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Tess Lugos - Acupuncture
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Want to quit smoking?

12/1/2020

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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

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How can acupuncture help with fertility?

3/11/2019

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This is the question I heard the most at the Fertility Show last weekend. I was volunteering to answer questions at the stand of the British Acupuncture Council, which is the UK’s largest professional body for the practice of traditional acupuncture.


Problems with fertility are common, affecting one in six couples in the UK. Many couples came to enquire, but mostly they were individual women who wanted more information. Some have been through numerous (unsuccessful) cycles of IVF (in vitro fertilisation), and wanted to see how they can improve their chances of success. A few are just starting their journey and are very confused at the options available. Do they go down the route of IVF, ICSI (intracytoplasmic sperm injection), use donor eggs, or opt for a surrogate?  
 
My message was simple – acupuncture can help boost natural fertility, and if you do decide to go down the IVF route, acupuncture significantly improves the live birth rate of sub-fertile patients undergoing IVF or ICSI. My job is to support the ovaries to optimise their response to the drugs (e.g. ripen more ovarian follicles), reduce stress and anxiety, and manage the side effects of the drugs.



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A safer alternative to opioids

14/10/2019

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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

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Hope for chronic fatigue and fibromyalgia

4/10/2019

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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

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A halt to hiccups

19/9/2019

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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.


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The two professors

14/8/2019

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I have never met two of the most important men in my life. Professor Cheng Man-ching, one of the greatest tai chi masters of modern times, died in 1975, while Dr Wang Ju-yi, a giant in the global Chinese medicine community, passed away in 2017. Both men excelled in their fields and both taught far and wide from their native China. Which is why, living in London as I do, I feel their influence every day, from the moment I start my day with rounds of t’ai chi, to the hours in clinic applying classical Chinese medicine to modern ailments.

What Professor Chang and Dr Wang had in common was the desire to spread their knowledge to as many people as possible. National borders did not constrain them. They had many senior students inside and outside China, who in turn made it their goal to transmit this knowledge faithfully and with precision.

The other day I read a notice from Jason Robertson, one of Dr Wang's senior students, to mark the second anniversary of the doctor's passing. On that day I was attending a tai chi training in Sardinia, facilitated by four senior students of Patrick Watson, who studied with Professor Cheng. I felt so fortunate to be a recipient of such ‘transmission’ of knowledge. In my own way I am passing this on to future generations. Long may that continue.

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Blackbird sings with the piano

24/6/2019

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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!


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Emergency medicine

4/3/2019

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Last Wednesday afternoon I arrived in clinic just as the power went out. Although our consultation room has lots of windows, the treatment room itself gets no natural light and was too dark to work in. Most people in the other offices started to go home — without electricity to power computers and telecommunication devices, the modern office can’t function. However, I don’t need electricity to do acupuncture, so with the help of a colleague, we set up an emergency acupuncture clinic in a nearby room that gets plenty of sunlight. 
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Within 20 minutes, we were able to set up two “cubicles” with treatment couches, medical screens, chairs and table. It was basic but safe for treating. I managed to treat five patients before it got too dark to do anything. UK Power Network informed us that it couldn’t restore power for another couple of hours, so I reluctantly cancelled my last two patients. 


Later on I reflected on that strange day and realised how lucky we are to live somewhere with steady electricity supply and good infrastructure. What happened was such an abnormal occurence in London but it happens regularly in some countries. I also realised what were the absolute minimum requirements for safe acupuncture practice: running hot water and soap for washing hands, a “clean field” for putting down needles and other supplies, and some privacy for patients. And good eyesight for when the light starts to fade!

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Relief for burning feet

8/2/2019

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One of the joys of being a Chinese medicine practitioner is the variety of cases you get to see. It is never a boring job. Most of my patients come for pain relief or women’s health issues. However someone  recently came with symptoms that had me baffled from the word go. Dan (not his real name) suffered for many years from burning feet syndrome, where his feet and legs were so hot that he had to sleep with an electric fan aimed at his feet and he felt a constant dull pain.
 
His GP referred him to a consultant neurologist, who did blood tests and conducted nerve exams and found nothing wrong. After ruling out vitamin deficiencies, diabetes, chemotherapy- and HIV-induced neuropathy (disorder of nerves outside the brain and spinal cord), the consultant could not find an explanation. One possibility was the deterioration of myelin sheaths, which slows down the messages between the brain and the rest of the body. Dan was prescribed amitriptyline, an anti-depressant that is also prescribed for pain, but this didn't work so he turned to acupuncture.
 
I see cold hands and feet a lot but never burning feet. I first worked on increasing blood circulation, removing heat, and cooling down the body. I also later added electric stimulation after reading an article about the use of electro-acupuncture for similar cases of peripheral neuropathy*. The electric stimulation proved to be the key to unlocking this case. After eight treatments, Dan reported a 50% reduction in the burning sensation, with the pain gone. I am optimistic that we can continue to reduce the burning so Dan can lead a more normal and comfortable life.
 
I love leaving clinic at the end of the day having helped someone with something I knew absolutely nothing about.

​* Dimitrova, A. (2017) 'Introducing a standardized acupuncture protocol for peripheral neuropathy: a case series', Medical Acupuncture, 29(6). [Online] DOI: 10.1089/acu.2017.1242 (Accessed 21 January 2019). 


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Emergency acupuncture

13/12/2018

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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.

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    Tess' blog

    ... or a record of a Filipina's adventures in traditional Chinese medicine (TCM). 

    I am a practitioner of traditional acupuncture based  at Violet Hill Studios in St. John's Wood and in Hampstead Garden Suburb, both located in north London.

    ​I am registered and fully insured with the British Acupuncture Council. I studied Chinese Medicine at the Confucius Institute of TCM (within the London South Bank University) and at the First Affiliated Hospital of Heilongjiang University of Chinese Medicine in Harbin, China.

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