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A Simple Protocol for Holiday Stress
It's winter, a time when we should be deep in reflection, eating warming foods and sleeping long hours. Following nature's rhythms, we restore our bodies and minds in preparation for the renewal of spring.
6 Steps to Make 2017 Your Best Year Yet
People often ask me what defines success. Success, for me, is simple: doing exactly what you want to do in life. Whether it's the kind of practice you run, your life at home, your hobbies or something else, it's achieving anything you put your mind to.
Meshing TCM With Environmental Pediatrics: Where's the Overlap?
Pediatrics has a long history within Chinese medicine dating back to the late Han dynasty (i.e., the late 200s CE), with the two primary areas of emphasis being herbal medicine and xiao er tui na (pediatric massage).
DVT: Know the Signs and You Could Save a Life
I lost a friend several months ago. He died from a pulmonary embolism (PE) secondary to a deep-vein thrombosis (DVT) that originated in his lower leg. Bobby was in his mid-60s, soft-spoken and had a big heart.
Southwest Acupuncture College Brings It to Division 1 Athletes
When Michael Phelps' photograph with the distinctive round marks left by cupping went viral, the Division 1 student athletes treated through the Dal Ward Athletic Center at the University of Colorado (CU) could relate.
Can a Multivitamin Reduce Breast Cancer Recurrence?
There is a great deal of controversy regarding the value of multivitamin supplements in cancer prevention. However, with respect to preventing breast cancer recurrence, an important study was published in the Journal of Breast Cancer Research and Treatment in 2011 by Kwan ML, et al.
Another Chance to Make a Difference
Just a few months ago, "the worst natural disaster to strike the United States since Hurricane Sandy" hit Louisiana. During this storm, one area experienced 31 inches of rain in 15 hours as almost 7 trillion gallons of water rained down in just one week across the state.
Dedicated to Defending Chiropractic
Whether you're a veteran DC or a first-trimester student, the name George McAndrews should be part and parcel of your professional vernacular, as familiar as the word chiropractic.
A Letter to the Profession from the New President at AAAOM
Volunteering for a national, nonprofit organization brings with it such highs, lows, and accomplishments, as well as a steep learning curve.
Herbs for Digestion: The Power of Bitter
Many cultures (and indeed herbal clinicians) around the world have long respected the role of bitter herbs and foods for promoting digestion. For example, aperitifs – drinks consumed before a meal to stimulate appetite and digestion – were originally derived from bitter herbs.
Overuse Injuries in Young Athletes (Pt. 2)
Most overuse injuries are benign, but there are some high-risk injuries that, if unrecognized or inappropriately treated, can result in significant loss in time from the sport or even require leaving the sport.
Assessing Core Stability and ROM: 5 Basic Checks
One of the first steps in addressing core stability is assessing static posture, ranges of motion, and motion of the pelvic bones, sacrum, femurs, lumbar spine and thoracic spine.
News in Brief
New President / CEO Takes Office at Yo San University. Electroacupuncture for Constipation?
A First for the Profession: CCE Accredits First Chiropractic Residencies
The Council on Chiropractic Education (CCE) has awarded accreditation to all five chiropractic residency programs currently administered at Veterans Administration facilities, "the first residency programs in the nation ever to be awarded this distinction, a significant advancement in the evolution of chiropractic education," according to a VA press release announcing the milestone.
Molecular Motors: Tiny Machines Behind the Rhythm of Life
In the clinic, we aim to restore healthy patterns of movement for qi that has gotten trapped or misdirected, or may have even collapsed. We may be focused on freeing stagnation, releasing heat or redirecting counterflow qi, but it often comes down to helping re-establish a flow of sorts.
Little Sticker, Big Impact
It's the end of an election year. Hilary Clinton and Donald Trump were the subject of conversation for everyone, everywhere for the entire 2016 calendar year. I don't think any of us can deny that this election affected us all very deeply on a personal level.
Chiro School Reunion: Whatever Happened to...?
I opened the door to the closet slowly, carefully, since I knew it contained a large number of precariously stacked file boxes. It also held numerous outdated gizmos with electrical cords of various lengths that could trip or strangle a person.
A Q & A About Updated Codes
Yes, indeed there was an update to ICD-10 on Oct.1, 2016. This is a regular update to the diagnosis coding system and this type of update will occur every Oct. 1, just as it did when the ICD-9 system was in place.
2016: A Year in the Life of Acupuncture
Happy Holidays, may you, your family and friends have peace, joy and blessings throughout this special time of year. As 2016 comes to a close, we can look back and celebrate the many events and accomplishments for the profession of acupuncture.
All Fiber Is Not Created Equal
Sometimes the best place to start is at the end. So, the conclusion of this article is that all fiber is good ... but some fiber is better. Let's break it down. There are two main types of fiber: soluble fiber and insoluble fiber.
What We Can Learn From Spine Surgery
Patients with lumbar stenosis presumably present for conservative care to improve their quality of life and avoid surgery. However, providing clear guidance to these patients can be difficult for a number of reasons.
Branding: Set Your Practice Apart
Dr. Brad started his practice seven years ago on a shoestring budget. He created his generic logo in five minutes using a website because he didn't have the time to figure out how to make something special.
March, 2008, Vol. 08, Issue 03
When Is It Safe to Treat a Patient Taking Antibiotics?
By Charlotte Michael Versagi, LMT, NCTMB
Patients often arrive at a massage therapist's doorstep after a recent hospital release, recovering from bronchitis or another "bug." During intake, we discover they are taking some form of an antibiotic. Upon hearing these words from a client or patient, a red flag needs to pop into the therapist's consciousness. This isn't always a contraindication, but ingesting antibiotics presents certain precautions and demands certain questions are answered before proceeding with the massage treatment.
To clarify up front, in this article, massage treatment is defined as standard, full-body, Swedish-style massage consisting of effleurage, petrissage, some range of motion, perhaps some tapotement, etc. We are not referring to lymphatic drainage, energy work or other forms of bodywork. Those modalities are performed after advanced training and affect the body slightly or significantly different than normal Swedish massage.
First, what is an antibiotic? Antibacterial agents usually are called antibiotics. These medications cause irreversible and lethal damage to a bacterial pathogen or at least create bacteriostasis, inhibiting bacterial growth. You've heard of the common families of antibiotics: the penicillins, tetracyclines, sulfonamides and cephalosporins.
Here are some questions to ask when your client informs you they are on antibiotics. Why are they taking the medication? When did they start taking it? Are they suffering from an infection? Is the infection systemic or local? Do they presently have a fever? If so, is it spiking or is it low-grade? And at this point, you may be thinking to yourself, "What's the difference between inflammation and infection?" and "What effect will my massage have, based on the answers my client just gave me?" Our concern, as always, is safe treatment.
Let's clarify some definitions before discussing your treatment. An infection, according to Stedman's Medical Dictionary, 28th Edition, is an invasion of the body with organisms that have the potential to cause disease. Our own Ruth Werner tells us inflammation is a tissue response to the threat of bodily injury or invasion by antigens. The response is controlled by chemical, cellular and vascular functions. It's a chain of events; a reaction of injured tissue to defend and protect the body from invasion. The aim is to get rid of the pathogen, prevent the spread into the body (a massage therapist's primary concern) and prepare the injured area for healing.
Now prepare yourself for a generalization here, but it will help you with your treatment decision. Antibiotics most often are given to fight infection, something that is systemic or carries the threat of becoming systemic (although some infections can be quite local). Steroids and some other medications often are administered for inflammations; a problem we normally think of as local, yet sometimes is systemic.
You remember the cardinal signs of local inflammation, right? Redness, heat, swelling, pain and sometimes, lost function. The point is to help you intelligently understand what you are treating before you proceed. Does your client suffer from a local inflammation/infection (e.g. infected tooth socket after wisdom tooth removal) or are they taking antibiotics prophylactically before a procedure? Have they been diagnosed with bronchitis and started antibiotics three days ago? Do they have a fever of unknown origin and the doctor is simply experimenting with an antibiotic to try to allay symptoms?
Now let's put two and two together. You learned in massage school that one of the primary effects of massage is an increase in circulation, right? OK, if a one-hour massage is going to increase circulation, you must be as sure as you can about exactly what you are sending through that body. Are you potentially spreading infection or are you helping with waste removal and lymph flow to assist the body's fight toward health? The effects of massage are vast and wonderful; just keep reminding yourself that one of those effects is vascular. With infection and inflammation, you are dealing with the body's vascular (and immune) response.
As for the answer to the question of whether to treat a client, according to Werner, acute inflammation is a contraindication for circulatory massage. But massage may be appropriate for subacute conditions. (Think of a twisted and swollen ankle, for example. No massage therapist in their right mind would massage locally, but effleurage proximal to the injury, as well as massaging the rest of the body, would be completely appropriate.)
The mantra I learned in massage school was: "An antibiotic has to be taken for three full days for the patient to achieve a blood level (of antibiotic) before a massage can be safely given." Although this is generally sound advice, Jane Brown, director of the 1,000-hour massage program at Carnegie Institute in Troy, Mich., reminds us, "All antibiotics have different saturation levels in the blood; so although the three-day rule holds most of the time, you never really know which antibiotic has reached its height of effectiveness and when."
Jen Green, a naturopathic doctor and researcher practicing in Shelby Township, Mich., offers massage therapists a holistic view of treating patients who are taking antibiotics: "Antibiotics generally help control the bacterial population. But tell your massage therapists that the antibiotics are not doing the whole job - the immune system is still working. It needs a boost to work effectively and massage gives it that boost. I'd agree with waiting a couple of days (from the onset of taking the medication) to begin massage but after that, it would help the patients to stimulate the immune system by increasing circulation." Dr. Green continues, "Antibiotics, too, have a bacteriostatic effect; they can keep the bacteria from growing - but the body has to move. Increased blood and lymph flow helps get the problem out of the system."
It is probably safe to treat your patients after they have been taking antibiotics for two or three days and are manifesting none of the cardinal signs of heat, fever, swelling or pain. Remember, ask all the right questions, determine in your mind exactly what effect your increasing circulation will have on the body, and then proceed with intelligence and compassion.
Charlotte Michael Versagi is a medical journalist, national speaker and educational director of the School of Oncology/Hospital Massage in the Beaumont Hospital system in Michigan. Her private practice focuses on oncology patients.
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