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Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
May, 2009, Vol. 09, Issue 05
The Progression of Airway Obstruction
By Dale G. Alexander, LMT, MA, PhD and Thomas M. Walsh II, DDS
Subtle progressions that reduce the quality of our clients' lives and contribute to many of our clients' chronic somatic problems continues as a theme for this column. Thomas Walsh, DDS offers his 33 years of clinical experience as a general dentist and extensive orthodontics training to bring to light the progression of airway obstruction.
Air is one of our greatest needs for survival as human beings. The "airway is the tube" through which we breathe. It begins at the opening of the nostrils and continues all the way to the lungs. Visualize this tube as the snorkel through which we breathe. The diameter, shape and volume of this tube regulates the rate of exchange between oxygen entering the lungs and the exiting of carbon dioxide out of the lungs. A large diameter airway encourages an easy passage of air whereas a small diameter airway generates a greater resistance to airflow in both directions.
This essential airway tube is formed in utero and continues to develop from infancy until the teenage years. The airway is comprised of multiple spaces including the: nasal chamber; sinuses; and the upper, middle and lower pharynx. In normal growth, these chambers need to form in proportion to the size of the individual. That is to say that one needs a tube to breathe through that is large enough in diameter to support respiration during sleep and daily activity. The genetic design (preprogrammed in our DNA) mediates the enlargement of the bones, muscles, connective tissue etc., of our face and throat, to provide room for these spaces of the airway.1
Unfortunately, many times this airway tube does not form properly. A malformed airway can wreak havoc with muscle tone and head position. Research has clearly correlated head posture with mandibular position and temporomandibular joint disorders.2-7 Many of your clients will likely have these problems. They may complain of pain in the following muscles: masseters, sternocleidomastoid muscles (SCMs), trapezius, scalenes, splenius capitis and cervicis, medial and lateral pterygoids, temporalis and even the muscles of the low back. Simply put, if an airway is obstructed, a person will instinctively modify their muscle function to optimize or open the airway. This postulation reflects the essence of the Inside-Out Paradigm.
Clients rarely sense that they have a problem with their airway. (Dr. Walsh: "After 33 years of practicing dentistry, not one growing child or adult client has ever reported to me that they have a small airway.") The development of the airway is controlled by the autonomic nervous system of the growing child. Nature (your biologic engineer) detects this progressively developing constriction in the airway and makes alternate plans involving compensatory patterns of the musculoskeletal system.
For example, if the constriction is in the nasal cavity, the growing child will start to breathe through the mouth instead of the nose. The muscles of the face will pull open on the lower jaw, the mandible, and redirect the growth of this mandible to a more vertical or open position.8 If the airway obstruction occurs in the middle to lower oral pharynx (throat) the individual will likely extend their head forward to help open this airway tube.9-11 Again, this occurs without any conscious awareness within the individual. The head has now extended forward beyond the normal plane of vertical posture.
Forward head posture is very common and easily misunderstood. It is the opinion of these authors that many cases of forward head posture relate back to early childhood airway disorders, and improper muscle function of the oral cavity and have been clinically correlated to a congenitally short or an emotionally reactive esophagus.12
That being said, it is very difficult to separate the primary cause or etiology. We have the case of the proverbial chicken and the egg scenario, i.e., which came first? For some individuals the muscle function was altered first and in other children the airway obstruction occurred first.
There are many contributors to airway obstruction. Common influences include the following: improper swallowing habits developed from bottle nursing, air pollutants, food allergies, junk foods, broken nose, deviated septum, improper growth of the jaws (the maxilla and mandible), improper tooth position, imbalanced facial muscles, oral habits such as thumb sucking and many more. The thread that links all of these issues to you and your practice tends to be the compensatory forward head posture and associated muscle pain.
Feel this. Your head weighs about 12 pounds much like a bowling ball. Imagine if we placed a stick inside the hole of the bowling ball. Supporting this ball would not be difficult assuming the stick were directly under the bowling ball. Now, let's extend the bowling ball (your head) out beyond the stick (your spine) at a 45-degree angle. Suddenly the force on your spine from your head is dramatically increased. Forward head posture associated with airway obstructions places your neck and shoulders at a leverage disadvantage. It is reasonable to expect cervical bone remodeling and muscle pain to occur over time.
Airway obstructions and improper oral muscle balance commencing near infancy or in a growing individual have been linked to many systemic disorders later in life. These include the following: dental malocclusions, TMJ joint disorders, distorted faces, obstructive sleep apnea in children and adults, bed wetting, migraine like headaches, neck and back pain, lower IQ, stunted growth, criminal behavior tendencies, heart damage and increased risk of heart attack, arteriosclerosis and atherosclerosis, stroke, acid reflux and digestive disorders, anxiety and depression associated with lack of proper REM sleep, increased risk of occupational accidents and the list goes on.13-18
The following images graphically display the difference between normal and obstructed airways. These images have been acquired through cone beam imaging technology similar to CT scanning but with dramatically reduced radiation exposure as part of a comprehensive dental examination to evaluate patients for temporomandibular joint, orthodontic and sleep disorders. Figure 1 depicts the size and shape of a normal airway from a side view (coronal) and figure 2 from a cross-sectioned view looking downward (transverse). Notice the area identified by the pointer. Figures 3 and 4 demonstrate the reduced airway from both a coronal and transverse view. Note the constriction of the airway.
The diameter of the constricted airway is equivalent to the diameter of drinking through a straw. "Imagine the experience of breathing through a straw" all day. This client was completely unaware of any obstruction in the airway yet suffered from many clinical symptoms including lack of sleep, grinding of their teeth, pain and spasms in the neck and shoulders.
In summary, many of our clients suffer from airway obstructions that progress and worsen through life. As massage therapists we see many individuals with underlying problems as have been described here. Clients with head and neck pain including forward head posture are likely to have airway obstructions and are at risk for obstructive sleep apnea, a known contributor to decreased quality of life and reduced longevity. Your sharp observations can actually save lives.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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