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Ask an expert - general

189 questions

Q:  Is acupuncture an effective treatment of Bile Salt Malabsorption? I've put on about 3 stone since I've had this, and there is no cure. I'm desperate to lose weight and get some treatment for this condition, which although isn't life threatening is debilitating. Any advice you can give would be much appreciated.
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A:  Bile Acid Malabsorption syndrome is one of those conditions which appears to have only recently warranted a name of its own, so there hasn't been a great deal of chance for anyone to research the use of acupuncture under problems with this name. We are fairly sure that you have done a great deal of research on the internet over the time that you have suffered from these problems, so you are probably conversant with the different ways in which the condition can manifest and some of the causes. Unhelpfully, of course, one of the most frequent labels is 'idiopathic', which is a Western medical way of saying 'it just happens and we don't know why'.
 
From a Chinese medicine perspective, though, the disease labels are often very unhelpful. What interests a practitioner of Chinese medicine is the symptoms with which a patient presents, together with the history and sequence of how they developed and the patterns which they form. The Chinese understanding of the body is very different from the Western one, with the concept of 'qi', or energy, being a central one. The quantity, flow and balance of qi determines good health, and the Organs of the body (we always use capital letters because what they do is very different from the way they are understood in the West) have a variety of functions which with a good flow of qi they maintain. When symptoms arise, they point to a weakness of flow in parts of the system. With the help of the patient's description of their symptoms and case history, together with diagnostic signs which are unique to Chinese medicine like looking at the tongue and taking the pulse at the wrist, the practitioner aims to establish where disharmony lies and addresses it.
 
In your case the weight gain, which is commonly reported in this condition, might have one of a number of recognised causes from an Eastern perspective, and if the diagnostic signs and answers to questions about other bodily systems point in consistent directions, there may be something for which a practitioner could offer hope. In Chinese medicine,for example, weight gain can often be tracked back to the poor function in the Spleen (note the capital letter - we are not talking about the western organ, the spleen!), which can cause an accumulation of fluids, especially in the central part of the body. If this is malfunctioning to a significant degree, then other aspects of the Spleen's functions will start to manifest problems. Someone may find they are visiting the toilet more frequently and urgently with looser stools, or they may find themselves bruising more easily, or their short term memory and concentration may be not as good as it was. These are all signs that the Spleen may be off key. The Chinese medicine practitioner would ask many questions to get a sense of what may be going on, and if the tongue and pulse supported this diagnosis, there are clear protocols to follow.
 
The beauty and complexity of Chinese medicine,however, lies in its ability when practised well to go to the heart of the problem, not simply treating where symptoms arise. The complex inter-relationships within the system can mean an Organ under-performs not because it is actually suffering but because it is not being supported by another Organ, and the reason that one can never reduce good Chinese medicine to formula treatments for named conditions is that a single named condition might have any one of a dozen different causes - it is the skill of the practitioner which enables them to go the point which will have the greatest effect in putting things back in order.
 
This may not seem as though it is directly addressing your problem, but what we are saying is that this is one of a number of conditions where the symptom and disease label alone are not enough for us to be able to offer a view at a distance, especially since the variety of possible causes means that there has not even been any targeted research on the basis of the evidence of which we could offer a view. What you need is a brief face to face assessment by a practitioner, hopefully without charge, to establish whether what they see encourages them to offer treatment with some hope of success.
 
That is not to say that there has to be a distinct and visible cause from a Chinese medicine perspective; the oldest systems still in use were broadly asymptomatic, treating people rather than diseases in the straightforward belief that a system in balance did not generate symptoms. However, even within this system, a practitioner can usually give an honest appraisal of the possible value of treatment before committing your time and money.
 
You can find a list of all the BAcC members in your area by using the practitioner search function on the BAcC's home page.    
    


Q:  I am trying to find a member who specialises in treating chronic fatigue and fibrmyalgia in the north london south hertfordshire area

A:  We take the view that all of our members are competent to treat the vast majority of western named conditions with which patients present at their clinics, and therefore do not have specialists as such. There are one or two areas where we are developing guidelines for what we call 'expert practice' in which we recognise that for some groups of patients, especially children, pregnant women and people with mental health problems, there may be additional training which makes a practitioner better able to deal with the problems which they have. This does not mean that we would forbid our members from working with these groups without additional training, but we may decide that someone with this additional postgraduate training may be able to describe themselves as offering specialist practice.
 
Chinese medicine is very different from western medicine in one very central aspect - Chinese medicine treats the person, not the condition with which someone presents. It is founded on the belief that each person is a unique balance of energies, and that the skill and art of the practitioner lies in understanding the symptoms which someone has in the context of the patient's unique patters. This could mean thar twenty patients with headaches are treated in twenty different ways by a practitioner, a very different approach from western medicine. As such, we have practitioners who are skilled in treating people, not individual conditions which people may have.
 
In practice, we would advise that a prospective patient talks to a number of practitioners to determine for themselves who they would like to see. We have a search facility on our home page which means that you can quickly find all of the BAcC members close to your postcode, but it is important that you feel confidence in the practitioner, and all of us are more than happy to take a little time to explain who we are and what we do. Although we are all equipped to deal with problems like CFS and fibromyalgia, these can both be quite difficult conditions to treat, with results occasionally being very slow to gain and difficult to maintain, and having some experience of this can be an advantage in terms of managing expectations, from both sides!

 

Q:  Is the British Acupuncture Council on the approved list for blood donors, and what is the time scale for giving blood after a treatment?

A:  The most recent press release which we published on this subject was in June 2013. It said:

 

Blood donation current status June 2013

 

Date: Friday, 21 June 2013 12:42

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 statutory regulation of acupuncturists now unlikely in the foreseeable future, this could mean that someone having regular treatment with a BAcC member would never qualify 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 http://www.transfusionguidelines.org/document-library/documents/change-notification-no-32-2009/download-file/dl_change_note_2009_32.pdf and http://www.transfusionguidelines.org/document-library/documents/change-notification-no-33-2009/download-file/dl_change_note_2009_33.pdf 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.
 
We are sorry that many thousands of donors have been 'disenfranchised' by this change of policy and are working our hardest to bring them back within the list of eligible donors. 
 

 

 

 

 

A: The short, and somewhat trite, answer is that they make sure that they are properly trained to begin with. Training in the UK, at least for entry to registering bodies such as the BAcC, requires a three year degree equivalent course which ensures not only that the basic knowledge is wired in but also that the bestg possible clinical practice is inculcated in the students. Knowledge without wisdom and good practice is irrelevant, and the crucial element in training is not being able to generate lists of symptoms and syndromes but to be able to respond to the unique problems which each patient brings to the clinic. This requires a great deal of supervised practice, in our view, to give practitioners the confidence to be able to adjust and refine their work to the patient's best advantage, and also to deal with situations where things don't go as well as they hoped. Knowing what to do is important, but knowing what to do when something goes wrong is the sign of true skill and mastery.
 
Making sure that someone follows best practice is an individual responsibility, but regulatory bodies such as the BAcC have the responsibility for checking that practitioners registered with it maintain their skills and develop as practitioners. As well as offering our own advice and support, with a great deal of valuable material being available on our website and through our professional journals we also have a mandatory requirement for members to undertake what is called CPD, Continuing Professional Development, which is aimed at making practitioners develop their skills after they have qualifed and for as long as they practise.
 
That, of course, is the carrot. The stick is that we have some very well defined rules of behaviour, skill and conduct to which  we expect our members to adhere, and we are always ready to take sanctions against someone who does not continue to meet or adhere to our standards. Expelling members is a rare event, but we do have occasion to ask members to up their game in terms of basics like good record keeping or respecting boundaries. The BAcC is a particularly well-behaved professional body, and disciplinary cases are rare. Above us, however, sits the Professional Standards Authority, a government agency with whom we are accredited, and its task is to ensure that professional associations such as ours continue to demonstrate that we are protecting the public by making sure our members are properly trained and accountable, and that members of the public have access to advice, support and pathways to complain if they are unhappy with any aspect of the treatment which they receive.  

Q:  Are there any acupuncturists specifically trained in non-surgical "face-lifts" who are members of BAcC and if so, are there any in Oxfordshire?
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A:  We find ourselves a little bit conflicted when we receive questions like this. There are a number of areas where are developing standards of expert practice. This in turn might lead to qualifications which would enable us to recommend specific groups of practitioners. However, at the moment the focus is on paediatrics and obstetrics, so although we are aware of a number of courses which offer postgraduate training in facial or cosmetic acupuncture, we have not yet agreed the standards against which they should be measured.
 
However, it is widely recognised by many of the trainers in this area that using facial acupuncture techniques without also attending to the underlying patterns of energy is not as effective. We always recommend, therefore, that if someone is conducting their own search for a practitioner they should ensure that the person is a fully trained professional acupuncturist, not someone who has learned a few specific techniques as an adjunct to beauty therapy. There are also some safety concerns about being treated by someone who is not a professional acupuncturist. There is no difference in health and safety terms between someone who uses ten needles a year and someone who uses ten thousand. The same scrupulous attention to hygienic practice is essential. We have some reservations about very short coirses which offer the technique and all of the safe practice essentials in a very time.
 
If you undertake a google search under 'facial acupuncture oxford' you will find a number of BAcC members whose standards you can trust and who have undertaken additional training in this area of work   
 

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