Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
Acupuncture's cultural and historical roots go back to the emergence of Chinese civilization. For more than 2,000 years, acupuncture needling has been continuously practiced on the largest population in the world.
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Fish Oil: A Key Component of Positive Clinical Outcomes
Patients seem to be presenting with more complex problems, and many are responding to care more slowly or have completely unexpected results. Why?
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
March, 2010, Vol. 10, Issue 03
By Elaine Stillerman, LMT
The encouraging news about uterine fibroid tumors is that they are almost always benign, especially for women in their 30s and 40s. However, they can cause a multitude of discomforts, including heavy menstrual bleeding (menorrhagia), painful menstruation (dysmenorrhea), backaches, and/or abdominal or pelvic bloating and heaviness.If the fibroids grow large enough to protrude into the pelvic cavity, other pelvic organs may be involved, resulting in urinary frequency and urgency, or constipation. Most fibroids, however, are asymptomatic and many women don't know they have them until they cause a problem or a gynecological exam detects them.
Uterine fibroids are solid, noncancerous tumors made of fibrous and smooth muscle tissues. The preeminence of fibrous tissue gives these tumors their name. Their etiology is unknown, but they seem to be estrogen-dependent because they don't develop before a woman gets her first period and they decrease in size and occurrence after menopause, when estrogen levels are low. Oral contraceptives that contain estrogen compounds, and pregnancy can stimulate the growth of these tumors. (I have seen pregnant women who looked as if they were carrying twins when, in fact, one mass was a fibroid.) There also might be a predisposition based upon genetics.
The sizes of fibroids vary from microscopic to ones that takes up the entire abdominal cavity. Fibroids affect nearly 20 percent of women over the age of 20 and approximately 40 percent of women 35 to 45 years of age. In the United States, Asian-American and African-American women are two to five times more likely than Caucasian women to have them.
There are several different types of uterine fibroid tumors based upon their location within the pelvis:
The diagnosis of fibroids usually is made when the provider palpates a mass during a routine gynecological exam. An ultrasound confirms the diagnosis and determines the type of fibroid.
When a client with a confirmed fibroid comes for a massage, it is important to avoid massaging the abdomen with any deep strokes. If any type of pressure causes pain, the abdominal massage should be stopped. Client positioning also is determined by comfort level. If prone positioning is uncomfortable, position her side-lying with a pillow under her neck and others placed between her knees.
Women have many options to treat uterine fibroids. The most extreme is a hysterectomy to remove the uterus. Only about 10 percent to 20 percent of fibroids require surgery. While it is certainly an effective way to remove the fibroids that have been causing pain, it puts women into an immediate surgical menopause if the ovaries also are removed and, like any surgical procedure, has many risks. An incision is made in the lower abdomen, although it can sometimes be performed vaginally. Recovery from this major surgery can take as long as six weeks.
A less invasive treatment is a procedure known as myomectomy. During this surgery, which may be done as an outpatient procedure depending on the number, size and location of the fibroids, the uterus is left intact. If an abdominal incision is made, the recovery takes as long as a hysterectomy. It may be performed using a laparoscope - lighted surgical tubes inserted near the navel - or through the vagina with a hysteroscope.
Rather than going under the knife, some women opt for embolization of the fibroids. This nonsurgical procedure cuts off the blood supply to the fibroids, which effectively shrinks them, although they don't necessarily disappear. A catheter is inserted through the patient's femoral artery and gently moved to each affected uterine artery. Tiny pellets are inserted through the catheter which blocks the blood supply. A woman must remain in the hospital for a day or two and is able to resume normal activities within the week. Embolization studies have found an 85 percent to 95 percent reduction in fibroid symptoms, while not actually eliminating them.
Prior to undergoing any type of surgery or medical procedure, women might opt for acupuncture, with or without herbal remedies, to treat their fibroids. The first mention of uterine fibroids in traditional Chinese medicine was in the Ling Shu (ca. 100 BC), which described them as "stony tumors." Chinese medicine categorizes fibroid tumors as zheng xia, or "masses in the uterus with a feeling of pain, swelling or fullness, and with bleeding in severe cases." TCM recognizes three patterns of uterine fibroids and treats them accordingly: qi stagnation and blood stasis; yin deficiency and empty-fire blazing; and liver qi stagnation and spleen deficiency. Once the appropriate pattern has been determined, acupuncture and specific herbs are provided. TCM is very effective in reducing or eliminating many types of uterine fibroids, especially if they are caught early.
Pharmaceutical drugs also can be taken to reduce the size of these fibroids and control the bleeding they often cause. Nonsteroidal anti-inflammatory drugs (NSAIDs) can be taken alone or with the addition of progesterone. A synthetic form of gonadotropin-releasing hormone (Lupron) controls the supply of estrogen and progesterone, which causes the fibroids to decrease in size. However, its use is limited because long-term use contributes to osteoporosis and once a woman stops taking Lupron, the fibroids grow back. It is more effective when used prior to a myomectomy to shrink the tumors and make the surgery easier.
A cutting-edge procedure (which is not necessarily covered by insurance) is an MRI-guided ultrasound. High-intensity ultrasound is directed at the fibroids, heating them and breaking down their outer walls. The procedure takes a few hours and the patient has to remain in a prone position in an MRI machine with her head outside of the machine and her abdomen submerged in a pool of water. Risk factors include burns and nerve damage, and the effects of this intensive ultrasound on future pregnancies have not been determined.
Uterine fibroids are not life-threatening growths, but the symptoms they cause can have a major impact on a woman's quality of life. Thankfully, there are many options available today, and women can make their decisions based upon their own needs.
Click here for previous articles by Elaine Stillerman, LMT.
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