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Six Things Every Chiropractor Should Know About Opioids
An increase in addictions and deaths due to opioids has raised significant concern and media attention. We offer this brief overview on this important public health problem for the practicing chiropractor.
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.
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.
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.
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.
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.
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.
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.
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).
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).
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.
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.
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%.
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.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
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.
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.
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.
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.
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.
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.
September, 2005, Vol. 05, Issue 09
The Effects of Therapeutic Massage on HIV and AIDS Patients
By Jacob Gnanakkan
With the wide prevalence of individuals living with the human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), it is essential for massage therapists to understand the etiology, pathogenesis and treatment trends of the disease.It is likely that a person living with HIV/AIDS is, or at some point will be, under a massage therapist's care. The importance of understanding HIV/AIDS in massage therapy practice is reiterated by its inclusion in the curriculum for continuing education and maintenance of a license.
Epidemiology: The first AIDS case was reported in the United States 24 years ago. Since then, the Centers for Disease Control (CDC) reports HIV infection leading to AIDS is the fifth leading cause of death in people between the ages of 35-44, and AIDS is the leading cause of death among African-Americans ages 35-44.1 Moreover, data recently presented at the 2005 National HIV Prevention Conference in Atlanta, Ga., reports that more than 1 million Americans currently are infected with HIV.2 Each year, 40,000 new cases are diagnosed in the U.S. alone.3 A person infected with HIV does not always transition to the AIDS phase.
Pathogenesis: The etiological agent of acquired immunodeficiency virus (AIDS) is the human immunodeficiency retrovirus (HIV). The virus primarily targets the CD4+ T-lymphocyte, because of the affinity of the virus to the CD4+ T CELL surface marker. The clinical categories of HIV infection are: Category A, which includes asymptomatic or acute HIV infection; Category B, symptomatic conditions not included in Category C; and Category C, clinical conditions associated with AIDS.4 (For more information on clinical categories, visit www.cdc.gov.)
Current treatments: Since there is no cure for HIV, the current medical treatment is to inhibit replication of the virus and thus prevent it from causing AIDS. The virus is transmitted through direct blood contact with an infected person; the most common method of transmission is through sexual contact. Other modes of transmission include needle sharing, blood transfusions and the birth of a child to an infected mother.
Antiretroviral medications (ART) are used to inhibit the spread of HIV at various sites of activity. The ART medications are used alone or in a combination known as a "cocktail," a highly active retroviral therapy (HAART). General classification of drug therapies includes:
Massage Therapy Research
Some research on the efficacy of massage on HIV/AIDS patients includes the following:
Massage Therapy on HIV/AIDS Patients
Massage therapists play a role in the lives of those infected with HIV and AIDS by complementing the patient's medical team. Massage therapy plays a vital role in helping patients cope with the various symptoms of HIV/AIDS and indirectly boosts the immune system at the same time. The factors that seemed to contribute to immune enhancement were pressure strokes, dosage and period of massage therapy. A single massage dose on a healthy person indicated substantial increases in the NKCA. The effect on the immune system was even more intense when pressure was applied with multiple-dose massages lasting for a longer duration of time. Deep strokes, pressure points and trigger-point massage improved immune function in those living with HIV/AIDS.8 For the treatment to prove beneficial, it is recommended that the therapist use a full-body stress management approach. The technique should include pressure strokes, such as acupressure, trigger-point therapy and deep strokes, which should last approximately one hour and be performed at least once or twice weekly over an extended period of months for immune-enhancing results.
Massage Therapy and Gloves
Using gloves to massage an HIV/AIDS patient is the preference of the caregiver and patient. There is no evidence showing a positive correlation between the transmission of HIV/AIDS and touching or therapeutic massage. In conversations with individuals living with HIV/AIDS, it was unanimously expressed that the use of gloves by a therapist was negative. HIV and AIDS patients routinely are victims of discrimination. Despite years of health education, the disease continues to be misunderstood. Is it paranoia?
Massage therapy is a health profession. As such, therapists will be exposed to various diseases. The motive for wearing gloves should be weighed. Protection is important, but not at the cost of harming the patient, harboring professional paranoia or discriminating against people living with HIV/AIDS. There might be times in which the use of gloves is warranted, but there is no reason for them to be worn customarily in providing therapy to the patient. Remember, there is greater danger that the patient might contract a pathogen from the therapist because of his or her compromised immune system. According to the CDC, "People living with AIDS can get very sick from common germs and infections. Hugging, holding hands, giving massages, and many other types of touching are safe for you, and needed by the person with AIDS. But you have to be careful not to spread germs that can hurt the person you are caring for."9 If you feel you must use gloves because of the presence of blood, it is recommended you inform the patient and get his or her consent prior to therapy. The safest gloves are latex and vinyl.
Below are some general guidelines massage therapists can follow when working with HIV/AIDS patients:
The CDC also recommends: "To take gloves off, peel them down by turning them inside out. This will keep the wet side on the inside, away from your skin and other people. When you take the gloves off, wash your hands with soap and water right away."9
And finally, "If you get blood, semen, vaginal fluid, breast milk or other body fluid that might have blood in it in your eyes, nose or mouth, immediately pour as much water as possible over where you got splashed, then call the doctor, explain what happened, and ask what else you should do."9
Although most massage therapy research regarding HIV/AIDS is preliminary, the results in the studies that have been conducted are encouraging. As future studies reveal the benefits of the NK cells and their role in protecting patients with low CD4+ T-lymphocyte count, massage will become an integral part of the treatment of HIV/AIDS patients. As part of the medical team, massage therapists can greatly enhance the lives of people living with HIV/AIDS in the physical and psychological realms, by providing the personal touch other therapies do not generally provide.
Jacob Gnanakkan is a licensed massage therapist, information technology specialist, health & safety instructor, and piano instructor. He is the founder of Hunger Strike! Inc. (in the U.S.) and Genesis Health Foundation (in Sri Lanka and India), both of which serve the needy. Jacob conducts seminars worldwide on health, nutrition and natural remedies. He has an educational background in religious philosophies, medicine, medical science, health science and sports medicine, and currently is working on his doctorate in health sciences.
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