Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
The Three Heater Official
This Official, belonging to the element Fire, is responsible for maintaining and regulating the heating system of the body, mind, and spirit. It is named for its function. The trunk is divided into three "burning spaces" or "jiaos."
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
March, 2010, Vol. 10, Issue 03
The Silent Progression of Kidney Infections and Stone Formation, Part 2
By Dale G. Alexander, LMT, MA, PhD
The first article in this series postulated that kidney stone formation and chronic kidney infections may be possible causes of your clients' chronic ailments, especially those that relate to the low back, groin, knees, ankles and feet.This article will add more depth and breadth to your comprehension of these two disorders and how we may encourage our clients to seek appropriate medical testing. One point to consider is that individuals who seek out massage therapy on any regular basis may be subconsciously driven by an instinctual sense that they possess an anatomical anomaly or an avoidance of regular medical check-ups. It is our collective responsibility to make referrals when our common sense suggests it.
Let's begin by noting that there are five different kinds of kidney stones that have been identified. These include: calcium oxalate, calcium phosphate, uric acid, struvite (magnesium ammonium phosphate) and cystine. Knowing the type of stone may be especially helpful with an individual who experiences recurrent stone formation. The most common types of kidney stones are calcium oxalate and calcium phosphate.1
There are some questions we might ask to determine if clients have a greater-than-average susceptibility to kidney stone formation.
Have you or other family members have ever had an attack of gout? Kidney stones caused by uric-acid crystals occur in approximately 15 percent of people with gout. This compares to an 8 percent risk of kidney stones in people without gout.2
Have you had any surgery involving the large or small intestine? Conditions that increase the absorption of oxalate from the gastrointestinal tract (short bowel syndrome, chronic diarrhea, previous bowel surgery or gastric bypass surgery) may contribute to kidney stone formation.1 People with Crohn's disease also often have more susceptibility to kidney stones.3
Have you ever been diagnosed with hyperparathyroidism? This is a condition where one or more of the parathyroid glands becomes overactive. As a result, the blood calcium rises to a level that is higher than normal (called hypercalcemia).1 Once a person is identified with this condition, the usual medical protocol is to check for kidney stones via ultrasound or CAT scan of the kidneys. By asking if these tests were done, we can serve our clients.
Another question that is pertinent to ask clients is whether their urine has a foamy head like freshly poured beer? This is a sign that the kidneys are leaking protein.7
In hot weather, we all sweat more, which concentrates urine. "Concentrated urine is a breeding ground for kidney stones."4 Encourage clients to drink more fluids and eat more vegetables, fruit, and grains, which naturally contain water. The goal is to increase the amount of urine that flows through the kidneys and ureters and to lower the concentration of substances that promote stone formation."1 One suggestion is for clients to drink half of your weight in ounces per day. Thus, if you weigh 180 lbs., drinking 90 ounces of water is recommended.5
Two ironic items turned up in my research, suggesting that coffee drinkers have fewer kidney stones whereas those who drink excessive amounts of grapefruit juice have more kidney stones.4 This reminded me of a client from about 20 years ago who came to me with a right knee problem. I asked him if he had ever had a kidney stone and he replied, "about 50." I asked how much grapefruit juice he drank, to which he responded, "about two gallons a day."
Human physiology is an integrated whole. I postulate that few instances of kidney stones express themselves without a tendril of connection to other subtle physiologic progressions. According to NYU's David Goldfarb, director of the Kidney Stone Prevention Program At Saint Vincent Medical Center: "I tell my patients that the kidney stone that brought them to my office may be the least of their problems, and that any stones are the harbinger of their increased risk for diabetes, high blood pressure, and osteoporosis."4
Remember that the physiologic role of the kidneys includes re-absorption of glucose, amino acids and other small molecules; regulation of sodium, potassium, and other electrolytes; regulation of fluid balance and blood pressure; maintenance of acid-base balance; and the production of various hormones including vitamin D and erythropoietin (a hormone produced by the kidney that promotes the formation of red blood cells in the bone marrow).6 The kidneys also allow surplus concentrations of excess calcium or protein to be excreted in the urine. In this case, the most important question is why isn't the body absorbing and using these substances in a balanced metabolic fashion? An excess or shortage of biochemicals in our bodies can push our homeostatic capacity over the edge into the beginnings of pathology.
Statistically, more men will develop kidney stones, but my clinical experience is running 50-50. This variation may be a function of my specialization in working with chronic problems. An important revelation for me in researching this article is that kidney stones in children are on the rise.8 Children are less able to describe what they feel inside, so we are challenged to let their behavior and bodies speak to us.
Let's shift our attention to some pertinent anatomy. The functional workhorses of the kidneys are the nephrons. The two kidneys contain about 2 billion nephrons, each capable of forming urine. The nephron is basically a glomerulus through which fluid is filtered from the blood and a long tubule in which the filtered fluid is converted into urine on its way to the pelvis of the kidney. Most kidney difficulties relate to the destruction or damage of the nephrons so that they simply cannot fully perform their normal functions.9
There are many progressive disorders that may lead to this deterioration of nephron function: chronic glomerulonephritis, traumatic loss of kidney tissue, congenital absence of kidney tissue, congenital polycystic disease (in which large cysts develop in the kidneys and destroy surrounding nephrons by compression), urinary tract obstruction resulting from renal stones, pyelonephritis (infections) and diseases of the renal vasculature.9 Many of these difficulties can brew for years until pressure, obstruction or infection begins to affect the capsule of the kidneys or the ureters, or until infection spreads beyond the kidneys.
Chronic kidney infections may also morph into chronic kidney disease. A number of my clients have been medically diagnosed with kidney infections. These clients tend to be between the ages of 50 and 75, and often note that they have one or two of the conditions often associated with the decline of kidney function, kidney disease in their family, urinary tract infections, hypertension, diabetes or a beginning decline in their bone density. If a client says, "yes" to two or more of the questions from Parts 1 and 2 of this series, encourage them seek regular medical check-ups.
Medical tests that may be more sensitive to the early stages of progressive kidney disease include a 24 hour urine collection, a creatinine clearance test and a microalbuminuria test. These tests may be more appropriate because the standard screening for creatinine and blood urea nitrogen (BUN) for analyzing blood plasma "will not be raised above the normal range until 60% of total kidney function is lost."9
If a client's somatic complaints are consistently associated with the low back, groin, knees, hips or feet this raises my alert flag. Such complaints will often move between these areas during a series of sessions. I translate this as the body's attempt to distribute the internal strain of vascular and neurological congestion. It is also not uncommon for clients to respond quickly to bodywork only to have different, similar or the same complaints return. The quicker the reassertion of somatic difficulties, the more urgently I encourage clients to seek medical testing. My interpretation is that the body is signaling from the "inside-out" that there is more afoot than meets the eye.
Yes, people do have lumbar disc problems, accumulated strains, injuries or previous surgeries. However, if their history suggests that they have already been to competent physicians, orthopedists, chiropractors or physical therapists, this is another alert flag. By educating our clients to what possible difficulties exist empowers them with the capacity to choose, to select among the options to improve their quality of life.
Editor's Note: Join Dale as he teaches the pre-convention workshop (The Inside-Out Paradigm/Visceral Mobilization/Gall Bladder Dysfunction/Disease) for the AMTA National Convention in Minneapolis, Minn. Register at www.amtamassage.org after April 1. Inquiries can be sent to . Reading his Gall Bladder Article Series via www.masagetoday.com is a pre-requisite to attending the course.
Click here for more information about Dale G. Alexander, LMT, MA, PhD.
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