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Ask an expert - general
Q: My 9 year old daughter has transverse myelitis. I am looking for an acupuncturist who understands her condition and is qualified to treat a child. Can you advise me?
A: We do not have agreed special qualifications for treating children. However, for a number of conditions children are not simply small adults, and there have developed over the years a number of courses in the UK which train practitioners in the treatment of children. This extends to how best to handle small children and babies, and how to modify the standard treatments to ensure that they are not too powerful for a child. Because we have not yet reached agreement on the standards which would enable someone to advertise themselves as expert practitioners in this field, the best advice we can give is to use google to search 'acupuncture and the treatment of children'. This will generate a number of websites belonging to course providers who list postgraduate diploma holders who may well work in your area.
As far as understanding the condition itself is concerned, although most BAcC members have a thorough grounding in Western medicine, this may not extend to all of the technical details of specific conditions. What we imagine will happen, however, is that a practitioner would as a part of their normal duty of care for a patient find out more about the specifics if they treated someone with a problem such as this. Of course, Chinese medicine is based on an entirely different theoretical structure from conventional medicine, working with a concept of energy,or 'qi', and its flow and balance. That said, symptoms are the same whatever the system of medicine which describes them, and a practitioner's skill lies in understanding how the symptoms present from an eastern rather than western perspective. This can sometimes generate treatment options which are not available within conventional medicine.
However, there are conditions, and this is one of them, where the structural changes in the body are such that it would be over-optimistic to expect change. There are a small number of case studies, such as
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which describe encouraging successes, but these are too sporadic to be used as a basis for claiming efficacy, and with far too many potentially contributory factors involved in the changes.
If you can locate a BAcC member local to you who has undertaken postgraduate training in the treatment of children we are confident that they will be able to offer you a realistic and honest assessment of what they may be able to do for your daughter.
Q: I am considering accupuncture treatment for smoking cessation. i had this before some years ago combined with Chinese herbal medicine herbs and it worked wonderfully well, now i can't afford the herbs, just the accupuncture. i have been offered 5 appointments of 45 minutes each over 2 weeks for £150 total for accupuncture treatment. Do you think I will manage to give up smoking again with this treatment without the herbs? i just relapsed the last 3 months due to severe family upsets. After being a non smoker for 12 years, i would value your opinion. i have been diagnosed with schzophrenia in the past since 1992 and just recently have a new diagnosis of personality disorder instead.
A: This is a difficult question to answer. It is impossible to say whether it was the acupuncture, the herbs or the combination of the two which made such a successful impact on your cigarette smoking before, so the only way to find out, we suppose, is to see if the acupuncture alone can do it. There's no doubt that the fact that you managed to stay off cigarettes for twelve years would seem to indicate that you are more likely to be able to give up again, especially if the circumstances which brought about your relapse have resolved a little.
However, there are never any guarantees with treatment for giving up smoking.
We wish you the best of luck!
A: We are not aware of any reason why someone with polycythaemia should not have acupuncture, and we have checked with our GP colleagues that this is also their understanding.
There is no evidence that we can find which suggests that acupuncture has been used to treat polycythaemia, although we are sure that there must have been many patients over the years with PV who have had treatment without harm. Chinese medicine obviously rests on an entirely different theoretical basis from conventional medicine, and blood disorders are recognised in a language that may sound strange to the west - blood stasis, blood deficiency, and so on - but we are unaware of any direct correlation between the symptoms of PV and Chinese medicine treatment.
We are confident, however, that there should be no problems arising from the use of acupuncture in someone whose PV is well-controlled by conventional means.
A: As you can imagine this is a question we have been asked before. The answer we gave last year was:
The evidence for acupuncture helping people to stop smoking, either traditional acupuncture or ear acupuncture, is not that great. This was certainly the case when the BMA researched conditions for which acupuncture was effective over a decade ago, and nothing new in the field of acupuncture research has been published since to change that view.
However, research for areas such as nicotine addiction or stress tends to employ a model of treatment which is rarely similar to the ways in which a traditional acupuncturist normally works. The use of formula points, the same ones applied time and time again, does not square with traditional treatment which is developmental and evolutionary - the results from a session help the practitioner to refine the diagnosis and inform amendments to how they treat the patient on the next visit. This is all premised on a system of Chinese medicine which aims to balance energies in the body in the simple belief that a system in balance tends to see a reduction in the symptoms which arise from underlying disharmony. Various forms of addiction, anxiety states and system failures are seen as the alarm bells of disease, and treatment is aimed at correcting the underlying patterns.
It is often worthwhile talking directly and in person to a practitioner to get a sense of whether your own individual case is something which they believe they might be able to help. Using our 'find a practitioner' search on the website or your local Yellow Pages should identify a number of BAcC members working in your area.
This advice still holds good. We would like to say that the anecdotal evidence is good, but sadly it isn't. For some people, it appears that paying money to a health professional being told off or worse, being the object of disappointment, for smoking seems to work, but our sense is that the exact nature of the therapy is less important than the ritual involved. For many people, the attendance at a clinic is to meet someone else's need, and they light up as soon as they get outside.
The last five years has seen a great deal of additional help available within the NHS, however, and if you haven't trawled through the information available and the various support mechanism in place, these are well worth a visit.
Q: What protocols do all the acupuncturists follow also what legislation is most important to acupuncture?
A: A slightly difficult question to answer!
Taking the easier half first, since there is no statutory regulation of acupuncture practice, the only laws which directly apply to the practice of acupuncture are those to do with the safety and hygiene of premises. For most of the UK the relevant legislation is Local Government Miscellaneous Provisions Act 1982 as amended by the Local Government Act 2003. This requires every practitioner to register with the local authority's environmental health department, and requires a one-off fee for every practitioner in every premise where they work. Some authorities conduct annual inspections, but the majority don't.
The only exceptions are Greater London and Scotland. In Greater London, nearly all boroughs have adopted the London Local Authorities Act 1991 which requires acupuncturists to be licensed annually unless they belong to an exempt body, of which the BAcC is one. Statutorily regulated practitioners are also exempt from licensing. Although BAcC members are exempt from licensing there is a set of model requirements which they have to meet, largely the same as the BAcC's, and they have to notify the EHOs that they are working in a borough - exempt does not mean off the radar.
In Scotland the adoption of the new licensing system for skin piercing of all kinds in 2006 means that all acupuncture practitioners except those who are regulated by statute already are required to have an annual licence.
As far as ptotocols are concerned, the general requirements for acupuncture practice by BAcC members can be found at the website of the British Acupuncture Accreditation Board (http://baab.co.uk/downloads.html) where the Standards for the Practice of Acupuncture and the Standards for Education and Training in Acupuncture can be found. We must stress that these are BAcC standards; other acupuncture professionals can do pretty much what they want, although the majority aspire to similar levels of competence.
The word 'protocol' is also used in a much more specific context in Chinese medicine to describe treatment options and patterns which a practitioner might adopt for conditions as understood in Chinese medicine. Any of the textbooks by Giovannie Maciocia would be representative of this kind of approach. This is largely what is called 'TCM', a specific style of treatment. There are many others, and in a broad church like the BAcC there could not be a definitive list of protocols of this kind which was not exhaustive to the point of being useless. There are a number of majority styles in use, however, like TCM, Five Element and Stems and Branches, on which a google search will provide a wealth of detail. You will also find that there are conventional medical practitioners using acupuncture within three main styles - segmental, trigger point and neurophysiological. Again a google search will provide the background you need.