resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
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.
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?
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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
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."
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.
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.
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.
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.
May, 2011, Vol. 11, Issue 05
Obesity and Childbirth
By Elaine Stillerman, LMT
It's a sad fact that Americans are growing fatter every year as obesity rates are increasing faster than originally estimated. I am not referring to a few extra pounds or the pleasantly plump silhouette, but rather the serious health risks involved in carrying excessive weight.More than one in four Americans (72.5 million) were obese in 2009 and nine states (Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Missouri, Oklahoma, Tennessee, and West Virginia) reported 30 percent of their population was obese in 2009. In 2007, there were only three states that made that unfortunate claim. The highest rate was 34.4 percent in Mississippi. (Only Colorado and Washington, D.C. had obesity rates under 20 percent.)
The medical costs of obesity are estimated to be $150 billion a year. Obese people are more likely to die from heart disease, stroke, diabetes, and cancer than thinner people. The American Institute for Cancer Research projects there will be more than 103,000 cases of cancer caused by obesity in 2010. Forty-nine percent are expected to be endometrial cancer, 35 percent esophageal cancer, and 28 percent will develop pancreatic cancer. Nearly 112,000 deaths are caused by the complications of obesity every year.
The reason is simple enough: not enough exercise and too much of the wrong kinds of food. This epidemic is affecting our children too: one out of three children in the United States is now overweight or obese. This puts them at a higher risk for developing heart disease, diabetes, and cancer during their lifetimes. One-third of children born at the beginning of this millennium are expected to develop diabetes and the current generation is expected to have a shorter life span than their parents due to obesity rates. In addition, girls as young as seven or eight are developing breasts and reaching puberty much earlier, in part due to increasing rates of childhood obesity. I wrote for a PBS-TV show years back, and we did a segment on childhood obesity. I learned that for most six year olds in this country, the only 'vegetables' they ate were French fries.
And for pregnant women who are overweight or obese, the risks to them and their babies are of great concern. Obesity contributes to the increase in Cesarean section, more birth defects, and more maternal and neonatal deaths. Cesarean section rates increase tremendously the fatter the woman is. The National Institutes of Health reports that women with a 30-35 body mass index (with 20 BMI being the equivalent of a woman 5'6" weighing 124 lbs) have 25 percent more C-sections on average, 35-40 BMI equates to a 33 percent increase in C-sections, and over 40 BMI results in a 43 percent increase in surgical deliveries. (Body mass index is a calculation of body fat based upon an adult's height and weight. A BMI of less than 18.5 percent is considered underweight; 18.5-24.9 percent is considered average; 25-29.9 percent is considered overweight; an index of 30 percent or more is considered obese.)
In addition, obese women have few choices where or how to have their babies. For most, natural childbirth is not an option. Their heightened risk factors disqualify them from having home births or opting to have their babies in birthing centers. So a hospital birth is their only option. Hospitals have also had to adapt to the increase in maternal weight by purchasing longer surgical instruments, larger beds and gurneys, and increasingly more sophisticated fetal testing machines.
The birth experience for many of these women (and their babies) is far from ideal. Local anesthesia is difficult to administer because the additional bulk makes it nearly impossible to feel the spine and find the right place for an epidural, so general anesthesia has to be given. Doctors also find themselves in awkward, uncomfortable positions since they often have to stand on stools or platforms to reach over the patient's abdomen.
And the babies don't fare well. Babies of obese mothers are almost three times likely to die within the first month and obese women are almost twice as likely to have a stillbirth, which is the death of the baby after 20 weeks gestation. In New York State, between 2003-2005, 2 out of 3 maternal deaths were attributed to obesity.
Within New York City, a consortium of hospitals is considering creating specialized centers just for obese maternity cases. The maternity care the patients would receive would also include nutritional counseling and weight loss programs and would be staffed with sufficient medical personnel to handle emergency C-sections and intensive neonatal care. The cost of caring for these women and their babies can reach more than $200,000 as compared with $13,000 for a normal delivery.
From a massage point of view, these women are considered high risk for pregnancy and labor complications. And if they already have diabetes, signs of hypertension or blood clots, excessive swelling, thrombophlebitis, or cardiovascular disease, massage may have to be ruled out entirely.
Although the costs of obesity and its sequelae are staggering and add an unnecessary burden to health care costs, the bottom line isn't the bottom line. And it certainly isn't about fat-bashing. It's the health and survival of these women and their children that has to be of paramount concern. Making smart food choices and learning to eat nutritionally sound meals are small prices to pay for a long, happy, and healthy life with your child.
Click here for previous articles by Elaine Stillerman, LMT.
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