resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Day in the Life of an Advanced-Practice DC
Can you tell us a little about your background in the profession? Why did you want to become a DC? I studied at Boston University from 1968-1972 as a pre-med student majoring in biology.
How Many of Your Patients Have Sarcopenia?
Figure 1 demonstrates the typical appearance of sarcopenia in the paravertebral muscles. Have you considered evaluating your patients for this problem? Sarcopenia is the progressive loss of skeletal muscle mass and function that affects the older population.
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.
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.
An Alarming Lack of Accountability
Accountability seems to be a lost quality today. The simple act of taking responsibility and doing the right thing just doesn't happen as often as it should. Maybe it is the litigious nature of our society.
Identify & Adjust the Apex Posterior Sacrum
Low back pain involving an apex posterior sacrum (+θX-axis misalignment) typically presents with signs of lumbosacral joint impingement or facet syndrome.
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.
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.
Specialized Pro-Resolving Mediators: 21st Century Inflammation Fighters
Specialized pro-resolving mediators, or SPMs, are a portion of the omega-3 fatty-acid spectrum that have been shown to have a powerful effect on reducing inflammation.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
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.
Let's Streamline Your Front Desk
Your front office can be your greatest source of efficiency or a constant bottleneck. Increasing the productivity of this area without sacrificing the quality of patient interaction can be a little tricky.
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.
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.
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.
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.
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?
Excited to Share the Science of Chiropractic: An Interview With Dr. Heidi Haavik
Dr. Heidi Haavik has become known in the circle of chiropractic researchers as not only a rising star, but also one willing to do research that can have a major impact in the scientific world and how chiropractic is perceived.
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.
Misconceptions & Opportunities With Medicare
As I speak around the country on how to properly document Medicare patient encounters, I get questions regarding opting out of Medicare. There are many misconceptions about opting out of Medicare, including just what it means to opt out.
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.
Designing a Fitness Plan (Part 4): Blending Pain Relief With Healthy Aging
Pain relief is still the No. 1 reason patients come to my office. However, most of my patients have other goals as well, such as: "I want to lose 10 to 20 pounds"; "I feel old and want to slow down the aging process"; "My doctor says I am becoming a diabetic and need to exercise"; or "I'm tired and want more energy."
F4CP Launches New Social Media Campaign
The Foundation for Chiropractic Progress has launched a new service to help member doctors: a social media campaign called "Accelerator."
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.
Join the conversation
Comments are encouraged, but you must follow our User Agreementcomments powered by Disqus
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.