Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Data: The New Frontier in Health Care
Your practice is empowered with the data you need to improve patient health, run a more efficient (read: profitable) practice, get paid in timely fashion and help show the efficacy of chiropractic on the national stage in the midst of sweeping changes in health care!
Abdominal Acupuncture for Eye Healing: The Sacred Turtle and Ba Gua Map
Our ideas about western medicine have shifted in recent decades, while the public is asking more from health care providers.
A War You Can Help Patients Win
The average American consumes approximately 60 percent of calories from sugar, flour and refined oils. A donut is a good example of a so-called "food" that represents these calorie sources.
Online Marketing Basics: Google Ranking, Part 1
We all know there is so much opportunity with online marketing. And, let's face it, if you don't have a presence online with a website and social media, you are probably not where you want to be.
Medicine as Metaphor
The practice of medicine is both an art and a science. We study and learn the system so that when the time comes to apply it, there is a greater possibility of successfully helping others.
Can Acupuncture Treat Knee Pain?
Recently, an article in the Journal of the American Medical Association concluded that, "neither laser nor needle acupuncture conferred benefit over sham for pain or function" among older chronic knee pain patients.
Colon Health and TCM
I still remember many years ago, the loud "Yuck" from my wife at the time when we were together watching the Chinese movie "Last Emperor."
News in Brief
Support of F4CP Continues With Latest Donations; Walter Reed Honors Dr. William Morgan; Recognizing 40 Years of Public-Health Activism; Allstate Decision Reversed.
Melatonin: A Promising Natural Agent in the Prevention of ALS
A number of years ago, experimental studies suggested melatonin could block key steps in the development of Alzheimer's disease, primarily by acting as a brain antioxidant and inhibiting the build-up of beta-amyloid plaque in the brain.
ICD-10 Is Not Scary (and Not About Billing)
In my 13 years of consulting with doctors on billing and coding matters, ICD-10 has aroused the biggest combination of misguided fear and ignorance I can remember.
Treat Every Patient as an Athlete
Frontal-plane movement pattern dysfunction can set the stage for musculoskeletal injury. Frontal-plane stabilization is essential during the normal activities of daily living: think single-leg stance and gait cycle.
Exploring and Learning from the Gift of Life
I'm grateful to have had the opportunity to teach cadaver dissection classes and workshops with Stephen Cina at the New England School of Acupuncture over the past seven years, first through the Sports Medicine Acupuncture Program and later as a NESA elective course.
Making Public Health a Chiropractic Priority
As highlighted in this edition's News in Brief, Rand Baird, DC, MPH, FICA, FICC, editor and occasional author of our long-running column, "Chiropractic in the American Public Health Association", was recognized by the organization recently for 40 years of membership.
The Source-Luo Point Combination, Part 3
Dr. Nguyen Nghi (NVN) was born in Vietnam and is one of the most important scholars, writers, teachers and practitioners of modern time. Many of his theories and applications are the source of modern teachers from Europe and the United States.
The Art of Creating a Healing Space
I always advise my graduates to examine their group practice or treatment rooms with fresh eyes after they leave my CE workshops. I tell them, "Ask yourselves - is your space qi filled, welcoming and healing? Or is it cold and clinical?"
The Integrative Medicine Puzzle: Putting the Pieces Together
The conversation is changing in the broader healthcare community with patients actually moving the discussion toward more integrative topics. Patients today want to know their options.
The Roots of TCM in Depression Treatment
In traditional Chinese medicine, there is historical precedent for the treatment of so-called "Shen" (Heart-Mind) disorder, or disorder/dysregulation of the spirit, which is also considered as distinct but not separate from the cognitive function of the brain.
Lower-Extremity Overuse Injuries: Primer on Causes and Corrections
From ankle sprains to stress fractures, shin splints to plantar fasciitis, the research is clear: These common overuse injuries of the lower extremities – among dozens of others – may be related to abnormal foot function in your patients.
Technology Meets Practice: Chiropractic Every Day
About a year ago, I had an interesting conversation with a DC who made house calls. When I asked why, she was quick to explain she learns much more about her patients when she sees them at home than she could ever observe in the office.
Aetna Updates 97140 Policy
In a development the Association of New Jersey Chiropractors is calling "a resounding victory for chiropractors nationwide," Aetna Insurance Company has updated its national reimbursement policy regarding 97140 (manual therapy), reaching an agreement two years after the association filed a declaratory judgment suit in federal court against the insurer.
Adding Microneedling to Your Clinic for Results and Profit
Microneedling has taken the beauty world by storm over the last 10 years. Under the names dermaroller, microneedling or skin needling you will see these treatments listed in the services of nearly every fashionable beauty salon and day spa in the country.
Treating LBP in Golfers: Beyond Basic Assessment
The drive to master the most efficient swing demands a tremendous amount from the lower back. Maintaining stability in a flexed posture, supporting torso rotation and repetitively supporting the golf swing all put the lower back in a vulnerable position.
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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