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Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Sleep, Less Sleep or No Sleep?
I had a dream I wasn't getting enough sleep. It was a very realistic dream, even though I was probably slightly awake and not really deep dreaming. Most likely I had been dozing, caught in that twilight of sleep and wakefulness.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
January, 2012, Vol. 12, Issue 01
The Potential Dangers of Taking Medications During Pregnancy
By Elaine Stillerman, LMT
We tend to think that if the Food and Drug Administration approves a medicine, it is safe for us to take. And we don't give a second thought to the potential side effects of over-the-counter (OTC) medicines since they don't require prescriptions.But are these popular medications safe for pregnant women and their developing babies? Since very few drug trials involve pregnant women, how can anyone be sure that there are no harmful side effects or birth defects from these seemingly innocuous medicines?
Conception occurs about two weeks before the next menstrual cycle is due, and a positive confirmation of pregnancy may take another few weeks, so there is a window of extreme vulnerability for the growing baby if mom takes certain medicines (drinks or smokes) during this sensitive time. OTC drugs are used by many pregnant women and, as a rule, are generally safe. Some, however, have what are considered to be unproven safety and/or potentially harmful effects on the growing babies. Since an estimated 10% or more of birth defects are a result of maternal drug exposure, the FDA has assigned a risk category to each drug.
OTC medications that are considered relatively safe during pregnancy include most antacids, Acetaminophen, Chlorphenramine, Kaolin and Pectin preparations - although all expectant women should discuss the use of any and every medication (and herb) with their care providers. As an example, seemingly harmless Vitamin A (Retinol) used for skin conditions has shown to contain powerful teratogens which may cause serious birth defects. On the other end of the safety spectrum are drugs like H2 blockers, Pseudoephedrine, and Atropine/Diphenoxylate, to name a few, which are dangerous for developing fetuses.
During the 1940s – 1970s, DES (diethylstilbesterol) was often prescribed during pregnancy to prevent a miscarriage. That was until the daughters (and sons) of these DES mothers developed all sorts of reproductive anomalies and cancers during puberty. Then the use of this drug during pregnancy was immediately discontinued. But not until after the reproductive lives of thousands were adversely affected.
And for those of us old enough to remember the 1960's when thalidomide was prescribed to treat nausea during pregnancy, the images of those deformed babies was seared into our collective memories (remember the picture on the cover of Life Magazine?). Its use was quickly stopped after nearly 10,000 babies (mostly in Europe) were born with major physical disabilities – phocomelia, or seal-like flippers for arms and legs. Of course, the way these drugs received approval was very different 50 years ago than it is now.
The general rule is to avoid all drug exposure (including herbs and aromatherapy) during the first trimester when the fetal organs are developing (organogenesis) to prevent structural and functional abnormalities. Most drugs can cross the placental barrier (this includes pain medications and nerve blocks received during labor) and expose the developing embryo and fetus to harmful effects.
There are certain factors affecting placental drug transference and teratogenic effects:
Even one intrauterine exposure can have harmful effects. Thalidomide, for example, had catastrophic effects after brief exposure. When it comes to over-the-counter medications, some of them have unproven safety records or are known to affect the fetus. More than 80% of pregnant women take OTC or prescription drugs during pregnancy. Pain medications are widely consumed during pregnancy for relief of common aches and pains. A Danish study reported a direct link between the use of prescribed NSAIDS and miscarriages. Kaiser Permanente Medical also concluded the use of NSAIDS during pregnancy increased the risk of miscarriage by 80%, particularly when they were taken around the time of conception.
Categorized for risk during each trimester (1/2/3), this is a list of common analgesics used in pregnancy: Acetaminophen (B/B/B), Aspirin (D/D/D), Ibuprofen (B/B/D), Ketoprofen (B/B/D), and Naproxen (B/B/D). All of these drugs cross the placental barrier. Cold medicines, such as decongestants, expectorants, and antihistamines, may be unsafe during certain trimesters or their risk profile is unstudied.
Since most drugs taken while nursing are found in breast milk, all drugs and medications should be used carefully, conservatively and under medical supervision. The good news is that the concentration of the drugs in breast milk is low and the baby's exposure is less than what would be considered to be a therapeutic dose. If medication has to be taken while nursing, it is advisable to take the dose 30-60 minutes after nursing and 3-4 hours before the next feeding. This provides adequate time for the drugs to clear out of mother's blood, so the concentration in her breast milk will be minimal.
Pregnancy is a time of excitement and change. As the baby grows, mother's body adapts to the posture of pregnancy which can lead to aches and pains. Instead of reaching for that pill bottle, if she can, mom would be well-advised to pick up her phone and make an appointment with a qualified prenatal massage practitioner. So much safer and so much more pleasant.
Click here for previous articles by Elaine Stillerman, LMT.
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