Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Fish Oil: A Key Component of 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?
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
November, 2008, Vol. 08, Issue 11
The Progression of Cervical Stenosis Toward Cervical Spondylotic Myelopathy (CSM), Part 3
By Dale G. Alexander, LMT, MA, PhD
Since beginning to describe the progressions of chronic dysfunctions last year, I propose that my research and intuitive extrapolations have tripped over many of the default settings of the human aging process.1 My instincts suggest that there are more progressions than what has occurred to me. Six appear to be clear.
I have already proposed and described how gallbladder difficulties may underlie many of the gastrointestinal difficulties and their somatic expressions that accompany aging.2 Included in part 2 of that series, the connection between the progression of gallbladder dysfunction and the emergence of type 2 or non-insulin-dependent diabetes mellitus was noted. In this present series, I am describing and postulating how many motor-coordination and chronic sensory complaints are likely to be associated with cervical stenosis progressing toward cervical spondylotic myelopathy (CSM).3
The other four proposed progressions include: osteoporosis, atherosclerosis (deposition of fatty materials in arterial walls), desiccation and dehydration, and senility (the cognitive decline associated with dementia and Alzheimer's). I plan to explore these in future articles, so I invite you to consider what other progressions may exist and either let me know or write about them yourself. Please send me a copy. Let's combine our profession's capacity for astute observation, our willingness to listen to our clients and, our collective common sense to make a lasting contribution to humanity.
One of the most reliable indicators that one or more progressions may be occurring is that a client presents with one or more chronic somatic complaints without a recent precipitating event. My clinical experience has repeatedly shown that for a large majority of clients, chronic difficulties are the "canary in the coal mine" of underlying degenerative progressions. These fly under the radar of medical testing because they take decades to undermine physiologic function until reaching a tipping point of degradation and clinically detectable expression. Understanding such progressions will add to our collective ability to assist clients to make more informed medical and lifestyle choices.
All of these subtle progressions contributing to declining capacity, function and pain have two common denominators: the body's capacity for delivering nutritious oxygenated blood and the length of time it takes for the return of venous and lymphatic fluids to deliver the raw materials so that the lungs and heart can make new blood. As massage therapists, facilitating the movement of bodily fluids is at the core of our training. We are uniquely oriented to assist our clients to maintain the quality of their lives as they age.
Returning to the progression of cervical myelopathy, let's begin with my own cervical MRI from the previous article. The process of having an MRI is fairly simple and painless, especially one that allows you to sit or stand. Reading the radiologist's report however, was more of an emotional experience than I had anticipated. Even though I have reviewed thousands of medical reports, to read one that described what is going on inside of my own neck was sobering yet very educational. Early detection translates into an increased field of choices for us all.
My report described C4-5, C5-6, and C6-7 as having moderate to severe disc compression with posterior bulging of the discs, one of which is impinging upon the left side of the thecal sac (the meninges). It also noted left-sided and right-sided foraminal narrowings (where the spinal nerves exit) between each of these vertebrae. The report certainly helped me to understand how and why my upper extremity pain and numbness could express itself on either side or bilaterally and why my left lower extremity has been more symptomatic over many years. There was no evidence of frank spinal cord compression, only the stenosis or pinching of the left-sided thecal sac at C4-5.
In a discussion with my personal physician, he noted that he has seen many such MRI reports that reflected more significant stenosis along with frank spinal cord compression, but without accompanying symptomatic pain or numbness; instead, the patient's motor coordination was generally more the presenting problem. I also requested that a retired radiologist take a look at the films to confirm what the report stated. His response was, "What are you going to do, Dale? You're 55; it's not bad enough for surgery." My response was a declaration that I was going to attend to the integration of my soul and personality, seek out excellent bodywork, refrain from working with my neck in extension and arms over my head, as I do trimming the tropical trees and plants in our yard, and seek out nutritional sources to quell the activation of the inflammatory process. "That makes sense," he concluded. He also noted that more information would have been obtained had the MRI been done with my neck in extension as this would more directly activate the cervical ligaments. So, do pass this on to any clients who might seek out such information for themselves.
When I subsequently asked an orthopedic physician who is a client and has had surgery for CSM himself for his opinion of my MRI results, he advised me that what he saw did warrant surgery. I didn't want to hear that. This is what our clients are very often faced with - real dilemmas with differing medical opinions. I took to heart my personal physician's distillation of the human condition from his many years of medical experience: "Clots and inflammation are what disable us leading to our eventual deaths." Thus, based on his advice, the course of action I am pursuing is to contain the inflammatory process through the use of prescription-strength omega-3 salmon oil, baby aspirin and over-the-counter anti-inflammatory medication at the first sign of an escalation, and regulating more judiciously the number of hours I work each day in my clinic. This approach has reduced my daily upper extremity pain and numbness dramatically.
I am pleased that I followed my instincts in seeking out more information. I consistently offer this caveat to clients: "If you don't look, you don't know." Medical tests have their place and they are not always conclusive. However, with additional information we all have more perspective from which to make a choice.
Based on my research thus far, my current guidelines for encouraging clients to explore a surgical option for CSM include the following somatic profiles (individually or in combination): unrelenting upper extremity/neck pain or numbness, atrophy of the deltoid muscle group or muscular hand wasting (usually associated with the muscles of the thumb or the central portion of the palm), the development of an ataxic gait pattern (a clumsy and jerky walking style), and an escalating frequency of urinary or bowel urgency or episodes of incontinence. This last symptom is the one that slides under the radar for many.
It is important to consider that more than one degenerative progression may simultaneously co-exist in the same body. This was the case for both of the clients with CSM for whom I was unable to stem the tide of its progression. One was a male client who has been chronically overweight for years and I suspect has gallbladder dysfunction and/or progressed into a pre-diabetic state. For the other, a female client, her osteoporosis had insidiously accelerated despite her best efforts to track it with periodic bone density tests.
Researching this progression has been a humbling and rewarding personal and professional experience. Humbling to experience the "zone of limits" that my genetics and trauma history may be signaling in my own aging process. Rewarding in the vast appreciation for how well our bodies do adapt overall and in the realization that the progression of CSM is truly a broad symptomatic continuum that affects some more than others, both functionally and clinically across a wide spectrum of somatic expressions.
In my next installment of this column, I will touch on the issue of gender and CSM, and finish up by discussing my studies of CSM.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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