June 17, 2022
In modern day TCM offices, probably 99.99% of cases are chronic non-life threatening issues. If there are "acute" cases they are essentially all muscle related, like sprains, cramps etc., at least this is based on my experience. Life threatening issues people go to ER of course. I've only had a few acute cases come to me over the years and to be honest, they are not easy. There is always the potential that unexpected things could happen. Some of the cases I came across in the past didn't come back after the treatment, so I was unsure of what ensued afterwards. Through much hard work however I could typically at least control the situation to some extent, and have them leave the clinic at least slightly better than they came in. Though, this isn't always the case. We only try our best. Some would be seemingly better post treatment but would later call to tell me things were still the same, and some had to go to ER later on.
In my opinion, the emergency protocols of TCM are probably lost in this day and age, quite unfortunately. This particular department has been for the most part handed over to modern medicine. However, from time to time some acute cases still come by. When I say acute cases I don’t mean muscle joint pain problems—I am referring to organ issues. You might be asking why they even come. To be frank, some people do not know their issue probably is for the ER. They don't necessarily tell you over the phone. Even if they did you cannot really tell just from listening to them.
One individual came to me because he was experiencing shortness of breadth during exercise as of recent. He went for blood work and the numbers were not too good. Many key cardiovascular indicators are on the edge. Certain numbers were overboard. It is possible he may have some clot going on. His symptoms were too textbook. Plus, he didn't pass some diagnostic tests on the Western medicine side. It is a question why he was sent home and eneded up at my place, but that is another discussion. Situations like this can be quite precarious. In TCM though we have ways of assessing the situation to sort of gauge for the level of 'danger'. After my checkup I thought maybe while there is hidden risk but the overall 'danger' isn't quite imminent yet. From TCM perspective, this person's 'spirit' is still composed, he was able to go about things quite normally, and his frame is strong. So his internal condition in TCM I diagnose as "excess". Excess conditions in TCM have much higher rates of treatment success. I did acupuncture and gave him herbs to clean out the 'metabolic junk' inside his body. He came back a week later. There were some subjective improvement. He was also changing his diet afterI told him to in the initial visit. From my subsequent checkup however, there was massive improvement in his internal environment. So I knew, that danger is likely out of the way. The patient came for couple more visits later and subjectively nothing big has changed. I continued to clean out his metabolic junk. Later he didn't come back. I followed up with him about a month or so later, and he told me he went on a special diet and lost many pounds. His shortness of breadth has gone too. The patient's mindset and my mindset were not quite the same. He was thinking of one thing while I thought of something else. It was hard to say if this was a true emergency life threatening case. Patient probably wouldn't believe it but it felt like that to me at the time. If things were as bad as they appear to be, my gut feeling says it probably would be worse if left as is. The time frame between point A and point B won't necessarily be too long either in my opinion. Thankfully everything played out well. But his follow up checkup results are still unknown at this time of writing.
Another one was different. Patient came in saying he was very tired as of recent. Of note was his legs all swollen. When you press it the dent stays there. This typically is not very good. Especially not good is that he didn't have this last visit, which was a while ago. At that time he came to treat his gout which caused the legs to be swollen too, but that was only one leg and the 'texture' was very different, in Chinese Medicine terms. This time, his complexion was not good either. The "life-force" was waning, so to speak. I have seen similar cases like this in the past with elderly patients, usually is some sort of mortal danger and imminent medical attention is needed ASAP. I took his pulse, was very erratic, hard to discern any rhythmic normalcy. I told him, "this is out of my purview, you need to go to ER NOW." He didn't hesitate. Thankfully, he was still able to go there by himself. And his mental clarity was relatively intact, so he hailed a cab---that was a VERY SMART move. Later I didn't hear from him for months. Recently I followed up with him to ask what happened later. He told me---he actually had congestive heart failure as per ER diagnosis. Thankfully, they treated him and he's alright now.