resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Universal Design: Principles & Practice
In many respects, universal design serves as the core of ergonomics. It's also a good tool to use when designing a return-to-work program for injured and/or ill patients. Let's take a closer look at universal design and why it should matter to you and your patients.
An Unexpected Diagnosis: The Result of Lacking Communication
A couple years ago I had a case that showed me the importance of open communication between health practitioners. We need to show up with less fear, and let go of our judgments so we can do better for the patient.
Bill With Confidence: Learn What to Collect
Q: I am trying to understand what I may collect from my patient when there is insurance. Do I have to accept the amount allowed by the plan or may I collect up to my billed amount? Please note, I am not a member of any insurance plan.
Creating Good Business Buzz
What do patients really think about working with you? Rarely do you hear the whole truth. Those who improve may be candid in their gratitude.
A Major Role in Back Pain: The Multifidus
Back pain affects roughly 80 percent of the population at one time or another and is one of the leading causes of doctor visits.
Is It Time to Rethink Mental Illness? (Pt. 1)
Invariably, patients will ask their chiropractor about depression or various mental illnesses. Some practitioners will reflexively offer a cervical adjustment, suggest St. John's wort or contemplate a referral to a specialist.
Why I Quit Doing House Calls
My father was a chiropractor who did house calls, so when I became a DC, I figured doing house calls was part of the job. My March article recalled my experience as a small boy, accompanying my dad while he went to patients' homes to treat them.
Balancing Spring Challenges
As the winter months come to a close and warmer spring weather appears, patients may begin to present with new challenging pattern presentations.
Eczema & Acupuncture: A Sound Solution (Part 1)
Eczema affects approximately 3.5 percent of the global population and is one of the most common skin complaints seen by dermatologists.
Clearing Blocks: A Way to Improve Cosmetic Acupuncture
As a Five Element acupuncturist who teaches facial acupuncture classes nationally, I was surprised to learn that one of the basic principles I was taught in school is unfamiliar to most acupuncturists.
Taking the Chiropractic Message to the Press
"There is no better place on earth to have a news event," the National Press Club boasts, and it's easy to understand why: Every year, the 108-year-old Washington, D.C.-based organization hosts countless press conferences on the hottest topics impacting America and often the world.
Give Yourself the Digital Advantage
When you see this article in the print version of this issue and swear you read it already, don't be alarmed: you probably did. That's because by that time, the May issue will have been available online in digital format for three weeks.
Women's Hormones: A Western & Eastern Perspective
Sometimes it may seem that you require a degree in medicine to understand hormones and how they function.
News in Brief
ACA Adopts New Governance Model; ACA 2017 Awards; CCA Helps Calif. DCs "Share the Love"; $1 Million to Help Advance the Profession; D'Youville Raises the Bar on Anatomy Education; ErRatum.
The Visual Error Scoring System: A Concussion Tool
Postural stability and oculomotor function are the most easily recognized physical indicators of neurologic motor dysfunction associated with concussions.
An Integrated Approach to Chronic Pain
Findings from a unique Medicaid pilot project in Rhode Island involving high-use Medicaid recipients from two health plans were recently presented to the state's Department of Health, demonstrating stellar outcomes with regard to medication use, ER visits, health care costs and patient satisfaction.
A Daily Strategy for Heavy-Metal Detox
In modern society, we are constantly exposed to heavy metals such as cadmium, lead and mercury. These heavy metals have no essential biochemical roles in our body, and conversely, can cause us a great deal of harm if they build up to toxic levels.
Raditation & Your Smartphone: Is it Worth the Risk?
If radial arteries could talk (and in my experience they can to some extent), they would say, "Step away from the smartphone." At least that is the message I am receiving loud and clear as I feel the pulses of many patients.
New Relationships, Old Trauma: AOM & Other Healing Strategies
Being in love is one the most beautiful and enjoyable experiences. Most of us are willing to pay almost any price to have that experience, and still often find it elusive or fleeting. Navigating the ups and downs of loving relationships are often challenging — even for the most psychologically balanced among us.
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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