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"Doctor ... Always Do the Right Thing"
So says "Da Mayor" in the iconic Spike Lee movie. As a fresh grad questioning in-network versus out-of-network, it struck me that some doctors have explicitly skirted the issue, while others have argued adamantly for the latter and "sticking it to the man."
Don't Trust What a Patient Says
When a patient presents to the office for care, they typically have a specific complaint in mind – lower back pain, whiplash, sinus congestion, sciatica, etc.
News in Brief
D'Youville Vet Program Gets High Praise; A Moment of Silence for Dr. Paul Reginald ("Reg") Hug.
Vibrational Medicine: Frequency Micro-Current and Color Acupuncture
Vibrational medicine involves the application of various forms of energy frequencies to the body for pain relief, healing and rejuvenation. Vibrational medicine will become a major growing trend in our medical systems for the following reasons:
We Get Letters & E-Mail
Imagine What More Could Be Achieved With Your Support; A Lesson in Hygiene: What Do You Do in Your Office? Open Letter to the Profession.
The Importance of Knowing Mainstream Lingo
There is a secret lingo within mainstream medicine of which the vast majority of acupuncturists and Chinese medical professionals are unaware.
Shared Mechanisms Between Computer-Assisted Mechanical Adjusting and Contemporary Acupuncture?
Can contemporary acupuncture provide clues to the mechanisms responsible for pain relief provided by computer-assisted mechanical adjusting instruments, and clarify whether certain mechanical frequency combinations are superior to others for modulation of acute peripheral pain?
The Boston Benevolent Chiropractic Clinic: Standing Up for the Needy
Our chiropractic assistant, Bridget, greeted an arriving patient at the Emmanuel Church in downtown Boston. She said, "Hi, Michael, good to see you. It's been awhile. Have a seat and Dr. Ken will see you soon."
Medial Knee Pain: 11 Potential Causes (and Corrections)
We have all seen patients with medial knee pain that either has no traumatic origin or lasts well beyond when it should be resolved. How can we help these patients? Here is an overview of clinical scenarios and how we can provide conservative care.
CRREW Rallies for Ongoing Acupuncture Relief Effort in the Philippines
On November 8, 2013, Typhoon Yolanda (Haiyan) made her way through the Philippine Islands, leaving in her wake at least 7,000 people dead, millions homeless and complete communities destroyed.
Home Sweet Medical Home
While the Affordable Care Act (ACA) has received its fair share of praise and criticism since its adoption, few question the value of its emphasis on collaborative, patient-centered health care.
Medical Qigong for the Heart: Part I
According to the Center for Disease Control and Prevention, heart disease is the leading cause of death in the United States, affecting people of all ages and backgrounds. Coronary heart disease, in just the United States alone, costs close to 109 billion dollars a year.
The Search for the Origin of the Wiggle Technique
When Bob had adjusted me previously, most of the time I knew what he was doing. But this time, he had me lie on the treatment table in the usual side-posture position, and he "wiggled" my sacroiliac with the fingers of both hands, while stabilizing my pelvis with his forearm.
New Leadership Era at the WFC
The World Federation of Chiropractic recently announced not only a new president, as is customary every two years, but also an incoming secretary-general, marking the first time since the WFC's inception in 1988 that someone other than David Chapman-Smith, Esq., will serve in that capacity.
Halt Allergies With Moxibustion Therapy
An allergy is an immune system disorder in which the body is hypersensitive to normally harmless substances in the environment.
Low Melatonin Linked to Risk of Advanced Prostate Cancer
Epidemiological and experimental studies suggest the hormone melatonin, which plays a role in regulating the sleep-wake cycle, may play a role in the development of prostate cancer, as lower melatonin levels have been associated with an increased risk of prostate (and breast) cancer.
Deciphering the New CMS-1500 Claim Form
Q: I am confused about how and when to use the new 1500 form, particularly block 14 and block 15. What is required and how do I properly fill out these fields? And do I actually have to use this new form or may I continue using the old version?
Employers Need Chiropractic First and Sooner
From the Journal of Occupational and Environmental Medicine comes a study that gives excellent direction to employers (and insurers) regarding the management of low back problems (LBP).
Replenishing and Restoring Jing
I learned an important principle from my great Taoist Master Sun Hak. He taught me that all people "leak" Jing, and that we can mitigate or stop this leaking, and as a result strengthen our life force, develop enhanced adaptability and lengthen our life.
News In Brief
Pacific College of Oriental Medicine obtains grant funding from NIH; Yo San University of Traditional Chinese Medicine Announces New President; Kentucky Gets Licensed; PCOM Receives Approval from WASC to Offer FPD.
Wellness: A New Buzzword at the Aging in America Conference
Aging in America is "the nation's largest gathering of a diverse, multidisciplinary community of professionals in healthcare, social service, government, business and philanthropy with expertise in providing services and products for older adults."
Changes in Herbal Medicines from Ancient Times to the Present
The classical literature of Chinese medicine remains highly relevant in the modern era, as many of the basic theories and herbal combinations emphasized in clinical practice were first established in texts that are nearly 2000 years old.
Don't Trust What Your Patients Say
When a patient presents to the office for care, they typically have a specific complaint – lower back pain, whiplash, sinus congestion, sciatica, etc. They are often not interested or engaged in what they consider "unrelated" personal health history.
Working With The Yuan-Source Level: Resonance and the Extraordinary Vessels
How do we stay fresh with our medicine? As healers, how do we balance our medical selves with creative artistry? Chinese Medicine is not a fixed dogmatic entity, but a living system, reliant on a mysterious force called "resonance."
January, 2008, Vol. 08, Issue 01
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
Happy New Year! I hope your holiday season has been peaceful, fulfilling, inspiring and rejuvenating to help get you through winter's months ahead.
After a prolonged departure from my usual "What's on Your Table?" fare, we return today to a discussion of a particular pathological condition - one that several practitioners have requested more information about - post-polio syndrome (PPS). Polio itself is almost an anachronism; but to understand PPS, we need to revisit a few key features of this infection.
Poliovirus is a pathogen spread most efficiently through oral-fecal contamination. When a person picks up some virus through contaminated water, it concentrates in the gastrointestinal tract and the feces. If any symptoms develop at this time they include high fever, aches, headache, nausea and diarrhea (which helps spread the virus), and then for most people the infection is completely over. Less than 1 percent of all people exposed to poliovirus in this way progress to develop a second-tier infection. The motor neurons begin in the ventral horn of the spinal cord and control muscle function. The resulting destruction to motor neurons leads to muscle atrophy and paralysis. This often occurs in the lower extremities, but a particularly serious form of the infection affects breathing muscles. (One interesting mystery about polio is that we have never figured out how the virus migrates from the intestines to the central nervous system.)
Even with such a low rate of serious infection, polio traditionally has been viewed as a significant public health threat. After all, if 1,000 children swim in a contaminated lake or drink from a contaminated well, this means 10 could become partially paralyzed. And because young children are especially vulnerable, this disease has also been called "infantile paralysis."
People familiar with the history of massage may remember that Sister Kinney, an Australian nurse, pioneered the use of hydrotherapy and intense rubbing to help her polio patients recover some muscle function in the 1930s before polio vaccines were available.
The good news for us is that wild polio (polio that is not connected to a vaccination series) is practically extinct. The last recorded case of wild polio in the Western hemisphere was in Peru in 1991; the last case in Europe was in 1998. As of 2003, wild polio was endemic to only India, Pakistan, Nigeria, Niger, Afghanistan and Egypt. One of the consequences of the extremely successful world-wide polio eradication program is that a bodywork practitioner working in the U.S. today is extremely unlikely to have a client with an acute polio infection. However, we estimate that some 440,000 people in the U.S. had polio infections during childhood and these people are vulnerable to a long-term complication related to the virus: post-polio syndrome.
Post-Polio Syndrome: No New infection!
When a person develops polio-related paralysis, some of his or her motor neurons have been destroyed and the muscle cells those neurons controlled are likewise prone to atrophy. However, remaining functioning nerve cells have a tendency to develop new axon tips to support some muscle fibers. In other words, the motor unit (a single functioning motor neuron and all the muscle fibers it supplies) becomes larger. Over the course of years, this can lead to cumulative fatigue, stress and wear-and-tear both on the overworked motor neurons and on the under-stimulated muscle cells. The result is that anywhere from 10 to 40 years after an initial polio infection, a person may experience a sudden onset of symptoms that include muscle weakness, pain, breathing and sleeping problems, and debilitating fatigue; this is PPS.
It's important to emphasize that while a polio survivor has new symptoms, often with a sudden or specific onset, PPS definitively is not a resurgence of the virus as a new polio infection. It's simply the result of decades of overuse of tissues that have limited capacity for growth and adjustment. The most typical pattern for PPS is that a middle-aged person who had polio as a child develops the symptoms listed above and the symptoms tend to run in cycles: During flares the person loses function, and during remission the person is stable, but may not regain lost function. People most at risk are those who followed their original polio infection with a rigorous and aggressive physical therapy program to rebuild strength in damaged muscles. We see now that the nervous system can't keep up with long-term demands in this way.
Massage for Post-Polio Syndrome
Polio itself involves motor paralysis but no sensory deficit. This makes it safe for bodywork, since the client can accurately report how intense or safe the pressure feels. Post-polio syndrome is the same: it involves pain and weakness related to neuromuscular dysfunction, but the pain is not related to any attack or inflammation of sensory neurons. Furthermore, numbness is not a reported symptom of PPS. Typically, people with this condition are counseled to adjust their posture and movement patterns to take advantage of their strongest muscle groups, rather than the ones that were damaged and then overworked after their infection. This may mean using or adapting tools like braces, crutches or canes. Massage certainly can help in this area to de-stress overworked areas and to support and refresh muscles that are newly being pressed into service. Massage won't eradicate the problems behind PPS, but by focusing on taking the workload off the weakest muscles and supporting the strongest ones, bodywork can be part of a helpful coping strategy for our population of polio survivors.
I've had some interest expressed in exploring polymyositis: an autoimmune disease that affects muscle function. If you have experience working with clients who have this condition, be sure to share. 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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