resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Dealing with a Pain in the Butt
The patient came into my office with the classic antalgic stoop. She was bent over almost to ninety degrees, leaning on her husband for support and staggering to walk. She had been under supportive care for a long time, but this new pain scared her.
The Drug Epidemic: Are You Guilty, Too?
Attention-deficit / hyperactivity disorder (ADHD) has become epidemic among children in the United States. According to the Centers for Disease Control and Prevention (CDC), the percentage of school-aged children diagnosed with ADHD has grown from 7.8 percent in 2003 to 11.0 percent in 2011.
Case Study: 2-Year-Old Suffering From Urinary Reflux
A19-month-old female child presented to my office for treatment. Her mother reported the child had been diagnosed with urinary reflux and associated urinary tract infections, recurrent bouts of otitis media and inability to sleep.
Forward Head Carriage and the Feet: What's the Connection? (Pt. 2)
Clinical evaluation of standing posture using relatively low-tech tools has been confirmed as valid and reliable by several studies. The original device used to evaluate posture was the plumb line, which served as a reference line for the effects of gravity on body alignment.
HVLA Technique: Addressing Myths
In the annals of chiropractic history and literature, and in the imagination of the public, there is one manual adjusting technique that can produce a wide range of responses, both from patients and casual observers.
NBCE Fumbles Computerized Testing Process
Imagine being a student again, about to take one of the four tests required to become a doctor of chiropractic. You've studied almost nonstop for the past few weeks. You can feel your anxiety level rise as you sit down in front of the computer screen.
Patience vs. Patients
How long have you been in practice? I began my journey more than 20 years ago and opened my first acupuncture clinic in 2008. Just like you, I've learned a lot over the years. Recently, I sat in an interview and was asked what made me successful.
Acupuncture's Essential Role
Acupuncture should play a more prominent role in U.S. healthcare during and after this post-Affordable Care Act era when chronic care and population health management are key concerns for all healthcare providers.
Acupuncture Earns BLS Unique Code
The United States Bureau of Labor Statistics recently announced that acupuncturists will have their own unique occupational code in the 2018 BLS Handbook. The new Standard Occupational Code (SOC) is 29-1291, will be included in the next edition of the BLS Occupational Handbook, which will be published in 2018.
News in Brief
F4CP MEmbership Milestone Reached; ICA Challenging New California Vaccine Law; TCC Names New President; New Provost at UWS.
Letter to the Editor
On December 7, 1999, the U.S. FDA reclassified the status of acupuncture needles from class III (investigative devices subject to investigative device exemptions...) to class II (special controls).
Sacroiliac Joint Fusion: Where's the Wisdom?
We should be very skeptical of the purportedly less invasive version of the already defrocked sacroiliac fusion surgery, "minimally invasive" sacroiliac joint fusion; and concerned this procedure simply represents the device manufacturer's attempt to find yet another new market.
We Get Letters & Email
Our Medicare Challenges Aren't an Education Issue; Passion to Succeed: More Pivotal Than GPA?
Physical Examination in an Evidence-Based World
I have always had a fascination with physical examination procedures, particularly orthopedic tests. The origin of my fascination began just after graduation when I began the chiropractic orthopedics program.
The Lung Official
The Lung is known as the "Official Who Receives the Pure Chi From the Heavens." The act of breathing in, known as inspiration, brings oxygen into the body from the atmosphere. Each exhalation or expiration removes and releases carbon dioxide, a waste product of the body, into the atmosphere.
Putting POLITE Into Practice
First came the acronym RICE (Rest, Ice, Compression, Elevation), which eventually became PRICE (Protect, Rest, Ice, Compression, Elevation). Then in 2015, we started hearing POLICE (Protect, Optimal Loading, Ice, Compression, Elevation).
The Most Important Vitamin You've Never Heard Of: K2
Imagine if one in every three patients who walked through your door was afflicted with a debilitating, yet completely preventable and treatable disease.
University of Bridgeport Acupuncture Students Make Rounds at Sisters of Notre Dame
Nuns are not stereotypical acupuncture patients, Dr. Jennifer Brett acknowledges with a laugh. But then again, acupuncture has gone mainstream, just like cappuccinos and recycling. "It's changed a lot from the '70s and '80s," said Brett.
Why We Need to Fix the Mechanoreceptors (Part 2)
The muscle spindle, a particular type of mechanoreceptor, is located deep within the muscle belly, encapsulated in fascia made up of intrafusal fibers, all within the extrafusal muscle fibers.
Concerns Regarding CDC Guidelines for Pain Management
In response to the epidemic rates of opioid and heroin addiction, the Centers for Disease Control and Prevention (CDC) set new guidelines for physicians regarding treatment for pain.
CE Regulations Are Hurting Chiropractic
During my 35 years in the chiropractic profession, I have been forced to attend available continuing-education programs that were occasionally incredibly beneficial, but frequently not worth my time.
Infertility: Managing Irregular Menses
Infertility is an area where Chinese medicine is particularly helpful. In the main, in women below the age of 38 without organic disturbance, the success rate using TCM (Traditional Chinese Medicine) should exceed 85%.
Comparing Costs of Care: DCs, MDs or PTs - Who Costs More?
In a health care era where evidence is increasingly the benchmark for insurance coverage, patient care and even cultural authority, we get plenty of it courtesy of a retrospective cost analysis spanning 10 years, more than 660,000 "covered lives" and nearly 7.5 million claims from Blue Cross Blue Shield of North Carolina.
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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