Compiled by Kathryn Ann Caudell, Ph.D., R.N., A.O.C.N., Assistant
Professor, The University of New Mexico College of Nursing
Two patients from Dr. Sollins’ internal medicine practice entered a Bridges In Medicine™ T.E.A.M.
protocol in 1997. Each T.E.A.M. protocol lasted for two months. One patient suffered from fibromyalgia;
the other from chronic sinusitis.
- FIBROMYALGIA T.E.A.M. CASE STUDY
- History and Background :
M.N. was a 48-year-old female with a 13-year history of fatigue, neck pain, and lack of energy.
Her current medical history was significant for fibromyalgia, headaches, fatigue, insomnia,
hypertension, chronic constipation, and neck and upper back pain with stiffness. Her current
medications included Amitriptyline for sleep, Lotensin for hypertension, Kava Kava for sleep,
Ginko Biloba, Accutane, Fiorinal for headaches, a multiple vitamin, and calcium. Due to her low
energy levels, she was unable to exercise regularly on her aerobic rider, hiking, skiing or biking.
She required ten hours of sleep daily, including naps. Her presenting complaints were lack of
energy, waking up exhausted daily, difficulty sleeping, frequent dull headaches, and pain in the
C-7 to T-1 area and neck between the scapulae, both of which were rated on a scale of 1-10 as 10
and 9, respectively (0 being pain-free).
M.N. recalls first not having energy in the fourth grade. Her mother was reportedly an overachiever
and expected her daughter to continue activities despite low energy levels. M.N. reports
having an unhappy childhood. The fibromyalgia onset occurred around age 35, during a time of
intense personal stress caused by multiple family situations. She felt pulled in all directions and
had to depend solely on herself for support. M.N. also reported having been treated for anxiety in
- Treatment :
The T.E.A.M. for M.N. consisted of a rheumatologist M.D., a Doctor of Oriental Medicine
(D.O.M.), a licensed social worker, a yoga instructor, and a physical therapist and Feldenkrais
practitioner. After being evaluated by the rheumatologist, and a group T.E.A.M. consultation, the
alternative practitioners began to treat M.N.
Treatment Outcomes :
- The D.O.M.’s examination revealed wiry, tight pulses of 64. The tongue appeared swollen
and quivering with slight deviation to the left. The center of the tongue was peeled. The body
was pale and covered with red rough bumps and a light white coating. The right shoulder and
scapula were slightly dropped and a trigger points was noted in the trapezius with a strain
and pull on the muscles in the neck.
The pulse characteristics manifest in her system as one who represses emotions, a tendency
for anger or, as in M.N.’s case, depression. The pale tongue demonstrated that blood
was not nourishing the ligaments, tendons and muscles, thereby becoming dry and light. The
quiver in her tongue was due to her very weak chi, which is frequently observed in chronic
fatigue and fibromyalgia patients. The swollen tongue indicated a spleen chi deficiency. The
dry tongue was due to a deficiency of fluid in the body, while the pale color of the tongue
was secondary to a blood deficiency, which was also noted as the reason for her sleep disturbances.
The treatment recommended by the D.O.M. was acupuncture twice a week to
build the chi, smooth the liver energy, build and move blood, and relax the muscles. The
patient was also advised to avoid sugar, dairy, wheat, and preservatives.
The licensed social worker saw M.N. five times in two months for psychotherapy. M.N.
initially presented as anxious, depressed, and fearful. She had protected her family from her
health problems and discomfort which eventually led to an increased sense of loneliness and
helplessness. During therapy she explored a theme of self care versus self exploitation, a
feeling that she frequently felt during her childhood. The goals for self care included diet,
exercise, self esteem, visualization, rest, and setting limits and boundaries with her husband
and sons. M.N. was also encouraged to allow more emotional expression.
The Feldenkrais practitioner’s goals were to help M.N. become aware of her patterns of organization
in her life and her physical movement to guide her development of an enjoyable
and sustainable movement program. M.N.’s patterns of organizing included frequent holding
of her breath while being engaged in activities. Since exhaustion was a major complaint, this
breath pattern could have contributed to her low energy levels. M.N. also braced her chest
and neck when reaching from a sitting posture, moving forward to reach while the chest was
moving backward. This reach-while-pulling pattern requires increased energy expenditure.
Both the breath holding and the chest bracing make it difficult to find neutrality while in
action. M.N.’s postural habits while sitting and standing also greatly contributed to her neck
and shoulder discomfort. Her center of gravity while sitting fell behind her pelvis causing her
pelvis to roll backward, thereby creating a “C” curve in her spine that places her head
forward. This led to the neck and shoulder muscles working overtime to carry the weight of
the head. M.N. also over-isolated her neck when sitting and turning, and when looking up
and down, all of which led to additional muscular stress.
The Feldenkrais practitioner recommended restorative yoga, Feldenkrais hands-on and
movement lessons, and aerobic activity. While supporting the body, the restorative yoga
leads to a passive release of tension. While learning yoga, M.N. was also instructed in
breathing techniques for increasing energy and relaxation. Both the breath work and the
restorative yoga were given as meditation techniques to quiet the mind. In addition, M.N.’s
exercise program consisted of biking or walking for twenty minutes, three times a week.
The certified yoga practitioner discovered that M.N. had experienced long-term stress, which
results in subsequent, chronic “holding” patterns of muscular stiffness. The primary areas in
which M.N. was affected included loss of muscle tone in the arms and legs, tightness in the
hips and shoulders, and a gripping in the diaphragm and intercostals. To begin releasing the
tightness in the hips and shoulder, M.N. was instructed in a variety of ways to support passively
the body to allow an effortless release of tension. Non-supported postures such as
standing were also used to begin restoring muscle tone. Various props were used to help ensure
accurate alignment so that her energy could move in a balanced way.
M.N. responded very favorably to her integrated treatment approach. At the completion of two
months, she no longer required afternoon naps. She was beginning to sleep through the night and
awoke more easily and feeling more refreshed. Her activity level increased considerably and she
was able to maintain increased aerobic exercise. She also gained a keen awareness of how she
organizes herself in her movements. She was more sensitive to when she needed to stop and rest,
and how she should pace her activities. She also has participated in activities that are joyful and
fulfilling, which has contributed to feeling less depressed. Five months after treatment, M.N.
continued to maintain her increased activity level, biking for several miles an hour at a time. Her
discomfort and pain is considerably less, rated as a ˝ and 1 on a scale of 1 to 10 (0 being painfree).
Her appearance was more relaxed and animated. Dr. Sollins saw M.N. six months after the
conclusion of the T.E.A.M. protocol. Although personal stress was increased secondary to an
anticipated move out of the state, she continued to manage her pain and maintain a more active
and energetic lifestyle with continued positive emotional stability.
SINUS INFECTIONS AND SINUSITIS T.E.A.M. CASE STUDY
- History and Background :
J.H. was a 48-year-old male who presented with a 35-year history of chronic intermittent sinus
infections and sinusitis. Related surgical history included a tonsillectomy, a nasal polypectomy,
and a submucous resection. J.H. had allergy skin testing while in college and received injections
with no improvement. He had no hayfever-type symptoms, and never wheezes or is short of
breath. He experienced sinus infections intermittently during adulthood, which became more
frequent and severe since 1995–96. A CT scan of the paranasal sinuses revealed a whitened area
at the base of the lower frontal sinuses bilaterally, indicating that this may be residue from prior
infections and could provide the proper environment for future infections. Additional history
includes two broken metacarpals, kidney stone extractions, and alcohol treatment.
J.H. is a corporate executive, a high-stress position. For stress relief, he exercises strenuously
for 50–75 minutes three to five times per week. He is married and has two children.
- Treatment :
J.H.’s treatment T.E.A.M. consisted of an internal medicine M.D., a D.O.M., a nutritionist, a
Healing Touch practitioner, an allergist M.D., and a chiropractor.
Treatment Outcomes :
The D.O.M.’s treatment plan was to balance J.H.’s body, mind, spirit and emotions, to
disburse the chi stagnation, to clear heat, and reduce phlegm. The D.O.M. used acupuncture
needles, tuina massage, moxibustion, herbal therapy, diet therapy, cupping, and auricular
The allergist M.D. performed skin testing and pulmonary function testing (PFT). The PFT
was normal. There was no evidence of asthma. Skin testing showed a positive reaction to
grasses and weeds, cats, peanuts, and a slight reaction to wheat and corn. The allergist
offered a nasal spray for a drippy nose, and two puffs per day of a corticosteroid.
The chiropractor noted some elevation of the right shoulder, and significant left trapezial
tension with a mild trigger point in the left trapezius. Flexion and extension of various spinal
locations were accomplished without pain or difficulty. The treatment plan involved spinal
manipulation to improve integrity of spine and help his body function better. Cranial
manipulation in the sinus region was performed to facilitate sinus drainage.
The Healing Touch practitioner’s assessment of the seven chakras revealed diffuse achy
energy. The Root and Crown chakras were open and spinning clockwise. The others were
energetically compromised, feeling diffused and flattened. A buzz was noted in the energy
field over the area of the right jaw and face area. The treatment approach included healing
touch of the whole body and symptomatic complaints accompanied by soothing music.
Specific interventions for subsequent treatments included an opening spiral meditation, mind
clearing, pain drain, ultrasound and laser to sinuses, full body connection, attention to the
solar plexus and heart chakras, full body magnetic unruffling, pyramid balance connecting
the higher and lower centers, self-chakra connection, bridging technique for the heart and
back of throat, and a closing spiral meditation.
The nutritionist was seen three times during the first four weeks of treatment. She took a
dietary history and habits, and recommended that the patient restrict his intake of wheat,
sugar, and dairy products. She suggested he take vitamin B and C, as well as Bromeline and
liquid flax for mucous.
During the first week into the T.E.A.M. treatment, J.H. experienced the onset of one of his acute
sinus infections. He did not seek traditional allopathic therapy during this time from the internist
(Dr. Sollins, M.D.). The symptoms became severe, but subsided after one week. He felt that the
integrated care he was receiving helped give him the support to withstand the pain and pressure
from the infection. After completing the T.E.A.M. treatment, his sinus symptoms dropped from 9
to 2 on a pain scale of 1 to 10 (0 being pain-free). J.H. reported that after running he now no
longer experienced green, yellow or bloody discharges from his mucus, nor had he felt burning
pressure in his sinuses. His sinuses felt stronger and more elastic. Sinusitis was a major concern
in his life that had been put in its place, not in the foreground. J.H. also noted that he felt a
renewed spirituality and growth. He reported that the acupuncture and healing touch therapy
furthered, and perhaps accelerated, this development. Dr. Sollins has not seen J.H. for a sinus
infection since the conclusion of his T.E.A.M. treatment.
These two case studies demonstrate the effectiveness of an integrated medical approach to reduce
symptom distress and improve patients’ well-being in two distinctly different, longstanding illnesses.
These treatments did not control for extraneous variables that could have influenced these patients’
outcomes. These treatments also did not systematically introduce the different practitioners into the
treatment schedule to determine which treatment modalities had the greatest effect. Nevertheless the
intent of the integrated T.E.A.M. approach was to try to improve the health of two patients will illnesses
that had not adequately responded to traditional medicine.