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News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
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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