resourcesABOUT MT AUTHOR GUIDELINES CLASSIFIEDS EDITORIAL CALENDAR MEDIA GUIDE MASSAGE MART SCHOOLS & EDUCATION FEEDBACK
Optimism = Compassion = Trust
A randomized clinical trial recently published online in JAMA Oncology examined how patients viewed their doctor based upon how the practitioner presented bad news to the patient.
Functional Hip Impingement (Part 1)
Every time I sit down to write an article, I realize how much more there is to know about musculoskeletal pain. I also learn something new every time. (I want to give special thanks to Lucy Whyte Ferguson for assisting with this article.)
Will You Be an Amplifer or a Mute?
These times are changing, and changing quickly. There have been many challenges to this profession throughout the past few years. The challenge is to talk, then talk and talk some more about this medicine.
The Need for a New Medical Model: A Challenge for Biopsychosocial and Ecopsychologica Medicine
Chinese medicine speaks of alignment between humans, heaven and earth. It is a complex view with a focus upon relationship. These are comprehensive ideas with no specific terms in contemporary medical practice.
Term Limits: What's in a Word?
It was the French historian and philosopher Voltaire who once declared the Holy Roman Empire was neither holy nor Roman nor an empire.
TCM Congress in Rothenburg is Largest in Western World
In the medieval town of Rothenburg, deep set within the Bavarian countryside in Southern Germany, the TCM Kongress Rothenburg each year draws around 1.200 participants from more than 40 different countries to attend the biggest TCM conference in the Western world.
There Really is No Room for Sexism
Recently, Matteo* (a transgender male) approached me during a break in an advanced shiatsu class in Berlin where he was one of two men in a group of 20 women. "Pamela. Don't forget to remind the translator to include male endings."
A Well-Kept Secret: 5 Element Acupuncture, Part II
Supervising acupuncture interns at a TCM college, it has always struck me how funny it is to hear the clinic manager tell the patients that the Five Element clinic specializes in treating emotions, as if patients with physical pain have no emotions!
Synergy Doesn't Happen in Silos: Acupuncture in Hospitals and Other Healthcare Settings
As acupuncture and traditional East Asian medicine continue to intersect and integrate with biomedical approaches, the conversation about integration expands and becomes richer.
Turning a Blind Eye to History – and Reality
The American Medical Association is taking the Supreme Court's Feb. 25, 2015 decision exactly as it always does – by turning a blind eye to history, legal precedent and reality.
The Way We Are Designed: A Conversation with Gil Hedley, PhD
I was first introduced to the work of Gil Hedley by Tom DiFerdinando. He gifted me Gil's DVD series.
Low Back Pain in Professional Golf: A Common Muscular Relationship
Every sport creates its own unique demands on the body. Some sports require such a myriad of body positions that assessing pathology is often difficult and unpredictable.
Treating Beyond Pain
More often than not, when a patient presents to the office, it is for a pain complaint. Headache, neck pain, low back pain, sciatica, carpal tunnel... The pain is often the focus of the patient's mindset, and they don't often have any thought of what comes after the pain.
Recreational Cannabis Use and TCM
Many people are drawn to cannabis for its effects physically, mentally and emotionally. Medically, cannabis has some legitimate uses, however the scope of this article is limited to the recreational use of cannabis.
An Excerpt from TCM Case Studies: Pediatrics
This excerpt is reprinted with permission from Jamie Wu. TCM Case Studies: Pediatrics was released in 2014 by People's Medical Publishing House.
A View From the ER
The University of Western States has inked an innovative agreement with local nonprofit health system Legacy Health whereby UWS sports-medicine fellows can experience observational clinical rotations in emergency-room settings within the Legacy system.
The Dietary Supplement Research Dilemma
I do not care what the truth is, one way or another; I just want to know it. And when it comes to dietary supplements, the truth can be hard to find for a number of reasons.
Talking to Patients About Lumbar Facet Denervation (Medial Branch Neurotomy)
Lumbar facet denervation, more appropriately termed medial branch neurotomy (MBN), is a procedure that may be considered when patients suffer from recalcitrant non-radicular axial back and/or leg pain.
Converting More Patients to Your Practice
In 2013 and 2014, the theme was "the money is in the list." This meant that if you had a big email list, you were really making some "cha-ching." Unfortunately, having thousands of emails doesn't equate to thousands of dollars in profit.
A House Divided?
The American Chiropractic Association's House of Delegates voted on 30 resolutions at its annual business meeting in Washington D.C., but two in particular took immediate center stage due to their controversial nature.
Applying the Thin Skull Principle
The "thin skull" principle, also known as the "you take your victim as you find them" principle, is a legal principle that can be summed up by the following statement.
Gestational Diabetes: Does She or Doesn't She?
Nearly every pregnant woman is tested for gestational diabetes (GD) (or gestational glucose intolerance - GGI) at some point during her second trimester. But what constitutes a "normal" blood glucose level during pregnancy and when maternal or fetal morbidity occurs is controversial.
What is evident in cases of confirmed gestational diabetes is that babies grow larger, weighing over 4000g at birth (fetal macrosomia) or are in the 90th percentile for large-for gestational-age (LGA). And that often increases the likelihood of a surgical delivery and newborn monitoring for hypoglycemia. In the long term, these elevated levels appear to contribute to obesity and diabetes later in the child's life and an increase in the risk of the mother developing type 2 diabetes. On average, however, the rate of confirmed glucose intolerance is small and varies among different ethnic groups. Caucasian women are affected 1% to 2%, Afro-Caribbeans 2% to 3%, and Asians 4% to 5%.
The etiology of defining GD as a medical condition began in the 1950s with a study on women with high sugar values during pregnancy. It was "validated" in 1964 when Drs. O'Sullivan and Mahan, medical researchers, performed a 100g 3-hour oral glucose tolerance test on more than 700 pregnant women who were already hyperglycemic. Their study was to determine if these women were at greater risk of developing diabetes in the future. To no one's surprise, they were. And that led these two men to conclude that the "metabolic stress of pregnancy" exposed women to a "pre-diabetic status." But keep in mind, their research subjects had preexisting high blood glucose levels.
They also made an erroneous correlation that since insulin-dependent diabetes is a known risk to developing babies, this "pre-diabetic status" was as well. But their theory is unfounded. Diabetes types 1 and 2 are completely different in their manifestations and dangers than GD (GGI). For instance, both type 1 and 2 may result in blood vessel and kidney damage, the sequelae of which could be hypertension, insufficient circulation to the lower extremities, possible limb amputation and kidney disease. GD carries none of these risks.
Vacillating levels of high and low blood sugar during early pregnancy in type 1 diabetes might cause congenital malformations or miscarriage. Again, none of these serious complications are caused by GD. The only thing diabetes 1 and 2 share with GD is that the excess glucose goes directly to the babies, making them larger than they would be without the elevated blood sugar levels.
During pregnancy, the pancreas usually produces adequate amounts of insulin to regulate blood sugar levels. However, the hormone HPL (human placental lactogen) inhibits the maternal body's ability to transport the insulin properly out of the bloodstream and into cells, where it is used as fuel, resulting in elevated levels of glucose in the blood - or GD. So, in essence, there is more circulating blood sugar which the baby uses to grow and develop. And as pregnancy progresses, this delicate balance between adequate insulin levels and circulating blood sugar becomes trickier. After eating, blood sugar levels rise and by the time the third trimester comes, blood glucose levels are higher after eating than a woman who is not pregnant. (After a night's sleep, excess insulin goes to work to balance out the extra blood sugar, so morning levels of glucose are actually lower during pregnancy than in nonpregnant women - hypoglycemia.)
But there is a difference between elevated blood sugar levels and diabetes. And current research has not determined when high blood glucose levels, just shy of diabetes, cause harm to mothers and their babies. So screening for GD should come with an understanding, by both mother and her care provider, that the results may or may not be an indication of a serious problem.
Women can actively participate in their health during pregnancy by eating healthy, wholesome foods. They can avoid or control GD by consuming a diet rich in whole foods, high protein and high complex carbohydrates. They can start by eliminating empty calories - soda, white flour, white sugar, fructose and limit sweet desserts. Any food with a sugar content of more than 6 grams (read the label) should be accompanied by a protein source. Milk, often recommended by care providers for the necessary calcium it provides, and yogurt are filled with (milk) sugar and lactose is known to increase blood sugar levels. So consuming excessive dairy products might be contributing to high glucose values.
When eating cereals, the protein and fiber content should be more than 5g per serving and there should be less than 10g of sugar. One third of protein should come from complex carbohydrates. A glycemic index will help some women make healthier choices. And think color when it comes to food choices - the more varied and deeper the pallet, the healthier meals will be.
Clients with GD can still enjoy the benefits of massage. However, it is important to remember that massage, in general, lowers glucose levels. So you have to make sure your client's blood sugar level doesn't get too low, which can lead to impaired judgment and potential accidents. By providing your clients with a nourishing snack, it will raise their blood glucose level enough to get home safely where they can enjoy a healthful, wholesome meal.