There’s nothing better than mixing your love of the outdoors with your profession. When it’s your job and it helps you to bring an added resource into a wilderness adventure, that’s pretty cool. Musa Masala welcomes our friend Cami Hobbs, MAOM,DAOM, Dipl. O.M. (NCCAOM), L.Ac.
We met Cami at the Wilderness Medical Society’s Winter Conference in Jackson Hole, where she did the awesome video with us (below) where she described her acupuncture influenced medical kit.
We also traveled with Cami to Nepal for the official opening of the Wongchhu Sherpa Memorial Hospital, where, when bad weather stopped all flights from reaching the hospital, stranding the Wilderness Medical Society team in the mountains, Cami became the official representative of the society at the opening ceremonies. Everyone was impressed!! We want to thank her for taking the time to talk to us about the many ways acupuncture can provide for patient care in a remote setting.
Acupuncture in the Wilderness: Q&A with Cami Hobbs
MM: Tell us a little about yourself and how you got into acupuncture.
Cami: Hi, I’m Cami Hobbs, a licensed acupuncturist in Fairbanks, Alaska. I received my Masters from the Oregon College of Oriental Medicine and will finish up my doctorate from Emperor’s College of Traditional Chinese Medicine in the next few months.
MM: When did you start getting outdoors and what are your favorite outdoor activities?
Cami: I’ve always liked being outside. I’m from a fishing and camping family and rode horses growing up but I’ve definitely upped my game since moving to Alaska. I love being on the water and I’m learning how to have fun in the snow. My favorite outdoor activity is hiking.
MM: How did you start bringing your outdoor activities and acupuncture together?
Cami: I’m not really sure when I started bringing acupuncture into the wilderness. I think I just started throwing some needles into my first aid kit and then a few other tools until they had their own little pouch.
MM: Tell us a bit about how acupuncture can help keep you going in the outdoors.
Cami: Acupuncture is low cost and portable so it can be very effective when traveling. Used effectively, just a few needles can help relieve headaches, musculoskeletal pain including arthritic aches, old injuries acting up on a hike, or neck spasms after sleeping wrong on the hard ground, or even pain control for more serious injuries when a hike or heli choice has to be made. It can also help digestive concerns, like constipation or nausea.
Battlefield Acupuncture is a technique that non-acupuncturists can be certified in; it is the application of semi-permanent needles in the ear at points shown to be safe and effective to reduce pain. These can then be worn for up to 5 days as needed.
Or, if needles aren’t an option, there are other tools to stimulate points that are easy to use and don’t puncture the skin. The simplest to carry are seeds, pellets and magnets that can be adhered to the skin and stimulate points in her ears or the extremities so you can keep going.
And don’t underestimate your hands! Acupressure is a great way to test out points before inserting a needle or applying a seed or just by itself. Most acupuncturists are trained in some sort of bodywork as well. My favorite way to treat constipation is with a Shiatsu technique called ampuku. It takes about 10 minutes and, in most cases, is effective within a few hours. It can also be done in reverse and be somewhat helpful for diarrhea.
There’s also moxibustion, or moxa, a technique where you burn mugwort (ai ye in Chinese) to stimulate points. There’s tons of different techniques. I prefer a Japanese technique called tonetskyu or rice grain moxa where a little bit goes a long way. It’s not a go to in first aid but I always carry it on longer trips, especially in the winter. It can be used to treat many of the same things I would treat with needles.
There are several points that have historically been used in emergency situations such as Dazhu on the back of the neck for heat exhaustion or heat stroke and Shuiguo above the upper lip for loss of consciousness. These points can be used in conjecture with the modern conventional treatments that you might learn in a wilderness first aid course. There are also some techniques that would not be standard care in a typical setting, but if you’re stuck in a snowstorm with a positive McBurney sign why not try moxa on lanwei, a point on the shin, to avoid a burst appendix until you can get to a hospital?
The beauty of traditional and classical Chinese medicine is in its simplicity. Everything can be broken down into basic patterns and while there aren’t really one to one correlations with western/allopathic medicine, we are generally saying the same thing in a different language. The goal is the same: help people live their best lives. These patterns also allow for a lot of versatility in applications.
There’s some interesting thoughts and research on altitude sickness that I would like to explore more. I’ve used ear needles on boats for motion sickness. There’s plenty of tools out there that are traditional Chinese medicine but not acupuncture like herbal burn creams and topicals for pain. Yunnan Baiyao powder for lacerations from lava rocks or pike teeth. There’s herbal pills for a sensitive stomach when traveling abroad to Nepal. There are so many ways acupuncture and traditional Chinese medicine can enhance travel and keep you going during outdoor adventures.
MM: Tell us about your time in Nepal.
Cami: Trying to put what attracted me to it into words is a little tough. This is my 2nd time in Nepal and I’m already formulating a plan for my 3rd time, it’s just that kind of place. In addition to a chance to travel to Nepal, I came to finish up some educational hours for my Doctorate in Acupuncture and Oriental medicine from Emperor’s College of Traditional Chinese medicine and work towards my Fellowship in the Academy of Wilderness Medicine.
MM: How might doctors at a remote hospital with limited pain medication benefit from the ability to use acupuncture treatments on patients? (That’s something we are thinking about at the Wongchhu Sherpa Memorial Hospital.)
Cami: I had the pleasure of traveling with Melissa Perkins, an amazing army NP also based in Fairbanks, Alaska. She has been teaching battlefield acupuncture for some time and I’ve been able to co-teach a little with her. While in Nepal we were able to get several of the other WMS trekkers started with their BFA certification, including Marlena Strandir, the MD who stayed behind to volunteer at the hospital. Hopefully she is able to use the skill and let us know firsthand how it works there!
Acupuncture definitely has potential in austere settings. I spent today in Bajrabarahi, Makwanpur district volunteering at an acupuncture clinic. Suswathya (Good Health) Nepal was founded in 2013 and has been working with the Acupuncture Relief Project to integrate acupuncture into primary care in Nepal. They have established a very successful clinic that works closely with local health posts to provide comprehensive care. The hope is that this model can be copied throughout Nepal to improve rural healthcare. When I first came here six years ago the providers were all volunteers. However, today I worked alongside two incredible Nepalese providers, Satyamohan Dangol and Sushila Gurung, who started as interpreters for the ARP and have since gone to school and are now fully licensed and the backbone of the clinic.
MM: Is there anything you would like to add about acupuncture in the wilderness?
Cami: One thing I didn’t mention in the video is that you should always carry a Sharps Shuttle with you for safely transporting and disposing of used needles. Pack in, pack out!
I’d also like to emphasize that it is useful for so much more than pain. That can certainly be the most obvious or pressing need in the wilderness but it really shouldn’t be discounted as a tool to help with travel anxiety, insomnia, an unsettled digestive system, the sniffles, and many more health concerns that can pop up in an austere setting.
