resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
April, 2009, Vol. 09, Issue 04
Anaphylaxis: A Sudden and Deadly Progression, Part 2
By Dale G. Alexander, LMT, MA, PhD
The purpose of this two-part series is to raise our collective awareness as massage therapists of anaphylaxis progression, which potentially can be prevented by asking your clients a few simple questions. I am introducing 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 its progression.
In part 1 (MT, January 2009), we discussed my personal story in surviving an anaphylactic reaction, the detection of anaphylaxis and important background questions to ask your clients.
Part 2 has been designed to offer you more information about the primary allergens that may provoke a severe reaction and to alert you to products many massage therapists use that may trigger a reaction.
Once a person has been medically identified as susceptible to severe anaphylactic reactions, they are typically prescribed and encouraged to carry with them at all times a self-injecting device, such as EpiPen, that contains epinephrine (i.e. adrenaline). Some of these products that may be prescribed contain a double dose of epinephrine.2 Epinephrine has shown itself to be clinically effective in stabilizing the severity of an anaphylactic reaction, thus enabling a person to be transported to an emergency room for further treatment.1
The most commonly documented causes or triggers of anaphylaxis are: food, medication, insect venom, latex and exercise. In situations where a specific trigger remains unidentified, the patient is said to suffer from idiopathic (meaning "of unknown origin") anaphylaxis.1
According to the EpiPen Web site, "Food allergies are an increasingly common cause of anaphylaxis that result in about 125 deaths each year in the United States. Some allergists believe this perceived rise in incidence may be attributed to increased exposure to certain foods, such as peanuts, before a child's immune system is mature enough to handle them." There are eight types of foods that are accountable for 90 percent of all food-allergic reactions. The foods that most commonly cause anaphylaxis are: peanuts, tree nuts (walnuts, pecans, etc.), shellfish, fish, milk, soy, wheat and eggs. Sulfites added to foods can also set off anaphylactic reactions. For a small number of people who do not otherwise experience food-related anaphylaxis, exercising within a few hours of eating has been documented as an allergic trigger.1
Within our profession of massage therapy, many of the oils used contain either peanut or almond oil. These may be triggers for clients who have latent allergies they may not know about. According to a 1998 article in the Journal of the American Medical Association (JAMA), approximately 550,000 serious allergic reactions to medications occur annually in U.S. hospitals.3 While the prevalence of drug allergies in the general population is unclear, allergic reactions to medications cause the highest number of documented deaths from anaphylaxis each year. Penicillin accounts for an estimated 75 percent of the known anaphylaxis deaths in the United States.4
Most deaths occur in people who have no medical history of allergic reactions.4 I would add that probably no medical history existed because many people, like myself, didn't take their first allergic reaction seriously enough to seek out allergy testing. As just stated, death from anaphylactic shock can occur from a person's very first exposure to an allergen.
"The most common medications that cause allergic reactions are: penicillin, sulfa antibiotics, allopurinol, seizure and anti-arrhythmia medications, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, muscle relaxants, and certain post-surgery fluids. Other medications known to cause severe allergic reactions include vaccines, radiocontrast media, antihypertensives, insulin, and blood products."1
In a recent conversation with a client, Mel Eaton, DDS (who grew up on a peanut farm), we speculated that the top two severe allergens (penicillin and peanuts) have a common link - mold. Penicillin is derived from mold and the way peanuts are stored promotes the growth of mold.
It is estimated that 0.5 percent to 5 percent of the U.S. population, or as many as 13 million people, have insect venom allergies.5 Many of these venom-sensitive individuals are at risk for life-threatening anaphylactic reactions. An estimated 40 to 100 deaths due to anaphylaxis caused by insect venom are reported each year, half of which are attributed to fire ants, an increasingly common pest that is spreading throughout the United States. The insects most commonly associated with triggering severe allergic reactions belong to the Hymenoptera order of insects. This order comprises: bees, wasps, yellow jackets, hornets and ants, especially the fire ant.
Unlike people susceptible to anaphylaxis triggered by food, medication or latex, those allergic to insect venom have the option of undergoing immunotherapy, a preventive course of treatment that may provide long-term protection against insect sting allergies.1
An additional few points for your consideration include that using latex gloves for inter-oral work may trigger allergic responses in your clients. This did occur for me once over my 29 years of clinical practice. Nitrile gloves are now considered to be the best for such applications. Also, many of the essential oils or scented candles that are used by Massage Therapists can trigger respiratory allergies. Rarely do these provoke a systemic anaphylaxis but they are not practice builders either.
This two-part series only scratches the surface of the complex subject of anaphylaxis, yet presents you with those triggers considered most deadly. I encourage you to immediately integrate the proposed three questions with both new and established clients:
Your genuine interest, willingness to listen and personal encouragement for your clients to seek out advice from their physician may save a life.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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