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Why You Should Include the Single-Leg Stance Test in Every Patient Assessment
The single-leg stance (SLS) test, also known as the single-limb stance test, unipedal stance test or one-legged stance / balance test, is often used in the geriatric population to assess static postural and balance control.
By the Numbers: 3 Common Financial Mistakes With Major Consequences
Warren Buffett is on record for sharing the hidden art of becoming wealthy and making it simple enough for anyone to grasp.
Physical Exam 101: The Hands
I am sure you are familiar with the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
A History Worth Telling
The popularity and the use of acupuncture for the treatment of animals in the United States is at its peak.
Coding for the Subluxation: ICD-9 vs. ICD-10
When I attended chiropractic school, I was taught that chiropractors approach health care differently than the traditional medical establishment.
Are You a Bad Chiropractic Patient?
My father was a great DC. In fact, as you might expect, he was the doctor of chiropractic I measured all other doctors against. Sadly, he died at age 61 when I was in my early 30s.
Curbing Label Overwhelm
For the average consumer, reading a food package can be overwhelming: natural, organic, non-GMO, gluten free, free range ... you get the picture.
Remembering Clarence Gonstead and 50 Years of the Gonstead Clinic
Dr. Clarence Selmer Gonstead (1898-1978) took chiropractic practice from back-alley bone setting to an understandable biomechanical science. His life was dedicated to clinical competency.
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.
Vaccines and Chiropractic: Evidence-Based Medicine or Medical Dogma?
Right or wrong, the chiropractic profession has historically been against vaccinations. However, a growing trend within the profession is seeking to reverse this position.
Knee Pain From the Kinetic Chain
As practitioners of manual medicine, chiropractors often treat patients suffering from knee pain.
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!
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.
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.
Immunizations by Colorado DCs: Really?
You probably didn't hear about it, but back on Nov. 21, 2013, the Board of Directors of the Colorado Chiropractic Association (CCA) adopted "immunization authority" for Colorado DCs as its No. 2 legislative goal.
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.
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.
A Chinese Medicine Story: An Interview with Mazin Al-Khafaji
Mazin Al-Khafaji's work has interested me for years. In February 2014, we invited him for the second time to speak at the Southwest Symposium in Austin, Texas.
The Science of Stretching
In 1986, Rob DeCastella set a course record by running the Boston Marathon in 2:07:51, just 39 seconds off the world record.
November, 2005, Vol. 05, Issue 11
Avian Flu: How Threatening Is It?
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Fall is here, and with it, another flu season. Last year, we were bombarded with information (some of it pretty alarmist) about flu, flu vaccines and the emergence of a dangerous new player on the field of infectious disease: avian flu.Since massage therapists work closely with lots of people, and because we are health care professionals, it behooves us to be up to speed on the latest developments about flu, and I am here to help.
A brief disclaimer: this information changes almost daily, but it's accurate as of mid-September, 2005.
What is It?
Flu (short for influenza) is a viral infection of the respiratory tract. Flu viruses are classified as type A, B or C. Type A flu is by far the most aggressive, with the highest risk of significant complications or even death.
In the United States, often we don't consider flu to be a significant health issue, but for at-risk populations it can be a life threatening infection. Anywhere from 5% to 20% of the population has flu each year. It accounts for 200,000 hospitalizations and 36,000 deaths, mostly from pneumonia. The people most at risk for the serious complications of flu are the very young, the elderly or people with underlying diseases that affect lung or immune system function.
How Does It Work?
Flu viruses work in the usual way of infectious agents: they gain access to the body (often inhaled as airborne particles, although it can be spread by hand from contaminated surfaces) and then they invade their target cells. In this case, mucus-producing cells that line the respiratory tract. Once the infection becomes established, the immune system response causes most of the extreme symptoms, which appear one to three days after exposure. Flu is most communicable for three to seven days from onset of symptoms, depending on the age and health of the infected person.
Signs and Symptoms
In most cases, flu symptoms look like a bad cold: respiratory irritation with runny nose and dry cough; sore throat, headache, chills and a long-lasting high fever. Flu-related fevers often go over 102° in adults, and they might last for three days or more.
Unlike colds, flu infections affect more than the upper respiratory tract. Many patients experience aching muscles and joints, as well as debilitating fatigue. (One area flu viruses generally won't attack, however, is the gastrointestinal tract. What commonly is referred to as "stomach flu" is far more likely to be infection with norovirus or a case of food poisoning).
Flu symptoms usually appear one to three days after exposure to the virus, and they might persist for up to two weeks. If they last longer than that, or if the coughing begins to produce a lot of phlegm, the original viral infection might have opened the door to bacterial pneumonia: a potentially serious or even life threatening complication.
The Flu Vaccine
Every year, a flu vaccine is created from live, weakened viruses, based on predictions about which types of virus will be most active. Because predominant viruses change quickly, the vaccine is only effective for a year. For the 2005/2006 flu season, the vaccine is being distributed only to high-priority populations until late October; then it will become available to the general population. It's available in an injectable form or as a nasal spray (although the spray is recommended only for people between four and 49 years old).
I'm not going to open the floor to a debate about vaccinations here; that is a completely personal decision, and each individual must weigh possible benefits and risks. The Centers for Disease Control and Prevention caution, however, that persons who are allergic to chicken eggs, who have a history of Guillain-Barre syndrome or who have had an extreme reaction to a previous vaccine should not receive the flu vaccine.
Avian Flu: What's the Difference?
The avian flu that made the news last year is an infection with a particular subset of type A virus, called H5N1. (Other subtypes infect birds as well, but they appear to be much less dangerous to humans). The "H" stands for hemagglutinins; the "N" stands for neuraminidase. These are surface proteins on the virus; every flu virus is classified by what type of H or N it is. Water birds (ducks and geese) particularly are vulnerable to H5N1, although they often don't die from it. They shed virus in oral and nasal secretions, and in bird droppings. Wild birds can spread the infection to domestic poultry it's far more likely to kill chickens than ducks and from that point humans might be exposed.
Here's where it gets tricky. Bird-to-bird transmission of H5N1 is easy. Bird-to-human transmission of H5N1 is harder, but not impossible; it has happened a few dozen times in Thailand, China, and Vietnam. Symptoms are similar to human flu, with the added risk of conjunctivitis and viral pneumonia, but the mortality rate among infected humans is very high, close to 50%. So far, human-to-human transmission of H5N1 is very rare indeed, and might have happened only a few times that we know of. That's because H5N1 doesn't have many of the properties that make viruses easily transmissible between humans.
But that could change, and that's what health officials are worried about. At this moment, researchers foresee two possible ways for H5N1 to become easily transmissible between humans:
How high is this risk? That depends on whom you ask. While some public health officials are talking about "a time bomb waiting to go off," others point out that we are much better prepared to deal with an aggressive infection like H5N1 today than we were the last time a threat with a similar scope (Spanish flu, 1918-1921) hit the scene. Specifically, we are better at diagnosing the problem and aggressively isolating infected people, which, as we saw with SARS (Severe Acute Respiratory Syndrome), can quickly and effectively contain the problem.
On the other hand, no vaccine for avian flu has yet been developed (although this is being worked on), and it turns out H5N1 is resistant to the two most common anti-viral medications we have available: amantadine and rimantadine. So, our ability to shorten the lifespan of the infection is limited.
Massage and Flu
A person with flu who receives a rigorous, circulatory massage might find themselves with a much more serious infection than they would otherwise have. A person who receives massage after the infection has peaked and is on the mend, might find that recovery comes more quickly. However, two cautions must be kept in mind. The first is that squeezing several days of recovery into one or two days might make the client feel sick again. The client should know this is a possibility. The second is that a person recovering from flu still might be shedding virus.
What about our own self care? Like it or not, massage therapists are role models for taking excellent care of our own health. This means eating right, exercising, and getting good quality sleep: we all know these measures are the most important parts of keeping our immune systems strong. I will add one final point: if you're sick, be sick. Stay home. Drink hot fluids, get some rest. Do yourself and your clients a favor by investing your time and energy into conquering your infection, not into hiding your symptoms.
For Next Time
I would like to continue our exploration of emerging and re-emerging infections with a discussion of pertussis: whooping cough. This disease, which can be quite dangerous for young children, is on the upswing for two reasons: incomplete childhood immunizations and the fact that the pertussis vaccine doesn't have the lifespan we once thought it did. So, adults who were assumed to be protected are not. I would be especially interested to hear from people who have had this or seen this infection among their clients or children. Write to me and let me know: what's on your table?
Until then, many thanks and many blessings.
Special thanks to David Jackson, Communicable Disease Surveillance Program Manager, Utah Department of Epidemiology.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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