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News in Brief
ACA Exec. Vice President Out, Acting EVP In; F4CP Executive Director Retires; New ED Named.
Joint Supplements for Athletes (Part 2)
A fairly recent discovery in nutrition supplemental medicine has proven to be a breakthrough in maintaining athletic joint health. Research suggests a combination of undenatured type-II collagen and tetrahydro-iso-alpha acids helps revitalize joint function and performance in athletes.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Viewpoints: Massage Reduces Nonspecific Shoulder Pain, Improves Function
While seemingly universal, pain and stiffness in the shoulders can be a significant cause of disability. Often a pain that does not go away on its own, shoulder complaints tend to linger, sometimes for 12 months or longer.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Pain Is Only a Piece of the Puzzle
More often than not, when a patient presents to the office, it is for a pain complaint: headache, neck pain, low back pain, sciatica, carpal tunnel, etc.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Managing Tibialis Posterior Tendon Injuries
The tibialis posterior is the deepest, strongest and most central muscle of the leg, with fibers originating from the tibia, fibula and interosseous membrane.
God and the Chiropractor
My wife went to church last Wednesday night and brought home a CD of the pastor's message. As she handed it to me, she said, "You should listen to this; you'll like it." Our family regularly goes to church and our faith plays a major role in our lives.
Striking a Blow to the Medical Monopoly
The U.S. Supreme Court has issued a landmark ruling in North Carolina State Board of Dental Examiners v Federal Trade Commission.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
What Do You Know About Physician Compare?
Physician Compare is a website that allows consumers to search for and obtain information about physicians and other health care professionals who provide Medicare services.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Keep Seniors Safe: Age-Proofing the Home
I want to give Dr. Claudia Anrig kudos for her Dec. 1, 2014 column, which highlighted safety issues youngsters might encounter in the home.
Treating GERD and Incontinence: Focus on Trigger Points
Gastroesophageal reflux disease (GERD) is defined as the regurgitation of stomach acid in the esophagus. Previously, it was thought that GERD was caused by a hiatal hernia, but recent trials suggest the cause is an inability of the hiatal sphincter to contract normally.
How We Can Help the Injured Brain
The majority of patients with mild traumatic brain injuries recover within seven to 10 days. If concussion signs and symptoms continue beyond seven days, the diagnosis changes from acute concussion to post-concussion syndrome.
Older Patients, Stroke Risk and Manipulation
The first population-based study in the United States to evaluate stroke risk following spinal manipulation – and the first involving older adults – suggests that "[c]hiropractic cervical spine manipulation is unlikely to cause stroke in patients aged 66 to 99 years with neck pain.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
October, 2009, Vol. 9, Issue 10
Your Clients With Lyme Disease
By Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President
I am writing this in high summer, which is prime tick season. Consequently, in this installment, we will examine one of the most mysterious and frustrating conditions associated with summertime activities: Lyme disease. This comes about thanks to the comments of Joy Sablatura in response to my article about Sjogren's syndrome.
One of the things that I have a passion about is educating the public about Lyme disease. So often it is diagnosed as the symptoms that it presents with, such as arthritis, fibromyalgia, chronic fatigue, Bell's Palsy, Parkinson's, Sjogren's, lupus, multiple sclerosis, ALS, ADD, bipolar disorder, anxiety, meningitis or IBS. Reading about Sjogren's makes me wonder how many people with that diagnosis have Lyme as the causative agent? I think it's possible that the Lyme spirochete invades the joints, crosses the blood brain barrier, and spirals into the organs and tissues, causing inflammation. This is why the antibodies attack tissues and organs: They are trying to get to the spirochetes, which are masters of disguise and know where to hide in the body.
Lyme Disease History
In 1974 a group of children in Lyme, Conn., were diagnosed with juvenile rheumatoid arthritis. Because this supposedly noncontagious condition occurred in such concentration in an isolated area and over a short period of time, intensive research was conducted. The conclusion was that the diagnosis of juvenile rheumatoid arthritis was incorrect. Instead, these children had a bacterial infection that had settled in their joints. A scientist named Willy Burgdorfer isolated the spirochete, now called Borrelia burgdorferi. He found it in highest concentrations in the midgut of deer ticks. Burgdorfer's discovery in 1982 began a process of surveillance that continues today. The incidence of Lyme disease rises yearly. About 19,000 cases were diagnosed in 2006, the most recent year for which statistics are available.
Borrelia-carrying ticks have been found all over the Northeast, the mid-Atlantic, parts of the Midwest and in specific areas of the West coast. However, Lyme disease has been diagnosed throughout the country, because the people who have the infection often travel after their tick bite.
It is important to emphasize that a person with Lyme disease cannot transmit it directly to another person. This is a vector-borne infection. In most cases, it is a tick that carries the bacteria from one host to another, but theoretically it could also be spread through contaminated blood products or organ transplants. Humans are not the only species affected; dogs can also get Lyme disease. Of course, deer and mice are the reservoirs of bacteria that infect the ticks to begin with.
Process of the Disease
Lyme disease infection begins with exposure to a tick that carries the bacteria. Only a few species do this in the U.S., which is why the infection is associated with geographic areas where the ticks are common. Deer ticks are very small when they are in the nymph stage and when they haven't taken a blood meal: They are roughly the size of a period in 12-point font. Adult and fully fed ticks are much larger. For an excellent array of tick photos, see www.cdc.gov/ncidod/dvbid/lyme/ld_transmission.htm. Ticks are slow feeders. The risk of transmission within the first 24 hours of having a tick attach are quite low. This is why it is important to do thorough tick-checks every day when spending time in areas where they are common.
Lyme disease usually moves in three stages, although its progression may vary from one patient to another:
Stage 1: Early symptoms generally appear between 7 to 30 days after an initial tick bite. They include a circular red rash (a "bulls-eye" rash) that is hot and itchy, but not raised from the skin, accompanied by high fever, fatigue, night sweats, headache, stiff neck and swollen lymph nodes. If no rash appears, these early symptoms may be mistaken for flu, mononucleosis or meningitis. Many people with Lyme disease have no memory of a bulls-eye rash or this acute phase of the infection.
Stage 2: Systemic symptoms emerge during this phase. These include irregular heart beat and dizziness, chronic headaches, facial paralysis, numbness, tingling, forgetfulness and poor coordination, along with debilitating fatigue.
Stage 3: Many Lyme disease infections eventually involve extreme inflammation of one or more large joints, especially knees, elbows and shoulders. Most patients don't have the infection in more than three joints at a time. The inflammation can be extreme enough to damage the joint permanently, especially if it is left untreated.
Lyme disease presents multiple challenges both to the people who have it and to the health care providers who are charged with treating it. One of the most frustrating aspects of this disease is that it can be so difficult to identify. Blood tests for antibodies are often misleading, and they give no information about the timeline of the disease. In other words, a positive blood test only demonstrates a history of exposure. It doesn't explain whether current symptoms (which can be subtle and nonspecific) are related to that exposure.
Further, a certain percentage of people infected with Lyme disease don't respond to the typical 30-day prescription of antibiotics. They have what is sometimes termed "chronic Lyme disease" and are often resistant to treatment. Some experts theorize that the bacterial infection triggers an autoimmune response in these patients. In the meantime, the arthritis and central nervous system consequences of the infection can be debilitating.
Finally, the symptoms of Lyme disease are so unpredictable that it is often missed. People who are diagnosed with multiple chemical sensitivity, fibromyalgia, chronic fatigue syndrome, multiple sclerosis or lupus might be interested to pursue the possibility of Lyme disease. Even a disease as serious as amyotrophic lateral sclerosis (Lou Gehrig's disease) can be misdiagnosed when Lyme disease generates similar neurologic symptoms.
Massage therapists who work in areas where Lyme disease is common should know what deer ticks look like and proper removal techniques. With tweezers, grasp the tick as close to the skin as possible, pull up with steady pressure, then disinfect the puncture site. Never put noxious chemicals or a hot match head on the tick, as this may cause it to regurgitate; exactly what you don't want to have happen.
Clients who have been diagnosed with Lyme disease may have any number of infection-related problems that can be addressed with massage. Tendon, bursa and joint pain may be relieved, but of course therapists must avoid irritating inflamed areas. Headaches can be addressed, along with other neurological issues like facial paralysis and neuropathy, as long as sensation is intact and the client can give good feedback about comfort. Perhaps more than anything else, massage therapists can be receptive, supportive givers of comfort to clients who live with a frustrating and often very threatening condition.
Click here for previous articles by Ruth Werner, LMP, NCTMB, Massage Therapy Foundation President.
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