Jeff Rippey

What's going to help with chronic knee pain is going to depend heavily on what's causing the chronic knee pain. Is this a ligament strain? Tendon or muscle sprain or tear? Meniscus issue? Cartilage loss/osteo-arthritis? Residual pain from previous surgery?

Chronic pain rarely "just happens". There's a history to what's going on, and without that information there's not a lot I can offer in terms of potential solutions.

If you haven't done so already, get with your primary care provider and at least get an x-ray. We won't be able to see soft tissue on an x-ray, but sometimes we can make educated inferences based on what we can see. Knowing what's going on in the joint will help figure out the best course of treatment.

The problem with primary hypertension is: no one knows what causes it. Since we don't know the cause, it's hard to say whether or not it can be treated with dietary change or what kind of dietary change might be necessary.

You could try eating magnesium rich foods or adding a magnesium supplement to see if that brings your blood pressure down enough.

Chinese medicine and acupuncture have a pretty good track record with hypertension. In the Chinese system, there are multiple different potential causes so you'd need to see someone who understands that and knows how to differentiate the diagnosis to get you the most effective treatment. In other words, a chiropractor or a physical therapist are likely not going to be much help. You need someone who attended and graduated from a school of Chinese medicine and is licensed as an acupuncturist.

What is qi? What about the wisdom tooth removal process would lead you to believe yours is "out of balance"?

Most modern western interpretations of the Chinese character we pronounce as "qi" are fundamentally flawed/inaccurate. It's a term/idea/understanding that we probably should have adopted rather than attempted to translate.

That being said, if you're not experiencing any residual pain and there's no infection at the removal site, there's little call to do anything from a treatment perspective.

A lot is going to depend on where, exactly, in the knee you're experiencing the pain and what, exactly, is the cause of the pain. If this is something like osteoarthritis and you're already at the point where the cartilage is gone and you're bone on bone in that joint, acupuncture can manage the pain to a degree, but it's probably never going away.

Your first stop should be your primary care provider for at least an x-ray of the joint. Having some understanding of what the problem is will help to level set expectations about possible treatment outcomes.

Allergy to what? How severe? How long have you experienced the symptoms? What symptoms do you experience?

If this is something along the lines of seasonal allergies, acupuncture and Chinese medicine can often help. In time, seasonal allergy can often be reduced to the point that it's not a major life event. I used acupuncture and herbal medicine to manage my seasonal allergy and it took 2 years to get them to the point that I don't notice the season change.

If this is a food allergy, acupuncture can still help. For a time you will need to avoid the food item or items that are causing the issue.

If this is some other allergic type reaction, I'd need a lot more information.

Yes, acupuncture would certainly be on the table as a way to manage the pain and discomfort associated with carpal tunnel. I have quite a few carpal tunnel patients that I work with, most of them do quite well with acupuncture.

If you think you are pregnant and may be having a miscarriage, please go straight to the nearest emergency room.

Your images could be clotted blood, could be pieces of placenta.

I've been studying and practicing acupuncture for 20+ years myself. In that time, I've had one patient who had an allergy to surgical stainless steel. The needles weren't painful for her, but after treatment she would have large, red welts around the needle locations which took 2-3 days to resolve.

I have a few guesses here:

1. Your patient has a severe allergy to surgical stainless steel.

2. Your patient has been in chronic pain long enough that he has become centrally sensitized and his brain is now interpreting most signals as pain signals.

3. The acupuncturist is needling too deeply and/or has one track they use to treat issues like this and can't think outside the box enough to come up with another way that fits this patient better.

As far as the herbs go - it's very easy to miss on a Chinese diagnosis and get the wrong herbal formula. Most folks see "inflammation", think "heat" and go for heat clearing herbs. Sometimes this is the case, and sometimes it's a lot more complicated than that.

I'd have to see/evaluate the patient to give any more/better advice in this case. My best suggestion would be to see if you can find an acupuncturist who practices either Tung/Tan or has more of an ortho/sports medicine focus. You need someone who can either treat the painful area without needling in the painful area or someone who can address specific structure in the painful area with a high degree of accuracy. Unfortunately, most acupuncturists practice so-called "TCM" acupuncture and this leaves them limited when local needles either don't solve the problem, cause more problems, or both.

Any of the various prescription and over the counter antihistamines would likely help. Be aware that most of these medications can possibly cause drowsiness.

A lot is going to depend on why you have fatty liver (alcoholic fatty liver/cirrhosis vs non-alcoholic fatty liver disease), how well you can manage the causal factors (diet and alcohol intake), and how progressed the problem is.

The liver is unique among organs in that, if enough of it is healthy, it can regenerate to a degree. I've worked with several NAFLD (non-alcoholic fatty liver disease) patients and, assuming we can get the diet under control, there is almost always some progress that can be made. A complete fix, in certain circumstances, is unrealistic.

If the sprain is not so severe that you can't tolerate weight on that side, yes, sometimes exercises can help speed things up.

There are potentially several things that might work:

1. Over the counter anti-nausea pills like Dramamine can help if the nausea isn't too severe. Dramamine can cause drowsiness, so keep that in mind.

2. Prescription anti-nausea like meclizine or scopolamine can also be effective. Some of these medications also have a tendency to cause drowsiness.

3. Acupuncture has a pretty good track record managing nausea. You'd want to try to get a treatment immediately before flying which is sometimes impractical.

4. Most pharmacies in the US sell a product called "Sea Bands". These go on the wrists and look like the old 70s-80s sweat bands. They have a small plastic protrusion on the inside that places pressure on a wrist point often used in acupuncture for the treatment of nausea. For some folks this is enough to get them through their trip.

If you have an infection, antibiotics are your best bet.

Sometimes, yes. I do a lot of work with insomnia and my experience has been that some patients have their sleep issues resolved in a few treatments while other patients have their sleep issues improved but require maintenance to keep the improvement.

The only way to figure out which bucket you're in (resolution vs maintenance) is to try treatment and see where you end up.

There are a least a couple ways to come at this. Are you a person who has some level of anxiety in your day to day and flying increases what's already a baseline level of daily anxiousness? Or are you a person who is relatively calm day to day and only experiences anxiety with air travel?

If you have day-to-day anxiety, getting treatment for that will lower your overall anxiety levels and should result in lowered anxiety around flying. Therapy, Chinese medicine, conventional prescription medication can all help to improve this situation.

If you are relatively anxiety free except when flying then you're probably looking at some combination of therapy and conventional prescription meds to manage things when you need to travel by air.

Sometimes, yes. A lot is going to depend on how disciplined you can be and what other health issues may create roadblocks.

The first thing I'd do is get with your primary care provider and get a full workup. At the same time you should get their opinion on exercise - whether or not you'd be clear to engage in some level of activity.

The next thing you need to do is adjust your diet. More than half of any weight loss is going to be diet driven - it is virtually impossible to out exercise a poor eating plan.

Different people do better or worse on different eating plans. There are a variety of ways you can approach this: vegetarian/vegan, keto, paleo, mediterranean, intermittent fasting. You're going to need to research these and try a few in order to see what works best for you and your situation. When I say try, I mean you're going to need to be serious about that eating style for at least 90 days.

There are meds on the market which can help. The GLP-1 receptor agonists (ozempic, trulicity, etc.) have been shown to help people eat less and lose weight. These meds have potential side-effects and it would be up to your primary care provider to decide whether or not they're appropriate for you.

If you're clear for exercise, start exercising. Walking, even short distances, consistently will help. Any sort of weight-bearing exercise will help to build muscle which will increase your overall metabolic rate. Look for low impact initially and ramp things up as the weight starts to come off.

Many people who struggle with weight have issues around food. Sometimes they grew up in a food insecure environment, sometimes they use food as a band-aid for other psychological injuries. Getting some therapy is often very beneficial for understanding why a person has certain behaviors around food, and therapy can help to change those behaviors.

Here's, at least in my opinion, the most important thing: you are going to fail and you're going to backslide. You have to be able to pick yourself up, realize what you were doing wasn't working, and try again. Obesity isn't going to be corrected in a few months; it's likely going to take you a year or two to get the weight off in a healthy way.

Severity of the anxiety/depression is often a player in what treatments might be effective. Usually it boils down to some combination of therapy, Chinese medicine, prescription medication.

I generally recommend most folks start with therapy and Chinese medicine. If that's not providing enough relief, then adding prescription medications is often necessary.

Without knowing the level of severity, it's hard to say. Chinese medicine has treatments for hemorrhoids. My experience is that these treatments are very effective for mild to moderate cases. If your situation is different, you may need to add some level of conventional medicine - either prescription medication or a procedure for removing the distended veins.

Sometimes, yes, chronic headache can be resolved. There are a variety of things that could potentially cause headache. Some of these things can be serious and/or require immediate intervention. Your first stop should be your primary care provider and, possibly, a neurologist - just to make sure.

After that, you have a variety of options.

Lifestyle can be a player in headache - repetitive motions, high stress situations, exposure to chemicals can all potentially cause chronic headache. Reducing/managing/eliminating these causes can sometimes have a big effect on headache.

Massage can help, especially if the headache is stress based.

Physical therapy can help if the headache is related to posture or repetitive motion.

Acupuncture and Chinese medicine can help with just about any headache cause.

Prescription medication can help.

There can be serious health consequences to going without sleep for extended periods or experiencing very poor sleep for extended periods.

There are a variety of potential treatments. Lifestyle and "sleep hygiene" changes, over the counter sleep aids, prescription sleep aids, acupuncture and Chinese medicine, or some combination of all the above.