Lost A Sale, But Initial Phone Consultations — A Big Part Of Brilliant Customer Service
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Practice Policy (Gone Bad): The Sign
Every once in a while, you see something and think to yourself, That's a really bad idea. Case in point: I went to see my medical doctor the other day. Just after being "roomed," as they say, the nurse checked my vital signs. Then she left.
Harvard Health References Flawed AHA Position Paper
In its special health report, "Stroke: Diagnosing, Treating, and Recovering From a 'Brain Attack,'" Harvard Health Publications includes information from the American Heart Association's 2014 position statement on cervical manipulation and cervical dissection – a statement the American Chiropractic Association emphasized in a letter to Harvard Health mixes "scientific facts with half-truths."
Oriental Medicine on the World Stage
"Let me win. But if I cannot win, let me be brave in the attempt." This simple, yet powerful statement was lived out time and time again by so many of the athletes from around the world during the Special Olympics World Games in Los Angeles.
The Zen Art of "One Point"
We were always told in our Zen Shiatsu training (by Japanese and Japanese American instructors) that our ultimate aim was to to find that "One Point." To be so focused we could touch just one point to transform Qi throughout a client's body.
Change Lives by Supporting Chiropractic Research: Are You In?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fund-raising campaign to support chiropractic research.
Healing Trauma: Cultivating Resilience and Presence Through Mindfulness, Part 2
In the last issue of Acupuncture Today, the first part of this article introduced the topic of trauma and resilience, and their relationship to the autonomic nervous system response and the concept of the spirit being grounded in the body, and suggested the importance of mindfulness as a tool for healing.
The Short Leg Dilemma
When evaluating a new patient, it is common to note a relative shortening of one leg to the other. Some patients will even tell you they have one, and then pull out the store-bought heel lift they read about online.
More Chiropractors Required
An intriguing study published in the Journal of the American Board of Family Medicine examines how "chiropractic care affects use of primary care physician (PCP) services."
Modernization of Chinese Medicine
Language – written, spoken, signed, or otherwise is learned as a means to express our individualized perceptions about the world around us. Language is designed to communicate our personal experiences.
Improving Communication Between AOM and Biomedical Providers
How comfortable do you feel talking to Western medical providers? If you are like me, you may not feel as comfortable as you would like. Some of my interactions with MD's haven't been the fruitful steps toward integrative medicine for which I had hoped.
Getting a YES: An Effective Strategy for Overcoming Patient Objections
Patients make more excuses for declining care from an acupuncturist than perhaps any other type of doctor. Various reasons hold them back from making a commitment to care.
What's Chiropractic Research Worth to You?
The Palmer Center for Chiropractic Research (PCCR), in celebration of its 20th anniversary, has announced it is spearheading a fundraising campaign to support chiropractic research.
Acupuncture Rising: From Acupuncture Anesthesia to Assisted-IVF, Part 1
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.
An Acupuncturist's View of Medicinal Marijuana
The use of cannabis for medical purposes is very controversial. Use as a panacea by physicians uninitiated to the proper application of herbal medicine, as well as an excuse for recreational use have greatly confused the issue.
Practicing with Authenticity
To extrapolate from the above quote, patients love healthcare providers they can trust. One way to earn the trust of your patients is by practicing with authenticity. What does that mean, exactly?
Fertility and Poly-Unsaturated Fatty Acids
Starting or expanding one's family is a major milestone. It's something that more and more people seek out health care advice and support for.
Patient-Centered Care vs. Payer Restrictions: Your Ethical Obligation
Do you have an ethical obligation to evaluate your patients, make a diagnosis and provide evidence-based, patient-centered health care, irrelevant to the payer restrictions?
Dorsiflexion Dysfunction: Evaluation & Manipulation Techniques
Almost every condition from the foot to the hip can be attributed to the inability to dorsiflex the ankle mortice and other joints that participate in dorsiflexion. Let's start by understanding normal versus abnormal dorsiflexion.
A Chiropractor's Guide to Yoga
"Doctor, can I continue to do yoga while undergoing your care?" "Is it OK for me to go back to yoga while I'm getting my back treated?" "It is safe to start my yoga classes again after my neck pain improves?"
Do Some Good and Grow Your Business with Cause Marketing
Cause marketing is truly one of the best ways that you can promote your services as a acupuncture professional. Cause marketing refers to a type of marketing where a business partners with a non-profit organization to help bring awareness to a charitable cause.
News in Brief
Call for Abstracts Announced - Parker Las Vegas 2016; Logan Adds Doctorate Degree; New Role for Dr. James Edwards.
Nuts Reduce Risk of Heart Disease, Cancer and Other Health Problems
Several recent studies suggest regular consumption of nuts may provide a significant degree of protection against certain types of cancer, heart disease, possibly type 2 diabetes and some neurodegenerative diseases.
The New Age of Communication
In the age of technology, everyone, including the patient, is seeking faster, easier ways to communicate. With a wealth of social media, blogs, websites and videos, we are constantly barraged with information – to the point of overload.
Help: A Need at Every Level
One of the great gifts of training in acupuncture is the ability to take good care of oneself. I recently had a bout of frozen shoulder — an inflammatory syndrome which can be debilitatingly painful and take years to resolve.
The Food Conversation: Nutrition and Your Practice
It's morning and your first patient rolls in with a triple espresso steaming in one hand and a frazzled, desperate look in her eye. "You gotta help me, doc, I am constipated unless I drink one of these, and I am exhausted and anxious all the time."
Surprising Reasons for Orthotic Efficacy
Clinical outcome studies show orthotics are effective in the management of a wide range of injuries, including plantar fasciitis, Achilles tendinitis and patellofemoral pain syndrome.
June, 2013, Vol. 13, Issue 06
Adventitious Tissue Structures of Elevated Tissue Density
By Linda LePelley, RN, NMT
A 12-year-old boy was brought into my clinic complaining of pain in his right heel, which impaired his ability to participate in sports, even to walk normally. His doctor, having x-rayed it, diagnosed a bone spur, explaining that the pain may or may not resolve on its own and it could be surgically removed if it continued to bother him.The boy's mother had heard I'd helped a friend with a similar problem so she wanted to see if I could help her son with the pain until something could be done about the bone spur. A hard nodule the size of a pea was palpable on his right heel.
A mechanic came in complaining of right-sided upper back pain, with trouble raising his right arm. I found a large mass of dense tissue, approximately 9 cm long, 4-5 cm wide, with an approximate depth from 1 cm at the outer borders, to 3 cm deep at its center. Its presence, at the medial border of the scapula, involved all of the musculature at that region, and prevented full range of motion. Palpation indicated it was ensconced all the way through to the bones of the ribs.
A 65-year-old woman presented with severe low back pain. She stated that she had never had any problems with her back until several days earlier. She had driven for 6 hours to visit her daughter, stopping only for fuel and then going directly to bed once she had reached her destination. The following morning she awoke to find herself barely able to walk without grimacing and crying out in extreme pain. Upon palpation, I found a large, rubbery, firm area the approximate size and shape of a 5 x 3 cm oblong pancake, 2 cm deep, engulfing her right sciatic nerve and the tissues around it.
A friend showed me her left wrist where, over the period of just a few months, a knot had formed on the radius, proximal to the scaphoid bone. Her doctor had told her it was arthritis, and her sister told her that she had suffered the same thing on her wrist, and had it surgically removed – suggesting my friend should do the same. My friend was no longer able to wear her watch, due to tightness and irritation. The knot felt just as if it was solid bone.
What these seemingly unrelated conditions have in common with each other is that they all involve the formation of a new tissue structure. I refer to these tissue structures as "Adventitious" because they are extraneous and they do not belong where they occur. And while they are likely the result of a body's attempt to maintain homeostasis; their development often results in pain and dysfunction. In my previous article, "Tissue Density's Relationship to Pain and Dysfunction", from the April 2012 issue, I wrote as follows: "My thoughts regarding the etiology of elevated TD involve the lipid-rich components of our extracellular fluids, which I believe are attracted to the bio-polymeric nature of our cartilaginous tissues. This attraction, combined with a variety of dynamic factors, including body heat, compressive force, overuse, injury, hypo-hydration, torsion, sheer force, tensile force, inertia, chemical environment and fluid viscosity may cause the extracellular fluid to accumulate, thicken and eventually precipitate into gelatinous plaque. Over time, I believe that these plaques harden and become mineralized, turning into the rubbery nodules or bone-like overgrowth of arthritic joints, as well as contributing to many other conditions. The plaque may be as thin as a sheet of a single layer of fascia cells or it can form a large area of many tissue layers sandwiched together, such as those found over arthritic hip joints and the thick, tender pads which so often develop at the medial aspect of knees." (I suspect that the main component of this conglomeration is cholesterol.)
Elevated Tissue Density (TD) is, in my opinion, the first sign of adventitious tissue structure formation. It seems to continue to increase in size and hardness over time. I wouldn't characterize it as "growth," but as an accumulation. Tissue Density Restoration (TDR) massage is an effective way to prevent and reverse this condition. In most of the examples above, the structures were stable, easy to isolate, and not too difficult to resolve.
In the case of the mother who spent several hours driving, the problem was a little more complex. An adventitious tissue structure had formed and become dense at her sciatic nerve area. Because it had not impeded movement or caused her pain, she was unaware of its existence. Over time, it continued to accumulate and condense, holding the nerve firmly in place until, that is, it shifted. When my client spent several hours driving, with her right leg extended to the gas pedal, enough heat was created in the affected area to slightly melt the outer layer of the adventitious structure. She then went to bed, sleeping in a side-lying position. During the night, her tissues resumed their normal temperature and the structure re-hardened, but now it was in a slightly different position. While the structure maintained its solid grip on the nerve, it had shifted, pulling the sciatic nerve painfully out of place.
Adventitious tissue structures can form sharp points, such as the bone spur on the young man's heel; large, immobile, lumpy barriers to free movement, as found in the mechanic's back; unstable, shifting bodies such as the one experienced by the traveling mother; and some so smooth and solid one would easily believe that it was simply a large, bony prominence. Fortunately, these affected tissues can often be restored to normal density and function through the proper application of TDR massage, as happened with each of the examples listed above.
A client who has rheumatoid arthritis complained of pain in her right ankle, stating that she had erosion in an ankle bone, as explained to her by her physician, and evidenced by x-ray. She brought her x-ray in. It occurred to me that perhaps the eroded area might actually be an adventitious tissue structure, formed over the bone, which had then melted in one spot (due to the heat of RA inflammation), leaving the appearance of erosion. I applied TDR massage, relieving her pain. Our hope was to then have the ankle x-rayed again for comparison; however the health care provider was not interested in exploring the matter. Whatever the actual etiology may have been, almost a year later, the client has not suffered pain in that ankle since.
I surmise that the reason elevated TD and these adventitious tissue formations have been overlooked, is due to the fact that they are largely invisible to diagnostic imaging. They are, however, palpable and once located, treatable through the proper application of massage. Massage therapists have the ability to resolve a great deal of human suffering, literally, within their grasp.
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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