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Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
September, 2002, Vol. 02, Issue 09
Yin and Yang Deficiency, Part I
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
It is often said that all of Chinese medicine can be reduced to the fundamental theory of yin and yang. If you practice Asian bodywork therapy, the ability to understand, interpret and apply the concept of yin and yang are essential to one's practice.All anatomy, physiology, pathology and treatment principles boil down to yin and yang. The beauty of yin and yang is that something so simple can be all-encompassing and profound when examined more deeply.
You may remember a past article that presented the basic principles of yin and yang. (Editor's note: See "Got Yin/Yang" in the Dec. 2001 issue, or online at www.massagetoday.com/archives/2001/12/08.html.) Just about every other article I have written has mentioned yin and yang as well, including "Korean Four Constitutional Types, Part I and II" (March/April 2002), in which I discussed taiyang/greater yang and yaiyin/greater yin type of people. That two-part article gave an idea of what someone with an excess of yang or yin might look like from a Korean point of view, but I haven't really discussed in depth how yang or yin deficiency manifests.
It is interesting to see that as people age, they naturally start to get low in their gender-related yin or yang energy. For example, as women age and their yin begins to decline, they go though menopause. They may experience hot flashes, night sweats and frequent waking, which are all symptoms of yin deficiency. Their character also tends to become less yin. Some women grow less meek -- going out, doing more and standing up for themselves. If they become pathologically yin-deficient, they may become agitated, demanding and shrill. This is all relative, I suppose, based on your perspective or proximity to the person (e.g., "Your mother's driving me crazy!" Dad may say).
The opposite happens with men -- their yang decreases and they mellow with age, becoming more yin: easygoing, less confrontational and less combative. It's a good thing this happens to men, because their partners may be going in the other direction! This certainly isn't to the point of being pathologically yang deficient; on the contrary, both men and women may feel more centered, balanced and comfortable with themselves and others as they develop more gender-neutral dispositions.
If yang deficiency develops, men may become sexually impotent, thus the multi-million dollar market for Viagra. Getting up at night to go to the bathroom, cold extremities and lower back pain all point to a possible yang deficiency as well. A man's character may become too mellow, to the point of losing his confidence, becoming listless and apathetic. If he tries to "treat" his boredom with a younger woman, how ironic it would be if he couldn't "perform." It would be safer to get a sports car to prove his masculinity, but better still, he could start Asian bodywork treatments!
Please understand that this is a generalization. We can by no means put everyone in these categories. For one thing, men are not all yang, and women are not all yin. There is a balance of yin and yang within both genders in different proportions. But there is a tendency that you may have noticed for men and women to switch polarities slightly as they age.
This depends on how strong they are constitutionally, and how much they take care of themselves over their lifetime. Stress, drugs, overwork, environment and poor diet can contribute to depletion of yin or yang. This doesn't only pertain to growing older; anyone can become yin or yang deficient at anytime. In future articles, I'll address other causes, along with symptoms and treatment.
The symptoms of yin deficiency are mostly -related, but of small magnitude. This is called because the heat is not caused not by excess yang, but insufficient yin. So if you look at the first drawing below, you will see that it is only because there is less yin that the symptoms appear yang. An excess heat condition will give you symptoms showing the heat is predominant, whereas the heat caused by yin deficiency will be fairly mild in comparison.
Notice in both figures that the horizontal line signifies "normal balance." In the case of yin deficiency, the yang is not excess, meaning, above normal. Instead, there is only more yang, because there is relatively less yin.
The second drawing shows a true full-heat condition -- yang consuming yin.
In this instance, you see symptoms such as a rapid pulse, which signifies heat, but it's also thin or empty, which indicates yin deficiency. If it were rapid and full, it would indicate excess heat. With an excess heat condition, the tongue is deep-red, but with yin deficiency, it's red or even light-red. You will also notice that due to the depleted yin, there will be patchy areas or no coating. A full heat will cause the face to be all red, but with yin deficiency, only the cheeks will be red (called "malar flush" in Chinese-English). A full heat will cause someone to be hot all of the time all over his or her body. On the other hand, yin deficiency will cause mild heat, mainly in the afternoon or evening, night sweats and/or warm hands, feet and chest (called Five-Centers Heat).
Yin-deficient people find that they are thirsty but they don't really feel like drinking a lot, or they take small sips. They want to drink mostly in the afternoon or at night. Those with full heat want cold drinks and have a dry mouth all of the time. Both will have scanty dark urine and suffer from constipation (from being dried up), but those with full heat may have pain as well.
Emotionally, heat causes restlessness, but yin-deficient people experience vague anxiety and are not really able to pinpoint why in particular they feel edgy. They could even be defensive. A person with an excess heat condition is much more obviously agitated, and sometimes arrogant. Any heat will cause difficulty falling and staying asleep, but yin deficiency heat keeps people waking frequently during the night or early morning, whereas with a full heat, their sleep is extremely restless and dream disturbed.
All of these are general yin deficiency signs and symptoms. A person doesn't have to have all of them to be considered yin deficient. Become familiar with them in contrast to an excess heat and then look more deeply to figure out which organ is involved and what the etiology could be.
Yin Deficiency/ Empty Heat Excess Heat/ Full Heat Principle Signs and Symptoms Afternoon, mild fever High fever Night sweating Feeling of heat all day Five Centers Heat Hot all over Scanty, dark urine Scanty dark urine Dry stools, no pain Constipation, pain Thirsty with no desire to drink, or just small sips Thirst for cold beverages Dry mouth and throat at night Constant dry mouth & throat Mentally restless but tired, vague anxiety, fidgety Extreme restlessness, agitation or manic behavior Defensive Offensive or arrogant Waking frequently at night Dream-disturbed and very restless sleep Red line inside eyelid Red eyes Mild red, painless spots Red skin eruptions, burning pain Overextended Driven Complexion Red cheeks/ Malar flush Whole face ted Tongue Red with little coating, or peeled Red with yellow coating Pulse Rapid, thready, empty, floating Rapid, full Treatment method Nourish yin Clear heat
There are five common types of yin deficiencies, and three types of excess heat/fire. You will find others described in texts. In part 2 of this article, I will discuss what I see most frequently in my practice. The beauty of making yourself familiar with the general symptoms for a large category like yin deficiency is that all you then need to memorize are a few key symptoms for each organ/meridian, instead of a long list for each different pathology. In the next issue, I will be able to discuss many syndromes in fewer words, because now you know the basics!
This series of articles is only the tip of the iceberg. For a list of schools that offer in-adepth programs in Asian bodywork therapy, go to www.aobta.org. For information on the national ABT exam, go to www.nccaom.org.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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