Although I have been back from Burma for over a month now, it seemed to take a while to properly land. I am happy to say that I no longer feel suspended somewhere between different time zones, climates and cultures. Now that I am settled once again back home I feel I can begin to process the rich experience of traveling and practising acupuncture in Burma.

So here is a little summary of what I was up to:

I was in a team of 4 western acupuncturists invited to take part in a 3 week acupuncture programme which takes place twice a year at a hospital established by a monastery, near Mandalay. The idea of the programme is to enable local traditional Myanmar medicine practitioners who have studied at Mandalay university to gain experience of practicing acupuncture in a supportive environment and learn from more experienced western acupuncturists. In the west we are fortunate to have a very high standard of acupuncture training whilst our colleagues in Burma learn acupuncture as adjunct to their traditional medicine training which focuses on herbs and massage techniques.
The programme is centred around an acupuncture clinic which opens its doors 6 days a week for the period of our stay. At the end of the programme the clinic operates a reduced service 3 times a week and the local practitioners maintain it by volunteering their time but gain lots of experience, a sense of fulfilment and lots of friendship.

Every morning we would walk over the road to the acupuncture hospital where already there would be a long line of people queuing up for treatment and the local team would have just arrived off the bus from Mandalay, a half hour ride away. We would then get together in small teams, a western practitioner with 2 or 3 local practitioners, and work our way around the room.

There was a real variety of patients and we treated a wide range of conditions. There was always a large number of Buddhist monks and nuns, as the area is a hub for monasteries and temples. In order to treat them we would have to navigate the carefully arranged crimson (the monks) and pink (the nuns) robes.  Many of the patients were farmers and labourers with musculoskeletal conditions such as back  and knee pain. We saw a lot of people who had been in motorbike accidents with terrible scars. We were able to work on these scars with daily treatments and really saw the benefit of such regular treatments as scars became noticeably less raised, less purple and more supple. We also saw some impressive results with a lady who had recently suffered a stroke and was paralysed on one side. After 3 weeks of regular treatment her movement ability had significantly improved and she her whole being was much brighter and more able to engage. It makes you think what could be achieved if acupuncture was more widely accessible and part of the mainstream provision in our country. Some patients had travelled considerable distances for treatment with one lady coming from over 100miles. The state provision for health care is apparently very minimal in Myanmar and the population have few options when face with illness.
On some afternoons, after a good lunch of curries, soup, rice and pickles, we would take a short rest before offering a lesson to the students. We were invited to teach about whatever we were most inspired by. And so we offered lessons on acupuncture in pregnancy, qi gong, reading pulses, dental analgesia and safe practice.
A lovely addition to the experience of being in Myanmar was that we were invited to take part in a daily meditation sitting, at the nearby monastery. So we would start our mornings with an hour of meditation which really helped to ground me before a busy day in clinic. I also very much appreciated the special location we were in and the afternoon hikes into the hills behind the hospital to discover a myriad of little paths each leading to a monastery, temple or stupa. And once arriving at the top of a peak admiring the views of the mighty Irrawaddy in the soft, golden light of the late afternoon.
But I think what I was most inspired by was the warmth and generosity of our hosts, a truly humbling experience.

Last November at an acupuncture conference, I was invited be part of a team of volunteer acupuncturists going to Myanmar in January. An opportunity which was difficult to refuse, so I am off from 9th January 2015 for a month!
Our team of acupuncturists  will be providing treatments to local people and training to local acupuncturists who have much less continuing professional development opportunities than we do here in the west.
The clinic runs out of a hospital in a large village on the banks of the mighty Irrawaddy river, near Mandalay.
Whilst I am away I am very happy to have Tom Hirons looking after my patients in Exeter.
This promises to be a very rewarding experience. I hope to bring home with me lots of inspiration which will enrichen my practice back in the UK.
If you would like to know more about the project there is a video here: http://vimeo.com/46611296 and a website:http://www.myanmaracupunctureproject.org/2/Welcome.html
With blessings for 2015,

Charlotte

Painful periods affect many women and for some they can be truly debilitating, with cramps so severe they can do nothing but curl up on the sofa in pain. For some people it is not unusual for 1-3 days a month to be a write-off, unable to work or function at all. Too often a visit to the doctor results in being told this is ‘normal’, and just given painkillers or even advised to go on the contraceptive pill to address the problem. The contraceptive pill can have many other side effects and many women have to choose between the monthly debilitating pain from their periods or the emotional and physical roller coaster they get from taking hormonal contraception.

But the simple fact is: Severe period pain is not a natural part of the menstruation process! It is not something that we should have to put up with and accept. According to traditional Chinese medicine painful periods are seen as a pathological symptom of an imbalance in the body and it is something that can be resolved.

Why do we get pain?

Primary dysmenorrhoea is period pain that occurs without an underlying medical condition. When our body is ready to shed the uterine lining (endometrium) at the end of each monthly cycle, the muscular wall of the uterus contracts to constrict the blood vessels and cut off the blood supply to the endometrium. This causes the tissue to die and the endometrium is shed. a small degree of discomfort is normal, but studies show that in some women there is hyper-contraction of the muscles causing severe pain

Secondary dysmenorrhoea is pain that occurs as a result of an underlying problem with the uterus or pelvis such as endometriosis, fibroids or pelvic inflammatory disease

How does acupuncture help?

Extreme pain during a period is a sign that the natural process of shedding the endometrium isn’t working at its best. Many women also experience other symptoms such as irregular cycles, heavy or long periods, digestive problems or feeling irritable or tearful. In fact all these problems are a sign that the menstrual system isn’t functioning correctly. By finding out why this is happening and addressing the problem at its cause, it is possible to be problem free.

An acupuncturist will take a full case history to determine the root cause of the dysfunction. The treatment would be then tailored to each individual according to what needs rebalancing. It may be that other methods are used in addition to acupuncture. Sometimes heat is used in the form of Moxa. Sometimes lifestyle or dietary changes are suggested.

An acupuncturist’s aim is to allow the blood to move more freely during the menstrual process. Often those with severe pain will have many clots in their menstrual blood. This is a sign of what acupuncturists call Blood Stagnation and it is that lack of easy flow that causes many problems. Acupuncture could help whether someone experiences pain from primary or secondary dysmenorrhoea.

Acupuncture may help reduce symptoms of dysmenorrhoea by:

• increasing relaxation and reducing tension (Samuels 2008). Acupuncture can alter the brain’s mood chemistry, reducing serotonin levels (Zhou 2008) and increasing endorphins (Han, 2004) and neuropeptide Y levels (Lee 2009), which can help to combat negative affective states
• reducing inflammation, by promoting release of vascular and immunomodulatory factors (Zijlstra 2003; Kavoussi 2007)
• stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors, and changes the processing of pain in the brain and spinal cord (Pomeranz, 1987; Zijlstra 2003; Cheng 2009);
• increasing nitric oxide levels, which relaxes smooth muscle and hence may inhibit uterine contractions (Wang 2009)
• regulating neuroendocrine activities and the related receptor expression of the hypothalamus-pituitary-ovary axis (Liu 2009; Yang 2008)
  The evidence

for full information on the evidence and research behind this information, and information on how acupuncture can help other menstrual conditions, please see the British Acupuncture Council’s fact sheets for the following conditions:

Period Pain (dysmenorrhoea)

Endometriosis

Pre-menstrual syndrome (PMS)

PCOS

If you have menstrual problems and would like to know more, please contact us for a chat.

The Peoples Acupuncture Project, Bristol

Blood plays an important role in our mental and physical well-being in Chinese medicine. The Shen (our spirit and consciousness) is believed to be anchored in the Blood so when the Blood is depleted we can experience feelings of disconnection; we might become easily startled, find we are not able to bring our focus firmly into the present so become easily forgetful, or feel uneasy and anxious. The Shen is said to reside in the Blood at night so if the blood is not strong we might experience difficulty falling asleep. On a physical level the blood brings nourishment and lubrication to our muscles, sinews, organs and brain. If there is a lack of vitality in our blood we might feel weak and easily tire, experience postural dizziness and cramps, and our hair may become dry and our nails brittle.

Looking after our Blood requires attention to both what we eat and our lifestyle. It’s not enough to just eat the right things we need to support the body to be able to get the most out of what we put in. This means getting rest and avoiding excessive exercise regimes. A rest in the afternoon is especially beneficial to replenish the Blood.

A gentle reorientation in diet can lead to a really positive impact on the Blood. In Chinese medicine we recommend a balanced diet with an emphasis on foods with a strong lifeforce (qi); in other words seasonal foods which have not been denatured for their production, transportation or consumption. Foods can then be added to address imbalances however any diet should be adopted in a way that can be sustained not as a quick fix. Foods to add to strengthen the Blood include chlorphyll-rich and leafy green vegetables combined with grains, meat, fish, seafood and many beans. Animal organs are especially enriching to the Blood.

Specific foods which tonify Blood are: aduki bean, apricot, beef, beetroot, black soybean, bone marrow (make a chicken stock soup, for example), cherry, eggs, dates, figs, grapes, kale, kidney beans, liver, mussels, nettles, octopus, oyster, parsley, sardine, spinach, squid, tempeh, watercress.

Over 20% of the UK population suffers with ‘unexplained’ discomfort and irregularity in bowel habit. The term Irritable Bowel Syndrome is used to describe the experience of symptoms such as pain or discomfort in the abdomen, bloating, swelling, bouts of diarrhoea and/or constipation and feeling sick. It is a chronic, re-occurring and often debilitating condition which can cause misery for sufferers.

There is no single cause of IBS. Some people can trace their IBS back to a single event such as a bout of food poisoning or infectious illness; however in most cases the cause is unknown. Some people find their IBS is triggered by sensitivity to certain foods, others find it is exacerbated by stress or emotional states. Each person’s experience of IBS is different.

This lack of understanding of the cause means that conventional medicine finds IBS very hard to treat, instead focusing on symptom relief with antispasmodic drugs.

The inconsistency of symptoms and triggers isn’t a worry to a Chinese medicine practitioner. As acupuncturists we don’t treat IBS, we treat the person. An acupuncturist looks at each individual’s experience of IBS to fully understand what functional disturbances there are in their system and why. By working out why and how someone’s digestive system isn’t functioning, we are able to treat the root cause and bring about relief.

This means that alongside acupuncture treatment we may make suggestions as to lifestyle changes that may be helpful in combating IBS symptoms. This could be dietary changes, or techniques such as meditation to address more emotional causes.

How acupuncture can help

Research (see below) has shown that acupuncture treatment may benefit IBS symptoms by:

• Providing pain relief
• Regulating the motility of the digestive tract
• Increasing parasympathetic tone. Stress activates the sympathetic nervous system, which can stimulate colon spasms, causing pain and discomfort. In people with IBS, the colon can be oversensitive to the smallest amount of conflict or stress. Acupuncture activates the opposing parasympathetic nervous system, which initiates the relaxation or ‘rest and digest’ response.
• Raising the sensory threshold of the gut. (A lowered threshold to bowel pain and distention are hallmarks of IBS)
• Reducing anxiety and depression. Distressing IBS symptoms can lead to a vicious cycle of anxiety-pain-anxiety and lead to feelings of depression. Acupuncture can alter the brain’s mood chemistry, increasing production of serotonin and endorphins to combat these negative emotional states.

If you would like to know more about how acupuncture could help your digestive dysfunction, Please contact us for a no-obligation chat.

The People’s Acupuncture Project, Exeter

References

Chen J et al. Electroacupuncture improves impaired gastric motility and slow waves induced by rectal distension in dogs. Am J Physiol Gastrointest Liver Physiol. 2008 Sep;295(3):G614-20.

Han JS. Acupuncture and endorphins. Neurosci Lett. 2004 May 6;361(1-3):258-61.

Ma XP et al. Effect of electro-acupuncture on substance P, its receptor and corticotropin-releasing hormone in rats with irritable bowel syndrome. World J Gastroenterol. 2009 Nov 7;15(41):5211-7.

Lu B et al. A randomised controlled trial of acupuncture for irritable bowel syndrome. Program and abstracts of the 65th Annual Scientific Meeting of the American College of  Gastroenterology; October 16-18, 2000, New York, NY. Poster 268, p.428

Pomeranz B. Scientific basis of acupuncture. In: Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987:1-18.

Samuels N et al. Acupuncture for psychiatric illness: a literature review. Behav Med. 2008 Summer;34(2):55-64.Schneider S et al. Neuroendocrinological effects of acupuncture treatment in patients with irritable bowel syndrome. Complement Ther Med. 2007b;15(4):255-63.

Tian XY et al. Electro-acupuncture attenuates stress-induced defecation in rats with chronic visceral hypersensitivity via serotonergic pathway. Brain Res. 2006 May 9;1088(1):101-8.

Tian SL et al. Repeated electro-acupuncture attenuates chronic visceral hypersensitivity and spinal cord NMDA receptor phosphorylation in a rat irritable bowel syndrome model. Life Sci. 2008 Aug 29;83(9-10):356-63

Trujillo NP. Acupuncture for the treatment of irritable bowel syndrome. Med Acupunct 2008 Mar 20(1):47-49

Xing J et al. Transcutaneous electrical acustimulation can reduce visceral perception in patients with the irritable bowel syndrome: a pilot study. Altern Ther Health Med. 2004 Jan-Feb;10(1):38-42.

Xu GY et al. Electroacupuncture attenuates visceral hyperalgesia and inhibits the enhanced excitability of colon specific sensory neurons in a rat model of irritable bowel syndrome. Neurogastroenterol Motil. 2009 Dec;21(12):1302-e125

Yin J, Chen JD. Gastrointestinal motility disorders and acupuncture. Auton Neurosci. 2010 Apr 2.

for more information on this research please go to http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/irritable-bowel-syndrome-ibs.html