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Treatment of Type 1 Diabetes Mellitus: The Latest Breakthroughs
There are now more than 29 million diabetics in the U.S. and 10% of them have Type 1. The incidence has been increasing in recent years at an epidemic rate.
F4CP Campaign Addresses Public Misperceptions of Chiropractic
In late 2015, results of the Gallup-Palmer College of Chiropractic Inaugural Report: Americans' Perceptions of Chiropractic were published. The report found that 33.6 million U.S. adults (14 percent) had utilized chiropractic care within the previous 12 months.
The Good, the Bad and the Successful in Social Marketing
You might be thinking, "social marketing, don't you mean social media?" No, I mean social marketing. Every day, I keep reading, hearing and learning more and more about the changes happening in social media.
Herbal Medicine Continues to Evolve
Product manufacturers, industry partners, distributors and practitioners work as a collective Traditional Chinese Herbal Medicine (TCHM) community to produce high quality TCHM prescriptions that bring low-risk healthcare to thousands of patients everyday.
Bring on the Bitters
Out of all the possible flavor choices with foods, such as sweet, sour, salty, and umami (deliciousness), which would you choose first? Bitter, though not as enjoyable, is also a flavor.
Immunotherapy: Where Molecular Medicine Crosses Into Holistic Thinking
Immunotherapy, and its promise as a cancer treatment, has been in the news a lot in the last few years, and for good reason. Real shifts are happening in oncology and exciting researchers, clinicians, and patients.
The Effectiveness of Chinese Medicine in Treating Infertility in the Philippines
Infertility is defined as the inability to achieve a successful pregnancy after 12 months or more of regular unprotected intercourse.
Are Herbs Useful for Chronic Pain?
The human nervous system is what makes us special, but our greatest strength also makes us vulnerable: witness the growing incidence of chronic addictions, anxiety, depression, sleep disorders and chronic pain syndromes.
Five-Element Reaches Out to Serve the Community
In 2006, a student at the Institute of Taoist Education and Acupuncture (ITEA) approached the administration about an idea for his senior project.
Does Anyone Know You're a Good Chiropractor?
If you had a chance to read the recent article in Time magazine (April 6), you know it provided some good information about the efficacy of chiropractic to the magazine's substantial consumer audience.
Shoulder Rehab: The Gait Connection
Shoulder problems can be difficult to rehab completely for several reasons. The shoulder is made up of several joints that must function together smoothly to provide the extreme mobility that is possible and necessary for many activities.
Time for World-Wide Growth
Acupuncture is the organically growing around the world. The legislative body in Quatar has said acupuncture is "okay." The United States has five states to go to have every state recognized and regulated.
What Should You Call Your Patients (and What Should They Call You)?
When I walked into the exam room, the new patient looked uneasy, fumbling with his cellphone. He was a huge Polynesian man, probably in his 40s, with unrecognizable island tattoos.
Day in the Life of an Advanced- Practice DC (Pt. 2)
Let's continue our Q&A with Stephen Perlstein, DC, APC, chair of the New Mexico Chiropractic Association PAC and president of the American Academy of Chiropractic Physicians. Part 1 of this interview appeared in the May 1 issue.
Introducing the Dynamic Chiropractic Digital Edition
In response to the changing habits of our readers, Dynamic Chiropractic is proud to introduce a digital edition of the publication beginning with the July 2016 issue.
Acupuncture at a Pain Clinic
Introduction: Pain is the most comprehensive human experience. The experience of pain is associated with the somatic, emotional and social impact. Pain has not only somatic symptoms, but also psycho-social dimension, especially in case of chronic pain.
We Get Letters & Email
Another Slap in the Face for DCs; I Know Where to Find the Missing Chiropractic Patients; Clarification on Vitamin D Study.
The Liver: The Official of Planning
The Liver, with its paired Official, the Gall Bladder, belongs to the Element Wood within us. Wood grants us the power of birth – new beginnings, growth, breaking through boundaries and surging forward. It is the vigorous, exuberant energy of the spring season.
How to Bill Evaluation and Management Codes
Q: I am in need for guidance on how to bill evaluation and management (E&M) codes in addition to acupuncture the same date of service, I have never been paid for an exam when done with acupuncture and I believe I am doing it wrong.
The Eight Extraordinary Confluent Points
The eight extraordinary confluent points are a very popular set of acupuncture points in the modern practice of acupuncture. They are also called the intersection, meeting, command, opening, master, and the flowing and pooling points of the eight extraordinary vessels.
Who is Your Ideal Patient?
Being in a healthcare practice requires you to think critically about many things including your equipment, techniques, documentation, financial goals, and the retention of clients and staff.
Diet, Nutrition and the Context of Risk (Part 2): Food Poisoning
Other than the morbidity and mortality linked to eating too much food, "all-natural" organisms that contaminate our food cause more illness, more hospitalizations and more death than food contaminated by heavy metals, plastics, preservatives, artificial colors, emulsifiers, artificial sweeteners and pesticides combined.
2016 Trudy McAlister Foundation AOM Scholars
This year, the Trudy McAlister Foundation (TMF) received a record number of excellent applications for the 2016 scholarship awards and has awarded five scholarships for $2000 each. More information is available on our website: AOMScholarship.org
Chiropractic Needs a Lesson in Education
The American Chiropractic Association has launched a campaign, The National Medicare Equality Petition, to enact federal legislation that would achieve full physician status for DCs in Medicare.
Case Studies and Answer Analysis for NCCAOM Exam in Foundation of Oriental Medicine
Case studies are very common for acupuncture school students, either in class exams or during taking the national board exam. Most test takers feel they have no idea where they should start and how they should start to analyze those complicated cases.
December, 2013, Vol. 13, Issue 12
Know What You Are Dealing With: Radiation Therapy and Massage
By Tracy Walton, LMT, MS
Radiation therapy, often abbreviated as XRT for "X-Ray Therapy," is sometimes brushed aside as having fewer side effects than other cancer treatments. But radiation therapy can have strong effects on the body and some require significant adjustments in the massage session.
Myths and misinformation about massage and cancer treatment prevent patients from receiving good, supportive massage therapy care.
Radiation therapy is roughly classified as external beam radiation therapy (EBRT or EBT) and internal radiation therapy. External radiation is the more common of the two, where the patient lies on a surface and a machine, called a linear accelerator, delivers a beam of radiation to the tumor.
It can be used to shrink a tumor before surgery, prevent recurrence after surgery, or it can be used as palliative care when lesions cause pain.
Two Types of Radiation Therapy
External radiation treatments are usually only a few minutes long — most of the patient's session is spent making sure they are properly lined up on the treatment table.
A radiation oncologist typically maps out a specific field of treatment to treat the tumor from a number of angles. This is done to best target the tumor and spare the healthy tissue surrounding it. The sessions themselves are also usually painless.
Internal radiation often involves the placement of small radioactive implants inside the body near the tumor cells. This internal application, also called brachy therapy, allows for a higher dose of radiation and a more focused approach without the risk of damaging too much neighboring tissue.
Internal radiation seeds can be implanted and left in the body (such as with prostate cancer), a wand can be placed and removed (such as with gynecologic cancer), or a radioactive iodine solution can be ingested (as with thyroid cancer).
Touch and Radiation Therapy
Education about massage and cancer is limited in most basic training programs. As a result, a common misconception among massage therapists is that any client going through radiation therapy is "hot" and "radioactive" and either the practitioner should only touch them while wearing gloves, or the client should not be touched at all.
But the truth is that, in the case of EBRT, the radiation source is the linear accelerator which stays in the room. The client is not "contaminated" and the therapist should make appropriate massage adjustments for other factors in cancer treatment. It is safe for a massage therapist to touch the client.
In the case of internal radiation therapy, clients are considered "hot" if the implants are still in and if they are still radioactive (and not expired seeds, as in the case of prostate cancer). You should ask the client ahead of the session.
Ask where and when the internal radiation was implanted, and if there are any contact precautions in place. Most people are already following these precautions and clients are unlikely to seek out massage unless they are cleared for contact.
Radiation is aimed at the cancer cells, but nearby tissues in the path of the beam may be affected as well. Clients can experience swelling, reddening or change in pigmentation and dry and/or itchy skin. They may lose hair in the radiation field.
Another common side effect is overall fatigue. It often starts up a few weeks after treatment begins and can linger for weeks or even months after treatment is complete.
Some side effects depend on where the radiation field is located. Here are some examples:
One complication of XRT is of particular note for massage therapists: Radiation treatment can injure lymph nodes, and lymph nodes in the neck, axilla or groin are often included in the field. This can put a client at lifelong risk for lymphedema, a disfiguring, debilitating and often painful condition that can cause a host of complications.
There is little specific research on massage for clients in XRT, but our clients tell us that the contact of skilled touch can be healing. Relaxation during a stressful time and relief from side effects such as nausea, fatigue and pain provide welcome possibilities for clients.
The key is making sure we apply this touch safely. Finding out how to best serve our clients going through radiation therapy, or who have recently completed therapy, starts with asking the right questions in the intake interview. Here is a "starter list" of questions for these clients:
Therapists will find many massage adjustments for radiation treatment echo common sense: On a current or recent radiation field, we use no friction, pressure, no heat, hot stones or cold therapy, nothing besides hospital-approved lubricants (metals are contraindicated and fragrances can be irritating) and generally no direct contact if it's a current field.
A simple hold through the drape may be possible over a dry radiation field, and the hands-on contact may be soothing. Any other sort of technique brings with it the risk of disturbing healing skin and other tissues, or further exacerbation of skin changes such as flaking, itching, blistering or weeping.
Because the risk of lymphedema is very real in many clients after XRT therapy, it is important to fully understand the condition before attempting to work with clients with histories of cancer treatment. Lymphedema risk is an example of a "hidden contraindication." The adjustments are not intuitively obvious and working safely requires good interviewing and hands-on skills.
If key lymph nodes were in the radiation field, there are strict massage adjustments in pressure, stroke direction, joint movement and position.
It is essential to avoid anything that would redden the skin or injure the intact lymphatic structures. "Just working lightly" is not a complete guideline here and the wrong pressure, thermal application, joint movement or stroke direction could trigger irreversible, chronic lymphedema.
For specifics, refer to Gayle MacDonald's Medicine Hands: Massage Therapy for People with Cancer.
Language is Important
When speaking with a client, we do not ask about "radiation burns" or refer to any areas as "burned." Although we essentially treat these areas as if burned, in cancer care these areas are referred to by more neutral terms: "skin changes" or "skin effects."
For complete massage therapy guidelines, therapists are referred to the Society for Oncology Massage, to the literature on oncology massage and to the growing availability of specialized training.
Because radiation treatment can place a significant demand on the body and effects are often cumulative, oncology massage therapy is careful and does not introduce any more stressors.
Click here for more information about Tracy Walton, LMT, MS.
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