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News in Brief
Major Organizations Announce Joint Conference; Fighting for Section 2706; New Vice President of Chiro. Program at Parker; Two Families, One Chiropractic Dynasty.
Defending With Vitamin D: Helps Prevent Progression to Diabetes
A 2014 clinical trial published in the American Journal of Clinical Nutrition provides additional evidence that optimal vitamin D nutritional status may be important in preventing the progression of prediabetes to diabetes in prediabetic adults.
Image Is Everything: The Power of Branding
Successful businesses use color and design to attract people to their service. They understand how important image is and hire experts to create an attractive package. Starbucks works hard to create an atmosphere that is warm and inviting.
A Guide for Talking to Doctors about Acupuncture and Brain Chemistry
Before I begin any discussion of how to talk about the effects of acupuncture on brain chemistry, nervous and endocrine function, it is essential to understand just what physicians most need help with.
Are Your Work Orders in Order?
There are times when a patient's occupational duties will delay or prevent them from recovering. These circumstances create the need for the doctor to recommend modified duty or remove the patient from work.
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
We Get Letters & E-Mail
Not All Evidence Is Equal; An Abundance of Misinformation; A Well-Researched Decision; Far Too Dangerous.
Overcoming Barriers to Exercise Compliance
One of the most common questions other practitioners ask me is, "How do I get patients to do their exercises?" I am not frustrated by my patient compliance, as many doctors are; in fact, I am actually happy with my patients' involvement and commitment.
Is the EHR Ship Setting Sail Without Us?
The numbers are in: As of July 2014, 10,253 doctors of chiropractic have received $123,059,868 in EHR stimulus funds – and yet that represents less than 15 percent of our profession.
The Art of Day-to-Day Assessment and Treatment: Clinical Pearls
Let's focus on the day-to-day process of assessing and treating the patient. I am proposing a particular attitude; a way of looking at the patient. This often evolves over a few treatments and then changes as you figure out what is significant.
Finders Keepers: The Secret to Relationship-Based Marketing
Becoming a successful practitioner has less to do with what you learned in school, and more to do with your ability to find new patients and keep them!
Building From the Bottom Up
I caught up with my dear friend Honora Wolfe, in her Colorado painting studio where, if she is not praying in Bhutan or doing charitable work in a Nepali free clinic, she spends most of her time now.
The Wisdom of the Second Office Location (SOL)
There are some things I never want to do again, like riding a motorcycle 100 mph. I call these things my "negative bucket list." Other things I have on that list include water skiing, riding a roller coaster and eating habanero peppers.
New Medical Technologies You Need to Know
We're all familiar with how fast computers become obsolete, as well as the rapid pace of development in the field of cell phone technology. The latest smart phones are far more powerful than desktop computers were only a few years ago.
Love a Nurse – and They'll Love You Back
According to various sources, there are about 3 million registered nurses in the U.S., and according to the American Nurses Association, they are under serious pressure in today's health care reality.
A Dream Come True for Chiropractic: Funding Prevention and Public Health
Back in 2005, Sen. Tom Harkin (D-Iowa) said: "Let's face it, in America today we don't have a health care system, we have a sick care system.
Medical Qigong for the Heart: Part III
Part 1 and Part II of this series focused on the physical aspect of the Heart and mental emotional aspects of the Heart respectively. Now, I would like to focus on the spiritual aspect of the Heart.
State by State: Comparing Chiropractic Scope of Practice
"The issue of 'scope of practice' has been a bugaboo ever since our early quests for legal recognition for chiropractic," according to Dr. Claire Johnson, editor in chief of JMPT and National's other two chiropractic journals.
Billing for Same-Visit Extraspinal and Spinal Manipulation
Q: I have always been under the premise that when billing 98943, extraspinal chiropractic manipulation, on the same visit as spinal manipulation, 98940-98942, that the extraspinal manipulation requires modifier 51.
Women's Health: Herbal Formulas to Help Patients With Dysmenorrhea
Chiropractors have long treated women for menstrual pain (dysmenorrhea). Since roughly 60 percent of all chiropractic patients are women and 30-50 percent of women have a history of menstrual cramps, the vast majority of doctors of chiropractic will inevitably see patients with dysmenorrhea.
Peer Points: Always Seeking To Grow
Ellen "Kiki" Geary has spent the last decade honing her craft. As a specialist in integrative holistic care, she went straight from completing her master's degree in acupuncture and chinese herbal medicine from Bastyr University to building a successful and thriving practice in the small community of Anacortes, Washington.
December, 2004, Vol. 04, Issue 12
An Introduction to Aromatherapy
By Shellie Enteen, RA, BA, LMBT
This column will examine the practice of aromatherapy to increase reader knowledge about the use of essential oils in the practice of massage in therapeutic and spa settings, and for a range of client issues.I have taught continuing education classes in aromatherapy for over 10 years in Florida and across the U.S. Many massage therapists who take the introductory class have had little formal training in aromatherapy.
They are excited to learn that essential oils are not just for relaxation and that there are a large number of essences they can use to enhance their practices. They discover they don't need to rely on a few blends purchased from a supplier; with some knowledge, awareness and good intent, they can create blends more directly suited to a particular client's immediate needs.
Practice Issues: Appropriateness, Contraindications and Technique
Diagnosing and prescribing is not in our current scope of practice, but at this time there is no regulation on using essential oils in massage oils or air diffusions. It is common practice for spas to offer clients a choice of relaxing, cleansing, stimulating, or pain relieving aromatherapy blends. Some go further and have the client fill out an intake form that narrows down the complaint and helps the therapist select essences for an individual blend. I doubt you will have much to consider in this respect when using aromatherapy as part of your practice, though you might avoid sentences like "It sounds like you have a cold. I will make a blend of Eucalyptus, Lavender and Tea Tree for you." A way to deal with a scope of practice issue, should it arise, is to educate.
If you have a book like Aromatherapy, an A-Z by Patricia Davis (or any other standard text in the field), you can look up a condition and show your client what an author says. The client can then choose to follow the author's advice. Or you can use a personal example like: "When my Aunt Martha had this, she found relief from using..." Again, the client can choose to follow Aunt Martha's example or not. These approaches fall under the heading of "education," which we are all free to do.
The issue of contraindication is a bit controversial in the aromatherapy community today. Aromatherapists like Sylla Sheppard-Hanger (author of Aromatherapy Practitioner Manual, Vols. I and II) list the contraindications for certain essences and specific conditions, such as pregnancy or high blood pressure. Others, like Australian Aromatherapist Ron Guba, follow the French medical model that believes any danger from essential oils comes from the ingestion of fairly large amounts. If you read current trade publications like The Aromatherapy Journal or Aromatherapy Today, you will see articles from both sides. My own belief falls somewhere between the two. I feel that it is always best to trust your instincts about using some of the more powerful essences, like sage, thyme or oregano.
Because the most direct and effective method for aromatherapy is inhalation, as you give a treatment, you, too, receive a treatment. As a therapist, you have more exposure to the essences than your clients. Essences can remain in the body for up to 24 hours, and are eliminated in our usual ways of elimination. With daily use, essences can build up in the system, so it makes sense to vary the oils you use and reserve the stronger ones for situations that truly require them.
Most aromatherapists would agree that essential oils, with the notable exception of lavender, should not be used "neat," or undiluted, on the skin. Essential oils are highly concentrated and applying one directly to the skin can cause mild to severe irritation, depending on the essence and a person's sensitivity. Eucalyptus, peppermint, ginger, cinnamon, sweet orange, juniper, oregano, sage, black pepper, thyme, clove, and sweet birch are some of the more commonly used oils that are known irritants and should be used in high dilution (only a drop or two in an ounce of carrier oil) and not on sensitive tissue areas.
Some people can have allergic reactions to essential oils. If a person is allergic to pollen, you might avoid using essential oils that come from various pollen producers: flowering plants, trees and grasses. Likewise, some people are allergic to fruits. It's a good idea to clear those issues on your intake sheet before you blend. What does an allergic reaction to an essential oil look like?
Take heart, there are no reported cases of death due to anaphylactic shock in the extensive medical literature on essential oils (a great deal of research has been done by the food and cosmetic industries who use most of the essential oils produced.) An allergic response can include headache, sneezing, upset stomach and skin rash. The good news is that the reaction is not usually long lasting.
Phototoxicity means that the skin cell membrane is weakened, making it more permeable to ultra violet (UV) light. Some essential oils are considered phototoxic. Expressed bergamot, cedarwood, cinnamon, ginger, grapefruit, expressed lime, mandarin, expressed orange, and patchouli should be avoided prior to prolonged exposure to strong sunlight. The distilled oils of lime, orange and essence of bergamot that have had the furocoumarins (FCF) removed are not considered phototoxic. This is important to remember if you practice in a resort area or anywhere people sunbathe and partake in outdoor sports and activities.
Making a Blend
To make a treatment blend, use a cold pressed nut, seed or vegetable oil as your carrier. Choose something with no other ingredients or fragrances added. Never use mineral oil. Some kind of oil, fat or emulsifying agent must be present in your carrier to absorb the essential oils. I recommend fractionated coconut oil, which has had the solid white, smells-like-coconut component removed. This is a light, colorless and odorless oil that does not oxidize. And because it consists of saturated fatty acids - the closest substance to human subcutaneous fat - you have almost complete skin penetration.
While there are no hard and fast rules, generally speaking, for regular massage you would use up to seven drops of up to five different essences in one ounce of carrier oil. This number can vary due to the essences used and with need. For example, a blend for muscle ache might contain three drops of lavender, two drops of geranium, one drop of Roman chamomile, and one drop of Clary sage. You might double this recipe if the pain is chronic or severe. But if a blend for muscle pain included two drops of spike lavender, one drop of peppermint, one drop of helichrysum, and one drop of thyme linalool, you might increase the spike lavender, and maybe add one more drop of peppermint, but the intensity of thyme and helichrysum would limit them to one drop each. The intensity of the essence will be very clear to you from its smell.
I base my blends on information about properties and from information about inhalation. In this area of work, "the nose knows" is a true saying. When you inhale essential oils, the volatile molecules are carried via the olfactory nerve to the limbic region of the brain where the properties are recognized. The response of pleasure - yes, attraction - is an indication that the properties will be useful and helpful. A response of dislike, like nose wrinkling, would indicate that you shouldn't use that essence at this time. You get information for yourself and for others this way. Try it and see. Some of the best-laid blend ideas can be undone when inhalation is the judge.
Click here for more information about Shellie Enteen, RA, BA, LMBT.
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