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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?

Written by

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.

A:  There are no hard and fast rules about the frequency of treatment. It is fair to say, however, that clinical practice in China is radically different from that of Western Europe. It would not be at all unusual to have a course of ten treatments daily for a problem like yours, although this would perhaps be more likely immediately after the first tendinopathy developed.

In China, though, acupuncture is an accepted part of the state healthcare system so cost is not an issue, and in any event this is what practitioners have always done. In the UK, where cost is a factor, it is much more usual to have treatment weekly, occasionally bi-weekly if someone has an acute problem which needs more intensive treatment. This does not lessen the efficacy of the treatment; the intention is to trigger and reinstate the body's own healing systems, and this can be achieved just as well over time.

The key thing when a chronic condition is being treated is to set clear outcomes (range of movement, analogue scales of pain experienced, and so on) to determine whether there has been any improvement, and to set regular review periods to assess progress. Most BAcC members tend to use the four or five treatment mark as a point at which to make a judgement about how things are going, and to agree with the patient about continuing rather than just making repeat bookings week after week.

The important thing, if you have already started treatment and have any concerns about treatment, is to discuss them with the practitioner. This avoids any build up of frustration or annoyance if things aren't progressing as well as you would like.

A:We were asked this question a little while ago, and our answer was:

A great deal depends on what is causing the dark circles to appear. Normally we all associate dark circles under the eyes with tiredness, but assuming that this is not the case with your question, there are a number of diagnostic patterns within Chinese medicine for which dark circles might indicate an underlying weakness of energy, or 'qi' as the Chinese call it. Some people's inherited energy, for example, can have been compromised by the health of either parent at conception or by a difficult pregnancy. In these sorts of cases, their management of their life has to be a little more careful, i.e. they may not be able to manage 60 hour working weeks and party all weekend. In some cases the dark circles are a permanent feature.

The key thing to bear in mind is that this will be one symptom or sign amongst a number of others, and treatment would generally be focused on the underlying imbalance. You will see, however, a growing number of websites which promise to do away with dark circles and other signs with facial or cosmetic acupuncture. The BAcC's view is that these procedures are useful when used in the context of a traditional diagnosis and treatment of the whole system. If they are simply applied as one-off symptomatic treatments in many cases whatever gains are made will be lost very rapidly. That is not to say that there may not be cases where this is a sign of local stagnation which acupuncture might help to clear, but in the majority of cases treating the whole system would probably be necessary as well.

We cannot give out referrals to specific members who focus on this kind of work, but it is a relatively straightforward search using google to find a BAcC member in your area who also does facial or cosmetic acupuncture. There are indeed a number of organisations set up by BAcC members as support networks for people doing this kind of work, and they have searchable databases of members who have taken postgraduate training in this area. We recommend that you find someone who is both a BAcC member and trained in cosmetic acupuncture to assess whether treatment may be of benefit to your specific needs.

We think that with the benefit of hindsight we placed too much emphasis on the use of 'facial' or 'cosmetic' acupuncture.' That is not to say that this is not an interesting case of an ancient technique being used to meet modern needs, but there are more cases of darkness under the eye which are the result of a long-standing systemic weakness or simple genetic inheritance than there are case which are going to be fixed by a couple of good nights sleep and a few needles.

We would advise you to visit a BAcC member local to you, not necessarily one who uses cosmetic acupuncture, and see what they can tell you based on a brief face to face assessment.