Despite the recent importance being placed on women's health issues , the fact that many women with multiple sclerosis (MS) and other disabilities do not know how to obtain basic medical and emotional care often goes overlooked. Luckily, not by everyone.
In an effort to provide respectful, high-quality medical services for women with physical disabilities , the Initiative for Women with Disabilities ( IWD ) Elly and Steve Hammerman Health and Wellness Center is offering acupuncture and complementary therapies to its patients.
According to IWD Director Judith Goldberg, the IWD , which is located at New York 's Hospital for Joint Diseases, was initially founded in 1997 because "there was a need for women with disabilities to get gynecological care." Because of "lack of access, architectural and attitudinal barriers," women with physical disabilities were not getting adequate medical care.
In 1998, Goldberg started the Wellness Program component of IWD , which initiated the addition of such services as yoga, nutrition counseling, Reiki, meditation, Thai chi and mind-body physical therapy. In addition to promoting a healthy lifestyle, these programs help prevent osteoporosis, heart disease and musculoskeletal pain.
Since its foundation, IWD has treated over 5,000 women using these complementary therapies in conjunction with Western medical care.
"The whole premise of IWD is to help women with disabilities empower themselves," Goldberg said. "Our program is unique in the sense that we really teach the women to be their own advocate."
For many years, Goldberg and Frances Goodwin, a licensed acupuncturist, had wanted to offer complementary therapies to women with physical disabilities. The benefit of acupuncture was something she had experienced firsthand. The Health and Wellness Program at IWD presented the opportunity to implement this service.
Acupuncture is a 3,000-year-old practice that consists of the gentle insertion and stimulation of thin, disposable sterile needles at strategic points near the surface of the body. Over 2,000 acupuncture points on the human body connect with 14 major pathways, called meridians. Chinese medicine practitioners believe that these meridians conduct qi, or energy, between the surface of the body and internal organs. It is qi that regulates spiritual, emotional, mental and physical balance. When the flow of qi is disrupted through poor health habits or other circumstances, pain and/or disease can result. A main benefit of acupuncture is that is keeps the normal flow of this energy unblocked.
According to a Knowledge Networks survey conducted in May 2000, women are significantly more likely to try acupuncture , as well as other alternative therapies , than men. The North American Menopause Society also reports that 30 percent of women use acupuncture .
"Some of the women [at IWD ] had had acupuncture before, some had heard of it but couldn't do it because of physical, financial and emotional barriers," Goldberg said. "Goodwin thought a clinical-style rotation would remove these barriers and allow the opportunity to offer these services to women with physical disabilities ," Goldberg said.
Goodwin then approached the New York branch of the Pacific College of Oriental Medicine and asked them to join forces with IWD in October 2001. The first acupuncture clinical rotation soon began, with student interns supervised by Goodwin, a faculty member of Pacific College of Oriental Medicine .
According to Goldberg, "[The acupuncture program] got popular right away."
So popular, that this year the program expanded to three shifts per week to accommodate a waiting list of approximately 80 women.
"There is definitely a need and a goal to expand," Goldberg said.
A national survey conducted in 1997 showed that the acupuncture 's popularity at the IWD is reflective of a national trend. There has been a 47.3 percent increase in total visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997. An increasing number of hospitals are also starting to provide acupuncture as a standard of care, including Cedar Sinai in Los Angeles and Yonkers General Hospital in New York .
Goodwin thinks it's important to continue to offer acupuncture as much as possible.
"I personally believe that acupuncture should be used as a standard of care," Goodwin said. "Hopefully, we'll go to an inpatient standard of care," she continued, referring to IWD 's current clinical-style outpatient program.
The acupuncture shifts, which take place on Monday mornings and Wednesday mornings and afternoons, are four hours each. Over a period of 14 weeks, a participant may receive as many as 20 acupuncture treatments. According to Goldberg, when added together, all of the PCOM interns may give as many as 500 acupuncture treatments per semester.
"The women really get a lot out of it, the interns get a lot of it, and the supervisors really get a lot out of it," Goldberg said. "In general, I think it helps everyone. The impact on the medical community has been invaluable. Now, there is an opening of dialogue between Eastern and Western medicine."
Goodwin said that IWD participants have a variety of physical disabilities that can be improved with acupuncture- different arthritic conditions, spinal conditions, head trauma and neurological disorders. Acupuncture is also an excellent alternative remedy for multiple sclerosis .
While women are twice as likely as men to contract MS, the fact that there is no known cure makes relief hard to come by. However, studies show that when used in conjunction with other modalities, one benefit of acupuncture is the effective relief for many MS symptoms.
Because diseases such as multiple sclerosis cause damage to myelin in the central nervous system, the disease interferes with messages between the body and the brain. Acupuncture can mediate the effects of this disease because it releases endorphins and peptides in the brain, which modulate sensory information between the brain and body. Acupuncture cures or eases many symptoms of disease, including symptoms commonly associated with MS such as fatigue, pain, blurred vision, weak limbs, tingling sensations, unsteadiness and fatigue.
In a survey conducted by the MS Clinic at the University of British Columbia , 566 patients with definite MS reported using an alternative remedy for multiple sclerosis , with acupuncture being the most common method used. The rest of the questionnaire focused on the reported benefit of acupuncture , with respondents citing reduced pain, decreased spasticity, improved bladder and bowel dysfunction, and alleviating tingling and numbness, among others.
Dr. Duong Hoang reports a study of 40 victims of MS who were treated with acupuncture . According to the study, "MS patients that had been suffering for a lesser number of years improved even before the completion of 10 acupuncture treatments."
In one case, a 53-year-old Caucasian female had been suffering from MS for 15 years. She had been confined to a wheelchair because of parethesias on both legs, loss of balance and weakness. She also had optic neuritis, insomnia, bladder control difficulties, low back pain, muscle spasms and nervousness. After 10 acupuncture treatments, the patient was able to walk - sometimes without a cane. Her vision, sleep, muscle spasms, and general health improved, and her bladder control became normal again.
Another member of Hoang's study was a 42-year-old man who had also suffered from MS for 15 years. He had to use a cane to walk because of parethesias on the left side of his body, and also suffered from poor vision and equilibrium, low back pain, and trouble choking on foods. He had also been sexually impotent for nine years and experienced problems with bladder control. An alternative remedy for multiple sclerosis was a good option for him at his point. After the first acupuncture treatment, the patient had no more problems swallowing food. After the third treatment, his bladder and vision functioned normally. After six treatments, his impotence was improved and after nine treatments he was able to walk without a cane.
Some patients have even come forward of their own accord to testify how acupuncture has helped them deal with MS. Duane Perron has had Progressive-Relapsing MS since 1978. The treatments he tried - a mixture of ACTH and Cyclospasmal - could only keep his MS from getting worse for five years. Perron's MS was concentrated on the entire left side of his body; the optic nerve in his left eye did not function and he had no hearing in his left ear. He also had trigeminal neuralgia on the left side of his face and could not lift his left foot.
Perron decided to try an alternative remedy for multiple sclerosis . After two months of acupuncture, he could hardly believe the results. His testimony on acupuncture .com states, "My wife and I went grocery shopping and as we left the store I said to her, 'Stay behind me and watch how I walk.' She did and she said, 'You are taking much larger steps, you are lifting up your left leg not dragging it, and you are standing up straight!'"
Perron went on to say, "Then that Wednesday I had an appointment with my eye doctor for a six-month checkup and he said to me, 'I don't know the reason, but in all the tests run today, the parameters on the results have at least doubled. That should not occur but it did!' I also have cut down on the medication I was taking for trigeminal neuralgia from four tablets a day to one tablet a day."
Perron also wrote that the most exciting result of his acupuncture treatments was that he and his wife could now "walk through the beach sand to the water and waded in the water and waves a number of times each day. Now, I haven't been able to walk in the sand at a beach or let waves hit my legs for at least 12 years! But I did that week, and I did it bare-footed without my brace, just my cane for balance."
Larger studies also report the benefit of acupuncture for MS . According to a study conducted by the Washington Acupuncture Centre in which 10,000 patients were treated and tracked for three years, patients with MS significantly improved by 85 percent. Other conditions commonly treated at IWD also improved as a result of acupuncture . Patients with headaches or menopause significantly improved by 94 percent, patients with chronic pain significantly improved by 88 percent, patients with lumber disc problems experienced an 89 percent improvement, and cases of arthritis or depression significantly improved by 83 percent.
The IWD participants also feel that acupuncture has improved their conditions, many of which involve stress.
"It helps with stress," one woman said. "Overall, I do seem to be feeling better."
Another participant agreed, saying, "[I liked the acupuncture treatment] because it helped me a lot with stress and constipation."
Other participants felt more specific benefits as a result of acupuncture .
"This treatment helps me a lot with my pain," a third woman reported. "The people are also very caring and loving. This has helped my back pain decrease."
Shari Auth, who interned at IWD for two semesters in 2003, said it was obvious that the participants enjoyed their acupuncture sessions.
"[The IWD participants] are so happy somebody is looking at their real problem," Auth said. "I know their favorite part of the [ IWD ] program is the acupuncture ."
According to Goodwin, the acupuncture program has had visible benefits for the IWD participants.
"The women commonly report back to their neurologist and primary care physician that the benefits of receiving acupuncture has benefited them and improved their quality of life," she said.
The PCOM interns, all of who must be female because of the sensitivity of the IWD participants, also find the externship rewarding.
"There were times when I would insert a needle in someone's leg and [that leg] would move for the first time, and they would get really excited," said Margaret Greeves, a PCOM student who interned at IWD in the spring of 2003. "It made me think, 'Hey, Chinese medicine really does work.'"
Carmen Alejandro, who also interned at IWD in the spring of 2003, found the internship rewarding as well.
"The experience is a marvelous one and one filled with much humanness and compassion, and at the same time challenges your skills as an intern," Alejandro said.
Auth simply said, "It was the best thing I did at PCOM."
Goodwin believes that though the interns certainly gain a valuable experience, their participation at IWD also allows women with disabilities to improve their lives.
"I think any intern with compassion, knowledge, care and skill brings aid to IWD participants," she said.
Perhaps it is the knowledge that they are able to visibly improve the lives of others that makes the acupuncture externship so popular with PCOM students.
"Even if that's not what you want to do with acupuncture , it's such a great experience," Greeves said. "I would love to volunteer as a licensed acupuncturist just to get the experience."