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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?
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.
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.
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 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."
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
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."
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.
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.
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.
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 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.
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.
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.
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.
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."
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.
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.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
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.
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.
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.
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?"
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.
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.
October, 2011, Vol. 11, Issue 10
Massage and Diabetic Peripheral Neuropathy
By Rita Woods, LMT
You can use your massage skills and talents to work on clients with diabetic and chemotherapy induced peripheral neuropathies. The degree of success is dependent upon the stage/severity of the neuropathy, client compliance with their own medical care and the "homework" you give them, and your understanding and use of the correct massage therapy protocol.
Neuropathies are characterized by a progressive loss of nerve fiber function. Diabetic peripheral neuropathy or (DPN) can be defined as "the presence of symptoms and or signs of peripheral nerve dysfunction in people with diabetes after exclusion of other causes." This is by far the most common form of neuropathy and one that you are likely to see in your massage practice. Symptoms include pain, tingling, a burning sensation, numbness or loss of feeling, pins and needles feeling and even muscle weakness. This neuropathy usually starts in the toes (in the most distal peripheral nerves) then progresses to the foot, then up the ankle and so on. The hands can be affected in the same way. This condition is almost always bilateral, involving both feet and or both hands. While DPN can involve organs and other body systems, our goal here, staying within our scope of practice, is to normalize function in the feet and hands using appropriate massage therapy techniques. It's important to understand some processes to help hone your skills and to help educate your clients about why it is important to follow their doctors orders. Understanding the why of something often encourages participation and compliance.
First, let's look at the condition itself. The feet of a person with long-term or poorly treated diabetes will often look discolored in a mottled pattern, bluish, shiny/tight or swollen. The client may or may not have been diagnosed with diabetes. Often, it's the neuropathy that causes them to go see their doctor. Early stages usually show no outward physical signs but more advanced stages may show blue toes. This can (and usually does) eventually turn to gangrene where the tissue dies and turns black. The first sign of gangrene can look like a small poppy seed sized black spot. This tissue cannot be regenerated and amputation is the end result of this progression. Naturally, the goal is to begin working on these feet before the condition gets to that point. Following is a case study provided by Charlotte Versagi, LMT, using the massage protocol. This was her first and most dramatic case that eventually led to the saving of hundreds of toes and feet.
The client was a 55-year-old male construction worker with severe diabetes and bilateral cold/blue feet with numbness and tingling. He could barely stand to have his feet touched and his feet were so painful from neuropathy that he could barely get his feet into his work boots in the morning and almost cried when he pried his boots off at night. When he went to the doctor, he was told, "you should plan on an amputation sometime in the near future." There was no mention of any treatment option, no additional medication proposed, just "plan on amputation."
He came to Charlotte asking what she could do. She started the protocol, very slowly, very lightly and called in his wife to teach her. After a few weeks, they were going in "to the bone" as the protocol suggests. He came once per week. His wife was performing the protocol twice a day. He rubbed his own feet whenever he could. In four months, he had almost no pain, had full function and his feet were warm to the touch and normally colored. The doctor retracted his statement about amputation. It should be noted that the client was following a strict diet and taking his medication as directed and was compliant with all aspects of his diabetes care.
Glucose in the body undergoes a series of chemical reactions. If you consume normal amounts of sugars (fructose, sucrose, any form of "sugar" including honey) the early stages of the chemical reactions form an equilibrium reaction. This is called a reversible reaction and allows the body to function optimally. On the other hand, if too much sugar is consumed, these reactions are not reversible and a cascade of events take place by joining the glucose molecule with a protein or fat in an abnormal process which is pathological in nature. This process is called glycation and involves every fundamental process of cellular metabolism. Eventually, through a series of reactions, you wind up with advanced glycation end products or AGEs. These are bad things and cause nothing but harm and damage.
Glycation has been implicated in many diseases and inflammatory processes. It affects the cardiovascular system in a very big way. Tissues that have a slow turnover (more permanent) in the body are most affected by glycation. So the cardiovascular system, connective tissue and skin, nerve tissue and renal tissue are major targets. Inside a blood vessel are elastin fibers to which AGE molecules will attach, thus decreasing the diameter (or caliber) of the blood vessel. There is also a lot of collagen in the arterial walls that can cross-link with the AGE molecules further compromising the blood vessels ability to function properly. Each time there is a glucose spike and AGE molecules are formed, distal circulation is compromised and the blood vessels themselves become occluded beginning with the small capillaries. Unable to supply the surrounding tissue and nerves with nutrients and oxygen the resulting oxidative debt turns toes blue and causes nerves to malfunction sending signals to the brain of pain, tingling, burning and numbness. In addition to the mechanical damage, it is believed these toxic AGE molecules (and other toxins) also trigger the release of substances that further damage the adjacent nerves.
The most important factor to getting DPN under control is to first stop the sugar spikes. Clients must maintain their glucose at a balanced level. No great highs or lows. (They know what level their doctor wants them to maintain.) With diet and medication under control, the massage therapy protocol (coming next article) can truly help save toes and feet from amputation and relieve some or all of the pain and misery of the neuropathy. The next article will discuss chemotherapy induced peripheral neuropathy and give the detailed step-by-step massage therapy protocol for peripheral neuropathy as developed by Charlotte Michael Versagi who has graciously allowed me to share it, in its entirety, with Massage Today readers.
Editor's Note: For additional information, see Step-By-Step Massage Therapy Protocols for Common Conditions by Charlotte Michael Versagi with contributions by Rita D. Woods. Published by Lippincott Williams & Wilkins, 2011. To find this book and more on medical protocols, visit www.charlottemichaelversagi.com or www.darienlourde.com.
Click here for previous articles by Rita Woods, LMT.
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