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Clinical Story of the Month

(Copyright Stemmler 1998)

It was their last rehearsal. The next morning they were scheduled to leave for their first national competition. S.R. was almost 11 then, 5’-2", and 90 lbs. She had practiced intensely for the last 3 months, hoping to qualify, and pursue her dream to participate in the next Olympic games. She had been a gymnast for as long as she could remember, even as a toddler; her mother would tell the story about the crib rails over and over, until she would blush and excuse herself.

S.R. was the last one to perform. She chalked her hands, concentrated for a few, very intense minutes, and jumped onto the beam. Her first two flips were magnificent, and the third one was absolutely perfect. Then it happened: just for a second, she watched her sister coming in through the door. Perhaps it was just a split second, but enough to distract her from her tightly orchestrated routine. The next thing she felt was intense pain, and then darkness, followed by a swarm of colleagues and her coach surrounding her with expressions of concern.

She had fractured her left ankle, as x-rays confirmed 30 minutes later at the inner city ER. A cast was applied and everybody signed it and wrote little jokes and vignettes on it to cheer her up. Six weeks later it appeared to be healing well, and she begun to walk. But she continued to experience pain, and doctors were puzzled. She lived in an area that was served by one of the leading medical centers in the U.S., and perhaps in the world. Doctor after doctor would just shake his head: "The fracture is completely healed", they would say, "It is perfectly aligned", and "We cannot explain the source of the pain".

S.R. stopped all her activities, from gymnastics to walking. Every step was painful, and many nights were spent awake, longing for the life she had before. Only 11 years old, and for 18 months, S.R. was an invalid, her youth and energy on hold, wondering if she would ever regain her health and function.

Then her family moved to Houston. I first saw her on a Thursday afternoon, after school. She arrived in her plaid uniform, walking in with a limp and a little needle-shy. I examined her ankle and, indeed, it had a normal appearance and a full range of motion. I noticed a few tender spots on the top and the side of her ankle, which clearly corresponded to some important acupuncture points. From a Western medical perspective, it would have not meant much at all.

I treated her twice, once a week for two weeks with acupuncture, and I also prescribed some Chinese herbal combinations. Just within those two treatments, her ankle stiffness and pain diminished significantly, and she reported that her pain had changed from constant to intermittent, mostly with ambulation and no longer at rest. After her third treatment her pain resolved completely, and she reported running half a track. After her fifth treatment she was able to run a full track and had complete resolution of her pain.

She was then kept on a few maintenance treatments every one to two months, and her pain never recurred in 4 years. I wish I could finish the story here, but it would not be within my character to do so. Remember how many times I almost came to an end in our July story and then it kept on going?

Well, of course this section alone could be a happy ending, and Chinese medicine showing a victory over its Western counterpart. But life is not that simple and, in fact, it is often far more interesting than fiction.

Exactly 2 years later, S.R. came to my office quite distressed. No, she did not have any ankle pain, instead she was complaining of pain around her belly button, which had awaken her during the early morning hours. Now it had progressed to her right lower side, accompanied by nausea and vomiting. Her temperature was 99.6, and her pulse was racing at 106 beats per minute. One look at her, her history and what my hand found on palpating her abdomen was sufficient for a prompt diagnosis of acute appendicitis. Within less than an hour, S.R. was rolled into the operating room of one of Houston’s finest hospitals, undergoing an uneventful appendectomy without complications.

Three weeks later I saw her in follow up; she was doing well except for some residual abdominal pain. One acupuncture treatment resolved the situation and S.R. went on her way to grow up and eventually become a Dr herself. Of course, I have not told you of some of her subsequent visits between 1996 and 1998, some of which were Western, and others of which were Eastern. But I think I may have made the point in this case, and I do not want to keep you awake all night, (Recently a patient told me that she came home at midnight, saw my mailing and sat down to read it into the early morning hours!)

Ah, and one more thing before you fold me up: earlier this year S.R. had an opportunity to visit the"mainland": China; and of course she was able to walk one of the 7 Wonders of the World, and the only man-made structure visible from space: The Great Wall, which spans 1,500 miles across Northern China, and was built in the 3rd century B.C.!

Christina Stemmler, MD

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