Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
March, 2005, Vol. 05, Issue 03
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Author's note: There is a movement in the health sciences away from using the possessive form of a disease name. This makes some sense, since it's not really Parkinson's disease; it's the disease of those who live with it.Sometimes this change takes the form of turning a descriptive term into a noun (e.g., from Parkinson's to parkinsonism) and sometimes the apostrophe simply disappears (e.g., Alzheimer disease). Since my column "What's on Your Table" always strives to stay on the cutting edge of both grammar and science, I will do my best to incorporate this new adjustment to the language.
The consensus is clear: Parkinson's disease, also called parkinsonism, is the issue on the table for today. Parkinsonism is a fairly common progressive degenerative central nervous system (CNS) disorder that leads to dysfunction at the motor centers in the basal ganglia. It affects about one in 1,000 people in the U.S., and the majority of people with parkinsonism are mature. It is unusual to see diagnoses in persons under 50 years of age - Michael J. Fox is a famous exception to this rule.
Etiology: What happens? Understanding the etiology of this disorder is a little like playing "The House that Jack Built" because the sequence of events is so specific and predictable.
So the sequence goes like this: A voluntary impulse to stand on one foot begins in the cerebral cortex. It is sent through the basal ganglia where, because adequate dopamine is supplied by substantia nigra cells, this impulse travels to the prime movers and antagonists of the lower extremity and postural muscles in order to bend the knee (go ahead, try it).
Parkinsonism occurs when the cells in the substantia nigra unexpectedly and prematurely die. Consequently, dopamine is in short supply in the basal ganglia; it becomes difficult to initiate voluntary movement (this is called bradykinesia - the person often reports feeling "rooted to the floor"), and/or the balance between prime movers and antagonists is disrupted, leading to rigidity or tremor. Several other symptoms may develop as well; they will be discussed shortly.
Causes: Most of the time, it is unclear exactly why the substantia nigra cells die off. Genetics and environmental exposure (or the combination of both) are often thought to be contributing factors. Excessive exposure to carbon monoxide, heavy metals, pesticides or agricultural chemicals is sometimes suspected. Repeated head trauma causes a variation called pugilistic parkinsonism; this is the case with former boxer Muhammad Ali. Most cases of parkinsonism, however, are considered to be idiopathic (of unknown origin).
Signs and Symptoms: Parkinsonism presents very differently in different people, but most primary symptoms have to do with movement problems. A short list of primary and secondary symptoms includes the following:
Treatment: Chemical imbalances in the CNS are often difficult to treat because the blood-brain barrier (a layer of cells that wrap around blood vessels in the brain) blocks the introduction of many substances into this precious environment. Some drugs must be administered in high amounts to overcome this obstacle.
Treatment for parkinsonism often begins with a dopamine precursor, or dopamine agonists. These substances essentially try to replace what the damaged substantia nigra cells should be producing; however, remember that dopamine in the basal ganglia helps create coordinated movement, but too much dopamine in the frontal lobe can cause hallucinations - a significant side-effect! Furthermore, most patients eventually develop tolerance to these drugs, and they lose their efficacy.
Other drugs work to change dopamine metabolism and other brain activity, but at this time no permanent solution or cure for parkinsonism exists. Other options include surgery to affect the globus pallidus or thalamus (this helps to control very extreme tremor), deep-brain stimulation, and eventually the possibility of stem cell implantation with the goal of re-growing the damaged substantia nigra cells.
Massage? Parkinson's patients experience progressive stiffness and rigidity of voluntary muscles. Rigidity is safe for massage, especially when sensation is present, but it is important to remember that this comes about because of a CNS dysfunction, and won't be completely resolved, even with the most brilliantly applied bodywork.
Several different modalities have been quantifiably researched in the context of parkinsonism, including Trager, Alexander Technique and Swedish massage with specific muscle exercises. All modalities report improvement in function, from the reduction of rigidity and improvement of sleep, to the reduction of tremor and increase of daily activity stamina.
It is important to work in cooperation with a client's primary physician, because massage may impact the need for antidepressants and other medication. Be aware, however, that clients with Parkinson's disease do not have the freedom of movement that most other people do, and they may have great difficulty in getting on and off tables safely. Some massage therapists address this by working with these clients on chairs or floor mats.
On a final note, I'd like to recognize two people for their contributions to my preparation of this article. One is a reader named David Ponsonby, who has done an enormous amount of research on this topic and generously shared his information - this article barely scratches the surface of what he has collected on this topic. David has allowed me to put interested readers in touch with him for more information.
The other person is a massage therapist named Jan Mueller who, years ago, published a fascinating and lovely article on working with clients who have Parkinson's disease in the Massage Therapy Journal [Winter 1996, (35): 1]. I made mention of her wonderful work at a class I taught in Kentucky one time, and it turned out by chance that she was one of the participants! Thanks, Jan, for your pioneering work.
And now, loyal readers, a familiar plea: What will it be for next time? At the moment I'm on a progressive degenerative CNS disorder roll, and could easily continue with amyotrophic lateral sclerosis (a.k.a., Lou Gehrig's disease). If you have experience with clients who live with this disease, I invite you to share your wisdom with the rest of our readership. If you have other ideas about what you'd like to read about, let me know that, too. Please let me know: What's on your table?
Many thanks and many blessings,
Ruth Werner, LMP, NCTMB
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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