This week we have a special treat – a guest post from Doug Nordman a.k.a Nords, from The Military Guide. He’s sharing with us his experiences with medical tourism. He bravely (or foolishly?) underwent acupuncture, cupping, and moxibustion in Thailand.
Remember the Olympic swimmers and their purple dots this past summer? That’s what you look like after cupping. To learn more about these procedures, and medical treatment abroad, read on:
Thanks for inviting me to write about these treatments, Crew Dog!
I’m a 56-year-old retired U.S. Navy submariner. As a “recovering nuke,” I’m skeptical about alternative medicine. Before I believe in a medical technique I want to read a pile of peer-reviewed reproducible studies of double-blind experiments with statistically significant evidence– and acupuncture just isn’t there yet. If acupuncture achieves anything at all, it might be simply a gigantic placebo effect.
However I’ve lived in Hawaii for over 25 years, where Occidental and Oriental cultures overlap with science and technology. I’ve learned to keep an open mind when I encounter treatments which defy the explanations of medical research.
My physical therapy for joint injuries has taught me that Western medical science doesn’t always have a precise explanation for why a technique works. I’ll enjoy the results whether or not I fully understand the mechanisms. If acupuncture is simply just a gigantic placebo effect then I can live with that.
I’m also willing to try new approaches because I’m a little frustrated with my aging body. I’m encountering new limits in my maximum heart rate and recovery time. When I was in my 40s, I used to burn through the Navy’s physical fitness test and then go work out. These days, after that type of exercise I’m tempted to burn through 800 mg of Ibuprofen and take a nap. When I do a couple hours of heavy yard work, I have to be careful to maintain good posture in my knees and my back – I don’t want to end up in another round of physical therapy.
My body’s latest betrayal is my left shoulder (deltoid) muscle. Over 10 months ago I felt a small “pop” during a push-up set, and the next day I couldn’t raise my left arm above my shoulder. It slowly healed over the next six months but I kept re-injuring it. When we traveled to Bangkok, I still didn’t have full range of motion and I couldn’t put my left hand up behind my back. I was worried that I’d injured my rotator cuff and I felt like an idiot.
Thailand’s cost of living is incredibly cheap, and Bangkok’s major hospitals are a magnet for medical tourism. My spouse and I had heard about the Traditional Chinese Medicine Clinic of Hua Chiew Hospital, and we were happy to spend a few dollars to experiment on my deltoids.
Hua Chiew is definitely not practicing traditional Western medicine: the hospital takes walk-in patients. The lobby was a beehive of activity with a large waiting area by the cashier’s window. The clerk at the front desk explained (in English) that a typical acupuncture treatment would be less than 600 baht. (At 35 baht per dollar, that’s just over $17– and nobody asked us about insurance.) He entered our names into their computer system. We stopped by the next table for a quick health check of height, weight, temperature, and blood pressure before being sent up to room 504.
The fifth floor was quieter, with a few patients in the hallway and a family in the waiting area. When I walked into room 501’s open ward, it smelled like old cigarette smoke– and marijuana. (Hey, I have a training certificate from a 1980s Navy drug education class with a “test burn”.) I was greeted by an acupuncturist and an assistant who asked me where it hurt. A few minutes later the assistant was guiding me to an exam table.
“This won’t hurt a bit.”
I was asked to remove my t-shirt (which the assistant quickly hung on a hanger) and arranged on my right side with my left arm extended across a pile of pillows. While the assistant set up the privacy curtains, the acupuncturist came up behind me with a tray of needles and other tools. (Selfies were discouraged during this procedure, but I took photos afterward.) I turned my head to watch, but she politely asked me to relax on my pillow so that she could put needles into my neck.
She swabbed my skin with antiseptic and opened a package. Each needle was about three inches long with tiny coils at their gripping end, and they seemed very delicate. They must have been extremely fine and sharp because I could barely feel them going in– just a cool sliding sensation as she inserted them about an inch. My skin didn’t even dimple as she gently and quickly placed them from neck to elbow. A minute later I had a dozen needles sticking out, and she suggested that I should stay still. She even put two needles in the side of my left calf, explaining that there’s a nerve connection to the shoulder.
Then the assistant brought out a power supply and an electronics box. I later learned that this was an electrical muscle stimulation system, and the acupuncture needles make it easy to deliver the electrons directly to the injured area. She wrapped electrical wires around two of the needle coils and flipped a switch. My deltoid promptly started twitching gently, about once per second. After she checked the electronics display, she brought out an IR heat lamp and positioned that over my left shoulder. She said she’d check on me in 30 minutes and gave me a call button to push if I had any problems.
I stayed as still as I could despite being a human pincushion with my shoulder twitching like a frog leg in Dr. Frankenstein’s high-school biology class, while the lamp heated my shoulder (and the metal needles). It must have looked extremely uncomfortable.
A few minutes later I dozed off.
Judging from the assistant’s polite smile when she woke me up, this must happen a lot.
Well, technically my deltoid kept twitching while the rest of me had a very nice nap. When she turned off the machine, my entire shoulder relaxed.
She gently extracted all the needles that they’d inserted. (I kept count just to make sure.) I could barely feel the sliding sensation as they were removed, but there was no pain.
Then she picked up a tray of heavy glass cups, and I realized that I’d signed up for a bonus cupping session after the acupuncture.
Cupping
The assistant laid out a dozen cups of various sizes. They were each about 2”-3” tall and 1”-2” in diameter, made out of heavy glass. She rubbed a light coat of oil over my shoulder and back (to get a better seal).
Next she used her forceps to pick up a cotton ball and dip it in a liquid that looked like alcohol. Then she picked up a cigarette lighter, set the cotton ball on fire, and walked over to my shoulder.
An open flame. In a hospital. In a ward where there were probably oxygen canisters near more flammable liquids and oily skin. With a submariner who used to teach firefighting tactics at a training command.
I was not happy.
It turned out that the flaming cotton ball heated up the cups (and the air inside them). The acupuncturist briefly warmed each cup over the flame and then gently slapped them down on the skin that had held needles. As the air in the cups cooled and contracted, the suction drew the skin up into the cups and held them in place. A few cups were pried off and re-applied for a better seal.
As the skin on my shoulder and back was pulled up into the cups, I could feel a warm tingling as more blood was pulled up into my muscles. Several minutes later the assistant released all of the cups (with a wood tongue depressor) and wiped the oil off my skin.
The acupuncturist asked me to sit up and move my arm around. It was still warm from the treatment, and the deltoid felt particularly loose. I was happy to discover that I had much more flexibility and no pain. Wonderful!
When I checked my shoulder and back in a mirror, it looked like I’d lost a grappling match with an octopus. (This picture was taken an hour later.) The acupuncturist reassured me that the bruising would fade in a few days. In my case, the marks took nearly three weeks to disappear.
What happened to make my arm feel so much better?
According to traditional Chinese medicine, my body’s qi had been manipulated by the needles and the cups to bring more healing energy to my damaged deltoid.
Western medicine claims that my muscles had been stimulated by electricity, bringing more blood and lymph fluid to help repair the microtears. The heat and the cupping had brought even more blood into the muscle and skin, causing more bruising yet supplying more healing fluids. My body would focus greater effort on repairing damage in that area, which would also accelerate repairs to the deltoid muscle.
And, of course, the hour’s performance had kicked my placebo effect (and endorphins) into overdrive. No wonder I felt so good.
I’ll leave that debate to the doctors. Whatever happened during that hour, the pain relief (and the greater range of motion) was worth every penny of $17.
When I paid the bill at the cashier’s desk in the lobby, it was more like $16.75. My smartphone’s Google Translate software wasn’t much help here, but if you read Chinese or Thai then please feel free to share the details.
Followup
As I left the fifth floor, I was handed a small appointment card and admonished to return in three days for more treatment. My spouse and I got busy with other activities (there’s a lot to see & do in Bangkok) and we returned in nine days. When we walked in (still no appointment necessary!), the front desk checked our cards and started the routine again.
When I walked back into room 501 it still smelled like marijuana. I confidently returned to my treatment table, hung up my t-shirt, and laid down for an encore of my last visit. The setup went the same and I was soon bristling with acupuncture needles, but they didn’t haul out the electrical box.
This time the assistant unwrapped a couple small paper packages the size of a section of a Tootsie Roll. Later I learned that they held a dried Chinese herb called moxa, and I was about to experience moxibustion.
She poked two of the herb bundles on top of two of the acupuncture needles… and then lit them with her cigarette lighter. I immediately realized why the ward smelled like marijuana smoke, only it was burning moxa.
As she pulled the privacy curtains closed, she asked me to push the call button if my deltoid got too warm. I soon realized that moxa burns just like tobacco and it was heating up the acupuncture needles. Those, in turn, conducted the heat straight down to my deltoid muscle. I wasn’t exactly getting first-degree burns, but it was uncomfortably warm under my skin. I gritted my teeth and vowed to wait out the moxa.
It must have worked because I dozed off again. The moxa stopped smoldering in 20 minutes and the assistant followed up with the heat lamp for another 10 minutes. They removed the acupuncture needles and commented that my cupping bruises were sure taking a long time to heal, but that was the end of the session!
This time I only paid 525 baht ($15).
Long-term results
We’ve been back on Oahu for a couple of weeks, and my left deltoid is completely healed. It could be qi or it could be targeted electricity and heat therapy, but the results are undeniable. I’m back to pull-ups and push-ups and reaching up between my shoulder blades. I’m also doing more stretching and taking it a little easier with the multiple sets, but now I know what a local acupuncture clinic (or the placebo effect) can do for me.
Either way, I’m happy.
Crew Dog: Doug usually writes about Financial Independence and Early Retirement, and how he did it on a military salary, at the-military-guide.com. He’s also the author of The Military Guide To Financial Independence And Retirement.
Have you been a medical tourist, or tried alternative medical procedures? What were your experiences like? Comment below.