Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Online Marketing Basics: Website Creation
The various online marketing options make it a challenge, especially when all you want to do is help your patients feel better. With such a broad topic, I'm going to share some basics you should know about website creation.
Exercise Recommendations for Healthy Aging
Aging is inevitable, but how you age is not. Common physical signs of aging include decreased muscle mass, decreased muscular power, increased body fat, and decreased aerobic (lung) capacity.
Healing the Core: AWB Nepal Earthquake Relief Project
With almost 9,000 people killed during the earthquakes in April and May, another 23,000 suffering injuries, hundreds of thousands left homeless when entire villages collapsed, and many sacred sites destroyed, no one in this country of approximately 28 million has been left untouched by the disaster.
Relationship Marketing: A Modern Approach
Remember when you used to get real letters in the mail? Not the automated type, but the real deal, hand written with a personal message just because someone was thinking about you? You know what I'm talking about.
An Unexpected Superfood: All About Eggs
About 40 years ago, excessive dietary cholesterol was labeled a public health concern. Specifically, it was thought that there was a causal link between consumption of cholesterol-laden foods and increased risk of heart disease.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 1
All humans, by the very nature of being human, will experience moments of trauma and suffering. What, then, makes the difference in how the individual who experiences trauma, suffering, and spiritual loss reacts to such experiences?
Integrative Sports Medicine
One of the most rewarding and challenging clinical scenarios is the treatment of athletes.
Acupuncture Treatment of Trauma in the Canine
From 1972 until 1976, John Ottaviano and I were treating dogs at five different veterinary clinics in the Los Angeles county area. Usually, we were at a clinic for seven to eight hours.
What to do When Today Sucks
Have you ever had one of those days when nothing went the way it should have? The patient with migraines got worse instead of better from a treatment similar to one you've effectively used on him before.
Fish Oil: A Key Component to Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Patient Retention Techniques
When talking about techniques to grow your business, we tend to focus on the "large" aspect of the patient base, that is, on strategies to attract new patients. However, it is important to remember that "loyal" is equally, if not more, important.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
ASA Ready to Impact Profession
The American Society of Acupuncturists (ASA) is a 501(c)6 (pending), not-for-profit collaboration among state based, acupuncturist professional associations.
Preaching to the Choir: How to Extend Our Reach Beyond the CAM Community
Professional conferences offer unique opportunities to network, be exposed to cutting-edge innovators, share your interests and work, and be inspired.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Learning the Transformative Language of the Channel System: The Sinew Channels
The Chinese medical classics describe the energetic terrain of the body in much detail. The acupuncture channel systems, as presented in the Ling Shu illustrate the various expressions our qi energy can take.
It's Time to Wake Up
It is time for this profession to wake up and tell someone about the healing benefits of acupuncture. This is the time for Asian Medicine. Its popularity, growth and unusual acceptance is nothing short of amazing.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
The Ethics of Herbal Prescribing
While teaching ethics classes, I often encounter licensed acupuncturists who are surprised that our use of herbs and supplements has a specific section in the material. It is often an aspect within ethics that clinicians don't think of in practice.
Teaching Qi Gong to Children
Many of us have come to embrace Qi Gong or Tai Chi practice as a regular part of our lives. Qi Gong has been a stabilizing factor in my life for the last twenty years.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
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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