The long-tail symptoms of Covid involve multiple organs and physiological systems. Western medicine is struggling to understand this sequela, its disruption to full recovery and how best to treat it.
Worsley 5 Element Acupuncture, with its assessment focus on finding the root cause of illness, namely the causative factor, may offer a lens through which any acupuncture health care provider can understand the long-tail symptoms for any one patient and target their treatment. Case reports suggest the sequelae of symptoms that persist is linked to your causative factor. Treatment results point to 5 Element Acupuncture as an effective assessment and treatment intervention in long-Covid recovery.
Biomedicine: The Lasting Health Effects of COVID
Estimates are that "approximately 30% of people who've had COVID-19 experience prolonged symptoms."1 These are wide ranging from lung damage and breathing problems, to heart, immune system and brain dysfunction. Often reported are weakness on exertion, tachycardia, blood pressure variability, brain fog, dizziness, headaches, muscle pain and insomnia.
Not all patients experience the same cluster of symptoms, yet the symptom most common to all is post-exertional malaise or chronic fatigue.
Many long-haulers' symptoms resemble dysautonomia, a disorder that disturbs the autonomic nervous system (ANS), which controls bodily functions such as breathing, heart rate, blood pressure and digestion. Damage to this system, whether inflicted by the virus itself or by an overly intense immune response, might explain why many long-haulers struggle for breath when their oxygen levels are normal, or have unsteady heartbeats when they aren't feeling anxious. "Things that were once automatic are now erratic."2
Yet, as Dr. David Putrino at Mount Sinai Medical Center for Post Covid Care cautions: one cure does not fit all:
"There is no algorithm. There is listening to your patient, identifying symptoms, finding a way to measure the severity of the symptoms, applying interventions to them, and then seeing if those symptoms resolve. Even when symptoms such as fatigue are shared, their biological roots might differ – and those differences matter. Exercise might be devastating for one patient yet benefit another."3
All of this is giving rise to new medical frameworks for understanding infections and the body's responses, i.e., the response of the immune system is what does much of the damage to our bodies. And how one's immune system responds is individually determined by factors such as constitution and environment.
Why Acupuncture May Help: 5 Element Theory
Pathogen theory describes post-viral effects as the progression of exterior pathogens inward, first penetrating the skin; then if going deeper, the channels, then to the organs. If the virus lodges at the level of the organs, the zheng qi is vanquished and for some, this upright qi does not readily recover.
Fatigue, a primary symptom of qi deficiency, becomes a daily reality. Its role in holding things in place like rhythms of breath, heart rate and pulse is disrupted.
Qi, whose role is to nourish, protect and support, can no longer provide these basic functions. The emotional toll follows as one's daily life rhythms can no longer be maintained and even the slightest disruptions become insurmountable.
But long-haul symptoms are wide-ranging, affecting the qi of multiple organs: heart, lungs, kidneys, spleen. An acupuncturist applying general theory may end up treating every organ, thus running the risk of further overwhelming an already disorganized system.
Without a model to guide the practitioner to the source of the disturbance, one may become lost in a wilderness of symptoms, chasing them to find a way out. Therefore, the most important question in the treatment of long haulers is: What is the root and the branch of this qi deficiency?
In The Compleat Acupuncturist, Peter Eckman discusses the root / branch concept and makes an important observation:
"The roots can be thought of as more significant than the branches, which are relatively more expendable. Thus it may seem counter-intuitive that the roots are usually unseen (hidden in the ground for most plants), while the branches are easily observed, and where any abnormality may be readily detected. Human beings are not really different from trees in this regard: what is easily seen as an abnormality or symptom may be much less crucial to the survival of the individual than the unseen phenomena (the root imbalance) which may ultimately determine their fate."4
The strength of 5 Element differential dx is highlighted by Dr Eckman's observation. Its lens is pristinely designed to uncover the "unseen" root of imbalance. Applying 5 Element diagnostic cues, first recorded in the The Nei Jing, and discussed in Nan Jing, Question 61, of discerning color, sound, odor, emotion ... the very subtle, almost hidden, yet first signs of root imbalance; along with the quantitative pulse reading for each of the 12 officials, the source of imbalance is detectable. Through the lens of the causative factor, a patient's symptoms can be understood and treatment strategy uniquely guided for each long-hauler.
Editor's Note: In part 2 of this article (September issue), Jane presents two case studies highlighting the value of Five Element diagnosis and treatment in COVID-19 long haulers.
References
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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