Archives for posts with tag: acupuncture

I am pleased to announce that after seven acupuncture treatments, I am fairly convinced that it significantly reduced my menopause symptoms, even if I can’t prove it scientifically. (I will leave that task to the integrative medicine researchers.) Other improvements, increased energy, improved concentration, and improved mood are a bit harder to link to the acupuncture since there are a number of possible confounding variables such as healing after surgery, the impact of my daily exercise and healthy diet, the impact of my psychotherapy sessions, and the impact of my mindfulness exercises. It is possible that none or all of these factors are contributing to my improved health.

So, I am giving acupuncture the thumbs up. You might give it a try. The following blog might be helpful, Weekly Cup of Qi.

I had an acupuncture appointment last week. Dr. Wang placed the needles and then left me in the room for 30 minutes. While I was relaxing and listening to gentle music, I overheard a patient from the treatment room next door emerge into the reception area. “I’m like a new person! I can’t believe it! I feel so good!”

I am an expert eaves dropper, plus she was talking pretty loudly. I gathered that this was her very first appointment. I later learned that she is an elderly woman with major pain problems who noted concerns upon arriving to the office that she was in so much pain that she was not sure she would be able to complete all of the intake paperwork.

Before she left, I heard her make another appointment for the following week. Then she asked, “If you get an cancellation, call me.” Sarah, the office manager replied, “When?” “Any time. I will come any time.”

I was thrilled for this very satisfied first time acupuncture patient.

As I have mentioned in the past, my initial college career goal was to be an academic researcher. My particular emphasis was on conducting controlled clinical trials. And what I mean by that is doing research to evaluate a treatment by comparing it to an untreated group. This, ladies and gentlemen, is what we call an experiment! And I can say in all sincerity, “Yay, science!” And that’s what I did for my doctoral thesis and during the ten years following my obtaining my Ph.D. in 1997. My career trajectory took a different course, which I have explained in an earlier post. To make a long story short, I didn’t know how to effectively keep chasing grant money while maintaining a healthy family life. But don’t boo hoo for me because going into private practice full time ended up being the perfect job for me.

Back when I was doing science, there was a lot of effort put into designing experiments that were as highly controlled as possible. We picked measures that actually had statistical properties that demonstrated that they actually measured what they were designed to measure. And since we were trying to show that our treatments produced desired change, we had to choose measures that were sensitive enough to detect change. And if there was a variable we wanted to measure for which there were no suitable measures already available, we had to develop our own. Measure development is no joke, people. You might think good social scientists just make up a bunch of questionnaire items and then give them out to their research participants and assume all is being measured in a reliable and valid way but it just doesn’t work that way. Well, I guess one could do it this way but it would not be good science.

We also tried to “control” or account for variables  that could explain changes (or lack thereof) between the treatment and control group, other than the nifty treatment program we were testing. These little extra trouble making variables are called “confounds.” Confound it, variable, you have messed up my experiment! Sometimes these variables can be controlled for statistically but other times, they cannot. Inclusion criteria for studies are developed to screen out the latter variables. For example, when I was doing research evaluating a parenting program to support positive behavioral and emotional development in young children with behavior problems, we screened out children with Attention-Deficit/Hyperactivity Disorder because research on AD/HD shows that psychological treatment alone is not usually effective for kids with AD/HD. (I wish it were but it is not.) Young children with AD/HD often show behavioral problems but they would be unlikely to respond to treatment, unlike other youngster who did not have this additional diagnosis. So, those of you who have tried to join breast cancer trials and have been denied based on the inclusion criteria for the study, this is the reason why. The researchers are not trying to be mean. They are trying to get the clearest picture that they can about whether the treatment is helpful for its intended purpose. After a treatment has initial support and the findings are replicated, subsequent studies may shift the criteria to other groups, which may have been screened out of earlier trials. But if a researcher cannot show a positive impact in the early trials, they risk that treatment being seen as a dead end. And if the treatment looks bad, subsequent research on it will not get funded.

Okay, that’s a little about my former life as an investigator on clinical trials. As a clinician, the test tube gets a little dirtier. I am trained in using evidence-based practices and I use them. However, they do not describe every possible scenario. Often, my recommendations are based on my understanding of the principles that underlie the evidence-based treatment models that I use, rather than from a treatment manual. Also, families come in distress and I often recommend that they get a number of interventions going at once, interventions at home, at school, and with a physician. When there is improvement, from a science perspective, I don’t really know what the most critical components of the intervention were for that particular child. This is because I am not doing research on my patients. I am a clinician. I work systematically and my efforts are guided by what research is currently telling me about best practices. My work is also informed by my clinical experience. I can’t exercise the same control as I did as a scientist.

Now I am a cancer patient. My physicians, just like I do with my patients, have hit me with multiple treatments at once. To further muddy things, I have opted for an integrative approach to my treatment. In addition to my onco surgeon and my medical oncologist, I see a naturopathic oncologist and receive acupuncture from a physician trained in Chinese medicine. I also follow a special diet, take nutritional supplements, engage in mindfulness meditation, get a massage every 3 weeks, and walk 3 miles a day. My holistic treatment plan is quite variable in terms of the research evidence available to support it.

Does this mean that I threw my whole education away? I don’t think so. For one, I am mindful of the fact that there are no guarantees that my cancer won’t come back or that I won’t get sick with some other disease or that I won’t get hit by a bus tomorrow. My mindset is one of influencing rather than trying to control my outcomes. Some of my complementary or integrative practices are no-brainers. Maybe my losing nearly 40 pounds, eating healthy food, and walking 3 miles a day won’t keep cancer away. But I know that (1) I feel better now and (2) I am reducing my risk of all kinds of future health problems. Eating lots of chard and broccoli is not the same as buying snake oil. And research is still out on whether there are higher nutritional benefits for organically grown produce. I think there probably are more benefits nutritionally. But even if there is not, there are environmental sustainability benefits. So, this again, is a no brainer to me. I don’t exclusively eat organic, but I mostly eat organic. And my last example is the flaxseed meal I take every day. Maybe it will not really prevent breast cancer recurrence but it’s good fiber and Tamoxifen is a little constipating.

Some of the actions I am taking are for potential long-term benefit. I may never know if they help but they might help. (Obviously, I am omitting interventions that may cause harm unless there is evidence that the potential pros greatly outweigh the cons.) I am also not in favor of doing anything that just seems outright illogical or doesn’t have some kind of track record. I must admit that I don’t get the logic behind acupuncture but I respect that it is based on thousands of years of practice from a an amazing culture. It also has western-research validated applications, especially in pain management. Plus, I get to meditate while the needles are in and there is some research suggesting that mindfulness meditation reduces the risk of breast cancer recurrence. And even if that research doesn’t bear out, there’s ample research of the effectiveness of mindfulness meditation in stress and anxiety management. And in case you haven’t heard, having breast cancer is stressful and often causes anxiety!

But I haven’t thrown away my research training. Enter the single case study design. It’s a very simple design, often called “ABA” or “ABAB” design depending on how it’s set up. For me, the single case is me. “A” refers to baseline. “B” refers to treatment. What? Okay, it’s easier to explain with an example. As I have mentioned in the past, I have a long history of eczema going back to my early 30’s. My naturopathic oncologist suggested that it might be due to a wheat allergy and asked me to consider not eating wheat for a couple of weeks. In this case, “A” is my baseline, otherwise known as the 15 years I spent eating wheat and scratching. “B” is the time I spent off of wheat. I actually refrained from eating wheat for about three months. My skin cleared considerably. But there’s some variability in my eczema. It waxes and wanes. So the clearing could have just been part of that cycle. I decided to go back to “A” by eating a slice of pizza that one of my brother’s brought to me right after my TRAM surgery. Two days later, bam! Huge outbreak of eczema. So I promptly went back to “B”, not eating wheat and my skin improved. Usually, results are not this striking. This was a darned good use of the ABAB single case study design. I am using the AB or possibly ABA design with acupuncture. Although I am noting improvements in hot flashes and my energy level, it is hard to say whether the former is just due to the general pattern I’ve noted of improvements in hot flashes a couple of months after each Lupron shot and the latter might just be due to the natural course of my healing from my surgery. However, I got my new three month Lupron shot yesterday and another session of acupuncture today. All of these variables manipulated at once! We will see what happens.

You can try AB or ABA or ABAB designs for yourself. One trick is that it will only work for interventions for which you expect quick results.  I can’t eat Swiss chard for two weeks, stop eating it for two weeks and expect to detect any changes in my health, for example. But don’t make the same mistake a coworker made years ago. She had chronic neck pain for many years (A) and decided to try acupuncture (B). She decided to stop acupuncture (back to A) to see if it was really a “cure” because unless it was a cure, it was not real in her eyes. Her neck pain came back so she decided that acupuncture didn’t work. This is like deciding to no longer take insulin injections because your Type 1 diabetes is poorly controlled when you don’t take it. Not all effective treatments are cures but that doesn’t mean they are fake or useless. I suspect she would have viewed diabetes treatment differently and her illogical reasoning had more to do with her discomfort with eastern medicine because she was quite an intelligent person.

Finally, I found an excellent article on the Anderson Cancer Center website that describes practice guidelines for integrative care for cancer.  Check it out!

It is day 6 since my initial acupuncture visit. Time will tell the full story but my hot flash frequency has been less since the treatment. Also, they are more predictable. My first flash of the day is between 5:50 and 6:10 pm. I have an alarm set on my phone to remind me to take a few nutritional supplements (I take most of them in the morning). I find that my 6pm hot flash is a good reminder! I have continued to have hot flashes at night but fewer of them and for the most part they are less intense and shorter. I have gotten one hot flash each night that leaves me in a puddle of sweat but it doesn’t last that long. The intensity of it is actually greater than before acupuncture.

My energy level is noticeably higher this week but this could just be part of my normal post-operative healing process since it has been 5 weeks since TRAM reconstruction.

I have another appointment tomorrow so I will keep you posted. I really didn’t expect to experience any change at this point so I am quite intrigued.

The Weekly Cup of Qi has a post today about what to expect during one’s first acupuncture appointment. It meshes with my first experience exactly so I encourage you to read it if you are interested in learning more about what happens during an acupuncture visit.

I had my first acupuncture appointment today. The doctor was trained in both western and eastern medicine for 8 years in her native country of China.  She seemed bright and vivacious. Her touch was gentle but precise as she took my pulse, which was reassuring to me.

The needles were no big deal. I could barely feel her putting them in. They were left in for 30 minutes, during which I did relaxation breathing and occasionally reminded myself not to scratch my nose because my hands were full of needles that I couldn’t even feel. I was not even creeped out by the fact that she put one needle between my eye brows and another on the top of my head.

The 30 minutes passed fairly quickly. She skillfully and quickly plucked the needles from me like daisy petals. Then she ran her hands gently over my body to make sure that she’d removed all of them. I left feeling refreshed.

I am going to see her once a week for 6-8 weeks. We’ll see what happens!

In the meantime I have a couple of practical tips for those of you who might consider receiving acupuncture:

1) Use the restroom before your appointment. I ended up being fine but when she said, “30 minutes, you be okay?” after placing about 40 needles my first worry was that I would need to use the restroom. (Women, who have given birth and/or women of a certain age, you know what I am talking about.) In general, I am what I call an “opportunistic pee-er”. Just like I did with my daughter in the first few years after potty training, I often make sure that I at least “try” upon leaving the house or upon arriving at a new destination. Today, I didn’t because I came into the waiting room with a 20 ounce beverage. You might think that’s more reason to use the little girl’s room but although I’m not religious about it, I don’t like to bring food to the bathroom with me. I had planned to get settled in the waiting room and then scope out the facilities. But then I got absorbed in the paperwork and chatting with the fascinating woman who works in the waiting room. Although I did not make my usual potty stop, I ended up being just fine.

2) If the thought of needles creeps you out, I just want to remind a lot of you out there that you have endured much more invasive and creepy procedures in your medical treatments. This treatment was actually relaxing, pleasant, and blood free. And for bonus points, I didn’t even have to take off more than my shoes and socks! She just pulled up the legs of my yoga pants a little and pulled them down a bit at the waist.

3) Be prepared to talk about how you life, especially stress may have contributed to your disease and what methods you might use to reduce the stress in your life. I know that to some people, this approach feels like the patient is being blamed for their disease. I don’t take it that way myself but as a psychologist, I think of the brain (mind) as being part of the body, rather than being separate. So the idea that emotions, thoughts, or other “mind stuff” impact the way the rest of one’s body works is no news to me. To be clear, I don’t believe that disease is caused only be stress, attitude, etc.

It was pouring down rain this morning so I waited to take my walk. It’s beautiful so I’d better get going!

I remember being in church as a teen listening to a homily by a visiting mission priest and an interesting man. One of the remarks he made in his sermon was some thing like, “The only one you convert when you are missionary is yourself.” It was a thought-provoking statement with I believe some truth in it.

In the spirit of his words, I have taken the Health Activists Writers’ Challenge today to help activate myself. I have been procrastinating about making an appointment for acupuncture. I left a phone message yesterday and today, I made an initial appointment. It is spring break for many schools so the doctor’s schedule is a bit lighter this week. So my initial appointment is tomorrow.

I will let you know how it goes.

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