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The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
CMT & Stroke Risk: Myth vs. Fact
By now, most of you have probably heard that the American Heart Association recently published a statement regarding the association between cervical dissection (CD) and cervical manipulative therapy (CMT).
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
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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