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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.
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.
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.
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.
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.
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.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
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.
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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).
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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.
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).
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.
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.
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.
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.
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.
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%.
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.
June, 2003, Vol. 03, Issue 06
The "Secret" of Chinese Pulse Assessment
By Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc
The little-known fact about Chinese pulse assessment is this: It's really easy. When I hear teachers go on and on about the need to take 500 pulses before it means anything, I roll my eyes.Yes, memorizing all 28 pulse qualities takes time; connecting the information to what you feel takes a little longer; and perfecting a more complex system, such as the one described by Dr. Shen in Leon Hammer's comprehensive and eloquent pulse diagnosis tome (800 plus pages), will take quite a bit of discipline, but immediately obtaining usable information you can trust takes only a few hours. These articles will give you an idea of how to complete a qualitative pulse assessment, judging whether qi is weak or strong in each of the 12 main positions. It takes longer to distinguish between the 28 pulse qualities, but when you get confident in assessing the relative strength or weakness in each position, you can start to describe the different qualities of the pulse waves.
Examination Approaches: East vs. West
Although the pulse can give you important information in developing a treatment plan, you must consider it in relation to other signs and symptoms. Actually, looking at the pulse in isolation is contrary to the spirit of Chinese medicine; rather, it must be viewed as an integral piece of a whole complex of symptoms. The Chinese medicine view is broader in scope than the subjective or objective data collected in Western medicine approaches, in which the signs and symptoms are considered directly related to the client's chief concern.
For example, a client presents with lower-back pain. A Western-based practitioner conducts a detailed intake in which he or she asks about the quality of the pain; what relieves and aggravates the pain; the severity of the pain; when the pain started; and how posture, lifestyle and attitude come into play. The practitioner may look at X-rays, MRIs, ROM and other physical exams. Most of this information is thought of as directly relating to the lower-back pain, which yields an assessment and treatment plan.
Suppose the same person with lower-back pain comes to see a practitioner of East-Asian medicine. Many of the results from the same type of examination are considered, but information that appears unrelated can be just as - if not more - important. For example, a weak pulse in the third position can be a tip-off to the presence of lower-back pain even before the client says anything. A slow and deep pulse points to its root cause as a Kidney Yang Deficiency (see corresponding article www.massagetoday.com/archives/2003/03/12.html), but there would have to be other symptoms present to confirm that assessment, such as getting up at night to urinate; cold feet; lack of motivation or will; impotence; and/or a swollen tongue with white coating. At this point, a clear, cohesive picture of the energetic balance of the client develops, including emotions and physical manifestations, so the practitioner can select treatment principles and a plan to obtain optimal results.
Back to pulses. If you are an Asian bodywork therapist (ABT), you gather the above information using the Four Pillars of Assessment, sometimes called the Four Examinations, which are pulses belonging to the "touching" category. Other examinations include looking, hearing, smelling and asking. There are so many strategies under each of these categories that you could spend all day doing an initial intake. I prefer to gather a little bit of information at a time because I find that people don't reveal everything right away anyhow, no matter how thorough the examination. I gather enough information to begin treatment; as clients open up in subsequent visits and I see how they have responded to their last sessions, I can adjust my approach (called "assessment by treatment").
The pulses are examples of how the microcosm reflects the macrocosm. Basically, any part of the body gives you a picture of the entire body. Microsystems developed for the ears, eyes, hands, feet, face and tongue have proved accurate and useful. I'm sure you could come up with a microsystem for elbow assessment and treatment if you were so inclined!
In my next article, I will give you the method for taking the pulse and a map with which to start. For "hands on" pulse instruction, visit www.aobta.org/schools.htm for a list of schools that offer in-depth programs in Asian bodywork therapy.
Click here for previous articles by Barbra Esher, AOBTA CI. Dipl. ABT & Ac. (NCCAOM), LAc.
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