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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).
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.
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.
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.
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.
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.
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.
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.
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).
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
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.
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 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.
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%.
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.
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.
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.
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.
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.
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.
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 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.
November, 2005, Vol. 05, Issue 11
Questions From Readers
By Shellie Enteen, RA, BA, LMBT
In a previous column, I invited questions from readers. Fortunately, I received some important questions and felt everyone might benefit from the information in the answers. I have received permission to use the names and questions that appear below.Again, please do contact me with any comments and questions you might have and I will answer you directly and, where appropriate, might ask to use your question as part of an Aromatic Message column.
My first question came from Angela Barker:
Question: "I just read your very interesting article on essential oils. Can any essential oils be used during pregnancy?"
Answer: Yes, essential oils can safely be used during pregnancy within certain parameters. There is some controversy over how cautious one has to be during this time. Some Aromatherapists are very conservative, while others are more liberal in this respect. Most would agree that if you don't have problems with bleeding during the first trimester, Lavender is safe to use throughout. One of the safety concerns is that essential oils pass through the placental walls into the fetus. Another is that essential oils affect the hormonal system and also stimulate processes in the digestive, elimination and reproductive systems.
If you decide to use essential oils, it's best to remember that and use less of the oils considered safe than you would in a regular massage blend (up to four or five drops as opposed to seven or eight drops of all combined oils in one ounce carrier oil). You safely can inhale Peppermint for morning sickness (however, best not to use Peppermint if you are nursing, as it can stop the milk flow). Floral waters (also called 'hydrolats' and 'hydrosols') can be used with more confidence as they are more dilute.
Later in the pregnancy, other essential oils considered safe on the body and in the bath are Rose, Neroli and Chamomile. In small doses, Geranium, Jasmine, Petitgrain, Patchouli, Mandarin, Sandalwood and Ylang Ylang also can be used. I have had great success with a highly diluted blend of Rosemary and Lemon (1 drop each per one ounce carrier oil) used only on the feet and legs of a woman in her ninth month, suffering from decreased circulation and swelling. During labor, Clary Sage, Jasmine and Lavender help relieve pain, anxiety and assist delivery. Much of this information comes from "The Aromatherapy Practitioner Manual" by Sylla Sheppard-Hanger. You also might like to read some other authors on the subject, Patricia Davis and Valerie Worwood for example.
Several questions came from David Ponsonby:
Question: "You have an interesting overview of aromatherapy in the current MT. However, I still find it difficult to make choices or blends. We see a lot of 'failed back syndrome' patients...everything hurts, all the time. They often have surgical scars and retained hardware. They can be 10 years post-surgery. We tend to feel there is a psychosomatic component. There might be aches, sprains and spasms as well. They might be unemployed and surviving on insurance and security payments. Women tend to be more sensitive to scents than men. Do we combine approaches so that the patient smells the scent (e.g. cotton ball in bra for females), as well as having it on their lumbo-sacral region? Or have it on their pillow, clothes closet...for longer term exposure? Some essences are quite expensive."
Answer: I would like to refer you to an article I compiled on treating Fibromyalgia with Aromatherapy on the NAHA Web site www.naha.org, as you say you feel there is a psychosomatic component and an overall chronic pain issue, and we explore this in the article on Fibromyalgia. Another suggestion is to combine Bach Flower remedies with essential oils, as they treat the mind. You can read more about Bach Flowers on my Web site at www.astralessence.com. Bach Flowers can be put into a treatment blend that your client applies themselves and might use in a bath. You would shift the vibration of the Bach Flowers if you apply this type of blend to someone else, so they need to do it themselves. You also can suggest Bach Flowers they can take orally.
As for blending, I believe you do need to learn the properties, but there is no substitute for your own sense of smell. In my classes, I teach blending with the nose as the final judge. Make a list of what you think you should be using based on the properties you either know or have found in a reference book. Before you add the essence, smell it and allow yourself to come up with a quick 'yes' or 'no' answer. Don't linger over the smell, if in doubt, 'no' is the answer. What is happening is that the limbic region of the brain is registering all the properties and the 'yes' or 'no' is the response you have to indicate if those properties are the ones needed, for yourself and for others. Smell each proposed addition along with the blend you have going before you put it in. You will know if you should add it and also how much of it you should add. If you get some 'no' answers, another essential oil, not on your list, might come to mind and even if you don't know why, if it smells right, put it in. It might be that you will discover the reason you chose it, either through a communication the client makes during the session or something you read about that essence later. Trust yourself. I highly recommend having books that address the psychological/spiritual aspect of essences such as "Aromatherapy for Healing the Spirit" by Gabriel Mojay and "Subtle Aromatherapy" by Patricia Davis.
It's fine to fragrance a cotton ball if you are working on the psychological levels, stress, etc., but I would highly recommend using the essences in the treatment oil (you will notice I don't say lotion because you would need one that will totally absorb the essences and many won't do that). There is a powerful therapeutic effect when essential oils touch the skin, due both to their physical and vibratory effect. You certainly can give the client some of the blend to use at home.
You say some essential oils are very expensive and that is true, but when you figure the cost per drop, you will discover that even the most expensive essence is very affordable. A regular massage blend in one ounce carrier oil would contain up to seven drops of essential oils. The cost per drop is calculated by taking the price and dividing that by the number of millimeters (price divided by quantity) and then dividing that figure by 25 drops (the approximate number of drops in a ml). For example, if you bought 10 ml of Lavender for $14, you would divide $14 by 10 and have a price of $1.40 per ml. Then, divide $1.40 by 25 and you find that good quality therapeutic Lavender is a bit less than six cents a drop. You might use three or four in the blend, which would be 18 to 20 cents. Suppose you bought Rose at retail for $45 a ml. No need to divide by the number of ml, it's $45. If you divide this by 25, you get $1.80 per drop. Rose is a strong scent so you might add only one drop. When you realize your blend is now costing you $2, even using one of the most expensive essential oils, you find that this definitely is do-able.
I always would charge at least $5 or even $10 more for adding Aromatherapy to massage for both your material cost and your expertise. Even if you do an expensive blend occasionally, much of the time your blends would cost you a lot less than $5, even with the carrier oil figured into the price.
Question: "I still wonder about trusting my selection. Should the client select his/her own?"
Answer: No, the client should not select their own essences. Every inhalation is a treatment, so if the client is inhaling a lot of essences, they already are being treated and even over-treated. Try spending a little time blending for yourself or for friends first, and you will feel more confident. If you absolutely don't feel comfortable with blending after this, then you can opt for purchasing premixed blends for pain relief, relaxation, circulation or detoxification. You can ask the client to select one of those by the name and not by the smell. This is not my favorite way of treatment because there are more levels to each of those areas and each client is an individual, but a generic blend will do if necessary!
Click here for previous articles by Shellie Enteen, RA, BA, LMBT.
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