
DATE: Monday, November 10, 1997             TAG: 9711100041

SECTION: FRONT                   PAGE: A1   EDITION: FINAL 

SOURCE: BY PAT DOOLEY, STAFF WRITER 

                                            LENGTH:  128 lines

ACUPUNCTURE'S ACCEPTANCE GOOD NEWS TO AREA DOCTOR AT ISSUE: LAST WEEK, A PANEL FOR THE NATIONAL INSTITUTES OF HEALTH SAID ACUPUNCTURE IS AN EFFECTIVE TREATMENT FOR PAIN.

Carole Skestone was sitting at the computer in her Hampton home one day last fall when suddenly she felt as though someone had thrown darts at her head.

As Skestone stumbled into the bathroom, her legs gave way beneath her. She sailed to the floor, striking her left shoulder and head on the bathtub.

Her husband called 911 and Skestone was rushed to the hospital. Later, unable to walk, she learned she'd had a stroke.

When she returned home two months later, the 50-something mother who enjoyed bicycling could do little more than feed herself.

She couldn't use the left side of her body. Worse, she suffered ``excruciating'' pain in her left shoulder and her knees, despite prescription pain pills, physical therapy and steroid injections.

Then, a daughter living in New York told Skestone about acupuncture, a 2,500-year-old Chinese therapy in which stainless-steel needles are inserted into the skin. The therapy is said to restore a person's qi (pronounced chee), or balanced patterns of energy.

One of a number of alternative, or complementary, medicines rooted in Eastern culture, acupuncture got a boost last week in the more skeptical West. An expert panel convened by the National Institutes of Health examined research and other information from acupuncturists, physicians and patients from around the world.

After 2 1/2 days, it concluded that there is ``clear evidence the therapy is effective for postoperative and chemotherapy nausea and vomiting, nausea of pregnancy and postoperative dental pain.''

It also said acupuncture poses few risks to the consumer and may be effective in the treatment of other conditions, including addiction, stroke rehabilitation, headache, menstrual cramps, lower back pain, carpal tunnel syndrome and asthma.

That was good news to acupuncturists such as Dr. Alan F. Doyle, a physician who specializes in physical medicine and rehabilitation at Norfolk's Eastern Virginia Medical School. Doyle, who attended the NIH conference, has used acupuncture since May in some patients with chronic pain.

The institutes' consensus statement, although not government policy, ``carries a certain weight,'' says NIH spokesman Bill Hall. Since 1977, NIH has issued about six statements a year on controversial medical issues such as breast-cancer screenings and biofeedback.

The goal is to close the gap in knowledge between research and daily practice, Hall says.

In 1993, Americans spent about $500 million on acupuncture, part of a growing trend toward alternative therapies, the Food and Drug Administration reports. People often pay out of pocket for those 9 million to 12 million annual visits; few insurance companies cover acupuncture.

Some health experts say the public's persistence is evidence that acupuncture is effective.

Skestone's daughter, for example, believes acupuncture relieves her chronic headaches.

So Skestone, who sometimes couldn't sleep because her post-stroke pain was so severe, started looking for an acupuncturist in Hampton Roads.

Through her physical therapist, she found Doyle, who often works with patients recovering from major trauma such as stroke, cancer and car accidents.

Like many in Western medicine, whose training does not typically delve into acupuncture, Doyle once was skeptical of the therapy. ``I was sort of a non-believer,'' he says.

But patients who had lived in areas where acupuncture is more common kept telling him about their success with the therapy.

Doyle looked at the literature. More than 2,300 studies since 1970, he says, offer evidence that acupuncture is effective, especially in treating chronic pain.

Last fall, Doyle enrolled in a six-month acupuncture training program at the University of California at Los Angeles and became licensed to practice the therapy in Virginia.

About 10,000 licensed acupuncturists practice across the United States, the NIH reports. About 300 are medical doctors, although that is not a requirement for licensing. Non-physician practitioners, for example, can attend an acupuncture school to train to qualify for licensing.

Doyle treats three or four people a week with the 2 1/2-inch needles, sometimes with impressive results, he says.

Skestone, for example, says the pain in her left shoulder is ``completely gone,'' though she still has knee pain.

She believes the treatments she receives for 30 minutes every three weeks have helped her.

The procedure isn't painful, she says. As she lies on her back on a low mat in a treatment room, she feels the slight prick of the 10 or so needles as they're slipped under her skin.

Doyle likens the sensation to a mosquito bite, followed by a feeling of the muscle grabbing onto the needle.

Acupuncture is not for everyone, he says. Some people do not improve.

But it is one option in treatment - one Doyle believes physicians and insurers now may be more willing to support.

Despite its cautious optimism, though, the NIH consensus statement recommends more studies ``that can withstand rigorous scientific scrutiny.''

The American Medical Association last week issued a response to the consensus, saying it believes ``scientific evidence from well-designed and controlled clinical trials is the foundation of quality medical care.''

Because acupuncture is a procedure, like psychotherapy, and not a drug, it has been difficult to evaluate using the West's gold standard: randomized double-blind trials.

The AMA also urged physicians to educate themselves and their patients about alternative therapies, their potential effectiveness and safety.

In the meantime, Americans like Skestone appear increasingly open-minded when it comes to complementary therapies such as acupuncture - even when they plunk down their own dollars.

``I think it's well worth it,'' Skestone says. ``I really believe in it.'' ILLUSTRATION: Color Photo

TAMARA VONINSKI/The Virginian-Pilot

Dr. Alan F. Doyle at Norfolk's Eastern Virginia Medical School

treats three or four people a week with the 2 1/2-inch needles used

in acupuncture.

Graphic

TIPS

If you're looking for an acupuncturist, the American Association

of Oriental Medicine offers these tips:

Find a practitioner who is certified by the National Commission

for the Certification of Acupuncturists in Washington, D.C., or

licensed by the state in which he or she practices.