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Sit or Stand? Analyzing a Mixed Message
I'm more than a bit confused. At my age, that seems to be a rather common occurrence. However, today more than ever, I'm getting a mixed message.
Increasing the Value of Spine Care: CMS Approves New Low Back Pain Registry
The Centers for Medicare and Medicaid Services has approved the Spine IQ Low Back Pain Registry as a qualified clinical data registry for the Physician Quality Reporting System (PQRS) in 2016.
Introducing the Acupuncture Today Digital Edition
In response to the changing habits of our readers, Acupuncture Today will introduce a digital edition of the publication (in addition to our print edition) beginning with the August 2016 issue.
Believe it or not, an estimated one-third of your patients have eaten some form of fast food within 24 hours of their appointment with you.
Acupuncture's Impact on the World
For several years, I have been hearing about the town of Rothenburg, Germany. It seemed just a dot on a map until I arrived. It is the home of the TCM Kongress which began in 1968. It has been held annually for 47 years and it has only missed one year.
What's New in Phytonutrition: Mangifera Indica, "The King of Fruits"
One hundred percent pure Indian green mango fruit (mangifera indica), harvested at a special degree of ripeness for efficacy and taste, can now be concentrated as a phytonutrient nutraceutical powder.
An MD Who Understands the Opioid Epidemic
Doctors of chiropractic have an important role to play in ending the opioid epidemic and dealing with chronic pain by conservative means (see our top story in this issue) – but who's to blame for opioid dependence and abuse in the first place?
Tai Chi Documentary Premier
First Run Features recently announced the world theatrical premiere of Barry Strugatz's documentary The Professor: Tai Chi's Journey West, which premiered last month at the Laemmle Music Hall in Los Angeles.
Adventures with the San Jiao
Those of us who have been in practice for several decades relish the way meridians and points reveal new diagnostic clues and new insights. I love to encourage my students to see this as an adventure that goes way beyond the textbooks.
What You Say Isn't Always What Patients Hear
A few years ago, my aunt Edna (name changed for the purpose of this story) suffered a stroke. After a short hospital stay, she was transferred to a nursing home for rehabilitation. When she arrived at the nursing home, Edna requested a private room.
Acupuncture Muscle Trigger Point and Oriental Medicine Sports Therapy
It is difficult to ascertain the internal condition of professional basketball player Lebron James during game one of the 2014 NBA finals, in which he developed debilitating muscle cramps that led to his premature removal from the game.
AOM Hospital-Based Practice: A Future Reality?
The natural evolution of health care on the planet is integrative health. We may have some challenges ahead, but based on my research, all indicators are pointing in a positive direction. There seems to be an evolving consciousness among our patient population that is "getting it."
Multivitamin Supplement May Reduce Breast Cancer Recurrence
There is a great deal of controversy regarding the value of multiple vitamin supplements in cancer prevention.
Beating the Odds: Interview With Para-Powerlifter Adeline Dumapong-Ancheta
Since October 2015, the FICS Foundation, the charitable organization affiliated with the International Federation of Sports Chiropractic (FICS), has been supporting disabled athletes internationally.
How to Stay Sane During the Elections: Understanding Through the Lens of Chinese Medicine
In Chinese Medicine philosophy, everything consists of Yin and Yang. The law of polar opposites – one cannot exist without its opposite.
Three Tips to Help You Analyze the Acupuncture Case Studies of the NCCAOM Exam
Confirm the answer quickly by the elimination method. Case study:
After two treatments for back pain, a patient presents for a third
session complaining of rapid breathing and wheezing that is made worse
during cold weather.
The Pertinent Negative
We all have to perform evaluations on patients. Most of us don't like doing it – exams take time, and worse it takes even more time after the evaluation to put together a narrative summary of the findings. Sometimes, this process becomes downright tedious.
Treating Hip & Groin Pain With Abdominal Release of Upper Lumbar Nerve Impingements
Have you encountered patients with groin and hip pain you can't seem to solve? You know it's not a worn-out hip; you suspect the pain is somehow connected to the spine. But somehow, you just can't help them break through.
Chronic Pain: Become Part of the Solution
I have lectured to more than 7,000 chiropractic physicians over the past five years regarding the chronic pain and opioid epidemic in this country.
Kansas Achieves Licensing Law
Kansas Governor Sam Brownback signed House Bill 2615 into law on Friday, May 13, 2016. HB2615 includes provisions for the licensure of acupuncturists in the state of Kansas.
An Emerging Partnership Model
Maryland University of Integrative Health (MUIH) has educated integrative health and wellness practitioners for the last 40 years, originally as an acupuncture clinic and school. The institution's transformative, relationship-centered programs integrate traditional wisdom with contemporary science
Insuring Quality Control in Herb Importation: An Interview with Wilson Lau
Wilson Lau is the vice president of Nuherbs, a Chinese herb importation company based in San Leandro, California. Before joining Nuherbs, he trained as a lawyer specializing in FDA law.
A Long-Overdue Win for Oregon Medicaid Patients - and the Implications for Other States
Beginning July 1, 2016, Oregon Medicaid patients with spinal pain (cervical, thoracic, lumbar, pelvic) who are determined to be low risk based on a biopsychosocial assessment tool (STarT Back – Keele University) can receive four chiropractic visits per episode.
March, 2010, Vol. 10, Issue 03
Communicating With Stroke Survivors: What Matters Most?
By Ann Catlin, LMT, NCTMB, OTR
It is likely that at some point, someone you know - a grandparent, parent, sibling, friend, neighbor or client - will suffer a stroke. It is one leading cause of long-term disability in the United States.I've met literally hundreds of stroke survivors while working as an occupational therapist in rehabilitation programs, and my grandfather suffered a stroke when I was a child. Even though I've had all this experience, the one thing that stands out as challenging, yet critically important, is communication. The topic of stroke, or cerebral vascular accident, is very complex, and people who suffer a stroke commonly experience physical, behavioral and communication effects.
The focus of this article is communication, so it's important to have a basic understanding of what happens during a stroke that leads to serious communication impairment. The term stroke refers to a situation that occurs when blood flow to the brain cells is interrupted. There are basically two types of stroke. An ischemic stroke is when an artery becomes blocked by a blood clot, depriving cells of oxygen. About 83 percent of strokes are ischemic. Hemorrhagic stroke is when there is actual bleeding from the arteries into the brain tissue, accounting for about 17 percent of all strokes. The resulting functional impairment or disability following a stroke depends on the location of the vascular lesion in the brain. Speech and language is a function primarily of the left hemisphere of the brain, so when the stroke occurs in the left hemisphere, communication - the ability to speak, understand, read and write - will possibly be affected. The extent is determined by the severity of the damage to the brain.
This brings me to the point I really want to make. What does the stroke survivor experiencing communication disorders need from us? I know what my own observations tell me, but I wanted to see what others say about it so I set off to find out. In the process, I found a jewel of an evidence-based report called "The Psychosocial Spiritual Experience of Elderly Recovering from Stroke." The elders recalled that the early period following the stroke was terrifying. Connection with others was important in recovery, and communication difficulties led to feelings of isolation. They stressed that the work of recovery requires a great deal of physical and psychological effort, and that hope and inner strength were important.
What people who survive strokes may need most from us is not found in any kind of therapeutic technique or approach. It's found in our ability to show up and be real in our caring. It's found in the simple gift of touch and heart-to-heart connection. It's found in acknowledging that the stroke survivor is a person whose life has been altered, but the individual inside the body remains the same. It's found in shared hope. I'll leave you with this poignant story called "Poor Thing" by Judith A. Russo, who cared for her husband following his stroke.
"Did you hear that Joe had a stroke?" asks Person A.
"Oh yes, poor thing!" says Person B.
"He was such a good person and a good worker," says A.
"Yes, too bad, isn't it?"
My husband had a stroke in February 2000, which left him with Broca's aphasia. Do you know what Broca's aphasia is? What you need to know is that he is not a "poor thing." And he still is, not was, a good person. He is a survivor who is living a richer life now than he was before. He was in the rat race of existence, going round and round with the dizzying effects of a non-stop merry-go-round. Now, he has time to smell the lilacs, watch the egret fish for its dinner and marvel as his granddaughter grows inch by inch. How poor can that be?
He is, perhaps, disabled, but the same person he was before the stroke. Most folks become so intimidated with the affliction "stroke" that they forget there is a real person living in that body, a person who thinks, hurts, laughs and cries just like you.
"I don't know," replies Person B.
"Well, I won't bother him now, or call or visit. After all, he's probably busy, and I don't know how much he understands anyway."
"I agree," says B. "He probably wouldn't know who we are, and we don't want to embarrass him."
By the way, Broca's aphasia is the inability to communicate effectively by speech. What is the therapy for people with aphasia? Talking to the survivor and encouraging them to respond. You might have to wait for two or three awkward moments for them to think about what to say. In the meantime, you may see the egret fish for its catch of the day. You may see the lush brown velvet cat-o'-nine tails waving in the wind, or the rabbits playfully goading each other on the lawn, or the huge turtle crawling along the banks of the pond with a goldfish in its jaws. Come at dusk and perchance you will see the deer as they come to the pond to drink. You will go away richer for the visit because you will have escaped the runaway merry-go-around, if only for a few moments. You will feel rich and will have blessed the heart of the "poor one who was such a good person."
When a stroke happens to a relative, friend or co-worker, please do not put them into an isolation they never asked for. Reach out and touch someone today.
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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