Acupuncture miracle

Correspondent Lorne Oliver is highly skeptical of acupuncture, but faced cognitive dissonance because he believed acupuncture saved his life. He describes the experience on his blog at http://www.filletofseoul.com/2008/10/acupuncture.html

Briefly, he developed itching after eating a dried persimmon, broke out in hives, developed a rapid pulse, then shallow, rapid breathing and dizziness. He concluded that his airway was closing off and he was going into anaphylactic shock. Thinking he wouldn’t live to get to a hospital, he stopped at a nearby acupuncture clinic. The acupuncturist stuck needles in various places, and had him lie under a heat lamp. He was back to normal in half an hour. The acupuncturist told him that he only had 20 minutes to live when he entered the clinic.

Did acupuncture save his life? I doubt it. I suspect he had a simple case of hives. LOTS of people get hives and don’t develop anaphylaxis. When he saw the hives he panicked, thinking he was going into anaphylaxis and might die. Fear made his heart beat fast and made him hyperventilate. Hyperventilation raises O2 levels and lowers CO2 levels, raising the pH of the blood and causing various physiologic changes. You’re breathing too much but paradoxically you feel like you can’t breathe or can’t take deep enough breaths, you get dizzy, you may have numbness and tingling in your hands, a headache, chest pain, and you can even pass out. This is very frightening: patients often believe they are dying or having a heart attack. I’ve helped many patients out of this fix by simply reassuring them that they were in no danger and talking them down or getting them to re-breathe in a paper bag.

The acupuncturist helped Lorne calm down, and the symptoms resolved just as they would have anyway. The needles had nothing to do with it.

Refreshingly, Lorne accepted my explanation. “Well, that explains that then, doesn’t it? …fits the situation better and makes more sense; Occam’s razor and all that.”

One case of cognitive dissonance cured; one acupuncture miracle debunked.

First of all Harriet, thank you so much for your swift and clear response. My thinking about your thinking on the matter is quite simply, “Well, that explains that then, doesn’t it?” I had had allergic reactions to things as a child such as grass clippings, dust, and mould, but not to my knowledge, any serious food-related allergies. Nor have I had any allergic reactions since my early 20s, some twenty years ago. I, of course, must admit that my limited (read: non-existent) medical knowledge led me to believe it was an anaphylactic reaction but your response fits the situation better and makes more sense; Occam’s razor and all that. Panic induced hyperventilation seems much more than plausible, especially since I didn’t die of anaphylaxis. I shall chose to ignore intervention by any of the “deities” listed in your response, although if I had to choose, I would pick the Flying Spaghetti Monster. He’s my favourite. Thank you again for your time and response.

Sincerely,
Lorne

P.S. May I include some of the (non-personal) parts of your email explanation in a follow-up posting?

On Fri, Oct 10, 2008 at 2:18 PM, Harriet Hall <hhall@skepdoc.info> wrote:

We have no way of knowing if you were really going into anaphylactic shock. It doesn’t sound like it to me. Your description fits better with urticaria (hives) and hyperventilation.

Hives can occur for many, many reasons. It could have been what you ate, but it could have happened for no discernable reason. My mother broke out in hives once and only once in her life and could never figure out anything she did different that day. They spread at first, then gradually faded and were gone later the same day.  At least 15% of the population gets hives at some time during their life, but anaphylactic reactions are very rare – and they don’t typically start with hives, but with a deeper swelling called angioedema and with other symptoms.

Once you had developed the itching and seen the hives, it was only natural for you to become anxious and afraid. These emotions cause the heart to beat rapidly and cause you to hyperventilate. As you breathe more, you take in more oxygen and blow off the carbon dioxide. The lower level of carbon dioxide in your bloodstream changes your body chemistry, altering the pH, constricting blood vessels that supply the brain, and producing a variety of symptoms. It makes you feel short of breath when actually the opposite is true. You feel like you can’t breathe or can’t take deep enough breaths, you get dizzy, you may have numbness and tingling in your hands, a headache, chest pain, and you can even pass out. The treatment is to calm down and slow your breathing, which is what the acupuncturist helped you do.

I’ve seen many, many patients hyperventilate. They refuse to believe they have been over-breathing – it just doesn’t feel possible. Sometimes they’re certain they’re dying or suffering a heart attack. I’ve talked many of them down. Reassurance that they’re in no danger and a calming presence is often all that’s needed; other times I would get them to rebreathe into a paper bag or breathe slowly following my count. This can happen to ANYBODY. It almost happened to me. I had given myself an allergy shot and there was no other doctor around in case I had a reaction, so I started thinking what if I got short of breath and started to have an anaphylactic reaction, what would I do? As I worried, I realized I was having difficulty breathing and my chest felt tight. I realized what was happening in the nick of time, forced myself to breathe slowly, and was fine in a matter of minutes.

Your story is typical of many claims for alternative medicine – an apparently miraculous recovery but not enough documented medical information to make sense of the story. Lots of people who were “cured” of cancer never really had cancer in the first place. Some conditions resolve spontaneously with no treatment, just from the natural course of disease. I know a man who called a chiropractor’s office on a Friday because his back pain just wouldn’t stop. The appointment was for Monday. The pain stopped over the weekend and never came back. If he had seen the chiropractor on Friday he would have been convinced that the chiropractor had cured him. He describes this as his narrow escape.

I can’t say for sure what happened because I wasn’t there and we don’t have any medical test results to help us. I can’t rule out the possibility that the acupuncturist saved your life. I can’t rule out the possibility that the Virgin Mary or Osiris or the Flying Spaghetti Monster intervened to spare your life either. All I can say is there is a plausible natural explanation that doesn’t depend on imaginary lines, points, forces, or supernatural entities. A plausible explanation that is far, far more probable than a cure by acupuncture. If I had to bet money, I wouldn’t put a penny on the acupuncturist.

This article was originally published in Swift, the online newsletter of the James Randi Educational Foundation

Dr. Hall is a contributing editor to both Skeptic magazine and the Skeptical Inquirer. She is a weekly contributor to the Science-Based Medicine blog and is one of its editors. She has also contributed to Quackwatch and to a number of other respected journals and publications. She is the author of Women Aren’t Supposed to Fly: The Memoirs of a Female Flight Surgeon and co-author of the textbook, Consumer Health: A Guide to Intelligent Decisions.