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DR. STEMMLER’S MONTHLY TEACHING ROUNDS

MARCH, 1999

CLINICAL STORY OF THE MONTH

(Copyright Stemmler, 1999)

Some health problems can be a real headache and some headaches can be a real problem.

So was Mr. E. R.’s condition, who for the previous 8 years, since his mid-forties, had suffered from serious, debilitating headaches. Although happily married for about a decade, he was unable to join his wife in bed, because every time he went to bed, or soon after falling asleep, his headaches would soon wake him up. So he decided to sleep in a chair, night after night, to avoid pain and insomnia. He also complained of painful armpits and numbness in his arms when adopting certain positions. His headache typically started on the back of his head, moving up to his forehead and temples, essentially embracing his whole head like a band. Mr. R. had tried all avenues to cure his headaches: from chiropractic care to a leading headache clinic, as well as submitting to multiple tests and trying various medications on the market. Yet every night he had another encounter with his pain.

As I evaluated E. R., I realized he was ambitious and hard working yet perhaps too intense for his constitution. He had a "type A personality" by medical standards, which his wife was prompt to confirm. They both run a very successful business, with the stressors of tight deadlines and increasingly higher goals, all of which tended to concentrate in Mr. R.’s neck muscles.

On examination he had numerous rock-like deposits in his neck, known as trigger points, and it was obvious that his headache was not originally coming from his head but rather from his neck. This explained the negative CT scans and other unrewarding work up in the past. I treated him with Chinese and Korean acupuncture and an herbal combination, an analgesic ointment, neck exercises and I advised him to sleep with a cervical pillow. He was very needle shy and at times overly anxious, but after a few sessions we figured out that he preferred to be treated in a sitting position over a reclining position, most likely because he associated lying down with the onset of his headaches. After I began treating him in an upright, sitting position, his anxiety decreased significantly. Yet he always kept a certain degree of tension, never quite letting go altogether. Given his constitution and personality, he could only relax as long as he kept some form of control.

Over the next 2 days and 2 visits he reported no headache but still felt stressed and tense. He had a headache one day following the 3rd treatment, but thereafter began to feel increasingly better. After 6 visits, over a two-week period, he had no more headaches. He reported "doing everything he could think of to test it", yet the headache did not return. By the 7th visit he announced: "I’m cured!" He reported sleeping in his conjugal bed every night, and appeared to be well rested, relaxed and in an excellent mood. After the 9th visit he was scheduled for a month later, and then placed on every 2 months’ "maintenance visits". And even though he has had some seasonal allergy problems in the Fall, his headaches have not recurred in 6 months. He was completely discharged 4 months ago.

This man’s entire life changed dramatically over a period of only 2 weeks, after suffering constant headaches for 8 long years. He had gone through the whole gamut of orthodox and non-orthodox medical approaches, which offered him little more than temporary relief and a myriad of side effects. He finally tried the Chinese approach with some reticence, being rather skeptical and squeamish when he first started treatment. And yet, as his symptoms resolved, he needed no further explanation for how "this stuff really works." He was just happy and appreciative that he could again work and rest like a normal human being

Headaches, although an extremely common problem, can be completely disabling. The constant pain, lack of rest and inner restlessness could have eventually led to other disorders, such as hypertension (which ran in his family), diabetes mellitus (which also ran in his family), and a series of degenerative and eventually destructive disorders, such as rheumatic diseases and cancer, if not attended to.

This man did not just receive treatment for his headache. He also regained his center, his inner self, his marital relationship and the stamina he needed to perform his everyday professional activities. He has started to plan his next 50 years, yet from a far better baseline than before he received effective treatment.

Now, headache free, he is back where he left off 8 years ago, full of vigor and dynamism, leaving behind him years of unnecessary suffering.

Christina Stemmler, MD


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