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A Journey

Sometimes trying to summarize an experience is more difficult than the experience itself. The past two days I have spent trying to get my mind around all of the things I would like to convey about my time in Nepal. After nearly 1000 patient treatments, sometimes my days were just a blur of painful knees and low backs but that doesn't account for the miriad of emotions that I feel now that I'm on my way back to the US. I'm sure just like a million other healthcare practitioners, I now have a thousand stories of my successes and failures in the treatment room. I hope, however, that through a few of these stories, you might come to see how a much of a journey of the spirit this has been for me.

One of the things I discovered along the path is a hidden interest in paralysis, strokes and other neurological disorders. I witnessed some profound changes in these conditions using acupuncture and I would like to share a few. Of course not everyone gets better and in this fact the journey really begins.

 

Meet Ganesh. At eighteen years of age he contracted bone tuberculosis in his upper back. This slow growing infection is difficult to kill and in one year's time it progressed to his spine completly distroying his T9 vertebre (a condition known as Pott's spine).

Ganesh

At twenty, Ganesh is a parapalegic, struggles with severe pain and is without any bladder control. Everyday, his father would carry him for over an hour to reach our clinic.

Ganesh2

Of any case I have ever treated, this was one I dearly wished to have some effect. My treatment goals were to hopefully relieve his pain and to restore some bladder function. I treated Ganesh everyday for three weeks. He also suffered from constant tremors in his legs which gradulaly started to subside with treatment and his pain was reduced to just one location in his groin, however, that was all I could do. After 25 treatments the groin pain was still just as severe and his bladder control was unchanged. I'm left with the image of Ganesh's cheerful face and the thought... maybe 100 treatments... maybe 1000. Maybe it can't be changed at all... Maybe.

Anju

Anju is nine years old, very bright and very afraid of needles (who isn't). Her father brought her to see me because six weeks ago she suddenly developed drop foot (a condition in which the anterior and lateral muscles of the lower leg are paralysed and the foot helplessly drags on the ground when walking). Anju had recieved a diagnosis of leprosy (Hansen's Disease) from the hospital in Kathmandu and her father was rightfully freaked out. I didn't know alot about leprosy or how it is diagnosed but I read everything I could find and could not determine how Anju had received such a diagnosis other than the fact that she had drop foot. I supposed that peroneal nerve entrapment was a more likely diagnosis and reasoned that it should respond to tuina and acupuncture. I agreed to treat her everyday for 10 treatments and then reevaluate. After five treatments the foot was completley unresponsive and I was begining to despair. Anju's father anxiously asked everyday what he should do and I could feel his skeptisism and fear increasing as the days went by without change. I was begining to think that surgury might be a better treatment strategy when after the sixth treatment I asked Anju to lift her foot... it lifted. My interpeter and I nearly fell over with suprise and Anju's father openly wept. The foot was very weak but functional and I encouraged her father to bring her back for more treatment until she had fully recovered. I never saw her again. I can only hope that she enjoyed a rapid and full recovery... but I don't know that

Ganga

Ganga, is a patient that I inherited from Diane when she returned to the US. This young woman fell off the roof of a building while trying to escape a beating she was receiving from her husband. It is unknown exacly what damage she sustained to her spine becase she did not receive any medical care after the accident. She spent one year in bed recovering and came to our clinic mostly paralysed below the waist. I remember the first time I treated Ganga because she would intently watch each needle insertion and try to connect to some sensation of it. Contrast that to the fact that 5 weeks later she was complelty needle sensitive and would walk an hour and a half each way to the clinic without pain. Not to say she was cured in any way as her walking was not a pretty sight to behold and she still lacked function in the anterior and lateral muscles of her lower legs.

Ganga

The really amazing part for me was to see the revitalization of spirit in this young women. In the few short weeks I worked with her I saw hopelessness surrender to the bright light of hope behind her dark eyes and I will not soon forget the power of this transformation.

Noresh

Mr. Noresh is a 42 year old police officer who suffered a sudden stroke nine years ago and is mostly paralysed on his right side and cannot speak clearly. I learned in school that recovery of motor function after such a long time is extremely unlikely but I agreed to try. After only 5 treatments I was shaking his hand. He could move each finger individualy and he could walk with a cane (he could not hold his cane before). When I began working with him he claimed that I could "cut off his leg" and he wouldn't be able to feel it. After treatment he had sharp/dull and soft touch sensitivity in all of his fingers and toes. The interpeters all reported that he was speaking much clearer than before. He's one happy guy. I'm one happy practitioner and I hope he will continue to improve.

bigsmile

One of my favorite patients was this young girl who contracted typhoid fever at age 16. The fever damaged her cerebelum (part of the brain responsible for coordinating movement and balance) and now she has difficulty walking and falls often. I can't say that my treatments had even the slightest effect on her condition but I can say that her attitude and bright smile had a profound effect on me. On days that I would be struggling in the clinic wondering why some people wern't responding or worring that I might have missed something that would cause someone harm, she would come in and tell me a joke or sing a song. Attitude is so important in influencing outcomes and I am so grateful to this patient for that constant reminder.

In fact, I will end this entry on this note. I'm eternally grateful for what each and every patient brought to me on this journey. They shared their stories, they shared themselves and they trusted me. I hope I helped... I know they all helped me. -Andrew

Seasons Greetings from Nepal

Garret



When Leith. Garret and I originally began this project we envisioned a six week project in which we hoped to see maybe 3000 patients. We worked like demons on all of the logistics of founding a non-profit organization, raising money, gathering supplies, transporting hundreds of pounds of said supplies and standing up to the rigors of treating so many patients in less than optimal conditions. As we have reached our official project benchmark I am proud to announce that the Acupuncture Relief Project has provided 116 practitioner treatment days and administered 2443 acupuncture treatments to 806 patients in the Campagoan valley of Nepal.

LeithWe have seen some amazing results especially in the areas of chronic pain, fever paralysis and GI disorders. We have also had to work though many frustrations and a few disappointing outcomes (mostly involving patients near death, victims of domestic violence and patients suffering from serious long term illness').

At this point our team will be taking separate directions. Leith and Garret will be taking some time to travel (Leith to India and Garret to Japan) while I will continue to see patients for 3 more weeks. I've decided to focus my attention on a few promising patients who are suffering from bone tuberculosis, Pott's spine, fever induced paralyis, foot drop and neuropathy. All of the patients I have selected have made substantial improvment and I am hoping that intensive treatment over next few weeks will provide lasting results.

Garret will return to the clinic in late January and treat for an additional 8 to 10 weeks. Leith returns February 1st for an additional 4 weeks in the clinic. This should bring our project to over 200 practitioner treatment days in Nepal.

In this season of family and friends, I think of my family far from here and hope that they know I am exactly where I need to be. I'm proud of the work we have done here and extremely honored to have worked with Leith, Garret and Diane over these past few months.

AndrewAnd thanks to all of you who follow our project with all of your loving support. -Andrew

Diane Returns to the U.S.

Diane with Patient

I wanted to take a moment and share some reflections of my time with the Acupuncture Relief Project in Nepal. I write with a longing in my heart, and lightness or thankfulness, for what the experience has been. ...Longing for the opportunity to be treating patients in need, longing to see those familiar smiling faces that the first week were so unknown, and longing to fall into the simple rhythm of my life at the monastery, mealtimes with the monks, Nepali tea, and early mornings on the rooftop. ...Thankfulness for the experience of new places, new people, shared experiences with friends, and endless hours of conversation with those friends distilling out the nuggets of our learning.

Through my time at the clinic, I have had the opportunity to explore more deeply the quality and accessibility of my education & clinical experience from the Oregon College of Oriental Medicine (OCOM). What can I say – thank you OCOM for the very solid foundation in Traditional Chinese Medicine (TCM) and the practical confidence to draw upon what I have learned time and time again. In Nepal, there were some extremely complicated cases that would come into the clinic and it was easy to feel overwhelmed by where to start. It was nice to have this experience early on in my "career" – I am more prepared for it now and have more ideas about how to take a deep breath, lean into the unknown and what might feel difficult, and trust that acupuncture works.

I also have a greater practical foundation in western medicine. I gained confidence in recognizing what conditions really needed referrals – for most people in Nepal money is an overwhelming obstacle. I gained practice in taking a symptom picture and fitting the pieces together. I feel that many people walked in with a story and though they usually did not know the name for what they were experiencing, I could understand their issue. I often found myself at night reading through the pages of the Merck Manual - researching certain conditions, thinking about what kinds of treatment are available, or how to best explain to the patient what was happening in their body. In the end, it all came down to how a person felt with treatment. As Kalpana noted in her letter... "people get well and feel happy".

I also value experiences that offer a different perspective than what our normal day to day experience is. I like the shift in what "normal" is because it keeps me open to change, and less attached to the world as I might get used to it being simply through pattern and habit. I like it when the power goes out for 40 hours every week. I like having to figure out how to needle or just palpate someone through 20 feet of material wrapped around their waist when they come in (known as a zumi in Newari but commonly referred to by us as "the armor") with a chief complaint of low back pain. I like weathered faces and smiles that reveal compassion and beauty. I like it when so many things don't matter – like the nature of your clothes, the shoes on your feet, and the house were we live. Instead we get to honor and connect to the person in each of us – the eyes that we meet. One of the greatest gifts of Nepal was the nature of the way people say hello and goodbye. The phrase is "Namaste", while the hands are placed together close to the front of the chest or the face - even slightly touching the space between the eyes on the brow. It's the pause, the moment of eye to eye contact that happens, the moment of stillness - when one is either coming in or leaving. It's not casual - or formal - it is a moment of intention with one another. It's a gift of stillness for a moment, never compromised.

My appreciation goes out to each patient that provided me with an opportunity to learn. My appreciation also goes out to Nicky, the Clinic Director -- she's amazing for figuring out how to make it work everyday! Also to each interpreter and the front desk/front room staff - they helped to make this experience as valuable as it has been.

It's good to be "home" -- and sad to be gone. Namaste ~ Diane Wintzer

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