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Healing With TCM at San Quentin State Prison
For the prisoners at San Quentin State Prison, life-sentences are the reality of every day life. It is not often that prisoners get the opportunity to use alternative medicine to deal with common ailments they encounter behind bars such as, depression, anxiety and pain.
Lime Jello on Morphine
Taste is in the eyes... actually the mouth... of the beholder. My food preferences have changed, lightening from the food of my youth. My parents loved heavy eastern European cuisine and I loved it as a child. Now I enjoy leaner, healthier whole foods.
Commingling Money: 12 Questions for the ACA About the CHAMP / NCLAF Merger
The American Chiropractic Association recently announced it was merging the National Chiropractic Legal Action Fund and the Chiropractic Health Advocacy and Mobilization Project into a single entity that will support both legal and legislative actions.
Chiropractic Research in Review
Predicting Pain With Disability in Office Workers; Traction Approaches for Discogenic Cervical Radiculopathy; Intra-Articular Gas Bubbles Following Manipulation; Nonresponsive Chronic Ankle Sprains: Think Tendon Rupture.
Jingei Diagnosis: An Effective and Powerful Diagnostic
I graduated from the Kotatama Institute under the direction of Drs. Masahilo and Katsuharu Nakazono in 1984. As a student, I was exposed to the practice of most of the various theories and modalites of Oriental Medicine.
Sports Science: What's in That Drink?
Athletes frequently ask me what the best liquid is to drink during exercise – water or a sports drink? Water provides the necessary hydration, but unfortunately, it lacks the key nutrients to aid in performance and recovery.
The Wonders of Light Therapy: An Interview with Wes Burwell
I first met Wes Burwell in 2011 when he was teaching a class on light. Since then, every time I hear him speak, his understanding of the benefits, function and capacity of light has evolved.
Uncle Sam Needs You (Part 2)
Where chiropractic care has been used in the military health services, it has been deemed very successful.
Correcting Pelvic Rotation Around the Long Axis: Adjustment Protocol
The pelvis can be considered a ring that can misalign on the sacrum rotating around the long axis. The following is a description of an adjustment that helps to correct sacroiliac rotation around the long axis.
Communication 101: Please Explain Yourself!
Twice this past week, I overheard conversations about chiropractic. As you can imagine, it is a topic my ears naturally pick up. In both cases, a patient was talking to a friend about their experience with a chiropractor.
The Case for Immunization
As long as I have been a chiropractor, I have seen many in this profession oppose vaccinations. Indeed, it has often been taken as a "given" that to be a principled chiropractor requires a curmudgeon's willingness to hold aloft that banner of opposition.
A Commonly Missed Spinal Fixation: The Upper Lumbar Spine (Part 2)
As mentioned in part 1, using a flexion-distraction table is a great way to unlock this particular fixation. You have found the stuck segment. You have determined whether it is unilateral, midline or bilateral.
The Tao of Gender
If you think gender is as simple as having a new client check off the "male" or "female" box on your intake form, we hope this article will expand your understanding and thus the reach of your health care.
Essential Orthopedic Testing: Tests That Involve Standing on One Leg
Since these tests have a common mechanism of performance (standing on one leg), there are differential diagnostic concerns during testing. The tests cannot be completely isolated from each other for performance.
The Heart Protector
On the physical level, the Pericardium is a double-layered sac of fibrous tissue that envelops the Heart. The space between the layers is filled with serous fluid that protects the Heart from external shock or trauma and lubricates to allow for normal Heart movement.
Dr. George Goodman and His Legacy to Logan University
Those who knew him called him a revered leader, a visionary and one of chiropractic's biggest advocates. George A. Goodman, DC, Logan University's sixth and longest-serving president, passed away on Sept. 9. He was 70 years old.
Managing Patient Expectations About Acupuncture
Last year, I attended the Pacific Symposium in San Diego for the first time in six or seven years. It was the 25th anniversary of this event, and on one evening there was a panel discussion with the title; "What is Qi?."
Managing Today's Fertility Patient
I recently received an email from one of my fertility patients: "Got my lab results back. FSH is 11, AMH is 0.7. My doctor said these numbers aren't good. I guess I'm infertile. Just as a thought. Just set up an appointment to speak with an adoption agency."
AOMA Strengthens Leadership Team
AOMA Graduate School of Integrative Medicine, a leading college of acupuncture & herbal medicine, announced the appointment of Donna LaPoint Hurta, MBA as the new VP of Finance & Operations this Fall.
To The Finish Line With the Help of TCM
When acupuncturist Eddy De Smedt pursued a career in Traditional Chinese Medicine, he knew he wanted to make a difference.
Simple Ways To Find True Happiness
Patients in our clinics are always seeking happiness. As their health advocate, we need to ensure we inform them that in order to find happiness, they have to make sure to identify what makes them happy in the first place.
Pulse Diagnosis: What We Know
I am still finding pearls of wisdom from the books and papers that I inherited from my pulse diagnosis mentor Jim Ramholz.
October, 2010, Vol. 10, Issue 10
Chasing the Pain
By Rita Woods, LMT
Cholesterol lowering drugs are one of the most widely prescribed medications. Statins, the class of cholesterol lowering drugs are HMG-CoA reductase inhibitors. In short, they suppress the enzymes the liver needs to produce cholesterol naturally.The body makes its own cholesterol which is important for many bodily functions including lubricating the joints. Some people are genetically predisposed to over produce their own cholesterol and some people lack dietary discretion and consume foods high in cholesterol. High cholesterol is viewed as a risk factor for cardiovascular disease which has prompted the prolific use of drugs intended to lower it.
Several types of statins exist such as atorvastatin, cerivastatin, fluvastatin, lovastatin, mevastatin, pitavastatin, pravastatin, rosuvastatin, and simvastatin. These medicines are sold under several different brand names including Lipitor (atorvastatin), Pravachol (pravastatin), Crestor (rosuvastatin), Zocor (simvastatin), Lescol (fluvastatin) and Vytorin (combination of simvastatin and ezetimibe). Mevastatin is a naturally occurring statin that is found in red yeast rice.
Over 20 million people in the United States take statins. Muscle and joint pain are some of the most common side effects of cholesterol lowering statins. These side effects are clearly stated by the drug manufacturers and in some cases, may be serious.
Giving any medical advice is not within our scope of practice. There is no real or implied intent to give advice or join in the great debate about the use or misuse of said drugs.
The intent of this article is to bring to light those side effects that a massage therapist may encounter. They include but are not limited to muscle aches or weakness, tendon problems, muscle cramps and arthralgia.
Encourage your client to read the pamphlets included with their prescription and educate yourself on possible side effects that may play a role in your practice as a bodyworker. Older clients may not have Internet access so keep a copy of The Pill Book in your office as a helpful reference for them (and for you). Typically, the consumer information section on the drug's Web site is short and easy to understand. You may want to copy those pages for some clients. For example, at www.lipitor.com I was able to get clear and concise information.
While muscle and joint pain complaints are common for many people taking statin medications, neuropathy - often experienced as the tingling, numbing, pins and needles feeling in the extremities, has also been cited as a side effect.
In an article "Statins and Risk of Polyneuropathy" (American Academy of Neurology), the authors concluded: "Long-term exposure to statins may substantially increase the risk of polyneuropathy."1
In Annals of Internal Medicine, Michael Jacobs, MD, reported on a case study with the following conclusion: "The appearance, disappearance, and reappearance of symptoms in association with treatment and retreatment with related cholesterol-lowering medications strongly suggest that a peripheral sensory neuropathy may occur with the use of HMG-CoA reductase inhibitors."2
As massage therapists, we are trained to think of pins and needles, tingling and numbness as probably involving nerves or circulation. Medically induced myalgia and neuropathy adds a new dimension to your treatment plan and a new perspective on patient interaction and education.
While the information from clinical and medical sites is helpful, I find that listening to the stories of real people is most helpful when building a basis for dialoging about a condition. One Web site that I found particularly interesting was www.medications.com. While I don't recommend that you take the information as medical advice or as actual case studies, I find it helpful in understanding how the daily activities of these patients has been impacted. These statements would be similar to the subjective comments on your SOAP notes. These anecdotal comments were screened to include only those that provided a direct correlation to the use or cessation of the medication. Let's listen to some of them:
"My body has aches and pains all over. I'm having knee issues and weak ankle issues and also the top part of my arms hurt so bad (feels like symptoms someone with 'frozen shoulder' would have). I have developed lower back pain. I bend over to bathe my puppy and I can barely raise back up."
"The worst of it all, was the shooting pains up and down my right leg all the way down to my foot. It felt like barbed wire being raked across the inside of my leg."
"I get leg cramps, jimmy legs, shooting arm pains and severe back pain. He upped my dose and my back pain is a lot worse than before."
In an article, "Tendon Disorders Due to Statins" (PubMed.gov3), tendons were cited as being affected by statins. According to the article, "French authors have analysed about 100 reports of tendon disorders attributed to statins. The Achilles tendon was most often affected. This adverse effect mainly occurred during the first year of treatment and appeared to be more frequent in patients with diabetes, hyperuricaemia or a history of tendon disorders, and in persons engaging in strenuous sports. In practice, tendinopathy appears to be a rare adverse effect of statins, but patients should be closely monitored during the first year of treatment, especially when they have associated risk factors."
I spoke with a pharmacist about the side effects and asked what complaint he heard most often. "Joint pain. Elbows and knees, especially," he said. "However, back pain is common but I think most people consider that normal. They attribute it to everyday aches and pains but joint pain will be experienced as something different and out of the norm. So they notice that."
Mayo Clinic Cardiologist Thomas Behrenbeck, MD, advises: "If you have muscle aches or other troubling symptoms after starting statin medications, talk to your doctor as soon as possible." In many cases, the symptoms started or worsened after an increase in the drug dose or with the addition of other medications. High blood pressure and diabetes are linked to a higher risk of statin complications, according to a recent paper (Golomb and Evans) in the online edition of American Journal of Cardiovascular Drugs.
It's now more important than ever to get a full medication list from your client as part of your medical intake forms. I interviewed one therapist about her medical questionnaire with the following response, "It's vital to get the list of medications. I had one client who was taking 11 different medications and came to me for migraine headaches. Upon researching the meds, I discovered that three of them listed migraine headaches as a side effect. She was, by the way, on a migraine headache medication. I made a chart for her listing pertinent side effects using reputable medical resources and presented her with the list at her next appointment."
The key for us as therapists is to listen as the client describes their symptoms to determine if it's systemic (meaning all over pain), if it started after beginning a medicine, or if the pain has been triggered by normal activity such as playing tennis. If no known cause can be found, then look to the possibility of medically induced pain. Without a thorough client intake evaluation that includes medications, you may spend time chasing the pain that can never be caught.
Click here for more information about Rita Woods, LMT.
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