} blockquote{margin:0 0 0 4px;} .replbq {margin:4;} --> ________ Answers - Got a question? Someone out there knows the answer. Try it now. http://uk.answers./ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted April 25, 2007 Report Share Posted April 25, 2007 I am also impressed with this approach. I like to use the idea of 'time lines', getting a long-term sense of patient and pattern progression, based on the Nan Jing's view of time and health. Frames and phases makes a lot of sense to me. On Apr 25, 2007, at 7:47 AM, Liz wrote: > Hi Hugo, I really like your idea of progress frames. Could you tell > us more about this? I'm interested in how you describe these levels > or phases to your patients. Thanks for any more info that you can > provide. > Peace, Liz Casey > > - > Hugo Ramiro > Chinese Medicine > Tuesday, April 24, 2007 11:06 AM > Re: Additional info desired > > Hi Meredith, I apologise in advance for not answering your question... > > I did wrangle with this question for a while (not too long) and I > disposed of it by saying to myself that I would not pander to our > modern fixation with schedules, even if it costs me patients. Of > course sometimes I do try to give time frames, but I find that > there are far too many factors in an outpatient and noncomittal > setting to give accurate timeframes unless teh practitioner has a > lot of experience. > What I do is give people " progress frames " . I.e. I simplify their > condition into one of steps, levels or phases. Then the patient and > I watch as they progress through each level, and hopefully the > patient learns more from this process rather than fixating on " I'll > be better in 3 months " . I find that this also builds loyalty, since > the patient becomes involved and begins to realise that everything > has ups and downs, ebbs and flows - they seem to become more > forgiving with themselves as well as the treatments. > > Hope that was useful, > > Hugo > > > natdoc48 <natdoc48 > Chinese Medicine > Sunday, 22 April, 2007 8:54:47 PM > Additional info desired > > This is tagging onto Jason's question a little bit. Can anyone > > suggest a good source that recommends typical lengths of time for > > different syndromes and/or diagnoses. I felt my education was really > > weak in this area and that my practice could benefit substantially if > > I could educate my patients and give them some clarity about how long > > treatments can be expected to last. We used Wu's book in school but I > > think that often the recommendations are more consistant with TCM in > > China and not in the US. > > I look forward to hearing from others who have a good resource for > > this info. > > Meredith > > <!-- > > #ygrp-mlmsg {font-size:13px;font-family:arial, helvetica, clean, > sans-serif;} > #ygrp-mlmsg table {font-size:inherit;font:100%;} > #ygrp-mlmsg select, input, textarea {font:99% arial, helvetica, > clean, sans-serif;} > #ygrp-mlmsg pre, code {font:115% monospace;} > #ygrp-mlmsg * {line-height:1.22em;} > #ygrp-text{ > font-family:Georgia; > } > #ygrp-text p{ > margin:0 0 1em 0;} > #ygrp-tpmsgs{ > font-family:Arial; > clear:both;} > #ygrp-vitnav{ > padding-top:10px;font-family:Verdana;font-size:77%;margin:0;} > #ygrp-vitnav a{ > padding:0 1px;} > #ygrp-actbar{ > clear:both;margin:25px 0;white-space:nowrap;color:#666;text- > align:right;} > #ygrp-actbar .left{ > float:left;white-space:nowrap;} > .bld{font-weight:bold;} > #ygrp-grft{ > font-family:Verdana;font-size:77%;padding:15px 0;} > #ygrp-ft{ > font-family:verdana;font-size:77%;border-top:1px solid #666; > padding:5px 0; > } > #ygrp-mlmsg #logo{ > padding-bottom:10px;} > > #ygrp-vital{ > background-color:#e0ecee;margin-bottom:20px;padding:2px 0 8px 8px;} > #ygrp-vital #vithd{ > font-size:77%;font-family:Verdana;font-weight:bold;color:#333;text- > transform:uppercase;} > #ygrp-vital ul{ > padding:0;margin:2px 0;} > #ygrp-vital ul li{ > list-style-type:none;clear:both;border:1px solid #e0ecee; > } > #ygrp-vital ul li .ct{ > font-weight:bold;color:#ff7900;float:right;width:2em;text- > align:right;padding-right:.5em;} > #ygrp-vital ul li .cat{ > font-weight:bold;} > #ygrp-vital a { > text-decoration:none;} > > #ygrp-vital a:hover{ > text-decoration:underline;} > > #ygrp-sponsor #hd{ > color:#999;font-size:77%;} > #ygrp-sponsor #ov{ > padding:6px 13px;background-color:#e0ecee;margin-bottom:20px;} > #ygrp-sponsor #ov ul{ > padding:0 0 0 8px;margin:0;} > #ygrp-sponsor #ov li{ > list-style-type:square;padding:6px 0;font-size:77%;} > #ygrp-sponsor #ov li a{ > text-decoration:none;font-size:130%;} > #ygrp-sponsor #nc { > background-color:#eee;margin-bottom:20px;padding:0 8px;} > #ygrp-sponsor .ad{ > padding:8px 0;} > #ygrp-sponsor .ad #hd1{ > font-family:Arial;font-weight:bold;color:#628c2a;font-size: > 100%;line-height:122%;} > #ygrp-sponsor .ad a{ > text-decoration:none;} > #ygrp-sponsor .ad a:hover{ > text-decoration:underline;} > #ygrp-sponsor .ad p{ > margin:0;} > o {font-size:0;} > .MsoNormal { > margin:0 0 0 0;} > #ygrp-text tt{ > font-size:120%;} > blockquote{margin:0 0 0 4px;} > .replbq {margin:4;} > --> > > ________ > Answers - Got a question? Someone out there knows the > answer. Try it > now. > http://uk.answers./ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 1, 2007 Report Share Posted May 1, 2007 Hi Liz, Z'ev and all... The system I use is a personal system and therefore not " systematised " , but I can give a very simple example that I used the other week. Please keep in mind that I am not doing anythng unusual, I actually expect that most of us do this, perhaps I just focus on it a little more than most. Male, 60, sinus pain, 5 years Pain is constant, fixed and dull, does not vary in intensity or quality except when he sneezes. Pain with sneezing is very intense, with a terrible pressure and stabbing pain. Thinking is vague, unfoccussed. Timeframe: I have no idea. " Phase " or " Levels " I take the complaint that he suffers most with (Pain) and divide it into three stages. Level 1 Constant Pain Level 2 Intermittent (half pain, half no-pain) Level 3 Highly intermittent (mostly no pain, rarely pain) (Level 4: Cure (haha)) In order to focus this patient, I had to pair the pain with another marker, sneezing. As with many chronic pain patients a tolerance for the pain is developed, and it can be difficult to assess improvement or aggravation without this kind of marker. Level 1 Constant Pain i.e. Pain with /every/ sneeze Level 2 Intermittent Pain (not every sneeze is accompanied by pain) Level 3 Highly Intermittent Pain (most sneezes are not accompanied by pain) What I am trying to teach the patient, beyond noticng change, is the meaning of stagnation versus good flow: Level 1 (Stasis / No change) = Constant Pain Level 2 (Stasis transforming to Free Flow) = Intermittent Pain Level 3 (Little Stasis, much Free Flow) = Little Pain Most people do not intellectually grasp that an unchanging, fixed (stable) condition is much worse than a changing, moveable (unstable) condition. The immense difference between contant, fixed, pain, and intermittent, moving, pain is lost on most of us. I am sure you can see how simple this system is. Nothing special. All it does is move the focus away from an arbitray timeline (4 and a half weeks (??)) to actual progressions in the condition, however long each one may take. I believe the further step is along the lines of what Z'ev was saying (although I would like for him to elaborate on it) - " We can expect your condition to get worse during the Spring " , " Each summer you condition will improve, while winters will be periods of stability for you " , " You are coming up on 42 years of age, and so we expect... " and so on. We shoudl try to practice a living medicine rather than blandly repeating 1st year TCM systematics to our patients. They are not going to CM school, and yet they must grasp, as firmly as we do, the essential concepts that they are in need of. I believe that is one of the biggest challenges in medicine. Thanks for your time, hope that helped. Hugo Liz <lizzzrd Chinese Medicine Wednesday, 25 April, 2007 10:47:21 AM Re: Additional info desired Hi Hugo, I really like your idea of progress frames. Could you tell us more about this? I'm interested in how you describe these levels or phases to your patients. Thanks for any more info that you can provide. Peace, Liz Casey - Hugo Ramiro Tuesday, April 24, 2007 11:06 AM Re: Additional info desired Hi Meredith, I apologise in advance for not answering your question... I did wrangle with this question for a while (not too long) and I disposed of it by saying to myself that I would not pander to our modern fixation with schedules, even if it costs me patients. Of course sometimes I do try to give time frames, but I find that there are far too many factors in an outpatient and noncomittal setting to give accurate timeframes unless teh practitioner has a lot of experience. What I do is give people " progress frames " . I.e. I simplify their condition into one of steps, levels or phases. Then the patient and I watch as they progress through each level, and hopefully the patient learns more from this process rather than fixating on " I'll be better in 3 months " . I find that this also builds loyalty, since the patient becomes involved and begins to realise that everything has ups and downs, ebbs and flows - they seem to become more forgiving with themselves as well as the treatments. Hope that was useful, Hugo natdoc48 <natdoc48 > Sunday, 22 April, 2007 8:54:47 PM Additional info desired This is tagging onto Jason's question a little bit. Can anyone suggest a good source that recommends typical lengths of time for different syndromes and/or diagnoses. I felt my education was really weak in this area and that my practice could benefit substantially if I could educate my patients and give them some clarity about how long treatments can be expected to last. We used Wu's book in school but I think that often the recommendations are more consistant with TCM in China and not in the US. I look forward to hearing from others who have a good resource for this info. Meredith <!-- #ygrp-mlmsg {font-size:13px; font-family: arial, helvetica, clean, sans-serif;} #ygrp-mlmsg table {font-size:inherit; font:100% ;} #ygrp-mlmsg select, input, textarea {font:99% arial, helvetica, clean, sans-serif;} #ygrp-mlmsg pre, code {font:115% monospace;} #ygrp-mlmsg * {line-height: 1.22em;} #ygrp-text{ font-family: Georgia; } #ygrp-text p{ margin:0 0 1em 0;} #ygrp-tpmsgs{ font-family: Arial; clear:both;} #ygrp-vitnav{ padding-top: 10px;font- family:Verdana; font-size: 77%;margin: 0;} #ygrp-vitnav a{ padding:0 1px;} #ygrp-actbar{ clear:both;margin: 25px 0;white-space: nowrap;color: #666;text- align:right; } #ygrp-actbar .left{ float:left;white- space:nowrap; } .bld{font-weight: bold;} #ygrp-grft{ font-family: Verdana;font- size:77%; padding:15px 0;} #ygrp-ft{ font-family: verdana;font- size:77%; border-top: 1px solid #666; padding:5px 0; } #ygrp-mlmsg #logo{ padding-bottom: 10px;} #ygrp-vital{ background-color: #e0ecee;margin- bottom:20px; padding:2px 0 8px 8px;} #ygrp-vital #vithd{ font-size:77% ;font-family: Verdana;font- weight:bold; color:#333; text-transform: uppercase; } #ygrp-vital ul{ padding:0;margin: 2px 0;} #ygrp-vital ul li{ list-style-type: none;clear: both;border: 1px solid #e0ecee; } #ygrp-vital ul li .ct{ font-weight: bold;color: #ff7900;float: right;width: 2em;text- align:right; padding-right: .5em;} #ygrp-vital ul li .cat{ font-weight: bold;} #ygrp-vital a { text-decoration: none;} #ygrp-vital a:hover{ text-decoration: underline; } #ygrp-sponsor #hd{ color:#999;font- size:77%; } #ygrp-sponsor #ov{ padding:6px 13px;background- color:#e0ecee; margin-bottom: 20px;} #ygrp-sponsor #ov ul{ padding:0 0 0 8px;margin:0; } #ygrp-sponsor #ov li{ list-style-type: square;padding: 6px 0;font-size: 77%;} #ygrp-sponsor #ov li a{ text-decoration: none;font- size:130% ;} #ygrp-sponsor #nc { background-color: #eee;margin- bottom:20px; padding:0 8px;} #ygrp-sponsor .ad{ padding:8px 0;} #ygrp-sponsor .ad #hd1{ font-family: Arial;font- weight:bold; color:#628c2a; font-size: 100%;line- height:122% ;} #ygrp-sponsor .ad a{ text-decoration: none;} #ygrp-sponsor .ad a:hover{ text-decoration: underline; } #ygrp-sponsor .ad p{ margin:0;} o {font-size:0; } .MsoNormal { margin:0 0 0 0;} #ygrp-text tt{ font-size:120% ;} blockquote{margin: 0 0 0 4px;} .replbq {margin:4;} --> ____________ _________ _________ _________ _________ _________ _ Answers - Got a question? 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