Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Peaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
March, 2002, Vol. 02, Issue 03
Working with Multiple Sclerosis Patients
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
You've done it again: I put out a request for input, and you came through in a big way. December's article on central nervous system dysfunction seemed to hit a cord with many therapists, so for the next couple of columns I will respond as best I can.(Editor's note: Ruth's December 2001 article is available on line at www.massagetoday.com/archives/2001/12/16.html.)
Although I had feedback on several issues related to central nervous system disorders, the majority of respondents requested information on multiple sclerosis (MS). This is a mysterious disorder; its population distribution is unusual, its progression is unpredictable, and its diagnosis is often a particular challenge. Patients with MS can benefit greatly from carefully managed massage, however, and most therapists probably have some clients who live with this disease.
This article will provide some brief information about how this disease develops and whom it affects, followed by a discussion of how various types of bodywork might and might not fit into the picture.
MS: who gets it? The highest incidence of MS is among Caucasian people who live in Northern or extreme Southern latitudes, or who lived there for the first 15 years of life. It is generally diagnosed in patients somewhere between 20 and 40 years old. Women are diagnosed with the disease approximately twice as frequently as men. It affects about 300 thousand Americans, with about nine thousand new diagnoses each year.
MS: what happens in the body? MS often works in cycles of inflammatory "flares" followed by periods of remission. During flares the myelin is damaged, probably by specific types of white blood cells, and is replaced by scar tissue. MS usually affects the optic nerve, brain stem, cerebellum, and spinal cord. During remission, inflammation subsides, and some regeneration of myelin may occur. In this way, MS patients may lose some neurological function during flares, but regain some or all of it during remission. The cause or causes of MS remain a mystery. Leading theories suggest that a combination of factors is at work: exposure to some pathogen that stimulates an ongoing immune system attack, environmental factors, and genetic predisposition may all be part of the picture. At this point no specific genetic, environmental, or pathogenic factors can reliably predict the incidence of multiple sclerosis.
MS: what does it look like? This disease is sometimes called The Great Imitator because its initial symptoms can look like a variety of other diseases, depending on what area of nerve tissue has been affected. The order with which symptoms appear also varies greatly from one person to the next. Some of the most dependable signs and symptoms include:
MS: how does it progress? The progression of MS is highly unpredictable. It has a few characteristic patterns, but some patients move from one pattern type to others within their disease process. Some of the basic patterns are as follows:
MS may also present as a combination of the R/R and P/P varieties.
MS is not a terminal disease in and of itself. MS sufferers generally have a lifespan about six years shorter than the average, although that statistic may improve as new medications prolong the time between flares and limit central nervous system damage. People who die prematurely from MS are usually immobile, and they fall prey to an opportunistic disease such as a kidney infection, urinary tract infection or pneumonia.
MS: what about massage? This is where it gets interesting. I've received letters from some people asking, "what do I do for this type or that...?" and letters from others saying, "I've had success with this approach..." I couldn't be happier to put all of this information together here in this article.
First of all, let me offer some words of warning. In its acute, or "flare" stage, MS is an inflammatory condition. True, the inflammation is happening in the CNS where we don't have access, but the general rule for massage and acute inflammation is to let it pass.
During an MS exacerbation, the body has a lot of activity to process. In my opinion (and absolutely anyone is invited to disagree), I think it's a better idea to let the dust settle before adding any more input in the form of massage. Some varieties of energetic work may be appropriate during MS flares, as long as the process is respected and the client is not overwhelmed or overchallenged by the stimulus being supplied.
During remission, however, we have a different story. The level of function a person achieves during remission depends on the severity of the flare, and how deeply the myelin was affected. If it was only a superficial attack, the damaged myelin may grow back and no permanent changes may occur. If it was a more intrusive flare, however, some amount of permanent damage may accrue to the nerve tissue, resulting in muscle weakness, sensory changes including parasthesia ("pins and needles"), or even complete numbness. This is where massage (as well as other therapeutic modalities) may have a profoundly positive impact. While we generally say, "if a client can't feel it, we shouldn't try to change it," some massage therapists have found that working deeply and specifically on the antagonistic muscle groups of isolated numb or weak muscles of MS clients yields exciting results.
Here is what one therapist (Jim McFarland of Virginia) has found:
Another reader, Michael Eisenberg of Washington State shared with me that Thai massage, which he describes as being just as beneficial to give as it is to receive, has helped him to manage his own MS:
And yet another reader has a client with very advanced MS who has lost most of the function in his legs. This is what she has to say:
All of these wonderful stories point in the same direction: massage has a lot to offer clients who live with MS, as long as some basic principles are kept in mind: avoid mechanical or manipulative work during periods of flare; respect numbness; only work deeply where the client has sensation; and monitor your results carefully so that you can continue to make positive choices for your client's needs.
Readers who are interested in learning more about MS, either for themselves or for their clients, would do well to visit this website: www.mic.ki.se/Diseases/. This site has an extensive list of recent articles on just about any disease you could think of. MS is listed under Neurological Diseases as a demyelinating disease.
In next month's article, I plan to discuss another aspect of CNS dysfunction: working with spinal cord injury survivors. I've had several questions from readers about "do's" and "don'ts" for these clients; what advice do you have for massage therapists?
Ruth Werner, LMT, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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