"Give her a Brazilian in Room 1!" This is the new catchphrase
around Stroger. That's right, we're giving Brazilians at the pain
clinic in Cook County Hospital. I occasionally worry that a passing
doctor thinks I'm waxing ladies in the treatment room, but the
concern quickly fades as I get down to business. This Brazilian is
all in the ears, and the only intimate part is the bleeding. I
always think bleeding is sort of a personal interaction.
According to a successful acupuncturist in Brazil, the best
treatment for relieving joint pain with heat signs is to tonify the
energy of the major internal organs, direct it towards the affected
joints, and then bleed it out of the body. How do we do this
exactly? Here's a sample case: inflammatory knee pain, let's say on
the left knee. It's painful, the area is red, swollen, and warm to
the touch. The patient often reports feeling warm, the pulse is
slightly rapid, and the tongue is often red.
The Brazilian technique is essentially a three-step process.
First, we needle the following points on the ear of the
non-affected side: Shen Men, Sympathetic, Liver, Kidney, Heart, and
Lung. Six needles so far, if you're counting. Then, we needle the
corresponding painful body parts on the ear of the affected side of
the body: Knee. OK, we're up to 7 needles so far. Totally doable.
Now we let those needles rest for a while while we enter the SOAP
note in the lovely electronic medical records system at
After about 10 or 15 minutes, we take those needles all out.
Next step, we get intimate. It's time to bleed the Ear Apex on the
affected side. I like to give it a few hard squeezes to ensure I'm
stealing as much hot blood out of this person's body as possible.
Don't worry -- it's usually just a drop or two.
What happens next? Well, it varies. Often times, though, it goes
like this. The patient stands up, wiggles around to "test" for any
perceptible changes in pain level and range of motion, and starts
to smile. "I feel better!" Pain levels are dropping from 10/10's to
4/10's in that 15-minute treatment time. Is it unorthodox?
Somewhat. Is it effective? Seems to be. Will we keep giving
Brazilians at Stroger? You bet.
Dr. Yurasek and I scrubbed into the isolation unit, donned our
masks, and needled an in-patient right in her hospital bed. I knew
that shift would be different. It was only my third day, but it
just felt different when I punched in that morning...and I was
Between our usual out-patient pain
clinic cases at Cook County Hospital, Dr. Yurasek, the other
morning interns, and I were discussing some of the more remarkable
results achieved with auricular acupuncture. That's putting needles
on ears, for the laypeople reading today. He told us about a
patient in a wheelchair who rolled in with several bullet wounds
and walked out the same day after the acupuncture
treatment. We told him about patients whose pain level went from
10/10 to 0/10 after their acupuncture treatment. It was basically
"one time at band camp" day at Stroger.
Dr. Yurasek was explaining that these types of staggeringly
effective results are the reason that acupuncture has been making
its way into the world of western medicine. Specifically, he said
it was the "portal to acupuncture ecstasy." That's actually the
start of an entirely different "one time at Stroger" story from
last week... but we aren't talking about that one here.
The point was that with the obvious decrease in patient pain
after a 10-minute needling and tui na treatment, it's hard
to shut the door in the face of the acupuncturist who wants to
treat the people. Let us into your hospitals! Share your space with
us, MDs! We were all on board... but how would we get the
administration to give us the time of day?
Then, the call came. The sixth floor
had an in-patient in acute abdominal pain, and her doctor wanted
the acupuncturist to come up and lend a hand -- a hand with a
needle at the end of it. And, since they called Dr. Yurasek, it
would be a big hand with a really, really big needle on the end of
it. We all know he likes those 6-inch needles. I don't even
near-faint anymore when he whips them out and drives them into a
patient's leg. I still look at the other side, though, expecting to
see the needle sticking out back there... I do still do that.
I had just hooked up my patient to the E-Stim machine and dimmed
the lights in her treatment room, when Dr. Yurasek peeked his head
in my room and said, "Let's go." Where were we going? I didn't know
yet. He calmly said, "There's an inpatient on the 6thfloor in acute
abdominal pain, and we're going up to needle her." Alrighty. If you
say so, sir. I walk next to him, fumbling through the pockets in my
white coat, knowing I probably needed to be bringing supplies or
Halfway upstairs he, very casually, mentions that the patient is
actually in an isolation unit, and we'll need to take extra
precautions. OK, ummm, is it too late to go back downstairs? What?
Thoughts of bringing home some exotic virus (other than the ones
I've already had) to my kids were flying through my mind.
Well, now I'm so nervous that I don't even know
where I am. Where are we heading? East wing? West wing? Where's the
lake? Finally, we make it to her unit. The nurses glance up at us
like, hey, no big deal, go on in. She's through that set of doors,
and then through that next set of doors... the ones with those red
signs taped to the window. OMG. "Droplet isolation"! I don't even
know what that means, but I'm nervous. Very nervous. We scrub in,
the nurse finally steps in and helps us with our facemasks before
we tied them on backwards, and basically pushed us through the next
set of doors.
Well, too late to back out now. Here we go. Luckily I had
needles in my pocket. Or he did, I can't even remember. The next 30
minutes were a blur, mostly because I was nearly passing out from
the recirculating carbon dioxide in my facemask. How do people wear
those for extended amounts of time? Clearly I was doing it wrong.
First timers, right here.
"Where's your worst pain right now," Dr. Yurasek asks the
patient, who I definitely thought was unconscious when we first
walked in, splayed out in her bed with the usual useless hospital
gown covering her nothing. "My back, and my leg, all the way down
to my foot," she says. Well, she's conscious. Great news for my
burgeoning anxiety. Abdominal pain, back pain, she's got it all,
but her back hurts the most right now. So, we treat her back pain.
Cue the 6-inch needles into the ancient secret lock-and-key points
now called "Gall Bladder 30" and Gall Bladder 34." Sciatic pain
relief on the way!
The patient is in less pain and is visibly more relaxed in her
body tension. She was in the middle of telling us a story, but then
she suddenly passed out asleep. OK. As long as she's not dead, I'm
going to make it. I run around like a crazy person in a crazy mask
looking for a gauze pad so we could take the needles out, and
finally, our job is done here. We walk back downstairs to the
outpatient pain clinic and resume our day.
"How's your internship at Stroger going," people keep asking me.
Awesome. It's freaking awesome. If you have the opportunity to
intern at Stroger, and you're not doing it, you're missing out.
Can acupuncture help you stop smoking? Maybe. Like most smoking
cessation plans, the most important part will be whether or not you
firmly desire to quit using tobacco. If you have the will, then
acupuncture might just have the way.
cessation is one of the more long-standing mainstream applications
of acupuncture in the United States. My husband recently asked me
for ideas about the effectiveness for his co-worker who has been
trying to quit, and my mind has been making the connections ever
since. How does it work? Will it work? Which points should be used?
How often will he need treatment? Can he do some of the work at
home between acupuncture sessions?
Naturally, being just a student, I didn't know the answers to
these questions without looking into them myself. Now that I feel
like I have a handle on some of these factors, I'll go ahead and
give you lowdown. Of course, I'm not telling anyone to try this at
home, but this is what your acupuncturist might do if you walk into
the clinic and ask for help in your journey to drop the cigarettes
First, let's talk about the mechanisms. Why does a needle going
through your skin make you want to stop smoking? Actually, there
are multiple methods to this madness. On one hand (literally, on
the side of your hand, via an acupoint called Tim Mee) a needle can
actually make your cigarette taste bad. Personally, I think they
already taste bad, but apparently people who smoke tend to like the
taste. Moving on, if changing the taste of a cigarette from lightly
ashy to repulsively garbagy isn't strong enough magic for you,
there are other things that might still work for your stubborn
Next, auricular acupuncture can help
control your cravings, addiction, and withdrawal symptoms while
trying to quit. Think ear piercing with a purpose! While ear
acupuncture can sound even scarier than regular body acupuncture to
the faint-at-heart-newbies, rest assured that the needles are
hair-thin and barely felt. I should tell you that
electro-stimulation of these auricular points is also commonplace.
Some commonly used ear points for smoking cessation include the
following: Shen Men, Sympathetic Autonomic, Point Zero, Endocrine,
etc. Your acupuncturist will add additional points depending on
your individualized condition. Nope, auricular acupuncture for
smoking cessation is NOT necessarily a one-size-fits-all
Now, what can the patient do at home to keep these positive
no-smoking juices flowing between acupuncture sessions? Luckily, we
have a plan for that, too. If you've never heard of ear seeds, you
will if you seek help to quit smoking from an acupuncturist! Small
seeds or magnets (fancy name--auricular pellets) with clear tape
backing are stuck on the above mentioned ear points, and then the
patient is instructed to squeeze them several times a day until
they eventually fall off. If you shower regularly, this is
generally in around three days. If you're looser with your bathing
schedule, you might keep your home care going for a whole week I
suppose. But, let's just pretend everyone showers more than once
Back to the main event: Can acupuncture help you quit smoking?
It really is UP TO YOU. Unless your acupuncturists steals your
cigs, robs you of any available currency, and prevents you from
bartering in the streets for your next nicotine fix, it really is
in your hands. Studies show a variety of outcomes; some are very
positive indeed. If you're ready, call the clinic!
Effect of Acupuncture on Smoking Cessation or Reduction: An
8-Month and 5-Year Follow-up Study. Preventive Medicine, Volume 33,
Issue 5, Pages 364-372. Dong He, Jon I. Medbø, Arne T. Høstmark
Acupuncture to Stop Smoking - Yin Yang
• So What Is Chinese Medicine?
• Jabbing Nerves with Needles
• Mission in Nicaragua
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