A stroke of good fortune

Many people who survive a stroke are never the same again, but one traditional Chinese medical physician is having great success with stroke patients. Dara Wang reports.

There came a blinding pain and then 63-year-old Lee Yue (pseudonym) was left dizzy and off balance. A terrible weariness came over her. She felt numbed. Lee had just put her grandson to bed and thought she was just overtired. Then, the world suddenly went dark. When Lee regained consciousness, she was in hospital. She had a stroke and they told her she was alive because she had been found quickly and given early treatment.

Lee was paralyzed on her left side. Her face looked crumpled. "I couldn't move or talk properly. I looked like a monster," said Lee, seeming to relive those moments of panic that began the darkest period of her life, 21 years ago.

People meeting her today would hardly sense that she'd been felled by a stroke and confined to a hospital bed for six months. Today, she feels certain of the source that brought her back to normal - acupuncture.

She can never have the vacation she was planning when she was ill. She'd planned to spend the vacation taking care of her daughter's new born baby on Lantau Island.

Lee lay in bed that first morning and tried to touch her face, but she couldn't lift her hand. Fearing permanent disability, she asked her daughter to find Tsui Hung-chuen, a Chinese medicine practitioner renowned for helping stroke victims get back their normal lives. Lee knew the name because one of her friends had recovered from a stroke after receiving treatments from Tsui. Lee didn't know him but Tsui seemed to be her only hope.

Tsui arrived several hours later. The moment he stepped into the ward, Lee cried. Tsui recalls: "Her expression was distorted, mucus and tears covered her twisted nose and mouth."

With the approval of the doctor, Tsui began acupuncture on Lee. Over the next hour, Tsui records that Lee was penetrated by more than 30 needles inserted into acupoints to stimulate blood flow. The electro-acupuncture was powered by an electromagnetic pulse. It vibrated at a prescribed frequency. After 30 minutes, Lee turned over and was given acupuncture on her back.

Tsui said Traditional Chinese Medicine (TCM) treatment varies from person to person. In Lee's case, Tsui stopped applying the needles when Lee felt pain. That's the feedback Tsui looks for to determine the right acupoint. "Everyone's acupoints are different. So the treatment depends largely on the experience and judgment of the TCM doctor," Tsui noted.

Five days later, Lee was discharged from hospital. Even with the help from her family, she could barely walk. Her features were distorted, and TCM takes time. Tsui estimated Lee would need at least six months. The treatments continued after Lee went home. Tsui gave her acupuncture twice a week, which costs HK$500 ($64.5) each time.

After three months, acupuncture began to show results. Lee was able to get around slowly on crutches. Another three months passed. By then Lee was walking unaided. Her features started returning to their normal cast. "Thanks to your treatment, I looked normal, as if I never had a stroke," Lee said to Tsui.

Working mechanism

Tsui said normally it takes a year or more to recover fully after a stroke. Lee's recovery was sped along by early treatment. In the theory of TCM, the golden period for recovery after a stroke is within 100 days. If treatment has not been taken within a year after the stroke, the chance of full recovery is low.

Stroke was the fourth leading cause of death in Hong Kong in 2017, according to the Centre for Health Protection of the Department of Health. More than 25,000 people suffered new or recurrent stroke every year in Hong Kong. They are left paralyzed, numbed, struggling with loss of balance or coordination, inability to concentrate and speech problems. Acupuncture is approved by the World Health Organization as an alternative and complementary strategy for standard stroke treatment and for improving after-stroke care.

Clinical trial findings cited in the International Journal of Molecular Sciences have demonstrated the importance of acupuncture for improving balance, reducing spasticity, and increasing muscle strength.

The working mechanism, according to the studies, is that the penetration of acupuncture needles could promote the production process of neurons and cell proliferation in the central nervous system.

Articles published in the Journal of Acupuncture and Meridian Studies by Nam Min-ho and others in 2011 and 2013 pointed out that acupuncture increases important cellular components, such as ribonucleic acid (RNA) or some neurotrophins.

Neurotrophins are a family of proteins that induce the survival, development, and function of neurons, which carry messages to the brain. Increasing them will boost the growth and survival of developing neurons and necessary for adult neurogenesis.

Aside from physical dysfunction, depression is common in stroke survivors. It is often caused by biochemical changes in the brain. When the brain is injured, the survivor may not be able to feel positive emotions. The very fact of suffering a stroke can cause depression.

The onset of depression usually comes within three to 12 months after a stroke. The incidence runs as high as 68 percent among the community-dwelling post-stroke elders, according to research by a team at the University of Hong Kong, led by Zhang Zhangjin. The study, published in 2010, focused on the effects of TCM on post-stroke depression (PSD).

PSD not only affects the mood of patients, but also impedes rehabilitation. Western medicine's antidepressants have certain cardiovascular side effects. TCM works better, the team learned.

In the article published in the Journal of Affective Disorders, Zhang and his team unveiled the results of 76 clinical studies examining the effect of acupuncture on PSD. The article concluded that acupuncture was superior to antidepressants for improving patient response and reducing the severity of the condition. The rate of recurrence after acupuncture also was significantly lower than in cases where antidepressants were prescribed.

Lee became much more cheerful. She could walk again. She looked normal. Her self-confidence came back. Tsui explained the good feelings came from stimulating the acupuncture points of her forehead.

In TCM theory, there are more than 300 acupuncture points in the human body. The points are said to be connected by pathways, called meridians. These meridians carry the qi, or life energy that TCM believes is an essential element of human life. Stimulating the points allows the energy to pass through the meridians fluidly, and brings improvement of health.

As explained by Western medicine, dense electro-acupuncture improves the neurochemical balance related to the onset of depression in the brain, refreshing the brain and alleviating the condition.

By way of a basic explanation, the neurochemical imbalance happens when there is either too much or too little of certain chemicals, called neurotransmitter - natural chemicals that help facilitate communications between nerve cells. Acupuncture alters the activities of neurotransmitters and helps restore the balance.

Factory to clinic

With more studies published in mainstream science journals, the credibility of TCM continues growing. It's an evolution of recent years. Not all that many years ago, when Tsui moved to Hong Kong from Fujian province in 1987, the future of TCM seemed cloudy.

The then-British authorities in Hong Kong gave little importance to Chinese medicine. TCM was unregulated, Tsui said. "Practitioners of TCM did not need to be registered. My diploma was no more than a scrap of paper."

Before coming to Hong Kong, Tsui obtained a TCM diploma at a medical college in his hometown and practiced Chinese medicine for six years at a public hospital. There was no acknowledgement of those professional credentials in Hong Kong at that time. Tsui, who could not speak Cantonese, couldn't find a job practicing TCM.

After several setbacks, Tsui found a job at a factory. He got the position because Tsui and the boss came from the same province. "Even getting a job as a factory worker, I had to go through the 'backdoor'. Survival in the city became a big issue for me," he said.

Tsui's job was packing tapes in a box and then putting that box in a bigger box. The boring routine swept away Tsui's rosy expectations for his new life in Hong Kong. The sweltering heat gave Tsui an allergic rash all over his body. He never gave up hope of working in the field of Chinese medicine.

In July 1987, Tsui got his chance. Tung Fong Hung - one of Hong Kong's largest pharmaceutical companies of that era - posted a vacancy for a senior TCM practitioner. The boss recognized the value of Tsui's diploma and experience, and gave Tsui the job at a monthly salary of HK$5,500, and the boss even assigned a translator to make Tsui's job easier.

Tsui worked for the company for nearly 10 years. He saved his money and made connections. At the end of 1996, he quit the job and bought a store room in Shau Kei Wan. By the time Hong Kong returned to the motherland in 1997, Tsui already had opened his own TCM clinic - Tsui Chi Bun Herbalist.

In 2000, the Hong Kong SAR government started regulating TCM practitioners. Even professionals like Tsui, with 10 to 15 years and a holder of recognized academic credentials, needed to pass an assessment of their abilities, as a condition for registration. Tsui applied that year. In 2002, he appeared on the first list of registered TCM practitioners in Hong Kong.

His practice extends over 30 years. He treats 20 to 30 stroke patients a year. "Initially, many people were dubious about TCM. They could not believe several needles could help a paralyzed person walk again," Tsui said.

"I do not debate with them. I prove the case with results."
Word of mouth plays an important role in drawing new patients to TCM. Tsui earned trust through his medical skills. The wall of his clinic is a showpiece, full of silk banners that are acknowledgements from his patients of their gratitude for his skills in healing them, a Chinese custom.

Most of his office equipment, TV, computer and air conditioner, were donated by his patients. "Without the effectiveness of the treatment, I would not survive in the field", said Tsui.

In a world rampant with agism, TCM practitioners become more venerated, as they grow older. Though he has practiced TCM for a long time, the 63-year-old physician believes there's a long way from the acme of his career, just as TCM with its history as long as China's still climbing in its quest for recognition by modern science. He studies new ways of treatment and works to promote TCM. He believes, for his career and for TCM, the golden years are still ahead.

Contact the writer at
dara@chinadailyhk.com