resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
NCCAOM Launches New Membership Organization
The National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) recently launched a new national membership organization, the NCCAOM Academy of Diplomates.
The Power of Eccentric Exercise: Hamstring Injury Prevention and Rehab
For almost 20 years, I've worked with professional athletes who make a living by running really fast. It goes without saying that hamstring injury (HSI) prevention and rehabilitation is a big part of what they expect from a sports chiropractor.
Essentials of Assessment: The Squat
The squat is a simple, fast and functional tool to evaluate patient symmetry and function. As simple and easy as it is to implement, it can yield considerable amounts of valuable, clinically relevant information.
Health and Wellness Partnership
Yo San University of Traditional Chinese Medicine and The Wellness Center at the LAC + USC Historic General Hospital recently joined forces to extend care to the residents of Boyle Heights area of Los Angeles.
The Value of Melatonin in Breast Cancer Prevention and Adjunctive Treatment
Although melatonin (MLT) is best known for its sleep-aid properties and as a natural remedy to prevent jet lag, extensive experimental studies suggest it possesses anticancer activity through several biological mechanisms.
Transparency is Key at ASA First Annual Meeting
On March 4th and 5th the American Society of Acupuncturists (ASA) held a successful first annual meeting in Albuquerque, New Mexico.
Filling the Gap: The Role of Alternative Practitioners in a Broken Health Care System
I have been asked many times what got me into alternative medicine. My answer is simple: I want to truly help and make a difference in people's health.
Vitamin D Fails to Help Knee OA? The Proper Perspective
The March 8, 2016 issue of JAMA includes a study about vitamin D supplementation for osteoarthritis of the knee. This is a really weird study.
News in Brief
A Moment of Silence for Dr. Stephen Press; New ACA President Elected; F4CP Offers New MemBership Benefit.
Musculoskeletal Disorders Take Center Stage
Looking for the latest on the musculoskeletal pain epidemic and the increasing premium placed on preventive strategies including chiropractic? Check out The Impact of Musculoskeletal Disorders on Americans – Opportunities for Action.
An Interview with Amanda Shayle
JW: Can you share with us some of your history and how you became an acupuncturist? What did you do prior to becoming an acupuncturist? Where did you go to school?
Constructing Our Reality: The Primary Channels and Perception, Part 1
My favorite topic of discussion within Chinese medicine is the acupuncture channel systems. First of all, each of us have them. They are part of our bodies; not something external to us. To learn about the acupuncture channels is to learn about ourselves.
The Art of Listening
One of the most important clinical concepts for me was voiced by the legendary physician William Osler. "Listen to your patient, he/she is telling you the diagnosis." After treating literally thousands of patients, it can become almost second nature to quickly discover clues which reveal the underlying diagnosis.
The IME System: A Current Public Health Risk and Solutions That Are Working
I strongly believe in the independent medical examination (IME) system. There are far too many doctors in every profession who are not following E&M protocols and never claim MMI (maximum medical improvement) has occurred for their patients, which has caused financial stress for many private and public carriers.
Asking Patients the Right Questions
When was the last time you asked a patient a question? Maybe 30 seconds ago? But, are you asking the right questions to elicit valuable and useful information? As a healthcare provider, you've likely spent hundreds of hours learning to ask the right questions to gather critical health information from your patients.
Energy: For Life and For Death
Energy is a deep topic in Traditional Chinese Medicine. Qi is understood to underlie all of existence, animated or not, and the qi of the living is studied with special attention.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
The Rest of the Patient Story
I've written previously about allowing a patient to tell you their story – about taking the time to listen and engage all the aspects of their case history, the injury in question, and the related issues.
Recording and Appropriate Billing of Timed Physical Medicine Services
There is a common misunderstanding about timed therapy services and although you do have some knowledge of timed service documentation, based on your comment on the 8-minute rule, your understanding is correct, but incomplete.
Business Lesson #1: Adapt or Else
My wife and I recently enjoyed an excellent meal at a restaurant recommended by some friends. We often have concerns about restaurant recommendations, as many have been disappointing.
How to Find and Fix TL Nerve Impingements
The thoracolumbar junction (TLJ) and the peripheral sensory nerves that exit from it are frequent, important and rarely recognized sources of lower back, pelvic and hip pain. Let's outline a clear exam protocol for diagnosing the problem.
Building Relationships and Referral Networks with Allopathic Practitioners
Dr. Doug, an orthopedist of 20 years, had heard stories from patients who tried acupuncture. While he was able to address many of their complaints effectively, some appeared to gain additional benefit when their care included TCM.
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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