Kevin Coughlin MD Blog

I have been treating nerve pain more often of late: Shingles (Herpes zoster) pain, trigeminal neuralgia (facial pain), and painful legs. A recent issue of Time magazine addressed the difficulty of chronic pain. It is very common. Among several articles Acupuncture was mentioned - largely in a positive light. I agree that acupuncture can be helpful. It releases endorphins (internal morphine). It also increases blood flow in the area of treatment. I see this as providing immediate relief (endorphin) and long term improvement (healing through the blood flow). A patient with painful legs for 7 years since cancer treatment, saw “95%” improvement with a single treatment last week. Most people take 3-5 treatments to see significant change, but the miracle responses are fun to see. Pain can be very limiting to quality of Life. Having a treatment to address it - with fewer medications - or with no medications - is rewarding for me and those I treat.

A follower recently challenged all acupuncture as worthless. “Studies have shown that people get the same results when the needles are placed in ‘real’ points and in ’sham’ points”. He also cited a study done by Harvard, Duke and other famed medical centers which showed no benefit from acupuncture for a group of people with carpal tunnel syndrome. My response - there is no such thing as completely “sham” acupuncture. What is usually meant by this term is placing needles near acupuncture points - off the mark a little - or a lot! The fact is, though, that any time the skin is penetrated by an acupuncture needle there is an effect on the central nervous system. Bruce Pomeranz, PhD from the U of Toronto, among many others, has shown by research that acupuncture affects the endorphins, serotonins, and the autonomic (sympathetic, parasympathetic) nervous system.

In response to the followers other point: There are many studies which DO show benefits from acupuncture. The AAMA symposium highlighted many such studies - for several countries including the US, Germany, Mexico, Brazil and of course China.  I read a quote recently that said “We know how acupuncture really works. If you poke a needle in someone every time they complain - pretty soon they stop complaining”. Not sure if that is serious or a joke, but I do know that my days are filled with patients waiting for the needles to do positive things for them. There most common complaint is when the needles come out. They would like to keep them in longer.

April 22-25 I attended the national symposium of the American Academy of Medical Acupuncture. This is the annual meeting for all MD acupuncturists in the US. It was outstanding. The speakers and workshops included researchers, and clinicians from some highly regarded institutions: Harvard, Johns Hopkins, U of California, Penn State and the Mayo Clinic. Acupuncture is being studied and used in cancer treatment, anesthesia, pain control, blood pressure control, among others.There were clearly 2 groups: Researchers - very important for validating acupuncture in the modern setting, and Clinicians, like me, treating real people with all types of issues. This is also important for the improvement of pain and well-being. I came back with several approaches and techniques which I am using.  My commitment to the practice of Medical Acupuncture has never been stronger.

Oh, and there have been 2 recent articles on acupuncture in the Wall Street Journal / Personal Journal section. The latest was June 1st reporting on the chemical mechanism of how acupuncture influences the human body through a particular metabolic pathway. Evidence continue to grow.

We had an interesting week as we closed out February 2010. 2 Positive IVF pregnancy results - I will be supporting them weekly until the pregnancies are established. Another treatment course was to turn a 34 week baby from breech to head down - results are pending. Still another treatment was induction of labor for baby number 7! Spleen 4 and Spleen 6 were particularly effective and she left the office with hard steady contractions - waiting to hear how long it took to deliver. But, not every treatment was Baby related. Recent patients include a gentleman with ALS and arm weakness, and a lady from far West Nebraska with a neurological degenerative disease too new to have an insurance code! Her hearing and blinking are affected but mostly we are working on strength in her arms too. Monday will be her second visit. Other new patients this week have Fibromyalgia, Bipolar disorder, Chronic migraines, withdrawal symptoms from anti-depressants and pain medication. And on it goes - of course with low back pain, neck and shoulder pain holding their good share of appointment slots.  I am still fascinated and encouraged by responses we see. On we go.

The web talk was well-received last week. I covered the applications for acupuncture during cancer treatment, and recovery phase. Sources included the research from such prestigious sites as MD Anderson, Johns Hopkins, Mayo Clinic, and Sloan Kettering.  I cited the work of Keith Block, MD from Chicago, a leader in integrative oncology. But during the Q/A at the end “Frank” a “retired MD” took issue with acupuncture stating that “nothing has changed in 50 years” and this is “all hocus pocus” (I sensed that he wanted to use a stronger phrase) and no better than hypnosis. I replied that I respected his opinion, but knew of hundreds of colleagues around the country who practiced acupuncture every day and saw clinical results. “Well, maybe one in 200 would fall for this, but most doctors are TOO HONEST!” after which he hung up.  The moderator apologized, but I felt and stated that it was educational to hear first hand that such opinions do exist, and may be all too common among Western physicians. The rest of the questions were thoughtful and sincere. Several came from cancer patients, and some from nurses and caregivers. So heckle away, those who protest. You will not dissuade the advance of Integrative Medicine.

Next Week - I will be presenting a talk for the Catholic Health Initiatives network titled “The Healing Power of Acupuncture”. This is part of the Strong & Smart - Living Well with Cancer series. I will address the growing field of Integrative Oncology (Conventional + Alternative) and the applications of acupuncture within that setting. The details are:

Tuesday, February 9, 2010

10AM PST - 11AM MST - Noon CST - 1PM EST

45 minutes of Presentation + 15 minutes Q/A

Register and receive log in information at 800-278-7837

There is no charge.

You will be able to watch on your computer screen and listen on your phone. For yourself, friends, and family this is an opportunity to hear how acupuncture can enhance cancer treatment and recovery. It will also be recorded for later access. We would love to have you join the audience.

2010 finds Medical Acupuncture in steady demand. The balance remains at 60% pain management; 40% energy work but some dynamics are changing. I find MORE fellow physicians are suggesting that patients consider acupuncture - and then referring for treatment. This is very encouraging. So often in American Medicine the sequence only includes medication, then surgery. Sometimes it includes some physical medicine such as physical therapy - or injections of medications before surgery. But in the last 6-12 months I find more of my colleagues are inserting acupuncture (no pun intended) into their sequence of management. And really, why not try a series of $90 acupuncture treatments for a knee or low back before commiting to a $50, 75 or 100K surgery bill + the risks of anesthesia, hospital-borne infections, etc. It just makes sense.

Headache (HA) patients are a significant % or my practice. The last 2 weeks I have seen a NUMBER of new HA patients ranging in age from 11-85 y/o. Acupuncture offers a whole host of approaches. Some very direct and logical. Some very complex and steeped in the most traditional understandings of Chinses Medicine, Yin/Yang, Qi and the 5 Elements of Wood, Fire, Earth, Metal, Water. A recent patient saw immediate relief from HA she has had for years [holding now for 3 weeks; her co-workers can’t believe it; she is happy]. 2 new patients are over 50 with new onset of nagging HA with in the last 12 months [CT and MRI have ruled out tumors, thank goodness]. Overall, HA patients have had some of the most dramatic responses in my practice. I look forward to the challenge of a new HA patient - especially those who have “tried everything”. If you are in that category consider a series of acupuncture treatments. Perhaps life can be better. A lot better.

We continue to  have positive pregnancies. Some are IVF with assistance by acupuncture. Several have been spontaneous (although) some couples do use IUI. In reviewing the acupuncture literature there continue to be a number of thoughts on which are the best meridians. I individualize, but favor Chong Mo and Ren Mo for their deep energy connections and influence on reproductive energy.

I have several patients following recommendations of Randine Lewis, PhD. She has written The Infertility Cure (Traditional Chinese Medicine based) and host The Fertile Soul retreats (search online).

I recently became aware of the Sher Institue at haveababy.com. They have a partial refund policy if IVF is not successful. There are other clinics with similar policies around the country.

I also continue to see a LOT of different drugs used by the Reproductive Endocrinologists and I try to strike a balance with my patients to not be OVERLY dependent on external hormone manipulation. Many patients are also told “gain weight” and “don’t exercise at all”. I understand the theory of hormone suppression if one is TOO lean, but I think it is unwise to eat excessively just to gain weight. And exercise, in balance, is very beneficial for the mind and spirit - so I chafe at stopping it completely. Again, balance is the key. A colleague recently said “Keep your focus on your partner and his or her needs. Don’t always focus your love and energy on the baby you want to have.”  I like that. To all of you trying - I wish you success. Call or email if we can help.

If you or someone you know is dealing with Cancer, these are 2 NEW books just out.

First, “Life Over Cancer” by Keith Block, MD. Dr. Block is a conventional oncologist (cancer doctor) who is leading the movement in the US to combine chemo / radiation / surgery WITH complementary treatments like acupuncture and sound nutrition advice to support people before, during and after their cancer treatments. This book is designed for the PATIENT at whatever point they are. I HIGHLY recommend it. Check online to get a copy.

Second is “Integrative Oncology” Donald Abrams, MD / Andrew Weil, MD. This book is more for the DOCTOR but is one you might share with your oncologist. It addresses a host of supportive treatments for patients during cancer therapy (including acupuncture). You can also find it online.

Share this information - and use it yourself. Dr. Block’s chapters on eating for cancer prevention are for ALL of us. Cheers!