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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.
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.
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?
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.
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.
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.
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.
News in Brief
Northwestern Student Honored for Addressing Concussions Head-On; Northwestern Announces New CFO; Life U. to Provide Unique Opportunity.
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.
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.
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.
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.
Roots in the Community, Branches Far Beyond
The Jung Tao School of Classical Chinese Medicine (JTS) was founded in 1998 by Sean Christian Marshall in Sugar Grove, North Carolina, a small community near Boone in the state's westernmost mountains.
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.
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.
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."
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.
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.
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.
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.
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.
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."
February, 2012, Vol. 12, Issue 02
Seeing Your Massage Clients Through a New Lens
By Ann Catlin, LMT, NCTMB, OTR
I've worked with people young and old with complex medical conditions since 1979 when I began my career as an occupational therapist. From rehabilitation centers, home health agencies, psychiatric hospitals, hospices and long-term care facilities, I've been around the block a time or two.But my work the past decade as a massage therapist has helped me see things through a new lens.
One such thing is the importance of distinguishing between a primary diagnosis and the secondary conditions resulting from the primary illness or injury. It's important to realize that secondary conditions can impact our clinical reasoning, leading to modifications in our approach or techniques, as well as our own feelings and emotional reaction to our client.
There are many diagnosis commonly found in older adults who require skilled nursing or home care. However, I'm focusing on only one — Parkinson's disease, a progressive neurological disorder. Nerve cells located in the area of the brain that controls movement degenerate causing symptoms associated with this disease. In spite of aggressive research, the exact cause is unknown; however there is speculation that genes and environmental toxins might play a role.
So, let me ask, is it necessary to be an expert about Parkinson's disease to have a safe and beneficial massage session for a person with the disease? I don't think so. It's not the diagnosis itself that drives our approach, but rather our observations of the secondary conditions or symptoms. Secondary conditions are those things we can see, feel, hear and sense during a session. They impact our decisions about how to carry out a session; how we position our client; how we communicate; what techniques to use.
What follows are three secondary conditions (symptoms) of Parkinson's disease and corresponding questions that influenced my own clinical reasoning when a woman was referred for massage therapy sessions to improve physical comfort and sleep. Mrs. P. was a woman with advanced Parkinson's disease being cared for in her home by family and a team of home care professionals.
Symptoms included tremor while at rest, involuntary shaking of an extremity, often the hands when the muscles are relaxed. For example, the hands shake when they are lying in the lap. But when the person reaches for something or performs other purposeful movement, the tremor is lessened. Clinical questions: Will her hands shake while I'm trying to massage them? If so, is it okay to massage them anyway? How much pressure should I use? Would compression be a good technique to use? Will massage help quiet the tremor?
When I started seeing Mrs. P., I noticed her right hand had a mild tremor that continued as we talked about how she wanted to receive her massage. I determined that gentle compression techniques to the arm and shoulder attachment sites would be a good technique to use since compression has an inhibitory effect on the nervous system. If compression did not ease the tremor, I understood there was still benefit to offering unconditional touch to sooth her.
Bradykinesia is when people have difficulty initiating movement and appear to move in slow-motion and walk with small, shuffling steps. Speech becomes slurred because the muscles of the mouth and tongue are affected and some people have a mask-like facial expression. It was clear that Mrs. P. was not able to get onto a massage table. Should I use a table-top massage device or have her get up on the bed? Is the area free of clutter or anything that might be a fall risk should she need to move from the chair? Should I have her remove clothing knowing that it takes her a long time to do so? She had a mask-like look on her face making it difficult to read her non-verbal expressions. How else might I determine her reactions and watch for signs of pain?
Mrs. P's speech was very hard to understand because she had difficulty forming the words and her voice was very soft. It took my full attention to understand. But she made it clear that she preferred to get onto her bed for our sessions. Her daughter helped her transfer from the chair to the bed. Mrs. P's movements were excruciatingly slow making the process difficult. It took several minutes for Mrs. P. to get settled in a supine position on the bed. She was dressed in loose fitting clothes and I decided it best to not ask her to remove anything. We would work around and through the clothing.
There was muscle rigidity and atrophy causing stiffness and sometimes painful contractures in the arms, legs and trunk. Is there pain? Does it hurt to move? How much range of motion is present? Should I try stretching it? Are there any positioning techniques I could use to increase her comfort and support during the massage?
As the disease progressed, Mrs. P's muscles became very tight and stiff especially in her arms, legs and neck. She now found it extremely difficult to speak and was now mostly silent. But she was alert and her eyes were bright. Now, when I arrived for our evening sessions she was already in bed. Her arms were usually bent at the elbow and held tightly to her chest. Muscle spasticity in her legs caused them to be clasped together and crossed at the ankles. Her daughter reported that Mrs. P. had difficulty sleeping because of pain. I discovered that effleurage strokes, gentle compression and focused touch, eased the spasticity that caused the stiff posture and she was able to relax her arms enough to be placed comfortably on pillows at her side. Her legs relaxed allowing them to uncross at the ankles. Within minutes of starting our session Mrs. P's eyes would close as she drifted into sleep. Her family reported that on nights she had massage she slept through the night, giving all of them much needed rest.
As our sessions continued, the fact that Mrs. P. had Parkinson's disease became less relevant in my mind. More important were my keen observation skills; meeting her in present time, responding to each moment of every session and allowing her to receive the gift of touch in any way that served her. Sometimes that meant having her cat sit on her stomach watching my every move. I'm not sure if that's a secondary condition or not, but I know I sure enjoyed it!
According to the Mayo Clinic, "Massage therapy can reduce muscle tension and promote relaxation, which may be especially helpful to people experiencing muscle rigidity associated with Parkinson's disease."
Click here for more information about Ann Catlin, LMT, NCTMB, OTR.
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