Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Fish Oil: A Key Component to 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?
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
July, 2005, Vol. 05, Issue 07
Amyotrophic Lateral Sclerosis: Part 1 of 2
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In my last article I put out a call for massage therapists who work with Amyotrophic Lateral Sclerosis (ALS) patients to get in touch with me. I hoped to share some of their stories with Massage Today readers. Well, the response was amazing. I have lots of information to share, both on the development and latest research into this disease (part 1), and on what therapists are doing to help improve the quality of life of their clients who have it (part 2).
Amyotrophic Lateral Sclerosis: What Is It? Also known as Lou Gehrig's Disease, ALS is a rapidly progressive, irreversible condition that destroys motor neurons in the central and peripheral nervous systems, leading to the atrophy of voluntary muscles. ALS usually affects people between 40 and 70 years old; the average age at diagnosis is 55. It can occur in higher rates within families, but the distribution and incidence of this disease is usually random. Men have it slightly more often than women. Approximately 20,000 people in the U.S. are living with ALS at this time, and life expectancy between diagnosis and death for most patients is two to 10 years.
Etiology: What Happens? The primary feature of ALS is the destruction of motor neurons. In most cases, it begins in the anterior horn cells and the descending tracts in the spinal cord. Large motor axons degenerate and are replaced with fibrous astrocytes, a type of glial cell. This is the derivation of the name of the disease: "lateral sclerosis" refers to the scarring of the motor tracts on the lateral aspects of the spinal cord. Without stimulus from the upper motor neurons, lower motor neurons (that take messages from the spinal cord to the neuromuscular junction) atrophy. Ultimately, the skeletal muscles deteriorate without sufficient motor stimulus: "amyotrophic" refers to muscle wasting.
While we have a reasonably clear idea about how this disease progresses and changes function, its causes are still unknown. At this point in time, the features of ALS that are being intensively studied include abnormal glutamate levels (this is an excitatory neurotransmitter that accumulates in the synaptic cleft, killing the affected neurons); exposure to neurotoxins (including lead, agricultural chemicals and others); free radical activity (this is an issue especially when ALS runs in families); a deficiency of neurotrophic factors (these are chemicals that allow for healing or new growth of nerve tissue); and a new avenue of inquiry: Almost half of all ALS patients show signs of retroviral exposure. Further explorations of these factors may eventually open new doors to effective treatments to stop or even reverse this mysterious disorder.
Signs and Symptoms. ALS presents different early symptoms in different people. The most common pattern is stiffness, weakness and awkwardness in one body part, which slowly spreads to other parts of the body. About two-thirds of ALS patients have their first symptoms in the arms or legs; these cases are called spinal ALS. The final third will begin with "thick speech," excessive salivation, and difficulty with swallowing. This implies damage to cranial nerves rather than spinal nerves and is called the bulbar form of ALS. Fasciculations, or visible muscle twitching, may be present, along with painful cramping. One side is typically worse than the other, and the stiffness eventually moves proximally up the limbs, eventually to affect the trunk muscles for breathing. The leading cause of death for ALS patients is respiratory failure.
The nerve damage seen with ALS is to motor neurons only; sensory neurons are not affected. This can be a painful disease, however, as the body gradually collapses and gravity puts musculoskeletal stresses on muscles that have no power to respond. ALS does not influence intellectual capacity at all. While depression and anxiety are certainly a part of the process, the disease itself does not affect cognition or awareness.
How Is It Treated? Traditionally, treatment for ALS has been strictly palliative; that is, aimed at managing the severity of the symptoms only. Recently, some medications have been developed that can slow but not stop or reverse the progress of the disease. Other interventions include drugs for muscle spasms, along with moderate exercise and speech, and physical and occupational therapy to maintain muscle strength as long as possible. (This turns out to be a delicate balance. Too little exercise allows muscles to degenerate; too much exercise puts a dangerous demand on low-functioning neurons - which can also cause muscles to degenerate.)
Assistive devices such as leg braces, arm braces or wheelchairs can improve a patient's ability to function. In advanced cases, swallowing may be so difficult that the insertion of a stomach tube (gastrostomy) may be recommended. Since this disease does not impede cognitive or emotional processes at all, psychological therapy for ALS patients and their families is an important part of the treatment plan.
Massage? We'll get into specific ideas about massage techniques for clients with ALS in part 2. In the meantime, bear in mind that this is a disease that involves the degeneration of motor neurons but not sensory ones, and the client is fully aware of the changes occurring in his or her body. This combination of factors makes massage a great choice for many ALS clients because sensation is intact and the client can communicate (until he or she is very advanced) about how the massage feels and what is needed. Massage therapists who work with a client who has ALS are probably going to be working with someone in the process of dying. What a gift and privilege to be invited into this holy process.
I'm still accepting communications from therapists about their experiences with clients who have ALS - please share your wisdom with other readers through this column.
Until then, many thanks, and many blessings,
Ruth Werner, LMP, NCTMB
Editor's note: Read part 2 of Ruth Werner's article in the Sept. issue.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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