Oct 03 2007

Needle Nonsense for Stroke

As further evidence that the internet is a double-edged sword, the following comment was left on a previous post:

Dr. Novella,

Thanks for this information. I’m writing because one, I’d like to commend the NESS and your podcast for the work its been doing in bringing a rigorous debate on science, pseudo-science, and outright quackery to the public and two, being in the healthcare field such as yourself, I’m simply amazed at the nonsense the media shovels out to the laypeople because I’m seeing the results of the hysteria and paranoia first hand in the ER where I work.

I just received this email from my father this am and he was absolutely convinced that this procedure to help “rescue” a person suffering a stroke would work.

A Needle Can Save a Life

Worth noting. Never know who or when it may be needed …

A NEEDLE CAN SAVE THE LIFE OF A STROKE

PATIENT-From Chinese professor

Keep a syringe or needle in your home to do this… It’s amazing and an unconventional way of recovering from stroke, read it through it can help somebody one day.

This is amazing. Please keep this very handy.. Excellent tips. Do take a minute to read this. You’ll never know. One’s life may depend on you.

My father was paralyzed and later died from the result of a stroke. I wish I knew about this first aid before. When stroke strikes, the capillaries in the brain will gradually burst.”(Irene Liu)

When a stroke occurs, stay calm. No matter where the victim is, do not move him/her. Because, if moved, the capillaries will burst. Help the victim to

sit up where he is to prevent him from falling over again, and then the bloodletting can begin. If you have in your home an injection syringe that would be the best, otherwise, a sewing needle or a straight pin will do.

1. Place the needle/pin over fire to sterilize it, and then use it to prick the tip of all 10 fingers.

2. There are no specific acupuncture points, just prick about a mm from the fingernail.

3. Prick till blood comes out.

4. If blood does not start to drip, then squeeze with your fingers.

5. When all 10 digits is bleeding, wait a few minutes then the victim will regain consciousness.

6. If the victim’s mouth is crooked, then pull on his ears until they are red.

7. Then prick each ear lobe twice until two drops of blood comes from each ear lobe. After a few minutes the victim should regain consciousness.

Wait till the victim regain his normal state without any abnormal symptoms then take him to the hospital, otherwise, if he was taken in the ambulance

in a hurry to the hospital, the bumpy trip will cause all the capillaries in his brain to burst. If he could save his life, barely managing to walk, then it is by the grace of his ancestors.

” I learned about letting blood to save life from Chinese traditional doctor Ha Bu-Ting who lives in Sun-Juke. Furthermore, I had practical experience with it. Therefore I can say this method is 100% effective.In

1979, I was teaching in Fung-Gaap College in Tai-Chung. One afternoon I was teaching class when another teacher came running to my class room and said in panting, “Ms. Liu, come quick, our supervisor has had a stroke!”

I immediately went to the 3rd floor. When I saw our supervisor, Mr.Chen Fu-Tien, his color was off, his speech was slurred, his mouth was crooked-all the symptoms of a stroke. I immediately asked one of the practicum students to go to the pharmacy outside the school to buy a syringe, which I used to prick Mr. Chen’s 10 fingers tips. When all 10

fingers were bleeding (each with a pea-sized drop of blood), after a few minutes, Mr. Chen’s face regained its color and his eyes’ spirit returned, too. But his mouth was still crooked. So I pulled on his ears to fill them with blood. When his ears became red, I pricked his right earlobe twice to let out 2 drops of blood. When both earlobes had two drops of blood each, a miracle happened. Within 3-5 minutes the shape of his mouth returned to normal and his speech became clear. We let him rest for a while and have a

cup of hot tea, then we helped him go down the stairs, drove him to Wei-Wah Hospital . He rested one night and was released the next day to return to school to teach.

Everything worked normally. There were no ill after-effects. On the otherhand, the usual stroke victim usually suffers irreparable bursting of the brain capillaries on the way to the hospital. As a result, these victims never recover.- ” (Irene Liu)

Therefore stroke is the second cause of death. The lucky ones will stay alive but can remain paralyzed for life. It is such a horrible thing to happen in one’s life. If we can all remember this bloodletting method and start the life-saving process immediately, in a short time, the victim

will be revived and regain 100% normality.

If possible, Please forward this after reading. You never know if it may help save a life from stroke.

Yikes!

What are your thoughts? I understand the need for the general population in wanting to help their loved ones, but this remedy reeks of quackery. Not only is this sort of information dangerous for the layperson to have but it also can hinder the true treatment of a CVA with tPA because of the danger of hemorrhage. Who knows how many people this email has been disseminated to?

Thank you for your continued work and look forward to future blogs and podcasts.

William Paunan NP MSN

Yikes, indeed. I searched on the title of this urban legend chain e-mail and the first hit was, thankfully, to Snopes, which had appropriately tagged the claims made as false. However, the links that followed were all to credulous websites helpfully reprinting this misinformation. Most were blogs with Asian authors. One website reprinting this e-mail is named “wonderfulinfo.” Apparently (unlike Snopes) they just reprint random crap without any significant filter.

The information contained in this e-mail, credulously spread around the internet, is both wrong and dangerous. Anyone believing and following its advice would almost certainly cause harm.

First let me dispense with the claims that are made – primarily that minute bleeding through finger or earlobe pricks will prevent permanent damage from a stroke.

There are actually several kinds of stroke. The term refers to the presentation of symptoms – stroke-like or sudden in appearance. The two main types of stroke are hemmorhagic and ischemic. Hemmorhagic strokes are caused by bleeding into the brain. Ischemic strokes are caused by lack of blood flow to a portion of the brain, and are further divided by the cause of the blockage. Ischemic strokes can also secondarily bleed from the damage to the brain tissue and its blood vessels.

There is no situation in which all of the capillaries in the brain burst – this is not part of a stroke. The closest thing to this that actually occurs is that an ischemic stroke may subsequently bleed, but there is no evidence or any plausible reason to think that any of the things mentioned in this e-mail would lead to or prevent secondary bleeding.

Further, pricking the fingers or earlobes would cause (thankfully) a negligible amount of bleeding and would not in any way affect the stroke victim’s hemodynamics. And if it did,that would just worsen the stroke by decreasing brain perfusion and oxygen delivery.

Next, let’s take a look at the specific recommendations of this e-mail to see how harmful they are. The recommendations begin with statement “when a stroke occurs,” but it is not possible to say by observation alone when a stroke has occurred. All that you can tell from symptoms and examination is that a “stroke-like event” has occurred. Stroke-like symptoms can be caused by a seizure, a bleed, or a true ischemic stroke. There is no way to tell the difference without imaging. The management will depend upon an urgent X-ray – usually a CT scan.

The e-mailer then advises not to move the patient, but there is no reason not to move a stroke victim. Then is says to sit the patient up. If the patient has a bleed sitting up (to a degree) may be helpful. But if they have an ischemic stroke then sitting up with further impair blood flow and make the stroke worse. Again, there is no way to tell without a picture which kind of stroke a patient has, but most are ischemic so this advice is likely to cause harm by worsening the stroke.

The bleeding, as I mentioned above, is worthless but it does serve to delay getting the stroke victim to proper care. We have a saying in neurology, time = brain. There is a public health campaign to treat stroke like a “brain attack” and to get patients to emergency medical care as soon as possible. This kind of nonsensical misinformation works directly against these efforts by telling people to waste a considerable amount of time before doing anything useful.

The next statement is even worse – wait for the patient to regain consciousness (most stroke victims actually don’t lose consciousness) and for the symptoms to resolve. Wow – that is exactly the opposite of what you should do. Do Not wait for the symptoms to resolve (which may not occur or may take hours), get the patient as quickly as possible to the nearest emergency room. A bumpy ride will not burst the capillaries, delaying emergency care will cost brain tissue.

Delaying treatment is even more of a bad idea these days because of the use of TPA – a clot-busting drug that can reverse some strokes. In order to use TPA a stroke victim must come to medical attention very quickly. The drug can only be given within three hours, so arrival at the ER within two is usually necessary. But any delay could lose the opportunity to treat with TPA.

What about the anecdotal evidence of success? Well, there is no compelling reason to believe anything contained in this e-mail. It has all the markings of urban legend SPAM. However, many strokes are actually what we call transient ischemic attacks, or TIA’s. TIA’s, by definition, completely resolve on their own within 24 hours, but most will resolve within 10-15 minutes. Therefore treating a TIA with any method will often correlate with a complete resolution of symptoms. This, of course, proves nothing.

Conclusion

The claims made in this e-mail are absurd from a physiological/medical point of view and the recommendations based upon them are actually dangerous and almost certain to cause harm, mainly by delaying appropriate diagnosis and care in the setting of a genuine medical emergency.

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4 responses so far

4 Responses to “Needle Nonsense for Stroke”

  1. jonny_ehon 03 Oct 2007 at 9:20 am

    It’s for reasons like this that I hate it went people into alt med say “What’s the harm?”

    Once you accept medical nonsense, where does it end?

  2. Sqrrl101on 03 Oct 2007 at 11:34 pm

    I saw a poster in a Chinese herbal “medicine” shop close to me which read:

    “Natural treatment instead operation!
    Coronary heart disease
    Free consultation
    Money back guaranteed!”

    I complained to the shopkeeper that advertising a clinically unproven (and for all intents and purposes useless) treatment like this, especially where the advert implies that potentially life saving surgery can be ignored, is incredibly immoral. She sadly turned out to not own the shop, so I’ll be looking to see if the advert is still up next time I’m passing. If it is, I’ll definitely be calling trading standards.

    People can have fun with all the overpriced placebos they want to “cure” their imagined aches and pains, but this kind of thing gets really dangerous when people start believing the hype.

    On a similarly disturbing note: http://www.badscience.net/?p=531

  3. Freddy the Pigon 04 Oct 2007 at 2:13 am

    This is ultimate altie woo – it has everything
    Traditional Chineses medicine
    A complete lack of understanding of the medical problem.
    A self limiting condition (TIA) that it appears to cure so that it gains credibility
    A claim that conventional evidence based treamment causes harm.
    A totally ludicrous and ineffective treatment.
    A dangerous recommendation (don’t call an ambulance, instead fart aroung and then take your time getting to the hospital)

    One can only hope that when someone who has been appertly cured of a TIA gets to the hospital, someone talks some sense into them and explains how their friend/relative’s idocy could have killed them, since TIAs indicate risk of a full fledged stroke.

  4. oc1deanon 19 Oct 2011 at 2:57 pm

    The 3 hour neurologist makes the rounds on the internet also.
    Author: Unknown

    During a party, a friend stumbled and took a little fall – she assured everyone that she was fine and just tripped over a brick because of her new shoes. (they offered to call ambulance)

    They got her cleaned up and got her a new plate of food – while she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening. Ingrid’s husband called later telling everyone that his wife had been taken to the hospital – (at 6:00pm , Ingrid passed away.)

    She had suffered a stroke at the party . Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today.

    STROKE IDENTIFICATION:

    A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke…totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

    What about bleeders? or the ones that tPA doesn’t work for?

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