Needle therapy gaining converts

Duke physician tries to bridge gap

Allen Baum is not a New Age kind of guy. But when the Cary patent attorney was offered acupuncture to ease possible nausea and vomiting from gall bladder surgery, he figured, "Why not?"

"I decided, 'What's it going to hurt to have a couple of needles in my arm when they're going to be cutting on me anyway?' " said Baum, who had his surgery at Duke Hospital on Nov. 2.

A growing body of research suggests that the ancient Chinese practice of acupuncture is both safe and effective for treating nausea, vomiting and pain associated with surgery.

In a review of 15 clinical trials, Dr. Tong Joo "T.J." Gan, a Duke anesthesiologist and acupuncturist, found that the ancient treatment significantly reduced pain and the need for painkillers among surgery patients. What's more, patients who had acupuncture were about 1.5 times less likely to experience nausea, severe itching and dizziness -- all complications of opiates such as morphine. Such side effects can lengthen patients' hospital stays and cause them to rate their surgical experience as poor, Gan said.

Yet just a handful of hospitals in the country routinely offer acupuncture to surgical patients. Mainstream medicine's reluctance to embrace it is not hard to explain, Gan said.

"Chinese medicine has been practiced for thousands of years, but it is so different from the Western system, so completely alien, that it has been slow to catch on," said Gan, who completed a two-year course in traditional Chinese medicine after finishing his training in anesthesiology. He offers the treatment to his patients at Duke.

Western-trained doctors learn anatomy and physiology and diagnose illness based on biological processes they can see or confirm with tests. Chinese medicine teaches that health depends on achieving balance in the opposing forces of yin and yang and maintaining the flow of vital energy known as qi (CHEE). Acupuncture is said to regulate qi by using needles to stimulate specific points that lie along meridians thought to course through the body just beneath the skin.

Even when studies show that acupuncture works, Western doctors often find it difficult to overcome reservations about the alternative treatment. Or, Gan said, physicians find fault with the studies themselves, which are often small and frequently don't compare results with a control group of patients who did not receive acupuncture.

To help bridge the gulf between East and West, Gan recently sifted through dozens of acupuncture studies, including some he led himself, to find those that meet Western standards for clinical research. He found 15 that fit the criteria and presented his findings recently to a national meeting of anesthesiologists.

Post-surgery risk

Baum, the Cary lawyer, had never had surgery before getting his gall bladder taken out. But he had heard horror stories about vomiting after surgery. He was worried he might be particularly susceptible, especially after he learned while being prepped for surgery that motion sickness is a risk factor. Baum, 40, gets sick whenever he is a passenger in a car.

Baum asked Gan, who was the anesthesiologist assigned to his surgery, whether there was anything that could be done to minimize nausea and vomiting. He was expecting the doctor to suggest some alternate drugs. Instead, Gan offered acupuncture.

Shortly before Baum's surgery, Gan inserted two fine needles into his left forearm, near the wrist. That site is established as the most effective at controlling pain and nausea. Then Gan carefully bent the needles to one side and taped them down so they would not be disturbed during the surgery.