Knee Surgery and TCM Care (by Ling Zhang, RN (US), L.Ac.)
The knee consists of tibia and femur these two long bones, patella, cartilage, synovial membrane, ligament, tendon and meniscus. Various types of arthritis may affect the knee joint. Osteoarthritis, a degenerative joint disease that affects mostly middle-aged and older adults, may cause the breakdown of joint cartilage and adjacent bone in the knees. Rheumatoid arthritis, which causes inflammation of the synovial membrane and results in excessive synovial fluid, can lead to pain and stiffness. Traumatic arthritis, which is arthritis due to injury, may cause damage to the cartilage of the knee. Knee replacement surgery is a treatment for pain and disability in the knee. The most common condition that results in the need for knee replacement surgery is osteoarthritis.
Normally patients try anti-inflammatory and pain medications, physical therapy or sometimes cortisone shots first, but when the knee joint has been damaged and knee pain cannot be controlled by other conservative treatments, then patients will go for the knee replacement surgery.
Before the surgery, preventive care is provided to help minimize damage from surgical incisions and speed the recovery process. The most serious complication of the knee replacement is an infection of the joint. Acupuncture and acupressure are employed to help strengthen the immune system by increasing white blood cell antibodies so that the patient has an increased resistance to infection. Also, the treatment before the knee replacement surgery can help manage the stress, reduce the blood loss, enhance the effect of anesthesia and reduce its side effects.
In most cases, for pre surgical preventive care we tell the patients to come for a total of 3 treatments from two weeks prior to surgical procedure up to and including the week of the procedure.
After the surgery, we can use Acupuncture, herbs and acupressure to enhance the recovery through general care. The treatment will help with detox from the anesthesia and strengthen the patient's energy.
For special care after knee replacement, the first one will be Deep vein thrombosis: Deep vein thrombosis in the leg is the most common complication of knee replacement surgery. Besides periodically elevating a patient's legs, lower leg exercises to increase circulation, support stockings and medication to thin your blood, our holistic treatment will try to release this blood stasis resulting from the surgical procedure by means of a three-day Chinese Herbal formula to be taken immediately following surgery. This formula helps remove blood stasis, recover microcirculation, and aid in the healing of scar tissue.
After the surgery, sometimes patients still will experience pain at the surgical site. Most patients will do the physical therapy after the surgery to strengthen the muscles connected to the knee and do the physical therapy to help with the knee range of motion but sometimes a patient will have more pain from the physical therapy. And a lot of time patients have knee pain on the non- surgical site too because the good knee tries to compensate with the one that just had surgery so gradually it will have pain too. The knee replacement surgery itself may lead to the tightening of some soft tissues around the knee, and nerve injuries. Acupuncture can be employed to relieve pain and reduce the dosage of pain relievers. Also, acupuncture needles put to the local knee area can help with the local qi and blood circulation to release the stiffness and swelling. This treatment will also help speed the overall recovery process.
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Hip Surgery and TCM Care (by Ling Zhang, RN (US), L.Ac.)
Hip pain can be from all sorts of reasons and our clinic provides the proper therapy to help ease the pain. When a patient’s hip pain is very advanced or sometimes a hip fracture or bone tumor involved, patients have to choose surgery as a resort. Developed over the past several hundred years, surgery may resolve a great many medical conditions as well as prove lifesaving. Acupuncture has been demonstrated to help the patients before and after the surgery in different ways.
Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a half replacement. A total hip replacement consists of replacing both the acetabulum and the femoral head while hemiarthroplasty only replaces the femoral head. Hip replacement is currently one of the most common orthopedic operations.
Surgical procedures do, however, result in physical trauma to the body and there are potential side effects such as reaction to anesthesia, blood loss, blood clots, body tissue damage, scar tissue development, infection and so forth. Our pre/post-surgical treatment plan helps to minimize trauma, scarring and bodily damage to help achieve the best possible recovering results after surgery. This type of therapy is usually combined with Acupuncture with physical rehabilitation to achieve optimum healing. In most cases, for pre surgical preventive care we tell the patients to come for a total of 3 treatments from two weeks prior to surgical procedure up to and including the week of the procedure.
The patients may suffer from chronic pain after a hip replacement for different reasons such as improper movement, scar, bursitis, surgical related muscle or nerve damage etc. Some patients can experience pain in cold or damp weather. Patients normally spend 1 to 3 days in the hospital after surgery. Specific exercises and movements are usually applied by a physical therapist or Massage therapist to help improve blood flow, build muscle strength, promote specific functional strengthening and range-of-motion. Our post-surgical therapy plan refers that Acupuncture, Acupressure and herbal remedy be employed to relieve pain, improve the circulation and reduce the dosage of pain medication gradually. Moreover, it will help speed the overall recovery process.
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Caesarean Section (by Ming Jin, PHD, LAC)
Cesarean delivery (C-section) is a surgical procedure used to deliver a baby through incisions in the abdomen and uterus. It might be recommended by Doctor in various medical conditions such as labor can't progress, baby is in distress or in an abnormal position, a mother carrying multiples, placenta problems, prolapsed umbilical cord, Mechanical obstruction, health concern or had a previous C-section.
If it is not an emergency, the date of the caesarean section is scheduled. We will provide Pre-C-section Therapy to prevent infection, relieve stress and improve physical strength.
Post C-section Therapy will be involved:
- Post anesthetic conditioning: most cesarean section is carried out under regional anesthesia, including spinal cord block and epidural block. In an emergency, general anesthesia is sometimes required. Acupuncture on back or scalp points is recommended twice a week after C-section since it promotes blood circulation to prevent low back pain, cold and numbness on the legs or memory loss.
- Cesarean section may be accompanied by certain risks such as endometrial infection, postpartum hemorrhage, anesthesia reaction, blood clot, wound infection and so on. Taken Shenghua Decoction and Sanqi Powder are TCM postpartum routine care in order to prevent these problems.
- Scar Care: Acupuncture promotes wound recovery and scar absorption. Inserting acupuncture points around the scar combined with moxibustion (box or stick), applying gentle manipulation with essential oil works effectively for scar healing.
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During labor and birth, the pressure of the baby against your cervix, and then against tissues in the pelvic floor, stimulates Oxytocin (Pitocin) and contractions.
Oxytocin is produced in the hypothalamus and is secreted into the bloodstream by the posterior pituitary gland. It is a signal to start labor by contractions of the womb. It also increases the production of prostaglandins, which move labor along and increases the contractions even more.
Oxytocin is often known as the "hormone of love" because it is involved with lovemaking, fertility, contractions during labor and birth and the release of milk in breastfeeding.
It helps us feel good, and it triggers nurturing feelings and behaviors. It is also associated with empathy, trust, sexual activity, and relationship-building. It is sometimes referred to as the “love hormone,” because levels of oxytocin increase during hugging and orgasm.
Oxytocin is critical for milk removal through milk ejection reflex, and it's also an important factor for postpartum women to produce enough lactation and promote milk discharge smoothly. The studies have shown that oxytocin given to a woman during or immediately after the birth is effective in reducing excessive bleeding.
To sum up, the secretion of oxytocin in cesarean section women might be relatively insufficient due to lack of normal labor process. Even mothers who routinely use oxytocin during cesarean section are more likely to suffer from postpartum depression than normal childbirth, so mental care is an important part of postoperative care; and for them to have good amount milk secretion and discharge after the operation, and to prevent milk deficiency or breast inflammation is also one of the focuses of our concern. Oxytocin can also help mothers stop lochia earlier and restore physical strength and fitness. We consider all of them to be the routine health care plan for post C-section.
- Oxytocin is mainly produced in the hypothalamus. Acupuncture might affect and balance the secretion of hypothalamic hormone by stimulating ear points: brain, brain stem, endocrine; scalp acupuncture: cerebral cortex, cerebellum and Du meridian points, Huatuo Jiaji.
- Help breast milk secretion: ST18, ST36, SP6, LI10, SI1,
- Herbal Tea: Shengru Tang
- Release stress and depression: Sishencong, LI4, ST36, Sp6, LIV3
- Herbal Tea: Xiaoyao Wan, Ganmai Dazao Tang
- Recovering & Fitness: ST25, ST28, Ren4, SP9, SP6
- Herbal Tea: Shenghua Tang, Balan-Fit Tea
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Cosmetic Surgery & Facelift (by Ming Jin, PHD, LAC)
Plastic surgery is a surgical specialty involving the restoration, reconstruction, or alteration of the human body. It can be divided into two main categories: reconstructive surgery and cosmetic surgery. Plastic surgery is intended to correct dysfunctional areas of the body and is reconstructive in nature. Cosmetic surgery is focused on enhancing appearance through surgical and medical techniques. Cosmetic surgery can be performed on all areas of the head, neck and body. The top cosmetic surgeries are breast augmentation, liposuction, nose reshaping, eyelid surgery, tummy tuck, and facelift.
A facelift, or rhytidectomy, is a procedure in cosmetic surgery that aims to give a more youthful appearance to the face. The procedure can reduce the sagging or folds of skin on the cheeks and jawline and other changes in the shape of your face that occur with age. A neck lift (platysmaplasty) is often done as part of a face-lift to reduce fat deposits and sagging skin on the neck.
A face-lift involves elevating the skin and tightening the underlying tissues and muscles. Fat in the face and neck may be sculpted, removed or redistributed. Facial skin is then re-draped over the newly repositioned contours of the face, excess skin is removed, and the wound is stitched or taped closed. A traditional face-lift incision starts at temples in the hairline, continues down and around the front of ears and ends behind ears in the lower scalp. An incision might be made under the chin to improve the appearance of the neck. Patients may experience mild to moderate pain, drainage from the incisions, swelling, bruising, numbness after face-lift.
Post-Facelift Care includes:
- In the first week after operation, Aroma- lymphatic - drainage massage in submaxillary lymph plexus, supraclavicular lymph plexus, axillary lymph plexus and medial upper limb can help to eliminate swelling and relieve pain as well as Acupuncture at LI11, LI4, SP9 and SP6.
- From the second week after operation, Acupuncture on scalp points or ear points can promote scar healing, absorption and recovery.
- The connective tissue at the chin is relatively loose. Acupuncture around the incision can tighten the skin, reduce swelling and relieve pain.
- Acupuncture facelift once a month after surgery can enhance and tighten the skin, so that the effect of cosmetic surgery can be best consolidated and maintained.
Acupuncture facelift in our clinic includes lifting, tightening skin, removing wrinkles, lightening spots, reducing edema of eye bags, and increasing skin elasticity and luster. It is a natural acupuncture beauty technology.
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Breast Reconstruction (by Ming Jin, PHD, LAC)
Breast reconstruction can be an important part of the overall care plan for women affected by breast cancer. It combines the latest in breast cancer care with sophisticated Plastic Surgery techniques to preserve and restore shape, form, beauty, and function.
About Type:
There are two main techniques for reconstructing your breast: （1）Implant reconstruction: Inserting an implant which is filled with saline (salt water) or silicone gel. （2）Autologous or "flap" reconstruction: Using tissue transplanted from another part of your body (such as your belly, thigh, or back). Sometimes the implant and flap procedures are used in combination with reconstructing a breast. In addition, nipple /areola tattooing, and fat grafting can be done to help make the reconstructed breast look more like the original breast.
Most women who have breast conservation surgery (lumpectomy or partial mastectomy) do not need breast reconstruction. These women may be candidates for different types of breast reconstruction to reshape the breast including: Smaller implants, Fat grafting, Breast reduction, Breast lift, Revision of scar, Smaller tissue flaps etc. [Read More...]
About Incision:
Mastectomy procedure is performed using an elliptical incision 6 to 8 inches in length that begins on the inside of the breast, near the breastbone, and extends upward and outward toward the armpit. The inframammary approach, often called the crease incision, is the most common approach for breast enhancement surgery. The opening is created in the crease under the breast, called the inframammary fold, where the breast meets the chest wall.
About Time:
Immediate breast reconstruction is the procedure that can be performed as a combination with the mastectomy. Once the mastectomy is completed, the plastic surgeon will place an implant to result in an immediate breast mound. The incision generally is performed through the mastectomy site. With this procedure, we may achieve more rapid recuperation and rare complications.
Delayed breast reconstruction utilizing tissue expander: The initial portion of this procedure entails the breast surgeon performing a standard mastectomy. Once these procedures have been performed, the plastic surgeon will form the pocket for the breast expander at the base of the breast or the inframammary crease. The pocket is made large enough for the expander to be placed and the muscle closed. Tissue expansion usually occurs weekly according to patient tolerance. The volume of the tissue expanders commonly exceeds the weight of the mastectomy tissue. Once this is completed, a second outpatient procedure will be necessary to remove the tissue expander and place the permanent breast prosthesis.
Possible complications include skin loss, exposure of the expander, excess bleeding, infection, malposition of the implant so that asymmetry occurs, wrinkling or rippling of the implant, possible fluid collection underneath the implant, pain at the injection site, muscle spasms with expansion and/or unfavorable scarring.[Read More...]
A tissue flap procedure (also known as autologous tissue reconstruction) use tissue from other parts of the body, such as your tummy, back, thighs, or buttocks to rebuild the breast shape. Tissue flaps generally look more natural and behave more like natural breast tissue than breast implants.
Tissue flap procedures can also have some potential downsides that need to be considered: In general, flaps require more surgery and a longer recovery than breast implant procedures. Flap operations leave 2 surgical sites and scars – one where the tissue was taken from (the donor site) and one on the reconstructed breast. The scars fade over time, but never go away completely.
Reconstructing the Nipple and Areola After Breast Surgery：When treating breast cancer with a mastectomy, the nipple is typically removed along with the rest of the breast. The patient can decide if she wants to have the nipple and the dark area around the nipple (areola) reconstructed through surgery or tattooing, or both. The nipple and areola are usually the final phases of breast reconstruction. It can be done as an outpatient procedure. It's usually done about 3 to 4 months after surgery after the new breast has had time to heal.[Read More...]
APEX FlapSM Breast Reconstruction
The APEX FlapSM breast reconstruction is a highly sophisticated microsurgical technique. A DIEP Flap, excess living fat from below the belly button is transplanted to the chest to restore volume and shape. The APEX FlapSM differs from an ordinary DIEP however, as it allows for the natural anatomy and blood vessels to be rearranged to perfectly preserve the abdominal muscles and improve blood flow to the tissue transplant when necessary. This technique is an advancement over the DIEP procedure and has very specific indications and benefits.
Like the DIEP procedure, the APEX FlapSM technique affords the recreation of the breast with soft, warm, living fat that is permanent and doesn’t require maintenance over time. For women who’ve undergone a mastectomy in the past, the APEX FlapSM procedure also allows for the avoidance of tissue expanders.
Women who undergo APEX FlapSM breast reconstruction benefit from improved abdominal shape, much like a “tummy tuck.” Using fat from unwanted areas of excess produces a flatter, tighter abdomen as a nice compliment to the newly reconstructed breast and the APEX FlapSM allows the abdominal incision to be kept lower in the bikini line than conventional DIEP procedures.
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Breast Reconstruction Post-Surgical Care
The supportive care for breast reconstruction in our clinic is formulated according to the type of operation selected by each patient. Generally, the following will be taken into consideration:
- The effect of operation type and acupuncture points: the breast implant surgery mainly uses scalp and ear acupuncture; the needle is not supposed to insert around the breast area so as to avoid damaging the implant. "Flap" reconstruction requires a fine facial needling technique around the breast tissue, which can increase the blood supply of the implanted tissue and promote the regeneration of blood vessels and nerves.
- Because of the load bearing and plica, the scar under the breast might absorb and recover slowly. In summer, because of sweating, some patients will have some rash. We will apply acupuncture and external application of herbs or essential oil 3 weeks after operation to relieve symptoms and promote scar absorption.
- Immediate postoperative breast reconstruction is started two times a week from the first week after operation. The main purpose is to promote the lymphatic reflux, detumescence and inflammation, and reduce the postoperative side effects of anesthetics. Because of the tissue damage at the surgical site and the implantation of fillers, these patients will have traction pain in the shoulder and back, so the essential oil massage and massage on the upper back is one of our main treatment plans.
- The follow-up breast reconstruction actually involves two operations. After the first mastectomy, because of the built-in drainage tube and tissue expander, the patient's chest and back have chest tightness, stretching pain, acupuncture and massage can effectively relieve these symptoms. Generally, the acupuncture site is in the upper back, and the best acupuncture time is the second day after the tissue expansion once a week. The second day after the expander was removed and the permanent breast prosthesis was placed in the second outpatient surgery, the acupuncture treatment plan was to reduce edema and pain, prevent infection and promote postoperative recovery. The patients who chose "flap" breast reconstruction actually allowed to have two incisions to the body. This obvious physical consumption needs to be considered about the whole body condition in the post-surgery care plan. Traditional Chinese medicine attaches great importance to promoting blood circulation and removing stasis, diuresis and detumescence, and also uses appropriate herbal decoction or diet therapy to replenish qi and tonify deficiency. The common use herbs are: San Qi, Huang Qi, Lin Zhi, Fu Ling, Chen Pi, Yiyi Ren, etc. Acupuncture around the breast area can promote the regeneration of blood vessels and nerves. Acupuncture the area where the "flap" donated can promote wound repair and prevent the atrophy of local soft tissue. Some patients choose "skin flap" breast reconstruction surgery might consider a benefit of simultaneous aesthetic effect on breast and belly. Our clinic provides acupuncture and massage therapy once or twice a month, which can maintain the effect of body shaping by natural and effective methods.
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