resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Help Save an Important Chiropractic Landmark
The chiropractic profession has a splendid and varied history. Sadly, many landmarks have been lost to bulldozers and wrecking crews, such as the Ryan Building, Little-Bit-O-Heaven, Spears Chiropractic Hospital, and Clearview Sanitarium.
Toxicity & Kids: The Importance of Environmental Intake
The old adage is true that children are not little adults. Traditional Chinese medicine (TCM) has long known that the physiology of children is unique, as are the diseases that plague them.
The Chiropractor's Guide to CRISPR
Science magazine's "Breakthrough of the Year" award for 2015 was described as "the gene-editing tool called CRISPR." CRISPR stands for "clustered regularly interspaced short palindromic repeats."
Insomnia Treatment Based on the Yu Theory
In recent years, acupuncture has risen in popularity as a form of alternative or supplemental medicine for the treatment of many different types of disorders.
The First (Only) Choice for Spinal Pain
The study on NSAIDs for spinal pain summarized on the front page of this issue is intriguing on a number of levels, the most obvious being the conclusion that "compared with placebo, NSAIDs do not provide a clinically important effect on spinal pain, and six patients must be treated with NSAIDs for one patient to achieve a clinically important benefit in the short-term."
Shedding Light on the Benefits of Heliotherapy
I can't imagine anyone not feeling good strolling in the sun on a beautiful spring day. The sun is responsible for all life on earth and is best illustrated along the equator touting the richest biodiversity on the planet, in stark contrast to the Arctic Circle and South Pole.
News In Brief
A "Modern" Business Model. Acupuncturists may have a new professional atmosphere to consider, as a new concept is on the horizon - at least for one business.
The Qi Focus: A Guide to Managing Stress
Stress, are you experiencing heightened stress levels? Your own, and your clients? Is Trumpitis getting to you? I recently polled a cluster of acupuncturists, Asian Bodywork Therapists (ABT) and psychotherapy colleagues on the issue.
Waist Circumference: A Conversation Starter (Part 2)
Now let's discuss the clinical approach to reducing WC and implementation in today's chiropractic practice. The primary intervention centers around dietary modification and lifestyle habits aimed to reduce adiposity, improve insulin sensitivity and ultimately, diminish systemic metabolic dysfunction.
5 Ways to Enhance Your Family Practice
Every practice has a personality style. A practice that caters to athletes, PI cases or adults, for example, projects differently to patients than a family wellness practice.
What's Bugging You? Probiotics and Your Health
An estimated 100 trillion microorganisms representing more than 500 different species inhabit every normal, healthy bowel. Gut-dwelling bacteria keep pathogens in check, aid digestion and nutrient absorption, and contribute to immune function.
Caring for Refugees in Greece
At the beginning of 2016 I had no idea what was in store for me, but I was looking forward to a personal retreat on the Greek island of Paros; a graduation gift to myself after 22 years of motherhood, and four-plus years of Chinese medicine school.
Good Works at the Canandaigua VA
Faculty and students of the Finger Lakes School of Acupuncture and Oriental Medicine (FLSAOM) of the New York Chiropractic College have provided acupuncture to veterans at the Veterans' Administration Medical Center (VAMC) in Canandaigua, New York since September of 2007.
Making Sense of Liver Regulation
In Chinese medicine, the liver has the function of moving and storing qi and blood. In its moving function, the liver smoothly distributes qi and blood to the tendons, muscles and flesh through microcirculation.
Scope of Chiropractic Practice: Why Now Is the Time to Expand
In my January article, "Scope of Chiropractic Practice: Is It Time for Change?" I discussed the use of the term primary spine care practitioner, the loss of privileges to diagnose in Texas, and the fact that the definition of "chiropractic" varied from state to state.
Chiropractic: A Great Fit for the White House
Dr. Eric Kaplan is a New York Chiropractic College alumnus; a No. 1 best-selling author whose books include Awaken the Wellness Within and The 5 Minute Motivator; a chiropractor for professional sports teams and elite athletes; and even served as an advisor under the Clinton Administration to the President's Council on Sports & Physical Fitness.
Give Your Patients the Ergonomic Advantage
Prolonged sitting contributes to low back pain and is a health risk. When I discuss my POLITE technique practice recommendations with patients, ergonomics may be last, but not least!
Treating LBP the Right Way: Think Natural
An updated clinical practice guideline from the American College of Physicians (ACP) recommends spinal manipulation and other non-invasive, non-drug therapies as first options for acute, subacute and chronic low back pain, rather than pain medications, as stipulated in the original 2007 guideline.
NSAIDs No Better Than Placebo for Spine Pain
A meta-analysis of randomized, placebo-controlled trials comparing the efficacy and safety of NSAIDs with placebo for spinal pain concludes that among 6,065 spine pain patients, "NSAIDs reduced pain and disability, but provided clinically unimportant effects over placebo."
How to Correct a Cuboid Subluxation
Cuboid subluxation is a poorly recognized condition, even though it is not uncommon. It has been described in the literature under various names: cuboid subluxation, cuboid syndrome, locked cuboid, dropped cuboid, cuboid fault syndrome or peroneal cuboid syndrome.
Treating the Terrain of Chronic Sinus Infections
Chronic sinus infections can be stubborn to treat, but the therapeutic path forward can be simplified when utilizing three distinct treatment principles which take into account the terrain of the body, and the way in which microbes grow.
January, 2009, Vol. 09, Issue 01
Anaphylaxis: A Sudden and Deadly Progression, Part 1
By Dale G. Alexander, LMT, MA, PhD
From the author: The purpose of this column is to provide our profession with a broad reference of anatomy and physiological science, which have guided my ability to assist so many with chronic difficulties. Understanding how the body works from the inside-out and how progressions from stress-related disorders evolve toward physical pathology allows us the opportunity to supply our clients with the best possible care.
The purpose of this two-part series is to raise our collective awareness as massage therapists of anaphylaxis progression that potentially can be prevented by asking your clients a few simple questions. On Aug. 31, 2007, I got lucky and survived a severe anaphylactic reaction. In July 2008, a dear friend's brother did not. I am introducing Dr. Thomas Walsh, DDS, as the co-author of this article, as his perspective on anaphylaxis was most helpful in assisting me to understand the full scope of this progression.
Anaphylaxis can exhibit a sudden, rapid, and deadly progression. Such systemic allergic reactions typically become progressively more severe with each additional exposure to an allergen. However, even the second exposure can be fatal if an individual has had a sensitization experience.1 Acute anaphylactic shock which results in death is most often associated with the ingestion of peanuts for children and penicillin for adults or, as a result of an insect venom for all ages.2
There are two primary important questions to ask your clients that seem most relevant to Dr. Walsh and myself. First, have you ever had any severe allergic reaction in which you have experienced one of the following: itching and hives over much of the body; swelling in the throat or tongue; difficulty breathing or swallowing; dizziness, severe headache; stomach cramps, nausea, or diarrhea; rapid decrease in blood pressure; or shock and loss of consciousness?
The second most important question is whether or not they had a previous exposure to a suspected allergen without any reaction. Remember that penicillin, peanuts and insect stings tend to be the most deadly, but other triggers of anaphylaxis do exist. The third question is if they have told their physician about their reaction and requested testing to determine the severity of their allergy.
My most important lesson from Dr. Walsh has been the notion of a sensitization experience. I had such a sensitization in February 2007, during a dental cleaning at another dentist's office. My internal sensations included a sudden onset of severe itching spreading throughout my vascular system, my face turned bright red and became puffy, and my hands and feet swelled to the point of mild discomfort. My dentist administered 50 mg of benadryl by mouth, and a hygenist sat with me for 50 minutes while the symptoms gradually subsided.
In discussion before I left the dentist's office, we speculated about what might have been the trigger for my reaction. Since nitrous gas was being administered, an iodine solution was used, and I had requested amoxicillin because of my genetic heart history, it was unclear what might have been the specific reactive cause. My dentist instructed me to seek out allergy testing to make this determination.
I was able to make the 40-minute drive home and finish my afternoon schedule of three clients. Though quite tired that evening, I mentally and emotionally minimized the experience because there were no lingering effects over the next few days. Still, I was curious, so the next weekend, I consulted a couple of physician friends who specialize in emergency medicine. Neither seemed alarmed by the description of my symptoms, noting that if 50 mg of benadryl had been effective, they considered it a relatively mild reaction.
The key question that could have been the focus of our discussions was whether or not I had a previous allergic reaction to anything. I have taken penicillin and its antibiotic derivatives all my life without any degree of reaction. This is what made the dental office experience qualify as a sensitization.
As part of our clients' early-detection team, we need to be aware of this notion of a recent sensitization. The general population has yet to be educated about this, and even well-trained physicians sometimes forget to ask the most pertinent question. Once a sensitization experience has been identified, follow-up allergy testing is a must - something that had been recommended by my dentist, which I did not do.
So, the short tale of my near-death anaphylaxis experience began with a client confusing our appointment time and my grousing a bit, wondering how to spend my time. I coughed a few times, jogging my memory that my last client from the evening before had been violently coughing and I had neglected to wear a face mask for self-protection. I thought that I could take a couple of the antibiotic pills left over from a previous prescription as a hedge against any possible contagion. I had done this a few times before with success. Guess what I forgot in that moment? It was amoxicillin, one of the possible triggers of my reaction six months earlier. (It is amazing how the mind compartmentalizes.)
Immediately, the uncomfortable itching feeling began to spread throughout my veins. Oh, my gosh! I remembered my previous experience and began to evaluate my options - one being to just lay on my table and wait for it to pass. My instincts then motivated me to drive to a pharmacy a half-mile away to purchase benadryl. I never once entertained the idea of calling 911, as I did not have the knowledge that such a reaction had the ability to escalate so fast or actually could kill me. As my symptoms escalated beyond what I had experienced in the dentist's office, I abandoned the pharmacy idea.
Instead, I drove to an urgent care center located seven blocks away. Along the way, I had numerous visual white-outs during which I only had peripheral vision, and one moment of total blindness. I stopped my vehicle completely in that moment until I was able to regain some slice of vision. The angels were watching over me.
Upon reaching the physician's office and clutching at the door, I collapsed completely. The urgent care center's owner, Dr. John Van Tuyl, MD, reached me as quickly as he could. Finding no pulse, he pronounced me in full cardiac arrest and instructed his staff to call 911. He later recounted to me that I rallied momentarily, lifted my head and stated, "No, I am not...amoxicillin." As an emergency care specialist he split the difference between the possible protocols and placed an atropine patch on my heart to increase its cardiac output. He later explained to me that the visual whiteouts I had experienced were in response to the lack of blood flow to my brain as my heart was being crushed by the sudden swelling of the pleural and pericardial sacs.
What is most important is to anchor this notion of sensitization in your awareness and to specifically ask your clients if they have had allergic responses to any of the common triggers (food, medication, insect venom, latex and exercise); especially a recent one. If they have, please do encourage them to seek out allergy testing with the guidance of their physician.
Beyond my personal story, it is important as a massage therapist to know that anaphylaxis affects more than 10 percent of our population in North America and is increasing in frequency. In more than 25 percent of cases, there is a delayed or biphasic course, with severe symptoms occuring three to five hours after exposure. In more than 20 percent of cases hypotension or laryngeal edema occurs without hives and can be difficult to identify. Most fatal reactions occur in people who knew they were allergic but had accidental exposures. The cause is often not the most obvious and may include combinations of factors including food and exercise. Moreover, most individuals do not inform their personal physicians that they have had severe allergic reactions during routine history and examination.2
In part 2, we will discuss persons medically identified as susceptible to severe anaphylactic reactions along with common products or triggers found in any massage therapist's arsenal.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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