Prickled Pink
Acupuncture gains acceptance in U.S. children’s hospitals
By Sara Solovitch
Illustration by Jessie Hartland
A nurse’s assistant sits outside the open doorway. Her job is
to keep watch over the girl on the bed. The girl is 16 but she looks
40. Pockets of loose skin hang over her eyes. She weighs 76 pounds and,
if left on her own, will starve herself to death.
Brenda Golianu, MD, a Lucile Packard Children’s Hospital anesthesiologist
trained in acupuncture, darkens the room and waits for the girl to roll
up her pink pajama bottoms and make herself comfortable on the air mattress.
Anorexia has left her with abdominal pain and severe headaches. Acupuncture
relieves both symptoms.
“Take a deep breath in,” Golianu instructs, then eases a small, transparent
acupuncture needle just below a bony knee. “If it causes a little bit of
aching, that’s OK. If it causes a sharp pain, I want you to tell me and
I’ll take it out.”
She slips another needle behind the other knee, then one in each foot,
thumb and wrist. Within seconds, the girl is sleeping. Her narrow chest
rises and falls rhythmically while Golianu waits beside her in the darkness
and watches the monitor. When the respiratory rate falls to eight breaths
a minute, she nods, satisfied. It’s an indicator of profound relaxation.
Golianu, a Stanford assistant professor of anesthesia, was an undergraduate
at MIT doing her junior year abroad in China when she first observed
acupuncture at work. She later traveled to Taiwan, spent several months
observing acupuncture at the Chinese Medical College there and then studied
it in a clinic in Japan. But it was during her residency at Stanford
that she became convinced of its benefits.
“There were patients in the pain clinic for whom nothing seemed
to work,” she says. “Medications were of no significant benefit.
It was very frustrating.”
In the past 10 years, acupuncture has made its way into a growing number
of major children’s hospitals – including Packard Children’s
Hospital and Children’s Hospital Boston, where doctors use it to
wean babies off opiate medicines, ease the pain of rheumatoid arthritis
and reduce nausea from chemotherapy.
More than a third of all pain treatment centers in the United States
offer it as therapy and an estimated 3,500 physicians have acupuncture
credentials — using it to treat everything from heroin addiction
to low back pain and postoperative surgery pain.
Good points
Acupuncture offers pain relief
Not long ago most U.S. caregivers placed acupuncture on the
far side of alternative medicine. Times have changed. Now many
hospital-based pain and palliative care centers recommend acupuncture
for a wide range of common problems, including:
• Abdominal pain
• Carpal tunnel syndrome
• Dental pain
• Fibromyalgia
• Hip pain
• Lower back pain
• Menstrual cramps
• Migraine headaches
• Myofascial pain
• Nausea from chemo- therapy
• Postoperative surgical pain
• Tennis elbow
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“There has been an explosion of interest in the hospital setting
over the last five or six years,” says James Dowden,executive administrator
of the American Academy of Medical Acupuncture.
The centuries-old Chinese practice was developed from observations that
led to the theory that energy flows through channels between the surface
of the body and internal organs. Traditional Chinese medicine teaches
that pain and disease result when these channels become blocked.
Physiological Logic
Western medicine has a different explanation. Scientists have identified
the body’s nearly 400 acupuncture points as conductors of electromagnetic
signals, prompting the release of endorphins and opioids – the
body’s natural painkillers – to the muscles, spinal cord
and brain.
Physiologic changes have been well documented, including alterations
in brain chemistry through the release of neurotransmitters and hormones.
A 1998 study in the Proceedings of the National Academy of Sciences showed
changes in blood flow in the visual cortex of the brain when an acupuncture
needle was inserted in the fifth toe to treat ocular problems.
“Acupuncture has the singular advantage of being a relatively
benign treatment,” says Dowden. “You can treat the patients
and the worst that can happen is they don’t get better. So it is
very good as an alternative treatment – if the alternative is surgery
or medication.”
For Golianu, it isn’t an either/or issue. “I think it’s
a matter of integrating the two,” she says.
But it can take a healthy dose of persuasion to get a child to try acupuncture,
despite the fact that its fine, solid needles typically do not cause
any of the pain associated with vaccinations.
Indeed, an April 2000 study in Pediatrics found that 70 percent of children
treated with acupuncture felt it helped their symptoms, while two-thirds
described the treatment as pleasant.
Babies and teenagers make the best subjects. Carly Brown, a 14-year-old
Packard Hospital patient suffering from unexplained abdominal pain, is
eager to try it when Julie Good, MD, a pediatrician who specializes in
palliative care, stops by her hospital room.
Good, who studied acupuncture during her fellowship in pain management
at Packard, has just inserted three needles in Carly’s abdomen
when Tzielan Lee, MD, a pediatric rheumatology fellow, enters the room.
Lee had ordered some tests on Carly and wants to discuss their findings:
the possibility that minocycline, a strong antibiotic that she’d
been taking months earlier for acne, might have set off an autoimmune
reaction that would account for her abdominal pain.
But first Lee apologizes: She has a stuffy nose, she says, and is sounding
very nasal.
“Would you like to try a little acupuncture for that?” Good
offers. Without wasting a minute, she tears out a couple of needles and
pushes them into opposite sides of Lee’s nose. It makes her look
a bit like a walrus.
“Oh wow!” she exclaims, laughing. “That feels really
good. The electricity is amazing. Oh yes, that just opened it all up.”
Lee turns to Carly. “Do you mind if I talk to you like this?”
Carly, prone on the bed with needles still sticking out from various
parts of her body, giggles.
“It’s going to get better,” Lee reassures her. “It
could take up to a year but it will get better.”
“But she’s not going to have to suffer for a year?” her
mother asks anxiously.
“She’s not going to have to suffer for a year because we
have some tools to work with here,” says Lee. The needles in her
nose wiggle as she speaks.
Lee turns to Good and marvels: “I’m definitely less stuffed!”
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