IT'S HALLOWEEN!

Lady Gaga and her entourage...the lil monsters love her and her needling!

Happy Acupuncture and Oriental Medicine Day!!!

October 24th is Acupuncture and Oriental Medicine Day!!! 

http://www.aomday.org/

The 2007 National Health Interview Survey (NHIS), which included a comprehensive survey of CAM use by Americans, showed that approximately 38 percent of adults use CAM.   Join the growing group of Americans who use CAM in their daily life! 

Today's the perfect reason to try acupuncture, acupressure, reflexology, massage, reiki, or aromatherapy!  

My First Acupuncture Experience and Tips for the Acupuncture-Naive

At my first acupuncture visit, I arrived as the naive patient I was and not as the medical student I’ve been trained to be.  Instead of emulating the perfect patient that I always dream for, I arrived slightly late with incomplete forms and without proper payment methods (cash/check).  I finished the ten pages of forms a few seconds before I was whisked away from my two 3-year students and their preceptor.   Immediately, I was impressed that a student-run clinic actually was functioning on schedule!

The patient interview consisted of some standard Western medical questions interspersed with some questions I definitely didn’t expect, including whether I liked cold or hot beverages and what kind of dreams I had at night.  Rushed, out-of-breath, and slightly sweaty, the students looked at me with concerned eyes and questioned my sleep and energy level.  After feeling my pulse three different ways in both hands, they left to discuss a treatment strategy and left me to relax on the table.

When they returned, I lay as the students “needled” me on my feet, ankles, knees, stomach, sternum, head, wrists – and I’m sure multiple other points that I didn’t even realize.  My treatment was for an immune boost (due to the upcoming cold season), general well-being, and “liver boost”.  After the needles were in, I was left to lie on the table for about 15-20 minutes.  The students came back to remove the needles and asked if I had any pain or new symptoms, and then the visit was done.

Michelle, an acupuncturist here at ITPCU who also teaches at the school, said I “looked great!” after my treatment.  She claimed she witnessed a marked improvement, but my sleepy boyfriend could not.  While I’m not sure if it was the forced relaxation or the actual treatment, but I definitely felt more awake and energized! 

I definitely want to go back, but I want to go back with a concrete complaint.  Therefore, I’ll have a more complete experience with acupuncture treating physical symptoms versus general well-being.

A Few Lessons for the Acupuncture Newbie:

1.   Wear loose and short clothes – points are placed on the ankles, knees, stomach…basically everywhere

2.   Relax as much as possible – falling asleep is fine, especially if you’re getting therapeutic benefit from it

3.   The needles hurt minimally when they’re being inserted at the acupuncture points.  If anything hurts after the initial entry of the needle, let them know!  Acupuncture is NOT supposed to hurt.

4.   Try not to move after the needles have been inserted.  I moved my finger slightly, and I definitely felt my tendon moving against the needle.  Try to stay as still as possible.

5.   Try to relax – you’ll benefit more from the experience if you do.

6.  Bring the right payment method!  Stressful runs to ATMs after treatments is an easy way to ruin your post-needle buzz.

Our Case for Personalized CAM: Aromatherapy Part 2

Inhalation aromatherapy in children and adolescents undergoing stem cell infusion: results of a placebo-controlled double-blind trial. 

Ndao DH, Ladas EJ, Cheng B, Sands SA, Snyder KT, Garvin JH Jr, Kelly KM..  Psychooncology. 2010 Dec 27. http://www.ncbi.nlm.nih.gov/pubmed?term=Inhalation%20aromatherapy%20in%20children%20and%20adolescents%20undergoing%20stem%20cell%20infusion%3A%20results%20of%20a%20placebocontrolled%20double-blind%20tria

The Study:  In a placebo controlled, double blind randomized trial, bergamot inhalation aromatherapy was compared with a pleasant smelling shampoo that did not contain essential oils.  Both were administered around the time of stem cell infusion in 37 children and adolescents undergoing stem cell transplant to both patients and their parents.

Overall, aromatherapy was not found to be beneficial in reducing nausea, anxiety, or pain.   Nausea and pain subsided over the course of the intervention for all children, though nausea remained significantly greater in patients receiving aromatherapy.  As administered in this study, bergamot inhalation aromatherapy may have contributed to persistent anxiety following the infusion of stem cells.  Although no more effective than placebo, parents receiving aromatherapy showed a significant decrease in their transitory anxiety during the period between the completion of their child’s infusion and one-hour following infusion.  These findings suggest the diffusion of bergamot essential oil may not provide suitable anxiolytic and antiemetic effects among children and adolescents undergoing stem cell transplantation. 

Limitations:  The study population was fairly small.  There was a high rate of aromatherapy use pre-intervention, potentially confounding results.  In addition, it was hard to differentiate between treatment- or transplant-related effects including anxiety and nausea.  

What this Means:  This study, in combination with the previous one I posted, provides some opposing evidence for the use of aromatherapy during stem cell transplant.  The difference in study design may explain the differing results, as single blinded or nonblinded trials in general supported the aromatherapy intervention.   In double-blinded studies, both the study leaders and participants do not know what intervention the patient is receiving; they are the gold standard in research since they remove many factors that could alter data. However, the strong emotional link to the sense of smell makes it extremely difficult to control for in research settings.  Since the symptoms measured, primarily anxiety and nausea, are also closely linked to emotions, it is difficult to ascertain any improvement or worsening of symptoms. In addition, this study also showed that essential oils have unknown side effects, possibly nausea and anxiety in this study, that we do not quite understand. 

My Take:  These two studies, in combination, sort of contradict each other.  However, they did use two different essential oils and two different study designs so they are difficult to directly compare.  From personal experience, I’ve seen that other scents may have been more likeable to a pediatric population such as peppermint, grapefruit, orange, and lavender.  However, bergamot, a citrus, has been described as efficacious for pediatric anxiety and nausea in aromatherapy literature  (1,2).  While each essential oil has a clinical indication, the CAM practitioners here at Columbia’s pediatric oncology department mostly go by patient preference.  The scent of smell is so closely related to emotions Often, they find that individual smells “speak” to a certain patient and provide relief regardless of the initial clinical use.  This type of patient-centered treatment allows us more flexibility and better patient care.  In the CAM world, it’s our form of patient-centered personalized medicine. 

1.       Wildwood C. The Encyclopedia of Aromatherapy.  Healing Arts Press: Rochester, 1996.

2.        Price S, Price PP. Aromatherapy for Babies and Children.  Thorsons Publishers: San Francisco, 1996.