What to Expect
A visit with a Traditional Chinese Medicine practitioner often starts with an initial assessment, which may include a variety of questions, manual pulse-taking, and tongue diagnosis.
They will ask questions designed to diagnose your body's internal environment; at its current state, in the state it was in just before illness first occurred, as well as any changes that may have occured during the course of the illness.
Once a diagnosis has been reached, treatment will follow (usually a combination of some or all of the following treatment methods):
How to Prepare
It is helpful to familiarize yourself with the kinds of questions that may be asked (see the section entitled "Questions T.C.M. Doctor's Ask").
Before you visit your T.C.M. practitioner, make a list of (previous and current) issues, symptoms, or complaints that you can refer to.
Bring a list of medications, supplements, and herbs you are taking (Western, T.C.M., Naturopathic, Ayurvedic etc...), as well as results of diagnostic tests you have had performed (bloodwork, X-ray, M.R.I., C.A.T. Scans etc...). If you have seen T.C.M. practitioners in the past, bringing along the formulas they prescribed (both successfull and unsuccessfull).
Refrain from strenuous or extensive exercise either directly before or after treatment, and do not have acupuncture or tuina performed while on an empty stomach. If you feel dizzy or light-headed during the course of your treatment, inform your T.C.M. practitioner.
Tuina (Therapeutic Massage):
Tuina is the manual diagnosis and manipulation of nodes and connecting pathways in the body (acupoints and meridians).
Under a skilled practitioner, tuina is gentle but firm, and can alleviate pain, knots, and muscle spasms, and restore circulation.
It is often used before acupuncture to relax the tissue and increase blood flow, allowing acupuncture to be more effective.
Tuina is most effective through passive manipulation: try not to help (or hinder) the actions of the practitioner. Instead, just relax and let them move or manipulate you as if you were in a deep sleep.
If you feel tense or anxious, focus on deep, slow breathing, or bring some calming music to listen to.
Tuina is typically done while the patient's clothing is kept on.
Keeping this in mind, try to wear or bring clothing that is loose-fitting and wont restrict your movement or circulation.
Before treatment, remove any belts, buckles, hard or sharp objects, loose change and cell phones from your pockets.
Acupuncture
Acupuncture is the use of fine, sterile needles to access and treat imbalances using acupoints (nodes) on meridian pathways.
Acupuncture needles are typically 1/40th the size of the needles used in typical syringes (they do not need to carry liquid through them into the body).
While some may experience a sharp prick when the needle enters the skin (particularly in inflamed tissue), it quickly dissipates as the needle enters deeper into the tissue.
While acupoints exist all over the body, the most commonly used points occur on the arms (at or below the elbows), legs (at or below the knees), back, abdomen, and head:
Bring clothing which, when rolled up to expose these areas, does not impair circulation (ie. loose-fitting, elastic-free clothing).
If possible, wear natural, breathable fabrics (cotton, linen, hemp).
Try not to focus on the needles or area being needled, as this tends to increase unnecessary tension in the tissue.
Acupuncture is most effective when the patient remains calm and relaxed. In fact, many people fall alseep during treatment, which is even more benficial.
Moxibustion
Moxibustion is the burning of herbs (moxa).
It is either placed on the outer "tail" of inserted acupuncture needles, directly on or hovering over the skin, or above herb cakes placed on the skin.
Smokeless moxa or TDP mineral lamps can be used in place of moxa for those affected by the smoke, though efficacy will suffer.
Moxibustion smoke tends to seep into clothing (part of its ability to enter into the body's tissues): you may consider bringing an extra pair of clothing (to be worn during treatment).
As moxibustions burns, oils from the herbs will penetrate the skin, gently warming and relaxing the tissue underneath. If, over the course of treatment, the heat becomes uncomfortable, let the attending practitioner know.
TDP lamps generate heat, which gradually increases. If it becomes uncomfortably warm, inform the attending practitioner.
(Acupuncture and Moxibustion are often used together: acupuncture excels at draining excess, while moxibustion excels at boosting deficiency. Their combined use tends to increase their individual effects, enabling the body rebalance itself more efficiently.)
Herbal Formulas
Herbal therapy is often used to aid acupuncture and tuina affect change in organs systems beyond the level of muscle or fascia: a T.C.M. herbal regimen can help revitalize deficient organs and drain excess or overactive systems.
Herbal fomulas are devised and tailored for each individual's present state of balance: since functional balances change throughout the course of an illness, T.C.M. practitioners typically change the herbs, their amounts or the entire formula on a weekly basis.
Some herbs may taste bitter, or spicy. When the herbs start to take effect, the body often associates the taste of the herbs with their benefits, leading many people to develop a taste for previously less-palatable herbs.
In some cases, standard (OTC) formulas in pill, powder, or other form may be substituted for the sake of convenience, long term use, or if your condition closely approximates a standard formula.
T.C.M. formulas filled by herb shops will usually consist of dried herbs wrapped in several (usually 3-7) packages. Each package contains one day's supply of herbs.
Herbs should be prepared in an inert pot. Traditionally, clay pots were used, but glass and/or enamelled pots can be substituted. If you do not have an innert heating vessel, stainless steel pots can be used for some herbs. Copper, Iron, Aluminium, or Tin pots should be avoided, as they will negatively interact with the active ingredients in the herbs.
To prepare the formula, first reconstitute the dried herbs by soaking them in water for twenty minutes to an hour.
Then, bring the soaked herbs along with 4-6 cups of water to a boil.
When the herbal soup has reached a boil, turn the heat down to a simmer: formulas for newer, or acute conditions (colds, fevers etc...) tend to be simmered for a shorter period of time (20-30 minutes), whereas those for chronic diseases tend to be steeped for a longer period of time (40-50 minutes).
When the herbs are ready, divide the liquid into two portions: take half in the morning, and the other half in the evening.
Alternatively, some Chinese herb shops offer the option of preparing the herbs for you.
Cupping
Cupping is the use of suction to dislodge stagnant blood and stimulate blood and energy flow to an area of the body.
It was traditionally performed by heating the air inside bamboo or glass cups before applying them to the skin. Nowadays, plastic cups with a valve and a vaccuum pump are often substituted.
While cupping is very effective, it often leaves red or purple marks on the skin, which can remain for a few days while the body breaks down and reabsorbes these dead cells. T.C.M. circulation-increasing topical formulas or tuina can be used to speed up this process.
If the area being cupped will be exposed and you are uncomfortable with marks being left on the skin, please inform the practitioner before they perform the procedure, so they can either use less pressure during the process, or modify the style of cupping to leave less of an imprint.
Supportive Therapies (Diet, Guasha etc...):
Imbalances are often the result of (or can be affected by) dietary issues, so patients are cautioned of harmful dietary tendencies, or advised of beneficial ones.
Guasha involves raking rounded pieces of horn or bone over the skin. It is often used in lines along the neck and back to break high fevers or external diseases.
As diet varies significantly between people, it it often helpful to keep a food jounal with the time, amount, and type of food your consume. This can help the practioner diagnose imbalances or provide suggestions to improve your condition.
Guasha will leave red or purple marks on the skin which can remain for a few days while the body breaks down and reabsorbes these dead cells. T.C.M. circulation-increasing topical formulas or tuina can be used to speed up this process.