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A: We have been asked this question on a number of occasions, and one of the more recent responses was:

There are a number of small studies, two of which you can find here

http://www.ncbi.nlm.nih.gov/pubmed/14562135

http://www.ncbi.nlm.nih.gov/pubmed/10098953

which give some encouragement to the possibility that acupuncture in conjunction with conventional strategies can help men suffering from ED. However, the studies are small and far from conclusive, so we couldn't give a definite and positive recommendation.

As a general comment we would say that there are many reasons why men can begin to suffer from ED. These can range from the simple fact of ageing and the effects of conditions which become more apparent in older age, like mature onset diabetes, or to the problems associated with excessive drinking or smoking, through to the kinds of complex psychological issues which have arisen as a consequence of someone's life experience. Whether acupuncture can offer any help depends a great deal on the background against which the problem has arisen.

Traditional Chinese acupuncture is primarily concerned with the restoration of balance and flow in the energy of the body, and there are several distinct patterns of disease, or 'syndromes', in which poor flow or blockage of energy ('qi' as it is called in Chinese medicine) can cause erectile problems. If this were to be the case, and there were other confirming factors pointing to a specific syndrome in the overall diagnosis, there may be some possibility that acupuncture could provide some help. However, if the cause of the ED lies in a pathological condition which means that there has been some permanent loss or weakening of blood supply to the sexual organs, then acupuncture would be less likely to have any effect.

Our only advice to you can be to seek the view of a BAcC member local to you and discuss the matter face to face, perhaps offering them a little more background information on which they can give you a clearer assessment of whether they think acupuncture treatment may be of benefit.

We think that this is still the best advice that we can give.

A:A great deal depends on the overall pattern within which the symptoms you are experiencing sits. Even from a conventional medical perspective there are a number of different reasons why someone may be experiencing cardiovascular disease in the lower leg, and the adjuncts to treatment can range from changes of diet and lifestyle to giving up cigarettes and alcohol.

From a Chinese medicine perspective the poor flow of blood in the lower limbs can be seen either as a localised problem or as the tip of a much larger iceberg, and the skill of the practitioner lies in determining which this is and focusing their treatment accordingly. Chinese medicine is based on an entirely different way of looking at the body, mind and emotions as a flow of energy, called 'qi'. Diagnosis and treatment is aimed at identifying where the flows of energy are blocked, deficient or over-flowing and using fine needles to stimulate change towards what is normal.

The fact that the treatment is described in these terms does not mean that the Chinese were unaware of blood flow. There is considerable evidence that they were well aware of the flow of blood long before scientists like Harvey were credited with its discovery in the West. However, they saw the flow of blood as a part of a wider system of flow in which all aspects of bodily functions could be improved.

Cardiovascular disease manifests at all sorts of levels in the body, though, and in some cases there can be considerable damage to the peripheral arteries which no amount of treatment is going to be able to put right. The best advice that we can give in cases like yours, where the range of possibilities is so large, is that you visit a BAcC member local to you for a brief chat and perhaps a face to face assessment of what benefits acupuncture treatment might offer you. Most members are more than happy to spend a little time with prospective patients before they commit to treatment to ensure that expectations on both sides are realistic.

Q: I had my middle and lower right lobe removed from my lung 7 weeks ago. I have recently had an infection around the lung and been on IV anti biotics in hospital for 1 week and now home on oral antibiotics . During this time I have had severe nausea and intermittent sickness. I take anti sickness tablet cyclzine but it appears to make no difference. I also still have pain and take paracetamol . What I would like to know is could accupuncture help or cure the nausea or even help with the pain as the traditional treatment doesn't seem to be .

A: We are very sorry to hear of what you have been through

It's very heartening to be able to point to some very good quality research for the treatment of bot post-operative pain and post-operative nausea, as our fact sheets demonstrate:

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/nausea-and-vomiting.html

and

http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/post-operative-pain.html

We aren't able to offer this as conclusive evidence, at least not to the standards which the ASA

require us to demonstrate for claims of efficacy, but there has always been a decent consensus amongst both traditional and medical acupuncturists that nausea in particular is treatable. Indeed as the factsheet shows, there is one acupuncture point on the arm which is cited in nearly every trial as one that 'does what is says on the tin.' This is the same point which is used in the various seas sickness bands which are found on sale in most chemists.

Any practitioner taking you on will need to be a little more cautious than usual, because there is no doubt that from both an eastern and western perspective your immune system will have taken a serious knock, but as long as someone works carefully within our Code of Safe Practice or equivalent all should be well.

The best advice, which you will see repeated in most of our answers, is to contact a BAcC member local to you and seek a brief face to face assessment of whether they think acupuncture treatment may be of benefit. You may find that home visits are more appropriate at this stage, and many members are happy to do this.

Q: Please could you tell me if acupuncture can definitely help with muscle tension dysphonia which affects the voice box, excessive mucus production and choking due to constriction of the entrance to the trachea. A: None of us could say that acupuncture can definitely help with anything. From a Chinese medicine perspective each individual has a unique balance of energies, and even where several people have the same visible symptom they could nonetheless each be treated differently depending on the patterns of disharmony in their general energy flow. We were asked earlier this year about spasmodic dysphonia which has overlaps with the MTD you describe and we replied: A: There are a very small number of studies such as these http://www.ncbi.nlm.nih.gov/pubmed/14513964 and http://www.ncbi.nlm.nih.gov/pubmed/9181547 which provide a basis for arguing that a larger scale trial would be useful. However, small scale trials are always problematic when being used in evidence for a form of treatment. Although we are not great fans of the randomised double blind control trial which is often taken as the gold standard for research, the need to take individual and unique variations out of the equation is important, and case studies on this scale can often owe a great deal to extraneous factors. However, that said, Chinese medicine has a very different way of looking at the functioning of the human body, one which rests on a theory of energy called 'qi' and its flow and circulation around the body. When blockages or deficiencies occur, this can lead to aggravation and symptoms. The Organs of the body as understood by Chinese medicine (always capitalised to differentiate them from a western understanding of organs) have a variety of functions on all levels - body, mind and emotions - some of which may have an impact on the ability to speak. One of the great strengths of Chinese medicine is that each patient is seen as unique and different, and the practitioner will look at all of the systems of the body, as well as all of the circumstances surrounding the onset of the problem, to try to understand the patterns of causation. Although symptoms can suddenly appear out of nowhere, there are often underlying issues which predispose someone to develop these symptoms. If this were to be the case with your problems, then there may be something in the overall presentation to encourage a practitioner to feel that they may be able to help to sort things out. Given that each case is unique and that research on this condition is sparse, your best bet would be to visit a BAcC member local to you for a brief face to face assessment of whether in their view acupuncture treatment might be of benefit. Even when there isn't a clear 'audit trail', the premise of the very old traditional systems was that treating the person and re-establishing balance would surely remove symptoms. This can cause problems in modern practice; it is possible to get rid of a symptom without anyone ever establishing what caused it, which some people find perplexing! The standard options, such as botulin injections, remain available to you, we imagine, but these offer only temporary relief from the problem. It would be nice to think that acupuncture treatment might offer a more lasting solution, but we have to be realistic and say that if you do choose to have some acupuncture sessions, you should set a very clear review date to make sure that acupuncture doesn't become a habit process. We have known patients to clock up a dozen sessions or more without much change because weekly bookings become a weekly pattern which easily stacks up to a large-ish sum of money. This is basically the same advice we would give now for your problem. The one factor which you mention, the excessive mucus production, is a factor in the condition anyway, but would certainly be of particular interest to a Chinese medicine practitioner because there may be other aspects of the system which are contributing to the problems you have.
Wednesday, 22 October 2014 10:17

Acupuncture and bladder incontinence?

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Q: Can acupuncture cure bladder Incontinence where the muscle has been damaged due to radio therapy and the bladder continually leaks?

A: We're not sure how much background information we are missing. The fact that you have had radiotherapy points to surgery of some kind, possibly the bladder or the prostate, and if so the radiotherapy may be the precipitating factor rather than the cause itself.

There isn't a great deal of research which we can point to. Studies like

http://www.ncbi.nlm.nih.gov/pubmed/21092614

seem to point in a favourable direction, and when we were asked a similar question last year we replied:

Q: In 2010 I had a T.U.R.P on my prostate and after the operation I had stress incontinence for several weeks. I still have slight leakage now and again e.g. when lifting something heavy. I wondered if acupuncture is used to treat this problem.

A: There is no evidence which we can find of the treatment of post-TURP incontinence with acupuncture. Most research into male incontinence is done on subjects who have had spinal injuries, but the evidence from these is not very conclusive. There are some very useful articles on the problem, such as

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2938549/

but none which make a positive recommendation for treatment. If you google the condition you may find a number of individual practitioners who make claims about treatment in this area, mainly from the USA, but you would be well advised to treat such websites with caution.

Having said that, the use of acupuncture treatment to improve the overall function of the system is one of its purposes. In ancient times patients paid the doctor to keep them well, not to get them better after they had become ill, and the underlying theories of Chinese medicine are about maintaining good health as much as trying to resolve symptoms. It is possible that there have been aspects of the condition itself and of the treatment which you have received which have lowered your system as a whole, and a skilled practitioner might find that there are aspects of your balance which, if corrected, may have consequences for your ability to recover successfully foir what can be quite unpleasant surgery.

We are aware, though, that without a proven evidence base for treating this condition any form of treatment aside from the ones outlined in the article above will involve a certain leap of faith, and as such we would recommend that whatever you might try you draw a very sharp line in the sand about the number of sessions you have before determining whether to carry on, and to set measurable outcomes for your progress. 'Feeing a bit better' is difficult to quantify, and can change very quickly, but recording episodes on a chart is hard evidence.

We recommend that you visit a BAcC member local to you for advice on whether they think acupuncture treatment may be of benefit to you based on a brief face to face assessment

We think this remains the best advice we can give without knowing more about the specifics of your case. We have treated people who have had muscle damage after radiotherapy and it can be a long haul, but each case is unique and different. What we can say with certainty is that it won't do any harm, and may help to alleviate some of the stress that is no doubt accompanying what can be a very distressing symptom. We have found that it has been an aid to recovery, but that is very much what we hope to achieve with traditional acupuncture, a speeding up of natural healing after damage. The limiting factor, though, is the extent of the damage; radiotherapy can be a 'blunt object' kind of treatment, and can sometimes cause irreversible damage in pursuit of a more wide-ranging benefit from the problems it is aimed at eradicating.

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