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Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
December, 2002, Vol. 02, Issue 12
Flushing Out Myths
By Keith Eric Grant, PhD, NCTMB
There's a statement, seemingly pervasive throughout massage education and massage books, that unspecified toxins accumulate in the body, and that these toxins can be flushed out by massage.I believe this is yet another myth that continues to be passed on as misinformation to massage students. This is not to dispute that there are very real toxins that accumulate in the body, notably persistent organic pollutants (POPs) in fatty tissues and heavy metals in skeletal tissues. [7,8] However, these toxins are too chemically bound to their target tissues to be significantly liberated by the mechanical motions of massage.
A more significant issue is whether metabolic wastes and cellular debris can significantly accumulate and be flushed out by massage. To elucidate a negative response to this, I turn to consideration of the circulation of blood and lymph. If the tissue is to accumulate wastes in a static manner, i.e. not as an instantaneous balance between production and removal, the tissue must be isolated. If we assume that the tissue is isolated from blood circulation, then necrosis (cellular death) is the rapid consequence. Such gangrene is, for example, one of the results of the vascular pathology of diabetes. We have to conclude that non-gangrenous tissue must be receiving oxygen and nutrients via circulation and that, for this to continue, venous return flow must also be occurring. If the toxins are accumulating, they cannot be doing so within the reach of the circulatory system. Perhaps we should look instead in the interstitial spaces served by the lymphatic system.
As noted by Bruno Chikly, the lymphatic system is a second pathway back to the heart, parallel to the blood system [2, pg. 27]. Chikly further notes that "about 1.5 to 3.5 liters of lymph per day circulate through the thoracic duct, although the total volume of the flow of lymph has yet to be precisely measured" [2, pg. 51] and expands on the process of lymphatic circulation.
What arises is a picture of tissue far from being in static isolation. If neither necrosis nor severe edema is to result, the tissue environment must be continually bathed in the fluid circulations of blood and lymph, ruling out the accumulation of free toxins. Where there are restrictions, such as adhesions between fascial planes, they must be of a more macroscopic nature, still allowing for the microscopic flow of circulation, just as water can flow through cheesecloth.
Based on the above considerations, I can only conclude that the flushing of toxins is yet another persistent myth. However, this does not imply that massage is powerless to benefit the body. While massage does not appear to directly increase overall blood flow , it can be used to relax muscle hypertonicity. Lowering the level of muscle activity will locally reduce the need for energy and oxygen and the rate of production of metabolic wastes. It will also reduce the muscular pressure on surrounding tissues, effectively improving circulation and recovery from use. This, however, is not massage moving out toxins, but massage facilitating a better homeostasis. It is just this improvement in homeostasis by which, I believe, massage facilitates recovery from exercise and allows a higher level of training to occur.
In cases of excess lymphatic fluid production (overloading a normally functioning lymphatic system), or partial lymphatic system compromise, lymphatic drainage massage may be helpful in promoting the process of lymphatic filtering. The key sign here is the existence of edema. Normally, local muscle contractions promote sufficient lymph drainage. A notable exception exists with breast tissue. Since there is no contractile tissue within the breast to assist lymphatic drainage, overall tissue movement becomes important [3, pg. 101].
There remains a consideration that some clients respond to a massage with reactions of flu-like aches and malaise. Such symptoms have often been attributed to the toxins released. Dispelling with the concept of toxins means that we must seek other explanations for such post-massage malaise. Chaitow notes that fibromyalgia syndrome (FMS) and chronic fatigue syndrome (CFS) are the distant end of spectrums of dysfunction that can include aches, malaise, and flu-like symptoms [1, pg. 6]. He believes that a great many people are somewhere on those spectrums. Some of the models of dysfunction that Chaitow presents include a sort of systemic allergic reaction characterized by a great deal of pain, either muscular and/or joint-related [1, pg. 33]. Chaitow also notes the hypothesis that the inability to produce an adequate cortisol response to a stress can result in symptoms: "Deficiency in cortisol is characterised by fatigue, weakness, muscle and joint pain, bowel symptoms, nausea, increased allergic reactions, mood disturbance" [1, pg. 68]. I tend to think of a body's neurochemical system on the edge of its ability to adapt being pushed temporarily beyond the edge by accommodating to the work being done. This reaction may be exacerbated by effects of athletic overtraining or by a genetic metabolic predisposition [5,6].
To explain the effects of massage, think not of flushing out toxins, but flushing out tensions - not just in the sense of emotional holding, but in the basic sense of muscles "idling" with the throttle open. As with good mechanics, we're simply readjusting the throttle to a reasonable idle rate. Underlying this way of looking at things, however, is a fundamental shift in orientation from mechanically moving something that accumulates to changing a dynamic balance within the living human body. It is, I believe, an important shift away from mythology and toward better understanding of our work.
Click here for previous articles by Keith Eric Grant, PhD, NCTMB.
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