Keep The Change

This week’s guest columnist is Dr. Hanh-My Tracy Tran, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

It’s shameful getting sent to the principal’s office, so I recall the time it happened to me.  My fourth-grade teacher was worried that I was ill, and then grew more concerned when she noticed red marks and bruises on my neck, back, and shoulders.  When she asked me about them, I said that’s how my mom treats me when I’m sick.  Even more freaked out, she sent me to the principal’s.

My response raised fears of abuse, but to me, a Vietnamese, the practice of “coining” is normal. Known as cao gio (pronounced gow yaw), coining is a common traditional technique in Southeast Asia.  It’s used to treat flu, colds, muscle pain, and fatigue.  The literal translation is “catching the wind.”  It’s believed that we get sick because of being  too much in windy weather, causing an imbalance in the immune system.  To restore balance, ”bad wind” is released from the body by coining.  Objects with smooth edges like coins or spoons are dipped in heated oil and rubbed in a specific pattern on the back, chest, shoulders, and neck.  This leaves red lines that last for 3 to 5 days.

When children come to the Emergency Department, doctor’s offices, or schools with these marks, things can become hectic.  Doctors, teachers, and other parents who aren’t familiar with coining worry about abuse, and think about reporting it to police and the Department of Family and Children’s Services.  All the more reason for doctors to listen to patients and their parents without prejudice.  Physicians must be willing to be open-minded about different practices.  For parents, it can be uncomfortable to discuss alternative medicine with doctors, fearing judgement.

It’s important to discuss alternative practices with doctors, because some can help, but some can be harmful.  Doctors are becoming more aware of these practices, and science is helping to figure out which are actually good, and which might be dangerous.  The National Institutes of Health now has a Center for Complementary and Integrative Medicine (NIH-NCCIH) to study these issues.  Stay tuned!

In these high-tech days with tele-medicine, you can meet your doctor or specialist over the computer. They can see you, discuss your problems, look at labs and xrays together, and have a nurse practitioner do a proxy physical exam .  I know a woman with a low-tech equivalent: she calls up her traiteur, and gets her healing over the phone!

Alternative medicine is ancient.  Wherever there’s people with limited access to health care, lack of understanding of disease, or few resources, they turn to what’s at hand.  In medieval Europe, they used what herbs grew in the forest or garden.  In Asia, they used coining like we discussed above, and other methods like cupping, acupuncture, massages, and their own herbs.

Many of these therapies survive today.  Olympic athletes use high-tech training tools like high-speed filming of their techniques and oxygen/substrate burn measures, but then show up with odd red circles all over them.  In the 2016 Olympics in Rio De Janeiro, Michael Phelps and others used cupping, a centuries-old technique where a cup is heated and applied to the skin.  When the air cools inside the cup, it sucks onto the skin, leaving distinct round bruises. It’s believed that cupping helps muscles recover from fatigue.

Science is just starting to evaluate these practices, to see which really help, and which might be harmful.  For example, St. John’s Wort is a plant that’s been used for centuries for depression, and is available as a dietary supplement.  However, it can interfere with some life-sustaining medications, like prescribed antidepressants, heart medications, chemotherapy, and a host of others.  To get the facts on St. John’s Wort and other dietary supplements, go to the NIH-NCCIH (mentioned above) website for their “Using Dietary Supplements Wisely” fact sheet.  This is especially important when considering supplements for kids, as their ability to handle these can be different than adults.

When you take your child to the doctor, be sure to mention all alternative practices you use.  Some are helpful, some aren’t, and it’s important to know so we can make sure  standard medicine doesn’t interfere with the alternative stuff.  And so when we see odd circles or coining streaks, we don’t panic either!

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