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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.
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.
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.
Low Back Pain: Posture and Movement Analysis
When performing static and dynamic movement analysis of the lumbopelvic hip area, begin with standing visual posture analysis of the pelvis, and then perform lumbar range of motion and assess what you might see during normal versus abnormal lumbar flexion motion.
A Reality Check – and a Chance to Educate
Imagine working in the public relations department of nutrition retailer General Nutrition Corporation (GNC) and reading the The New York Times announce...
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."
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.
Primary Spine Care: Addressing Concerns & Criticisms
The Dec. 1, 2013 issue of Dynamic Chiropractic included an article describing the implementation of a training program for primary spine practitioners (PSP) within a metropolitan region and supported by a large BC/BS plan.
Interpersonal Skills 101: Enhancing the Value of Our Patient Interactions
Recently, I read an interesting article in our local newspaper titled "The Value of Human Interaction." The article presented comments from a senior editor for Fortune magazine who discussed "Civility in the Business World."
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!
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.
Atypical Femoral Fractures and Bisphosphonate Use: What to Watch For
Bisphosphonates (BP) are popular drugs, with more than 8 billion in sales in 2008; however, profits have declined as patents began expiring. Nonetheless, BP remain the most commonly prescribed drugs for patients at risk of osteoporotic fractures, with several million prescriptions written every year.
Impacting Chiropractic's Future With Technology
When it comes to electronic health records (EHR), Robert Moberg and Dr. Steven Kraus are two of the leading industry experts on the topic.
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.
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.
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.
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.
Avoid Random Treatment of Trigger Points (Part 2)
We must acknowledge that the fascia, which surrounds literally everything in our bodies, including every muscle fiber, is more than just a covering.
Help Update the LBP Practice Guideline
The Council on Chiropractic Guidelines and Practice Parameters has announced the release of an updated Clinical Practice Guideline for Chiropractic Management of Low Back Pain for stakeholder review and comment.
Expanding Access, Branch by Branch
The big news coming from Capitol Hill isn't merely the recent introduction of a pair of bills designed to expand chiropractic services in the Veterans Affairs and military health care systems; after all, similar legislation has made its way through Congress before, never reaching the Oval Office for presidential signature.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
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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