Thursday, September 30, 2004

http://seattlepi.nwsource.com/local/193061_hcenter30.html

Children's Hospital explores acupuncture, other alternative therapies

By JULIE DAVIDOW
SEATTLE POST-INTELLIGENCER REPORTER

After Emily Behrens' successful bone marrow transplant at the age of
6 months, her parents were anxious to take her home.

Diagnosed with leukemia at birth, she'd spent most of her life in
the hospital.

But Emily couldn't leave until her tiny body kicked a dependence on
morphine.

Every time doctors at Children's Hospital and Regional Medical
Center tried to lower her daily dose of the powerful pain
medication, Emily would shake and vomit, said her mother, Collette
Behrens.

After two weeks, a doctor on Emily's pain management team suggested
a type of acupuncture to ease her withdrawal symptoms.

"Her (other) doctors were skeptical," Behrens said. "They thought it
was pretty humorous."

Children's in Seattle is one of a few pediatric hospitals across the
country slowly introducing alternative therapies, including
acupuncture, massage and therapeutic touch, to treat their young
patients.

To help Emily, Dr. Anjana Kundu taped tiny magnetic pellets and
small needles to key pressure points inside her wrists and the
cartilage of her upper ear.

Acupuncturists use the metal beads for babies and very young
children, who can't sit still for treatments with needles, Kundu
said.

Emily had already endured so many procedures and been on so many
medications, her mother figured the alternative approach couldn't
hurt.

"Because of Emily's age and the fact that she was so sick, there
hasn't been a whole lot we can do for her," Behrens said. "I was
excited to try something."

Within two weeks, Emily was weaned off morphine without the severe
withdrawal symptoms she had at first, Behrens said.

"For her, it wasn't all mental because she didn't know what was
happening," Behrens said.

Kundu, an anesthesiologist and pain specialist who started at
Children's last year, is the only physician at the hospital trained
to perform acupuncture.

Hospital administrators say that's one of the reasons they hired her.

"A significant percentage of the children coming to our hospital or
clinics are already participating in complementary medicine," said
Dr. Rich Molteni, medical director at Children's. "Whether it was a
mom trying echinacea for colds or parents dedicated to naturopathic
or chiropractic techniques taking their children to those providers."

It is hoped that Kundu's presence will help convince otherwise
skeptical doctors that complementary medicine can be useful, Molteni
said.

Acupuncture is not entirely new at Children's.

A licensed acupuncturist from Bastyr University has been available --
at patients' request -- for two years, but arranging the treatments
was cumbersome, said Dr. Corrie Anderson, director of Children's
pain program.

"We had to get emergency approval," Anderson said. "Now, we don't
have to go through all the paperwork."

Kundu said she's having some trouble keeping up with demand. She
sees several kids for outpatient acupuncture appointments and steals
moments from her day to check in on hospital patients.

Children's is also developing a pediatric pain fellowship that would
allow residents to do a rotation in complementary medicine at Bastyr.

"You want to create an environment where patients feel comfortable
and can seek different therapies within the hospital," Anderson said.

Parents with the sickest children often aren't satisfied with the
remedies Western medicine has to offer, Molteni said.

"The risk of the treatments is so high and the chance of survival is
only moderately good," Molteni said.

But Moleteni remains cautious about relying on alternative
therapies, especially as cures.

He points to a 2003 study published in the Journal of the American
Medical Association led by doctors at Children's and Bastyr. They
found that echinacea, an herbal remedy, does not relieve cold
symptoms and can cause allergic reactions in some children.

"It's one thing for me to go into a hospital and demand acupuncture
or naturopathic medicine because I've used it and I believe in it,"
Molteni said. "It's another thing for a hospital that has an
obligation to protect patients who can't speak for themselves from
unnecessary harm."

There's not a lot of evidence linking acupuncture with pain relief,
but some studies suggest acupuncture stimulates internal substances
that work on the same pain receptors in the brain as opioid-based
medications, Kundu said.

Unlike acupuncture, pain medicine, especially in young patients, can
cause side effects, including stomachaches and digestion problems,
said Kundu.

"Sometimes that adds to the problem," Kundu said. "If you're using
acupuncture, you can minimize the amount of medications (a child is
on)."

For Michele Meola, whose teenage son was recently diagnosed with
Crohn's disease, cutting down on medications was key.

"We didn't want him to live on prescription drugs, especially as a
16-year-old driver," Meola said. "At this point, needles weren't
going to hurt him any more than the constant use of steroids,
antibiotics and immunosuppressants."

During an appointment last month, Aaron Meola, who said he used to
be "incredibly needle-phobic," kicked off his shoes and waited for
Kundu.

Since starting acupuncture, the severe joint and stomach pain that
kept him awake at night for more than a year has dissipated, Aaron
said.

"This is one (doctor's appointment) I can look forward to because I
know it's actually going to be helpful," he said.

To get sick kids get over the hurdle of more needles, Kundu lets
them touch the thin, flexible pins and shows them pictures of other
children receiving acupuncture.

Sometimes, she distracts young children during treatments by blowing
bubbles.

"I never tell them it's painless," Kundu said. "I do tell them
they're going to feel something, but it's not necessarily painful."

P-I reporter Julie Davidow can be reached at 206-448-8180 or
juliedavidow@...