It’s your first time–you’re going to a Traditional Chinese Medicine doctor. Everyone’s been raving about their success with acupuncture or how much they love their TCM doctor, and that nagging problem just isn’t getting better even with the advice of your GP, so you give in.  You’ve made the appointment, but then you start to get nervous. What really happens in there?

Initial Impressions

It will likely be a calm, serene setting, with quiet, peaceful music playing. You should take this time to relax, calm your breathing, and drop some of the stress. The decor may be similar to a average doctor’s office or it may be more like a spa. You will have to answer standard questions about your medical history and insurance. Nothing out of the ordinary so far.

Diagnosis

When you first meet with the doctor, they will ask you to stick out your tongue.  This is one of the key diagnostic methods in TCM. He or she will also lay three fingers on your wrists, maybe one or both. No, she is not checking your pulse rate, she is checking you pulse according to TCM diagnostics: heart, liver, lung, spleen, and kidneys.

She will usually ask you about (1) feeling hot/cold or any sweating, (2) locations of pain or discomfort, (3) appetite and thirst, (4) bowel movements-frequency, consistency, irregular or not, (5) menstruation for women, (6) personal medical history and illness history, (7) possible reasons/sources for your complaints, and (8) work/stress level. Don’t be embarrassed, this is what she’s needs to know to help you. It is important that at this time you tell the doctor your 1-2 biggest complaints.

You may not notice but she is also looking at your face, especially the eyes, noticing your breathing, pace and rhythm of your speech, and mannerisms. She is also checking for any distinctive or overwhelming odors. Don’t try to hide or change any of this, it will lead to mis-diagnosis.

Ideally you should not see the TCM doctor immediately after eating, when you are terribly hungry, or when you are in a rush; these can all affect a proper diagnosis.

TreatmentTCM Treatment

If not already, you will be led to the treatment room where you will sit or lie down on a medical bed or massage table.  The doctor will normally discuss the treatment with you at this point and then using any or a combination of these: (a) acupuncture, (b) moxibustion (burning herbs), (c) cupping, (d) scraping, (e) massage, (f) topical herbs, or (g) herbs to be taken orally. In most cases, though it depends on your condition, it’ll be acupuncture. During the typically 20-40minute session you are encouraged to relax as much as possible and perhaps even fall asleep. Unless otherwise directed, don’t move.

Acupuncture

For acupuncture, first the doctor will use alcohol to clean the selected areas. Then he will retrieve sterile, one-time use, individually-wrapped needles. Some doctors prefer to use a small plastic tube as a guide for quick insertion, while others will just use their finger to steadily insert the needle.  You may initially feel a pinch when the needle goes in, but it won’t really hurt (unless you expect it to). Then the doctor may do some needling techniques such as thrusting the needle in farther, flicking it, or scraping it.

You may have a strange sensations or feel like the needle is tickling your muscle from the inside.  You can let the doctor know you have this feeling–it guides his work.  Normally a soreness or distinct feeling on the needling point is a good sign. You may have the sense that electricity is pulsing through your body connecting the points, or you may feel the blood is flowing smoother or you’re getting warmer.  These all indicate that the meridians are opening up and Qi is moving.  This is a good thing.

He may hook up the needles to a small machine which mildly stimulates the point. It may cause your muscle to flicker or mini spasm a bit.  If this is too uncomfortable, ask him to reduce the stimulation. Otherwise just relax (or even sleep) until its time to remove the needles. Removing the needles is usually super simple and pain free; the assistant often does it instead of the doctor. You may bleed a tiny bit, but this is rare, and nothing to worry about. It usually means you moved too much during your treatment.

For explanation of the other treatments, click the links above.

Wrapping Up

If you had any strong reactions during the treatment, mention them now. After your treatment, the doctor may discuss your diet with you or suggest taking a course of herbs at home for a few days to a few weeks. Follow the instructions, but don’t panic about exactness and perfection. Some forms of herbs, such as liquid, granules, etc you may be prescribed are discussed in this post: TCM Herbal Medicine: Multiple Forms.

Finalize payment or insurance details. Schedule your next appointment, which is typically 4 to 14 days later.

For many people, a visit to the TCM doctor is more like going to the spa than a visit to the doctor as it can be very soothing. For me, one of the places I felt most calm and relaxed when living in Shanghai was at my TCM doctor’s.

I hope this eased any anxiety you may have before going to an acupuncturist. If you have any questions, post them below and I’ll respond. Or if you had a different experience, let us know in the comments below.

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