resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
January, 2003, Vol. 03, Issue 01
Working With Clients Who Have Hyperthyroidism
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my previous article on thyroidism (October 2002 issue), I discussed how insufficient levels of thyroid hormones circulate in the bloodstream, or receptor cells become resistant to these hormones (or both).Hypothyroidism is a fairly common condition, but getting an accurate diagnosis can be challenging. Its symptoms can overlap with those of fibromyalgia syndrome, candidiasis, chronic fatigue syndrome and other conditions. Furthermore, current measuring standards for "normal" hormone levels are rough at best, which means a person with a borderline case, but significant symptoms, may have difficulty getting a useful diagnosis.
This article focuses on a corollary disorder: hyperthyroidism. Hyperthyroidism and hypothyroidism are closely linked. Both may result in the development of a goiter - a painless enlargement of the thyroid gland. People who begin with hyperthyroidism may end up with hypothyroidism as a result of their treatment. Also, as one reader informed me, a baby born to a mother with hypothyroidism may develop hyperthyroidism as an overcompensation response.
Before we begin this discussion, I'd like to include an excerpt from a correspondence I had with David Ponsonby, a massage therapist from Dallas, Texas, who generously shared his experience with hyperthyroidism:
My mother had the iodine deficiency variety of hypothyroidism, which I believe initially causes the thyroid to enlarge in an attempt to meet demand, then to fail. My mother was the Anglo-Australian equivalent of a "G.I. bride." She went to Western Australia and had two babies. Away from fish and pre-iodized salt, she developed goitre (English spelling). I came across one reference that suggested the fetus will overcompensate for a deficiency and become hyperthyroid - i.e., me. She had two surgeries in the next four years, and a third almost 50 years later that resulted in pneumonia and death. Throughout the 50 years, her breathing, speech and activity level were impaired.
My own hyperthyroidism had some curious "coincidences" at initiation. I developed an apparent cellulitis after being bitten by a mosquito near a city sewer plant. (No association, they tell me?)
My lower right leg swelled up. When the swelling went down, it was very lumpy -- pretibial myxedema. The parathyroid is mixed in, with calcium deposition around the periosteum - like a soccer player's shin. I am a former soccer player, and it was interesting that the site of some of my old injuries seemed to be the focus.
My eyes popped out, I became very hot, my skin was flushed and itchy, my blood pressure went up, my heart pounded in my ears, and I fainted on two occasions -- very scary. I tried to maintain my exercise, although the sweating and fainting made it scary because there was always the possibility that I could collapse while riding my bike, etc.
I tried acupuncture, which seemed to relieve the swelling on one side, under the eye. I tried detoxification, energy therapy, homeopathy, etc. Gradually, most of the symptoms went away. I still have some swelling under one eye.
What Is Hyperthyroidism?
Hyperthyroidism is a condition in which the thyroid gland produces excessive amounts of two forms of thyroid hormone (T3 and T4), resulting in the metabolism of fuel into energy - lots and lots of energy. A person with hyperthyroidism has an engine that runs hot all the time, and never really lets up.
Demographics: Who Gets It?
Hyperthyroidism affects between 1 percent to 2 percent of all people in the United States at some time in their lives. About 500 thousand new cases are diagnosed each year. Women are affected more often than men, by a margin of about 3 or 4 to 1. Most cases are diagnosed between the ages of 20 and 40.
Etiology: What Happens?
Hyperthyroidism is usually caused by one of three things: a thyroid infection; a nodule or group of nodules that become hyperactive for unknown reasons (this is called toxic nodular or multinodular goiter); or an autoimmune attack against the thyroid gland that causes it to secrete excessive amounts of metabolic hormones (also called Grave's disease).
Grave's disease is by far the most common variety of this disorder, accounting for 70 percent to 80 percent of all cases. In this situation, antibodies called thyroid-stimulating immunoglobins (TSI) mistakenly attack the thyroid gland, causing it to grow to huge dimensions (this is called a goiter) and so to secrete excessive levels of both forms of thyroxine.
Under normal circumstances, pituitary secretions of thyroid-stimulating hormone (TSH) tell the thyroid when and how much to metabolize fuel into energy. When Grave's disease is well-established, the thyroid produces its own TSH for local action, so circulating levels of this hormone drop significantly. At the same time, levels of TSI, the antibodies that attack the thyroid, increase systemically throughout the circulatory system. The result is that the conversion of fuel into energy increases by 60 percent to 100 percent.
While genetics clearly play a major part of developing Grave's disease, its onset often seems to be connected to a stressful situation like a death in the family or a job change. Other risk factors for developing this disorder include exposure of the thyroid to X-rays, or previous use of antiviral medications such as interferon or interleukin.
Signs and Symptoms
The primary symptom of Grave's disease is the development of a goiter: the thyroid becomes enlarged enough to create a visible, painless swelling in the neck. Other signs and symptoms are mostly related to the emphasis on metabolizing fuel for energy, rather than growth or storage.
Grave's disease patients may show anxiety, irritability, insomnia, rapid heartbeat, tremor, increased perspiration, sensitivity to heat, and unintentional weight loss. Skeletal muscles, especially in the arms, often become weak. Other symptoms may include a lighter flow during menstrual periods, dry skin and brittle nails. Grave's disease can also affect the muscles that lift the eyelids. When the eyes seem to protrude, this is called exophthalmos. (Think of Marty Feldman in Young Frankenstein - he was a famous hyperthyroidism patient.) Grave's ophthalmopathy is a rarer disorder that causes the eyeball to protrude beyond its protective orbit because tissues and muscles behind it swell. The front surface of the eye can dry out, causing light sensitivity, double vision, decreased freedom of movement within the orbit, pain, and excessive tearing.
Some Grave's disease patients develop red raised patches of skin on their shins and feet. These rashes are called pretibial myxedema, and they are generally not painful or dangerous.
One of the most serious complications of Grave's disease is the risk of episodes of dangerously accelerated metabolism called thyroid storms. In these episodes symptoms may include rapid heartbeat, fever without infection, intolerance to heat, confusion, agitation, and finally fainting or shock. Thyroid storms can be medical emergencies and require immediate intervention to slow the heart and bring down the fever.
Grave's disease is usually diagnosed through a physical exam, a blood test, and an examination of how the thyroid takes up radioactive iodine. The physical exam concentrates on issues like goiter, temperature, heart rate, muscle weakness, and tremor. Blood tests will look for low levels of TSH combined with high levels of TSI, along with abnormally high levels of thyroxine. The ingestion of radioactive iodine shows how quickly the thyroid absorbs iodine (a primary component of thyroxine), along with which parts of the thyroid appear to be hyperactive. This test helps to delineate between Grave's disease and nodular hyperthyroidism.
Hyperthyroidism can be treated in a number of ways, depending on the underlying causes and the severity of the symptoms.
Alternative therapies for hyperthyroidism focus on the use of certain foods and/or vitamins that inhibit thyroid activity, but I couldn't find any information on modalities that can actually interrupt the immune system attacks on the thyroid gland.
What About Massage?
As long as the skin is healthy and intact, and the cardiovascular system can adjust to the changes we bring about, massage of all types may be beneficial to clients with hyperactive thyroid glands. The calm, relaxed response bodywork creates may provide a welcome change to the sympathetic-like symptoms of hyperthyroidism.
In my next article, I will discuss reflex sympathetic dystrophy syndrome (RSDS). Also referred to as causalgia, sympathetic maintained pain syndrome, or complex regional pain syndrome, this chronic pain syndrome presents special challenges for massage therapists. If any of you live with this, or have clients who do, I'd love to hear from you.
Until then, many thanks, and good health and happiness.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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