Preventive Acupuncture … What is it?

Ancient Chinese Medicine practitioners stressed that it was wiser to treat the healthy, and in the process prevent disease, than to treat the sick only after illness had taken hold. In my previous post I explained this more fully, and I also described how I came to learn the value of that philosophy in person. Now if you read that post, you may have gathered that as an acupuncturist, the focus of my clinical work is Prevention. And you’d be right. My business card makes that very point: Prevention is Better than Cure … because I believe in that age old common sense approach wholeheartedly. However, if by chance, you came to the conclusion that I don’t, won’t or only reluctantly treat existing complaints – you’d be mistaken. Why? Well for starters, it has nothing to do with my bottom line.

The way I practice preventive acupuncture is in stages. I stress the I factor here, simply because not all acupuncturists practice in the same way. There are as many ways to practice the art as there are practitioners out there, and if you’ve ever tried acupuncture or other natural therapies with more than one health worker, you would have noticed this for yourself. So, the way I practice preventive acupuncture is in a four-fold manner. Let me explain.

When a patient consults with me, the first question I ask is: ‘How can I help you?’ A no brainer, right? Well, not quite. The reason I ask this question is to quickly ascertain what stage of preventive acupuncture I need to apply with this particular patient at this particular time. It’s important for me to establish this right away, because to a great extent, it determines which diagnostic methods I use from that point onwards, which differentiation model to choose, what treatment protocol to follow, what acupuncture prescription to write, and what other techniques, such as warming, cupping, etc I will apply. All this after the first question, you may ask. That’s exactly right, because I know the answer to ‘How can I help you?’ will invariably involve one of four responses:

1.      First Stage Prevention: The answer here will go something like this – ‘I’m not sure how you can help me, or if you can help me, because apparently there’s nothing really wrong with me. I just don’t feel well but my doctor can’t pinpoint it. Sometimes I get headaches/aches and pains/I feel sluggish/I don’t sleep real well/I feel tired/stressed/foggy/ etc. I’m sure there’s something wrong with me but my bloods/pressure/function tests/scans/ etc don’t show anything abnormal.’

Or sometimes … ‘I’ve come to see you because I’ve never had acupuncture, I’ve  wanted to try it for a long time but didn’t know how to go about it until so and so recommended you/I saw your ad/read your blog/ etc.’

2.      Second Stage Prevention: This answer will be along these line – ‘I always get a migraine just before/during/after my period and I’m sick of it/ I used to be a professional dancer. I still like to keep in shape but I get these pains down the sides of my legs when I stretch. The physio reckons it’s sciatica, what do you reckon?/ Every now and then I break out in an itchy rash. My doc says it’s urticaria and now wants me to use a corticosteroid lotion, but I don’t want to cause I hear it stains the skin/ I’m on my third course of antibiotics for a dry cough that just won’t go away/I’m a sinus sufferer. I usually manage it ok, but I just want to get rid of it altogether, is there a cure?/ etc.’

3.      Third Stage Prevention: This answers sounds a bit like this – ‘I’ve recently been diagnosed with heart disease and my wife told me to come here. I actually feel fine/ I’m going through menopause and I think I might be depressed/ I’ve got RSI. I think it’s getting worse but I’m allergic to anti inflammatories / There’s something wrong in my uterus, my periods are getting really strange/etc.’

 Or … ‘I fell and twisted my ankle/ I passed gallstones/ I can’t get pregnant/ etc.’

4.      Fourth Stage Prevention: Finally, this answer – ‘I have rheumatoid arthritis/I’ve been an asthmatic since I was a small child/I’m a diabetic/ I have chronic fatigue syndrome/I have crohn’s disease/I have lupus/ etc.’

Notice the difference between the answers and you’ll get an idea of how I practice. Treatment strategies for first stage patients involve preventing the onset of disease generally. These patients are not sick, but they may still want to feel better, physically, mentally, emotionally, etc. I enjoy treating these patients because I can do things with them that I can’t do with the others, at least not initially, and these patients allow me to delve into the more esoteric acupuncture practices which I really dig.

Care for second stage patients is more about preventing the recurrence of some particular ailment. These patients are more able to define what is wrong with them, and are either seeking help for the first time, or (the more likely scenario) have done the health rounds already and have come to see me as a kind of last resort. Treatment here needs to first address the condition until the signs and symptoms improve and then move onto prevention of recurrence, which also eventually involves stage one, preventing the onset of disease generally, that is, preventing other diseases.

I find third stage patients the most challenging, but don’t get me wrong, I enjoy a challenge. At this stage the main treatment outcome involves preventing further damage and/or preventing the condition from getting any worse. Sporting injuries and many long term musculoskeletal disorders fall into this category, so do some types of chronic diseases, though chronic illness tends to fall mainly into fourth stage. It’s important at this stage (as in all stages, but more so here) to look at lifestyle factors and modify what can be changed, for example diet, smoking, alcohol intake, etc. Most of the patients I see fall into this category and my intention is always to move them up to second stage (managing and eventually preventing recurrence). Once this is established we can look at progressing to first stage.

Finally, there is fourth stage, or managing chronic illness and persistently recurring disorders, often of the type that are characterised by acute onsets with periods of remission. These complaints, often called syndromes because of the complex nature of the pathophysiology, are very difficult to treat successfully. Often these patients are well aware of that fact and are simply looking for ways to better manage their conditions. Treatment here is aimed at addressing the acute onsets, when they occur, and working preventatively during times of remission. Because of the multi-layered nature of these conditions, which often involve systemic or all body processes, it’s difficult to move these patients up the preventive ladder. That is, move away from managing their condition to preventing further damage or a worsening of symptoms with the next recurrence. It can be done, but moving any further up is difficult, although the prevention of many complicating factors can be achieved.

These stages are not set in stone, however, the margins can blur and there can be significant overlap. This is simply the working model I use to determine how to best assist my patients at any given time.

If you’re interested in acupuncture and want to learn what a consultation at any of these stages looks like, join me again as I explore this further and also take a closer look at what well-ness is. Tips and hints for self-help also coming up …