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A: From a Chinese medicine perspective the $64,000 question is what is causing the fluid retention, and your question illustrates perfectly how difficult it is to take a symptom by itself and offer a view about its treatability. There are a number of reasons in Chinese medicine why someone might start to retain fluid, many of which track back to under-performance in one or two organs (we capitalise the word because an organ in Chinese medicine is not simply a physical object but a description of a range of functions in body, mind and emotion). The fact that we can then say that a spleen or kidney is under-performing leads to the next level of questioning: what is it aboutthe overall balance in the person's system which causes this part to malfunction? Is the problem in the organ itself, or is it caused by another organ not working well and having a knock-on effect?
This again leads to questions about the person's lifestyle and daily routines. As an example, many cases of fluid retention track back to the Spleen, which in Chinese thought is responsible both for sending fluids around the body and also for holding things up, a sort of internal gravity. When it does not work well, fluids gather and tend to sink, so many people end up with swelling in the middle and lower part of the body and then related problems like varicose veins. The Spleen does not thrive on cold and damp conditions, so a diet rich in raw fruit and vegetables, dairy produce and other cold, damp foods will already put pressure on the Spleen even if it is healthy,and in one which is already under-performing push it a stage further into malfunction. Treatment might then be supplemented by dietary advice.
However, this is jumping the gun! The very first thing that a practitioner might do would be to look at the circulation in the area, not just the blood circulation from a western point of view but the energy circulation from a Chinese medicine perspective. There are often functional disturbances behind problems like this, but there can also be much simpler superficial disturbances, the treatment of which can be much more straightforward.
To have a really good idea of what is going on, and to avoid guessing at how problems like this might respond to treatment it is always best to trot along to a local BAcC member who with very little investigation will probably be able to offer you a reasonably accurate estimate of what may be possible after looking at your feet and asking you a number of questions. Crucially they will also be able to take the pulse at the wrist and look at the tongue, both Chinese methods of diagnosis that can very rapidly point to major areas of disturbance and change. On this basis they are likely to be able to give you a fairly good idea of what may be possible.
A: As you can imagine, this is a topic which pops up relatively frequently, and a typical answer we have given in the past is:
Weight loss was the subject of some critical scrutiny a decade ago, and the conclusion drawn at the time was that acupuncture did not have any significant effect onweight loss. However, trying to test whether acupuncture can help someone to reduce their weight is likely to be a difficult matter; there are dozens of reasons in Chinese medicine why someone's weight may be increasing. Trying to group together a sufficiently large number of patients whose western problemand eastern diagnosis are the same is extremely difficult.
In one or two cases there is a very direct correlation between someone's weight and their underlying imbalances from a Chinese medicine perspective. Correcting these may have an immediate impact on, say, the amount of fluid someone is carrying, and that could create a 3-5kg loss very quickly.
However, all of the best dietary programmes say that after the initial and often quite dramatic week or two most good weight loss programmes at best will see someonelose only a pound or two every month, and in fact, there is discouragement from trying to do more in order for the body's system to keep pace with the change.Acupuncture may well have been used successfully alongside some fairly strict dietary rules, and from a patient's perspective it would be very difficult to say whether the acupuncture treatment added value to what someone was doing already.
The bottom line is that there are are no 'magic' points which reduce someone's weight without effort, and the effect of acupuncture may be no more than to givesomeone the support and commitment to keep trying with diet and exercise programmes. However, if someone remains motivated as a consequence of acupuncturetreatment that itself would be a very positive outcome.
There is nothing that we would add to this advice other than to beware of anyone making promises they cannot keep about what acupuncture treatment can deliver. Some of the less reputable high street shops still appear to be making claims of a fairly speculative nature without any evidence which supports what they claim.
This is probably the best advice that we can give. Our clinical experience is that their are often subtle emotional and spiritual issues underpinning the loss of control which people have of their weight, and some of these are amenable to acupuncture treatment. We have answered many questions on anxiety and depression, and we find quite often that a response to depression is to comfort eat. Helping with the depression may well reduce the desire to use food in this way.
One has to be realistic, however. Some of the psychological issues are not best suited by long term acupuncture treatment and really do need to be addressed directly bysomeone skilled in this area. There are also many occasions when the 'habit energy' to eat is so well entrenched that a direct intervention like hypnotherapy or cognitive behavioural therapy is appropriate because it goes straight to the point. We also have to tell some patients, sensitively we hope, that oaks breed oaks and willows breed willows. If a family are all size 18, then the chances are that trying to be a size 8 is not going to be likely.
The best advice we can give is that visiting a BAcC member local to you will be able to provide you with advice based on a brief face to face assessment. This is verylikely to offer you the best range of options for you. All of our members are concerned to ensure that a patient gets the help they need, which is not always what they have to offer. We often refer to other colleagues if we feel something would work better. Each patient is unique, and finding what works for each individual case is the best guarantee of success.
Q:I have had an ongoing feeling being 'spaced out' for about 6 weeks now. It seems to take two forms, the first -and worst- a tense, queazy, feeling in my stomach which is accompanied by the feeling almost like flu, without the flu, if that makes sense, This is generally in the mornings and it then seems to revert to a more generalised feeling of being 'spaced out' in the day. It seems to lessen in the evening. I have had blood test, all clear and an MRI scan, again all clear. I was told it could be related to a migraine issue and I have also cut out certain dietary triggers ie caffeine/ dairy. I would prefer not to take medication to try to resolve this. Do you think acupuncture could help?
This is the kind of presenting problem which many of us love to address. One of the great strengths of Chinese medicine is that it can take symptoms such as these and offer several different possible explanations within a conceptual framework which is entirely different from that used in Western medicine. As you probably already know, Chinese medicine is based on the understanding of the body mind and emotions as a flow of energy, called 'qi', the various patterns, flows and rhythms of which contribute to good functioning in the body as a whole. Where this flow is disturbed, for whatever reason, symptoms will begin to appear, although not necessarily where the imbalancemanifests.
If someone were to look at your case history there would be in all probability other aspects of your functioning which, from a Chinese medicine perspective, would probably indicate a wider pattern of which this symptom was a part. There are also some very complex diagnostic signs which would also help the practitioner to refine their view of what is happening.
If the cause is similar, from a western point of view, to vertigo or migraines, there is considerable evidence for the treatment of both of these problems, as our factsheets show
to suggest that you would not be wasting your time on giving acupuncture treatment a go. However, these are usually precisely defined in western medicine, whereas the feeling which you have is a more indefinite presentation, although none the less disturbing even though it doesn't have a distinct label.
To give you an example of how different the diagnostic process can be, this expert treated a patient once who was experiencing a similar problem, and it turned out that she was eating as much as half a pound of cheese every evening. Given the energetic balance of her body, which was already out of kilter, this contributed to the formation of what the Chinese call 'phlegm' which embraces what we give the same name but can also extend to solid lumps in the body as well as something which the Chinese call 'mist'. This is said to rise and cause all manner of symptoms of which feeling spaced out is one. Other patients can often manifest the same symptom is their work orpersonal circumstances are very stressful. This can lead to a condition called the Rising of Internal Wind, again causing the same problem.
Poetic as these descriptions can sound, they are based on over 2000 years of successful clinical observation and experience, and also 2000 years of successful treatment. On that basis, we think it would be potentially very beneficial to give acupuncture treatment a go, but to make sure that you review progress very carefully so that you don't run beyond the first four or five sessions without assessing what progress there has been. This may involve you in trying to get as objective a measure as you can of howfrequent or severe the symptoms are to be able to assess as accurately as possible whether there has been a change.
Your best bet is to visit a BAcC member local to you to seek an informal face to face assessment of what may be possible. Even a ten minute chat will probably give significant clues about what is going on and whether treatment would be of benefit.
We are sorry to say that there are no acupuncture courses of which we are aware in Cornwall. The ones which we recognise for automatic eligibility to the BAcC are listed on the website of our sister body, the independent British Acupuncture Accreditation Board http://baab.co.uk/accredited-courses.html. This website also has a great deal of what useful information about what we regard as the appropriate level of training to become a traditional acupuncturist.
There may be other courses provided by some of the smaller acupuncture associations, but we have never heard of any being held in Cornwall, the nearest being in Bristol some years ago. However, when we trained a long time ago many several people did travel from Cornwall to undertake the training, and there are some new developments now involving larger elements of distance learning which may make a course viable even when distant.
The problem for any course provider is that setting up a suitable infrastructure takes considerable time and money, and would probably only interest someone as a project if there were a patent demand for training in an area. The current training structure sees about 200 to 250 students enrol every year, so this may give you some idea of the market into which a new provider would be emerging. That is not to say the places would not be taken up immediately; demand for training is quite high. Capital, however, after four years of recession, isn't.
Q: BAcC registered acupuncturists' patients are prevented from giving blood. What does the BAcC intend to do about this parlous state of affairs?
A: The current situation has moved on a little since our last press release in July last year:
The BAcC continues to receive calls and emails about the NHBTS policy that any patient who has had acupuncture treatment delivered by a practitioner who is not statutorily regulated has to wait four months before they can donate blood. This change to the NHSBT's donor criteria came into effect in late 2009,and with the statutoryregulation of acupuncturists now unlikely in the foreseeable future, this could mean that someone having regular treatment with a BAcC member would neverqualify to donate blood.
The BAcC has exemplary safety standards and campaigned vigorously to challenge this decision. We have since done our best to make sure that all of our members let their patients know that they must wait four months to donate blood or bone marrow products.
The official notification and rationale for the decision is available on
but some enquirers have found this difficult to locate on official sites.
The BAcC is fully committed to reversing this decision for the benefit of the patients of its members. The recent accreditation of the BAcC under the Professional Standards Authority Assured Voluntary Register scheme has given us hope that this new flagship scheme will provide the recognition of exemplary standards the BAcC needs for its members to be granted exemption from the deferral period for donation.
Since then, we have met senior officials in the NHBTS, and discussed with them how we might help to re-instate the donation of blood by non-statutorily regulated healthcare profesisonals, there having been no reported instances of blood borne virus transmission by acupuncture practitioners in the last decade. In order to change policy, however, there has to be evidence, and the NHBTS is proposing to conduct an analysis of previous screened donors to establish the level of risk. This study will take place later this year or early this year.
The wheels of bureaucracy turn slowly, and until that time anyone who has had acupuncture treatment from a BAcC member will have to wait four months until they are allowed to give blood.
The study mentioned in the press release has now progressed a great deal further, and the information which has been gathered will be given the full statistical analysis by August, we are told. It is also interesting to note that the Welsh Assembly has accepted the BAcC's accreditation with the Professional Standards Authority as a basis for exemption from its new licensing arrangements, and this opens up a potential second front if the statistical evidence is inconclusive.
The whole situation has been rather odd from the outset. Leaving aside all of the arguments about accountability and statutory recognition, the simple fact is that we all use single use disposable needles, and short of a practitioner with a blood borne virus inserting a needle in themselves and then into a patient, itself a criminal offence which even statutory regulation could not prevent, there is no possible risk of cross infection. However, by the time that this very simple fact became a part of the discussion the moment had long been lost. Indeed, there had been minimal consultation at the outset because the decision makers did not anticipate any adverse reaction to what they planned.
However, there's no point in re-hashing a poor process. We are where we are, and still working constructively to bring back into play the 10,000-15,000 donors we believe may have been lost as a consequence of this decision.
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