On vacation!

Oh my gosh, where does the time go? After an invigorating and exciting beginning of 2008, July has arrived! And I’m ready for some relaxing and goofing around time with my family. For the next few weeks I’ll be a slacker. Well, as much of a slacker as one can be with a family that includes a one-year-old. But that one-year-old needs time to connect with more than one generation of family, so here we come! I’ll be back soon.

As Garrison Keillor puts it, Be well, do good work, and stay in touch.

Pregnancy

OK, this one’s for the women out there who are pregnant or considering becoming pregnant.

Choosing your health team

First, choose an OB who you are comfortable with – i.e you can talk with easily and who listens to what you say. There are many other things to consider, and good advice abounds on the web, so have a look around. WebMD and the March of Dimes are two sites that I recommend. And speaking of recommendations, a local OB that I highly respect is Lisa Johnson at the Women’s Clinic P. C. here in Portland.

Who else should you recruit for your support team? Every mother and every pregnancy is different, so there is no standard answer to this question. Some mothers enlist the help of a doula. Some a massage therapist. Some a midwife. Some an acupuncturist.

Acupuncture and my pregnancy

What does acupuncture have to offer? To start with, and speaking from personal experience, an acupuncture session can be about the most relaxing experience you can imagine. I looked forward to my regular appointments so much! Luckily, I didn’t have many specific symptoms that needed treatment, but the fatigue and stress of daily life are somehow intensified by pregnancy. Finding someone to help me with these was really important. Thanks, Emily; thanks, Brandon (now in Wisconsin – how is the badger state?).

My practice

In my practice I have treated patients for just about every pregnancy-related condition you can imagine, from morning sickness and lower back pain to nasal congestion and numbness in the hands (due to edema, temporary carpal tunnel syndrome can arise.) I recommend early treatment to help with nausea – the sooner it is treated, the better. And, I’ve found that although ginger is helpful for some, for others it makes nausea worse. So in addition to acupuncture, I find myself sharing from the cupboard of take-home tips.

When and how often should appointments be scheduled? This depends entirely on the individual patient. Some I see weekly from the very beginning, some only when a need arises. Like maybe sleeping isn’t as easy as it should be, or leg cramps are a problem, or it’s time for the 20-week ultrasound, or, well, whatever. I’ve treated mothers whose babies were in breech position (the best time to move the baby is 34-37 weeks), and when mothers have come full term, I have helped stimulate contractions. So I’m ready to help at any point, from conception to contraction, so to speak. I used to offer birth support, too, but with my own baby at home now, my schedule isn’t as flexible as it once was. All mothers will understand that!

An unexpected delight

At some point during treatment – I can’t say exactly when – I become aware of the baby as a person. I know all along that the intention of my treatment is to help the mother and the baby, but even so, there’s this moment when I sense the baby. Its pulse can sometimes be felt hovering around the mother’s. (In case you’re new to Chinese medicine, the pulse here is something more than you’re used to thinking of.) And right away I get this sense of connection with a new human being.

Now, I don’t consider myself an overly emotional person, but I have to say that when a mother first introduces me to her newborn baby, I am overpowered by a sense of . . . of what? Connection. Joy. Wonder. Motherhood.

Mind-body

When it comes to health and well-being, we all know that what goes on in the mind can influence what goes on in the body. Who could doubt, for example, that psychological stress can have a negative impact on one’s physiological function? Positive mind-body interplay can occur, too, and the simple act of anticipating good health can at times promote healing. The question is, at what times?

The therapeutic encounter

Surprisingly, one of the best known catalysts for promoting healing is the interaction that takes place between a healthcare professional and a patient. I’ve written about this healing alliance before, and even humbly suggested that this natural baseline healing process receive more attention in the world of medical research. So imagine my surprise when — babba-bing, babba-boom — I come across a book published this year that provides all of the scientific evidence one could hope for regarding the importance of the therapeutic encounter: The Placebo Response and the Power of Unconscious Healing, by Dr. Richard Kradin. He is an MD, psychoanalyst, and medical researcher. If anyone is going to probe the role of mind-body interactions in maintaining health, who better than a practicing MD who conducts research and is also a psychoanalyst who has co-directed a course at Harvard on Mind/Body Science?

The placebo response

Medical researchers have known about the placebo response for a long time and have been concerned with designing experiments that take this phenomenon into account when attempting to test for the effectiveness of new treatments. This natural tendency toward healing is a distraction, in a way, for researchers, and it must be tested for as rigorously as the effects of the main treatment.

But what is a distraction for some is the core issue for others, and Dr. Kradin systematically goes about demonstrating how the mind can bring about objective, measurable healing responses. People don’t just imagine that they are getting better, they really are getting better.

And he describes how the interaction of healthcare providers and patients is a crucial component of this response. So there you have it: the very act of seeking help from another can enhance acquiring that help. The origins of this response undoubtedly lie in our deep history as social animals, but I’ll leave that part of the story for Dr. Kradin to relate.

Parade Magazine

If you missed it in last month’s March 9 issue of Parade Magazine, here’s what many were reading over their Sunday a.m. coffee cups: Thoughts Can Heal Your Body, by Robert Moss.

PNAS

Placebo responses are commonly associated with the modulation of pain, and in the on-line June 26, 2007 issue of the Proceedings of the National Academy of Sciences is this article: Placebo effects on human u-opioid activity during pain. A pharmacologically inert cream was applied to the arms of healthy volunteer patients. In some instances the doctors told the patients that this cream would have no effect on pain. In others, they were told that the cream was a highly effective pain reliever. Same cream in both cases. No possible physical effects. Then a painful heat stimulus was applied, and the researchers measured the analgesic effect on their subjects. They also measured opioid activity in the brain.

And the results? Partly expected, partly wow. Expected: the placebo group reported perceiving less pain. But here’s the amazing part: their brains were behaving differently. Several regions of their brains were responding by altering the pattern of their endogenous opioid activity. They were unconsciously creating a therapeutic effect. Wow.

Mind-body interactions. What will we learn next?

News, views & pets

Thinking about my profession and the public’s understanding of it, I became interested in how acupuncture is presented by the press. And what kinds of treatments catch the attention of health reporters. Treatments for fertility, particularly when used in conjunction with state-of-the-art Western procedures, seem to be the clear winners for shear numbers of reports. (Here’s another AP story on the subject to add to those I posted last month.)

Pets

Acupuncture for pets also catches the attention of news organizations. This recent article in the Oregonian tells the story of how an aging Labrador Retriever was successfully treated by Dr. Kelly Jenkins Nielsen. That’s right – Dr. Nielsen. After 20 years as an orthodox Western veterinarian, she decided to study acupuncture as an alternative treatment for the pets that came her way. Now it’s Dr. Nielsen, DVM LAc. (She is featured in an article in the Lake Oswego Review.)

Well, my sorta-half-Lab Otis is in good health and I have not yet entertained the idea of treating any non-human animal. But who knows? If he rolls in one more smelly thing, I may just start some sort of treatment program on him.

I had never heard of Buzzle.com before, but their news summaries include an article about how complementary modalities (acupuncture and chiropractics) have entered the world of veterinary medicine.

Humor

I don’t know why, but animal acupuncture seems to inspire a lot of humor. When browsing on-line organizations, for example, you find sites such as More Pets Get the Point, and the The “Paws-itive” Effects of Treatment. And some great cartoons are based on animals. My favorite has a woolly mammoth in it, and my vote for the animal most likely to show up in future cartoons is the species in this one.

The rest of the story

Although this article on the treatment of back pain is a notable exception, most acupuncture stories dealing with humans will not reach the threshold for being newsworthy. There’s nothing unexpected about that, I suppose. It’s probably the same for all healthcare providers — the big story is preventive medicine. The big unwritten story, that is.