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As is often the case there is an article or a study which has some very positive outcomes for a condition which it is difficult to treat with conventional medicine. This is then frequently cited and gives the impression that there is a great more activity than is the case. Such is the case here. The article itself
now has the contents 'locked' since Acupuncture in Medicine was taken over by the BMJ, but it does describe a quite dramatic improvement in a single case.
Sadly our clinical experience is not quite as encouraging as this. Chinese medicine works on an entirely different theoretical basis, predicated as it is on the notion of energy, or 'qi', as it is called, and the functional relationships which the Organs have. These are very different from the western understanding of an organ, which is why we capitalise them, and they do encompass things like the sense of smell. In rare cases there is a direct correlation between this loss and other symptoms which points to a specific functional disturbance. However, we have to be honest and say that this is rarely successfully treated.
A huge amount depends on what else, from both a conventional and Chinese medicine perspective, going on. Many of our faculties become less acute with age, and the sense of taste and smell can also be badly affected by sinus problems, as well as by neurological problems. Determining what else is happening, as well as how the problem started to manifest, is equally important for both systems of medicine, and no practitioner would give a view unless and until they knew more about the background to the problem.
Our advice becomes a littl;e repetitive at times but the nature of this problem especially means that you would benefit from contacting a BAcC member local to you and seeking a brief face to face consultation, hopefully without charge, at which someone can give you a better idea whether there is something in the overall presentation or history of the problem which would give a better indication of whether acupuncture treatment may be of benefit.
Q: I was diagnosed with sarcoidosis in my lungs 18 months ago. I was told by my GP at the time I had chronic scarring on my lungs as a result. I had another x- ray recently and the condition still exists. I suffer from shortness of breath and at times have to take an inhaler. I am really anxious to know if acupunture could be of any benefit to me.
A: There is very little research to support the use of acupuncture in the treatment of sarcoidosis, and that is a requirement for us to be able to offer the kind of advice which you seek.
If you do a websearch, however, you will find individual case studies such as this one about the use of Chinese herbal medicine and sarcoidosis
which illustrate very clearly the problem of trying to treat named western conditions with traditional Chinese medicine. The authors are at pains to point out that there is very rarely a one to one correspondence between a disease and a syndrome as understood in Chinese medicine, and more to the point, each person will present an individual syndrome pattern which has generated the symptoms which are gathered together under the western heading 'sarcoidosis.'
Symptoms are the bridge between different systems of medicine, the one factor which is usually not in dispute, Chinese medicine has an entirely different conceptual framework against which those symptoms are assessed and interpreted, and from our perspective it would be a matter of seeing how your symptoms arose and how they manifest. Chinese medicine systems are 2500 years old and although they may at times use language which is alien to most westerners there is considerable sophistication in how the whole system is interpreted.
The only advice we can give you for a condition such as yours is that you visit a BAcC practitioner local to you and seek their advice based on a face to face assessment of whether treatment may be beneficial. Chinese medicine certainly has a long tradition of treating breathing difficulties, and many differential diagnoses for their cause, but from a distance we are unable to say whether your symptom pattern 'fits' any of these classifications.
What we would say, however, by way of advice is that with chronic conditions such as this it is very important to establish good outcome measures to assess progress while at the same time acknowledging the continuing damage which the condition causes. We are sometimes asked questions by patients who have had twenty or thirty sessions with no discernible benefit, and we are most keen that BAcC members undertake regular reviews to establish whether the treatment is of benefit.
Q: I have been suffering with Uveitis for around 5 months and have ready that acupuncture can really help to reduce the inflammation. Are there acupuncturists that specialise in eye treatments or will any acupuncturist be able to look at this problem?
A: We have to sound a note of caution, insofar as there is not a great deal of research to underpin claims for efficacy in treating uveitis with acupuncture. There was a small study in Vienna three years ago
which demonstrated reductions in pain and improved visual acuity in five patients, but this is not robust enough evidence to make any more serious claims about efficacy.
From a Chinese medicine perspective, there are obviously other ways of looking at what happens in uveitis within the diagnostic framework. The manifestations of the problem are understood within an entirely different paradigm based on a concept of energy, called 'qi', and its rhythms, flow and balance within the system. There are both functional aspects of eyesight which are governed by different parts of the system and local energy flows which might be compromised and generate problems such as this. The skill of the practitioner lies in making sense of the symptoms within the diagnostic framework and seeing what may be done. This can sometimes generate solutions where western medicine has none to offer, but one has to be realistic and recognise that some conditions do not respond well to acupuncture.
Your best avenue is to see if a BAcC member local to you can offer a brief face to face assessment of whether acupuncture treatment may help your specific presentation. There are none that specialise in eye conditions as such, although if you undertake a google search you will find one or two who have written quite a great deal about eye problems and acupuncture. We remain committed to the policy, however, that all our members are equally well qualified to address the great majority of problems which their patients bring them, and we do not promote individual members.
A: There are no 'rules' as such about self-needling by practitioners. The advice most acupuncturists were given in their initial training was that a practitioner could not have sufficient objectivity to make an effective diagnosis of themselves and to make the acupuncture as efficacious as possible. However, there are some short term emergency situations, like acute toothache, where there are commonly agreed pain relieving points which can buy a few hours of relief until emergency dental treatment. There is no reason why someone should not needle themselves in this kind of situation.
Self-needling by patients is a more contentious issue. We are aware of two or three highly successful programmes where patients undergoing chemotherapy for cancer are using a well-tried and tested point to reduce the nausea this can induce. Although we have some reservations about this, as long as the patients are trained in safe needling and the safe disposal of clinical waste, we accept that this is likely to be a part of mainstream care in the future.
Our major concern with self-needling is not knowing what to do but knowing what to do when/if something goes wrong. The true test of expertise is being able to react to unpredicted responses. If someone is only able to perform one task with one expected outcome then it is difficult to expect them to be able to react if they get an adverse reaction, like bruising or fainting. The same applies, in terms of reacting, to both practitioner and patient alike with self-needling; fainting is rare but putting a needle in onself and keeling over is not a great option.
With nearly 3000 BAcC members in practice, it isn't as though there weren't enough practitioners around!
Q: I hade acupuncture for the first time at my local hospital and although I was very emotional straight after the short 10 minute session I felt fine. 12 hours later I was itching, 17 hours later I had passed out and hit my head resulting in concussion. Speaking to my acupunturist she said that, although uncommon, it is not impossible that the fainting was caused by the acupuncture. My GP however is very doubtful. Whilst not blaming anyone at all, I would obviously like to know why I passed out. I never have before. Is this possible, could the acupuncture have caused it? Dr has done ECG and blood tests, ECG was fine, blood tests are still in the system.
A: As your acupuncturist said, fainting is an unusual but not unknown reaction to acupuncture treatment. In the majority of cases this is a combination of nerves or anxiety, often with not eating for quite a while before treatment, and the treatment itself. Even with optimal preparation there can be occasions where the treatment induces a rapid short-term drop in blood pressure, often diagnosed as vasovagal syncope and a reaction by the vagus nerve to the treatment. This can often be triggered by over-vigorous needling, perhaps slightly more strong than the average traditional acupuncturist might regularly employ.
However, when fainting does occur after treatment the effect is usually within the session itself or very shortly afterwards. It is rare to hear of circumstances such as your where there is a precursor symptom of itching followed by a faint 5 hours later. The fact that all of the usual readings - bloods, ECG,etc - are good is a reassuring sign, although I suspect that were we to be in the same position as you we would also want to know what drove the process along.
If you were our patient we would probably recommend that you sought further conventional testing from orthodox medicine. It is just about possible that the symptoms, itchy skin and fainting, may relate to an anxiety reaction to treatment, and you do mention that you felt quite emotional after the treatment was administered, but if we rule this out, then the gap before your faint occurred is just a little too long for us to say with confidence that acupuncture is the causal factor. However, we would certainly want to know what you did in the hours immediately following treatment to rule out the usual suspects: hunger; tiredness; highly stressful situations; and so on.
You do not mention whether you had subsequent treatments which did not affect you so badly. If you have now completed the course of acupuncture treatment, you could always drop into see a BAcC member local to you for advice. The diagnostic systems of Chinese medicine can sometimes offer understanding of unusual symptoms where orthodox medicine does not, and this may prove beneficial in trying to establish what happened to you.