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Keeping Malpractice Allegations at Bay
It has been suggested that in the litigious environment in which we live, the practice of chiropractic should be defensive and practitioners should constantly be watching their backs. An element of defensive practice is a good idea.
Parker University Embraces New Era
Change is in the air at Parker University, which recently announced the selection of both a new president and a new consultant for its seminar program.
News in Brief
NYCC Aggregates Degree Programs in New School; Palmer Chancellor Receives Education Award From ICA; Oklahaven Announces "Have a Heart" Winners.
Prostate Cancer Risk
A large study published in January 2016 in the American Journal of Clinical Nutrition showed that men who are vegans had a 35% lower risk of developing prostate cancer compared to non-vegan men. The study followed more than 26,346 men who are part of the Adventists Health Study-2.
How to Reach Your World With the Chiropractic Message
My latest effort to share chiropractic occurred in mid-May while I was sitting at an introductory parent information night for high schoolers. The IT instructor informed us that each student would be receiving a computer for all their studies.
The Need for Standards
ISO-TC-249: You may look at these letters and numbers and wonder what they are and what they might mean. They turn into: International Standards Organization- Technical Committee – 249. There is a global organization called The International Organization for Standardization.
Living Well: Lessons From Our Oldest Old
Aging is a significant public health problem, important to chiropractors in practice and important to DCs who teach students training to become chiropractors.
A Different Way of Looking at It
The way you and your chiropractic colleagues access information has changed over the past decade. According to a recent survey conducted by Dynamic Chiropractic, almost half (48 percent) of DCs read online articles on their personal computer or laptop daily.
Sleepless nights, anxiety, mood swings, euphoric energy bursts, obsessive thinking, and a strange feeling in his chest. That is what Matt was experiencing when he first entered my practice. Rather than being concerned, he was loving every minute of it.
Building Bridges with Discipline
As practitioners of traditional Chinese herbal medicine, our role is to educate patients and medical practitioners about the various safety aspects of our medicine. Medical doctors that embrace Chinese medicine want to collaborate and include Chinese herbal medicine in more aspects of clinical care to support their patients.
Distal Style Treatment of Neurogenic Pain
Treat locally or distally? This question has frequented my thoughts for the treatment of pain throughout my acupuncture career. Each style has strengths and weaknesses, thus the versatile practitioner would do well to forgo dogmatic adherence to any one style in deference to the needs of the individual patient.
Billing Timed Services
Q: I do not always use physical medicine services but in my state I do have a scope of practice that allows me to provide many of these services. I am trying to understand what "direct one-on-one patient contact" means in relation to physical medicine services.
Understanding Levels of Evidence
The concept of levels of evidence is a cornerstone of research literacy and a great starting point for understanding basic principles of how research works.
Transforming Las Vegas
On a warm spring day in Las Vegas, Sonia Kim, clinic front desk staff, is busy preparing for a full day of intern shifts at Wongu Health Center. She greets patients, makes sure documents are properly signed, and lets the interns know that their patients have arrived.
Discovery: Finding Insights and Each Other in Different Disciplines
Recently I've been thinking about all sorts of things which are hidden from our daily direct experience. That general category is what links nearly everything that catches my attention and then demands some kind of investigation.
Billing One-on-One, Direct Patient Contact
This is often misunderstood and leads to trepidation when documenting and subsequently billing timed services.
Constructing Our Reality, Part 2
My last article discussed perception and its relationship to the primary channels. Before we get to the channels most commonly used to treat sensory disturbances, the small intestine and triple heater, we should first talk about the bladder channel.
With Low-Back Pain, Sometimes Little Things Matter
Typical treatments for low back pain involve large muscles like the quadratus lumborum, iliopsoas, and piriformis. However, there are situations when a very small muscle, the multifidus, can play a significant role in the diagnosis and treatment of low back muscular or spinal injury.
Low Fat vs. Low Carb & the Power of Protein
A science-based website recently posted a nice summary of 23 randomized, controlled trials from peer-reviewed journals pitting low-carb diets against low-fat diets.
Streamline Your Front Desk
Your front office can be your greatest source of efficiency or it can be a constant bottleneck. Increasing the productivity of this area, while not sacrificing the quality of patient interaction, can be a little tricky. However, with some focused effort and intention, your front desk can keep your practice running smoothly.
One of the most common trends to see in clinical medical practice and public health is the cycles of health "buzzwords." These come and go depending upon the current cultural zeitgeist. One year, "parasites" are causing all the issues, and the next year it's "candida."
In This Current Age of Anxiety
Anxiety, also referred to angst or hysteria, goes by many names. One, popularized by the sagacious Zhang Zhong Jing, who many practitioners of Chinese Medicine may be familiar with, is known as Restless Zang/Fu disorder.
Holistic Skin Care and Modern Technology
Anti-aging is a concept that we hear in reference to skin rejuvenation and growing older on a daily basis. Aging begins as soon as we are born; therefore "pro-aging" is embracing all stages of life gracefully, with vitality, wisdom, joy, and gratitude as the goal.
Finger (Pad) Pointing: Repetitive-Use Injury Waiting to Happen
"My wrist and hand hurt. I spend all day working on computers and then I come home and spend more time on a computer, usually playing video games."
A Whole-Body Approach to Chronic Tension Headaches
Nearly every day in our practices, we see patients with chronic headaches that have not responded to traditional treatment. They present in our offices with a feeble hope that "maybe" a chiropractor can help.
Hip Flexor Contractures & LBP in Above-the-Knee Amputations
Patients with above-the-knee amputations (AK or AKA) are particularly prone to developing hip flexor contractures. Not to be confused with muscle tightness, contractures are a permanent shortening of tissues which cause deformity or distortion.
August, 2013, Vol. 13, Issue 08
Vacuum Therapies for Surgical Preparation and Recovery
By Anita J. Shannon, LMBT and Rita Woods, LMT
Surgery can be one of the most traumatic, yet helpful, events that a person can undergo. Proper preparation and effective techniques for recovery can make a world of difference in the experience.Vacuum therapies present a successful path to integration with the medical community, and allow us to work directly with the surgeons and have access to diagnostic reports.
Preparation for surgery includes vacuum therapies to drain and clear lymphatic pathways, decongest the tissues, and release any soft tissue restrictions to movement of muscles and fascia or flow of blood and lymph. Post-surgical care includes the same approach, and adds in potential scar work to diminish appearance and adhesions, along with release of inflammation, pockets of anesthesia, and soft tissue issues that may have resulted from surgical positioning.
Surgical complications often include the formations of adhesions, nerve compression damage and reactions to the anesthesia. While any adhesion is a potential restrictive problem, abdominal adhesions are a particularly burdensome complication. They form in approximately 90% of all patients undergoing any type of abdominal surgery, but the risk is greater for operations on the lower abdomen including pelvic, bowel and gynecological surgeries.
These surgery induced adhesions can be caused by tissues incision, especially those involving internal organs, the handling of organs, the drying out of internal organs and tissues, contact of the internal tissues with foreign materials such as gauze, surgical gloves, stitches, etc., as well as blood or blood clots that were not rinsed out during surgery. Abdominal adhesions are bands of tissue that form between tissues and organs causing them to adhere and stick together. They can become larger and tighter as time passes causing problems years after surgery.
Other less common, but just as serious, causes of abdominal adhesions involve inflammation from sources not related to surgery including appendicitis- in particular appendix rupture, radiation for cancer treatment, gynecological infections and abdominal infections. The use of vacuum therapies is extremely effective in working with these scars and adhesions, with very little discomfort for the client.
Prolonged surgeries in which the body has been placed and maintained in an unnatural position can lead to peripheral nerve damage. While the cause of damage varies, it can range in severity from mildly annoying to disabling. In most cases, the damage is temporary and the discomfort or numbness decreases in the weeks following surgery. But a small percentage of patients have lasting nerve problems. Decompressing the involved area with vacuum therapies relieves the pressure and allows the tissue to return more quickly to a normal state. Damage can also occur at the site where medications were injected or at the site of a spinal epidural.
Another potential complication of surgery relates to the anesthesia. Most problems arise from the use of general anesthesia (when the patient is put to sleep) but some problems may arise with local or regional anesthesia- usually at the site of medication injection as mentioned above.
General anesthesia, however, can foster a whole different set of problems. Two separate studies, one from Sweden and one from Duke University, showed that the length of time spent under deep anesthesia is a significant risk factor for predicting death up to two years after surgery. In both studies, the common cause of those deaths after surgery (non cardiac surgeries), were primarily from heart attacks or cancer. Additionally, a subsequent study indicated a cognitive decline in elderly patients up to two years following surgery. One popular theory as to why this happens is based on the production of inflammatory neurochemicals that negatively impact the body and undermine the immune system. One of the key uses of vacuum therapies involves the ability move fluids and clear the body of toxins and inflammatory residue.
The most incredible aspect of this work for preparation and recovery from surgical issues is the decompression that the vacuum produces. The lifting and stretching of the tissue and the release of restrictions, as well as the drainage and clearing of debris creates space and the opportunity for the body to resume normal functioning.
Protocols for each client will depend on a thorough intake and review of supporting documentation from the surgeon (if possible), and then the application of a six-step evaluation and tracking criteria that we developed over years of creating protocols using vacuum therapies. Recovery techniques can be used on clients of any age, and can produce some surprising results on sites that are quite old.
A recent experience while teaching in France was the perfect opportunity to show the class how the age of a scar can determine the techniques used to treat it, yet the results were dramatic with both examples. A wonderful German man who was also a guest at the inn where we stay and hold our classes offered to let us work on his recent scar from carotid artery surgery.
As he settled on the massage table, we could not help but notice a large scar completely surrounding his right knee and restrictions in his leg. His leg would not lay flat on the table and the posterior attachments and muscles felt like bands of steel. He described a low level of pain and restriction on both the neck area and leg, with discomfort beginning to radiate to the hip and low back.
These scars were both from surgery, but the approach to relief for the neck was to address the congestion in the scar area by working superficially with a very small cup to smooth puckering and facilitate soft pliable tissue that will move and blend with the surrounding area. For pain relief, the anterior and posterior muscles of the neck were treated, starting with slower pumping movements using deep suction to gently release the muscles from the position they were held in during surgery.
The approach for the older knee issues was to do much deeper techniques directly on the scar with straight suction and a larger cup, and look for areas that needed released. The anterior, posterior, lateral and medial knee attachments were worked with deep, slow pumping movements while the entire leg was treated with the largest cups possible and observed to develop protocols for subsequent treatments. The leg was treated with pumping movements first and then gliding and other techniques were introduced at a comfort level that was kept pleasant for the client.
Vacuum therapies can be used to work on so many conditions and prepare the client for a speedy and full recovery. Consider the approach for vascular issues, assess the client for any lymphatic and vascular restrictions and use decompression to open those up, see if there is dark congestion that can be cleared from spider veins, and finally use techniques designed to strengthen the vascular walls and stimulate lymphatic flow.
Mastectomy issues are usually best addressed post-surgically, with the focus on softening scar tissue and establishing lymphatic drainage. As with any oncology work, please have training and a thorough understanding of this condition, being especially careful with vacuum therapy for clients who have had recent radiation or are currently under chemotherapy treatment. Vacuum therapies have a very different effect on the body and can release radiation and chemotherapy from the tissues.
Scoliosis, joint replacements and carpal tunnel syndrome are also a real favorite at our clinic and the physician referrals keep rolling in due to the great results that their patients experience from this work combined with expert surgery. Each of these conditions will require research to understand the best way to treat safely and effectively, combined with a sound education in the use of vacuum therapy techniques and assessment, to produce significant results.
Vacuum therapies have begun to link the medical and massage community in a new way where we can work directly with physicians to greatly assist their patients with pre- and post-surgical issues. The constant stream of new cases makes each day an adventure, and the results from these techniques make clients and their physicians extremely happy. Much of the stress is removed when the clients know that they are well prepared and that they have a gentle and effective program in place for recovery and pain management.
For the practitioner, producing excellent results requires thorough training in and experience with vacuum therapies techniques and this powerful tool can also utilize the foundation of knowledge you currently possess. Developing critical thinking based on specific evaluation and tracking criteria, along with practical experience, can lead to such high levels of personal satisfaction and further evolution as a therapist. Service fees can be raised to be commensurate with the results you produce and successes build your reputation as a premier and specialized service provider.
Anita Shannon is a Licensed Massage Therapist and a licensed Cosmetologist since the 1980's, specializing in skin care, body treatments, clinical aromatherapy and various modalities of massage therapy. She is a national educator since 1990, and the Director of Advanced Continuing Education (ACE), an NCBTMB CE provider established in 2001.
Click here for previous articles by Rita Woods, LMT.
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