Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Sports Medicine 101: Surgery or No Surgery?
In the world of sports medicine, many careers are saved by surgeries that correct traumatic damage to the body. Muscle tears, ligament damage, fractures, spinal disc herniations, and joint instabilities are a few of the issues frequently addressed with surgical intervention.
NCCAOM Video Contest
The NCCAOM is excited to announce the launch of the second annual video contest "Because it Works!" 2015.
Integrative Medicine for the Underserved: A Seat at the Table
Numerous organizations have risen to the challenge of providing care to medically-underserved populations and here we feature one such group.
Desert: A Metaphor from the Study of Genetics
In most of the human lives I know about, there are stretches of time which feel stagnant, or worse. We can feel adrift, or wounded and sidelined, and these times don't seem to carry much usefulness while they are unfolding.
Should You Change an Athlete's Natural Running Form?
Once past the ankle, impact forces travel at about 200 mph into the knee. In addition to allowing the quad to absorb force, bending the knee (E) prevents the hip and pelvis from moving up and down too much (F), which is important for injury prevention and efficiency.
An International Life: An Interview with Mary Elizabeth Wakefield
I met Mary Elizabeth Wakefield during her class last summer in Seneca Falls, New York at the Finger Lakes School of Chinese Medicine.
Creating Relationships at Southwest Symposium
The month of May brought many interesting activities. As I have said in many previous columns this year, this profession is moving in a very exciting direction. Make sure you are getting involved. If you're not, you just might get left behind.
Chinese Doctors Poke Holes in Australian Study
A recent Australian clinical trial, published in the Journal of the American Medical Association (JAMA) in 2014 by Rana Hinman, et el., evaluating the effectiveness of both needle and laser acupuncture for chronic knee pain.
Key Changes and Updates to the 7th Edition CNT Manual
Acupuncture Today recently interviewed Jennifer Brett, ND, L.Ac. regarding the updates to the CNT manaul.
Treatment of PTSD: An Opportunity for the Practice of Integrated Medicine
PTSD is widespread across America today. Not only do many of our honored men and women in uniform bring it home with them from the war zones they have been active in, but it often follows any life-threatening event people go through when their lives have been in danger.
Leg-Length Inequality and Pelvic Fixation: A New Approach to the Negative Derifield (Part 3)
A patient with sacroiliac fixation and dysfunction ordinarily demonstrates a noticeable leg-length inequality when placed in the prone position on the adjusting table.
Marketing with a Microphone
When given an option, it stands to reason that people prefer to do business with those they know, like, and trust.
Q&A With the First VA Chiropractic Residents
As you may have read previously, a major step forward for the profession occurred in July 2014 when the Department of Veterans Affairs began piloting a chiropractic residency program at five locations.
I was sitting in a Pizza Hut in Peoria, Ill., with my friend Reggie, sometime in the spring of my senior year in college, when he started doodling on his paper placemat. In those days, the company had a picture of U.S. on the mats, showing all the locations of the "Huts" in the country.
The Source-Luo Point Combination, Part 2
The Da Cheng includes symptoms for the source-luo points that indicate when to use them for treatment. Yang defines the method as the guest-host (it is one of a variety of acupuncture point combinations called guest-host).
News in Brief
Investigating the Cellular Impact of Mechanical Force; National Board Seats (Not-So) New Officers at Annual Meeting.
Going On-Site With Chiropractic Care
The Foundation for Chiropractic Progress has released a position paper highlighting the financial, clinical and patient-satisfaction benefits of providing chiropractic care at on-site corporate health clinics.
Meet Cheyenne: Your Future Colleague
Allow me to introduce you to Cheyenne (Chey), the daughter of some of our family's closest friends. We attend and serve at the same church together, and have known each other for many years.
Free Yourself From the Pocketbook Practice
Let's take a journey together; there's an important lesson to be learned. Imagine a town or city just like yours.
The Risks I Took
We all take risks when we choose this profession. For some, it is not knowing if you can make a living practicing TCM. For others, it is parental or cultural disapproval.
Nomenclature and Classification of Lumbar Disc Pathology: Version 2.0
The Nomenclature and Classification of Lumbar Disc Pathology consensus, published in 2001 by the collaborative efforts of the North American Spine Society, the American Society of Spine Radiology and the American Society of Neuroradiology, has guided radiologists, clinicians and the public for more than a decade.
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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