resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
May, 2006, Vol. 06, Issue 05
Celiac Disease, Part 2: What Is Going on Here?
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
In the March issue (see www.massagetoday.com/archives/2006/03/16.html), I introduced the basic concepts behind celiac disease (also known as celiac sprue), a disorder involving an inflammatory reaction to gluten.When people with celiac disease eat gluten-containing products (which is hard to avoid in processed foods), the body launches an immune response that damages or even destroys the intestinal villi. This makes it impossible to absorb nutrients, not just from gluten-rich foods, but from everything else as well.
One point that came up in reader responses to part 1 of the article was a need to clarify the difference between wheat allergy and gluten sensitivity. A wheat allergy is an immune response to anything with wheat in it; this is typically rare, and is detected in infants and young children who experience inflammatory reactions when they include wheat products in their diet. Gluten sensitivity, by contrast, is a reaction to incompletely broken-down gluten in the GI tract. The symptoms are not immediate, and they are not limited to wheat products, because gluten is found in many other grains as well.
Symptoms and Complications of Celiac Disease
Celiac disease can be mild or severe, depending on the severity of the inflammation and the extent of damage to the villi. Very severe cases are diagnosed in young children as "failure to thrive," since the affected child can derive little value from food. More often, it occurs as a subtler problem that is easily misdiagnosed as irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, hypothyroidism, lactose intolerance, candida, depression, or other chronic, multi-system conditions. Some people don't develop symptoms until adulthood, often after a stressful trigger such as an infection, surgery or childbirth.
Signs and symptoms of celiac sprue usually are arranged around malabsorption and malnutrition. Pain, gas, bloating and diarrhea are common. Stools tend to be high in volume, oily and very foul smelling. Anemia, irritability, depression, osteoporosis and muscle cramps are other frequent signs or complications of celiac disease; any one of these can be traced to poor absorption of nutrients, including iron, B12 and vitamin D. Poor absorption of folic acid can lead to neural tube defects (i.e., spina bifida) in infants of pregnant women with celiac disease.
Other dangerous complications of celiac disease are associated with chronic inflammation in the GI tract: Adenocarcinoma or lymphadenoma are cancers of the small intestine linked to celiac disease. Non-Hodgkins lymphoma is another type of cancer with a statistical connection to this disease.
Research is underway that would create a drug to limit intestinal T-cell hyperactivity in the presence of incompletely broken-down gluten. This might eventually open the door to a less limited diet for celiac disease patients. In the meantime, the best treatment option is to avoid gluten in any form, which is a considerable challenge. Flour made from corn, potatoes, beans or soy can be used as a wheat flour substitute. Fruits, vegetables, fish, and meats (that are neither marinated nor breaded) also are gluten-free. It's possible to have a varied and well-balanced, gluten-free diet, but eating processed foods or at restaurants might be problematic.
The good news is that the majority of celiac disease patients who can avoid all sources of gluten for months or years heal completely, and achieve the complete rebuilding of their intestinal villi. However, a person with celiac disease must commit to a lifelong dietary adjustment to accomplish this.
Massage has some specific cautions in the context of gastrointestinal tract problems. Because many symptoms of GI problems (gas, bloating, indigestion, constipation) can be related to stress, many people find that massage, even if not administered directly to the belly, has a positive effect. Most of the time, this is wonderful, but not always. GI symptoms are notoriously vague. The complaints of a person with irritable bowel syndrome (a functional problem that, although painful and inconvenient, is not life-threatening) can be similar to the symptoms of a potentially dangerous problem, such as ulcerative colitis or diverticulitis. Therefore, if a person finds that massage relieves symptoms, even temporarily, an accurate diagnosis might be delayed. Massage therapists should encourage clients who report new or persistent GI problems to seek medical advice, regardless of whether massage temporarily relieves symptoms.
In relation to celiac disease specifically, massage has no direct impact on the health of intestinal villi. Consequently, massage can neither improve nor exacerbate celiac disease. However, its ameliorating effects can make the transition to a gluten-free diet easier to take - if you can't have chocolate cake anymore, at least you can have a wonderful massage!
For Next Time
I've been receiving inquiries lately about MRSA: methicillin-resistant staphylococcus aureus, the causative agent behind some difficult and stubborn skin injuries. Massage therapists exposed to this pathogen are at particular risk for spreading it to others. If you have experience with this condition, write to me and let me know: What's on your table? Until then, many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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