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East Meets West
Gung Hay Fat Choi. Welcome to the year of the Monkey. There will be fireworks for both January and February this year. What great celebrations.
Do Doctors Lie to Patients? (Do You Lie to Yours?)
In a previous column ["When Patients Lie (Bribe or Flatter)," Oct. 1, 2015], I discussed the issue of patients lying to doctors, and the many reasons why this can occur.
Percussion Therapy: An Experiment
My study of qi began more than 20 years ago — long before my study of TCM, points or pathways. It all started with an awareness in my hands and physical manifestations in the way of blockages while working on clients.
Yo San University Helps Make LA Communities Healthier
An element of healthcare training often overlooked is the residual benefit to communities served by Acupuncture and Oriental Medicine (AOM) schools nationwide.
Chiropractic Around the World: WFC Country Reports December 2015
The following country updates are reprinted with permission from the December 2015 World Federation of Chiropractic (WFC) Quarterly World Report. Information is excepted for space and edited to DC-specific style guidelines.
Diet, Nutrition and the Context of Risk (Part 1)
Food and supplement safety is a topic that often comes up when I speak to chiropractors for CE relicensing, even when it is not the advertised subject.
Billing and Coding for Moxibustion
Q: I am trying to locate a code for cupping and moxibustion, and have had various fellow acupuncturists indicate that they bill using the existing codes for heat, 97010 hot packs or 97026 infra-red for moxa and 97016 vasopneumatic device for cupping.
Lab Rats (Roaming the Streets)
The title of this article is an accurate description of American consumers (regardless of age) in the modern era.
Asking the Insurance Rep the Right Questions
One of the first or last questions a potential patient often asks is: "Do you take insurance?" An ill-informed or optimistic, "yes" can result in delayed or non-payment. Instead, just say: "Let me check if you are eligible first."
RAND Study Recruiting DCs
Dr. Ian Coulter, RAND / Samueli chair for integrative medicine and senior health policy researcher for the RAND Corporation, has issued a call for participation, recruiting doctors of chiropractic for a practice-based research study that will examine "the impact of evidence, outcomes, costs and patient preferences on the choice of treatment for chronic low back pain and neck pain."
Treating Pain: The Hypermobile Coccyx
When I write about the coccyx, I recognize that I am talking about a relatively small subset of patients. When I write for Dynamic Chiropractic, I am trying to reach 60,000 chiropractors.
From Antiquity to Modernity: Huang Qin Tang at Yale Medical School, Part 1
Traditional Chinese medicine is a coherent medical system with several unique characteristics: it originated almost 3,000 years ago; in its area of origin, it has been practiced without interruption since its inception.
Changing the Cultural View of Medicine
Many hospitals in the U.S. are incorporating integrative clinics that include Traditional Chinese Medicine. Cleveland Clinic has led the charge for adding a traditional Chinese herbal medicine clinic to their existing acupuncture program.
Ethics: The Glue That Holds Us Together
Kudos to the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for creating a code of ethics for the nationwide profession and for deciding to make courses in ethics a requirement for certification renewal.
Is There a Neurological Basis and Correction for Macular Degeneration?
Macular degeneration, aka AMD (age-related macular degeneration), is a common eye disease and a leading cause of blindness in people age 50 years and older, according to the National Institutes of Health National Eye Institute.
Interprofessionalism: What it Means and Why You Should Care
Interprofessionalism in education and in practice is a growing trend across health care in the United States. The idea that team-based care and collaborative practice can improve health care has been around more than 50 years.
The Roots of Insomnia
One of the most common clinical presentations is insomnia. Next to digestive disorders, sleep disorders are one of the most common complaints the clinician will encounter in daily practice.
Forgotten Options for Musculoskeletal Health
Challenges with musculoskeletal health are of tremendous concern for many people today.
How to Humanize Your Content to Create Stronger Relationships
Content marketing is about building relationships, whether that is through updates on social media, offers on your website, blog posts, email campaigns, or even printed material. Now days a business needs to make a human connection.
The MRI: What to Do With the Results
As I wrote in my previous article on this topic, it is my goal for you, the doctor, to be an expert in interpreting MRI images yourself; and to be able to independently make decisions based upon a combination of clinical presentations and findings, followed by the MRI images.
The Clinical Versatility of Milk Thistle (Part 2)
Evidence is growing that the silymarin complex of flavonolignans from milk thistle can impact serum ferritin and iron overload in various clinical circumstances.
Window of the Sky Points
The acupuncture points known as Window of the Sky are a modern creation. There is no reference in Chinese medical texts for an acupuncture point category called Window of the Sky.
Enhancing Performance in Cross-Fit Athletes
Cross-fitness centers are expanding in number and increasing in popularity. To remain relevant to this growing portion of society, practitioners need to learn about the exercises and injuries common to this group.
Integrative Medicine Can Shape the Profession
As the AOM profession struggles to define the role of "integrative" medicine within their practices their schools and organizations, students, faculty, alumni and administrators at schools wrestle with discussions of how much, where, how, and what to "integrate."
March, 2009, Vol. 09, Issue 03
Hospice Massage: Easing the Pain of a Life-Limiting Illness, Part 1
By Ann Catlin, LMT, NCTMB, OTR
A couple of years ago, I had the privilege of spending a few days at a residential hospice in Washington, D.C. called Joseph's House; I was there to conduct a workshop for the staff. While I was there to teach, in the process I learned so much about dying with dignity. You see, Joseph's House takes in and cares for homeless men and women with terminal illness. Witnessing the impact of touch on the lives of these men and women was profound and has stayed with me ever since. Anxiety was eased, relationships were deepened and spirits were lifted for those receiving the touch and those giving it. I recall gently massaging the legs and arms of a young man who, it was believed, was only days away from dying. As I watched him fully receive my touch with a look of peace, I felt blessed to be doing this humble work. Those who entered the doors of Joseph's House were given the gift of living well with dignity in their final days.
I believe that is the essence of hospice care to help the dying person live well and to support quality of life. A paramount concern in hospice care is alleviating pain. As massage practitioners, we have much to contribute to easing pain and suffering on many levels. The complex nature of pain is holistic, meaning it is related to the whole person: the body mind and spirit. By acknowledging only the physical component of pain, we are disregarding a significant part of the pain experience that may have as much impact on the quality of life as the physical discomfort. The dimensions of pain obviously include the physical, however the psychological, emotional, social and spiritual dimensions equally impact the quality of life as well.
Dimensions of Pain
The dimensions of pain include:1
Massage: Why it Works
The American Massage Therapy Association (AMTA) defines massage as "a manual soft tissue manipulation, and includes holding, causing movement, and/or applying pressure to the body." The intention of applying massage is, according to the AMTA to positively affect the health and well-being of the client.
A hands-on complementary approach for those in eldercare, hospice and palliative care enhances quality of life. Combining sensitive massage techniques, focused touch, one-on-one attention and specialized communication skills can be highly effective for those in later life stages. The concepts and techniques of this hands-on approach are effective as a non-pharmacological tool in alleviating discomfort associated with the dimensions of pain. What follows is an exploration of the effects of massage along with some of the rationale for why massage may be important tools in alleviating pain for individuals with life-limiting illness.
Physiological Effect: Physical sensation of pain is reduced. Massage has been shown to affect the nervous system through stimulation of sensory receptors. The gate control theory refers to the idea that pain impulses pass through a "gate" to reach the nerve fibers leading from the spinal cord to the thalamus in the brain. Pain impulses are transmitted by large and small diameter nerve fibers. Massage stimulates the large-diameter fibers, preventing the small diameter fibers from transmitting signals, suppressing the sensation of pain.2
Massage stimulates production of endorphins. Endorphins are opiate-like compounds produced by the body that relieve pain and produce feelings of euphoria.2 Massage decreases cortisol levels. Cortisol is a stress hormone that is produced by the adrenal glands during prolonged stress. When cortisol levels are lowered it enhances sleep quality and the immune system.2
Behavioral Effect: Physical tasks are performed with greater comfort (i.e. transfers, dressing, ambulating). When the burden of pain is eased the individual may increase his or her involvement in self-care and participate more actively in daily life and level of function is improved.
Emotional Effect: Positive feelings and mood is enhanced. Massage has a generalized effect on the autonomic nervous system, resulting in changes in mood and an induced relaxation response.2 Massage seems to increase serotonin levels. Serotonin is a neurochemical that regulates mood; feelings of calm; and subdues anxiety and irritability.3
Cognitive Effect: The cycle of pain and fear may be interrupted, resulting in more positive thought patterns. One hypothesis4 states that pain has three phases: the anticipation phase; the sensation phase; and the aftermath phase. The person suffering from chronic or intermittent pain may experience fear in the anticipation phase stemming from unpleasant past painful experiences. When the pain experience is eased with massage and one-on-one focused attention, those associations may lose their grip on the belief system of the person.
Social Effect: Touch and massage is a medium that enhances the relationship between the ill person and caregivers.
Bush5 reports that substantial evidence points to the fact that the experiences of touch are laden with psychosocial as well as physiologic implications. It is a viable means of improving both verbal and non-verbal communication. Human touch creates a way for the dying person to interact and connect with others, decreasing feelings of isolation and loneliness.
Spiritual Effect: Human touch enhances spiritual well-being. Nelson6 reports that when individual felt cared for by staff during and after receiving complementary approaches, the burden of disease (i.e. physical, emotional) seemed less and allowed them to feel like they had more of a desire to participate in life.
The unconditional gift of touch acknowledges the individual's worth regardless of the condition of the body or mind easing suffering on all levels. Hospice organizations are offering massage therapy as a complementary service more than ever before. We truly hold within our hands the means to make a meaningful difference in the quality of life at life's end.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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