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Making Sense of an Increasingly Obvious Conclusion
Where's U.S. health care heading? Like it or not, the list of telltale signs is growing to a point that stands out to even the most myopic observer. Consider this list of facts as you look into the future of health care in the United States:
Dietary Fat and Prostate Cancer: An Important Update
K.M. Di Sebastiano and M. Mourtzakis published a review paper examining the role of dietary fat on prostate cancer development and progression late last year that does a stellar job of summarizing the available data on fat and prostate cancer.
Omega-3 Fish Oil: An Underappreciated Element of Men's Health
As a clinician with many male patients -- and as a man myself -- I am all too aware of the fact that we like to convince ourselves that we are doing great, when that may be the farthest thing from the truth.
One Size Does Not Fit All: Exercise and Nutrition According to Your Yin/Yang Body Type
There are countless new exercise and nutrition plans out there, emphasizing the latest ground-breaking research and claiming to revolutionize the way we view health.
Too Many to Remember: Tips to Revive Your Ortho / Neuro Test Skills
When I was at Palmer in the mid-1980s, we were given a set of notes in one of our diagnostic courses. The notes covered approximately 70 orthopedic and neurological tests for various regions of the body.
Chinese Herbs and Pulmonary Fibrosis: A Case Study
"Mary M."* recently celebrated her 90th birthday. Even the former sheriff dropped by to kiss the hand of this diminutive retired teacher, to honor the years she interpreted for him during interviews with Latinas and Latinos.
Targeting the Bad Apples in the Bunch
While everyone was focused on the conversion to ICD-10, the Office of Inspector General for Health and Human Services released a new report on chiropractic titled "CMS Should Use Targeted Tactics to Curb Questionable and Inappropriate Payments for Chiropractic Services."
The Concussion-Subluxation Complex
In the Aug. 1, 2014 issue of Dynamic Chiropractic, I reviewed some of the literature demonstrating the role of the chiropractic adjustment in post-concussive care.
Footsteps of the Sages: An Apprenticeship with Dr. Kezhan Zhang
When I met Dr. Kezhen Zhang in May 2013, I was his translator and the integrity, creativity, and passion he demonstrated as a practitioner and advocate of the medicine convinced me to travel to Beijing to study with him.
Acupuncture and Oriental Medicine in the West
We know acupuncture and Oriental medicine as the indigenous medicine of East Asia; in particular China, Korea and Japan are the countries of origin of this wonderful healing system.
Diagnose Sprain Injuries in MVA Cases With Dynamic X-Rays (Pt. 1)
Am I the only person to notice hospitals are doing a seemingly insufficient job lately in their initial radiological workup of motor vehicle accident (MVA) victims?
Mechanism: Experimental Approaches to Understanding Acupuncture, Part 1
The clinical benefits of acupuncture are difficult to ignore, but also can be difficult to explain to a Western audience. For nearly 50 years, relentlessly inquisitive scientists and physicians have been working toward a conceptual model to explain acupuncture.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 2
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.
It's Time to Review
It is amazing to see the changes that are occurring in the acupuncture profession. Let's look at some of the news and events that have contributed to this growth and awareness.
Which Way is the Energy Going? Are You Burning Yourself Out?
One of the simple methods that I use to define Yin/Yang theory to patients is to ask the question, "Which way is your energy going?"
North Carolina Acupuncture Board Files Dry Needling Lawsuit
In early September, the NCALB filed a complaint against the North Carolina Board of Physical Therapy Examiners over the issue of dry needling, a form of acupuncture that uses solid needles to puncture the skin and muscle tissue to relieve pain.
Syncretism: Acupuncture and Public Health in Cuba
"Syncretism" is defined as a union of diverse tenets or practices. On a recent trip to Cuba designed to demonstrate the integration of Traditional Medicine and biomedicine, our group witnessed this union firsthand.
Tailor-Made Knee Pain: The Sartorius Muscle
A patient was referred to my office after receiving treatment from various providers with no results. The patient was training for the Olympics as a marathon runner and was unable to run or walk without severe medial knee pain.
Pro-Con: Swaddling for Newborns
The practice of swaddling has been used for thousands of years and was popular until the 1700s, when it was slowly abandoned by many cultures that considered it old-fashioned or barbaric.
Your Billing Questions Answered
I hear a lot of the following questions: I am afraid I may doing something illegal. I have heard I cannot have different fees for the same service.
F4CP Making a High-Impact Impression
The Foundation for Chiropractic Progress has released details of its 2016 strategy, certain elements of which are already in play. The strategy includes ads, posters and other resources available to all F4CP members.
Designing a Fitness Plan (Part 1)
It doesn't matter if you come to my practice for pain relief, weight loss, healthy aging or something else. The formula I talk about for each patient's fitness strategy is pretty much the same.
The Modern Application of Ancient Mei Rong
Chinese Medical Cosmetology (Mei Rong) has a well-documented and venerated history dating back to the Qin (221-206 BC) Dynasty.
March, 2013, Vol. 13, Issue 03
TDR Massage for Self-Care of the Breast
By Linda LePelley, RN, NMT
A new client stated that his doctor had recommended massage to reduce his anxiety level. He had been experiencing frightening episodes of chest pain, but all the tests indicated that his heart was fine – hence the diagnosis of anxiety.I found elevated tissue density (TD) in his chest overall, as well as several pectoral trigger points. I released the trigger points and instructed him on how to massage his chest, and his chest pain has never returned.
Tissue density restoration massage for the breast was developed to relieve non-cardiac related chest pain, and to help detect and prevent breast cancer. If you experience chest pain but have been told by your doctor that it is not related to heart disease, a simple routine of chest/breast massage can relieve and prevent pain symptoms. Hyper-dense chest and breast tissues can be a source of pain, especially during periods of elevated tension, for men and women alike. When tissues harden, nerves are caught up within them, impairing normal sensation. While many men assume breast massage would be for women only, it is important to point out that men get breast cancer as well, as many as 1 in 1,000. Whether you are seeking to relieve achy chest tension, or promote breast health, the treatment is the same.
Several years ago, in the course of having a sonogram on my liver, pancreas and gall bladder, the doctor told the technician to try to visualize my heart as well. He added that it most likely would not show up. I asked why, and he told me that at my (plus) size, my tissues would most likely be too dense to "see" through. I explained to him that, as a massage therapist, I made it a practice to keep my breast tissues massaged so that they are malleable, and hopefully, any lump that might develop would be easily detected. He dismissed the idea that massage could change the density; stating that it is either dense or it is not. At completion of the testing, the technician let me know that there were no visualization problems, even at my size. I do not offer this one, personal, anecdotal experience as proof that TDR massage can improve the ability to visualize breast tissue; I would have needed to have a pre-massage test, as well as several other subjects being tested. I do, however, offer it as a possibility. It is my hope that one day someone researches the visualization differences in breasts before and after TD alteration massage.
I am gratified that my suspicion from years ago of the relationship between breast density and cancer has been found to be accurate. I discussed the cancer risk of having elevated breast density with anyone who would listen to me, from radiation nurses to doctors, but was told that density had nothing to do with it. That opinion has changed; a government cancer fact sheet states that having dense breasts is a breast cancer risk factor. And by "gratified," I mean I am pleased that - even though we can't change our genes or physiology, elevated tissue density is a condition that can easily be altered, by the individual, at no cost.
Self TDR massage for the breast is performed the same way for men as for women. You will want to be sure the space you are working in is warm and free of drafts. Warm the chest for about 20 minutes before performing assessment with a warming pad or pack. You will be looking for tissue that:
The guidelines of TDR massage are to keep the tissues warm and not to go over a 3 on a 1/10 pain scale. Keeping that in mind, the goal is to use as much pressure and movement as possible to ensure that each layer of tissue is fully hydrated, perfusing well and is not immobilized. Remember that normal, healthy tissue does not hurt when pressed into.
Lie on your right side. Raise your left arm and grasp it firmly at the elbow with your right hand. Gently jiggle the underarm area, looking for tight, firm or hardened areas. Palpate the tissues from the elbow, moving toward the armpit with your fingers in long, smooth strokes. Do this several times all around the arm, on the top, sides and bottom. Make a fist of your right hand and press it into your left armpit, making wide, firm circular strokes. Cup and lift your left breast with the left hand and, using the tips of your fingers, press gently into the chest wall. Using small, circular movements, palpate the borders of your entire breast. Still cupping the breast, use fingers to lightly jiggle the body of the breast, noting any sensations of tightness, adhesions or discomfort. Press the fingers of your right hand into the ball of left shoulder, dragging towards the center of your chest, palpate the tissues around the collarbone. Repeat on left side. In an upright position, place the palms of your hands at the sides of your chest wall, gently press and rake your palms across the chest, toward the mediastinum, mobilizing the pectoral muscles.
You now have a good idea of where you may have elevated TD. You can restore the density by massaging thoroughly, using massage cream and a heated pad, or simply a good warm shower and gentle soap. I would do any work needed in the axillary region first, simply because it will encourage and promote proper lymph drainage. After that, pick the area that was most uncomfortable and clear it up first. If it feels too tight, warm and massage it as firmly as possible without eliciting pain. Once you are able to press into that tissue without discomfort, move to the next worst area. If an area feels denser than it should, warm it and move it around until it softens and normalizes. Even slight sensory changes indicate elevated TD, so if there is a muscle or area that feels tingly or itchy, work on it as well. Always modulate the amount of pressure and movement you use based on the pain level, keeping it under a mild 3.
Another important aspect of any form of TDR massage is to take whatever time is needed to affect a change in the tissue density. I expect to spend at least 45 minutes on a hardened area before it will soften, pink up and stop hurting. Once an area is cleared up it will stay that way for a long time, maybe permanently with maintenance massage. For this reason, you really need to emphasize to your clients that they will be better served to work on one area until it improves, rather than to try to work on multiple areas during a single session. Once they experience the benefits of TDR massage, they appreciate the improvements and are willing to "do the work."
A female client once complained that her breasts felt like hard balls in a sagging sack. I suggested she perform breast massage in a warm shower every day. Several weeks later she told me she was very pleased that her breasts were no longer hardened and, rather than sagging, they felt full, plumped and buoyant. She no longer had the sensation that the tissues were separated from each other.
Linda LePelley, RN, NMT is a registered nurse and licensed massage therapist with 19 years of clinical massage experience. She developed Tissue Density Restoration (TDR) Massage, an effective treatment for the pain found in hyper-dense tissues. For more information, visit www.MyHealingHands.com.
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