Ah, new year, new resolutions. Whether it's dry January or Veganuary, lots of us want to start the year right by starting a healthy habit or kicking old ones.

I like supporting patients who want to stop smoking, or indeed any addictive substance. I use points on the ears as well as on the body. Why the ears? In the mid-1970s an auricular (ear) acupuncture protocol was developed in New York to treat many common drug addictions. The protocol is now referred to as the NADA protocol (NADA stands for the National Acupuncture Detoxification Association), which involves the insertion of small, stainless steel and disposable acupuncture needles into five points on the outer surface of the ears.
 
When the auricular points are combined with acupuncture points on the body, the treatment aims to relax the patient, relieve anxiety, regulate the autonomic nervous system, and strengthen the lungs and immune system, among other things. There is even a point on the wrist that makes cigarettes taste bad. 

As with all these things, acupuncture is not the one magic bullet that replaces all the hard work. It is one tool at your disposal, along with having a strategy in place, getting a buddy to help you, or getting behavioural counselling.

Photo by Paweł Czerwiński on Unsplash

I recently wrote about my friend Maria, who came to visit and stayed for two weeks while I gave her intensive acupuncture treatment for chronic fatigue and fibromyalgia. One of the things that struck me was how for years, she was prescribed very strong opioids like OxyContin. Opioids are a class of drugs that are prescribed to relieve persistent or severe pain, and include morphine and codeine. We know now that opioids are addictive and side effects are numerous, including increased pain. The US is in the grip of an opioid crisis, and abuse of these drugs has caused tens of thousands of deaths a year.

Part of the response in the US has been to push non-pharmaceutical options for pain control. This is when Chinese medicine can be invaluable. For example, the US Food and Drug Administration (FDA) and the National Academy of Sciences, Engineering and Medicine (NASEM) recommend acupuncture as a first-line therapy for coping with the opioid crisis because it is found to be effective, safe and cost-effective for numerous types of acute and chronic pain.

In the UK, there is no official support for acupuncture or other unconventional treatment options to opioids. Acupuncture primarily sits outside the National Health Service, so people usually pay privately for treatment. But people come for treatment because they hear about it from friends and family. The evidence is also clear about the effectiveness of acupuncture for 117 conditions.

In my day-to-day practice, about a third of patients come for pain, usually for musculoskeletal or neurological reasons. It is wonderful seeing someone walk out of clinic a different person, one in less pain, more relaxed, and with a smile on their face. Because this is what I do every day I sometimes take acupuncture for granted, but it is a truly remarkable system of medicine.

​Photo by Dima Vishnevetsky from FreeImages

When an old friend from Manila - let's call her Maria - got in touch six weeks ago to ask if I can help with fibromyalgia and chronic fatigue, I said yes of course. But when that friend said she will stay in London for two weeks to have acupuncture treatment, I was bowled over by her trust and commitment.

So over these past two weeks, I saw Maria roughly every other day to give her acupuncture. She has suffered from a debilitating constellation of low-grade fevers, muscle/joint aches and pains, sweating, and fatigue for the past 15 years. But it had worsened significantly in the past two years so she could barely walk a few minutes without getting wiped out. All that conventional medicine doctors could offer were painkillers, steroids and antidepressants - at one point Maria was told there was nothing they could do for her any more.

When I told my friend that of course Chinese medicine can help, it's because it sees auto-immune conditions as difficult but not impossible to treat. The incidence of auto-immune diseases such as fibromyalgia, multiple sclerosis, lupus and rheumatoid arthritis has been on the rise, and there is universal agreement among scientists that industrial toxins and chemicals in the environment are interfering with the functioning of our immune systems. According to the UK's National Health Service, fibromyalgia (a long-term condition that causes pain all over the body) is estimated to affect one in 20 people.

I focused on releasing the fever, lowering her temperature, removing toxins, and easing the aches and pains in her body. And over the past two weeks, Maria has got stronger as the sweats and fever abated and pain reduced. Chinese medicine focuses on lifestyle choices as well - part of Maria's work is making changes to the food she eats (her daily medicine!) and learning Qi Gong (Chinese internal exercises that focuses on breathing and simple movements) to circulate and generate energy, allowing her to get stronger and manage her condition.

It was wonderful to see the shift in Maria's energy levels in a short space of time. She was grateful because she hasn't felt this well in 10 years. But I was also grateful to have had an opportunity to see how intensive treatment can work with someone so committed to getting better.

Photo by Christian Fregnan on Unsplash

I love Chinese medicine for many reasons, but over the past weekend I discovered another one. I was spending the weekend with some dear friends in the beautiful medieval town of Rye, in East Sussex. My host, Brian, who is in his late 80s, had just had a procedure done to alleviate knee pain. All of a sudden, he started to have bouts of hiccups, which no amount of water-drinking or being given a fright could alleviate.

I scoured my memory for some acupuncture point that might help. Hiccups are sudden, involuntary contractions of the diaphragm muscles, so I thought of using one of the lung points (the diaphragm being involved in breathing) on the arm. So while chatting away at friends across the dinner table, I pressed Lung 6 on one of Brian's forearm for a few minutes. Lung 6 (Kong zui or Maximum opening) is an acupuncture point used for acute respiratory conditions such as asthma, wheezing or severe cough.

Sure enough, after a few moments, Brian's hiccups stopped. A nice way to end the evening.

I am always on the lookout for good music to play in the treatment room. When I first started learning tai chi in Hong Kong many years ago, my teacher Alex used to play opera and reggae to accompany our rounds of t'ai chi. So before long I started associating these genres with relaxation and Chinese medicine (tai chi being one modality of Chinese medicine, along with acupuncture, herbs, food and tuina massage). So when I started my acupuncture practice some years ago, I automatically played classical music or reggae in the treatment room.

These days I tend to favour playing "non-music" in the treatment room so  patients have something to listen to while I leave the needles to do their work. Tibetan singing bowls or the sound of water are my favourites. Not everyone likes opera, but most people  appreciate the soothing sound of chimes being gently caressed by the breeze.

Imagine my delight when a patient gave us a CD recording of her playing the piano while being accompanied by a blackbird in her garden. This patient is a piano teacher and said she first noticed the blackbird singing in her garden two years ago, especially while she played the piano. So one day she recorded the blackbird while she was playing. Later on when she was playing back the recording, she realised that the blackbird seemed to be accompanying her piano-playing. And this magical CD is often what I play when I'm treating these days because the sound of nature is deeply relaxing. 

This isn't the first time I've heard of birds accompanying musicians playing. A famous recording from 1924 captured cellist Beatrice Harrison dueting with nightingales at her home near the  woods in Surrey, England. She received 50,000 fan letters from this time!

Last week I attended what I thought would be an ordinary case study day -- where acupuncturists present difficult or challenging cases and explain their clinical reasoning and acupuncture points used. Like other clinicians, acupuncturists have to do a certain number of continuing professional development (CPD) hours a year, and this case study day was free to members of the British Acupuncture Council. 

I enjoyed the interesting cases, but by far the most thought-provoking presentation came from Sheria Chan, an acupuncturist who helped organise free emergency acupuncture clinics for victims of the Grenfell Tower fire in June 2017 (a fire in a 24-storey block of flats in west London that claimed 72 lives and shocked the UK).

I always knew that this 2,000-year-old medicine is used in disaster situations. I have heard of acupuncture used to help people suffering from post 9/11 trauma in New York City. Battlefield acupuncture is used by the US military to give rapid pain relief, enabling medical personnel to get wounded soldiers away from the battlefield quickly. I regularly treat patients for symptoms of trauma in my clinic. But as I listened to Sheria talk about the the immense challenges of setting up emergency acupuncture clinics in a chaotic disaster environment, I was moved and inspired. 

In the Grenfell case,  volunteer acupuncturists used ear acupuncture to treat shock, trauma and anxiety at three clinics for more than a year. This is an emergency measure, to help people caught up in the chaos after the fire, to help them cope until they can get formal treatment. It is a reminder of the power and flexibility of this ancient medicine.