KristinWisgirda: April 29, 2019, 12:21am
Hi Everyone,
This morning a patient came in with disabling exhaustion, sorethroat , tickling in her nose and constant hunger. The
first 3 symptoms started when the warming coil on her CPAP machine stopped working so that the machine was
blowing cooler than normal air all night. Her face looked gray and her body appeared pressed down.
I supplemented the Lung on the left and her color and throat improved. But the gnawing hunger persisted. I
checked the position of H8- it had shifted and was pointing with the flow of the channel. I corrected it and threaded
it so it couldn’t shift again. The patient reported that her hunger was reduced by 75%. When she got off the table
she looked much more lively and her sorethroat was gone.
This was a good reminder that all 4 points need to be meticulously needled with a clear direction. Such experiences
make me confident threading hand and jing well points. Temporary needle discomfort is a small price to pay for
great clinical results.
michaelmax: April 10, 2019, 3:33pm
Hey @KristinWisgirda thanks for this.
I too have found that needle placement is critical. Prior to using Saam I did not really put much credence into
directions of needles, as long as I got qi I thought that was enough.
It changed for me when I accidentally put needle in the wrong way on a 4 needle treatment to tonify the ST. The
patient kind of settled… a little… but not enough for me to feel comfortable. As I was thinking of what to do next I
noticed that ST41 was pointing the wrong way.
I took out, replanted it, and the patients gives this long sigh and closes her eyes.
It really can be that obvious!
Your reminder here to thread that needle so it stays going the direction you want it to is really helpful.
2 Likes26/01/2024, 12:35A lesson in needle placement – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/a-lesson-in-needle-placement/71/print2/4
Adina_Kletzel: April 12, 2019, 2:10pm
HI,
I am not familiar with the term ‘threading a needle’. Is that just making sure that the needle is either going with the
channel or against the channel or is there something else to it?
THanks!
KristinWisgirda: April 12, 2019, 2:38pm
Hi Adina,
By threading the needle mean that the needle is going in a clear direction and is securely in the tissue so that there
is no chance that it will budge.
Toby demonstrated needling in person and on slides in Seattle in January. The needles were at acute angles either
with or against the flow of the channel. He said he often used 1.5 inch needles on points like K10 and Liv8 and
sunk them almost to the hilt with such an acute angle that the needle handle is really close to the skin. A strong
message to the channel!
When Toby mention that his teacher threaded and bound tissue in well points, I squirmed! But seeing that, with
jing well points, the needles could change direction with fine needles that weren’t firmly sunk, I started threading
them. First I treated myself, a sensitive patient, and found that sensation wasn’t as strong as I thought it would be. I
have even been playing with binding tissue on wells on myself- brief intense sensation.
I’m getting a sense that when the needles are right and the practitioner is confident that even the most sensitive
patient can tolerate more stimulation.
I hope this helps.
Donley: April 13, 2019, 4:01am
Kwisgirda,
Your explanation was great, but when you mentioned ‘binding tissue’ I became confused. I’ve not heard of binding
before. Could you explain this as well?
Thank you!
KristinWisgirda: April 13, 2019, 9:27am
Hi Donley,
Binding tissue is when tissue get caught up with the needle so that when you try to move the needle there is
resistance. This happens with thicker needles when you are rotating the needle. I haven’t been able to get this to26/01/2024, 12:35A lesson in needle placement – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/a-lesson-in-needle-placement/71/print3/4
happen with thinner needles much at all.
To remove a bound needle, you may need to rotate the needle in the opposite direction of initial stimulation to
unwind it from the binding.
Toby has mentioned multiple times that his teacher would often bind tissue.
Donley: April 13, 2019, 1:22pm
Ah yes! of course! In school we were taught this for Sp Qi sinking among others.
Thanks for the clarification!
michaelmax: April 14, 2019, 1:20am
KristinWisgirda:
Binding tissue is when tissue get caught up with the needle so that when you try to move the needle there is
resistance.
@Donley, Perhaps I’m being too crude here… but it seems to me that Toby basically screws the needles in.
He twists them either tonify or sedate depending on the channel and direction. The “binding” is getting the threads
of connective tissue to wrap around the needle.
As the practitioner you will feel this happen when you twist the needle. It’s actually a satisfying feeling when you
know you’ve got it.
ngmatthews: October 4, 2021, 5:15pm
When I was in school, back in the dark ages, it was our goal often to wrap fibers around the needle while twirling.
That was the traditional Chinese needling method described in our one book. I believe it is still prevalent today in
certain schools of practitioners. The Japanese techniques of tonification and sedation by needle direction along the
channel, but without twirling have become so prevalent in the US that I think we have forgotten some of those
older Chinese ideas on needling.
What I’ve found in using the Saam system, is that the Seirin needles, even the largest two gages, purple and brown,
that I always use in Saam treatments, do not tend to catch a fiber to wrap. They do not get stuck in the tissue easily.
This seems to be because of the very smooth surface of the steel. I do remember that with other more traditional
Chinese brands, like Carbo, I was able to wrap fibers and might have a needle “stick” in the tissue. So I am
considering going back to a “less smooth” needle.26/01/2024, 12:35A lesson in needle placement – Sa’am Clinical Questions – Qiological Community
https://forum.qiological.com/t/a-lesson-in-needle-placement/71/print4/4
However, despite this, I am twirling, and I use very acute angles in needling, like 15 degrees. I seem to be getting
good results, but there is always room for improvement.
ngmatthews: October 4, 2021, 5:15pm
I have also had a needle in H8 “change direction”. I think it is when the patient relaxes their palm and everything
shifts. It seems a bit painful to thread the needle at H8, but it really does help prevent this from happening.
This also reminds me that it is always good to check needles one last time before leaving the room, to be sure they
are correct.
Sometimes when a patient is speaking to me in an animated way, or talking about something intense, I’ll forget
whether to sedate or tonify a point. More than one time I have found that I needled in the wrong direction because
of being distracted. Even by my own talking. So I’ve taken to writing out the treatment and placing the paper on
the patient’s lap or somewhere on the table so I can be sure I am doing everything correctly. I don’t think I’ll have
to do this for ever, but for points like SI 5 which we do in either direction fairly often, it has been helpful to me.
Now that I think of it, yesterday I needled GB 43 instead of GB 44 on someone who was talking about their son’s
suicide and family activities at Easter. I was so distracted that I forgot the correct number/location of the point.
Even after 27 years of doing this medicine, I can get momentarily confused…
michaelmax: April 25, 2019, 3:10am
ngmatthews:
This also reminds me that it is always good to check needles one last time before leaving the room, to be sure
they are correct.
I’ll second that. I’m getting better with correct placement, but this morning I came back in the room and thought
“the needles in this guy’s foot look funny” and then realized I’d dispersed his GB41 instead of tonifying it.
I’ve had other situations were I caught it sooner. The pulse was not quite settled or something felt “off.” And then
I’d see I the direction on the needle was incorrect. More than once I’ve pulled the needle out, replanted it in the
proper direction and then hear a deep sigh from the patient.
Direction does make a difference.