All patients are seen for an initial session, which lasts for an hour and a half. This session is used to identify the patient's condition or syndrome. This involves taking the patients case history by asking questions about any symptoms the patient may be experiencing, or any diagnosis given by a western physician. There will be questions about the whole of the person such as digestion, sleep, medical history and medication so that an entire picture of the person may be established and from this patterns may be diagnosed so that the problem that is affecting them can be treated. Several traditional methods also may be used such as pulse taking and examining of the tongue. From this initial session, it will be possible to ascertain the type of treatment the patient requires and to design a suitable course of treatment that is tailored to that patient. If someone came with a western medicine diagnosis of hot flushes then there may be up to 5 different syndromes they may be suffering from, so that often no two people will be treated in the same way. The course of treatment may not just involve acupuncture, but in some situations massage, dietary advice, acupressure, electro-acupuncture, magnets and pre-prepared traditional Chinese herbs formulas may be used.
Once the case is taken a prescription of points to treat is decided upon, but this may involve palpation of the area if it is a musculoskeletal problem.
The patient is then asked to remove their shoes and socks and appropriate garments depending on the problem but often it is just to roll up their trousers, and then to lie down and relax, which is easy to do in the environment created by Anne. The patient is then asked to take a deep breath and to exhale as the needles are placed in the appropriate points. The needles may be felt as a slight prick when being put in place and then may cause a tingling sensation or a dull ache, or perhaps nothing at all.
The needles are very fine, much smaller than a pin or hypodermic needle, and only enter the skin 1-2 mm on some parts of the body but may go further up to 1- 2 cm on others. All needles are single-use sterile and disposable. Needles are disposed of in the correct manner according to the Department of Health procedures.
The needles are left in place for around 10 - 20 minutes depending on the constitution of the patient, during which time you are left to relax. Anne may rotate the needles during this period to stimulate the Qi. Once all needles have been removed, the patient is encouraged to sit up slowly, to remain seated for a short time and eventually to stand. Anne then gives a few minutes for the patient to compose themselves and then to put on their shoes, at which point the session is over.
Subsequent sessions will be about 45 minutes long. These sessions will be required by the patient usually once a week initially although in very acute situations it might be more, and as the condition improves, less frequently.
In a 'typical' session, if such a thing exists, the following may occur; the patient arrives and Anne questions the patient about the symptoms that have improved since the last session, and whether they have any new symptoms. Anne keeps notes on this, to help see if any patterns emerge and to observe the progress of improvement. This may take around 10 minutes.
Anne then observes the patients tongue and takes their pulses and will then decide depending on the information, whether to alter the point's prescription or to repeat them like last time. The actual treatment session will be similar to the first although treatment time may vary.