resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
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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