AERD Report 2023 Q 3.75
Please forgive the delay in what was supposed to be a quarterly report. I got COVID for the first time in September, and wow, I finally know what everyone’s been talking about! Losing that week-plus at the beginning of Q3 has taken awhile to recover from in terms of work. Anyway, my plan is to report here on what’s happened since the last summary, and then do more of a year-end reflection for Q4. Thank you to everyone who sent in reports, POCA Tech truly appreciates all of them! So without further ado:
We had twenty-two total completed reports to the AERD from July up through today. Some reports referenced more than one category of AE (for instance, bleeding/bruising/psychoemotional trigger). The breakdown looks like:
AERD Greatest Hits
bruising/hematoma, five (including one bruise “the size of a softball”!)
symptoms worse, three
pain after treatment, two
psychoemotional trigger, two
needle left in, one (at Yin Tang)
nicked tendon on insertion, one
extreme fatigue after first treatment, one
people paying too much for acu, one (submitted under the heading of “an adverse event for the whole profession” -- extra points for creativity!)
just plain weird, three (one was a tingling sensation radiating from R shoulder to L shoulder -- with no needles in EITHER shoulder, but patient had recently had a series of medical tests that involved having a heart monitor; two were feeling needles where there weren’t any)
And there’s one report in this batch that I’d like to highlight under the “symptoms worse” category --because it was educational, and also because it happened at POCA Tech so I have more details than I otherwise would.
POCA Tech has a feedback form for treatments in the student clinic, and one day we received one that went something like this:
Hi, I have a question about whether acupuncture might be contra-indicated for people in my age group? After my last treatment I had an unusual issue: two sharp stabbing pains in my temple that made me feel foggy, I had some difficulty driving home. Since the fogginess and the headache lingered I went to urgent care the next day. They sent me to the ER where I had an eight hour ordeal but finally it was determined that I was not having a stroke or a heart attack. I am a little concerned about future acupuncture treatments, thank you for your response.
Yes, I thought, if I spent eight hours in the ER after getting acupuncture I’d be a little concerned too! I called the intern who gave the treatment and asked if they felt comfortable calling the patient to follow up, and then calling me back.
They did, and the patient was pleasantly surprised to receive such a quick response. The intern said that they were going to make a report to the AERD so would the patient mind going over what happened in detail? No, the patient said, and they reviewed the timeline of events again. Two days before the treatment, the patient had two invasive medical tests that involved anesthesia. The intern confirmed that the acupuncture treatment had included some scalp points but no needles in the temple, where the headache started. The conversation ended on a friendly note and the intern called me back.
As we talked through it, my impression was this was indeed an adverse event. The headache came on in the way that headaches sometimes do after acupuncture -- there are many other examples of this phenomenon in our database. The intern had not made any errors as far as we could tell; the patient had been a regular in the student clinic for some time and had had many similar treatments. It seemed like the heavy-duty medical testing plus the anesthesia just a few days before HAD to have something to do with the intensity of the headache and the fogginess -- but also, acupuncture clearly triggered these symptoms.
When the intern talked with the patient, they made sure to address the patient’s question about whether acupuncture could be contraindicated for older people. The intern let her know that there’s no research that we know of that indicates any contraindications based on age alone. The POCA Tech student clinic has successfully treated people in every age group from babies to nonagenarians. But it’s a valid question to ask and the answer is, “not to our knowledge”.
When an adverse event happens, patients (understandably) create their own narrative about it. This person’s narrative involved their age, but it could just as easily have focused on any number of other factors. This is why good communication is so important! Because the intern responded promptly to the patient’s concerns in an open, non defensive way, the story has a happy ending: two weeks later the patient returned to the same intern for treatment, with the news that the headache eventually went away and she got a clean bill of health from her cardiologist.
This batch of reports includes another example of a patient having weird sensations with acupuncture in the wake of biomedical testing, which suggests that there’s a possible increased risk that acupuncturists should be aware of. There’s so much desire in the acupuncture profession to integrate into conventional medicine, but we’re not really prepared to do that unless we have a feedback loop to learn about incidents like this. It’s important for POCA Tech to be able to give students a heads up that if patients have recently had anesthesia or have used a heart monitor, that they could have unexpected responses to (even gentle, distal) acupuncture. If we had known at the time that this reaction was happening, we could have cautioned the patient against driving; it's fortunate that she got home without incident, but the part about how she "had some difficulty" with that makes me cringe.
Thank you again to everyone who submitted a report -- your generosity helps us make acupuncture safer!