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Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Merger Creates New Model of Care
Two San Francisco powerhouses of holistic healing, the American College of Traditional Chinese Medicine (ACTCM) and California Institute of Integral Studies (CIIS), are merging. Together they are building a visionary approach to applied integral health.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
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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