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The legs

Part 1 – the Sclerosa Highway

Arty chuckled a bit, and dopishly pointed to Sclerosa with his thumb ,”she’s the one whose really  got the veins,doc, check these out,” he said crassly but before he could get at Sclerosa, she pulled away.

“It’s okay, I don’t have to see them,” Emily said soothingly, as Sclerosa was giving Arty the evil-eye, “It really works the same way, it’s just that the condition is more superficial, and less serious. Arty, a DVT is a more serious issue than something like superficial thrombophlebitis or variscose veins.”

“Why is it different?”
“Well, for one thing her varicose veins are not necessarily indicative of coronary heart disease.”
“But…” Emily said, “Sclerosa, do you have any major health issues?”
“She’s got all kinds of issues,” Arty blabbed.
Sclerosa nodded. “I have Fibro[myalgia] and a heart murmur, and RA. (rheumatoid arthritis)”
Emily nodded. “OK, see then I am less worried that it is purely stuck blood, and instead it could be a heat process…”
She started taking the pulse.
“Beggin’ your pardon, doc, but what do you mean? We really don’t understand…”

“Arty, Chinese Medicine (TCM) is very different in many ways in its approach to health from western medicine. We like labs and diagnostic tools, but we rely primarily upon signs, symptoms, tongue, pulse, odors, palpation, and questioning the patient to really diagnose them. You see in our medicine anything that comes home to roost and stays within the body too long is a pathogen. We have food and water pathogens, emotions can be a pathogen, and also things like temperatures, humidity, and stasis – where things aren’t moving. In Sclerosa’s case, it seems likely from the pulse that the blood stasis formed as a result of an internal heat process slowly cooking her blood. This is opposed to your poor diet and lifestyle, and functional stasis leading to internal blood issues. See, in her, the blood stasis is superficial because heat comes to the surface.”

“Which is more dangerous?”
“It depends on the person, and the day, but in your case your own condition is far more serious. But that doesn’t mean she should live with this. Because if the blood is stuck outside long enough, it’s a safe bet it will get stuck inside.”
“What can you do?”
“External blood stasis is dealt with with herbs and cupping-bleeding. Unfortunately, our malpractice does not permit cupping-bleeding. But if you come to one of my classes, you can learn the technique yourself to do at home.”
“Wow… sounds scary.”
“It’s not really, and it’s very educational. With large varicose veins, though, you have to be careful because you can’t just rupture them. You would need to get laser treatment. But if they are small enough you can slowly withdraw the stasis and not bleed too much.”

Part 2 – Arty’s knees

“Now Arty, don’t think you can forever keep the discussion off of your knees. You know they are a big pain for you,” Sclerosa chided him.
“Tell me about it,” Emily directed.

Arty found himself suddenly wishing he’d kept his big mouth shut. “Well…” he thought, “they really ache on the inside of the leg, right here, he said pointing to the medial surface, and also like… deep inside the joint. Almost burning. Sometimes it just feels good to sit and take a load off, until my back aches too much, then I have to get up and walk around again.”

Emily ran a series of physical exams to test the stability of the knee, its different ligaments, and she percussed it to elicit pain.
At the end she said, “OK. This is pretty easy to explain, but not so much to treat. First of all, the inside hurts because for years and years you have had splayed feet twisting the ligaments and channels that run through this area, call the Pes Anserine, and it’s stretched out and inflamed. This means that you’re not able to heal properly. If you can fix your gait, you should be OK.
“However, the problem inside your knee is more complex. Now you remember how the knee cap, called the patella, was tracking off to the side? That’s because your VMO, which is inside the leg is weak and not pulling correctly. Over time, and from repetitive movement, this and your standing at work has worn down the cartilage inside the knee. Normally this wouldn’t be a big deal but it’s affecting the joint capsule, and because the capsule has low blood flow, it gets inflamed and is hard to reduce. Also, using too much ice is a real issue there.”
“But it hurts, what else can I use?”
“For one thing, you can get some balm, like a custom ICE balm, or a tiger-balm and rub it where it hurts. Secondly you can get a custom herbal liniment and use it to wash your knee and get rid of inflammation rather than just slowing blood flow to the area. At first that works great, but then it may actually start causing problems as the lack of blood flow fails to repair the area or keep it warm enough for activity.”
Arty looked surprised. “What about the knee cap?”
“Your patella can come back to center, not easily, but with a concentrated effort to exercise the VMO and relax the TFL/IT Band. For that I can recommend a good physical therapist or personal trainer to guide you through the restoration process. Probably should anyways for what is to come later.”

Part 3 – Sciatica Schmiatica

“Now we get to your major issues – your hip and radicular pain in the legs. Let me see something,” Emily said, and then performed more exams and measurements, then pressed on his butt, “Does this hurt?”
She smiled.
“What’s that mean?” Sclerosa asked.
“You don’t have Sciatica. You have bursitis and tight hip extensor muscles due to atrophy.”
“What? What do you mean?”
“Arty, sciatica is a specific condition caused by the nerve – in rare cases – going through the glute medius muscle and getting pinched. Your pains are not occurring when we press the nerve and besides, they are caused by atrophy, not spasm.”
“Well how do you know?”

“It’s a TCM concept. In our medicine, everything can be excess or deficient, and in your case it’s deficient. Sure you have microspasms, in the few muscle spindles left operating at capacity. But the majority are actually malnourished because of the Girdle Vessel being weak and mineral malabsorption. That last bit might have to do with diabetes or with your kidney and prostate issues, but either way you’re not getting enough minerals to relax the muscle.”

“Well I’ll be… no wonder why the chiro and massage stopped working after a few months.”
“Right… they go rid of your work-related spasms, fine… and your vertebra and hips keep getting thrown out of place by the muscles being out of shape… but really what you need is a stronger CORE and a good diet program. Interestingly enough the pancreas belongs in our medicine to the Earth Element, which also controls and nourishes muscles (glucose related). So when the Earth got weak, so did the muscles.”
“Son-of-a-gun,” he said looking at his inner thighs which were a bit flabby and pale, and dry.
“Yes, and worse than that, you have a  lot of reflective problems from the back, meaning that your imbalances translate down the spine into the hips and up from the feet to the socket joint and that is why your hip pain is pronounced. Your hips are like a series of pullies, and yours have had to adjust for a long time. Your PT should be able to help you rebuild these groups, meanwhile we can keep them relaxed as you go through the rebuilding process and also we can keep the tension manageable and reduce the inflammation of the bursa.”

“What’s a bursa?”

“A bursa is a fluid filled sac that protects the bones from the wear and tear of passing muscle. or tendon. In your case, the tension of the muscle has forced the bursa to work harder, and they don’t get much bloodflow, so the inflammation has increased. Once the channel is unlocked, the bursitis should disappear.”
“Well that sounds nice. Not too bad.”
“That’s true, it’s nothing compared to what we’re about to talk about…”
Arty got a concerned look on his face, as he knew they were about to talk about his back and hips.
End of Issue 3

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