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  • on 13.04.2010
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Take two needles and call me in the morning: A Minneapolis hospital uses acupuncture and more while seeking ways to ease pain [Pioneer Press, St. Paul, Minn.]

Apr13

Apr. 14FIVE PATIENTS with three new knees and two new hips among them were rolled into a dimmed, windowless room at Abbott Northwestern Hospital in Minneapolis for group acupuncture.
None had received the treatment before, but Cynthia Miller, a clinical acupuncturist, quickly had thin needles protruding from precise points in their feet, ankles, arms and ears to ease their joint pain. Low lights and calm music were having an effect as well.
Cheryl Harelstad and Clinton Peterman were motionless in their easy chairs, opening their eyes slightly before nodding off again. Not Don Kline. The 67-year-old with a replacement to his bad catcher’s knee sat forward and alert, a two-pronged needle sticking out of his right ear like an antenna.
"Just try and relax," Miller told him with a smile.
"Oh, oh," Kline said with a nod. "You’re supposed to relax."
Patients of all kinds are receiving alternative forms of pain relief at Abbott’s Penny George Institute for Health and Healing from the relaxed to the restless, the believers to the doubters. So confident is the institute in this approach to medical care and pain management that it is paying the cost of the so-called integrative therapy for all of its inpatients.
Participation has spiked fivefold in the past five years as patients have tried acupuncture, aromatherapy and visualization exercises as adjuncts to their pain medication. Most popular are therapeutic massage and mind-body sessions.
"The
challenge is you can’t always give as much (medication) as you’d like and you can’t relieve as much pain as you’d like," said Dr. Gregory Plotnikoff, medical director of the institute. "Our point is that it’s not always about the medications."
The next challenge beyond winning over patients is proving the effectiveness of these integrative pain remedies through research and winning over insurers, who are loath to cover alternatives without proof that they work.
Toward that end, researchers
at the George Institute published a study in March showing a 55 percent reduction in patients’ self-reported levels of pain after they received any of the integrative therapies offered at the hospital.
Patients estimated their pain levels on a 10-point scale before therapy and immediately afterward. Progress was reported regardless of whether patients had received joint replacements or were being treated for heart problems, cancer or other conditions.
"We’re not talking voodoo," Plotnikoff said. "We’re talking solid science."
The study in the Journal of Patient Safety had limitations. The pain relief was measured only after the therapy, so it wasn’t clear whether the benefits lasted. The study also didn’t compare patients receiving therapy with patients receiving medication alone.
Integrative therapy isn’t viewed as a replacement to pain medication, rather as a complement, said Jeffery Dusek, director of integrative health research at the George Institute. The hope is that patients who receive integrative therapy won’t need as many pain pills, which can be addictive and cause side effects and complications.
Future research will study whether patients receiving this therapy recover faster and suffer fewer drug-related complications. If so, then there is a strong economic argument that investments in integrative therapy by hospitals and insurers actually save money, Dusek said.
In the group acupuncture session, conducted in late March, patients waited quietly for several minutes until Miller began removing their needles.
Harelstad was surprised how the insertion of the needles immediately relaxed her. She was skeptical but fascinated by the theory behind acupuncture how needles inserted in her left ankle could alter her body’s electrical flow and reduce the pain level of her right hip.
The benefits wore off once she was wheeled to her room.
Peterman, 89, who’d had a knee replacement, was feeling good when his session was over. He refused a nurse’s offer to wheel him to his room.
"I’ll walk back," the Minneapolis resident said.
Mary Kay Brown had struggled after her hip replacement, partly because the anesthesia hadn’t been effective during surgery. The 64-year-old Minneapolis resident had slept little the prior night, suffering from cramping as she couldn’t move or roll onto her right side.
Miller tried an additional remedy, using a metal rod to poke specific points on Brown’s right hand. The so-called Korean Hand Therapy is designed to relieve pain by stimulating portions of the hand that correspond with the hip.
"Anything but the drugs," said an exasperated Brown, who worried that more pain medication would make her senseless.
Dusek said there have been success stories all over the hospital and that many skeptical doctors are frequently requesting integrative care for their patients. The approach appears to have delayed childbirth for women with high-risk pregnancies, allowing their babies to be born at healthier weights and gestational ages.
Abbott has the nation’s largest integrative medicine center with 22 practitioners and more than a dozen specialties. It is hardly alone, though. Children’s Hospitals and Clinics of Minnesota prides itself on its alternative therapy offerings for children and teen patients. Most oncology centers in the Twin Cities have added acupuncture due to studies showing it can reduce chemotherapy-related nausea.
"What you’re catching here is a glimpse of the future of medicine," Plotnikoff said.
Previously at Harvard, Dusek studied how alternative therapies cause physical changes to the body. Mind-body therapy involves limited physical contact, and yet it causes a patient’s body to release nitric oxide, which influences blood pressure and relaxation by opening blood vessels.
The skeptical Kline returned home to St. Anthony the next day after acupuncture. He didn’t notice much benefit but was glad he tried.
"When they cut something out of you and put something new in," he said, "that’s pretty major."
Harelstad, a 49-year-old from Eden Prairie, said she has always been skeptical of holistic remedies, but was interested in acupuncture after learning about it during a preoperative education seminar. She figured she’d try anything to help her get back to work and strong enough to enjoy spring gardening.
"It’s kind of bizarre," she said. "I’m not normally a holistic person, but that’s why I thought it was interesting and worth trying."
Jeremy Olson can be reached at 651-228-5583.
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Copyright (c) 2010, Pioneer Press, St. Paul, Minn.
Distributed by McClatchy-Tribune Information Services.
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