John Aguilar, Jr., L.Ac., R.Y.T., M.S.TCM

Licensed AcupuncturistChinese Medical HerbalistYoga and Tai Chi Instructor

What to Expect

What will actually happen at the acupuncture session, itself? This is going to vary, depending on the style of practice of your chosen acupuncturist. Some prefer clinics resembling a modern medical set up, while others prefer a more relaxed setting, perhaps similar to a psychologist's office than an MD's.

An initial visit may last up to two hours, again depending on the style of practice of your acupuncturist. This may seem like a long time, but keep in mind that the practitioner relies solely on his personal skills and his direct interaction with you to come to a diagnosis. There are no machines or labs to go through; it's just you and him.

During this time, you will likely be asked a lot of questions. The practitioner needs to get a full medical history on you. This includes your personal history of illnesses, surgeries, hospital visits, etc., as well as those of your immediate family members. In fact, you may want to plan for this ahead of time and create a list with this information, saving you some time at the acupuncturist's office.

Your practitioner will then likely move to your current health. With my patients, I always explain upfront that Chinese medicine is inherently a holistic medicine. This means that no matter what you come in for, be it headaches, depression, or sports injury, we are going to ask you about everything. In our holistic paradigm, every individual bit of information about you tells us about every other part of you, in a very real, clinically relevant way.

For example, I have treated several broken bones. In order to effectively mend the bones I need to know the state of the person's systemic resources. There are the systems that are directly responsible for healing the bone, but there are other systems that support that one. Everything is related. Two different people may break the same bone, but if one has difficulty sleeping, while the other has a history of digestive problems, they are going to receive different treatments.

In your initial intake, the practitioner needs to collect all this individual information on you because they will be treating your illness, whatever it may be, in context of you. No two treatments are the same because no two people are the same. Keep this in mind when you come in complaining of foot pain and the acupuncturist keeps asking questions about your head or your urination.

After this extensive intake, the practitioner will likely have you lay down on their table to take your pulse and maybe look at your tongue. Chinese medical pulse diagnosis is drastically different from Western medical pulse reading. It takes years of study and practice to even begin to develop true pulse reading ability. To summarize this practice, in Chinese medicine we divide up the pulse on the right and left wrist into various areas and depths (and each wrist gives different information from the other). We use three fingers on each wrist, and each finger is feeling a distinct 'position' of the pulse. This means there are three positions on the left and three on the right for a total of six individual pulses we're reading.

Each of these relates to a different system of your body; each gives us diagnostic information on different parts of your body and different aspects of your mood and psyche. Each of these six positions can have any number of depths, as well. Depending on what illnesses are affecting you, your pulse will divide into different levels. Generally, the superficial depth - where the practitioner applies very light pressure to the pulse - reflects the more superficial aspects of your being. This would include the surface of the body, such as the skin, the current, conscious thoughts and feelings, and disorders of very recent onset. Deeper pulses - felt by applying more pressure to the individual positions - reflects deeper structures of the physical body, muscles to bones and individual organs, as well as the deeper aspects of the psyche.

Tongue diagnosis is much more simple. A practitioner will look at the tongue to inspect the shape of the tongue, any cracks, the coating, and so forth. The nature of what they find combined with its location on the tongue gives highly reliable diagnostic information about you and your condition.

After 'reading' your tongue and pulse, the practitioner will put all this information together to come to a diagnosis. Some practitioners will focus primarily on the current issues you are facing, while others will place greater emphasis on an overall picture of you. In the latter, the treatment will be geared towards treating what the practitioner believes to be the root constitutional deficiencies of your body and being. According to this style of practice, every person has certain inherent predispositions to weaknesses and vulnerabilities of certain types. Through life, it is this base weakness that is at the root of all other injuries and sufferings. Therefore, to make any real progress, that root issue must be addressed.

Once the practitioner has a working diagnosis, he will formulate a treatment plan. If he is strictly an acupuncturist, this plan will be a set of acupuncture points chosen specifically and in specific combination for the problems you are facing. Again, just as no two patients are exactly the same, no two acupuncture treatments are the same. Even if the same points were chosen, the treatments will differ in their effect.

Style and technique of actually inserting the needles vary greatly. Your practitioner may twist and turn the needle after inserting it eliciting a response from you, or she may insert it with you barely even aware of what happened. Your experience of having the needles inserted will also vary greatly. Often there will be a very slight pin prick sensation when the needle is inserted, followed by a dull ache or mild throb. Some patients report sensations moving out from the point, going up or down the leg or arm. Often with my patients, when I needle one acupuncture point other acupuncture points will 'light up'. That is, as I needle the foot, the patient will become aware of acupuncture points at other areas of the body. All this is common as the all the points are connected via the acupuncture channels.

Acupuncture points are located all over the body, from head to toe. The needles themselves are very small, compared the needles used in Western medical settings. Most acupuncturists use 32 to 38 gauge needles, compared with an intravenous (IV) needle which is likely to be 12 to 18 gauge. To demonstrate the thinness of acupuncture needles to my patients I will often bend them into knots in front of the patient. Acupuncture needles are sterile and for single use, disposed of immediately following the treatment.

It is common for the practitioner to insert the needle and then leave them in, or 'retain' them, for up to 20 minutes. Though, classically, this is not indicated, it has become modern practice to do so. During this time, the practitioner will likely leave the room. I like to have my patients lay in silence so the treatment will have their undivided focus, but often practitioners will play soft, gentle music for the patient. Most acupuncturists return and remove the needles themselves, discussing your experience with you, but it is not unheard of for an acupuncturist to have an assistant remove needles for them.

Follow-up visits are generally 30-60 min in length and resemble the initial treatment but with much less time devoted to gathering information from you. Usually, you will come in and give an update on your symptoms, specifically, and on life in general, depending on your practitioner.

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