Regional Node-ness

New England is an endemic area for Lyme disease. People all over the country are susceptible to Lyme, but if you live in any of the 6 New England states you are more susceptible. I am a likely candidate for Lyme. I am outside any chance I get, I crawl around in underbrush looking for mushrooms, I walk in the woods, I go in my yard, hunt for fruit in tall grass. I frequent tick-infested places. But I have never had Lyme…until last week.

It started as what seemed like a flu, which I would have expected to get over in a couple of days. Later, I thought I was still feeling crappy because right after the initial onset I took a long ride with a friend in a U-Haul. We drove 16 hours to Grand Rapids, MI to unload a very full truck full of his family’s stuff. Heavy stuff. But when we got back (luckily we flew home) and I still had fever, aches all over, and a strange rash I finally went to go see my doctor, who was willing to meet me at her office at 6am on a Sunday. Bless her. I started a 3-week course of antibiotics 3 days ago and I am starting to feel better.

In my clinic I see a lot of people with chronic Lyme disease. These unfortunate folks have had Lyme disease, or the symptoms of Lyme disease: fatigue, joint pain, headaches, nerve pain, rashes, fevers, cystitits, etc, etc. for a long time. Sometimes years. Most of the chronic Lyme folk went undiagnosed as having Lyme for a long time. This is in part because the blood test for Lyme is not reliable, and there is not much agreement even among Lyme experts, about the best course of treatment. Some say 3 weeks of deoxcycline if caught early enough, some say at least a month with an antibiotic that crosses the blood/brain barrier. Once you have had Lyme for a long time oral antibiotics may not be strong enough. I know people who have been on IV antibiotics for months. The side-effects of the antibiotics can be rough, as can the co-infections that often occur with Lyme disease. It is a scary disease from what I’ve seen.

I am not absolutely sure that I have Lyme, and even if my Lyme tests come back negative (I am still waiting for the results) there is no guarantee that I am really free of the Lyme spirochete. It can take several weeks for the antigen to show on a blood test. It makes more sense to me to start the antibiotics now—at the very earliest stages—and then depending on the blood tests and how the symptoms progress, figure out another plan soon. I could just have a parvovirus, or enterovirus, the type that are common in the Summer. Whatever it is, it has been kicking my butt.

In June, I attended the 1-day Maine WCA conference along with 46 other interested people. During the workshop I answered some questions about starting my clinic, Providence Community Acupuncture, born just 6 months ago. It was like being the proud parent of a healthy baby in front of a room of cooing aunties… sort of. I am very happy to be doing CA. On so many levels this model works well in my life; it meshes with my ideals, it allows me to work enough to make a living, but also to have time to have a life outside of work,. After eight years of boutique practice I was definitely burned out, I was making a living, but it was rough at times. I felt like a fisherman, having to fare high-seas, fishing bans, and red tides, while still hoping to have a large enough catch to break even. But CA makes all of that uncertainty manageable. There are always going to be fluctuations in patient flow, but for the first time in years this flow is much more stable. It is so stable in fact, that at this point we are ready to take on more acupuncturists to cover our expanding clinic hours. We’re getting busy…

On the CAN regional node forum, I recently put out there to folks in New England, or from anywhere really, an invitation to come see PCA. Two weeks ago an acupuncturist called to say that she would be in Providence that day and she would like to come see the clinic and to have a treatment. That same week a medical resident who also has extensive training in acupuncture (he trained in Germany) had been in the clinic every day observing. He and I had worked out a rhythm where I would ask the patient if they were okay with him observing before he entered the treatment room. Everyone was fine with it. His interactions synched with mine. Sometimes we would take pulses in tandem (I showed him Jin Gei). He asked questions and had interesting ideas to discuss. It slowed me down a bit, but mostly it went smoothly.

When the visiting acupuncturist arrived I had not thought much about how I would have her observe in the clinic. I didn’t know she was coming until about ½ hour before my shift started. So when I walked into the treatment room to ask my first patient about having an observer she excitedly followed me. I decided to just go with the flow and proceed to treat the patient without his explicit permission. Although the interaction, including needling lasted less than 10 minutes I became very self-conscious about the patient’s comfort with the observer present. It was probably my own discomfort I was feeling. I did my best to keep focused on my treatment, but I know that my patient could sense my discomfort.

Both the German medical resident and the visiting acupuncturist had an impact on my ability to focus on my patients. I enjoyed having them in the clinic, sharing knowledge, answering questions, but I have a concern that I cannot sustain these two types of interactions simultaneously. I want to share my clinic, my experience, my knowledge with my colleagues, but my patients come first.

So how do I make my clinic also accessible to other practitioners, without compromising the quality of the interactions my patients can expect regularly at the clinic? This is what I am thinking: Invite the other acupuncturists in NE down for a weekend. I can tell my patients that if they want free treatment, from myself or a visiting acupuncturist, in a teaching/learning setting, that they can schedule this during that weekend. We acupuncturists can spend time exchanging information about creating, running, growing, etc. community acupuncture clinics.

In an effort to reach to the broader acupuncture community of patients and practitioners (not just preach to the choir so to speak) we community acupuncturists, could hold a New England style Town Meeting with the broader topic being healthcare accessibility. This might spark some more clinic openings spurred on by patient interest. We could talk about how community acupuncture is a great way to manage symptoms of Lyme disease (stiffness, pain, inflammation, headache, foggy headed ness, neuralgias, etc.)

There isd always some truth in stereotypes, and the stereotypical New Englander is a thrifty (think Yankee ingenuity), hardworking, person who maybe a little provincial, but would be happy to accept something as exotic as acupuncture, if it works. Community Acupuncture seems like a perfect fit for this region. Other regions could hold regionally appropriate gatherings, a community acupuncture smorgasbord in the Midwest, a community acupuncture rodeo in the Southwest, a community acupuncture barbeque in the South, and of course in the Northwest, as we already know, they are holding community acupuncture nekkid love-ins. Ah, regional node-ness.