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The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
July, 2006, Vol. 06, Issue 07
Methicillin-Resistant Staphylococcus Aureus: A Moving Target
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Last time, I promised to look at an emerging condition: MRSA, or methicillin-resistant staphylococcus aureus. This is based on several communications, including this one from a massage therapist in the Northeast:
Anyone who works in a hospital setting probably is already familiar with methicillin-resistant staphylococcus aureus, or MRSA, but this pathogen is now being found in community settings. Since we work so closely with people, it's in our best interest to be well-educated about this bug.
What Is MRSA?
Staphylococcus Aureus (named staphyle, Greek for grapes, and aureus for its yellow color under a microscope) is a group of bacteria known for colonizing human skin and nasal passages. Staph has two mechanisms to cause damage to humans: active tissue invasion through the building of abscesses, and the release of corrosive toxins that can kill cells. MRSA is an antibiotic-resistant form of staph that usually colonizes the skin, respiratory tract, or urinary tract. It's estimated that about 1 percent of the population carries MRSA.
We all know that bacteria can be transmitted from one person to another, but they also can be transmitted from one area to another within the same person. In other words, if a child wipes his nose and then scratches his scabbed knee, it's possible his knee injury could develop a staphylococcus infection. Further, once such an infection is established, it's possible for the staph bacteria to travel through the bloodstream to set up infections elsewhere. Pneumonia, bone and joint infections, heart valve damage and varieties of toxic shock syndrome are all possible complications of superficial staph infections. These are particular risks for people who already are immune-compromised.
MRSA has been a relatively common nocosomial (hospital-based) infection since the 1950s, but in the past several years it has been identified in nursing homes, outpatient treatment centers, prisons, athletic facilities, and others; these outbreaks are called community-acquired infections. MRSA is considered an emerging disease because it's easily communicated from one person to another, and its incidence is rising quickly. It has been identified in about 12 percent of all cultured boils outside of hospital settings.
Signs and Symptoms: Community-acquired MRSA infections usually are picked up through skin-to-skin contact, cuts and abrasions or contaminated surfaces. They often look like a boil or spider bite: a single pustule that is large, red and might be mildly to extremely painful. Fever and fatigue might accompany the lesion, which gets progressively worse. It does not respond to topical or oral applications of methicillin, penicillin, oxacillin or amoxicillin.
Treatment Options: Treatment for MRSA requires long doses of antibiotics that are not in the penicillin family. Infections can recur if antibiotic treatment is not completed. MRSA currently is sensitive to vancomysin, but vancomysin-resistant bacteria have already been observed in some settings, and the crossover from MRSA to vancomysin-resistant staph is a distinct possibility. In addition to antibiotic prescriptions, MRSA infections might be lanced and drained. Pain usually is managed with NSAIDs.
The continuing evolution of this and other pathogens makes prevention of infection vitally important for any person who comes in close contact with other people. Preventive measures include washing and carefully covering all open sores, avoiding picking at or touching open sores, not sharing any personal items like towels or razors, and disinfecting all surfaces touched by many people.
The recommended protocols to prevent the spread of MRSA are the same as those to prevent the spread of any contagious condition: observe standard precautions by covering any skin lesions, and cleaning all surfaces and fabrics that clients contact.
Any client with an undiagnosed skin lesion, especially if it's inflamed, painful and showing signs of infection (i.e., pus), should consult his or her primary care physician before getting massage. Certainly, if a boil-like lesion is accompanied by fever and malaise, the massage needs to be rescheduled and the client should be counseled to see a doctor. MRSA is a contagious and potentially dangerous bacterial infection that must be cleared before any modality that moves lymph or blood increases the risk of spreading infection.
Massage therapists who develop boils themselves and worry about whether they've been exposed to MRSA would be well-advised to consult their doctors, too. As long as the therapist is treating his or her diagnosed infection appropriately (this means taking the correct antibiotics exactly as prescribed), and as long as any lesions are carefully covered and not in an area that comes in contact with clients, giving massage is safe.
One resource available to people with concerns about contagious diseases is your local hospital. If you call and ask for the infection control department, they will connect you with a person whose job is to answer exactly these kinds of questions. Whenever I have done this I have left messages and received a call back within a day. This is a wonderful community resource and I encourage everyone to use it!
For Next Time
I've been on a communicable disease track for a while. In the past several issues, I have written about avian flu, whooping cough, and now MRSA. I am content to stay here: I could do a piece on meningitis, or mononucleosis ("kissing disease"). Or, we could pick up a new thread with a common, stubborn chronic skin condition: psoriasis. It's up to you - let me know, what's on your table?
Many thanks and many blessings.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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