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Overuse Injuries in Young Athletes (Part 1)
More than 45 million children ages 6-18 participate in some form of organized athletics, and 75 percent of American families with school-aged children have at least one child participating in organized sports.
Chiropractic in the Eyes of the Public: 2nd Gallup-Palmer Poll
The second Gallup / Palmer College poll has been completed, yielding significant additional data regarding Americans' experiences with and perceptions of chiropractic care.
Time to Fight for Your Medicare Right
I have heard a lot of noise and a lot of debate about what is going on with Medicare. As an ACA delegate, I often get asked: 'What is the ACA even doing?'
A Study of Relationships
Sa-Ahm's five element acupuncture method is known to be one of the most effective acupuncture techniques in Korea because it gives an instant response at the time of treatment and has a high success rate in resolving chronic problems.
Lessons from Functional Neurology
Chiropractic neurology, also known as clinical neuroscience or functional neurology, is moving the chiropractic profession forward by leaps and bounds.
The National Institutes of Health (NIH) lists more than 80 common autoimmune diseases including asthma, Crohn's disease, Guillain-Barré syndrome, multiple sclerosis, myasthenia gravis, psoriasis, rheumatoid arthritis, and lupus.
Illuminating the Hidden, Freeing the Source
Amongst the Primary Channels, from a classical point of view, the small intestine is perhaps the most important channel to understand. It is one of the least used acupuncture channels in modern acupuncture, yet it within it can be found a wealth of theories from the Ling Shu.
What are the Meridians?
The meridian and collateral system (jing luo, hereinafter referred to as "Meridians") is comprised of the main meridian channels (jing mai) and the collateral vessels (luo mai). Jing takes from meaning of the Chinese word pathway (also jing) and are the main branches of the system.
Analyzing Acupuncture Case Studies
Confirm the answer quickly by the elimination method. Take this case study as an example. 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.
International Congress on Integrative Medicine
"Bridging Research, Clinical Care, Education and Policy" was the theme for the International Congress on Integrative Medicine and Health 2016 (ICIMH).
Work Stress and Musculoskeletal Health: Do Your Patients Get the Connection?
Most people underestimate the impact their job has on their health, especially if that job isn't particularly physically demanding. Big mistake.
Less Time Than Required
Q: When is it appropriate to use a modifier -52? Can I use it for a timed service when I do less than the time required by the code?
Don't Ignore the Lower Half of the Pelvis (Part 1)
When your patient complains of lower back or pelvic pain, but your usual treatments are not getting the job done, what do you examine and treat? You may be missing important structures in the lower half of the pelvis.
The Professional and Practice Benefits of Political Activism
Welcome to election season, a vital part of our American culture. Every two years, without fail, we are bombarded with TV, print materials and phone messages seeking our vote.
What's New in the NCCIH Strategic Plan
The NIH National Center for Complementary and Integrative Health (NCCIH) released its draft strategic plan 2016-2021 for public comment in early spring of 2016.
Adventures with the Pericardium
My previous column on the San Jiao deserves equal time for SJ's loving partner, the pericardium. I nicknamed SJ the travel meridian – but pericardium can also play a crucial role in air travel.
Are Probiotics Doing More Harm Than Good?
Considerable controversy exists concerning the efficacy of probiotic supplements. Very few human studies show any real positive impact on the microbiome or health. The "promise" of probiotics is based on the few animal studies that suggest a positive effect.
Traditional Chinese Herbal Medicine in Taiwan Hospitals
This spring, a team of Western medical doctors and TCM practitioners from Cleveland Clinic traveled to Taiwan to visit Kaiser Pharmaceutical Co. (KP), and China Medical University (CMU), Taiwan's leading integrative medicine hospital.
Know Your Research: Tips for Evaluating Literature Reviews
Clinical and experimental studies are not the only types of published research we might encounter as we look for evidence to inform our practices. One of the most useful types is the literature review, which summarizes a group of studies.
Let's Talk About Biceps Injuries at the Elbow
While most muscles cross over only one joint, the biceps crosses two joints: the elbow and the shoulder. Injuries to the lower biceps cause considerable elbow pain. Here's how to assess and treat an injury to this area conservatively.
Code Connection: Guidelines for the Use of Modifier -52
Modifier -52 identifies that a service or procedure has been partially reduced or eliminated at the physician's discretion. This is to indicate the basic service described by the procedure code has been performed, but not all aspects of the service have been performed.
MPA Media Wins More Publishing Awards
The American Society of Business Publication Editors (ASBPE) has honored Dynamic Chiropractic with a national award and two regional awards for editorial excellence, and sister publication DC Practice Insights with two regional awards for graphic design excellence.
May, 2012, Vol. 12, Issue 05
Gestational Diabetes: Does She or Doesn't She?
By Elaine Stillerman, LMT
Nearly every pregnant woman is tested for gestational diabetes (GD) (or gestational glucose intolerance - GGI) at some point during her second trimester. But what constitutes a "normal" blood glucose level during pregnancy and when maternal or fetal morbidity occurs is controversial.
What is evident in cases of confirmed gestational diabetes is that babies grow larger, weighing over 4000g at birth (fetal macrosomia) or are in the 90th percentile for large-for gestational-age (LGA). And that often increases the likelihood of a surgical delivery and newborn monitoring for hypoglycemia. In the long term, these elevated levels appear to contribute to obesity and diabetes later in the child's life and an increase in the risk of the mother developing type 2 diabetes. On average, however, the rate of confirmed glucose intolerance is small and varies among different ethnic groups. Caucasian women are affected 1% to 2%, Afro-Caribbeans 2% to 3%, and Asians 4% to 5%.
The etiology of defining GD as a medical condition began in the 1950s with a study on women with high sugar values during pregnancy. It was "validated" in 1964 when Drs. O'Sullivan and Mahan, medical researchers, performed a 100g 3-hour oral glucose tolerance test on more than 700 pregnant women who were already hyperglycemic. Their study was to determine if these women were at greater risk of developing diabetes in the future. To no one's surprise, they were. And that led these two men to conclude that the "metabolic stress of pregnancy" exposed women to a "pre-diabetic status." But keep in mind, their research subjects had preexisting high blood glucose levels.
They also made an erroneous correlation that since insulin-dependent diabetes is a known risk to developing babies, this "pre-diabetic status" was as well. But their theory is unfounded. Diabetes types 1 and 2 are completely different in their manifestations and dangers than GD (GGI). For instance, both type 1 and 2 may result in blood vessel and kidney damage, the sequelae of which could be hypertension, insufficient circulation to the lower extremities, possible limb amputation and kidney disease. GD carries none of these risks.
Vacillating levels of high and low blood sugar during early pregnancy in type 1 diabetes might cause congenital malformations or miscarriage. Again, none of these serious complications are caused by GD. The only thing diabetes 1 and 2 share with GD is that the excess glucose goes directly to the babies, making them larger than they would be without the elevated blood sugar levels.
During pregnancy, the pancreas usually produces adequate amounts of insulin to regulate blood sugar levels. However, the hormone HPL (human placental lactogen) inhibits the maternal body's ability to transport the insulin properly out of the bloodstream and into cells, where it is used as fuel, resulting in elevated levels of glucose in the blood - or GD. So, in essence, there is more circulating blood sugar which the baby uses to grow and develop. And as pregnancy progresses, this delicate balance between adequate insulin levels and circulating blood sugar becomes trickier. After eating, blood sugar levels rise and by the time the third trimester comes, blood glucose levels are higher after eating than a woman who is not pregnant. (After a night's sleep, excess insulin goes to work to balance out the extra blood sugar, so morning levels of glucose are actually lower during pregnancy than in nonpregnant women - hypoglycemia.)
But there is a difference between elevated blood sugar levels and diabetes. And current research has not determined when high blood glucose levels, just shy of diabetes, cause harm to mothers and their babies. So screening for GD should come with an understanding, by both mother and her care provider, that the results may or may not be an indication of a serious problem.
Women can actively participate in their health during pregnancy by eating healthy, wholesome foods. They can avoid or control GD by consuming a diet rich in whole foods, high protein and high complex carbohydrates. They can start by eliminating empty calories - soda, white flour, white sugar, fructose and limit sweet desserts. Any food with a sugar content of more than 6 grams (read the label) should be accompanied by a protein source. Milk, often recommended by care providers for the necessary calcium it provides, and yogurt are filled with (milk) sugar and lactose is known to increase blood sugar levels. So consuming excessive dairy products might be contributing to high glucose values.
When eating cereals, the protein and fiber content should be more than 5g per serving and there should be less than 10g of sugar. One third of protein should come from complex carbohydrates. A glycemic index will help some women make healthier choices. And think color when it comes to food choices - the more varied and deeper the pallet, the healthier meals will be.
Clients with GD can still enjoy the benefits of massage. However, it is important to remember that massage, in general, lowers glucose levels. So you have to make sure your client's blood sugar level doesn't get too low, which can lead to impaired judgment and potential accidents. By providing your clients with a nourishing snack, it will raise their blood glucose level enough to get home safely where they can enjoy a healthful, wholesome meal.
Click here for previous articles by Elaine Stillerman, LMT.
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