resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
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.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
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.
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.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
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.
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.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
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.
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?
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.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
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.
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.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
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.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
June, 2007, Vol. 07, Issue 06
Glimpses of the Big Picture: Leptins
By Leon Chaitow, ND, DO
The topic covered in this article is relevant to practitioners of all disciplines, particularly those who are providing health care services to people who suffer from conditions as diverse as chronic inflammatory conditions, autoimmune diseases, neuropathic pain, obesity, diabetes, thyroid hormone resistance (e.g., unexplained hypothyroidism), many cardiovascular diseases, syndrome-X, food cravings ...and more. Before getting to the unlikely link that can connect these apparently unrelated diseases and conditions, a background setting is called for.
An image I like to use when explaining contextual issues in relation to health is that of an iceberg floating in the ocean. The visible portion of the iceberg - perhaps 20 percent of its total mass - simplistically can be seen to represent those aspects of the patient that we observe, palpate, assess, discuss and evaluate. These divinations result in a greater understanding of the unseen inner workings of the patient - equivalent to aspects of the unseen, underwater portion of the iceberg.
And then there is the ocean itself, in which the ice mountain floats. In relation to the iceberg, this would include elements such as the relative salinity, temperature and pH of the water, as well as the weather, currents and more. In relation to the patient, the context includes multiple influences - environmental; psychosocial, biochemical and biomechanical; past and present; intermittent and constant; acute and chronic - that affect the individual from cradle to grave.
The complexity of such interacting influences, overlaid on the person's genetic and acquired characteristics, as well as the symptoms being manifested, often seem too daunting to make sense of. Hence, the reductionist approaches of so much of health care, whereby modifications of single aspects of this confusing edifice are attempted in order to nudge it toward more normal function. This may be done via diet, medication, nutritional supplements or herbs, needles, manual treatment, exercise, hydrotherapy, better breathing or posture, homeopathy, and many other options. Any of these interventions might modify etiological features sufficiently to encourage the self-regulating functions and systems of the body toward better health.
Lifestyle changes might be suggested that appear to offer more fundamental health-enhancing possibilities. Here, treatment is not a feature, but rather the initiation of changes that aim to align the individual more closely with evolutionary imperatives - offering a chance for homeostatic functions to operate more efficiently. Such changes might involve reforming nutritional, exercise, sleep and other basic behavior patterns.
Many such changes are common sense. Practical lifestyle modifications have been demonstrated to lead to profound influences on well-being and health enhancement. These suggestions range from more exercise, adequate sleep, balanced/reformed dietary habits (avoiding or modulating intake of high-sugar, high-fat junk food and stimulants such as caffeine and alcohol), as well as better breathing and relaxation methods. Other simple choices also are now available, backed by solid scientific evidence; much of it relating to hormones produced by white adipose tissue (fat), such as leptin.
The Leptin Story
I am grateful to Judith DeLany, LMT, with whom I have happily co-authored three books, for drawing my attention to the rapidly-evolving area of leptin research and putting together a summary for use in one of our revisions. Credit for collating a great deal of the information outlined below belongs to her. Recent research points toward basic lifestyle changes that can have profound influences on the evolution of diseases. Due to space constraints, I will outline only some of the most pertinent information, with appropriate references that can be used to expand on the summary below:
A simple plan has been devised8 to help regain normal leptin levels and thereby, balance the hormonal cascade discussed above. Although this plan may not be ideal for every one, it is presented here for the majority who it is suggested should benefit from its use. The foundation of the plan contains five basic rules. Breaking any of the rules or guidelines (below) can lead to setbacks.
Rule 1: Never eat after dinner, not even a snack or glass of wine or juice. Allow 11-12 hours between dinner and breakfast. Generally, finish eating dinner at least three hours before bed. This rule is designed to allow leptin, melatonin, cortisol and other chemicals to balance during the night. Individuals with night-eating syndrome have abnormal hormonal patterns apparently associated with nocturnal eating.9
Rule 2: Eat three meals a day. Allow 5-6 hours between meals. Timing is crucial, so that insulin levels can drop, glucagon (produced by the liver) can rise, and fat metabolism can kick in. If this occurs a couple of hours before more food is eaten, fat stores can be utilized until the next food is eaten. Snacking between meals sends the insulin back up and fat stores remain untapped. Therefore, snacks are to be avoided. Protein and carbohydrate portions are the size of the palm of the hand and most vegetables can be eaten as desired. Peas, carrots and corn are taken in moderation.
Rule 3: Do not eat large meals. Eat slowly and, if overweight, always try to finish a meal when slightly less than full. Eating slowly allows time for hormonal signals to reach the brain before overeating occurs. Smaller meals allow for better digestion. Do not overstretch the stomach and reduction in overall caloric consumption can be achieved.
Rule 4: Eat a breakfast containing protein. This helps set the hormonal cycles for day and night. Compromising this can have hormonal effects during the day and into the night, disturbing sleep. Weigle, et al.,10 showed that an increase in dietary protein from 15 percent to 30 percent of energy produced significant weight loss, presumably "mediated by increased central nervous system leptin sensitivity."
Rule 5: Reduce the overall amount of carbohydrates eaten. Unless one already is on a low-carb plan, chances are that too many carbohydrates are routinely consumed. Regarding carbohydrate influences, Garg, et al.,11 note, "Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5 percent increase in plasma triglycerides and a similar increase in [very low-density lipoprotein]-cholesterol levels; it also reduced levels of HDL cholesterol by 11 percent."
This brief summary suggests that eating regular, balanced (low-sugar, for example) meals, including a protein breakfast; avoiding snacking between meals and reducing overall carbohydrate intake; and getting enough sleep can beneficially impact a huge range of diseases, including those that involve excessive inflammation.
If you or your clients are overweight, suffering from inflammatory conditions and/or any of the long list of conditions mentioned by researchers investigating leptin, these simple changes could offer a way of beneficially influencing health. When they do, this represents an example of contextual health care, as discussed at the start of this article.
Click here for more information about Leon Chaitow, ND, DO.
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