Case Studies

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Amanda had been coming into my clinic for two years to receive treatments for her chronic lower back pain and fatigue. One day, she asked what acupuncture could do for her anxiety about an upcoming surgery on a bone spur in her neck that had been troubling her for many years. Acupuncture, herbs, massage and other approaches had helped her live with the pain, but had not eliminated it.

“The surgery sounds terrible, and reading about the procedure didn’t inspire confidence,” she said. “They cut your neck open from the front and move everything aside to saw off the spurs.” She went on for some time about it, but I’ll spare you the gruesome details.

The Importance of Relaxation

After our discussion, we took some time to create a relaxing atmosphere. I worked on her feet and her neck and shoulders — gently — with acupressure and polarity therapy. I placed needles in her heart meridian and other key calming points, especially in her ear.

Shen men (which means “heavenly gate”) is an effective point for helping calm the mind or spirit in many situations, and it’s a point that can be used anytime. Use your fingernail, or squeeze your ear with your thumb and forefinger at the correct point (see illustration) for a few minutes whenever you feel anxious or nervous. Try to find the tenderest spot and keep on applying steady pressure. You should experience some discomfort at first, and soon, if you have the correct point, it will begin to “hurt so good,” and you will notice a decided calming effect. The Shen men point can be pressed every few hours, or any time you feel anxious or unsettled.

Amanda went home with an “ear seed” I had applied to provide pressure to the correct location. This traditional treatment consists of a small piece of tape over a tiny metal “seed” that creates continuous pressure on the exact spot located by the acupuncturist. You can add extra pressure to the seed with your thumb and forefinger as needed.

Impressive Research Results

When you think of acupuncture, you are likely to imagine its pain-relieving effects, for which it is best known. Pain specialists are very aware of this association. A survey published in 2000 showed that, of 362 pain specialists throughout the United States who responded to the survey, 84 percent said they considered acupuncture a legitimate medical practice for relieving pain, and 69 percent either practiced it themselves or referred patients to an acupuncturist.

As acupuncture has gained international stature as a respected treatment for relief of pain and other symptoms, such as fatigue or nervousness, researchers have designed many studies to discover modern scientific evidence of the technique’s clinical effectiveness.

Acupuncture has been studied for its ability to support surgery patients. Although the studies are not yet conclusive, some encouraging clinical trials have shown positive benefits. The most widely used treatment involves a wristband patients can wear continuously, often with a very small electrical stimulation that targets the anti-nausea point, pericardium 6 (P-6). Several controlled studies show a reduced amount of postoperative nausea with the wristband, for instance after gynecological surgery, such as hysterectomy. One type is called ReliefBand and is widely available.

In any surgery, nausea and vomiting are common after the effects of anesthesia wear off. In one controlled, double-blind study, the wristband was used along with a prescription anti-nausea drug for patients after plastic surgery, versus the drug alone. Only 20 percent of the patients using the band experienced nausea, while 50 percent of the patients given the drug reported feeling nauseated. Vomiting was reduced to none in the wristband group versus 20 percent in the drug-only group, and the need for rescue anti-nausea drugs was reduced from 37 percent to 10 percent, all measured 24 hours after surgery.

In 2004, Drs. Lee and Done from the Chinese University of Hong Kong published a complete review of the available 26 international clinical trials that studied the effects of acupuncture for reducing nausea and vomiting after surgery. They found that P-6 stimulation significantly reduced nausea and vomiting compared with patient volunteers who got a placebo treatment, and even reduced nausea more effectively than anti-emetic drugs, with a confidence level of 95 percent. Since the anti-emetic drugs often given after surgery can have unpleasant side effects themselves, the results of this study are encouraging.

In other double-blind controlled studies, acupuncture has demonstrated effectiveness for reducing pain before and after lumbar disc surgery, for preventing postoperative dental pain and for reducing anxiety in mothers in the operating room as their children were undergoing surgery.

Another study showed that acupuncture anesthesia plus general anesthesia had less of an impact on the immune system function of patient volunteers after surgery. A small study (20 in each group) published in 2003 concluded that stimulating acupressure points, such as P-6, ST-36 (stomach 36 — a major energy and immune point on the upper leg) and SP-6 (spleen 6, the most widely used tonic point, located on the inside of the ankle) for three minutes was effective in restoring digestive functions to normal after hysterectomy performed through the abdominal wall, compared with patient volunteers receiving acupressure on placebo points. In another study, acupuncture reduced nausea and vomiting by 68 percent compared with 30 percent in a control group after hysterectomy surgery.

Electroacupuncture proved effective for reducing the urgency to urinate frequently after prostate surgery in a study that followed a group of male patients for one year after their surgeries.

In the Yale University department of anesthesiology, researchers found that up to 42 percent of patients were interested in using acupuncture for managing preoperative anxiety. The researchers found that most patients use some form of complementary medicine (such as prayer, herbs, acupuncture or massage) and are interested in having it be part of their management protocol during surgery.

Amanda’s Surgery and Success

Amanda came in for acupuncture treatments for several weeks before her surgery and twice in the week of the surgery. For Amanda, the support of our work together, a calming herb prescription with California poppy (Eschscholzia californica) extract and the acupuncture allowed her to go into the operation feeling more sure that she could handle whatever came up. The experience of pain, anxiety and nausea are often very subjective. I’ve found that sometimes the amount of pain isn’t as much of a concern as how the person responds to and handles the pain.

As it turns out, Amanda’s operation was successful, and several months afterward, she feels that the operation was worth the anxiety and recovery time she needed. Even though her experience was positive, surgery isn’t always this successful. Because of the risks and the insult to the body, it’s wise to exhaust other more natural and less stressful means to relieve symptoms. Once surgery is determined as the only treatment with the potential to be effective, complementary medicine offers many options to assist the body’s own healing and coping mechanisms.

Christopher Hobbs’ case studies are gleaned from his 30 years of studying and practicing herbalism. Hobbs is the author of Medicinal Mushrooms (see Bookshelf, Page 55), and the creator of the correspondence course Foundations of Herbalism;

“Case Studies” is not intended to replace the advice of your health- care provider.

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