resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. After two treatments for back pain, a patient presents for a third session complaining of rapid breathing and wheezing that is made worse during cold weather.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
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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