Sunday, May 20, 2001
Acupuncture brings relief after sevenmonths of pain
By Marjory Sherman
Eagle-Tribune Writer
Acupuncture is not the cure for Ric Blake's terminal thyroid cancer, but it
surely lifted the pain he has been feeling for several months.
The relief was so instantaneous, so long-lasting that it came as a
revelation.
"All of a sudden, like a light switch, the pain was gone. It's like a
miracle,'' he said.
It marked the first time Mr. Blake, 56, was pain-free since he agreed to
allow the Eagle-Tribune to follow his personal journey with terminal
illness. His original goal was to spark public discussion about end-of-life
issues and now, it seemed, acupuncture and complementary medicine should be
part of the story.
"I'm a believer,'' he said with a grin.
In many ways, Mr. Blake is now in the countdown period, with only 14 days
until he leaves for the National Institutes of Health in Bethesda, Maryland.
He knows his treatment of radioactive iodine no longer works. He knows a
tumor, or tumors, are growing in his neck, probably precariously near his
esophagus, laryngeal nerve and other crucial nerves and arteries. And he
knows that if tests the week of June 3 confirm the tumor has grown large
enough, doctors will operate June 12.
While Mr. Blake is firmly grounded in Western medicine and believes that
potential surgery in June at the National Institutes of Health could add
time and quality to his life, he has also come to believe in the benefits of
complementary medicine.
He can track the pain in his neck almost to the day in September when a
pea-size lump mysteriously popped up, left of midline, accompanied by a
dull, gnawing ache. He suspected that it came from the largest tumor,
identified on two nuclear medicine scans, a tumor he imagined might be
pressing on a nerve or some other anatomical structure.
He told his doctors at Massachusetts General Hospital about it. He tried
Tylenol. He attempted to set mind over matter. Nothing worked.
Then in April he volunteered on the spur of the moment to be a guinea pig in
an acupuncture demonstration at a thyroid cancer-support group in Nashua,
N.H. Just like that, without a word to the therapist about the pain in his
neck, the ache went away within 10 minutes.
"This was luck, pure luck, that I happened to be there," he said.
But there it was. A man who wanted to know nothing about the whys and
what-fors of acupuncture found something that works for pain. Never mind
that he did not understand a lot of the details.
"He went into this metaphorical explanation about the Qi (pronounced chee)
and the meridian. He might as well be talking about goat's hooves and eye of
newt. But use any metaphor you want, any language you want, I don't care.
The pain went away,'' said Mr. Blake. "I'm leaving the metaphors to the
practitioners. It's like leaving the religious language to the priests and
rabbis.''
He signed up for another, longer session with the acupuncturist, Sean P.
Doherty at Nashua Natural Medicine.
During the 90-minute work-up in a dimly lit room with incense burning and
soothing Native American music playing, Mr. Doherty took a double pulse
diagnostic exam and then placed needles in Mr. Blake's abdomen, legs and
knees, each with a pathway to a certain organ, according to Eastern
medicine. After a time, Mr. Doherty twirled the needles around, giving Mr.
Blake a sense of an electric shock pulsing through him.
Suddenly, a wave of freezing cold swept through Mr. Blake even though the
temperature in the room had not changed. The acupuncturist lit a
cigar-shaped "moxibustion'' stick and placed it over Mr. Blake's abdomen,
smoke curling from the end. Mr. Blake instantly felt warm, like being
immersed in a warm bath.
Mr. Doherty later explained that the moxibustion stick -- a stick topped by
moxa, also known as the herb mugwort -- is a means of superficially heating
the dampness, clearing out the phlegm.
"With tumors, in Chinese medicine, there are manifestations of dampness in
the body or phlegm,'' he said.
A month later, Mr. Blake's pain is still gone. Ask Mr. Blake and he can say
exactly the number of days since acupuncture -- since he's been pain free.
"It lifted his spirits much more than I ever would have predicted,'' said
his wife, Diane Blake.
Search for other remedies
Acupuncture is but one thread that Ric Blake is following in these weeks and
months leading up to potential surgery for the tumor in his neck.
But it is the thread that prompted him to call and write to Ann Berger, head
of palliative care at the National Institutes of Health and ask what types
of complementary care are available at NIH and how he might access them.
In his letter to NIH, he described his acupuncture experience and noted that
none of his three physicians had suggested anything like it for pain control
during his seven months of pain.
"All three knew I was experiencing pain; all three managed to ignore it
because I was such a nice, compliant patient, and all of us were focusing on
the larger issues. Still, no one should have persistent pain if it can be
eliminated,'' he wrote.
He noted that a similar situation faces him as he heads to NIH, where he
felt the onus was on him to ask for complementary care, rather than the
other way around.
"From the lab rat's side of the maze,'' he wrote, " I am experienced enough
to know that my treatment at NIH is taking care of my disease but ignoring
my mind and spirit. And I believe that NIH can do better.''
After his letter and phone calls, NIH added a pain and palliative care
consult to his schedule on the day after he checks in, allowing time for
treatment during his stay.
As the June 3 departure date for the NIH looms, Mr. Blake wants everything
to be in order days, or even weeks ahead of time.
The trick is, time is limited.
For the past several weeks, Mr. Blake has exhibited a phenomenal rate of
productivity. The casual observer would have no idea that this man hurtling
along at breakneck speed has a terminal illness.
At work at Greater Lawrence Family Health Center, he has been seemingly at
the top of his game, promoting a Latino health fair in Lawrence expected to
draw thousands, organizing a strong bones fair for the Elder Coalition,
tidying up loose ends.
In his volunteer mode, he pulled together a huge Thyroid Cancer Association
(ThyCA) conference this week for thyroid cancer survivors at Massachusetts
General Hospital. He has continued to run support groups for thyroid cancer
survivors for ThyCa, the national organization he helped build.
He also set aside time, with his wife, for a weekend in Vermont for cancer
survivors; checked on each new bloom in his flourishing perennial garden;
and enjoyed life with this aging cat, the 18-year-old Annie the Empress
Dowager.
Through it all, he has been a patient first and foremost, managing his care
to the finest detail.
He knows that once he is hospitalized, it will be very difficult to be his
own spokesman.
"I have to do all this stuff now, while I have a brain,'' he said. "I can't
imagine doing this when I'm sick. It's like closing the drawbridge and
circling the wagons.''
His mantra is that every patient should have all sorts of support available
from the moment of diagnosis -- pain management, emotional support,
nutrition guidance and alternative therapies -- everything people need to
live well until the end, services referred to in total as palliative care.
Most patients get none of that. Whether the void is due to a lack of
foresight or denial or optimism or passivity, Mr. Blake does not know. But
he does know that things do not have to be that way.
"Probably very few people are like me, because most people are in denial.
Most people want to think of the best outcome, which is understandable. It's
human nature,'' he said.
Mr. Blake is blazing a trail not only for himself but also for all of the
others with terminal illness, trying to set up possibilities for palliative
care and alternative medicine and pain treatment that would be available
routinely.
"I want to know, not just for me but for all the thousands of me who come
afterwards, all those compliant, passive patients who come later from East
Overshoe. You know, what I'm doing is I'm working for all these nice,
passive people,'' he said.
He and his wife went to Boston twice to talk about their experiences, first
to a group of doctors and nurses a few weeks ago on the invitation of Dr.
Andrew Billings, director of palliative care at Massachusetts General
Hospital, then to a group of Harvard Medical School students. Both times,
the audience was moved beyond words.
"There were 10 doctors around the room, and by the time we finished, seven
of them were crying. I think when they heard about some of the bad things
that have happened to me, I think it's very upsetting. ... Like having pain
for seven months without anybody paying attention to it. They couldn't
believe that my doctors labeled me a hysterical patient the night before my
first surgery (six years ago). You listen to my story and it's one bad thing
after another.''
As a gift, a friend gave Mr. Blake a session with a North Andover
psychotherapist who prepares people for surgery using the mind-body
techniques of Peggy Huddleston, a Cambridge therapist and author.
Mr. Blake learned about using meditation and other focus points to calm
anxiety before surgery and feel less pain afterward in a session with
clinical social worker Jeanne Hoegger.
His preparation for NIH is, by now, almost complete.
He has tried complementary medicine, set up a palliative care consultation
at NIH, planned for his stay at NIH, arranged for a reporter and
photographer to tag along, and begun planning for possible postoperative
radiation treatment at Massachusetts General Hospital. He is also working,
going to lunch with friends, showing off his garden, and taking time out for
a movie with his wife.
"He's looking at his whole life and putting things in their proper
perspective and place,'' said Mrs. Blake. "And when he doesn't want to do
something? He won't do it ... I see him playing more.''
Even she can lull herself into believing that all is well, living with this
man whose optimism and realism are in fine balance.
"Sometimes for me, it's like being in disbelief,'' she said.
But there is the part that catches her up short, the other side of Ric Blake
that has him tumbling into bed, exhausted, earlier than ever.
Yet Mr. Blake is at this point, fully prepared.
"By June 1, I have to have every t crossed and every i dotted, because when
I go down there, I have to focus on testing and surgery,'' he said.
He worries more about his wife than himself.
"This is going to be hard for her,'' he said. "It's not going to be hard for
me. You go into surgery and they put you to sleep. She's sitting out there,
worrying. I can't imagine how hard that's going to be.''